Form 0920-0879 Online Survey Instrument_Web version

Form Approved
OMB No. 0920-0879
Expiration Date 01/31/2021

Instructions
Welcome! This data collection is meant for state and local health department staff. Thank you for
your interest in completing this survey. We hope to gain a better understanding of health
departments’ efforts to address ethics issues that arise in the practice of public health. Your
feedback is important. It will help us understand how health departments are currently addressing
ethical issues and what barriers may exist for implementing public health ethics activities. We are
also interested in what data sources are available within your health department for evaluating the
impact of having a systematic approach for addressing ethics concerns.
Completing the questionnaire is voluntary and takes approximately 11 minutes. There are no known
risks or direct benefits to you from participating or choosing not to participate, but your answers
will help CDC improve the public health ethics resources, training, and guidance that the Public
Health Ethics Unit at CDC provides to health departments throughout the country. In order to
preserve your privacy, we will not link your name or the name of your health department to your
individual responses in our report of the findings.
If you have any questions or concerns about this survey, please contact Drue Barrett, PhD, Public
Health Ethics Unit Lead, at phethics@cdc.gov or 404-639-4690.

CDC estimates the average public reporting burden for this collection of information as 11 minutes per response, including
the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the
data/information 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 burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS
D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).

Section 1: Background Information

What is your position title?

How many years have you served in this role?

Which of the following most accurately describes your health department's accreditation status (i.e.,
accreditation through the Public Health Accreditation Board)?
Accredited
Unaccredited, working towards accreditation
Unaccredited, not working towards accreditation
Unsure

Section 2: Current Ethics Activities

Does your health department have a formal process to identify, analyze, and resolve ethical issues that
arise in public health practice?
Yes
No, but we are currently working to establish a formal ethics process
No
Unsure

Approximately, how long has your health department had a formal ethics process?
Less than 1 year

5 years or more

1 year or more but less than 3 years

Unsure

3 years or more but less than 5 years

Which of the following are components of that process? Check all that apply
Ethics committee
Consultations with ethicist (e.g., academic or hospital ethicist)
Consultations with lawyer/ legal experts
Designated decision-maker/ ethics champion
Other (please specify)

How long has your health department had an ethics committee?
Less than 1 year

5 years or more

1 year or more but less than 3 years

Unsure

3 years or more but less than 5 years

Who serves on the ethics committee? Check all that apply
Health department leadership
Health department staff
Ethicist (e.g., academic or hospital ethicist)
Lawyer (includes health department attorney)
Community partners (members of the public)
Other partners (interest groups such as businesses, patient
advocacy groups, professional associations)
Unsure
Other (please specify)

How frequently does your health department's ethics committee meet?
Monthly
Quarterly
Yearly
Ad hoc, as-needed basis
Other (please specify)

Who identifies issues that are brought to your ethics committee? Check all that apply
Health department leadership
Health department staff members
Community partners (members of the public)
Other partners (interest groups such as businesses, patient
advocacy groups, professional associations)
Unsure
Other (please specify)

Please describe examples of the types of issues your ethics committee has addressed.Your response
should not include any sensitive but unclassified information (SBU), which includes personally identifiable
information (PII).

Does your health department require members of the ethics committee to receive ethics training?
Yes
No
Unsure

How often are ethics committee members trained?
Monthly

Ad-hoc, as needed basis

Quarterly

Unsure

Yearly
Other (please specify)

What types of training are offered to ethics committee members? Check all that apply
In-person
Live webinar
Self-study
Other (please specify)

Does your ethics committee use real or hypothetical case studies as a part of ethics training?
Yes
No
Unsure

Does your health department evaluate the impact of its formal ethics process?
Yes
No
Unsure

Does your health department provide either internal or external public health ethics-related training to
health department staff?
Yes
No
Unsure

Are public health ethics trainings required for health department staff?
Yes
No
Unsure

What types of training are required for health department staff? Check all that apply
In-person
Live webinar
Self-study
Other (please specify)

Please indicate which health department staff are required to attend ethics trainings:
Yes

No

Staff in leadership
positions
Scientific staff
All health department
staff
Other Staff, Please list

How often are health department staff required to take ethics training?
Monthly

Ad-hoc, as needed

Quarterly

Unsure

Yearly
Other (please specify)

Unsure

Section 3: Needs Assessment

To what extent do you agree with the following statement: “My health department has the capacity to
identify, analyze, and resolve ethics issues that arise using its current knowledge and training.”
Strongly agree

Disagree

Agree

Strongly disagree

Neither agree nor disagree

How often do you refer to “The Principles of the Ethical Practice of Public Health” (sometimes referred to as
the Public Health Code of Ethics) for guidance in addressing ethical issues that arise within your health
department?
Always

Never

Often

Unsure

Sometimes

Not aware of this resource

Seldom

Do you use any other framework to provide guidance on how to address ethical issues that arise within
your health department?
Yes
No
Unsure

Please briefly describe the other frameworks you use.

To what extent do you agree with the following statement: "I know where to obtain information about public
health ethics."
Strongly agree

Disagree

Agree

Strongly disagree

Neither agree nor disagree

From which of these organizations has your department sought resources about integrating public health
ethics principles into your health department’s practice?
Centers for Disease Control and Prevention (CDC)

Public Health Accreditation Board (PHAB)

National Association of County and City Health Officials
(NACCHO)

American Public Health Association (APHA)
Academic institution/ university

Association of State and Territorial Health Officials (ASTHO)
Unsure
Big Cities Health Coalition (BCHC)
Have not sought resources from external organizations
Other health jurisdiction
Other (please specify)

To what extent would the following resources be useful for you?
Highly Useful

Useful

Information on how to
build an ethics
committee
Information on how to
develop an ethics
committee charter
On-line course on public
health ethics
In-person training on
public health ethics
Ethics guidance on
specific topics
Please describe other topics for which you would like to receive ethics guidance:

Not at all Useful

Unsure

To what extent do you agree with the following statement: "My health department has the resources it
needs to address ethics issues that arise within public health practice."
Strongly agree

Disagree

Agree

Strongly disagree

Neither agree nor disagree

In your experience, which of the following are challenges to creating a formal ethics process? Check all
that apply
Lack of financial resources

Lack of public health ethics training materials

Lack of leadership support

Lack of guidance

Lack of ethics expertise

Lack of community support

Other (please specify)

Section 4: Impact of Public Health Ethics Activities

Is it important to be able to demonstrate the impact of a formal public health ethics process in your health
department?
Yes
No
Unsure

What data does your health department collect that would allow for an assessment of the impact of a
formal ethics process? Your response(s) should not include any sensitive but unclassified information
(SBU), which includes personally identifiable information (PII).

In addition to this survey, we are conducting 60-minute telephone interviews with a subset of survey
respondents to gain more detailed information about how state and local health departments are
addressing ethical issues that arise in public health practice and what needs they may have in building
ethics capacity. If you are willing to participate in a telephone interview, please select yes below. We will
only be selecting 8 people for telephone interviews.
Are you willing to participate in a follow-up interview?
Yes
No

Survey Complete

Thank you for participating in our survey. Your responses are very important to us. If you have any
questions about the survey or the telephone interview, please feel free to contact Drue Barrett at
Phethics@cdc.gov or 404-639-4690.