Form 0920-18ATK Questionnaire

Form Approved

OMB Control No.: 0920-xxxx

Expiration Date: xx/xx/xxxx

Understanding Collaboration: Questionnaire

Instructions: Please enter a score ranging from 1 (not at all, or strongly disagree) to 7 (to a great extent, or strongly agree) for each item.

Statement	Response (1-7)
Partner organization takes your organization’s opinions seriously when decisions are made about the collaboration.
Your organization brainstorms with partner organizations to develop solutions to mission-related problems facing the collaboration.
You, as a representative of your organization in the collaboration, understand your organization’s roles and responsibilities as a member of the collaboration.
Partner organization meetings accomplish what is necessary for the collaboration to function well.
Partner organizations (including your organization) agree about the goals of your collaboration.
Your organization’s tasks in the collaboration are well coordinated with those of partner organizations.
The collaboration hinders your organization from meeting its own organizational mission.
Your organization’s independence is affected by having to work with partner organizations on activities related to the collaboration.
You, as a representative of your organization, feel pulled between trying to meet both your organization’s and the collaborations expectations.
Partner organizations (including your organization) have combined and used each other’s resources so all partners benefit from collaborating.
Your organization shares information with partner organizations that will strengthen their operations and programs.
You feel what your organization brings to the collaboration is appreciated and respected by partner organizations.
Your organization achieves its own goals better working with partner organizations than working alone.
Partner organizations (including your organization) work through differences to arrive at win-win solutions.
The people who represent partner organizations in the collaboration are trustworthy.
My organization can count on each partner organization to meet its obligations to the collaboration.
Your organization feels it worthwhile to stay and work with partner organizations rather than leave the collaboration.

CDC estimates the average public reporting burden for this collection of information as 90 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 this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).

Optional Section: Collaboration Questionnaire Feedback

Instructions: This section is optional, and will provide the researcher with valuable feedback on the questionnaire you just completed. Please read through the section below and respond to the 7 questions

The questionnaire you completed assessed the following domains:

• Governance

  • Structures and rules put in place by partners to preserve the collective nature in decision-making, participant behavior, and division of resources required for collaboration.

• Administration

  • Structures in place to implement and manage collaborative processes needed to achieve the purpose of collaboration (often in the form of joint goals and objectives).

• Mutuality

  • Extent to which organizations experience interdependence, based on either shared or complementary interests, and contribute to meeting one another’s interests without negatively impacting their own.

• Norms (of reciprocity and trust)

  • Belief that collaborators will demonstrate honesty and honor agreed upon commitments and not take advantage of vulnerabilities that may be exposed during the collaboration process.

• Autonomy

  • Ability of organizations to meet the collective needs and interests of the collaboration without sacrificing their own interests.

We are interested in learning your thoughts on this questionnaire. Please complete the short feedback form below:

1. Do you think governance relates to collaboration with the partners you are familiar with for GHSA activities? Why or why not?

2. Do you think administration relates to collaboration with the partners you are familiar with for GHSA activities? Why or why not?

3. Do you think mutuality relates to collaboration with the partners you are familiar with for GHSA activities? Why or why not?

4. Do you think norms relates to collaboration with the partners you are familiar with for GHSA activities? Why or why not?

5. Do you think autonomy relates to collaboration with the partners you are familiar with for GHSA activities? Why or why not?

6. Are there other areas we have not discussed that are important for a strong collaboration? If yes, what are they?

7. Do you think the questionnaire you completed accurately assesses collaboration strength? Please explain your answer.