Telephone Interview guide

Attachment A – Telephone Interview guide

Form Approved

OMB No. 0920-0879

Expiration Date 01/31/2021

Good morning/afternoon.

I want to start off my thanking you for taking the time to speak with us today about local Shigella prevention and control efforts. I am joined on the line by [NAME] who will be taking notes during our discussion.

Today’s discussion is part of a needs assessment CDC’s Shigella Prevention and Control Program is doing to better understand the specific needs of state and local stakeholders with regards to shigellosis. The goal of this needs assessment is to help us to understand how we could improve our support of local shigellosis prevention and control efforts. We plan to use the results of these discussions to help us prioritize and shape our future prevention and control work so that they are more useful to state and local stakeholders.

We know that Shigella is just one of many pathogens that local stakeholders work on, and we know your time is limited. We really appreciate your participation and honest feedback.

All information collected from these interviews will be housed on a secure drive on the CDC network only accessible to project members and will be shared only in aggregate form. The interview should take no longer than 60 minutes. If you would like to skip a particular question, or would like to stop the interview at any time, please let me know.

Do you agree to participate?

 Yes

 No

Do you have any questions before we begin?

1. [Role] To start off with, can you tell me about your role in the prevention and control of Shigellosis?

   • How long have you been in this role?

2. [General – Control Activities] When there is an outbreak or cluster of shigellosis in your, what are some of the strategies your group uses to control these clusters or outbreaks?

3. [General – Education] What type of outreach efforts with parents or facilities are used control outbreaks or clusters?

Probes:

• What types of materials are used? What types of CDC materials are used?

• Satisfaction with those materials? What would you want more of?

4. [General – HCP] What type of outreach efforts with the clinicians or healthcare providers are used control outbreaks or clusters?

5. [General – Environmental] What types of environmental or facility level efforts are used to control outbreaks or clusters of shigellosis?

6. [General – Regulatory] Are there any types of regulatory efforts used to control outbreaks or clusters of shigellosis?

Probes:

• What influences decision to close a facility? How make that decision? How communicate it?

7. [General – WASH] What types of hygiene or sanitation efforts are used efforts are used to control outbreaks or clusters of shigellosis?

8. [General –Challenges] What are some of the challenges associated with controlling outbreaks or clusters of shigellosis?

9. [General – Recommendations] What do you think could help you overcome some of those challenges?

10. [General – CDI] What role do communicable disease investigator’s play in the control of clusters or outbreaks of shigellosis?

    • What is their role as health educators?

    • Do CDI’s use booklets, guidelines, “quick sheets” or other reference or guidance materials as part of their work? Where do those come from? How satisfied are you with the content? Does it contain information on prevention?

11. [General – CDI Challenges] Are there challenges related to communicable disease investigators responding to clusters or outbreaks of shigellosis?

IF YES: Probes

• Tell me about those challenges

• What do you think could help you overcome those challenges?

• What have you done to overcome these challenges?

12. [General – Other Staff] In addition to CDI’s, what role do other health department staff play in the control of clusters or outbreaks of shigellosis?

    • Epidemiologists?

    • Environmental hygienists?

    • Communication?

Pivot statement – We are going to switch gears to talk bit to talk about your experiences working with CDC and the type of materials or support that could be helpful.

13. [CDC – Experience] Can you describe any experiences you have had working with CDC to control clusters or outbreaks of shigellosis?

IF YES: Probes

• What worked well during those interactions? What did you like about those interactions?

• What did not work well during those interactions? What did you not like about those interactions?

• What would you want more of in terms of interactions with, or the type of support received from, CDC?

• What would you want less of in terms of interactions with, or the type of support received from, CDC?

IF NO: Skip to Question 14

14. [CDC – Resources] Can you describe any experiences you have had using CDC resources, such as fact sheets or web materials, as part of shigellosis control activities?

    • What do you like about those materials?

    • What don’t you like about those materials?

    • How could materials be improved?

15. [CDC – Support] More broadly, what could CDC do to better support local efforts to control outbreaks or clusters of shigellosis? What do you need from us?

Probes:

• What types of resources could CDC develop or provide?

• Training? Web materials? Fact Sheets? Toolkits? Guidelines? Case Studies? Webinars? SME support?

16. [CDC – Support] What would you like CDC support to look like? How would you want us to engage with you?

Probes:

• How would you want us to engage with you? Active or passive?

Children and Childcare

Pivot statement – One population that is disproportionately impacted by shigellosis are children, including those in childcare or school settings. For the next few questions I am going to focus on outbreaks and clusters among children, and those in childcare or school settings.

17. [Childcare – Control Activities] You have talked about the range of activities you do to control outbreaks or clusters of shigellosis. Are additional or different control strategies used to control clusters or outbreaks of shigellosis among children or in school or childcare settings?

    • Different health communication or educational outreach?

    • Different clinician or healthcare provider outreach?

    • Different outreach to schools or facilities?

    • Different environmental or facility level efforts?

    • Other regulatory efforts?

    • Sanitation and hygiene efforts?

18. [Childcare – Control Challenges] In addition to the general challenges controlling outbreaks or clusters of shigellosis, are there unique challenges to controlling these outbreaks among children, or in childcare settings or schools?

Probes:

• Can you talk about any challenges related to exclusion policies? What are those?

• Can you talk about the challenges related to environmental sanitation or hygiene behaviors among parents, caregivers, or staff? What are those?

• Can you talk about any challenges related to closing schools or facilities? What are those?

19. [Childcare – Challenges] What do you think could help you overcome some of those challenges?

20. [Childcare – Support] More broadly, what could CDC do to better support local efforts to control outbreaks or clusters of shigellosis among children? What do you need from us?

Probes:

• What types of resources could CDC develop or provide?

• Training? Web materials? Fact Sheets? Toolkits? Guidelines? Case Studies? Webinars? SME support?

Shigellosis among MSM

Pivot statement – Another group impacted by shigellosis are gay, bisexual, and other men who have sex with men, or MSM. For the next few questions I am going to take a deeper dive into this population

21. [MSM – Investigations] Have you or your health department been involved in any clusters or outbreaks of shigellosis among MSM?

IF NO: Skip to Question 29

22. [MSM – Definition] Is asking about sexual activity part of standard case investigation forms for shigellosis?

Probes

• How measured?

• How is MSM defined on case investigation forms? What about supplemental investigation forms?

23. [MSM – Control Activities] Building off what you spoke about before and activities you do to control outbreaks or clusters of shigellosis. Are additional or different control strategies used for clusters or outbreaks of shigellosis among MSM? What are they?

    • Different health communication or educational outreach?

    • Different education or communication efforts with clinicians or healthcare providers?

    • Different outreach to schools or facilities?

    • Contact tracing?

    • Different environmental or facility level efforts?

    • Sanitation and hygiene efforts?

24. [MSM – Control Challenges] Are there additional or unique challenges to controlling outbreaks and clusters among MSM? What are they?

Probes:

• Challenges with behavior change?

• Challenges with education and outreach?

25. [MSM – Challenges] What do you think could help you overcome some of those challenges?

26. [MSM – CDI Challenges] With regards to communicable disease investing, are there any challenges related to CDI’s investigating or responding to clusters or outbreaks of shigellosis among MSM?

IF YES: Probes

• Tell me about them?

• What do you think could help you overcome those challenges?

27. [MSM – STD Collaboration] Does your group collaborate with STD epidemiologists or investigators when engaging in efforts to control outbreaks or clusters of shigellosis among MSM?

IF YES: Probes

• What does that collaboration look like?

• Are those relationships helpful? Are they continuous?

28. [MSM – Support] More broadly, what could CDC do to better support local efforts to control outbreaks or clusters of shigellosis among MSM? What do you need from us?

Probes:

• What types of resources could CDC develop or provide?

• Training? Web materials? Fact Sheets? Toolkits? Guidelines? Case Studies? Webinars? SME support?

Prevention Strategies

Pivot statement – Up to this point we have been talking about controlling outbreaks and clusters of shigellosis, but what about general proactive prevention of shigellosis.

29. [Prevention – Strategies] Does your health department engage in any proactive prevention efforts focused on shigellosis? This would be proactive prevention beyond cluster or outbreak control efforts?

IF YES: Probes

• What do those efforts look like?

  • What are the proactive prevention efforts do you engage in focused on children/childcare settings or schools?

  • What are the proactive prevention efforts do you engage in focused on MSM?

IF NO: Probes

• Why not? What are some of the things that get in the way of implementing strategies to proactively prevent shigellosis?

30. [Prevention – Recommendations] What do you think proactive prevention of shigellosis should look like? What would proactive prevention entail?

31. [Prevention – CDC Role] What do you think CDC’s role in proactive prevention of shigellosis should look like? How could CDC support proactive prevention activities?

Pivot statement – We are approaching the end of the interview but I have a couple of closing questions for you.

32. [Closing] Based on today’s discussion, would there by other staff in your health department who you would recommend we speak with to better understand local shigellosis prevention and control efforts?

33. [Closing] Finally, is there anything that you want to add that we did not ask about today or do you have any remaining questions?

    • If not, we want to thank you again for taking the time to speak with us.

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).