Att G - Survey Instrument

ATTACHMENT G - Survey Instrument

National Outbreak Reporting System: An Evaluation of Foodborne Disease Outbreak Surveillance and Technical Requirement

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Introduction:

Form approved: OMB No. 0920-0879: Expiration Date 03/31/2014

The NORS-Foodborne team is conducting a survey to evaluate the National Outbreak Reporting System (NORS) for foodborne disease outbreak reporting. We are asking all Reporting Site Administrators (RSAs) responsible for entering foodborne disease outbreak reports into NORS to complete the survey.

Your participation is voluntary. By returning the survey you are consenting to participate. There is no penalty for declining to participate and there are no foreseen risks to you or your state if you do not participate. You will receive no direct benefits from participating in the survey; however, your participation will help to improve the reporting system.

The information you provide will not be considered to constitute your NORS reporting agency's official policy or position, and will not be used beyond the scope of this evaluation without your permission. We would like to share the results of this evaluation with participating NORS reporting agencies, but all responses will be kept anonymous.

The survey will take approximately 20 minutes to complete. The survey must be completed in one sitting, so please make sure that you have ample time to complete the entire survey before starting.

Your time, assistance, and input are invaluable and greatly appreciated.

If you have any questions about this survey, please contact Maho Imanishi (hwl2@cdc.gov, 404-718-4689), Karunya Manikonda (hum6@cdc.gov, 404-639-3530) or Hannah Gould (dvj9@cdc.gov, 404-639-3315) at the CDC Enteric Diseases Epidemiology Branch.

Public reporting burden of this collection of information is estimated to average 20 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).

Part 1. General questions

1. State name

[State]

2. Are you at a local health department or state health department?

Local

State

Other (please specify_______________________________________)

3. What is your job title or function?

Foodborne/enteric disease epidemiologist

Health officer

Food program director

State epidemiologist

Other (please specify _____________________________________)

4. How often does your NORS reporting agency enter foodborne disease outbreaks into NORS?

As they occur (‘real time’)

Weekly

Monthly

Every 6 months

Annually

When CDC closes out data

Other (specify _______________________________________)

5. How does your NORS reporting agency use foodborne disease outbreak data collected by NORS? (Choose up to 3)

 For outbreak investigations

 For analyses of foodborne disease outbreaks

 To learn about investigations by other states

 To respond to requests for data (e.g., The Freedom of Information Act, open records requests)

 To inform other state or local agencies

 To verify state outbreak database

 Other (please specify _______________________________________ )

 My agency does not use the NORS data

Part 2. Questions about the NORS interface

6. On a scale from 1 to 5, where 1 is not user-friendly, and 5 is very user-friendly, how would you rate the NORS interface

(a) in 2009 when NORS first launched?

(b) today?

For (a) and (b):

 1 (not user-friendly)

 2

 3

 4

 5 (very user-friendly)

 Not sure

7. Comparing NORS with the electronic Foodborne Outbreak Reporting System (eFORS), do you feel the system for foodborne disease outbreak reporting is better or worse?

 Much better => 8

 A little bit better => 8

 About the same => 8

 A little bit worse => 8

 Much worse => 8

 Not sure/I never used eFORS => 9

8. Please tell us why you feel the NORS system for foodborne disease outbreak reporting is better or worse than eFORS.
   
   

9. Comparing NORS with eFORS, how has the number of foodborne disease outbreaks reported to CDC from your NORS reporting agency changed since the introduction of NORS in January 2009?

 Many more foodborne disease outbreaks reported

 Slightly more foodborne disease outbreaks reported

 About the same number of foodborne disease outbreaks reported

 Slightly fewer foodborne disease outbreaks reported

 Many fewer foodborne disease outbreaks reported

 Don’t know

 Not sure/I never used eFORS

10. In 2009, did your agency experience any of the following interface problems when using NORS to enter foodborne outbreak reports?

 Yes => 11

 Never experienced any problems => 12

 Do not remember or not sure => 12

 I wasn’t here or did not enter any reports in 2009 and could not find someone who was => 12

11. In 2009, how often did your agency experience the following interface problems when using NORS to enter foodborne outbreak reports?

i) System (interface) froze or was non-responsive

ii) Lost data or failed data retrieval

iii) Locked out of the system

iv) Tabs within the interface did not appear when expected

For i)-iv)

 Never

 Sometimes

 Often

v) Other interface problems (please specify)

12. In the past 3 months, did your agency experience any of the following interface problems when using NORS to enter foodborne outbreak reports?

 Yes => 13

 Never experienced any problems => 14

 Do not remember or not sure => 14

 I wasn’t here or did not enter any reports in 2009 and could not find someone who was => 14

13. In the past 3 months, how often did your agency experience the following interface problems when using NORS to enter foodborne outbreak reports?

i) System (interface) froze or was non-responsive

ii) Lost data or failed data retrieval

iii) Locked out of the system

iv) Tabs within the interface did not appear when expected

For i)-iv)

 Never

 Sometimes

 Often

v) Other interface problems (please specify)

14. Who do you first contact when you encounter a technical issue?

 CDC (NORS team)

 IT personnel in your health department

 Colleagues in your health department

 Other (specify):

 Not sure

15. When you encounter a technical problem that affects routine data entry into NORS that requires CDC’s assistance, in general,

(a) how quickly does CDC respond to your inquiry?

(b) how quickly is the issue resolved?

For (a) and (b):

 1-2 days

 1 week

 2 weeks

 More than 2 weeks

 Don’t know

 Haven’t encountered a technical problem that required me to contact CDC

16. Approximately what proportion of foodborne disease outbreaks were not entered because of technical problems with the NORS application

(a) in 2009?

(b) in the past year <Dates to be specified before the survey is sent out>?

For (a) and (b):

 None

 Less than 10%

 10-<25%

 25-<50%

 50% or more

 Don’t know

17. Does your NORS reporting agency solely house its foodborne disease outbreak data in NORS (i.e., agency does not have its own outbreak data system)?

 Yes => 19

 No => 18

 Don’t know =>19

18. If no, what other type of system does your NORS reporting agency currently use to house foodborne disease outbreak reports? (Check all that apply)

 Paper-based system

 Excel spreadsheet

 Access database

 State-specific electronic reporting database

 Other (please specify)

19. Does your NORS reporting agency currently send any foodborne disease isolate or outbreak data through Public Health Information Network Messaging System (PHINMS)?

 Yes

 No

 Don’t know

20. How would you prioritize the following planned future NORS enhancements (not specific to foodborne disease outbreaks)? [Order at least 4: 1 being the most needed and 6 being the least]:

[ ] Increase allowed size for attachments

[ ] NORSDirect (i.e. feature to support direct upload of site data into NORS)

[ ] Access a specific outbreak report from the NORS Admin screen

[ ] Grant read/write access to a specific user

[ ] Other (please specify below)

21. Do you feel like you and other NORS users have received enough training or guidance about how to enter foodborne disease outbreak data into NORS?

 Yes

 No

 Not sure

22. What topics would you like further training on? (Check all that apply)

 NORS interface navigation

 The enhanced Full Download feature as soon as this functionality is available

 NORSDirect (i.e., uploading data directly into NORS via Public Health Information Network Messaging System (PHINMS) as soon as this feature is available

 Mode of transmission assignment (i.e., when to select food as the primary mode of transmission versus other modes of transmission)

 Other (please specify)

Part 3. Questions on data quality

23. Approximately what proportion of detected foodborne disease outbreaks are entered into NORS in your NORS reporting agency?

 90-100% => 25

 75-<90% => 24

 50-<75% => 24

 Less than 50% => 24

 Don’t know => 25

24. Which of the following factors most influence whether a detected foodborne disease outbreak is reported to NORS? (Choose up to 3)

 Pathogen

 Vehicle of the outbreak

 Location where the outbreak occurred

 Time of the year the outbreak occurred

 Quality of evidence about the outbreak (e.g., laboratory confirmation, implicated food)

 Available personnel and financial resources

 What else is happening in the state (e.g. non-foodborne outbreaks)

 IT issues at your health department

 IT issues with NORS

 Other (please specify)

 Don’t know

 None

25. On average, how many people review each foodborne disease outbreak report before it is entered in NORS?

[Number]

Don’t know

26. On a scale from 1 to 5, where 1 is low priority (data entered only if time/staff available) and 5 is high priority (make time to enter all the data), how would you rate the effort your NORS reporting agency puts into entering data on all foodborne disease outbreaks into NORS?

1 (low priority)

2

3

4

5 (high priority)

Prefer not to say

27. On a scale of 1 to 5, where 1 is low impact (does not affect reporting) and 5 is high impact (significantly affects reporting), how important is grant funding from Epidemiology and Laboratory Capacity (ELC) or Affordable Care Act (ACA) for reporting to NORS in your NORS reporting agency?

1 (low impact)

2

3

4

5 (high impact)

Don’t know or prefer not to say

28. In 2009, many health departments were dealing with H1N1 outbreaks. Did your NORS reporting agency experience decreased resources available to work on foodborne disease outbreaks?

    1. For detection (e.g., lab capacity):

    2. For investigation:

    3. For data entry and reporting:

For (a)-(c):

Yes

No

Don’t know

Part 4. Questions on mode of transmission in NORS

29. The revised guidance for reporting outbreaks was sent out in June 2012. Is the description of each mode of transmission in the guidance document useful and clear in deciding how to report outbreaks?

Useful and clear

Useful, but not clear

Clear, but not useful

Neither useful or clear

Don’t know

30. Does your NORS reporting agency have a protocol to follow to determine which outbreaks are reported as foodborne? [if you are willing to share the protocol, please provide in the textbox, or email to mimanishi@cdc.gov]

 Yes

 No

 Not sure

[textbox]

31. Since 2009, outbreaks with other primary modes of transmission can also be reported (food, water, animal contact, environment, or undetermined). As a result, many states have noted to CDC that it can be difficult to determine the primary mode of transmission for some outbreaks.

(a) Is this a problem that you have experienced?

 Yes => 32

 No => 33

 Not sure => 33

32. Which combinations of modes of transmission have caused you problems and for each of the combinations that have caused you problems, would the outbreaks have been reported as foodborne disease outbreaks in eFORS (before 2009)?

Combinations:

(i) Foodborne vs. person-to-person

(ii) Foodborne vs. water

(iii) Foodborne vs. animal contact

(iv) Foodborne vs. environmental contamination

(v) Foodborne vs. indeterminate/other/unknown

For (i)-(v):

No problems

Don’t know if problems

 Very likely 

 Likely

 Sometimes 

 Rarely

 Never

Don’t know if reported

(vi) Other (please specify _________________________)

Comment: _______________________________________________________

33. Is there a “default” that your NORS reporting agency usually picks when the modes of transmission is not clear?

 None – no default

 Foodborne

 Water

 Person-to-person

 Animal contact

 Environmental contamination

 Indeterminate/Other/Unknown

 Not sure

34. Comment: Please provide any additional feedback you have on NORS.

Thank you for completing the survey. The results of the evaluation will be shared with the participating state and local public health agencies via email/written report and in a webinar.

If you have any questions about this survey, please contact Maho Imanishi (hwl2@cdc.gov, 4047184689), Karunya Manikonda (hum6@cdc.gov, 4046393530), or Hannah Gould (dvj9@cdc.gov, 4046393315) at the CDC Enteric Diseases Epidemiology Branch.

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