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0990-Appendix B - NCS Evaluation EQ Crosswalk.docx

National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care: Evaluation of Awareness, Adoption, and Implementation

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OMB: 0990-0429

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Appendix B

National CLAS Standards Health & Health Care Organization Evaluation

Evaluation Question/Instrumentation Crosswalk


The following crosswalk aligns evaluation questions to project instrumentation (Stakeholder interview guides and HHCO survey). It is intended to identify the extent to which questions are similar across instrumentation for ensuring evaluation questions are completed attended and for analysis purposes.


Evaluation Question


NCS Stakeholder Interview

CLAS Stakeholder Interview

HCO Stakeholder Interviewer

HCO/Public Health Dept. Survey

Analyses

Awareness and Knowledge of the National CLAS Standards

1. What is the level of awareness of the National CLAS Standards among health and health care organization (HCO) governance, leadership, and staff?

(Q9) With which version of the National CLAS Standards, the original (2001) or enhanced (2013), are you most knowledgeable?



(Q9) When did you first hear the term “culturally and linguistically appropriate services” or “CLAS”?


(Q10) How have you learned about CLAS?


(Q18) What do you think has been helpful in increasing awareness of the National CLAS Standards among leadership and staff in health and health care organizations?


(Q19) What do you think have been the main challenges in increasing awareness of the National CLAS Standards among leadership and staff?






(Q12) How familiar are you with the term, “culturally and linguistically appropriate services” or “CLAS”?


(Q13) When did you first hear the term “culturally and linguistically appropriate services” or “CLAS”?


(Q14) How have you learned more about CLAS?


(Q22) What has been helpful in increasing awareness of (CLAS)/the National CLAS Standards among your organization’s governance, leadership, management, and staff?


(Q23) What have been the main challenges in increasing awareness of (CLAS)/the National CLAS Standards among your organization’s governance, leadership, management, and staff?

(Q15) Have you ever heard of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards)?

(Q16) In approximately what year did you first hear about the National CLAS Standards?




Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


2. How did health and health care organization, governance, leadership, and staff become aware of the National CLAS Standards?

(Q10) How do you think leadership and staff in health and health care organizations become aware that the National CLAS Standards exist?


(Q13) What do you think has been helpful in increasing awareness of the National CLAS Standards among leadership and staff in health and health care organizations?


(Q13) How did you first become aware that the National CLAS Standards existed?


(Q14) When did you first become aware that the National CLAS Standards existed?


(Q15) How do you think leadership and staff in health and health care organizations become aware that the National CLAS Standards exist?


(Q18) What do you think has been helpful in increasing awareness of the National CLAS Standards among leadership and staff in health and health care organizations?


(Q19) What do you think have been the main challenges in increasing awareness of the National CLAS Standards among leadership and staff?

(Q14) How have you learned more about CLAS?


(Q16) How did you first learn that the National CLAS Standards existed?


(Q17) When did you first become aware that the National CLAS Standards existed?


(Q18) How do you think leadership and staff in your organization became aware that (CLAS)/the National CLAS Standards exist?


(Q22) What has been helpful in increasing awareness of (CLAS)/the National CLAS Standards among your organization’s governance, leadership, management, and staff?

(Q17) How did you first learn that the National CLAS Standards existed?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis



3. What knowledge do health and health care organization governance, leadership, and staff possess about the National CLAS Standards?

(Q11) Given your knowledge and experience, how would you describe the National CLAS Standards to leadership and staff in health and health care organizations?


(Q12) What are the National CLAS Standards’ purpose or purposes?


(Q14) What do you think have been the main challenges in increasing awareness of the National CLAS Standards among leadership and staff?


(Q13) What do you think has been helpful in increasing awareness of the National CLAS Standards among leadership and staff in health and health care organizations?


(Q12) With which version of the National CLAS Standards, the original (2001) or enhanced (2013), are you most knowledgeable?


(Q16) Given your knowledge and experience, how would you describe the National CLAS Standards to leadership and staff in health and health care organizations?


(Q17) What are the National CLAS Standards’ purpose or purposes?


(Q14) What do you think has been helpful in increasing public awareness of the National CLAS Standards?

(Q12) How familiar are you with the term, “culturally and linguistically appropriate services” or “CLAS”?


(Q15)With which version of the National CLAS Standards, the original (2001) or enhanced (2013), are you most knowledgeable?


(Q16) How did you first learn that the National CLAS Standards existed?


(Q19) What is the perception of (CLAS)/the National CLAS Standards within your organization?


(Q20) How would you describe (CLAS)/the National CLAS Standards to colleagues or others in your organization?


(Q21) (What is the purpose or purposes of CLAS?)/What are the National CLAS Standards’ purpose or purposes?


(Q22) What has been helpful in increasing awareness of (CLAS)/the National CLAS Standards among your organization’s governance, leadership, management, and staff?


(Q23) What have been the main challenges in increasing awareness of (CLAS)/the National CLAS Standards among your organization’s governance, leadership, management, and staff?

(Q18) Using the scale below, how knowledgeable of the National CLAS Standards are you?

(Q19) With which of the following aspects of the National CLAS Standards are you knowledgeable?


Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


4. From where do health and health care organization governance, leadership, and staff acquire knowledge about the National CLAS Standards?

(Q15) What resources would you suggest to leadership and staff who want to learn more about the National CLAS Standards?



(Q10) How have you learned about CLAS?


(Q11) What resources would you suggest to leadership and staff in health and health care organizations who want to learn more about CLAS?


(Q20) What resources would you suggest to leadership and staff who want to learn more about the National CLAS Standards?

(Q24) What resources do you suggest to others in your organization who want to learn more about (CLAS)/the National CLAS Standards?


(Q20) How did you gain knowledge about the National CLAS Standards?

(Q21) Does your organization/agency provide opportunities to learn about the National CLAS Standards?

(Q22) Of the opportunities your organization/agency may offer to learn more about the National CLAS Standards, which have you participated in?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


Adoption of the National CLAS Standards

5. How was the decision made to adopt the National CLAS Standards in a health or health care organization?



(Q25) Which version of the National CLAS Standards is your organization currently adopting, the original (2001) or enhanced (2013)?

(Q26)First, how was the decision made to adopt (CLAS)/the National CLAS Standards in your organization?

(Q16) What were the difficulties or challenges in your organization deciding to adopt the National CLAS Standards?

(Q27) To your knowledge, what were the major factors that contributed to the final decision to adopt (CLAS)/the National CLAS Standards?

(Q28)To your knowledge, what, if anything, could have made the decision to adopt (CLAS)/the National CLAS Standards easier?

(Q29) What were the difficulties or challenges in your organization deciding to adopt (CLAS)/the National CLAS Standards?

(Q24) Were you involved in your organization’s/agency’s decision to adopt the National CLAS Standards?

(Q25) How were you involved in your organization’s/agency’s decision to adopt the National CLAS Standards?



Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


6. How was the decision to adopt the National CLAS Standards communicated within a health or health care organization?



(Q30) Once the decision to adopt (CLAS)/the National CLAS Standards in your organization was made, how was that decision communicated throughout the organization?



(Q23) To your knowledge, has your organization/agency officially adopted (i.e., formally decided to use) the National CLAS Standards?


(Q26) How did you learn of your organization’s/agency’s decision to adopt the National CLAS Standards?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis

7. What are the anticipated outcomes related to the adoption of the National CLAS Standards?

(Q15) Based on your knowledge and experience, what do you think organizations gain by adopting and implementing the National CLAS Standards?


(Q16) What do you think are the costs to organizations adopting and implementing the Standards?



(Q27) What changes have you observed based on your organization’s/agency’s decision to adopt the National CLAS Standards?


Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis

Implementation of the National CLAS Standards

8. What are the anticipated outcomes related to the implementation of the National CLAS Standards?

(Q22) What outcomes do you think could be achieved after several years (e.g., 5+ years) of a health or healthcare organization implementing the enhanced National CLAS Standards?

(Q22) Based on your knowledge and experience, what do you think health and health care organizations gain by implementing the enhanced National CLAS Standards?

(Q27) What outcomes do you think could be achieved after several years (e.g., 5+ years) of a health and healthcare organization implementing the enhanced National CLAS Standards?


(Q37)What are the costs to your organization in implementing (CLAS)/the National CLAS Standards?

(Q45) What changes were expected in your organization as a result of implementing (CLAS)/the National CLAS Standards?


(Q46) What changes in your organization have actually been achieved as a result of implementing (CLAS)/the National CLAS Standards?


(Q48) What outcomes do you think could be achieved in your organization after several years (e.g., 5+ years) of implementing (CLAS)/the National CLAS Standards?

(Q31a) Based on your organization’s/agency’s implementation of the National CLAS Standards, what changes have you observed?

(Q31b) Based on your organization’s/agency’s implementation of the National CLAS Standards, what additional changes do you expect to see if your organization/agency continues to implement?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


9. How are the National CLAS Standards implemented in a health or health care organization?

(Q16) What do you think organizational implementation of the enhanced National CLAS Standards should look like?

(Q21) What do you think organizational implementation of the enhanced National CLAS Standards should look like?

(Q31)To what extent was your organization already implementing culturally and linguistically appropriate services before deciding to adopt and implement (CLAS) /the National CLAS Standards?


(Q32) Once the decision to adopt (CLAS)/the National CLAS Standards in your organization was made, how was the decision made to implement or start using them?


(Q33) How was the decision to implement (CLAS)/the National CLAS Standards communicated throughout the organization?


(Q34) What steps or actions have your organization taken to actually implement (CLAS)/the National CLAS Standards?

(Q35)Who in your organization is involved in the implementation of (CLAS)/the National CLAS Standards?

(Q36) Please tell me about the resources available in and to your organization that support implementation of (CLAS)/the National CLAS Standards?

(Q9) Which of the following have you observed happening in your organization/agency?


(Q10) Overall, how successful do you think your organization/agency has been in implementing the activities in question #9?


(Q11) Which of the following have you observed happening in your organization/agency?


(Q12) Overall, how successful do you think your organization/agency has been in implementing the activities in question #11?












(Q13) Which of the following have you observed happening in your organization/agency?


(Q14) Overall, how successful do you think your organization/agency has been in implementing the activities in question #13?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis

10. What factors facilitate implementation of the National CLAS Standards in a health or health care organization?

(Q18) What are some factors that could make (or drive) a health and health care organization to decide to implement the enhanced National CLAS Standards?


(Q19) What is helpful to health and healthcare organizations in implementing the enhanced National CLAS Standards?



(Q23) What are some factors that could make (or drive) a health and health care organization to decide to implement the enhanced National CLAS Standards?


(Q24) What is helpful to health and healthcare organizations in implementing the enhanced National CLAS Standards?


(Q36) Please tell me about the resources available in and to your organization that support implementation of (CLAS)/the National CLAS Standards?

(Q38) What factors made implementation of (CLAS)/the National CLAS Standards in your organization easier?

(Q42) How is implementation of (CLAS)/the National CLAS Standards evaluated in your organization?

(Q29) Using the following scale for each item, please rate how helpful each of the following has been to your organization/agency in implementing the National CLAS Standards?



Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


11. What factors hinder implementation of the National CLAS Standards in a health or health care organization?

(Q20) What are barriers to health and health care organizations in implementing the enhanced National CLAS Standards?


(Q25) What are barriers to health and health care organizations in implementing the enhanced National CLAS Standards?


(Q39) What barriers or challenges has your organization faced in implementing (CLAS)/the National CLAS Standards?

(Q40) How have the barriers or challenges to implementation been handled in your organization?


(Q30) Using the following scale for each item, please rate how difficult each of the following has made implementing the National CLAS Standards in your organization/agency?

Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


12. What has been the perceived short and long-term impact of the National CLAS Standards’ implementation?

(Q17) Based on your knowledge and experience, what do you think health and health care organizations gain by implementing the enhanced National CLAS Standards?


(Q22) Based on your knowledge and experience, what do you think health and health care organizations gain by implementing the enhanced National CLAS Standards?


(Q41) How is implementation of (CLAS)/the National CLAS Standards monitored in your organization?


(Q42) How is implementation of (CLAS)/the National CLAS Standards evaluated in your organization?


(Q43) What have been the lessons learned as your organization has implemented (CLAS)/the National CLAS Standards?


(Q44) Looking ahead, what changes in implementing (CLAS)/the National CLAS Standards do you think your organization will make?


(Q48) What outcomes do you think could be achieved in your organization after several years (e.g., 5+ years) of implementing (CLAS)/the National CLAS Standards?


Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis


13. What is the perceived and actual return on investment (ROI) for implementing the National CLAS Standards?

(Q21) What do you think are the costs to health and health care organizations implementing the enhanced National CLAS Standards?




(Q26) What do you think are the costs to health and health care organizations implementing the enhanced National CLAS Standards?


(Q37)What are the costs to your organization in implementing (CLAS)/the National CLAS Standards?

(Q47) Given the costs that you mentioned earlier, what do you think is your organization’s return on investment of implementing (CLAS)/the National CLAS Standards?


(Q48) What outcomes do you think could be achieved in your organization after several years (e.g., 5+ years) of implementing (CLAS)/the National CLAS Standards?


Data reduction and consolidation – categorize and connect qualitative and quantitative data


Data comparison – descriptive and cross-case analysis


Data display – generate theoretical maps and visual displays of analysis



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Created February 13, 2015 2

Modified January 25, 2021

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