OMB No. 0990-0281
Exp. Date 3/31/2019
Health Professional Survey
Draft March 6, 2019
Section I: Screening
What is your medical specialty?
What percent of your patient population is adult women?
Less than 40% [TERMINATE]
40% or more [CONTINUE]
Section II. Knowledge, Self-efficacy, and Barriers
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 |
|
|
|
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Ovarian cysts |
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|
|
|
Pelvic inflammatory disease (PID) |
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|
Polycystic ovary syndrome (PCOS) |
|
|
|
|
Premenstrual syndrome (PMS) |
|
|
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|
Prenatal care |
|
|
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Urinary tract infection (UTI) |
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|
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Uterine fibroids |
|
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|
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 |
|
|
|
|
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]
Lack of or unclear guidelines
Lack of adequate training on the topic/condition
Lack of credible provider resources or tools
Lack of experience treating the topic/condition (i.e., do not regularly see patients who present with given topic/condition)
Discrepancies in screening, diagnostic, or treatment recommendations between men and women
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 |
|
|
|
|
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]
Lack of or unclear guidelines
Lack of adequate training on the topic/condition
Lack of credible provider resources or tools
Lack of experience treating the topic/condition (i.e., do not regularly see patients who present with given topic/condition)
Discrepancies in screening, diagnostic, or treatment recommendations between men and women
Other __________
When caring for women, which of the following are challenges you have experienced? Please select all that apply. [RANDOMIZE]
Difficulty identifying risk factors
Unique sociodemographic considerations
Barriers related to interpersonal/environmental factors (e.g., competing family priorities, job issues, etc.)
Treatment adherence challenges
Challenges communicating with patients
Uncertainty of follow up or referral after identification of high risk or positive screening
Other ___________
I do not experience challenges caring for women
Section III. Communication With Patients
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. |
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I make the patient feel that she can talk with me about confidential, personal issues. |
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I reach agreement with the patient about the treatment plan to be implemented. |
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I advise and support the patient in making decisions about treatment. |
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I explain topics and options so the patient feels well-informed. |
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I am aware of when my own feelings affect my communication with the patient. |
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I avoid letting myself be influenced by preconceptions, biases, and stigma about the patient. |
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I separate my personal views from my clinical approach. |
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I talk to my patient about sensitive topics (e.g., intimate partner violence [IPV]). |
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I make eye contact with my patient and engage in active listening. |
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I talk with my patient about personal problems, family, and stressors. |
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I talk to and explain medications, therapies, and treatments options. |
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I talk to my patient about what may make it difficult to take care of their health. |
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I engage my patient through motivational interviewing. |
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I share patient education resources and materials with my patient (e.g., print, online). |
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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. |
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I ask if there is anything else to discuss at the end of a visit. |
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About which of the following health topics do patients initiate conversations most often (during wellness visits or otherwise)? Please rank your top three. [RANDOMIZE]
Mental health
Intimate partner violence (IPV)
Healthy lifestyle (e.g., exercise, diet/nutrition, sleep, stress)
Chronic pain and use of painkillers
Reproductive health
Change in health history
Chronic diseases
High risk behaviors (e.g., substance use, sexual activity)
Other ________________________
About which of the following health topics do you initiate conversations most often, during wellness visits in particular? Please rank your top three. [RANDOMIZE]
Mental health
Intimate partner violence (IPV)
Healthy lifestyle (e.g., exercise, diet/nutrition, sleep, stress)
Chronic pain and use of painkillers
Reproductive health
Change in health history
Chronic diseases
High risk behaviors (e.g., substance use, sexual activity)
Other ________________________
Section IV. Needs for Resources/Training/Tools and Preferred Communications Channels
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
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]
American Academy of Family Physicians (AAFP)
American Medical Association (AMA)
American College of Physicians (ACP)
American College of Obstetricians and Gynecologists (ACOG)
American Board of Internal Medicine (ABIM)
American Nurses Association (ANA)
American Association of Nurse Practitioners (AANP)
National Medical Association (NMA)
U.S. Department of Health and Human Services Office on Women’s Health (HHS OWH) [IF SELECTED, ASK 13A]
National Institutes of Health (NIH)
U.S. Food and Drug Administration (FDA) Office of Women’s Health
Centers for Disease Control and Prevention (CDC)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Health Resources and Services Administration (HRSA)
UpToDate
Medscape
Other ________________________
None of the above
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]
American Academy of Family Physicians (AAFP)
American Medical Association (AMA)
American College of Physicians (ACP)
American College of Obstetricians and Gynecologists (ACOG)
American Board of Internal Medicine (ABIM)
American Nurses Association (ANA)
American Association of Nurse Practitioners (AANP)
National Medical Association (NMA)
U.S. Department of Health and Human Services Office on Women’s Health (HHS OWH) [IF SELECTED, ASK 13A]
National Institutes of Health (NIH)
U.S. Food and Drug Administration (FDA) Office of Women’s Health
Centers for Disease Control and Prevention (CDC)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Health Resources and Services Administration (HRSA)
WebMD/Medscape
Other ________________________
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]
Fact Sheets
Your Guide to Breastfeeding
The Health Professional Listserv/Digest
Womenshealth.gov
OWH Facebook
OWH Twitter
OWH YouTube
OWH Pinterest
Other __________________________
Which of the following social media platforms do you use regularly for professional/clinical purposes? Please select all that apply. [RANDOMIZE]
Doximity
SERMO
Other ________________
None [SKIP TO Q18]
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]
Doximity
SERMO
Other ________________
What groups, if any, are you a part of on these platforms?
____________________________________________________________________
How are you most using these platforms? Please select all that apply. [RANDOMIZE]
To get updates on research or guidelines
To follow experts in your field
To engage with professional, medical, or scientific organizations
To connect with other health care providers
To share information or resources with your network
To ask questions of/gather input from other health care providers
Other _______________________
Which of the following resources would be beneficial to you in your practice? Please select all that apply. [RANDOMIZE]
Clinical practice guidelines
Decision-making tools
Peer-reviewed articles
Patient communication guides
Fact sheets
Materials for patients
Other ________________________
In what formats do you prefer to receive health-related information intended for clinicians? Please select all that apply. [RANDOMIZE]
Website
Hard-copy material
E-publication
Video
Social networks
Other ________________________
In what formats do your patients prefer to receive health-related information? Please select all that apply. [RANDOMIZE]
Website
Hardcopy material
E-publication
Video
Social networks
Other ________________________
How often do you attend professional conferences or events?
More than 10 times a year
Six to 10 times a year
Two to five times a year
Once a year or less
Never
What are the three conferences or events you have attended most regularly and that you find most helpful?
_______________________________
_______________________________
_______________________________
What do you find most helpful about these conferences or events? Please select all that apply. [RANDOMIZE]
Learning about the latest findings and advances in screening, diagnosis, or treatment
Learning about health care innovation
Networking with peers and colleagues
Access to new resources and tools for your practice
Other ____________________________________
Please rank the top three factors that inform your decision to participate in a continuing education activity. [RANDOMIZE]
Date and time of offering
Format of activity
Level of interactivity of the activity
Presenters
Topic
Types of continuing education credits received
Other ____________________________________
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
What best describes your practice setting?
Academic teaching hospital
Community hospital/clinic
Private practice
Public health facility
Other
What percentage of your patient population is uninsured?
Less than 25%
25% to 49%
50% to 74%
75% to 100%
What percentage of your patient population is insured through Medicaid (including Medicaid managed care plans)?
Less than 25%
25% to 49%
50% to 74%
75% to 100%
Which of the following best describes your practice location?
Rural
Suburban
Urban
How many years have you been in practice?
<1 year
1–5 years
6–10 years
>10 years
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
What is your race? (Select one or more)
White
Black or African-American
American Indian or Alaska Native
Asian
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).
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