Survey of Experiences with and Attitudes towards Zika Vi

Form Approved

OMB No. 0920-1154

Exp. 01/31/2020

Att A

#99

The American Academy of Pediatrics (AAP) is collaborating with the Centers for Disease Control and Prevention (CDC) to learn about pediatricians’ experiences with and attitudes toward infectious disease and disaster preparedness, with a focus on Zika virus.

Thank you for your participation in the Periodic Survey.

Infectious Disease and Natural Disaster Preparedness

1. Thinking about infectious disease and natural disaster preparedness at your main practice site, how prepared is your main practice site to respond to outbreaks of infectious disease or natural disasters (e.g., hurricanes, tornados, earthquakes)? For each of the following, please indicate A) if your main practice site has a preparedness plan and B) how prepared your main practice site is to respond.

	A) Main practice site has preparedness plan for:			B) How prepared is main practice site to respond?
	Yes	No	Unsure	Not at all prepared	Slightly prepared	Moderately prepared	Very prepared
Infectious disease outbreak							
Natural disaster (e.g., hurricane, tornado, earthquake)							

2. Thinking about infectious disease and natural disaster preparedness at your main practice site, please indicate the extent to which you think the following resources would be helpful to your main practice site. For each of the following, please select one response for A) infectious disease outbreak and B) natural disaster.

   	Infectious disease outbreak				Natural disaster
   	Not at all helpful	Slightly helpful	Moderately helpful	Very helpful	Not at all helpful	Slightly helpful	Moderately helpful	Very helpful
   Assistance with developing practice-based guidance								
   Educational materials for health care professionals								
   Educational materials for parents of affected children								
   Methods to connect pediatricians with local health departments								
   Methods to connect pediatricians with national health organizations								
   Strategies for communicating with patients during response								
   Guidance on practice-based exercises or drills								

3. Thinking about barriers to infectious disease and natural disaster preparedness for your main practice site, to what extent do you feel that the following are barriers to preparing for outbreaks of infectious disease and natural disasters? For each of the following, please select one response for A) infectious disease outbreak and B) natural disaster.

	Infectious disease outbreak				Natural disaster
	Not a barrier	Slight barrier	Moderate barrier	Significant barrier	Not a barrier	Slight barrier	Moderate barrier	Significant barrier
Financial costs								
Time required								
Personnel resources								
Lack of administrative buy-in								
Lack of knowledge								

Infectious Disease and Natural Disaster Training

4. In the past 2 years, have you personally participated in any education or training events on any of the following? Please select one response for each item.

	Yes	No
Natural disaster (e.g., hurricane, tornado, earthquake)		
Infectious disease outbreak		Skip to Q6 

Did this include education or training on Zika virus?

 Yes Go to Q5

 No Skip to Q6

Note: While the previous sections of the survey asked generally about infectious disease and natural disaster preparedness, the remaining questions refer specifically to Zika virus.

Zika Virus Training

5. In the past 2 years, which of the following education or training events specific to Zika virus have you personally participated in? Please indicate A) if you have participated in any of the following events and B) the sponsor of the event.

	A) Participated in event?		B) If yes, please indicate the event sponsor
	Yes	No	CDC	AAP	State/local government agency	Academic medical center	Other (specify) ___________ ___________
Grand Rounds							
In-person lecture or presentation							
Webinar, conference call, or telementoring program							
Other (specify)________ ____________________							

Attitudes toward Zika Virus

6. Thinking about your attitudes toward Zika, please indicate to what extent you agree or disagree with the following statements. Please select one response for each item.

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Zika was previously a critical issue for my community					
Zika is currently a critical issue for my community					
Zika could be a critical issue for my community in the future					
It is important to discuss risk factors and prevention strategies for Zika virus with my patients and their families					
Partnering with local public health departments and community agencies is important to prevent Zika					
Partnering with local public health departments and community agencies is important to manage Zika					

Zika Virus Counseling

7. How comfortable are you talking with patients and their families about Zika virus? (Consider risks, travel, screening, transmission, prevention, etc.)

	Not at all comfortable
	Slightly comfortable
	Moderately comfortable
	Very comfortable

8. Over the past 12 months, how frequently have you received questions from patients and their families on the following topics regarding Zika virus? Please select one response for each item.

	Never	Rarely	Sometimes	Often
Risk factors				
Travel issues				
Screening and testing				
Infection and transmission				
Preventive measures				
Birth defects				
Long-term follow-up				

Knowledge about Zika Virus

9. Overall, how knowledgeable are you about Zika virus?

	Not at all knowledgeable	Skip to Q12
	Slightly knowledgeable
	Moderately knowledgeable
	Very knowledgeable

10. Thinking about your current knowledge of Zika virus, how important have each of the following been in informing your current knowledge? Please select one response for each item.

	Not at all important	Somewhat important	Moderately important	Very important
CDC professional resources				
AAP professional resources				
State or local health departments				
Academic medical centers				
Employer				
Medical education (e.g., medical school, residency, CME)				
Academic or technical literature (e.g., journal articles, reports)				
News media (e.g., newspapers, online news, radio, TV)				
Interactions with other pediatricians				

11. How familiar are you with each of the following Zika virus resources? Please select one response for each item.

	Not at all familiar	Slightly familiar	Moderately familiar	Very familiar
Current CDC Guidance about Evaluation and Management of Infants with Possible Congenital Zika Virus Infection				
Zika reports in CDC’s Morbidity and Mortality Weekly Report (MMWR)				
AAP online resources				
AAP webinar series				

Zika Virus Resources

12. Overall, how interested are you in learning more about Zika virus?

	Not at all interested	Skip to Q14
	Slightly interested
	Moderately interested
	Very interested

13. How interested are you in learning more about the following related to Zika virus? Please select one response for each item.

	Not at all interested	Slightly interested	Moderately interested	Very interested
Preventive measures to discuss with patients and families				
Testing and referral procedures for Zika infection				
Clinical manifestation of Zika virus infection				
Risk factors				
Reporting infants born to women with laboratory evidence of possible Zika virus infection to health department officials				
Use of or reporting to the U.S. Zika Pregnancy Registries				
Counseling parents of infants affected by Zika virus				
Management of infants affected by Zika virus				
Communicating public health information to your community				
Identifying local and state public health resources				

Zika Virus Screening and Treatment

14. Over the past 12 months, how frequently have you or your practice site done the following? Please select one response for each item.

	Never	Rarely	Sometimes	Often
Screened or recommended a patient be tested for Zika				
Treated a patient who is reported to be infected with Zika virus				
Treated an infant patient born with congenital Zika virus syndrome				
Took Zika exposure histories from parents of infant patients (including travel, sexual transmission, or mosquito)				
Received post-partum/discharge summaries from post-delivery that contain Zika testing results during pregnancy from parents or parents’ OB/GYN				
Conducted developmental screens of infant patients with possible Zika virus exposure				

15. Have you personally ever done the following? Please select one response for each item.

	Yes	No
Screened or recommended a patient be tested for Zika		
Treated a patient who is reported to be infected with Zika virus		
Treated an infant patient born with congenital Zika virus syndrome		

Zika Virus Preparedness

16. How prepared do you feel to address each of these areas in relation to Zika virus? Please select one response for each item.

	Not at all prepared	Slightly prepared	Moderately prepared	Very prepared
Providing travel advice to patients that may be travelling to areas affected by Zika virus				
Informing patients of preventive measures to avoid Zika virus				
Recommending testing for Zika virus				
Providing clinical referrals for infected infant patients				
Discussing potential birth defects with pregnant women who may be exposed to Zika virus				
Providing data to the CDC’s U.S. Zika Pregnancy Registry				
Managing infants exposed to Zika prenatally				
Informing patients of social services for Zika-affected infants				

Barriers to Zika Testing and Referral

17. Thinking about barriers to testing patients for Zika virus, to what extent do you feel that the following are barriers? Please select one response for each item.

	Not a barrier	Slight barrier	Moderate barrier	Significant barrier	Don’t know
Poor communication from the OB/GYN practice to the pediatric care provider					
Poor communication from the delivering hospital to the pediatric care provider					
Lack of reimbursement for services					
Patients’ inability to pay for services					
Reluctance from patients or patients’ families					
Inadequate screening and testing resources (e.g., staff, time)					
Lack of information about CDC guidance					
Difficulty following testing procedures recommended in CDC guidance					

18. Thinking about barriers to referring patients for Zika virus, to what extent do you feel that the following are barriers? Please select one response for each item.

	Not a barrier	Slight barrier	Moderate barrier	Significant barrier	Don’t know
Not enough subspecialty providers for consultation and follow-up					
Uncertainty about where to refer patients					
Care coordination with subspecialists for infant patients					
Patients’ inability to pay for services					

Physician Characteristics

19. During a typical work week, how many hours do you spend in the following professional activities? If you do not spend any time in an activity, please enter zero (0) hours.

Activity Hours

Direct patient care hours

Administration hours

Academic Medicine hours

Research hours

Fellowship training hours

Other (specify) hours

Total hours per week:

20. Please indicate yes or no to the following questions: Please select one response for each item.

    	Yes	No
    Are you currently a resident?		
    Do you currently work part-time?		

21. Approximately what percentage of your professional time is spent in the following areas? Note: percentages should sum to 100%.

General Pediatrics ____________%

Other specialty/subspecialty (specify)___________________________ ____________%

100%

22. Please indicate your primary employment setting, that is, the setting where you spend most of your time. Please check only one response.

	Solo or two physician practice		Medical school or university affiliated hospital or clinic
	Pediatric group practice		Community or non-university hospital or clinic
	Subspecialty group practice		Federal, state, or local government hospital or clinic
	Multispecialty group practice		Other

23. At your primary employment setting, are you a(n):

    	Employee		Independent contractor
    	Full- or part-owner		Other

24. Please answer the following questions by filling in a number. Please fill in one response for each item.

    In what year did you begin practice (excluding formal training)? Please fill in the year.
    What is the zip code of your primary practice/position? Please fill in the zip code.

25. Where was your medical school located?

• United States

  

• Other Please specify which country: ______________________________________

26. Do you currently hold an academic appointment?

	No		Yes, part-time academic faculty
	Yes, full-time academic faculty		Yes, adjunct, volunteer, and/or courtesy faculty

27. Please describe the community in which your primary practice/position is located.

	Urban, inner city		Suburban
	Urban, not inner city		Rural

28. Approximately what percentage of your patients would you estimate are covered by the following insurance sources and systems? Note: If you have no patients covered by a specific insurance source/system, please enter a “0” in that space; percentages should sum to 100%.

Private insurance %

Public insurance (Medicaid, SCHIP, or other) %

TRICARE (military insurance) %

Uninsured ___________ %

100%

Don’t know patients’ insurance sources

29. What is your gender?

	Male
	Female
	Prefer to self-describe_____________________

30. In what year were you born? Please fill in the year. 19

Thank you for your participation in the Periodic Survey

Please return in the enclosed envelope to:

Periodic Survey, Division of Health Services Research

American Academy of Pediatrics, PO Box 927

Elk Grove Village, IL 60009-9920

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