Customer/Partner Survey Instrument

Customer/Partner Survey Instrument

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

Introduction

This survey is sponsored by the Centers for Disease Control and Prevention (CDC) as part of an evaluation of the Centers for Public Health Preparedness (CPHP) program. The CPHP cooperative agreement program was initiated to strengthen terrorism and emergency preparedness by linking academic expertise to state and local health agency needs. The purpose of this survey is to gather information from representatives of organizations that may have utilized emergency preparedness training or technical assistance resources developed, delivered or sponsored by the CPHP program. This survey asks questions about your experiences and satisfaction with the CPHP program between 2004 and 2009. and also your suggestions for improving training and technical assistance activities intended to strengthen public health preparedness.

You have been identified as an individual who plays a key role in your organization’s emergency preparedness activities. We recognize that you may have had little or no contact with the CPHP program, but please be assured that your responses will provide valuable information for the evaluation regardless of your frequency of contact or familiarity with the CPHP program. Your participation is completely voluntary and information you provide will be treated in a secure manner. Generated reports will be in summary form only and no information you provide will be tied to your identity. If you have any questions, please contact Lea Ayers LaFave, Senior Project Director at (603) 573-3335 or [email protected].

Access to CPHP Programs & Products

The CPHPs work with state and local organizations to improve preparedness through a variety of activities including: development of academic courses, trainings and training resources; assistance with needs assessments, plan development and other technical assistance activities; design, facilitation and evaluation of exercises; and partnership development. For your reference, the CPHP program includes the Centers listed below:

• University of Alabama at Birmingham – South Central CPHP

• University of Albany - CPHP

• University of Arizona – Arizona CPHP

• University of California at Berkeley – Center for Infectious Disease Preparedness

• University of California at Los Angeles – Center for Public Health and Disaster

• Columbia University – CPHP

• Emory University - CPHP

• Harvard University – CPHP

• University of Illinois at Chicago – Illinois Public Health Preparedness Center

• University of Iowa – Upper Midwest CPHP

• Johns Hopkins University – CPHP

• Loma Linda University - CPHP

• University of Michigan – CPHP

• University of Minnesota - CPHP

• New Jersey CPHP at UMDNJ

Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the 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, GA 30333; ATTN: PRA (0920-XXXX).

• University of North Carolina – CPHP

• The Ohio State University – Ohio CPHP

• University of Oklahoma – Southwest CPHP

• University of Pittsburgh – Center for Public Health Practice

• Saint Louis University – Heartland CPHP

• University of South Carolina – CPHP

• University of South Florida – Florida CPHP

• University of Texas – Center for Biosecurity and Public Health Preparedness

• Texas A&M – Center for Rural Public Health Preparedness

• Tulane University - South Central CPHP

• University of Washington – Northwest Center for Public Health Practice

• Yale University – CPHP

• Yale New Haven Health System

• Emory University Southeastern Center for Emerging Biologic Threats

Identification of CPHP Programs

1. Identify the CPHP(s) your organization has worked with from 2004-2009.

This can include partnering with a CPHP, participating in educational/training offerings, utilizing

educational/training materials or products, and/or receiving services (e.g., evaluation of an exercise). Choose all

that apply.

• University of Alabama at Birmingham – South Central CPHP

• University of Albany - CPHP

• University of Arizona – Arizona CPHP

• University of California at Berkeley – Center for Infectious Disease Preparedness

• University of California at Los Angeles – Center for Public Health and Disaster

• Columbia University – CPHP

• Emory University – CPHP

• Harvard University – CPHP

• University of Illinois at Chicago – Illinois Public Health Preparedness Center

• University of Iowa – Upper Midwest CPHP

• Johns Hopkins University – CPHP

• Loma Linda University – CPHP

• University of Michigan – CPHP

• University of Minnesota – CPHP

• New Jersey CPHP at UMDNJ

• University of North Carolina – CPHP

• The Ohio State University – Ohio CPHP

• University of Oklahoma – Southwest CPHP

• University of Pittsburgh – Center for Public Health Practice

• Saint Louis University – Heartland CPHP

• University of South Carolina – CPHP

• University of South Florida – Florida CPHP

• University of Texas – Center for Biosecurity and Public Health Preparedness

• Texas A&M – Center for Rural Public Health Preparedness

• Tulane University – South Central CPHP

• University of Washington – Northwest Center for Public Health Practice

• Yale University - CPHP

• Yale New Haven Health System

• Emory University Southeastern Center for Emerging Biologic Threats

Contact with CPHP

2. On average, how frequently does your organization interact with a CPHP(s)?

• Never

• Daily

• Weekly

• Monthly

• Yearly

• Other ________________________

• Do Not Know

Rate the extent to which you are satisfied with the frequency of interaction between your organization and a CPHP(s).

	Not at All Satisfied	Minimally Satisfied	Satisfied	Very Satisfied	Extremely Satisfied	Do Not Know
3. The frequency of interaction between your organization and a CPHP(s).	1	2	3	4	5	X

Satisfaction with CPHP Access and Products

NOTE: If you or your organization has worked with more than one CPHP, please consider your overall experience with the CPHP program when answering questions.

Rate the extent to which you are satisfied with the following:

	Not at All Satisfied	Minimally Satisfied	Satisfied	Very Satisfied	Extremely Satisfied	Do Not Know
4. CPHP training and education activities.	1	2	3	4	5	X
5. The range of training/educational topics available to your organization through the CPHP program.	1	2	3	4	5	X
6. The delivery methods for CPHP-sponsored courses (e.g., online, in person, satellite broadcast) available to your organization.	1	2	3	4	5	X
7. The opportunities your organization has had to provide input on the development, implementation, or evaluation of CPHP program activities.	1	2	3	4	5	X

CPHP Program Utilization

Rate the extent to which you agree or disagree with the following statements regarding CPHP resources.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Do Not Know
8. The CPHP program is an important resource that helps to meet the education and training needs of my organization’s workforce.	1	2	3	4	5	X
9. The CPHP program is an important resource that helps to meet the exercise planning, facilitation, and evaluation needs of my organization.	1	2	3	4	5	X
10. The CPHP program is an important resource that helps meet the emergency response planning needs of my organization.	1	2	3	4	5	X

11. The CPHP Program is an important resource that helps provide emergency response surge support during emergencies.

1

2

3

4

5

X

12. Have you or your organization used the online CPHP Network Resource Center to access training materials and resources?

• No

• Yes If “yes,” Answer Question 12a.

• Do Not Know

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Do Not Know
12a. The online CPHP Network Resource Center is a useful tool for accessing training materials and resources.	1	2	3	4	5	X

CPHP-Delivered Educational/Training Offerings

Rate the extent to which you agree or disagree with the following statements regarding CPHP-delivered educational/training offerings (e.g., courses, seminars, workshops, modules)

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Do Not Know
13. CPHP-delivered educational/training offerings are relevant to the preparedness and response workforce needs of my organization and/or our partners.	1	2	3	4	5	X
14. CPHP-delivered educational/training offerings have resulted in increased knowledge among participants from my organization and/or our partners.	1	2	3	4	5	X
15. CPHP-delivered educational/training offerings have resulted in improved skills among participants from my organization and/or our partners.	1	2	3	4	5	X

CPHP Program Impact on Organization

Rate the extent to which you agree or disagree with the following statements regarding the impact of the CPHP program on your organization over the past four years.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Do Not Know
16. As a result of our experiences with the CPHP program, my organization has developed new or expanded partnerships with other agencies or organizations.	1	2	3	4	5	X
17. As a result of our experiences with the CPHP program, my organization has developed a stronger relationship with the academic public health community.	1	2	3	4	5	X
18. As a result of using CPHP training, services, or products, the response capabilities of my organization have improved.	1	2	3	4	5	X
19. As a result of using CPHP training, services, or products, my organization’s exercise program has improved.	1	2	3	4	5	X
20. Changes observed in employees’ on-the-job behaviors can be attributed to the use of CPHP training, services, or products.	1	2	3	4	5	X

CPHP Program Impact on Public Health Workforce

Rate the extent to which you agree or disagree with the following statement regarding the impact of the CPHP program on the overall public health workforce over the past four years.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Do Not Know
21. As a result of the CPHP program, the emergency response capabilities of the overall public health workforce have improved.	1	2	3	4	5	X

21a. If “Agree” or “Strongly Agree,” identify specific CPHP activities to which you attribute these improvements. (open-ended)

Comments & Suggestions

22. Identify and describe any specific, key CPHP-delivered trainings, products, services, or activities that have improved the preparedness and emergency response capabilities of your organization. (open-ended)

23. Provide suggestions for improvement regarding any aspect of the CPHP program. (open-ended)

Demographics

24. Identify your type of organization. (choose all that apply)

• Federal Government

• State Government

• City Government

• County Government

• Tribal

• Non-Profit/Community-Based

• Faith-Based

• Academic

• For-Profit (e.g. Business, Hospital)

• Other: ­­­______________________

25. Identify your current Job Title*

*Use descriptive terms (e.g., “State Epidemiologist”) versus administrative classifications (e.g., “Administrator IV”).

Title: __________________

26. Approximately how long have you been in your current position? (Years, Months)

Years/Months: ___________________

27. Provide any additional comments and/or suggestions. (open-ended)

Optional: We would like to conduct follow-up telephone interviews with a sample of survey respondents in order to gather additional qualitative information about your experiences with the CPHP program. If you would like to participate in a brief interview, please provide your contact information below. Please be assured that we will only use your name to potentially contact you for an interview. Your identity will not be associated with your responses within this evaluation.

Name: ___________________

Organization: _____________

Telephone: _____________ __

Email: ____________________