Attachment A: Needs Assessment Survey

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Attachment A:  Needs Assessment Survey
Emergency Risk Communication Network Needs Assessment
-- Member Feedback for Project Management and Development --


Public reporting burden of this collection of information is estimated to average 12 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to CDC/ATSDR Information Collection Review Office, 
1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333: ATTN:  PRA (0920-0798).

INTRODUCTION AND INSTRUCTIONS FOR COMPLETING SURVEY:
To provide better service and management of the Emergency Risk Communication Network, the Emergency Risk Communication Branch (ERCB) of the Centers for Disease Control and Prevention (CDC) requests your feedback concerning The Risk Communicator.  We value your insights and experiences, and will use your input and suggestions to update the newsletter and provide the best networking activities possible.
 
The form contains questions with several response options and areas for your comments.  All responses will be grouped for reporting; your individual survey results are confidential.    

Section I:  Demographics:

    1. Today’s Date:  ______________________

    2. Your highest Level of education:  
___ High School Diploma
___  A.A. Degree
___  B.A. / B.S. Degree
___ M.A. / M.S. Degree 
___ PhD / MD Degree
___ Other – please specify:  _________________________________________

    3. Discipline of Study / Expertise (please select one):  
___ Health Communication
___ Health Education
___ Healthcare / MD / RN
___ Epidemiology
___ Other – please specify: ­­­­­­­­­­­­­­________________________________________

    4. Your affiliation (please check the most representative selection):
___ Local health department
___ State health department
___ Nonprofit organization
___ College or university
___ Federal organization
___ Faith-based organization
___ Private sector organization
___ Other – please specify:  ________________________________________

    5. Your Role/Profession: (please check the most representative selection):
___ Communication Specialist
___ Public Information Officer
___ Health Educator
___ Epidemiologist
___ Emergency Response Coordinator
___ Medical Professional
___ Other – please specify:  ________________________________________ 
 
    6. How long have you been working in Public Health Communication?     ___ years


Section II: Experience with The Risk Communicator (RC)

    7. Which issues of The Risk Communicator (RC) have you seen? (Check all that apply)
___  None (skip to Question 19)
___ Issue One
___ Issue Two
___ Issue Three

    8. Where did you get The Risk Communicator? 
___ I’m on the membership list to receive the newsletter
___ I received it from a colleague
___ Through an Internet search
___ Don’t remember
___ Other – please describe:  _______________________________________


    9. Did you read The Risk Communicator online or in printed format?
___ Online
___ Print (Skip to Question 11)

    10. How many of the links did you follow for more in-depth information?  
___ none
___ a few
___ several
___ many
___ all

    11.  What was your overall impression of The Risk Communicator newsletter?
___ Completely dissatisfied
___ Somewhat dissatisfied
___ Neutral
___ Somewhat satisfied
___ Completely satisfied


    12. Please rate the format of the newsletter in terms of:

Poor
Acceptable
Good
Excellent
NA
a. Organization of materials/structure





b. Accessibility





c. Overall “look” (aesthetics)





d. Ease of navigation (if read online)





e. Length







    13. Please use the following scale to rate the extent to which …. 
1 – Not At All		2 – A Little	  3 – Somewhat	4–Very Much   NA – Not Applicable
 
1
2
3
4
NA
a.  Topics were of interest / concern





b.  Topics were relevant and useful 





­­c.  Topics were clearly presented





d.  The information was accurate / reflects your experience





e.  The information was practical





f.  The information was timely





g.  The information was clearly presented 





h.   You are interested in seeing future issues of the newsletter





Comments: 





	

    14.  Have you used any of the information?
___ No
___ Yes – please describe what information you have used and how you have used it:  _________________________________________________________
	 __________________________________________________________




    15.  Do you have plans to use any of the information in the future?
___ No
___ Yes – please describe what material you plan to use and how you will use it:  ___________________________________________________________________
 

    16. Did you disagree with any of the information?
 ___ No
___ Yes – please describe the information you disagree with and explain why:  ___________________________________________________________________

    17.    Is the presentation style appropriate for the audience?            
___ Yes;         
___ No    If no, how could it be improved?______________________________
 	    ________________________________________________________


    18.   Have you shared the newsletters or any part of them with others? 
___ No
___ Yes – please describe the information you have shared:  ________________________________________________________________

    19. What content or information would you like to see covered in future newsletters? 
________________________________________________________________
________________________________________________________________

    20. What tools or other resources would you like to see provided in future newsletters? 
________________________________________________________________
________________________________________________________________

    21. Please use the following scale to rate the extent to which you would use the following presentation formats if they were created and hosted by CDC?  

1 – Not At All 		2 – A Little	  3 – Somewhat  	4–Very Much    DK – Don’t Know
 
1
2
3
4
DK
a.  Facebook





B, Twitter 





­­c.  RSS Feeds





d.  Other – please describe





e.  Other – please describe





f.  Other – please describe





Comments: 








    22. The original intent of the Risk Communication Network was for an interactive  partnership (i.e. an exchange of  risk communication ideas, experiences, and successful practices)
    a. To what extent are you interested in a more interactive approach?
___ Not at all
___ A little
___ Somewhat
___ Very Much

    b. Do you have material you would like to share through the newsletter?   
___ No
___ Yes – please describe the information or type of information you would like to share: __________________________________________
__________________________________________________________
__________________________________________________________

    c. To what extent would you like to be involved in future network activities? 
___ Not at all
___ A little
___ Somewhat 
___ Very Much
If Somewhat or Very Much, please describe how you would like to participate: _________________________________________________
__________________________________________________________
__________________________________________________________

    23. How should CDC advertise The Risk Communicator newsletter? ________________________________________________________________
________________________________________________________________
 
    24. Do you know others who might be interested in participating in the network?  
___ No
___ Yes – How may we contact them?    
_______________________________________________________________


Thank you for completing this form.