Form
Approved
OMB
No. 0920-1154 Exp
Date 3/31/26
Post-Test #1
Knowledge
True or False |
True |
False |
Unsure |
Some medications may affect tolerance to the heat |
Ο |
Ο |
Ο |
Victims always stop sweating with heat stroke. |
Ο |
Ο |
Ο |
Dark, infrequent urination may mean dehydration |
Ο |
Ο |
Ο |
High temperature and humidity are the only risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Taking a break in the air conditioning will ruin your acclimatization |
Ο |
Ο |
Ο |
Having a previous heat-related illness puts you at higher risk for another heat-related illness |
Ο |
Ο |
Ο |
Salt tablets are an effective way to restore electrolytes lost during sweating |
Ο |
Ο |
Ο |
Heat stroke is not always a medical emergency |
Ο |
Ο |
Ο |
Public
reporting
burden
of
this collection
of
information is
estimated
to
average
20 mins
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 H21-8,
Atlanta,
Georgia
30333
ATTN:
PRA
(0920-1154).
30f. Thinking about the next 6 months, on a scale from 1 to 10, where 1 is not at all likely and 10 is extremely likely, how likely are you to do the following at your workplace? |
Not at all likely 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
Extremely likely 10 |
Use an acclimatization program |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Provide annual heat stress training for workers |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ensure workers take rest breaks |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ensure workers are hydrating properly |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Make updates or develop a heat illness prevention program |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Identify heat stress resources for my workers |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
For 30f, if you selected 1-5 for any of the activities, are there particular reasons? Please describe.
|
Self-efficacy
46f. How confident are you that you can do the following at work? |
Not at all confident |
Slightly confident |
Moderately confident |
Very confident |
Extremely confident |
Make a difference regarding heat stress safety at my workplace. |
Ο |
Ο |
Ο |
Ο |
Ο |
Know the signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Distinguish between heat exhaustion and heat stroke |
Ο |
Ο |
Ο |
Ο |
Ο |
Administer first aid for heat-related illnesses at my workplace |
Ο |
Ο |
Ο |
Ο |
Ο |
Know when to contact emergency medical services for a heat-related illness |
Ο |
Ο |
Ο |
Ο |
Ο |
Know what to do if one of my workers became ill because of the heat |
Ο |
Ο |
Ο |
Ο |
Ο |
Protect my workers from heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers to recognize signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers about risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers on first aid for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Attitudes
|
Strongly disagree |
Disagree |
Neutral |
Agree |
Strongly agree |
47f. I think that heat stress at work is a critical issue. |
Ο |
Ο |
Ο |
Ο |
Ο |
48f. I should make a strong effort to do something about heat stress at my workplace. |
Ο |
Ο |
Ο |
Ο |
Ο |
I have received sufficient training on: |
Strongly disagree |
Disagree |
Neutral |
Agree |
Strongly agree |
Recognition of signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
First aid for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Environmental risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Personal risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Proper hydration |
Ο |
Ο |
Ο |
Ο |
Ο |
Additional heat burden caused by exertion, clothing, and PPE |
Ο |
Ο |
Ο |
Ο |
Ο |
Acclimatization (how to achieve and maintain) |
Ο |
Ο |
Ο |
Ο |
Ο |
Using a work/rest schedule |
Ο |
Ο |
Ο |
Ο |
Ο |
Satisfaction
|
Strongly disagree |
Disagree |
Neutral |
Agree |
Strongly agree |
How satisfied are you with this online training? |
Ο |
Ο |
Ο |
Ο |
Ο |
Do you have any recommendations for changes or improvements to this training?
|
What was the most beneficial part of this training?
|
NIOSH Heat Stress Training for Employers of Outdoor Workers
Post-Test #2 (administered 6 weeks later)
Knowledge
True or False |
True |
False |
Unsure |
Some medications may affect tolerance to the heat |
Ο |
Ο |
Ο |
Victims always stop sweating with heat stroke. |
Ο |
Ο |
Ο |
Dark, infrequent urination may mean dehydration |
Ο |
Ο |
Ο |
High temperature and humidity are the only risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Taking a break in the air conditioning will ruin your acclimatization |
Ο |
Ο |
Ο |
Having a previous heat-related illness puts you at higher risk for another heat-related illness |
Ο |
Ο |
Ο |
Salt tablets are an effective way to restore electrolytes lost during sweating |
Ο |
Ο |
Ο |
Heat stroke is not always a medical emergency |
Ο |
Ο |
Ο |
Behavioral Intentions
30f. Thinking about the next 6 months, on a scale from 1 to 10, where 1 is not at all likely and 10 is extremely likely, how likely are you to do the following at your workplace? |
Not at all likely 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
Extremely likely 10 |
Use an acclimatization program |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Provide annual heat stress training for workers |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ensure workers take rest breaks |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ensure workers are hydrating properly |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Make updates or develop a heat illness prevention program |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Identify heat stress resources for my workers |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
Ο |
For 30f, if you selected 1-5 for any of the activities, are there particular reasons? Please describe.
|
Self-efficacy
46f. How confident are you that you can do the following at work? |
Not at all confident |
Slightly confident |
Moderately confident |
Very confident |
Extremely confident |
Make a difference regarding heat stress safety at my workplace. |
Ο |
Ο |
Ο |
Ο |
Ο |
Know the signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Distinguish between heat exhaustion and heat stroke |
Ο |
Ο |
Ο |
Ο |
Ο |
Administer first aid for heat-related illnesses at my workplace |
Ο |
Ο |
Ο |
Ο |
Ο |
Know when to contact emergency medical services for a heat-related illness |
Ο |
Ο |
Ο |
Ο |
Ο |
Know what to do if one of my workers became ill because of the heat |
Ο |
Ο |
Ο |
Ο |
Ο |
Protect my workers from heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers to recognize signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers about risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Train my workers on first aid for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Attitudes
|
Strongly disagree |
Disagree |
Neutral |
Agree |
Strongly agree |
47f. I think that heat stress at work is a critical issue. |
Ο |
Ο |
Ο |
Ο |
Ο |
48f. I should make a strong effort to do something about heat stress at my workplace. |
Ο |
Ο |
Ο |
Ο |
Ο |
I have received sufficient training on: |
Strongly disagree |
Disagree |
Neutral |
Agree |
Strongly agree |
Recognition of signs and symptoms of heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
First aid for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Environmental risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Personal risk factors for heat-related illnesses |
Ο |
Ο |
Ο |
Ο |
Ο |
Proper hydration |
Ο |
Ο |
Ο |
Ο |
Ο |
Additional heat burden caused by exertion, clothing, and PPE |
Ο |
Ο |
Ο |
Ο |
Ο |
Acclimatization (how to achieve and maintain) |
Ο |
Ο |
Ο |
Ο |
Ο |
Using a work/rest schedule |
Ο |
Ο |
Ο |
Ο |
Ο |
Public
reporting
burden
of
this collection
of
information is
estimated
to
average
20 mins
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 H21-8,
Atlanta,
Georgia
30333
ATTN:
PRA
(0920-1154).
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Sawyer, Tamela (CDC/NIOSH/OD/ODDM) |
File Modified | 0000-00-00 |
File Created | 2025-05-18 |