Form 0920-23DP PHL Fellowship Host Site Welcome

Form approved

OMB No. 0920-XXXX

Expiration date: XX/XX/XXXX

Public Health Law Fellowship — Welcome Survey 

Welcome to the Public Health Law Fellowship! 

 

To help us assess how participating in the fellowship affects your professional skills and career progression, we request that you complete a brief survey before reporting to your host site. The survey asks for your race, gender identity, disability status, and a series of questions about public health law. You will be asked for your race, gender identity, and disability status to help us assess the level of diversity in our fellowship program. These demographic data will be reported only in the aggregate. You may also select "prefer not to respond" to questions about your race, gender identity, and disability status. 

 

The requested information is used for assessment and continuous quality improvement of CDC fellowship activities and services. CDC will securely treat data/information and will not disclose it unless otherwise compelled by law. All data will be used to evaluate and improve the Public Health Law Fellowship and will be reported only in the aggregate.  

 

This survey is anonymous and confidential. Participation in the survey is completely voluntary. As a result, we will not be able to follow up with individual responses because we will not know who entered them. If you would like to speak with someone regarding your responses, please reach out directly to the fellowship coordinators. 

 

To complete this survey, please select the answer that applies to each question posed below. If it is possible to choose more than one answer, the question will have an instruction to “select all that apply.”

Text-To-Speech functionality is enabled. It is set to off but can be turned on when clicked. This will enable the text to be read out loud. You must have computer speakers turned on.

There is no time limit to complete the survey. All questions will be displayed on one page. You will see two options at the bottom of the page, “Save & Return Later” and “Submit,” indicating the end of the survey.

Before submitting your survey, you may save your progress and return later to complete the survey by selecting the “Save & Return Later” option at the bottom of the page. If you select “Save & Return Later,” you will be given a return code when leaving a survey. The return code is required to re-enter and finish the survey. We are not able to retrieve lost codes, so if you cannot find your code, you will need to restart the survey. Selecting “Save & Return Later” does not submit your answers.

To submit your answers, you must select “Submit.” Your survey responses will be submitted, and you will see a survey completion note thanking you for your submission. You will not be able to edit your responses once your survey is submitted.

If you have any questions or concerns, please reach out to Abigail Ferrell ([email protected]). 

Public reporting burden of this collection of information is estimated to average 6 minutes per response, including the time for reviewing the 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 aspects of this collection of information, including suggestions for reducing this burden, to CDC/ATSDR Information Collection Review Office, 1600 Clifton Rd. NE, MS H21-8, Atlanta, GA 30329; ATTN: PRA (0920-XXXX). 

 

What is the expected duration of your fellowship?  

• Semester 

• Academic year 

• Calendar year 

On average, how many hours per week do you anticipate that you will work? ________________ 

What is your expected graduation date? If you have already graduated, please enter the date you graduated with your most recent degree. _____________________________________________ 

Which of the below best describes your fellowship?  

• CDC – PHLP 

• CDC – not PHLP 

• Field placement 

• Other ______ 

Do you identify as having any kind of disability? 

• Yes 

• No 

• Prefer not to respond 

How would you describe your race? Select all that apply.  

• White

• Black or African American 

• Asian 

• American Indian or Alaska Native 

• Native Hawaiian or other Pacific Islander 

• Other (please specify) ______ 

• Prefer not to respond 

Do you consider yourself Hispanic or Latino? 

• Yes 

• No 

• Prefer not to respond 

How would you describe your gender identity? Gender identity can be defined as "one's innermost concept of self as male, female, a blend of both, or neither-how individuals perceive themselves and what they call themselves. One's gender identity can be the same or different from their sex assigned at birth." __________________________________ 

How many years of public health work experience do you have? 

• None 

• Less than 1 year 

• 1–3 years 

• 4–6 years 

• 6+ years 

For the following questions, you will be asked to rate your skills in areas related to public health law/policy. Your answers to these questions will be used only to establish a baseline of your fellowship cohort's collective skills and abilities 

	Very strong	Strong	Moderate	Weak	Very Weak
Describe basic public health law principles
Describe basic legal epidemiology concepts
Describe how law contributes to population health
Identify opportunities to include legal epidemiology in existing organizational activities
Identify opportunities to assess the potential impact of laws and policies on the social determinants of health
Identify opportunities to assess the potential impact of laws and policies on health equity
Identify the laws and policies applicable to a public health issue
Use relevant databases to track legal and policy information
Develop methods for collecting valid legal data
Apply a legal epidemiology coding system to collected laws and policies
Identify variations in laws and policies between jurisdictions over time
Identify data sources and analytic tools relevant to evaluate the health outcomes of laws and policies
Identify key findings of your data collection and analysis
Create audience-appropriate oral and visual presentations
Identify actionable next steps to improve health outcomes based on legal epidemiology data
Identify law-based tools available to public health agencies during a public health emergency
Describe a health department's legal authority to address public health problems and the limits on that authority
Identify law-based tools for improving health equity
Describe health equity issues relevant to a given public health topic

What are the top 3 skills that you are looking to improve during the fellowship?

Skill 1: ______ 

Skill 2: ______ 

Skill 3: ______ 

Answer choices:  

• Describe basic public health law principles 

• Describe basic legal epidemiology concepts 

• Describe how law contributes to population health 

• Identify opportunities to include legal epidemiology in existing organizational activities 

• Identify opportunities to assess the potential impact of laws and policies on the social determinants of health 

• Identify opportunities to assess the potential impact of laws and policies on health equity 

• Identify the laws and policies applicable to a public health issue 

• Use relevant databases to track legal and policy information 

• Develop methods for collecting valid legal data 

• Apply a legal epidemiology coding system to collected laws and policies 

• Identify variations in laws and policies between jurisdictions over time 

• Identify data sources relevant to evaluate the health outcomes of laws and policies 

• Identify key findings of your data collection and analysis 

• Create audience-appropriate oral and visual presentations 

• Identify actionable next steps to improve 

• Identify law-based tools available to public health agencies during a public health emergency health outcomes based on legal epidemiology data 

• Describe a health department's legal authority to address public health problems and the limits on that authority 

• Identify law­ based tools for improving health equity 

• Describe health equity issues relevant to a given public health topic 

What are your expectations for the fellowship? __________________________________