Attachment E
PSR Online Instrument
Form approved
OMB No. 0920-0879
Expiration date: 04/30/2017
Thank you for your participation in the Centers for Disease Control and Prevention’s (CDC) Prevention Status Reports (PSRs) assessment. Your voluntary participation will help CDC gather important information regarding the PSRs. The PSRs are composed of
Reports by Topic – Ten individual topic-specific reports for each state (click here for an example)
State Report – a report for each state that combines all ten topic-specific reports for that state (click here for an example)
State Summary – a report for each state showing that state’s ratings for each PSR public health policy or practice indicator (click here for an example)
National Summary – a national report that shows the percentages of states rated green, yellow, or red for each PSR public health policy or practice indicator (click here for an example)
This questionnaire should take you about 15 minutes to complete.
Your participation in this assessment is greatly appreciated. The information you provide will help CDC more effectively support your efforts to advance evidence-based public health policy and practice.
Eligible participants for this assessment include state health department staff (e.g., state health officials, deputy health officials, program managers).
We will follow up with a randomly selected sample of respondents to request voluntary participation in a brief phone conversation to get a better understanding of their experiences with the PSRs.
Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing the 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 aspects of this collection of information, including suggestions for reducing this burden, to CDC/ATSDR Information Collection Review Office, 1600 Clifton Rd. NE, MS D-74, Atlanta, GA 30333; ATTN: PRA (0920-0879).
When navigating between pages please use the forward (>>) and back (<<) buttons located in the lower right corner of the assessment. Do NOT use your Internet browser buttons, as you will exit the assessment.
How did you first find out about the PSRs?
I haven’t heard of the PSRs [SKIP TO Q24]
From a CDC email announcement
From the CDC website
From the Association of State and Territorial Health Officials (ASTHO)
From my health department website
From a search engine
From Facebook
From Twitter
From a CDC colleague
From a colleague at my organization
From a colleague at another organization
Other, please specify:
Prior to receiving this questionnaire, which of the following 2013 PSRs had you read or reviewed? (Please select all that apply. Click on the report name to view an example.)
I haven’t read or reviewed any of the 2013 PSRs [IF SELECTED, DISPLAY 3a]
State Report [IF SELECTED, DISPLAY Q4]
Reports by Topic [IF SELECTED, DISPLAY Q3b and Q4]
Why haven’t you read or reviewed any of the 2013 PSRs? (Please select all that apply.) [SKIP TO Q24]
I am not aware of the PSRs
I cannot access the PSRs
The content isn’t relevant to my job
I don’t believe the content is useful
Other, please specify:
Which of the following topic reports have you read or reviewed? (Please select all that apply.)
Excessive Alcohol Use
Food Safety
Healthcare-Associated Infections
Heart Disease and Stroke
HIV
Motor Vehicle Injuries
Nutrition, Physical Activity, and Obesity
Prescription Drug Overdose
Teen Pregnancy
Tobacco Use
All of the above
Of the 2013 PSRs you have read or reviewed, please indicate how much you agree or disagree with the following statements. [QUESTION 4 ONLY DISPLAYS IF “State Report” or “Reports by Topic” or both are selected in Q3 above]:
The 2013 PSRs … |
Strongly agree |
Agree |
Disagree |
Strongly disagree |
Not sure |
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How long has it been since you last read or reviewed any of the 2013 PSRs?
Less than 1 month
1–3 months
4–6 months
More than 6 months
Have you used the 2013 PSRs (e.g., for assessing your state’s status, educating decision makers, public health planning and priority setting, etc.)?
Yes [SKIP TO Q7]
No [IF SELECTED, DISPLAY 6a]
What are the reasons that you have not used the PSRs? (Please select all that apply.) [IF SELECTED, DISPLAY 6b]
I am uncertain about what to do with PSRs
They do not address topics relevant to my organization’s program or policy focus
The format of the PSRs makes them too difficult to use
I do not think the information found in the PSRs will help advance public health policy and practice
I can get the same information elsewhere
I have not gotten support from others at my organization to use the PSRs
Other, please specify:
Do you intend to use any of the PSRs (e.g., for assessing your state’s status, educating decision makers, public health planning and priority setting, etc.)?
Yes [IF SELECTED, DISPLAY 6c]
No [IF SELECTED, SKIP TO Q11]
In what ways do you intend to use the PSRs? (Please select all that apply.) [IF SELECTED, SKIP TO Q11]
Self-assessment: Review PSR ratings to assess a state’s performance within the local context (i.e., consider PSR ratings in conjunction with additional state data and information about facilitators and barriers)
Communication: Foster dialogue with internal or external partners (e.g., co-workers, coalitions, community-based organizations, private businesses) about public health problems and solutions
Educating decision makers: Inform decision makers (e.g., elected officials, public health leaders, community leaders) about public health problems and solutions
Public health planning and priority setting: Influence decisions about actions to improve policies or practices described in the PSRs (e.g., actions are addressed in health improvement plan or strategic plan)
Improving existing policies or practices: Influence the direction of existing programs and/or policy initiatives with the intent of improving PSR ratings
Implementing new policies or practices: Influence the development of new programs and/or policy initiatives with the intent of improving PSR ratings
Other, please describe:
Which of the following 2013 PSRs have you used? (Please select all that apply. Click on the report name to view an example.)
Reports by Topic [IF SELECTED, DISPLAY Q7a]
Which of the following topic reports have you used? (Please select all that apply.)
Excessive Alcohol Use
Food Safety
Healthcare-Associated Infections
Heart Disease and Stroke
HIV
Motor Vehicle Injuries
Nutrition, Physical Activity, and Obesity
Prescription Drug Overdose
Teen Pregnancy
Tobacco Use
All of the above
Please indicate which of the following ways you have used or intend to use the PSRs.
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I have used the PSRs in this way |
I intend to use the PSRs in this way, but have not yet done so |
I do not intend to use the PSRs in this way |
Review PSR ratings to assess a state’s performance within the local context (i.e., consider PSR ratings in conjunction with additional state data and information about facilitators and barriers)
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Foster dialogue with internal or external partners (e.g., co-workers, coalitions, community-based organizations, private businesses) about public health problems and solutions
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Inform decision makers (e.g., elected officials, public health leaders, community leaders) about public health problems and solutions
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Influence decisions about actions to improve policies or practices described in the PSRs (e.g., actions are addressed in health improvement plan or strategic plan)
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Influence the direction of existing programs and/or policy initiatives with the intent of improving PSR ratings
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Influence the development of new programs and/or policy initiatives with the intent of improving PSR ratings
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Please describe any other ways you have used or intend to use the PSRs.
Please share any challenges to using the PSRs that you have encountered.
Which of the following 2013 PSRs have you shared with others (e.g., internal colleagues, external partners)? (Please select all that apply. Click on the report name to view an example.)
I haven’t shared any of the 2013 PSRs with others [SKIP TO Q14]
Reports by Topic [IF SELECTED, DISPLAY Q11a]
Which of the following topic reports have you shared? (Please select all that apply.)
Excessive Alcohol Use
Food Safety
Healthcare-Associated Infections
Heart Disease and Stroke
HIV
Motor Vehicle Injuries
Nutrition, Physical Activity, and Obesity
Prescription Drug Overdose
Teen Pregnancy
Tobacco Use
All of the above
With whom have you shared the PSRs within your organization? (Please select all that apply.)
I haven’t shared the PSRs within my organization
Agency executive leader or manager:
State health officer
Chief information officer
Chief medical officer
Local health department liaison
Senior deputy
State epidemiologist
State laboratory director
Other, please specify: _______________________________________________________
Environmental health worker
Epidemiologist/statistician
Health educator
Laboratory worker
Nutritionist
Primary care office director
Public health manager
Public health nurse
Public health physician
Public health policy advisor/analyst
Public information specialist
Other, please specify:
With what types of individuals or organizations have you shared the PSRs outside of your organization? (Please select all that apply.)
I haven’t shared the PSRs outside of my organization
External colleague, partner, or other individual:
State health department staff
Local health department staff
Governor
Other state elected or appointed official (e.g., state legislator, etc.)
Local elected or appointed official
Legislative staff
Clinical practitioner (e.g., doctor, nurse)
Community member and/or concerned citizen
Other individual, please specify: _____________________________________________
External organization:
Government agency other than a health department (e.g., Department of Transportation)
Public health partner organization (e.g., community-based organization, national public health association, coalition)
Hospital or other healthcare institution
Academic institution
Private business
Foundation
Other organization, please specify:
How familiar are you with the CDC PSR website?
Very familiar
Somewhat familiar
Not too familiar
Not at all familiar [SKIP TO Q17]
Please indicate how much you agree or disagree with the following statements about the CDC PSR website:
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Strongly agree |
Agree |
Disagree |
Strongly disagree |
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Please give any suggestions you have for improving the CDC PSR website, including additional resources or content you would like to see.
The Quick Start Guide posted on the CDC PSR website provides tips and tools for using the PSRs. Have you read or reviewed the Quick Start Guide? (Click here to view the Quick Start Guide)
Yes
No [SKIP to Q20]
Please indicate how much you agree or disagree with the following statements about the Quick Start Guide.
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Strongly agree |
Agree |
Disagree |
Strongly disagree |
Have not used/Not sure |
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Please give any recommendations you have for making the Quick Start Guide (including the worksheet) a more effective tool to support use of the PSRs.
SUGGESTIONS FOR IMPROVEMENT
Please indicate how much you agree or disagree that the following CDC actions would improve use of the PSRs.
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Strongly agree |
Agree |
Disagree |
Strongly disagree |
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Please give any additional recommendations you have for how CDC could make the PSRs more useful in advancing evidence-based public health policy and practice.
Please indicate how much you agree or disagree with the following statements about topics to include in future PSRs:
CDC should continue to include this topic in future PSRs: |
Strongly agree |
Agree |
Disagree |
Strongly disagree |
Not Sure |
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Please give any recommendations you have for making the topic reports more effective for advancing evidence-based public health policy and practice. If a recommendation is particular to one or more reports, please identify the report(s) to which it applies.
In which U.S. state do you work? [DROP DOWN MENU for states and DC]
Which of the following best describes the level of your position within your organization?
Agency executive leadership or management (e.g., health official, public health director, senior deputy, or other executive leader)
Division, unit, or program leadership or management
Non-management
Which of the following best describes your job?
Agency executive leader or manager:
State health officer
Chief information officer
Chief medical officer
Local health department liaison
Senior deputy
State epidemiologist
State laboratory director
Other, please specify: ________________________________________________
Environmental health worker
Epidemiologist or statistician
Health educator
Laboratory worker
Nutritionist
Primary care office director
Public health manager
Public health nurse
Public health physician
Public health policy advisor or analyst
Public information specialist
Other, please specify:
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Garry Lowry |
File Modified | 0000-00-00 |
File Created | 2021-01-28 |