Form 1 OWH Health Professional Womens Health Survey Instrument

Prevention Communication Formative Research

OWH Health Professional Womens Health Survey Instrument 2-19-19_OMB_updated

OWH Health Professional Women's Health Survey

OMB: 0990-0281

Document [docx]
Download: docx | pdf

OMB No. 0990-0281

Exp. Date 3/31/2019

Health Professional Survey

Draft March 6, 2019


Section I: Screening


  1. What is your medical specialty?

    1. Obstetrics/gynecology [CONTINUE, skip to Section III]

    2. Family medicine [CONTINUE]

    3. Internal medicine [CONTINUE]

    4. Pediatrics [TERMINATE]

    5. Other [TERMINATE]


  1. What percent of your patient population is adult women?

    1. Less than 40% [TERMINATE]

    2. 40% or more [CONTINUE]


Section II. Knowledge, Self-efficacy, and Barriers


  1. How would you describe your level of knowledge about screening, diagnosis, and treatment for the following health topics or conditions in women? [RANDOMIZE WITHIN EACH GROUP]


Chronic health

Excellent

Good

Fair

Poor

Breast cancer





Chronic fatigue syndrome





Heart disease





Ovarian cancer





Overweight/Obesity





Stroke





Thyroid disease






Reproductive health

Excellent

Good

Fair

Poor

Breastfeeding





Contraception





Endometriosis





Infertility





Menopause





Ovarian cysts





Pelvic inflammatory disease (PID)





Polycystic ovary syndrome (PCOS)





Premenstrual syndrome (PMS)





Prenatal care





Urinary tract infection (UTI)





Uterine fibroids





Uterine fibroids





Vaginal yeast infections






Mental health

Excellent

Good

Fair

Poor

Depression during and after pregnancy





Eating disorders





Mental health disorders





Substance use disorders





Suicide






Sexual health

Excellent

Good

Fair

Poor

Female genital mutilation (FGM)





HIV and AIDS





Human papillomavirus (HPV)





Sexually transmitted diseases/infections





Trichomoniasis






Relationships and safety

Excellent

Good

Fair

Poor

Human trafficking





Intimate partner violence (IPV)/sexual assault






  1. You selected X [TOTAL # OF TOPICS FOR WHICH RESPONDENT SELECTED FAIR OR POOR] topics for which you feel your knowledge of screening, diagnosis, or treatment in women is fair or poor. For these health topics, which of the following contributes to knowledge gaps? Please select all that apply. [RANDOMIZE]

    1. Lack of or unclear guidelines

    2. Lack of adequate training on the topic/condition

    3. Lack of credible provider resources or tools

    4. Lack of experience treating the topic/condition (i.e., do not regularly see patients who present with given topic/condition)

    5. Discrepancies in screening, diagnostic, or treatment recommendations between men and women

    6. Other __________


  1. How would you describe your level of confidence in screening, diagnosing, or treating women related to the following health topics? [RANDOMIZE WITHIN EACH GROUP]


Chronic health

Excellent

Good

Fair

Poor

Breast cancer





Chronic fatigue syndrome





Heart disease





Ovarian cancer





Overweight/Obesity





Stroke





Thyroid disease






Reproductive health

Excellent

Good

Fair

Poor

Breastfeeding





Contraception





Endometriosis





Infertility





Menopause





Ovarian cysts





Pelvic inflammatory disease (PID)





Polycystic ovary syndrome (PCOS)





Premenstrual syndrome (PMS)





Prenatal care





Urinary tract infection (UTI)





Uterine fibroids





Uterine fibroids





Vaginal yeast infections






Mental health

Excellent

Good

Fair

Poor

Depression during and after pregnancy





Eating disorders





Mental health disorders





Substance use disorders





Suicide






Sexual health

Excellent

Good

Fair

Poor

Female genital mutilation (FGM)





HIV and AIDS





Human papillomavirus (HPV)





Sexually transmitted diseases/infections





Trichomoniasis






Relationships and safety

Excellent

Good

Fair

Poor

Human trafficking





Intimate partner violence (IPV)/sexual assault






  1. You selected X [TOTAL # OF TOPICS FOR WHICH RESPONDENT SELECTED SLIGHTLY CONFIDENT OR NOT AT ALL CONFIDENT] topics for which you feel not at all or slightly confident in screening, diagnosing, or treating women. For these health topics, which of the following contributes to gaps in confidence? Please select all that apply. [RANDOMIZE]

    1. Lack of or unclear guidelines

    2. Lack of adequate training on the topic/condition

    3. Lack of credible provider resources or tools

    4. Lack of experience treating the topic/condition (i.e., do not regularly see patients who present with given topic/condition)

    5. Discrepancies in screening, diagnostic, or treatment recommendations between men and women

    6. Other __________


  1. When caring for women, which of the following are challenges you have experienced? Please select all that apply. [RANDOMIZE]

    1. Difficulty identifying risk factors

    2. Unique sociodemographic considerations

    3. Barriers related to interpersonal/environmental factors (e.g., competing family priorities, job issues, etc.)

    4. Treatment adherence challenges

    5. Challenges communicating with patients

    6. Uncertainty of follow up or referral after identification of high risk or positive screening

    7. Other ___________

    8. I do not experience challenges caring for women


Section III. Communication With Patients


  1. To what extent do you agree with each of the following statements about communicating with women? [RANDOMIZE]



Completely disagree

Somewhat disagree

Somewhat agree

Completely agree

I identify issues that my patient wishes to address during conversations.





I make the patient feel that she can talk with me about confidential, personal issues.





I reach agreement with the patient about the treatment plan to be implemented.





I advise and support the patient in making decisions about treatment.





I explain topics and options so the patient feels well-informed.





I am aware of when my own feelings affect my communication with the patient.





I avoid letting myself be influenced by preconceptions, biases, and stigma about the patient.





I separate my personal views from my clinical approach.





I talk to my patient about sensitive topics (e.g., intimate partner violence [IPV]).





I make eye contact with my patient and engage in active listening.





I talk with my patient about personal problems, family, and stressors.





I talk to and explain medications, therapies, and treatments options.





I talk to my patient about what may make it difficult to take care of their health.





I engage my patient through motivational interviewing.





I share patient education resources and materials with my patient (e.g., print, online).





When making a referral to another provider, I provide a warm hand off and not just a name and number for the patient to follow up on without my support.





I ask if there is anything else to discuss at the end of a visit.






  1. About which of the following health topics do patients initiate conversations most often (during wellness visits or otherwise)? Please rank your top three. [RANDOMIZE]

  1. Mental health

  2. Intimate partner violence (IPV)

  3. Healthy lifestyle (e.g., exercise, diet/nutrition, sleep, stress)

  4. Chronic pain and use of painkillers

  5. Reproductive health

  6. Change in health history

  7. Chronic diseases

  8. High risk behaviors (e.g., substance use, sexual activity)

  9. Other ________________________


  1. About which of the following health topics do you initiate conversations most often, during wellness visits in particular? Please rank your top three. [RANDOMIZE]

  1. Mental health

  2. Intimate partner violence (IPV)

  3. Healthy lifestyle (e.g., exercise, diet/nutrition, sleep, stress)

  4. Chronic pain and use of painkillers

  5. Reproductive health

  6. Change in health history

  7. Chronic diseases

  8. High risk behaviors (e.g., substance use, sexual activity)

  9. Other ________________________


Section IV. Needs for Resources/Training/Tools and Preferred Communications Channels


  1. Please rank the sources you would look to for women’s health-related clinician education, training, and clinical tools. Start with number 1 for the source you would go to first, and so on. If there is a source you would not utilize, please indicate that as well. [RANDOMIZE]

Rank Order Would Not Utilize

    1. Medline/PubMed search ____ ____

    2. Government websites ____ ____

    3. Professional organization websites ____ ____

    4. Other internet sites ____ ____

    5. Journal articles ____ ____

    6. Medical conferences ____ ____

    7. Colleagues ____ ____

    8. Other ____________________ ____ ____


  1. Which, if any, of the following organizations and services do you use to find women’s health–related clinician education, training, and clinical tools? Please select all that apply. [RANDOMIZE]

  1. American Academy of Family Physicians (AAFP)

  2. American Medical Association (AMA)

  3. American College of Physicians (ACP)

  4. American College of Obstetricians and Gynecologists (ACOG)

  5. American Board of Internal Medicine (ABIM)

  6. American Nurses Association (ANA)

  7. American Association of Nurse Practitioners (AANP)

  8. National Medical Association (NMA)

  9. U.S. Department of Health and Human Services Office on Women’s Health (HHS OWH) [IF SELECTED, ASK 13A]

  10. National Institutes of Health (NIH)

  11. U.S. Food and Drug Administration (FDA) Office of Women’s Health

  12. Centers for Disease Control and Prevention (CDC)

  13. Substance Abuse and Mental Health Services Administration (SAMHSA)

  14. Health Resources and Services Administration (HRSA)

  15. UpToDate

  16. Medscape

  17. Other ________________________

  18. None of the above


  1. Which, if any, of the following sources do you use to find patient education resources for women’s health–related information? Please select all that apply. [RANDOMIZE]

    1. American Academy of Family Physicians (AAFP)

    2. American Medical Association (AMA)

    3. American College of Physicians (ACP)

    4. American College of Obstetricians and Gynecologists (ACOG)

    5. American Board of Internal Medicine (ABIM)

    6. American Nurses Association (ANA)

    7. American Association of Nurse Practitioners (AANP)

    8. National Medical Association (NMA)

    9. U.S. Department of Health and Human Services Office on Women’s Health (HHS OWH) [IF SELECTED, ASK 13A]

    10. National Institutes of Health (NIH)

    11. U.S. Food and Drug Administration (FDA) Office of Women’s Health

    12. Centers for Disease Control and Prevention (CDC)

    13. Substance Abuse and Mental Health Services Administration (SAMHSA)

    14. Health Resources and Services Administration (HRSA)

    15. WebMD/Medscape

    16. Other ________________________

    17. None of the above


13A. You indicated that you use HHS OWH to find women’s health–related information. What HHS OWH resources have you used? Please select all that apply. [RANDOMIZE]

  1. Fact Sheets

  2. Your Guide to Breastfeeding

  3. The Health Professional Listserv/Digest

  4. Womenshealth.gov

  5. OWH Facebook

  6. OWH Twitter

  7. OWH YouTube

  8. OWH Pinterest

  9. Other __________________________


  1. Which of the following social media platforms do you use regularly for professional/clinical purposes? Please select all that apply. [RANDOMIZE]

    1. LinkedIn

    2. Doximity

    3. SERMO

    4. Other ________________

    5. None [SKIP TO Q18]


  1. Do you have a preferred social media platform that you use regularly for professional/clinical purposes? Please select the one you use most often. [RANDOMIZE]

    1. LinkedIn

    2. Doximity

    3. SERMO

    4. Other ________________


  1. What groups, if any, are you a part of on these platforms?

____________________________________________________________________


  1. How are you most using these platforms? Please select all that apply. [RANDOMIZE]

    1. To get updates on research or guidelines

    2. To follow experts in your field

    3. To engage with professional, medical, or scientific organizations

    4. To connect with other health care providers

    5. To share information or resources with your network

    6. To ask questions of/gather input from other health care providers

    7. Other _______________________


  1. Which of the following resources would be beneficial to you in your practice? Please select all that apply. [RANDOMIZE]

  1. Clinical practice guidelines

  2. Decision-making tools

  3. Peer-reviewed articles

  4. Patient communication guides

  5. Fact sheets

  6. Materials for patients

  7. Other ________________________


  1. In what formats do you prefer to receive health-related information intended for clinicians? Please select all that apply. [RANDOMIZE]

  1. Website

  2. Email

  3. Hard-copy material

  4. PDF

  5. E-publication

  6. Video

  7. Social networks

  8. Other ________________________


  1. In what formats do your patients prefer to receive health-related information? Please select all that apply. [RANDOMIZE]

  1. Website

  2. Email

  3. Hardcopy material

  4. PDF

  5. E-publication

  6. Video

  7. Social networks

  8. Other ________________________


  1. How often do you attend professional conferences or events?

    1. More than 10 times a year

    2. Six to 10 times a year

    3. Two to five times a year

    4. Once a year or less

    5. Never


  1. What are the three conferences or events you have attended most regularly and that you find most helpful?

    1. _______________________________

    2. _______________________________

    3. _______________________________


  1. What do you find most helpful about these conferences or events? Please select all that apply. [RANDOMIZE]

    1. Learning about the latest findings and advances in screening, diagnosis, or treatment

    2. Learning about health care innovation

    3. Networking with peers and colleagues

    4. Access to new resources and tools for your practice

    5. Other ____________________________________


  1. Please rank the top three factors that inform your decision to participate in a continuing education activity. [RANDOMIZE]

    1. Date and time of offering

    2. Format of activity

    3. Level of interactivity of the activity

    4. Presenters

    5. Topic

    6. Types of continuing education credits received

    7. Other ____________________________________


  1. What topics are you most interested in for CME opportunities? Select up to three. [RANDOMIZE]


Breast cancer

Breastfeeding

Chronic fatigue syndrome

Contraception

Depression during and after pregnancy

Eating disorders

Endometriosis

Female genital mutilation (FGM)

Heart disease

HIV and AIDS

Human papillomavirus (HPV)

Human trafficking

Infertility

Intimate partner violence (IPV)/sexual assault

Menopause

Mental health

Mental health disorders

Ovarian cancer

Ovarian cysts

Overweight/Obesity

Pelvic inflammatory disease (PID)

Polycystic ovary syndrome (PCOS)

Premenstrual syndrome (PMS)

Prenatal care

Sexual health

Sexually transmitted diseases/infections

Stroke

Substance use disorders

Suicide

Thyroid disease

Trichomoniasis

Urinary tract infection (UTI)

Uterine fibroids

Uterine fibroids

Vaginal yeast infections


Section VI: Demographics


  1. What best describes your practice setting?

    1. Academic teaching hospital

    2. Community hospital/clinic

    3. Private practice

    4. Public health facility

    5. Other


  1. What percentage of your patient population is uninsured?

    1. Less than 25%

    2. 25% to 49%

    3. 50% to 74%

    4. 75% to 100%


  1. What percentage of your patient population is insured through Medicaid (including Medicaid managed care plans)?

    1. Less than 25%

    2. 25% to 49%

    3. 50% to 74%

    4. 75% to 100%


  1. Which of the following best describes your practice location?

    1. Rural

    2. Suburban

    3. Urban


  1. How many years have you been in practice?

    1. <1 year

    2. 1–5 years

    3. 6–10 years

    4. >10 years


  1. What is your ethnicity?

    1. Hispanic or Latino

    2. Not Hispanic or Latino


  1. What is your race? (Select one or more)

    1. White

    2. Black or African-American

    3. American Indian or Alaska Native

    4. Asian

    5. Native Hawaiian or Other Pacific Islander



Public reporting burden of this collection of information is estimated to average twenty minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Office of the Chief Information Officer, Department of Health and Human Services, Sherrette Funn, [email protected] or (202) 795-7714; ATTN: PRA (0990-0281).

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy