Prevent Child Abuse North Dakota Family Focus Group Application

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PCAND is hosting focus groups statewide as part of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) needs assessment. We are looking for any insight you might have about family services in your area, strengths of your community, and what could be improved. Focus groups will last approximately 90 minutes and participants who attend the full focus group will receive a $50 electronic gift card. Focus groups will be held virtually, so it is essential you have a device that can run Cisco WebEx and a strong internet connection.

Providing the information below signals consent for a PCAND staff member to contact you about focus group requirements and scheduling. Focus groups are fully voluntary and participants may leave or quit the process at any time. Unfortunately, participation in the focus groups is limited. We will notify you by email if you have been selected to participate.

Positive responses below are not required for participants (for example, we are not specifically recruiting pregnant individuals, or families who have utilized services such as WIC). However, we are looking for people who have some level of insight into the strengths and challenges of these kinds of programs in their community, so demonstrated participation in service programs may influence focus group participant selection.

Name *

Email Address *

What ND county do you live in? (Note: We are looking to speak to families in selected counties only. Focus groups will be held from 6:00-7:30 pm CT except for Grant County, which will be held 6:00 MT.) *

Untitled Title

Do you have children (may include biological, adopted, foster)? *

Yes

Do you currently have any children at home who are between the ages 0-5? *

Yes

Are you currently pregnant? *

Yes

I'm not sure or would rather not say

In the last five years, have you utilized any of the following services in the county you currently reside? Please check all that apply. If you have not, please check "None" at the bottom of the list. *

SNAP (Supplemental Nutrition Assistance Program, or food stamps)

WIC

Public health (immunization clinics, car seat checks, breastfeeding support)

Social services or child protective services/child welfare

Substance use treatment (alcohol or narcotics)

Child services such as Right Track or Early Intervention

Head Start

Child care

Home visiting (a trained home visitor who regularly visits your home to provide parenting support)

None

Other:

Required

If you would like to receive a meeting reminder, via text, you may provide your 10-digit phone number (this is optional.)

Is there anything you would like PCAND staff to know?

Thank you! Please be sure to hit "Submit" below!

Someone from PCAND will be contacting you shortly.

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