Introduction
|
The
Centers
for Disease Control and Prevention and Deloitte Consulting would
like to invite you to participate in a survey to learn more about
implementation of the National Diabetes Prevention Program
(National DPP) lifestyle change program at the site-level and how
the state health department is supporting your efforts.
Your
participation in this survey is voluntary,
and you may opt out of any question in the survey. Your answers
will be kept strictly confidential and will never be associated
with your name.
The
survey should take no more than 30 minutes to complete,
and you have until {survey
close date} to
submit your response.
Click
NEXT
to begin the survey.
If
you have any questions about the survey or experience technical
issues accessing or submitting the survey, please email
Nicolle
Dally, [email protected].
We
really appreciate your
time and
contribution to this effort.
Thank
you,
1815
National Evaluation Team
Deloitte
Consulting, LLP
Note:
Public
reporting burden of this collection of information is estimated to
average 30 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 CDC/ATSDR Reports Clearance Officer;
1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA
(0920-19BHC)
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Background
|
Please
select the option that best reflects your position within the
[insert program name] Lifestyle Change Program.
Program
Coordinator
Lifestyle
Coach
Community
Health Worker
Data
Preparer
Other,
please specify _____________________
|
What
is your educational and/or professional background (select
all that apply):
Public
health
Health
education
Nutrition
Physical
activity/ exercise
Other,
please specify ______________________
|
Are
you actively credentialed in any of the following areas (select
all that apply)?
Registered
Nurse
Registered
Dietitian/Registered Dietitian Nutritionist
Certified
Diabetes Educator
Certified
Health Education Specialist
Community
Health Worker Certification
I
am not actively credentialed in the listed areas
|
Are
you actively credentialed in any other areas? [Open
ended]
|
How
long have you been in your current role with [insert
program name]?
Less
than a year
1-2
years
2-3
years
3-4
years
5
or more years
|
In
total, how long have you worked with this program?
Less
than a year
1-2
years
2-3
years
3-4
years
5
or more years
|
LCP
Program Overview
|
Please
select the setting or type of organization in which the [insert
program name]
is located
Health
care organization (e.g. FQHC, Rural Health Center)
Pharmacy
Community-based
organization (e.g. community center, place of worship, etc.)
Worksite
YMCA
Academic
institution
Program
is independently operated
Other
setting; please specify ________________________
|
Does
your lifestyle change program have a strategic focus on reaching
specific population groups?
Yes
No
[Skip to Q10]
I
don’t know/ I’m not sure [Skip to Q10]
|
Please
indicate the population groups you serve primarily (select
all that apply)
Race/Ethnicity
White
Black
or African-American
American
Indian/Alaska Native
Asian
Native
Hawaiian or Other Pacific Islander
Latino/Hispanic
Other;
please specify___________
Gender
Male
Female
Other,
please specify___________
Age
Group
18-24
years
25
to 44 years
45
to 64 years
65
years and over
Geographic
focus:
Urbanized
Areas (population greater than 50,000)
Urbanized
Clusters (population more than 2,500 but less than 50,000)
Rural
Areas (population less than 2,500)
American
Indian/Alaskan Native communities
Other,
please specify: __________________________
Please
specify any other populations of focus in the field below (e.g.
low socioeconomic status, people with disabilities)(open-ended)
|
Participant
Recruitment
|
What
are the most common methods your program uses to market/promote
your CDC-recognized lifestyle change program? (select
all that apply)
Our
program does not directly market/promote the program [Skip to
Q14]
Health
fairs
Printed
informational materials for people with prediabetes
Printed
informational materials for health care providers
Mass
media campaigns
Presentations
to community groups
Presentations
to health professionals
Swag
items (bags, totes, mugs, kitchen utensils)
Other,
please specify ___________________
I
don’t know/ I’m not sure [Skip to Q12]
|
In
your opinion, which strategies have been most successful in
increasing awareness and interest in your program?
Health
fairs
Printed
informational materials for the general public
Printed
informational materials for health professionals
Mass
media campaigns
Presentations
to community groups
Presentations
to health professionals
Swag
items (bags, totes, mugs, kitchen utensils)
Other,
please specify ________________________
I
don’t know/ I’m not sure
|
To
what extent are these marketing/promotion efforts tailored to
meet the language or cultural needs of different target
populations?
1=Not
at all
2=Very
few materials/strategies are tailored
3=Some
materials/strategies are tailored
4=Most
materials/strategies are tailored
5=All
materials/strategies are tailored
99=I
don’t know
|
How
do you rate the state health department’s (SHD) assistance
with expanding your program’s marketing/promotion efforts?
0
= The SHD provided no assistance
1
= Not at all useful
2
= Slightly useful
3
= Moderately useful
4
= Very useful
5
= Extremely useful
99=
I don’t know
|
How
do you rate the SHD’s assistance with expanding your
program’s marketing/promotion efforts to new population
groups or geographic areas?
0
= The SHD provided no assistance
1
= Not at all useful
2
= Slightly useful
3
= Moderately useful
4
= Very useful
5
= Extremely useful
99
= I don’t know
|
How
do you rate the influence of health care organizations in
referring people with prediabetes to your program?
1
= Not at all influential
2
= Slightly influential
3
= Moderately influential
4
= Very influential
5
= Extremely influential
99
= I don’t know
|
How
do you rate local health care providers’ support of the
National DPP lifestyle change program as a preventive measure for
type 2 diabetes?
1
= Not at all supportive
2
= Slightly supportive
3
= Moderately supportive
4
= Very supportive
5
= Extremely supportive
99
= I don’t know
|
To
what extent, if any, has the COVID-19 pandemic affected
participant recruitment and/or marketing efforts?
|
Enrolment
and Retention
|
What
are the most common methods your CDC-recognized LCP uses to
encourage participant enrollment and retention? (select
all that apply)
Our
program does not have any special efforts to encourage enrollment
and retention [Skip to Q19]
Transportation
vouchers
Child
care assistance
Meal
prep assistance
Gym
memberships
Digital
physical activity trackers
Other;
please specify ________________________
I
don’t know/ I’m not sure
|
In
your opinion, which strategies have been most successful in
increasing enrollment and retention in your program? (select
all that apply)
Our
program does not have any special efforts to encourage enrollment
and retention
Transportation
vouchers
Child
care assistance
Meal
prep assistance
Gym
memberships
Digital
physical activity trackers
Other;
please specify ___________________________
I
don’t know/ I’m not sure
|
How
do you rate the SHD’s assistance with expanding your
program’s enrollment and retention efforts?
0
= The SHD provided no assistance
1
= Not at all useful
2
= Slightly useful
3
= Moderately useful
4
= Very useful
5
= Extremely useful
99
= I don’t know
|
What
would you say are the top 3 major challenges in enrolling
people with prediabetes? [Rank
your challenges on a scale of 1-3, with 1 being the most
challenging factor and 3 the least challenging]1-r]
|
What
would you say are the top 3 major challenges in retaining
participants until program completion? [Rank
your challenges on a scale of 1-3, with 1 being the most
challenging factor and 3 the least challenging]
|
What
additional support do you need to assist with expanding your
program’s enrollment and retention efforts?
|
To
what extent, if any, has the COVID-19 pandemic affected
participant enrollment and/or retention?
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Training
|
Have
you completed a CDC-approved Lifestyle Coach training?
Yes
No
[Skip to Q25]
I
don’t know/ I don’t recall [Skip to Q25]
|
When
was the last time you completed follow-up training?
Less
than a year ago
1-2
years ago
3-4
years ago
5
or more years
I
have not had any follow-up training
|
Are
you a National DPP Master Trainer?
Yes
No
I
don’t know
|
Does
your organization provide opportunities to attend CDC-sponsored
National DPP webinar trainings?
Yes
No
I
don’t know
|
How
confident do you feel in your ability to deliver all components
of the National DPP lifestyle change program?
1
= Not confident at all
2
= Slightly confident
3
= Somewhat confident
4=
Fairly confident
5
= Completely confident
|
17. To
what extent, if any, has the COVID-19 pandemic affected training
efforts?
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Program
Effectiveness
|
|
How
successful is the [insert program name] in helping people with
prediabetes lose weight?
1=Not
at all successful
2=Slightly
successful
3=Moderately
successful
4=Very
successful
5=Extremely
Successful
99=I
don’t know/ I’m not sure
|
To
what extent, if any, has the COVID-19 pandemic affected program
effectiveness?
|
Please
note any other thoughts you may have to share about the [insert
program name]
[Open
ended]
|