genIC Cancer Survivorship Needs Assessment for NCCCProgram Grantees

Attachment A—Cancer Survivorship Needs Assessment Instrument Word Version

Form Approved

OMB No. 0920-0879

Expiration Date 03/31/2018

Cancer Survivorship Needs Assessment for the National Comprehensive Cancer Control Program Grantees

Introduction

This assessment is part of an information collection being conducted by Battelle on behalf of the Centers for Disease Control and Prevention (CDC), Division of Cancer Prevention and Control (DPCP). Battelle is an independent, non-profit research organization.

The purpose of the information collection is to assess the cancer survivorship needs of comprehensive cancer control (CCC) programs, and to identify the types of activities, resources, and materials that could help the CCC programs address those needs. In addition, this information collection will assess how the activities undertaken and materials produced by the National Cancer Survivorship Resource Center (NCSRC) have met the survivorship needs of CCC programs. This information collection will support DCPC’s efforts to ensure that cancer survivors’ public health needs are being met, and will inform future survivorship technical assistance provided to CCC programs.

The National Cancer Survivorship Resource Center (NCSRC) is a collaboration between the American Cancer Society, the George Washington University Cancer Institute, and CDC to shape the future of cancer survivorship care and improve the quality of life of cancer survivors. Starting in 2010, the current NCSRC was funded through a 5-year cooperative agreement with CDC to support the development, implementation, and evaluation of strategies outlined in the National Action Plan for Cancer Survivorship.

You have been asked to participate in this 30-minute web-based assessment because of your affiliation with a comprehensive cancer control program funded through the CDC’s National Comprehensive Cancer Control Program (NCCCP).

Participation in this assessment is voluntary. You may choose not to answer particular questions, or to terminate at any time, without any penalty to you or your program. Battelle will keep your identity in this information collection private. After the assessment is completed, Battelle will deliver a data file to CDC. The data file will include your responses to the questions, plus the identity of your CCC program (e.g., an abbreviation for the state, tribal organization, territory, etc). The data file will NOT include your personal name or email address. CDC will analyze the data, prepare internal reports for program development and improvement, and may publish the results in aggregate form.

If you have any questions about the web-based assessment, please contact Battelle’s coordinator, <name> at <telephone number> or <email address>. If you have any questions about your rights as a participant, please contact Battelle at 1-877-810-9530, extension 500.

If you wish to proceed, please answer the questions to the best of your ability based on your personal knowledge and experience. You do not need to complete the assessment in one sitting; your answers will not be final until you hit the “Submit” button at the end.

By clicking on the Next button you provide your consent to participate.

<Next button here>

Thank you for participating in the cancer survivorship needs assessment. We understand your time is valuable and appreciate the information you are providing today. Your responses will help CDC better serve all who have a stake in cancer survivorship. Remember, you can leave the assessment and return to your saved answers at a later time by clicking on the link in the invitation email message.

First, we have a few questions about you and your CCC program.

1. What is your position or title in your CCC program?

______________________________________________

2. Please indicate the length of time you have been working with your CCC program:

( ) – Less than 1 year

( ) – 1-3 years

( ) – 4-5 years

( ) – More than 5 years

These next questions are about the cancer survivorship needs of your CCC program and its partners.

3. What types of information are important for you and your partners to provide to cancer survivors and their caregivers regarding cancer survivorship? Using the scale below, please rate each of the following areas:

If you select and rate ‘other,’ please specify in the box below.

	Very Important	Important	Not important	Don’t Know
Family history and cancer risk
Cancer diagnosis and treatment
Possible late- and long-term effects of cancer and its treatment
What to expect in follow-up care
Healthy lifestyle and behavior
Financial aid/management and health insurance
Reproductive health issues
Patient navigation referrals
Chronic disease self-management programs
Palliative care
Psychosocial resources and support
Links to additional resources
Other

Other (please specify)________________________

4. What types of information are important for you and your partners to provide to health care professionals regarding cancer survivorship? Using the scale below, please rate each of the following areas:

If you select and rate ‘other,’ please specify in the box below.

	Very Important	Important	Not Important	Don’t Know
Using survivorship care plans
Distress screening
Managing comorbidities
Psychosocial health care needs
Survivorship care coordination
Coordination of specialty care
Cancer recovery and rehabilitation
Clinical follow-up care guidelines for primary care providers
Prevention-empowering survivors to live well
Other

Other (please specify)____________________

5. What types of information are important for you and your partners to provide to policy-makers and decision-makers regarding cancer survivorship? Using the scale below, please rate each of the following areas:

If you select and rate ‘other,’ please specify in the box below.

	Very Important	Important	Not Important	Don’t Know
Data and statistics
Evidence based policy, systems, and environmental (PSE) change strategies
Promising practices to promote PSE changes
Policy briefs
Other

Other (please specify)______________

Next, we will ask some questions about awareness of the NCSRC, and how NCSRC resources are shared in your jurisdiction.

6. In general, how familiar do you think your cancer survivorship partners are with resources on the NCSRC website?

( ) – Extremely familiar

( ) – Moderately familiar

( ) – Somewhat familiar

( ) – Slightly familiar

( ) – Not at all familiar

( ) – Don’t know

7. How familiar are you with NCSRC resources?

( ) – Extremely familiar

( ) – Moderately familiar

( ) – Somewhat familiar

( ) – Slightly familiar

( ) – Not at all familiar

( ) – Don’t know

[If Question 7 = “Not at all familiar” or “Don’t know,” skip to question 129.]

8. How did you first learn about the NCSRC resources?

( ) – CDC Comprehensive Cancer Control Branch (CCCB)

( ) – American Cancer Society

( ) – American Cancer Society partners or networks

( ) – George Washington Cancer Institute

( ) – George Washington Cancer Institute partners or networks

( ) – Your professional/social network channels

( ) – Other:___________________________________________________________________

9. Has the CDC Comprehensive Cancer Control Branch (CCCB) provided you with information about NCSRC resources?

( ) – Yes

( ) – No

( ) – Don’t know

[If participant answers ‘No’ or ‘Don’t know’ to question 9, they will skip to question 11.]

10. In what ways has CDC Comprehensive Cancer Control Branch (CCCB) provided you with information about NCSRC resources?

[Check all that apply]

( ) – E-blast communications

( ) – Program Directors Conference Call

( ) – CCCB in-person meetings

( ) – Program Consultant

( ) – Other (please specify):___________________________________________________

11. Have you shared NCSRC resources and information with your coalition members, program partners, and other stakeholders?

( ) – Yes

( ) – No

( ) – I don’t know

[If participant answers ‘No’ or ‘Don’t know’ to question 11, they will skip to question 13.]

12. How do you generally share NCSRC resources and information with your coalition members, program partners, and other stakeholders?

[Check all that apply]

( ) – Links in email

( ) – Newsletters

( ) – CCC Program or Coalition website that links to NCSRC resources

( ) – Listservs

( ) – Social media

( ) – At coalition or partner meetings

( ) – Other: ____________________________________________________________________

Now we would like to ask you some questions about the following NCSRC resources you and your CCC program may have used or shared with partners and stakeholders.

• Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”

• Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer

• A Cancer Survivor's Prescription for Finding Information

• Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer

• Cancer Survivorship E-Learning Series: Online Learning Modules

• A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care

• Moving Beyond Patient Satisfaction - Tips to Measure Program Impact

• Cancer Survivorship - A Policy Landscape Analysis

13. Have you used or shared Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

( ) – Yes [Continue to Questions 14-26]

( ) – No [Skip to Question 27]

( ) – I Don’t Know [Skip to Question 27]

14. Please rank the following factors by their importance in your decision to use Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

15. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

16. How did you use Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

17. Did you share Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 22.]

18. How did you share Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

19. With whom have you shared Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

20. To your knowledge, have your program partners used Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 22.]

21. How have your program partners used Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”:

22. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

23. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

24. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 24 they will answer question 25. If the participant selected one of the three other responses, they will skip to question 26.]

25. In general, what made you feel Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives” was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

26. Please indicate your level of agreement with the following statements regarding Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for American Indians and Alaska Natives”:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

27. Have you used or shared Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

( ) – Yes [Continue to Questions 28-41]

( ) – No [Skip to Question 42]

( ) – I Don’t Know [Skip to Question 42]

28. Which of the following guidelines have you used or shared?

[Check all that apply]

( ) – Breast cancer

( ) – Colorectal cancer

( ) – Prostate cancer

( ) – Don’t know

29. Please rank the following factors by their importance in your decision to use Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

30. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

31. How did you use Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

32. Did you share Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 37.]

33. How did you share Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

34. With whom have you shared Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

35. To your knowledge, have your program partners used Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 37.]

36. How have your program partners used Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer

37. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

38. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

39. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 39 they will answer question 40. If the participant selected one of the three other responses, they will skip to question 41.]

40. In general, what made you feel Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

41. Please indicate your level of agreement with the following statements regarding Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate Cancer:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

42. Have you used or shared A Cancer Survivor's Prescription for Finding Information?

( ) – Yes [Continue to Questions 43-55]

( ) – No [Skip to Question 56]

( ) – I Don’t Know [Skip to Question 56]

43. Please rank the following factors by their importance in your decision to use A Cancer Survivor's Prescription for Finding Information.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

44. If you ranked “Other” in the question above, please describe that factor.

_______________________________________________________45. How did you use A Cancer Survivor's Prescription for Finding Information?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

46. Did you share A Cancer Survivor's Prescription for Finding Information?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 51.]

47. How did you share A Cancer Survivor's Prescription for Finding Information?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

48. With whom have you shared A Cancer Survivor's Prescription for Finding Information?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

49. To your knowledge, have your program partners used A Cancer Survivor's Prescription for Finding Information?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 51.]

50. How have your program partners used A Cancer Survivor's Prescription for Finding Information?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding A Cancer Survivor's Prescription for Finding Information:

51. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

52. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

53. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 53 they will answer question 54. If the participant selected one of the three other responses, they will skip to question 55.]

54. In general, what made you feel A Cancer Survivor's Prescription for Finding Information was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

55. Please indicate your level of agreement with the following statements regarding A Cancer Survivor's Prescription for Finding Information:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

56. Have you used or shared Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

( ) – Yes [Continue to Questions 57-70]

( ) – No [Skip to Question 72]

( ) – I Don’t Know [Skip to Question 72]

57. Which of the following guidelines have you used or shared?

[Check all that apply]

( ) – Breast cancer

( ) – Colorectal cancer

( ) – Prostate cancer

( ) – Don’t know

58. Please rank the following factors by their importance in your decision to use Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

59. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

60. How did you use Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

61. Did you share Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 66.]

62. How did you share Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

63. With whom have you shared Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

64. To your knowledge, have your program partners used Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 66.]

65. How have your program partners used Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer

66. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

67. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

68. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 68 they will answer question 69. If the participant selected one of the three other responses, they will skip to question 70.]

69. In general, what made you feel Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

70. Please indicate your level of agreement with the following statements regarding Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

71. Have you used or shared Cancer Survivorship E-Learning Series: Online Learning Modules?

( ) – Yes [Continue to Questions 72-84]

( ) – No [Skip to Question 27]

( ) – I Don’t Know [Skip to Question 27]

72. Please rank the following factors by their importance in your decision to use Cancer Survivorship E-Learning Series: Online Learning Modules.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

73. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

74. How did you use Cancer Survivorship E-Learning Series: Online Learning Modules?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

75. Did you share Cancer Survivorship E-Learning Series: Online Learning Modules?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 80.]

76. How did you share Cancer Survivorship E-Learning Series: Online Learning Modules?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

77. With whom have you shared Cancer Survivorship E-Learning Series: Online Learning Modules?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

78. To your knowledge, have your program partners used Cancer Survivorship E-Learning Series: Online Learning Modules?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 80.]

79. How have your program partners used Cancer Survivorship E-Learning Series: Online Learning Modules?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Cancer Survivorship E-Learning Series: Online Learning Modules:

80. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

81. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

82. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 82 they will answer question 83. If the participant selected one of the three other responses, they will skip to question 84.]

83. In general, what made you feel Cancer Survivorship E-Learning Series: Online Learning Modules was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

84. Please indicate your level of agreement with the following statements regarding Cancer Survivorship E-Learning Series: Online Learning Modules

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

85. Have you used or shared A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

( ) – Yes [Continue to Questions 86-98]

( ) – No [Skip to Question 99]

( ) – I Don’t Know [Skip to Question 99]

86. Please rank the following factors by their importance in your decision to A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

87. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

88. How did you use A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

89. Did you share A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 94.]

90. How did you share A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

91. With whom have you shared A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

92. To your knowledge, have your program partners used A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 94.]

93. How have your program partners used A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care:

94. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

95. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

96. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 96 they will answer question 97. If the participant selected one of the three other responses, they will skip to question 98.]

97. In general, what made you feel A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

98. Please indicate your level of agreement with the following statements regarding A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment: Guide for Delivering Quality Survivorship Care:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

99. Have you used or shared Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

( ) – Yes [Continue to Questions 100-112]

( ) – No [Skip to Question 113]

( ) – I Don’t Know [Skip to Question 113]

100. Please rank the following factors by their importance in your decision to use Moving Beyond Patient Satisfaction - Tips to Measure Program Impact.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

101. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

102. How did you use Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

103. Did you share Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 108.]

104. How did you share Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

105. With whom have you shared Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

106. To your knowledge, have your program partners used Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 108.]

107. How have your program partners used Moving Beyond Patient Satisfaction - Tips to Measure Program Impact?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Moving Beyond Patient Satisfaction - Tips to Measure Program Impact:

108. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

109. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

110. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 110 they will answer question 111. If the participant selected one of the three other responses, they will skip to question 112.]

111. In general, what made you feel Moving Beyond Patient Satisfaction - Tips to Measure Program Impact was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

112. Please indicate your level of agreement with the following statements regarding Moving Beyond Patient Satisfaction - Tips to Measure Program Impact:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

113. Have you used or shared Cancer Survivorship - A Policy Landscape Analysis?

( ) – Yes [Continue to Questions 114-126]

( ) – No [Skip to Question 127]

( ) – I Don’t Know [Skip to Question 127]

114. Please rank the following factors by their importance in your decision to use Cancer Survivorship - A Policy Landscape Analysis.

A rank of 1 would be the most important factor. Click on the N/A box if a factor is not applicable to you.

[ ] - It was convenient and easy to use

[ ] - CDC recommended it

[ ] - There were no other options

[ ] - It seemed to have a high level of credibility from a scientific or clinical standpoint

[ ] - It was relevant, appropriate for my purpose

[ ] – Other (click the N/A box if "Other” is not applicable)

115. If you ranked “Other” in the question above, please describe that factor.

_________________________________________________________

116. How did you use Cancer Survivorship - A Policy Landscape Analysis?

[Check all that apply]

( ) – As part of activities to address program goals and objectives

( ) – As a source of information for developing new resources, such as presentations, webinars,

trainings, website content, fact sheets, briefings, etc.

( ) –Not applicable

( ) – Other: ________________________________________________________________

117. Did you share Cancer Survivorship - A Policy Landscape Analysis?

[Check all that apply]

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” is selected, the participant will skip to question 122.]

118. How did you share Cancer Survivorship - A Policy Landscape Analysis?

[Check all that apply]

( ) – As part of information and resource sharing with coalition members and program partners

( ) – Distributed directly to relevant stakeholders and audiences (e.g., cancer survivors, health

care professionals)

( ) – Other: ________________________________________________________________

119. With whom have you shared Cancer Survivorship - A Policy Landscape Analysis?

[Check all that apply]

( ) – Primary care physicians

( ) – Nurses

( ) – Physician assistants

( ) – Oncology nurses

( ) – Patient navigators

( ) – Survivors/caregivers

( ) – Policy- or decision-makers

( ) – Colleague or PD for another CCC Program

( ) – Other: _____________________________________________________________________

120. To your knowledge, have your program partners used Cancer Survivorship - A Policy Landscape Analysis?

( ) – Yes

( ) – No

( ) – Don’t know

[If “No” or “Don’t know” are selected, skip to question 122.]

121. How have your program partners used Cancer Survivorship - A Policy Landscape Analysis?

[Check all that apply]

( ) – Education and outreach with survivors/caregivers

( ) – Education and outreach with health care professionals

( ) – Developing cancer survivorship programs

( ) – Implementing cancer survivorship care guidelines

( ) – Education and outreach with policy- and decision-makers

( ) – As a source of information for developing new resources, such as presentations, webinars, trainings, website content, fact sheets, briefings, etc.

( ) – Other: _____________________________________________________________________

Please indicate your level of agreement with the following statements regarding Cancer Survivorship - A Policy Landscape Analysis:

122. The content and design of this NCSRC resource was relevant and well-suited for the intended audience

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

123. This NCSRC resource was useful for addressing the needs of the intended audiences

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

124. This NCSRC resource contains information that represents the current state of science and is grounded in the best available evidence

( ) – Strongly Agree

( ) – Somewhat Agree

( ) – Neutral

( ) – Somewhat Disagree

( ) – Strongly Disagree

( ) – Don’t Know

[If the participant answers “Strongly Agree” or “Somewhat Agree,” to question 123 they will answer question 125. If the participant selected one of the three other responses, they will skip to question 126.]

125. In general, what made you feel Cancer Survivorship - A Policy Landscape Analysis was scientifically credible and evidence-based?

[Check all that apply]

( ) – They were produced by an organization I trust

( ) – The NCSRC is funded and supported by the CDC

( ) – They were based on the input and guidance of cancer survivorship experts

( ) – The resource is based on a rigorous systematic evidence review process

( ) – The resource contained reference lists for peer-review publications

( ) – The resource was endorsed by a person or organization that I trust

( ) – The resource was endorsed by our CDC Program Consultant

( ) – The resources had a professional, well-designed look

( ) – Other: ___________________________________________________________________

126. Please indicate your level of agreement with the following statements regarding Cancer Survivorship - A Policy Landscape Analysis:

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree	Don’t Know
a. This NCSRC resource was useful for addressing survivorship-related goals and objectives in my program’s action plan
b. This NCSRC resource was useful to our coalition members and partners’ organizations for addressing their survivorship-related needs
c. This NCSRC resource is unique and nothing else like it could have filled our survivorship-related needs

127. Considering all the resources we’ve just discussed which, if any, did you use more than others?

[Check up to 3 resources from the list below:]

( ) – Not applicable

( ) – Life After Treatment – either “The Next Chapter in Your Survivorship Journey” or “Guide for

American Indians and Alaska Natives”

( ) – Cancer Survivorship Care Guidelines Patient Page: for either Breast, Colorectal, or Prostate

Cancer

( ) – A Cancer Survivor's Prescription for Finding Information

( ) – Survivorship Care Guidelines: for either Breast, Colorectal, or Prostate Cancer

( ) – Cancer Survivorship E-Learning Series: Online Learning Modules

( ) – A Collection of Resources for Patient Navigators Assisting Cancer Survivors After Treatment

Guide for Delivering Quality Survivorship Care

( ) – Moving Beyond Patient Satisfaction - Tips to Measure Program Impact

( ) – Cancer Survivorship - A Policy Landscape Analysis

[If not applicable is selected for question 127, skip to question 129.]

128. Why were these resources used so frequently?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

129. How could the NCSRC resources be improved to meet the needs of your CCC program, your program partners, and coalition members?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

130. How could CDC or NCSRC improve dissemination of information/resources to help you address the cancer survivorship needs in your jurisdiction?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

131. What additional or new resources would you like to see for cancer survivors and caregivers, and why?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

132. What additional or new resources would you like to see for health care professionals and patient navigators, and why?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

133. What additional or new resources would you like to see for policymakers and advocates, and why?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CDC estimates the average public reporting burden for this collection of information as 30 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).