Evaluation | Trauma-informed Tobacco Cessation Care

Thank you for participating in the Trauma-informed Tobacco Cessation Care session.

We value your feedback. Please complete the brief survey below:

Learner Demographics *

Physician

Nurse

Patient

Other

Please specify: *

Future activities on this subject matter are necessary/important to my practice? *

Yes

No

I would like to see more activities on...

Extent to which identified program objectives were met: I am better able to ... *

	Outstanding	Good	Satisfactory	Fair	Poor
Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation.	Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation. - Outstanding	Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation. - Good	Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation. - Satisfactory	Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation. - Fair	Integrate a trauma-informed approach and motivational interviewing techniques with individuals considering tobacco cessation. - Poor
Identify patient strengths and potential alternative behaviors/healthy coping strategies.	Identify patient strengths and potential alternative behaviors/healthy coping strategies. - Outstanding	Identify patient strengths and potential alternative behaviors/healthy coping strategies. - Good	Identify patient strengths and potential alternative behaviors/healthy coping strategies. - Satisfactory	Identify patient strengths and potential alternative behaviors/healthy coping strategies. - Fair	Identify patient strengths and potential alternative behaviors/healthy coping strategies. - Poor
Support patient self-efficacy and establish trust.	Support patient self-efficacy and establish trust. - Outstanding	Support patient self-efficacy and establish trust. - Good	Support patient self-efficacy and establish trust. - Satisfactory	Support patient self-efficacy and establish trust. - Fair	Support patient self-efficacy and establish trust. - Poor
Share tobacco cessation resources and information about NRTs (nicotine replacement therapy).	Share tobacco cessation resources and information about NRTs (nicotine replacement therapy). - Outstanding	Share tobacco cessation resources and information about NRTs (nicotine replacement therapy). - Good	Share tobacco cessation resources and information about NRTs (nicotine replacement therapy). - Satisfactory	Share tobacco cessation resources and information about NRTs (nicotine replacement therapy). - Fair	Share tobacco cessation resources and information about NRTs (nicotine replacement therapy). - Poor
Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts.	Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts. - Outstanding	Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts. - Good	Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts. - Satisfactory	Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts. - Fair	Discuss culturally responsive and trauma-informed communication strategies to engage underserved and high-risk populations in tobacco cessation efforts. - Poor

What percentage of information presented during the activity was new to you? *

The information presented:

	Yes	No
Was timely and will influence how I practice	Was timely and will influence how I practice - Yes	Was timely and will influence how I practice - No
Will assist me in improving patient care	Will assist me in improving patient care - Yes	Will assist me in improving patient care - No
Fulfilled my educational needs	Fulfilled my educational needs - Yes	Fulfilled my educational needs - No

The information presented (check all that apply): *

Reinforced my current practice/treatment habits

Will improve my practice/patient outcomes

Provided new ideas or information I expect to use

Enhanced my current knowledge base

Does not directly apply to my practice

Will the information presented cause you to make any changes in your practice? *

Yes

No

Please describe any change(s) you plan to make in your practice as a result of this activity: *

How committed are you to making these changes? *

5 is very committed, 1 is not at all committed

Are there any existing barriers/factors that may prevent you from implementing a change in practice? *

Yes

No

Please describe: *

How would you rate the effectiveness of the following faculty? *

	Outstanding	Good	Satisfactory	Fair	Poor
Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH	Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH - Outstanding	Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH - Good	Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH - Satisfactory	Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH - Fair	Alicia O. Carranza, MPH, MCHES®, NBC-HWC, CTSS, DrPH - Poor

Was any bias toward a commercial interest noted in the information provided (products/services unduly favored or promoted)?

Yes

No

Please identify products/service, faculty and or presentation(s) that were biased: *

The presentation included educational components that addressed cultural linguistic competency and implicit bias

Yes

No

N/A (If a research or non-direct patient care topic)

Overall Satisfaction *

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I was satisfied with this training.	I was satisfied with this training. - Strongly Agree	I was satisfied with this training. - Agree	I was satisfied with this training. - Neutral	I was satisfied with this training. - Disagree	I was satisfied with this training. - Strongly Disagree
This training met my expectations.	This training met my expectations. - Strongly Agree	This training met my expectations. - Agree	This training met my expectations. - Neutral	This training met my expectations. - Disagree	This training met my expectations. - Strongly Disagree
I would recommend this training to others.	I would recommend this training to others. - Strongly Agree	I would recommend this training to others. - Agree	I would recommend this training to others. - Neutral	I would recommend this training to others. - Disagree	I would recommend this training to others. - Strongly Disagree
I can apply the content from this training to my work.	I can apply the content from this training to my work. - Strongly Agree	I can apply the content from this training to my work. - Agree	I can apply the content from this training to my work. - Neutral	I can apply the content from this training to my work. - Disagree	I can apply the content from this training to my work. - Strongly Disagree
The materials used in the training were helpful.	The materials used in the training were helpful. - Strongly Agree	The materials used in the training were helpful. - Agree	The materials used in the training were helpful. - Neutral	The materials used in the training were helpful. - Disagree	The materials used in the training were helpful. - Strongly Disagree

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Evaluation | Trauma-informed Tobacco Cessation Care