Attachment C
Form
approved
OMB No. 0920-0879
Expiration Date: 03/31/2014
Welcome! Thank you for participating in this survey about pandemic influenza and nonpharmaceutical interventions. Your voluntary participation is important, as it will help CDC develop new guidance, materials, and trainings for state, tribal, local and territorial health officials. We anticipate that it will take approximately 20-25 minutes to complete these questions.
Your participation is voluntary, and there is no penalty if you choose not to participate. You may change your mind about participating at any time during the survey without penalty. Your responses to all questions will be kept in a secure manner. No personal identifiers will be recorded. All information will be used for evaluation purposes only.
To participate in the survey, please select “Yes” to proceed. This serves as consent for this survey.
Yes
No
[Informational text will be placed to the left of the directions in a shaded box]: Nonpharmaceutical interventions (NPIs) are individual and community-level practices and policies that do not involve the use of vaccines or medicines. NPIs can help prevent, interrupt, or slow the spread of pandemic influenza within communities.]
• Individual-level practices include washing hands, covering coughs and sneezes, staying home when sick, cleaning surfaces, and using face masks;
• Community-level practices include social distancing measures, such as postponing or canceling mass gatherings, closing schools and childcare facilities temporarily, and teleworking.
Survey Instructions
Throughout the survey you will be asked to select your top 3 and then rank your selections.
To move from one page to the next, please use only the "Next" and "Previous" buttons found at the bottom of each screen. DO NOT use your browser's back and next button. If you accidentally click your browser's navigation button, you may be able to continue your survey by pressing the F5 key or by refreshing the web page.
Public reporting burden of this collection of information is estimated at 25 minutes per survey, 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 a collection of information, and a person is not required to respond 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 (0920-0735)
Background
1. Do you work in a state, tribal, local, or territorial public health department?
Yes [If yes, go to 1a]
No [If no, thank participant and end survey]
1a. Select the type of health department for which you work.
State
Tribal
Local
Territorial
2. Check your primary duty related to pandemic influenza and other emergency preparedness and response activities. (Check only one)
Health communication/education
Community liaison
Administrative support
Science (e.g., epidemiology, laboratory)
Clinical (e.g., nurse, medical officer)
Policy
Budget/finance
Other duties related to pandemic influenza and emergency preparedness and response activities, please specify ________
I do not have any duties related to pandemic influenza and/or other emergency preparedness and response activities [If selected, thank participant and end survey]
3. Are you a member of any the following professional organizations? Check all that apply.
Association of State and Territorial Health Officials (ASTHO)
Council of State and Territorial Epidemiologists (CSTE)
National Association of County and City Health Officials (NACCHO)
National Public Health Information Coalition (NPHIC)
Society for Public Health Education (SOPHE)
Other, please specify ________
No, I am not a member of any professional organization.
4.
Where do the constituents you serve reside? (Check at least one from
each column).
[For Region,
we would like a pop-up box to come up associated with each region, as
follows:]
•Region 1 - Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont
•Region 2 - New Jersey, New York, Puerto Rico, and the Virgin Islands
•Region 3 - Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia
•Region 4 -Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee
•Region 5 - Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
•Region 6 - Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
•Region 7 - Iowa, Kansas, Missouri, and Nebraska
•Region 8 - Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming
•Region 9 - Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau
•Region 10 - Alaska, Idaho, Oregon, and Washington
HHS Region (Select at least 1) Locale (Select at least 1)
Urban Suburban Rural
Region 2
Region 3
Region 4
Region 5
Region 6
Region 7
Region 8
Region 9
Region 10
Messages
5. What audiences would be most helpful for CDC to target in their NPI messages? (Rank the top 3, with 1 being your first choice)
General public and families
Childcare program administrators
K-12 school administrators
Institution of higher education (colleges, universities) administrators
Business owners and employers
Mass gathering and public event planners and organizers
Public health partners (please specify:_________)
Other, please specify:____________
Other, please specify:____________
Other, please specify:____________
6. During the 2009 H1N1 pandemic, what did you feel the CDC did well regarding NPI messages?
7. During the 2009 H1N1 pandemic, what gaps did you find in the CDC NPI messages that should be included in future messages?
Materials and Channels
8. Select the top 3 methods you find are most effective in communicating NPI guidance and messages to the audiences below. (Rank the top 3, with 1 being your first choice) [Respondents will select on one page and rank on the next]
General Public and Families
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
Childcare Program/K-12 School Administrators
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
College/University/Higher Education Administrators
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
Business Owners and Employers
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
Mass Gathering/Public Event Planners and Organizers
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
9. Select the top 3 materials you find are most helpful for CDC to use in communicating NPI guidance and messages to you and other state, tribal, local, and territorial health officials.
Materials (Rank the top 3, with 1 being your first choice)
Print ads, magazines, and newspapers
Printed handouts (e.g., fact sheets, checklists, posters)
Functional items with messages (e.g., magnets, sticky notes)
PowerPoint presentations
Social media (e.g., podcasts, e-cards, widgets, social networking sites)
Web sites
Mobile phone text messages and applications
Broadcast media (radio and television)
Billboards (e.g., on buses, bus stops, along roads)
Other (Please specify) _________________________
Other (Please specify) _________________________
Other (Please specify) _________________________
10. Select the top 3 languages, other than English, in which CDC should develop materials.? (Rank the top 3, with 1 being your first choice)
Chinese
French
German
Italian
Korean
Russian
Spanish
Tagalog (Filipino)
Vietnamese
Other (please specify):_________
Other, please specify _______
Other, please specify _______
Trainings
11. Rank the top 3 areas that you/your agency would like to have additional NPI information and training. (Rank the top 3, with 1 being your first choice)
Epidemiology of influenza pandemics and the role of NPIs
Lessons learned from past influenza pandemics about the use of NPIs
NPI strategies and triggers for implementation
Evidence of the effectiveness of NPIs
Decision-making strategies for implementing NPI recommendations
Monitoring NPIs
Communicating NPI recommendations to families and community-setting audiences (e.g., schools, businesses)
Other (please specify) ________
Other, please specify _______
Other, please specify _______
12. Briefly describe what you/your agency would want an NPI training to include for each of the following:
Topics_____________________
Length (e.g., 30 min, 1 hour, etc.)_____________________
Special features_____________
Other (please specify)_____________________
Guidance
13. Are you aware of the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States – Early, Targeted, and Layered Use of Nonpharmaceutical Interventions (The 2007 Guidance)?
Yes
No [Skip to 16]
14. Did you use The 2007 Guidance during the 2009 H1N1 response?
Yes [Skip to 15a]
No [Skip to 15b]
15a. How did you use the Guidance during the 2009 H1N1 response?
15b. What would have made you more likely to use the Guidance?
16. Select the top 3 kinds of pandemic influenza NPI guidance information that you / your agency would like from CDC. (Rank the top 3, with 1 being your first choice)
Information on…
Triggers for implementing NPIs (e.g., closing schools or canceling mass gatherings)
Legal authority for implementing NPIs
Policy issues concerning the implementation of NPIs
Alternatives for childcare during school closures
Face masks for personal and community use (non-healthcare)
Health messaging for various populations and settings
Culturally appropriate messages
Plain language adaptations of messages
State, tribal, local and territorial health department staff training on NPI implementation and messages
Range of NPI recommendations when severity of conditions is uncertain
Evidence of NPI effectiveness
Impact of NPIs, including personal protective behaviors
Other, please specify ___________
Other, please specify___________
Other, please specify___________
17. Select the top 3 NPI recommendations that are difficult for you / your agency to implement in community settings.
(Rank the top 3, with 1 being your first choice)
Getting people to stay home when sick
School closures
Alternative childcare
Workplace closings
Flexible leave policies
Procedures for jails, 911, public transit, and other facilities that operate 24 hours/day, 7 days/week
Canceling or postponing mass gatherings and public events
Other, please specify _______
Other, please specify _______
Other, please specify _______
18. Select the top 3 NPI recommendations that are difficult for you / your agency to communicate in community settings (Rank the top 3, with 1 being your first choice)
NPI recommendations across jurisdictions
NPI recommendations for individuals and the general public (e.g., handwashing, covering coughs and sneezes, staying home when sick)
NPI recommendations for childcare administrators (e.g., closures, policies)
NPI recommendations for K-12 school administrators (e.g., closures, policies)
NPI recommendations for college/university administrators (e.g., closures, policies)
NPI recommendations for business owners and employers ( e.g., workplace continuity options, policies)
NPI recommendations for mass gathering planners (e.g., cancellations)
Epidemiology of the virus
Severity of the disease
Other, please specify _______
Other, please specify _______
Other, please specify _______
19. Select the top 3 NPI recommendations that are difficult for you / your agency to monitor in community settings. (Rank the top 3, with 1 being your first choice)
Individual adoption of personal protective behaviors
Real-time school closings
Real-time workplace closings
Cancellation of mass gatherings
Level of response by public health departments in own jurisdiction
Other, please specify _______
Other, please specify _______
Other, please specify _______
20. Briefly describe under what circumstances you would recommend each of the following to your community.
Personal protective behaviors (e.g., handwashing, covering coughs/sneezes, staying home when sick, etc.) ________________________
Face masks________________________________________
School closures____________________________________
Mass gathering cancellations__________________________
Workplace closures___________________________________
Monitoring Systems
21. Does the health department you work in have a method in place to monitor the following? (Select all that apply)
School closings [If selected, go to 20b]
School absenteeism [If selected, go to 20a]
Business closings [If selected, go to 20b]
Business absenteeism [If selected, go to 20b]
Mass gathering cancellations [If selected, go to 20b]
21a. Are you able to collect information on influenza-like illness (ILI)-related absenteeism in schools?
Yes
No
21b. Please explain the methods you use to monitor [Selection from Q21].
School closings (please explain)______________________________
School absenteeism (please explain)__________________________
Business closings (please explain)_____________________________
Business absenteeism (please explain)_______________________
Mass gathering cancellations (please explain)__________________
Thank you for participating in the Pandemic Influenza and Nonpharmaceutical Interventions survey. If you are finished with the survey, please click "SUBMIT" to send your responses or use the previous button to review your responses.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CDC User |
| File Modified | 0000-00-00 |
| File Created | 2021-01-31 |