Attachment E-Online Survey

Attachment E: Online Survey Questionnaire

Online Survey Questionnaire

				Respondents Question Applies to
Number	Follow-Up (Yes/No)	Question	Potential Answers	EHC Center Staff	Stakeholders
Form Approved OMB No. 0935-XXXX Exp. Date XX/XX/20XX The Effective Health Care Program (EHC) at the Agency for Healthcare Research and Quality (AHRQ) is undertaking an evaluation of the program’s governance process and outcomes. There are various components to this analysis. This survey will solicit feedback about the EHC program’s governance from a broad and diverse group of individuals. The goal of the survey is to capture a robust view of the EHC program governance system from the vantage point of all stakeholders and within certain stakeholder groups, particularly related to the following topics: • EHC program Goals • Research Topic Selection Process • Priority Conditions and Populations • EHC program Research Impact • Engaging Stakeholders Your participation is extremely valuable to this evaluation and is greatly appreciated. Public reporting burden for this collection of information is estimated to 10-15 minutes per response on average, the estimated time required to complete the survey. Please send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer. Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.
		Which research program are you affiliated with? [check all that apply]	Eisenberg Center EPC Program (or Scientific Resource Center (SRC)) DEcIDE Research Network CERTs Program	
		Which best describes your affiliated organization? [check all that apply]	The EHC program Stakeholder Group Employer or Health Related Business Group Federal Partner Healthcare Industry Healthcare Provider Patient/ Consumer/ Advocacy Organization Pharmacy & Therapeutic Policy Maker Professional Organization Researcher Third Party Healthcare Payer Other (please specify)		
		Does your organization have a vested interest in research on any of the following specific conditions? [ check all that apply]	Muscle, bone, and joint conditions Cancer Heart and blood vessel conditions Brain and nerve conditions Mental health Developmental delays, ADHD, autism Diabetes Functional limitations and physical disabilities Infectious diseases and HIV/AIDS Obesity Digestive system conditions Pregnancy and childbirth Breathing conditions Alcohol and drug abuse None of the above		
		Which of the following EHC program research activities have you been involved with? [check all that apply]	Prioritized research topics Refined key questions to be addressed by the research Obtained input from expert stakeholders on the research approach Conducted an effectiveness or comparative effectiveness review Developed a technical brief Conducted new research Created a summary guide for clinicians, consumers and/or policymakers Participated in methods research activities Topic development Other (please specify)	
		EHC PROGRAM GOALS
		The EHC program was established as a part of a mandate to provide objective, timely, and rigorous assessments of therapeutics and other health care interventions. Do you agree that the EHC program is providing objective assessment of therapeutics and other interventions?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
		Please, elaborate on your response.	Open ended		
		Do you agree that the EHC program is providing timely assessment of therapeutics and other interventions?			
		Please, elaborate on your response.	Open ended		
		Do you agree that the EHC program is providing rigorous assessment of therapeutics and other interventions?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
		Please, elaborate on your response.	Open ended		
10a		Do you agree that the EHC program assessment of therapeutics and other intervention is useful?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
10b		Please elaborate on your response.			
		Do you agree that the EHC program provides effective translations of complex research findings into publications for policymakers?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
		Please, elaborate on your opinion.	Open ended response requested		
		Do you agree that the EHC program provides effective translations of complex research findings into publications for health care providers?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
		Please, elaborate on your opinion.	Open ended		
		Do you agree that the EHC program provides effective translations of complex research findings into publications for consumers/patients?	Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree		
		Please, elaborate on your opinion.	Open ended		
		RESEARCH SELECTION PROCESS
		What has been your role in suggesting topics for research? [check all that apply]	Solicited by the EHC program to nominate a research topic Collaborated with the EHC program to nominate a research topic Nominated, without solicitation from the EHC program, a research topic Other – please specify No role		
	18(e)	Do you have any interest in suggesting topics for research?	Very interested Interested Moderately Interested Of Little Interest Uninterested		
	18(e)	Do you know to nominate a research topic?	Yes No		
		In your opinion, can the transparency of the EHC program’s selection of research topics be improved?	Strong Need for Improvement Some Need for Improvement No Need for Improvement No Opinion		
	21(a), 21(b)	What improvements would you recommend to make the selection process more transparent?	Open-ended		
		The mandated criteria for prioritizing research topics in the EHC program are “health care items or services that: impose high costs on Medicare, Medicaid, or SCHIP programs may be over or underutilized, and those which may significantly improve the prevention, treatment, or cure of diseases and conditions which impose high direct or indirect costs on patients or society. Do you think the EHC program research selection process has been guided by these criteria?	Always Usually Occasionally Usually Not Never No opinion		
		Beyond the mandated criteria what do you feel significantly affects the selection of research topics?	Open ended		
		Beyond the mandated criteria what do you feel should affect the selection of research topics?	Open ended		
		I believe/think that my center has been appropriately engaged by the EHC program staff in the topic nomination and selection process.	Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree		
		Please, elaborate on your response.	Open ended		
		PRIORITY CONDITIONS & POPULATIONS
		Which of the following EHC program priority conditions MOST warrant additional research by the EHC program? [you may check up to 3 boxes]	Muscle, bone, and joint conditions Cancer Heart and blood vessel conditions Brain and nerve conditions Mental health Developmental delays, ADHD, autism Diabetes Functional limitations and physical disabilities Infectious diseases and HIV/AIDS Obesity Digestive system conditions Pregnancy and childbirth Breathing conditions Alcohol and drug abuse None		
		Please, explain further what specific research is needed.	Open ended		
		Which of the following priority populations have the most pressing needs/issues that have not been sufficiently addressed by the research of the EHC program? [you may check up to 3 boxes]	Medicare – elderly population Medicare – disabled population Medicaid – children Medicaid – adults SCHIP Other None		
		Please, explain further what specific research is needed.	Open ended		
		Which of the following priority populations have needs/issues that have not been MOST sufficiently addressed by the research of the EHC program? [you may check up to 3 boxes]	Low Income Groups Minority Groups Women Children Elderly Individuals with Special Needs Rural populations Other None		
		Please, explain further what specific research is needed and why.	Open ended		
		EHC PROGRAM RESEARCH IMPACT
		For what purposes have you or your organization used EHC program research publications? [check all that apply]	Aide clinical decision-making Change practice guidelines Change formularies Inform regulation Inform legislation Assist with personal health care decisions Other (please specify) Have not used publications		
		For what other purpose(s)?	Open ended		
		What have you observed as the impact of the EHC program publications? [check all that apply]	Provided new research Aided clinical decision-making Changes in practice guidelines Changes in formularies Influence on regulation Influence on legislation Changes to effective clinical practice Changes in patient behavior Improved clinical outcomes Improved communication between patients/consumers and clinicians Improved economic outcomes Improved quality of life Other (please specify) No impact		
		What other impact(s)?	Open ended		
		Overall, how significant/influential was this impact for your organization?	Very Significant Significant Moderately Significant Of Little Significance Insignificant No opinion		
		What type of EHC program research/publications have you found to be the most useful? [check the most helpful 3]	Effectiveness or comparative effectiveness review Technical brief New research report Summary guide for clinicians Summary guide for consumers Summary guide for policymakers Research method publication Other (please specify)		
		What other publication(s)?	Open ended		
		How would you rate the general awareness of the EHC program’s research and publications among your professional colleagues?	Completely aware Mostly aware Slightly aware Slightly unaware Mostly unaware Mostly unaware Completely unaware Don’t know		
		ENGAGING STAKEHOLDERS
		How would you change the representative range of stakeholders (patients, providers, policy makers) involved in the EHC program?	Increase Leave the same Decrease No opinion		
	47(a)	Which type(s) of stakeholders would you add?	Open ended		
	47(c)	Which type(s) of stakeholders would you remove?	Open ended		
		In your opinion, the outside stakeholders’ level of involvement in the nomination of research topics should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		In your opinion, the outside stakeholders’ level of involvement in the selection of research topics should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		In your opinion, the outside stakeholders’ level of involvement in the development of EHC program products should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		In your opinion, the outside stakeholders’ level of involvement in the translation of evidence into tools and products should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		In your opinion, the outside stakeholders’ level of involvement in the dissemination of the EHC program products should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		In your opinion, the outside stakeholders’ level of involvement with the implementation of the EHC program products should:	Increase Remain the Same Decrease No opinion	
		How would you change their involvement?	Open ended	
		The involvement of outside stakeholders in the nomination of research topics should be:	Greater than current level Current level Less than current level No opinion		
		How would you change their involvement?	Open ended		
		The involvement of outside stakeholders in the selection of research topics should be:	Greater than current level Current level Less than current level No opinion		
		How would you change their involvement?	Open ended		
		The involvement of outside stakeholders in conducting research should be:	Greater than current level Current level Less than current level No opinion		
		How would you change their involvement?	Open ended		
		The involvement of outside stakeholders in the translation of research results into tools and publications for the general public should be:	Greater than current level Current level Less than current level Don’t Know		
		How would you change their involvement?	Open ended		
		The involvement of outside stakeholders in the distribution of publications should be:	Greater than current level Current level Less than current level Don’t Know		
		How would you change their involvement?	Open ended		
		The involvement of outside stakeholders in the implementation of research results should be:	Greater than current level Current level Less than current level Don’t Know		
		How would you change their involvement?	Open ended		
		How else could the EHC program involve outside stakeholder groups in order to meet its mandate?	open text		
The following set of questions focus on stakeholders. There are two distinct groups of stakeholders in which we are interested. “EHC program Stakeholder Group” refers to an official group of selected members from whom the EHC program seeks input, guidance, and advice. “Outside stakeholders” refers to community members who have an interest in the work of the EHC program but are not members of the EHC program Stakeholder Group.
		Are you familiar with the EHC program Stakeholder Group that provides guidance to the EHC program?	Yes Somewhat No		
	75(a), 75(b)	The issues on which the EHC program seeks the consultation of the EHC program Stakeholder Group should be:	Expanded Remain the Same Reduced Expanded and Reduced No opinion		
	75(a), 75(b)	Which issue(s)?	Open ended		
	75(a), 75(b)	Are you aware of the process by which members are selected for the EHC program Stakeholder Group?	Yes No		
	78(a)	I feel the selection process is:	Very Fair Fair Unfair Very Unfair No Opinion		
	75(a), 75(b)	Do you feel that the composition of EHC program Stakeholder Group fairly reflects the various types of EHC program stakeholders?	Completely Somewhat Not at all No opinion		
	80(b), 80(c)	Which essential stakeholders are unrepresented or underrepresented on the EHC program Stakeholder Group?	Open ended		
		Do the opinions of and/or the guidance provided by the EHC program Stakeholder Group align with those of outside stakeholders in general?	Completely Somewhat Not at all No Opinion		
	82(b), 82(c)	Where do the opinions differ?	Open ended		
		Overall, how would you rate your experience as a stakeholder of the EHC program?	Excellent Good Satisfactory Needs Improvement Poor		
		Please explain/elaborate on your rating			
Thank you for sharing your experiences and thoughts about the Effective Health Care (EHC) program at the Agency for Healthcare Research and Quality (AHRQ).  Your input and responses will help us build a better, more efficient structure and program.  We appreciate your valuable time and feedback.  Should you have any thoughts, questions or concerns, please do not hesitate to contact me at ywang@impaqint.com. Ying Wang, PhD Project Director, Evaluation of AHRQ EHC Program Governance and Priority Setting IMPAQ International