OMB #: 0970-0143

Expiration Date: 10/31/99

STAFF ID:

EARLY HEAD START SURVEY
Self-Administered Questionnaire for Staff

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Table of Contents

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COPYRIGHT INFORMATION

Items D1-D20. MOS. Medical Outcomes Study (MOS) Short Form General Health Survey (SF-36®Health Survey). Copyrighted by the Medical Outcomes Trust and QualityMetric Incorporated, 20 Park Plaza, Suite 1014, Boston, Massachusetts 02116, http://www.sf-36.com.

INTRODUCTION

The National Early Head Start Research and Evaluation Project, sponsored by the U.S. Department of Health and Human Services, Administration for Children and Families, is conducting a longitudinal study of infants and toddlers in low-income families. Mathematica Policy Research, Inc., a national leader in social policy research, has been contracted to conduct this study.

The staff survey is one part of the data collection for this evaluation. It will be administered during site visits to selected Early Head Start programs in 1997 and 1999. The purpose of the staff survey is to gather information on the background, working conditions, and accomplishments of Early Head Start staff. The survey includes sections on your role in the Early Head Start program, working conditions, your professional development, physical and mental health, your background, and staff turnover (for Project Directors only). You may refuse to answer any question you do not wish to answer by writing “REFUSED” next to the question.

The answers you provide on the questionnaire will be held in strict confidence. Statistical analysis will be conducted on the combined answers from all returned questionnaires and presented in reports to the U.S. Department of Health and Human Services, Administration for Children and Families. Your local research team may also conduct statistical analyses of the data and present them in research reports or program improvement materials.

INSTRUCTIONS

The staff questionnaire will be distributed to all staff members in advance of the evaluation site visit. Please detach the front cover with your signed consent and seal the completed survey in the envelope provided to ensure confidentiality. Return both—the signed consent and the completed survey—to your program director prior to the end of the evaluator’s site visit. If you are unable to return the consent form and survey to your program director before the evaluator leaves, please make arrangements to send them to Mathematica Policy Research, Inc. in Princeton, NJ.

Thank you for your cooperation in completing the questionnaire. Your answers will assist us in providing a comprehensive evaluation of the contribution of the Early Head Start program to staff development.