Program Evaluation: Module 5: Supporting Pregnant and Postpartum Women to Quit Tobacco
Program Evaluation: Module 5
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Please select the most accurate rating for how well you believe the objectives of the sessions were achieved: *
Not at all
Slightly
Moderately
Very
Extremely
Objective A: Understand the unique issues related to supporting pregnant and postpartum women to quit tobacco.
Objective B: Confidently provide a robust, tailored response to pregnant and postpartum women.
Objective C: Make appropriate referrals to resources such as 1-800-QUIT-Now, NH Home visiting program, NH Lactation Services.
Please rate the following: *
Not at all
Slightly
Moderately
Very
Extremely
Daisy Goodman's presentation of the training material was effective.
Melody Williams's presentation of the training material was effective.
Lissa Sirois's presentation of the training material was effective.
Jenny Glennon's presentation of the training material was effective.
Mary Brunette's presentation of the training material was effective.
Teresa Brown's presentation of the training material was effective.
Jane Hybsch's presentation of the training material was effective.
The teaching strategies and resources were effective.
The timeframe for completing the activity was appropriate.
The objectives were relevant to the activity goals/purposes.
The information presented in this training is important.
My knowledge of the process for making referrals to 1-800-QUITNOW (formerly the NH Tobacco Hepline) has increased.
The content was presented without bias toward any commercial product or drug: *
What part of the training could have been better?  Please explain *
List up to two changes you plan to make as a result of this session. *
Will this training apply toward your state certification, Continuing Medical Education (CME), or Continuing Nursing Education (CNE) Contact Hour requirements? *
Please list additional topics you would like to have offered at future training sessions: *
What is your age? *
What is your gender *
Did you come from a disadvantaged background***? (***Disadvantaged: an individual who (1) educationally comes from an environment that has inhibited the individual from obtaining knowledge, skill, and abilities required to enroll / graduate from a Health Professions school or (2) economically comes from a family with an annual income below a level according to and published by the U.S. Bureau of the Census.) *
What is your race? *
What is your ethnicity? *
Please indicate the highest level of education your have completed? *
What was your field of study, if applicable?
What is the name of your current place of employment? *
Please indicate the location that best describes your current place of work. *
Do you work in one of the following site designations? *
Please indicate the occupational classification/discipline that best describes your position *
Where did you hear about this Tobacco Treatment Professional Development? *
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