Waterborne Disease Prevention: State Program Assessment

Attachment B—Instrument: Interview Guide

Form Approved

OMB No. 0920-0879

Expiration Date 03/31/2018

Introduction

Hi! My name is _____, and I’m with CDC’s Waterborne Disease Prevention Branch. Thank you so much for taking the time to talk with me. We are talking to state health departments to learn more about your waterborne disease prevention program’s capacity to detect, investigate, report, and prevent waterborne diseases. We’d also like to ask you questions about what you believe helps or hinders your program from achieving its desired capacity. The information you share will help us understand how we can support resources and facilitate your future efforts.

We truly value your feedback and appreciate any insights that you might have. I have a few questions I would specifically like to ask you, but please feel free to bring up your own topics I don’t cover that you think are relevant at any time during our conversation.

Before we get started, I wanted to briefly remind you that your participation today is voluntary. WDPB will explore opportunities for presenting and publishing information collection findings, but any information you share will not be publicly linked to you or your state. I will be recording the conversation in order to capture our conversation accurately, but the recording will be deleted once transcription is complete. Are you okay with me recording the interview?

Our interview will last no more than 60 minutes. Do you have any questions before we begin?

Introduction Questions

I’d like to start today’s conversation by asking you to...

1. Tell me about your current role in the health department.

2. How long have you been working at the health department? Within the waterborne disease prevention program?

3. Some waterborne disease prevention program activities sit all in one agency/branch at a health department, whereas others may be dispersed between different agencies/branches or even between state and local health departments. Could you describe the structure of your state’s waterborne disease prevention program?

Force-Field Analysis Questions

The next set of questions that I’d like to ask will help the Waterborne Disease Prevention Branch understand where you feel your program currently is in terms of waterborne disease capacity, where your program would like to go (the long term vision of program), and what helps or hinders capacity building (the ability to strengthen detection, investigation, reporting, and prevention activities.

1. I’d like you to first discuss your waterborne disease prevention program’s current capacity to detect, investigate, report, and prevent waterborne diseases.

Probes: Capacity for health promotion/prevention, investigation/reporting, laboratory detection?

1. If you had to pick one thing that you are most proud about of your waterborne disease prevention program, what would it be?

2. What has helped achieve your current capacity (facilitate progress)?

2. Now think about the long term vision of your program. Where would you like to be in terms of capacity?

Probes: What additional activities would you like to accomplish? Does health promotion/prevention fit into your desired capacity? Investigation/reporting? Laboratory detection?

3. What do you believe will help you get to the desired capacity (facilitate progress)?

4. What do you see as obstacles or challenges to making progress towards your desired capacity?

Component Model of Infrastructure Questions

A strong public health infrastructure provides the foundation and capacity to effectively address public health issues. A recent evaluation of state tobacco control programs found five elements that were key to building a strong infrastructure. The five core elements included:

• network of partnerships across various levels and organizations

• program leaders at multiple levels engaged with the program

• diverse set of resources: including funding, staff, and training provided to staff/partners

• data being used to inform decisions

• developing strategic plans that are used to respond and adapt to the environment

While these elements were linked to tobacco control program outcomes and success, it is unknown how applicable they are to other public health areas such as waterborne disease prevention. Next I’d like to ask you a few questions to understand how important you believe these elements are in achieving your waterborne disease program’s desired capacity. There are no right or wrong answers, as we are trying to understand how the following elements may or may not apply to waterborne disease prevention program capacity.

1. How important are partners or collaborators in achieving the desired capacity of the program?

1. What role do they play in achieving the desired capacity?

2. What type of partners or collaborators do you believe are important in achieving the desired capacity?

Probes: workgroups, partnerships with external organizations (local/state agencies, NGOS, business/corporate, etc.), collaboration between departments within agency, technical assistance to local HDs, other state HDs, “champions”, legislators

1. Do you currently communicate with or work with those partners or collaborators?

2. How important is leadership in achieving the desired capacity of the program?

   1. What role do they play in achieving the desired capacity?

   2. How do you define leadership?

Probe: are they leaders from various levels—within the program, at a local or state HD, etc. or just within your program

3. How important are resources (staff, funding, etc.) in achieving the desired capacity of the program?

   1. What role do resources play in achieving the desired capacity?

4. Influence of CDC support in achieving desired capacity [Note: Separate questions will be asked for CDC supported and non-CDC supported states around CDC funding]

CDC supported states:

1. Do you believe that the ELC funding and/or CSTE fellow has had a role in helping to achieve the desired capacity of the program? How?

   1. What has your program been able to accomplish with the ELC funding/CSTE fellow that it could not do before?

   2. Do you believe this is an effective route to building program capacity?

   3. ELC Question: Is core funding (i.e. staffing/infrastructure funding) or program funding (funding for one time projects) the most (or a more) effective route to building program capacity? Why?

   4. Do you have any suggestions as to what might work better?

Non-CDC supported states:

1. Are you aware of CDC’s funding opportunity announcement? [If not, explain]

1. Has your state ever applied for funding?

2. Why/why not?

3. Do you believe this is an effective route to building program capacity?

4. Do you have any suggestions as to what might work better?

5. How important is evaluating progress/performance in achieving the desired capacity of the program?

   1. What role does evaluation play in achieving the desired capacity?

2. How does your program evaluate progress/performance?

   1. What metrics/indicators are most important to your program to measure success?

3. How does your waterborne disease program use the data obtained from evaluating your progress/performance?

6. How important is strategic planning in achieving the desired capacity of the program?

   1. What role does strategic planning play in achieving the desired capacity?

2. Could you tell me a little bit about how your health department has planned for future activities?

Assessment of Presence/Absence of Component Model of Infrastructure components

1. Before we wrap up I’d like for you to assess these components in your waterborne disease prevention program on a scale of three values: whether you believe these components are currently “strong”; “weak/needs improvement”; or “absent”. There are no right or wrong answers to this question. These rankings will help us understand technical assistance priority areas to help states strengthen their overall infrastructure.

• network of partnerships across various levels and organizations

• program leaders at multiple levels engaged with the program

• diverse set of resources: including funding, staff, and training provided to staff/partners

• data being used to inform decisions

• developing strategic plans that are used to respond and adapt to the environment

2. We just got done talking about barriers and facilitators to achieving your program’s desired capacity to detect, investigate, report, and prevent waterborne diseases. Thinking specifically about those items you mentioned, what would be your program’s top need (resources, training, etc.) to either support the facilitators or overcome the barriers?

1. Do you believe that the CDC has a role in helping to achieve the desired capacity of the program? How?

That concludes the questions that I wanted to ask you today. Is there anything else that we haven’t discussed that you would like to share with me today?

Thank you for taking the time to complete this interview. The findings from your interview, as well as others will help us understand how states would like to build waterborne disease capacity and how CDC can help with both facilitators and barriers to achieving the desired capacity. A final report summarizing our findings will be made available to you once it is complete. In the meantime, if you have any other questions or thoughts that come up later on, please don’t hesitate to email me or give me a call.

CDC estimates the average public reporting burden for this collection of information as 60 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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 burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).