Form 0920-21GB Recipient Level Group Interviews

Form Approved

OMB NO: 0920-xxxx

Exp. Date: X/XX/XXXX

Public reporting burden of this collection of information is estimated at 1 hour and 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/Information Collection Review Office, 1600 Clifton Road, NE, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-xxxx).

Qualitative Data Collection – Interview Guide – DRAFT

Topic	Interview Guide Items
Purpose	To evaluate progress and challenges in implementing the Core SIPP program within the individual recipient-level context to inform tailored supports from CDC and partners. Interview respondents: recipient Core SIPP teams will participate in small group interviews. Key partners may (or may not?) be included.
Technical Assistance (TA)	Consider your Core SIPP activities THIS FISCAL YEAR. What TA resources have you used this year to advance your work? (Probe for specific resources used) Please describe how these resources influence your work. (Probe for concrete examples of ways TA has/has not been practical or actionable) How can routine calls with your CDC State Support Team be improved? (Probe for topics, frequency, organization/agenda) What unmet TA needs does your program have this year? (Probe for topics, modes of delivery, frequency)
Disproportionately-Affected Populations/ Health Equity (HE)	Health Equity – General Please describe your state context with regard to HE and public health work. (Probe for variation in language: health disparities, social determinants of health, etc.) How does your Core SIPP work inform HE? What is your HE approach? (Probe for if HE is embedded within all aspects of the work, or if it is a separate set of activities). Disproportionately-Affected Populations – Specific Have you identified a disproportionately-affected community in your jurisdiction for the focus of your Core SIPP work? [IF YES] What population(s) did you identify? (Probe for whether disproportionately-affected populations vary by topic areas – ACEs, TBI, Transportation Safety) How did you identify this/these population(s)? (Probe for data sources, needs assessment, etc.) How is the Core SIPP engaging with this/these population(s)? (Probe for partnerships, needs assessment, etc.) How is your work to address disproportionately-affected populations progressing across the three Core SIPP topic areas (ACEs, TBI, and Transportation Safety)? (Probe for successes and challenges) Have you engaged non-traditional partners to address these populations. How? [IF NO] What challenges are you facing in doing so? How might enhanced CDC TA to support you to further this work?
Program Improvements	Is your program tracking areas for improvement within your work? Tracking areas for functional capacity improvement Tracking ways to improve implementation efforts
Risk/Protective Factors	What injury-related risk factors have you identified for disproportionately-affected populations in your jurisdiction? What data sources did you use to identify these? What injury-related protective factors have you identified for disproportionately-affected populations in your jurisdiction? What data sources did you use to identify these? Have you identified risk or protective factors that are shared across more than one topic area (Probe for SRPFs across ACEs, TBI, and/or Transportation Safety)? What data sources did you use to identify these? If possible, please give concrete examples of ways in which risk/protective/SRPF identification has affected your program? (Probe for partnerships, decision making, strategy, etc.)