Form 0920-1027 NPIN Evaluation Screener

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

NPIN Evaluation Screener

2018 NPIN Evaluation Focus Groups

OMB: 0920-1027

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NPIN Evaluation Screener

S1. Are you currently an employee or fellow of the Centers for Disease Control and Prevention?

(Yes/NO)

PN : If “YES,” terminate participation



S2. Have you engaged with the Center for Disease Control’s National Prevention Information Network (NPIN) in the past 2 years? (YES OR NO)

PN : If “NO,” terminate participation



S3. In what ways have you engaged with NPIN (Check all that apply)

  • Received an NPIN email and read it

  • Downloaded materials or resources from NPIN.cdc.gov

  • Attended an NPIN sponsored webinar

  • Attended an NPIN sponsored training

  • Attended an NPIN Twitter Chat

  • Accessed the NPIN Community

  • Sent an email to NPIN info box

  • Engaged with NPIN Social Media

  • Stopped by Conference Booth

  • Other (please describe)

  • None

PN: If “NONE,” terminate participation



S4. Please indicate the disease prevention area(s) in which you work (check all that apply):

    • HIV/AIDS

    • Sexually Transmitted Diseases

    • Tuberculosis

    • Viral Hepatitis

    • Adolescent Sexual Health

    • Other (Please describe)

    • None

PN: If “NONE,” terminate participation



S5. What city do you live in? (open end)

PN: Use the State List provided by Schlesinger programmers

S6. What state? (Dropdown)







If GA, MA, NH, IL, TX, CA, NY, CT, NJ, FL, PA, DE, AZ MO are mentioned at S6, continue to S7. If not skip to SURVEY: NPIN Evaluation Data Collection Instrument

S7. Do you live within 30 miles of any of following cities?

Atlanta, GA CONTINUE TO FG.1

Boston, MA CONTINUE TO FG.1

Chicago, IL CONTINUE TO FG.1

Dallas, TX / Fort Worth, TX CONTINUE TO FG.1

Houston, TX CONTINUE TO FG.1

Los Angeles, CA CONTINUE TO FG.1

New York City, NY CONTINUE TO FG.1

Orlando, FL CONTINUE TO FG.1

Philadelphia, PA CONTINUE TO FG.1

Phoenix, AZ CONTINUE TO FG.1

San Francisco, CA CONTINUE TO FG.1

St Louis, MO CONTINUE TO FG.1

None of the above SKIP TO SURVEY: NPIN Evaluation Data Collection Instrument, S1



FOCUS GROUP SCREENING

FG.1 Would you be interested in participating in a face to face discussion in mid to late May along with other local people who are engaged with the Center for Disease Control’s National Prevention Information Network? The discussion will last approximately 90 minute to 2 hours.

Yes, interested SKIP TO FG.3

Maybe SKIP TO FG.3

No ASK FG.2



PN: If FG1=NO

FG.2 Would you like to continue participating in the online survey?

Yes – GO TO SURVEY: NPIN Evaluation Data Collection Instrument

No TERMINATE



PN: IF FG.1=Yes orIF FG.1=Maybe

FG.3 Please share your contact information. We will be in touch regarding further research opportunities in the next two to three weeks.



Name

Email address

Daytime telephone:





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorEverett L. Long
File Modified0000-00-00
File Created2021-01-21

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