If you selected "Other," or are taking a state training listed above, but you do not live in that state, please list your state of residence.

(Q2) If you selected "Other" in the last question, please describe it.

(Q3) What is the PRIMARY REASON you decided to take this training? *

My employer or county is requiring completion

My school or program of study requires completion

I am exploring a new job opportunity

I want to help care for a family member

I want to volunteer

For continuing education hours

So, I can be listed on the State Respite Registry

Other (please describe in next question)

(Q4) If you selected "Other" in the last question, please describe it.

(Q5) Have you received any PREVIOUS RESPITE TRAINING in the past? *

Yes (please describe in next question)

(Q6) If you selected "Yes" in the previous question, please describe.

(Q7) Do you currently work for an AGENCY that provides support to caregivers? *

Yes

(Q8) Are you a PRIMARY FAMILY CAREGIVER? Select all that apply. *

Yes, I am a primary caregiver of a child with special needs (0-18 years old)

Yes, I am a primary caregiver of an adult with special needs (18-65 years old)

Yes, I am a primary caregiver of an older adult (65+ years old)

(Q9) Have you provided respite care in the PAST? *

Yes

(Q10) Do you CURRENTLY provide respite care? Select all that apply. *

Yes, I am currently a respite provider for a child (0-18 years old)

Yes, I am currently a respite provider for an adult (18-65 years old)

Yes, I am currently a respite provider for an older adult (65+ years old)

(Q11) If applicable, how many YEARS OF EXPERIENCE do you have providing respite care? *

(Q12) If applicable, what is the average number of HOURS PER MONTH you currently provide respite care? *

(Q14) Other (please describe in next question)

(Q16.1) After completing the training, how CONFIDENT are you in your ability in understanding the importance of providing meaningful short breaks for family caregivers to promote the well - being of family caregivers, care recipients, and other family members? *

(Q16.2) After completing the training, how CONFIDENT are you in your ability in providing care that is focused on, and respectful of, family caregivers’ and care recipients’ preferences, needs, values, and goals for respite? *

(Q16.3) After completing the training, how CONFIDENT are you in your ability in understanding and providing services and supports that are respectful of the cultural preferences, traditions, and language needs of family caregivers, care recipients, and other family members? *

(Q16.4) After completing the training, how CONFIDENT are you in your ability in building and maintaining trusting relationships with family caregivers and care recipients through active listening and respectful verbal, non - verbal, and written communication that is easily understandable? *

(Q16.5) After completing the training, how CONFIDENT are you in your ability in supporting the physical health, functional ability, spiritual, and social - emotional well - being of care recipients based on the preferences of family caregivers and care recipients and in accordance with the respite care professional ’s training and certification, as well as local laws and regulations? *

(Q16.6) After completing the training, how CONFIDENT are you in your ability in helping protect care recipients from illness, injury, abuse, neglect, or other harm; understanding how to report incidents; and responding quickly and safely during emergency situations? *

(Q16.7) After completing the training, how CONFIDENT are you in your ability in working with family caregivers and care recipients to explore, define, plan, and engage in appropriate and meaningful respite activities for care recipients? *

(Q16.8) After completing the training, how CONFIDENT are you in your ability in working in an ethical and professional manner by maintaining boundaries, ensuring confidentiality, and respecting the privacy, rights, and preferences of family caregivers, care recipients, and other family members? *

(Q16.9) After completing the training, how CONFIDENT are you in your ability in obtaining appropriate training based on the unique needs of care recipients and seeking opportunities for ongoing education and training? *

(Q16.10) After completing the training, how CONFIDENT are you in your ability in recognizing the importance of selfcare and actively engages in practices that promote their own safety, health, and well - being?your ability in recognizing the importance of selfcare and actively engages in practices that promote their own safety, health, and well - being? *

(Q18) Which STATE COUNTY do you live in? *

A county is a specific region of a state.

(Q19) Which of the following best describes the COMMUNITY in which you live? *

Rural (open country and towns or cities with fewer than 2,500 people)

Small town or city (towns or cities between 2,500 and 49,000 people)

Medium city (between 50,000 and 99,000 people)

Medium-large city (between 100,000 and 250,000 people)

Large city (over 250,000)

(Q20) What is your AGE in years? *

(Q21) Do you identify as TRANSGENDER? *

Yes

Prefer not to answer

(Q23) If you selected "Other" in the last question, please describe.

(Q24) Are you HISPANIC or LATINO? *

Prefer not to answer

Yes

(Q25) What is your RACIAL/ETHNIC background? Select all that apply. *

(Q26) If you answered "Other" in the last question, please describe.

(Q28) If you answered "Other" in the last question, please describe.

(Q30) If you answered "Other" in the last question, please describe.

NRCPT Intro Survey