0920-0879 AttachmentJ - Questionnaire WORD version

Attachment J- State Questionnaire WORD version

Characteristics of a State Linkage System

Form approved

OMB No. 0920-0879

Expiration Date: 03/31/2014

1. What is today’s date?

MM DD YYYY

/ /

Please enter today’s date using the

following format.

2. Which state are you representing in completing this survey?

3. In case we have any questions or need clarification on responses, please provide your email address. Email addresses will not be linked to any data outputs.

4. How much of a priority would you say motor vehicle injury is in your state compared with other health problems?

	Highest priority
	Priority
	Somewhat of a priority
	Not a priority at all

5. What year did your state start its linkage project?

5. Is the linkage and analysis project in your state for which you are responding part of the National Highway Traffic Safety Administration (NHTSA) Crash Outcome Data Evaluation System (CODES)?

	Yes
	No

5. Which agency is responsible for… State Department State Department of Other

Of Public Health Transportation/Highways

The coordination of your overall linkage/CODES project?

Your primary linkage/CODES project linkage?

Your primary linkage/CODES project data analysis?

If you indicated “Other”, please specify the agency name(s) below:

5. If your state participates in the NHTSA CODES effort, in what year was the program begun?

Public reporting burden of this collection of information is estimated to average 40 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879)

5. Indicate the years of source data that are suitable for linking that you have available.

	Crash	Inpatient Hospital	E.D.	Emergency Medical Services (E.M.S.)	Drivers License	Traffic Violation/ Citation	Vehicle Registration
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011

If you have “other” data sources available, indicate the name and year(s) of data available below:

5. For which of the following years and databases have you linked your CRASH data:

	Inpatient	E.D.	Emergency Medical Services (E.M.S.)	Drivers License	Traffic Violation/ Citation	Vehicle Registration	Other
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011

If your state has “Other” data sets linked (i.e. E.M.S> data linked to trauma data), indicate the name and years of data sets that are linked.

5. Consider the following:

	Yes	No
Do you have a Board of Advisors or Directors for your linkage/CODES project?
Do you have a small group or subcommittee that assists as a steering committee, work group, task force, or other advisory board that assists you with identifying your linkage/research priorities?

Other comments:

5. Consider the following in relation to your linkage/CODES project:

	Annually	Bi-annually	Quarterly	Monthly	Other time period, please specify below
If your state has a Board of Advisors or Directors, how often does that group meet?
If your state has a small group or subcommittee that assists as a steering committee, work group, task force, or advisory board that identifies linkage/research priorities, how often does that group meet?

Please specify other time periods for each if option not provided.

5. Indicate the organizations that are represented on your linkage/CODES Board of Advisors or Directors.

	Members
State Highway Safety Office
State Department of Motor Vehicles
State Department of Public Safety
State Department of Transportation/Highways
State Police
State Trauma Board
State level hospital association
University/College: Specify name(s) below
Other state department, non-governmental organization, or other: specify name(s) below

If you listed University/College or other state department, non-governmental organization, or some other potential agency, please specify those agency name(s):

5. If your state has a small group or subcommittee that assists as a steering committee, work group, task force, or advisory board, that identifies linking/research priorities, list those agencies that participate in this with you. If this doesn’t apply, please indicate with N/A:

5. Indicate the funding streams that your state utilizes to support your linkage/CODES project

	Funding available to our state
Centers for Disease Control and Prevention (CDC)
NHTSA
National Institutes of Health (NIH)
State Highway Safety Office
State Department of Public Health
State Department of Transportation/Highways
State Department of Motor Vehicles
Substance Abuse and Mental Health Services Administration (SAMHSA)
The Robert Wood Johnson Foundation (RWJF)
Other

If you selected “other” indicate who those partners include:

5. Do you charge other agencies for data outputs from your linkage/CODES project?

	Yes
	No I

If you indicated “yes”, please share how you might charge other agencies (i.e. hourly, price by size of project or output, etc.)

5. Indicate your agency’s level of involvement with each of the following in your state: (i.e. involvement might mean that you attend meetings that they hold or they attend meetings that you hold – you mutually support those program efforts or they support yours).

	We interact frequently	We interact occasionally	We rarely interact	We never interact
Traffic Records Coordinating Committee (TRCC)
Department of Public Health – Injury Surveillance
Strategic Highway Safety Plan (SHSP)
NHTSA Regional Office
State Core Violence and Injury Prevention Program (Core VIPP)
Other

If you selected “other” indicate who the other partners are that you interact with and your level of involvement with them

5. Indicate how often you share or provide linked/CODES data to each of the following: (meaning that you have an ongoing relationship and commitment to provide them with data outputs or analyses).

	Frequently	Occasionally	Rarely	Never
Traffic Records Coordinating Committee (TRCC)
Department of Public Health – Injury Surveillance
Strategic Highway Safety Plan (SHSP)
NHTSA Regional Office
State Core Violence and Injury Prevention Program (Core VIPP)
Other

If you indicated “Other”, please specify the agency name(s) and the frequency with which you interact.

5. Indicate how often you get data requests from the following:

	Frequently	Occasionally	Rarely	Never
Traffic Records Coordinating Committee (TRCC)
Department of Public Health – Injury Surveillance
Strategic Highway Safety Plan (SHSP)
NHTSA Regional Office
State Core Violence and Injury Prevention Program (Core VIPP)
Other

If you indicated “Other”, please specify the agency name(s) that submit data requests and the frequency with which they request data from you.

5. How would you rate the demand for linkage/CODES data in your state?

	Many people use our data on an on-going basis	We receive data requests several times per year	We receive data requests occasionally	We rarely receive data requests	We never receive data requests
For use in identifying traffic safety problems
For use in supporting traffic safety decision makers
For use in educating the public
For use in legislative decision making

5. For each employee working on your linkage/CODES project, indicate the amount of time that they spend working on the project over the course of a year. (working on the project meaning: preparing a data feed for linkage, participating in meetings regarding linkage/analysis, preparing data regarding linkage/analysis, writing papers or preparing presentation materials on the results of analyses, etc..).

	Percent FTE	Percent Effort	Familiarity with Statistics/Epidemiology
Person #1			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses
Person #2			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses
Person #3			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses
Person #4			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses
Person #5			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses
Person #6			Bachelor’s	Masters	PhD	No degree but have taken courses (i.e. statistics, epidemiology, etc.)	No degree, no courses

If more than 6 people are employed with your linkage/CODES project, continue your list here.

5. If your state is NOT part of the CODES effort what linkage method do you use?

Probalistic

Deterministic

Please describe linkage method or any software used:

5. How would you describe your project staff’s proficiency in the following (proficiency meaning statistical background, knowledge of appropriate software, understanding of outputs, and ability to draw conclusions):

	Linkage (pick one for each software)	Analysis (pick one for each software)
LinkSolv	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all
CODES2000	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all
IVEWare	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all
SAS	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all
Microsoft Access	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all
Microsoft Excel	Our state doesn’t use this software for linkage	Our state doesn’t use this software for analysis
	Expert: Assists or able to teach others in using software	Expert: Assists or able to teach others in using software
	Intermediate: can generally develop linkage specifications /program or run software without assistance	Intermediate: can generally develop linkage specifications /program or run software without assistance
	Beginner: Needs assistance in developing linkage specifications/programs or running of software	Beginner: Needs assistance in developing linkage specifications/programs or running of software
	Not proficient at all	Not proficient at all

If you selected “Other software in general”, please specify what your linkage/CODES project uses and their proficiency in using. Identify as expert, intermediate, beginner, not proficient.

5. For each of the following indicate the areas in which your staff has received technical assistance or training:

	Yes	No
Understanding the structure and content of crash data
Linkage: using Linksolv
Linkage: using CODES2000
Linkage: using other linkage software (Specify)
Creating clean usable data sets for analysis: using linkage results
Missing data imputation
Analyzing linked, imputed data

If you indicated that your linkage/CODES project uses some “Other” linkage software, specify the name of that software package.

5. If you had the opportunity for additional technical assistance/training, what topics would your linkage/CODES project find important or relevant?

5. Estimate the lag time in months that it takes to receive data from your state data partners:

	Our state doesn’t use this data source	1-3 months	4-6 months	7-9 months	10-12 months	13-18 months	19-24 months	More than 24 months
Crash
Inpatient Hospital
E.D.
E.M.S.
Drivers License
Traffic Violation/ Citation
Vehicle Registration

If your state links data sets other than those listed, specify what data sets that includes and the lag time in months it takes to receive that data.

5. The next several questions refer to aspects of your linkage/CODES project that may serve as resources or barriers. Please indicate the extent to which you agree or disagree with the following statements. Our linkage/CODES project has…

	Strongly agree	Agree	Disagree	Strongly disagree	Neither agree nor disagree
Adequate financial resources to participate in data linkage and analysis efforts
Had at least 1 position in which the job description included work related to planning, implementing, and/or evaluating data linkage and analysis efforts
Provided access to data linkage and analysis results through publications, factsheets, etc.
Formal or informal partnerships with agencies with which we can collaborate on data linkage and analysis efforts
Adequate access to technical assistance when we run into problems linking data
Adequate access to technical assistance when we run into problems analyzing data

5. List the top three obstacles that might keep you from OBTAINING data or data sets timely:

Obstacle 1:

Obstacle 2:

Obstacle 3:

5. List the top three challenges that you have in LINKING data for your linkage/CODES project:

Challenge 1:

Challenge 2:

Challenge 3:

5. List the top three challenges that you have in ANALYZING data for your linkage/CODES project:

Challenge 1:

Challenge 2:

Challenge 3: