Form 0920-18ATK Questionnaire Feedback

Form Approved

OMB Control No.: 0920-xxxx

Expiration Date: xx/xx/xxxx

Collaboration Questionnaire: Feedback Form

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. 

   CDC estimates the average public reporting burden for this collection of information as 240 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).

   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.