Webinar Feedback Form

Attachment D – School Surveillance GenIC

Form Approved

OMB Control No.: 0920-1154

Expiration date: 01/31/2023

Public reporting burden of this collection of information is estimated to average 15 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 0920-1154

Webinar 1 Feedback Form

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This form is for State Data Coordinators. Thank you for your participation in the CDC Contract/Every Student Counts! webinar. Please take a few minutes to provide us with additional information that will help us with the CDC contract as well as Every Student Counts!.
 
Please complete one per state, if possible.
 
Please complete by ____________________

What state do you represent?

• Alabama

• Alaska

• Arizona

• Arkansas

• California

• Colorado

• Connecticut

• Delaware

• District of Columbia

• Florida

• Georgia

• Hawaii

• Idaho

• Illinois

• Indiana

• Iowa

• Kansas

• Kentucky

• Louisiana

• Maine

• Maryland

• Massachusetts

• Michigan

• Minnesota

• Mississippi

• Missouri

• Montana

• Nebraska

• Nevada

• New Hampshire

• New Jersey

• New Mexico

• New York

• North Carolina

• North Dakota

• Ohio

• Oklahoma

• Oregon

• OSHNA

• Pennsylvania

• Rhode Island

• South Carolina

• South Dakota

• Tennessee

• Texas

• Utah

• Vermont

• Virginia

• Washington

• West Virginia

• Wisconsin

• Wyoming

The first few questions are about Every Student Counts!
 
Please check which of the tier activities apply to your state regarding Every Student Counts! (check all that apply)

• Tier 1: Still need to identify all public school nurses in our state

• Tier 1: Still need to identify all private school nurses in our state

• Tier 1: School nurses in my state collect the data points included in Every Student Counts! (what % of school nurses in your state do this) ________________________________________________

• Tier 1: School nurses in my state who collect data are using their data to inform decisions (what % of school nurses in your state do this) ________________________________________________

• Tier 1: School nurses in my state who collect data are sharing their data with principals, school boards or other leaders (what % of school nurses in your state do this) ________________________________________________

• Tier 1: School nurses in my state are clear regarding local policies related to data sharing

• Tier 2: My state affiliate promotes data collection initiatives such as Every Student Counts!

• Tier 2: My state affiliate learning options (conferences, etc) include trainings or workshops regarding data

• Tier 2: My state affiliate or state has an infrastructure to collect the data points for Every Student Counts! ________________________________________________

• Tier 2: My state affiliate partners (in any way) with state office of education/health experts such as state school nurse consultant, epidemiologists or others on Every Student Counts!

• Tier 2: The laws in my state regarding data sharing are well-understood

• Tier 2: My state plans to collect aggregate, de-identified data from local school nurses for SY2018-19

• Tier 3: My state plans to submit aggregate data to a national database for SY 2018-19

In addition to the topics outlined in the webinar (data cleaning, data collection, coalition building, etc), what other topics do you think school nurses need training or guidance on?

________________________________________________________________

What type of templates or other materials would be helpful for school nurses to be successful and/or progress in data collection and use?

________________________________________________________________

Please rate your stress level regarding your role as a data coordinator for Every Student Counts!

• A great deal

• A lot

• A moderate amount

• A little

• None at all

Did this webinar and information on NASN's CDC contract change your stress level?

• Increased stress level

• No change in stress level

• Decreased stress level

Any other feedback related to Every Student Counts!. What do you need to be successful as the state coordinator?

________________________________________________________________

Now we are switching to the CDC contract related to data.
 
Should the November-December data webinars be just for state data coordinators or should we allow others to listen in? (They will be recorded and all will have access to them at that point.)

• Just for state data coordinators

• Any school nurse who wants to participate

• Other (please describe) ________________________________________________

For the Nov-Dec data webinar series, please pick the day of the week and time of data that you would generally be able to participate. (check all that apply).
We know you are not all in the eastern time zone-but Qualtrics isn't sophisticated to change time zones-so to be sure we are all comparing 'apples to apples'-please think of this in terms of eastern time (EST).
 

	8am-10am EST	11am-2pm EST	3pm-5pm EST	6pm-8pm EST
	Answer 1	Answer 1	Answer 1	Answer 1
Monday
Tuesday
Wednesday
Thursday
Friday

Are you aware of school nurses' activities in your state related to chronic absenteeism?

• Yes (please describe) ________________________________________________

• No

Are you aware of activities going on related to ME/CFS in your state?

• Yes (please describe) ________________________________________________

• No

Rate your level of understanding regarding what ME/CFS and the school-aged child.

• Not knowledgeable at all

• Slightly knowledgeable

• Moderately knowledgeable

• Very knowledgeable

• Extremely knowledgeable

The last few questions are the polls used during the webinar. We are asking again because we want everyone's responses (not just those on the live). Please answer even if you participated in the live.
 
How is Every Student Counts! different than Step up!? (check all that apply)

• Every Student Counts! emphasizes local school nursing use and understanding

• Every Student Counts! emphasizes partnerships at the affiliate and national levels

• There are no major differences

How similar are CDC's "data champions" and NASN's Every Student Counts! "state data coordinators"?

• Not alike at all

• somewhat alike

• very alike-not much difference

Would you be interested in learning to be a 'train the trainer' for some of the topics outlined above (so you could present to school nurses in your state about them?

• Yes

• No

Anything else you would like to add related to the CDC contract OR Every Student Counts!:

________________________________________________________________

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