Customer/Partner Follow-up Survery Instrument

Customer/Partner Follow-Up Interview Instrument

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

Introduction

Thank you for volunteering to participate in this interview. We have your responses to the CPHP Customer/Partner Survey that you participated in recently and may ask you to clarify or provide additional information surrounding your responses.

Purpose: Similar to the CPHP Customer/Partner Survey, the purpose of this interview is to collect information about your experience working with the Centers for Public Health Preparedness (CPHP), as well as your opinions regarding its impact on public health preparedness. For this interview, please consider your experiences working with one or more of the CPHPs between 2004 and the present (the duration of the CDC CPHP Cooperative Agreement). This interview is one component of the CPHP program evaluation conducted by the Centers for Disease Control and Prevention (CDC).

Intended Use of Information: The information gathered in this interview will be used to document outcomes generated by the collective work of the Centers, to provide timely and accurate responses to programmatic inquiries, and to inform CPHP program design and implementation in the future.

Logistics: The interview will last approximately 45 minutes. I will be leading the discussion and there are two people taking notes.

Security of Responses: I encourage you to be honest and candid in your responses. There are no right or wrong answers and nothing you say will be tied to your identity in any way. Generated reports will be in summary form only, and everything you share in this conversation is voluntary and will be treated in a secure manner.

Consent to Tape Record: I will also be tape recording the interview in order to accurately capture our conversation. Do I have your consent to record this conversation?

Association with CPHP

The first question solicits information about your organization’s association with the CPHP program. Please be as concrete and detailed in your responses as possible and keep in mind that your responses should only reflect the timeframe of the CDC CPHP Cooperative Agreement (2004-2009).

1. Describe your organization’s association with one or more Center for Public Health Preparedness (i.e., use of a CPHP-developed training activity, use of CPHP-developed tool or a product, technical assistance or other form of direct service, or relationship that has improved your emergency preparedness capacity).

Organizational Outputs

We would now like to ask you about CPHP-produced products, programs, and services. If you or your organization has worked with more than one CPHP, please consider your overall experience with the CPHP program when answering the following questions.

2. What CPHP-developed products, programs, or services* do you consider the most beneficial to your organization?

*Interviewer Note: This can be a CPHP-developed training activity, tool or product, technical assistance or other form of direct service, or relationship that has improved your organization’s emergency preparedness capacity.

Public reporting burden of this collection of information is estimated to average 45 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).

2a. Why* do you consider these the most beneficial?

*Interviewer Note: This can be that the CPHP-developed training activity, tool or product, technical assistance or other form of direct service resulted in increased knowledge and skills amongst target audiences, met an organization’s need, filled a gap in training, is at no financial cost to my organization, etc.

Organizational Outcomes

Over the past five years, think about a state, local, and/or regional emergency(s)* in which your organization has responded.

3. Describe in detail how, if at all, CPHP-developed training, tools, or services contributed to the effectiveness of your organization’s response to the emergency(s)*.

*Interviewer Note: Participation in a full-scale exercise can be substituted within the question only if the respondent cannot identify an emergency and/or its associated response. In response, identification of emergency should be included (e.g. hurricane response, flood, outbreak, etc.).

Working with CPHPs

4. Identify any challenges or barriers your organization has experienced in working with a CPHP*.

*Interviewer Note: Respondent should provide specific examples. Examples may include personality differences, lack of quality service, poor communication between a CPHP and its partners, etc.

5. If the CDC CPHP program/cooperative agreement did not continue, describe anticipated effect(s), if any, on your organization.

Concluding Comments & Questions

6. Do you have any additional comments or questions?

Closing

We are now finished with the interview. I’d like to thank you for your detailed responses and your time. Again, I’d like to reassure that nothing you have said within this interview will be tied to your identity in any way. Generated reports will be in summary form only, and everything you share in this conversation has been voluntary and will be treated in a secure manner.