andrew woodruff nv qtac program manager sharon goldstrohm nv qtac program coordinator dawn gentsch...
TRANSCRIPT
ANDREW WOODRUFFN V Q TA C P R O G R A M M A N A G E R
SHARON GOLDSTROHMN V Q TA C P R O G R A M C O O R D I N AT O R
DAWN GENTSCHN V Q TA C P R O G R A M C O N S U LTA N T
Healthy Living: Up2MeNevada Quality and Technical
Assistance Center2014 Survey Packet Training
Overview
NV QTAC requests your utilization of the HLU2M Program data collection forms and procedures that meet the necessary standards.
Use of forms is now a requirement for Nevada Lay Leaders and Nevada organizations implementing CDSME and DSME programs under the Stanford License held by NV QTAC.
Start utilizing immediately.
Must train personnel and start using updated forms by 05.01.14.
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Tips for Evaluation Paperwork
Process Overview4
Lay Leader Training
• Leader training and requirements (1 workshop in 6 mon)• Leader agreement form with NV QTAC or organization you are under• NVQTAC HLU2M Survey Packet Training and PII/Security Training (webinar &
test)
Pre-Workshop
• HLU2M workshop marketing, workshop flyer templates• Participant workshop consent/registration form (keep secure)• Workshop information form to HLU2M• Facilitator Non-Disclosure Agreement
Workshop
• Pre/post surveys – each participant (keep secure)• Welcome Letter (Leaders read at 1st class to workshop participants)• Attendance Log, Workshop Tracking Form
Post Workshop
• Workshop cover sheet• Material to NVQTAC OR your organization is authorized for Data
Portal• Data used for annual report to Stanford University for NV QTAC
license or by the organization’s license you are under. Helps with grants and overall program impact to improve the health of people in Nevada!
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All found on NVHealthyliving.org
Overview of all the forms included in the Survey Packet
For each Form Description Purpose How to use
About this Survey Packet
Updated Evaluation Tools6
About This Survey Packet
Data Collection Cheat sheet
Workshop Information Form
Facilitator Non-Disclosure Agreement
Welcome Letter Consent Letter Attendance Log
Participant Consent/Registration Form
Participant Survey Pre and post
Workshop Tracking Form Submitted with final
paperwork Workshop Cover Sheet Submitted with other
workshop materials
Workshop Information Form7
Without this form we will not know a workshop is going to happen or is in progress
Please download/print/scan/emailWhat do I need to
know to fill it out? Location Times/Dates Licensing information Registration contacts
Workshop Marketing Flyer8
Workshop flyers are available for:- CDSMP- DSMP- Spanish versions available soon!
Insert- your organization’s logo- workshop start and end date- workshop location, address, and
city- registration contact information
(name, phone, email, website)- Last date to register
Welcome and Consent Letters9
Welcome LetterREQUIRED to read aloud
If necessary due to challenges, may be handed to participants
Explains how participant privacy is protected and why data is being collected (the evaluation process)
For information purposes onlyConsent/Registration Form• Without this letter signed, no data will be submitted!• Even data that is submitted is shredded without a consent!
These Form Letters include a space for printed name
Facilitator Non-Disclosure Agreement10
New FormMust be filled out prior to
workshop start
One agreement form per facilitator
Substitutes (leaders) must also sign
Similar language to what is included in Lay Leader Agreement document with NVQTAC
Attendance Log11
Names on attendance log must correspond with names on surveys and consent forms Can use a nickname
Filled out by facilitatorsMust be legible
“X” for Present“A” for Absent
Pre and Post Surveys12
Two pages/survey May be copied double-
sidedResponding to each
questionCheck to make sure survey
is completedPRE and POST surveys are
in English and Spanish for CDSMP and DSMP
Enter data into the Data Portal
Workshop Cover Sheet13
Submitted with the Attendance Log and PRE & POST surveys at the end of a workshop Within 2 weeks
Indicate type of workshopExplain missing or
excluded paperwork
Use the checklist on page 2
Workshop Tracking Form14
Useful for keeping track of participant’s paperwork
Optional Does not need to be submitted to Institute
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Thank You!Thank You!
Andrew WoodruffNV QTAC Program Manager
775. 887.0417 [email protected]
Sharon GoldstrohmNV QTAC Program Coordinator
Dawn GentschNV QTAC Program Consultant
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Questions?