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Dissemination Project Survey

V4Final 031113

Purpose: Ross Brownson and colleagues at the Prevention Research Center in St. Louis are working on a new project in conjunction with NACDD and CDC on dissemination strategies to support uptake of evidence-based chronic disease prevention approaches among health departments. We are asking public healthstaff to help us by completing this survey.We will use the findings to plan ways to support use of public health knowledge in chronic disease prevention.

This survey will take approximately 15minutes of your time.Your responses are anonymous and participation is voluntary. Survey responses are not linked to anyone’s name or email address. Only summary findings will be reported that do not identify people, organizations, or states.

To thank you for your time, we are offering everyone who completes the survey a $20 Amazon gift card. The giftcard is not required to participate in the survey. At the end of the survey, you will be redirected to an optional separate webpagewhere you can choose to accept thegift card.

*Some formatting is not compatible with the Safari Internet browser. Please use a different browser.

Thank you.

SECTION A: BACKGROUND

Please answer the following questions about your background.

  1. How do you best describe your agency/organization?
  2. State Health Department
  3. Local Health Department
  4. Coalition
  5. Advocacy Group
  6. University or School
  7. Community-based Organization
  8. Voluntary Health Organization (e.g. American Cancer Society)
  9. Health Care Facility (e.g., hospital, clinic, medical health center)
  10. Other (please specify)
  1. Which of the following best describes your position?(Please check only one.)
  1. Program Manager/Administrator/Coordinator/Director
  2. Health Educator
  3. Epidemiologist
  4. Statistician
  5. Program Evaluator
  6. The overall director of all chronic disease programs
  7. Other Division or Bureau Head/ Deputy Director
  8. Department Head
  9. Community Health Nurse, Social Worker, Dietitian, Nutritionist
  10. Other (please specify)
  1. How long have you worked for this agency/organization?

Years

  1. How long have you been in your current position?

Years

  1. Over your whole career how long have you been involved in public health?

Years

  1. In what program areas do youspecialize? Please drag the mouse over as many as apply. (Required)

[Qualtrics has been programmed to randomly select 2of the 3-5 Section B topics where more than two would show based on the decision logic below. This way no one will be asked >2 Section B topics.]

  1. Tobacco[For Section B, Qualtrics to select tobacco]
  2. Obesity[For Section B, Qualtrics to select physical activity and nutrition]
  3. Physical Activity[For Section B, Qualtrics to select physical activity]
  4. Diet/Nutrition[For Section B, Qualtrics to select nutrition]
  5. Cancer Prevention and Control[For Section B, Qualtrics to show screening and skin ca prevention]
  6. Diabetes [For Section B, Qualtrics to select physical activity and nutrition]
  7. Cardiovascular Health[For Section B, Qualtrics to randomly pick 2 of PA, nutr, tobacco]
  8. Asthma [For Section B, Qualtrics to select physical activity]
  9. Health promotion[For Section B, Qualtrics to select physical activity and nutrition]
  10. School Health [For Section B, Qualtrics toselect only the new school health section]
  11. Evaluation[If only evaluation and/or epi is selected, skip to Section C]
  12. Epidemiology[If only epi and/or evaluation is selected, skip to Section C]
  13. Other (please specify)[For Section B, Qualtrics torandomly select 2 of the 5 possible topics]
  1. Does your program or work unit* (rollover definition)collaborate with healthcare systems that include hospitals, outpatient clinics, and/or Federally-qualified health centers?

YesNoI’m not sure

If yes:

7a. In what topic areas? (Please check all that apply.)

Cancer screening

Cancer survivorship

Other cancer prevention and control

Tobacco cessation

Obesity prevention

Diabetes prevention

Diabetes management

Cardiovascular health

Physical activity

Diet/Nutrition

Asthma

Arthritis

Other (please specify):

7b. Please give an example of your collaborations with healthcare systems:

[*Rollover: The planned definition was too long for a hover-the-mouse rollover, so we shortened it to:

The group of programs in the same administrative unit (chronic disease, health promotion, community health, or other) where you work.]

  1. Are you…?

Male

Female

  1. What is your age?

20-29 years

30-39 years

40-49 years

50-59 years

60 years or older

  1. Which degree/credentials do you hold (check all that apply)?

Associate degree

BS/BA

CHES

LPN

RN

BSN

ARNP (Advanced Registered Nurse Practitioner)

RD

MS or MSc

MPH or MSPH

MPA

MA

Other Masters Degree

MD or DO

DDS

PhD, DrPH, or ScD in a public health field

PhD or ScD in another field

EdD

RS (Registered Sanitarian)

Other (please specify below) ______

  1. In which state or territory do you work?

[Drop down box will be used, with Multiple States the first response option]

[If replied multiple states]

If you work in more than one state, in which states do you work?

  1. What stageof the Public Health Accreditation Board(PHAB) accreditation process is your state health agency in?

Phase 1: Doing pre-application work
Phase 2: Submitted PHAB application form and fee
Phase 3: Hosted a PHAB site visit
Phase 4: Received a PHAB Accreditation Committee decision

Don't know

SECTION B: INTERVENTIONS TO ADDRESS CHRONIC DISEASE PREVENTION

The following questions in this section are based on the program areas that you previously identified. You will read about various interventions intended to prevent or address cancer, cardiovascular diseases, or other chronic conditions. Please indicate whether or not your agency or agencies you fund have implemented each intervention by responding “yes, no, or don’t know” to each item. No single agency is expected to have implemented all the following interventions.

  1. Have you, your agency, or agencies you fund used any of the following interventions to increase cancer screening?

  1. Reminders to alert clients that it is time for their cancer screening (e.g. letters, postcards, phone calls)
/ Yes No Don’t know
  1. One-on-one education (e.g. telephone or face-to-face encounters conducted by a health professional such as a clinician or lay health advisor/promotora)
/ Yes No Don’t know
  1. Small media interventions to promote cancer screening in target populations (e.g.letters, brochures, or newsletters conveying educational or motivational information)
/ Yes No Don’t know
  1. Reducing structural barriers to breast or colorectal cancer screening to improve access (e.g. location, hours of operation, language)
/ Yes No Don’t know
  1. Reminders to alert healthcare providers that it is time or past time for clients’ cancer screening (e.g. chart or email reminders)
/ Yes No Don’t know
  1. Have you, your agency, or agencies you fund used any of the following interventions to prevent skin cancer?

  1. Educational and policy approaches in primary and middle schools to increase children's sun-protective behaviors (e.g. provision of sunscreen or shade)
/ Yes No Don’t know
  1. Educational and policy approaches in outdoor recreation settings to increase adults’ sun-protective behavior (e.g. provision of sunscreen or shade)
/ Yes No Don’t know
  1. Community-wide combined interventions to prevent skin cancer (e.g. mass media campaigns in combination with education or environmental or policy changes)
/ Yes No Don’t know
  1. Have you, your agency, or agencies you fund used any of the following tobaccocontrol interventions?

  1. Reminders for clinic healthcare providers to discuss tobacco cessation with clients (e.g. chart stickers, medical record check lists)
/ Yes No Don’t know
  1. Policies or programs to reduce out-of-pocket costs of tobacco cessation medications or counseling
/ Yes No Don’t know
  1. Mobile phone-based interventions for tobacco cessation (e.g. text messages that support quit attempts)
/ Yes No Don’t know
  1. Public education about clean indoor air policies
/ Yes No Don’t know
  1. Public education about the effects of price on tobacco consumption
/ Yes No Don’t know
  1. Working with hospitalsfor screening of inpatients for current tobacco use
/ Yes No Don’t know
  1. Working with hospitals so that inpatients are provided tobacco cessation counseling and medication
/ Yes No Don’t know
  1. Working with hospitals so that inpatients using tobacco cessation services are referred at discharge for follow-up cessation counseling and medications
/ Yes No Don’t know
  1. Have you, your agency, or agencies you fund used any of the following physical activity interventions?

  1. Individual health behavior change programs (e.g. teaching goal setting, self-monitoring of progress,problem solving)
/ Yes No Don’t know
  1. Interventions that set up social support for physical activity (e.g. buddy systems, walking groups)
/ Yes No Don’t know
  1. Programs or policies that make streets safe for motorists, cyclists, and pedestrians (e.g. street lighting, crosswalks, bike lanes, Complete Streets)
/ Yes No Don’t know
  1. Programs or policies that increase the amount of student physical activity timein school-based physical education classes
/ Yes No Don’t know
  1. Programs or policies that create or improve access to places for physical activity (e.g. walking trails, making exercise facilities more accessible)
/ Yes No Don’t know
  1. Have you, your agency, or agencies you fund used any of the following nutrition interventions?

  1. Worksite policy and environmental approaches to improve access to healthy foods (e.g. changing worksite cafeteria options, vending machine content)
/ Yes No Don’t know
  1. Improvement in nutrient content, presentation, and quality of school foods
/ Yes No Don’t know
  1. Nutrition labeling and information (e.g. point-of-purchase labeling in cafeterias and worksites, restaurant menu labeling)
/ Yes No Don’t know
  1. Food pricing and incentives (e.g. reducing pricing of healthy vending machine and cafeteria foods)
/ Yes No Don’t know
  1. Have you, your agency, or agencies you fund used any of the following school health interventions?

  1. Programs or policies that increase the amount of student physical activity time in school-based physical education classes
/ Yes No Don’t know
  1. Improvement in nutrient content, presentation, and quality of school foods
/ Yes No Don’t know
  1. Educational and policy approaches in primary and middle schools to increase children's sun-protective behaviors (e.g. provision of sunscreen or shade)

  1. Changes in crosswalks, sidewalks, street designs, or traffic flow to promote students walking and biking to school
/ Yes No Don’t know
  1. Joint use agreements between schools and communities for the public to use school athletic tracks, walking paths, and/or gyms
/ Yes No Don’t know

SECTION C: YOUR VIEWS ON EVIDENCE-BASED INTERVENTIONS

This section asks about your views on evidence-based interventions, which are programs and policies with evidence (based on published research ) of improving health, such as those interventions covered in the previous section. The term intervention refers to evidence-based behavioral strategies, changes to the physical environment, policy approaches, or clinical services that are specific and structured. Please indicate the extent to which you agree or disagree with the following statements. *Hover your mouse over blue text for definitions.

  1. Evidence-based interventions* are applicable to the specific populations my agency serves. [EBI definition rollover]

[*Policies, programs, strategies, and practices that are based on the best available public health science, knowledge, and data.]

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. I have the skills I needto adaptevidence-based interventionsfrom one population to another.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. I have the skills I need to adapt evidence-based interventions from one setting to another.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. I can effectively communicate information on evidence-based interventions toelected officials.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. Program staff in my work unit* (rollover definition) is aware of published evidence reviews of interventions.

Strongly Disagree 1 2 3 4 5 6 7Strongly Agree

  1. Program staff in my work unit is aware of toolkits for planning and evaluation.

Strongly Disagree 1 2 3 4 5 6 7Strongly Agree

  1. My work unit plans for evaluation of interventions prior to implementation.

Strongly Disagree 1 2 3 4 5 6 7Strongly Agree

  1. My work unit uses evaluation data to monitor and improve interventions.

Strongly Disagree 1 2 3 4 5 6 7Strongly Agree

  1. My work unit distributes intervention evaluation findings to other organizationsthat can use our findings.

Strongly Disagree 1 2 3 4 5 6 7Strongly Agree

SECTION D: EVIDENCE-BASED DECISION MAKING DEFINITIONS AND SUPPORTS

Now we are shifting to a broader context on use of an evidence-based process to plan and carry out public health services, programs, and policies in chronic disease prevention. Throughout the survey, such a process is referred to as evidence-based decision-making (EBDM). EBDM involves:

  • Making decisions based on the best available scientific and/or rigorous program evaluation evidence;
  • Applying program planning and quality improvement frameworks;
  • Engaging the community in assessment and decision making;
  • Adapting and implementing evidence-based interventions for specific populations or settings; and
  • Conducting sound evaluation.
  1. Which of the following would most encourage you to utilize EBDM*in your work? Using the list below, please rank the top three, where 1 is the most important. [Program Qualtrics for drag and drop]

[*Prioritizing issues and implementing interventions based on sound science combined with community engagement, sound management, and evaluation. [If too long, delete sound management]]

Leaders in my agency placing a high priority on EBDM

Direct supervisors placing a high priority on EBDM

Positive feedback or encouragement to use EBDM

Easy access to data resources for EBDM

An employee performance evaluation that supports the use of EBDM

Professional recognition for use of EBDM

Making EBDM part of job descriptions in my agency

Support for travel to regional or national meetings to learn about or present on EBDM

Other: please specify

  1. Each state health agency has different needs. Which of the following would be most useful to you in applying EBDM* in your work? From the items below, please rank the top three, where 1 is the most useful.

General EBDM training workshops

EBDM training for specific program areas

Access to peopleby phone or email for questions about EBDM

Help with EBDM processes (e.g. community assessment, evaluation)

EBDM webinars

Self-paced EBDM internet programs

Interactive EBDM web-based meetings

Summaries of research evidence (issue briefs)

Policy briefs

Network of partner organizationsthat meets online

Network of partner organizations that meets in person

Other: please specify

SECTION E: IMPORTANCE AND AVAILABILITY OF EBDM

Now, we would appreciate your help rating the importance and availability of each skill in the statements below.

First, read the statements (skills in EBDM) below; then, use the first scale to rate the importance of each of the skills to you. Next, use the second scale to rate how available each skill is to you when you need it (either in your own skill set or among others' in your agency).

  1. Prioritization: Understand how to prioritize program and policy options.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Adapting interventions: Understand how to modify programs and policies for different communities and settings.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Quantifying the issue: Understand the uses of descriptive epidemiology (e.g., concepts of person, place, time)in quantifying a public health issue.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Evaluation designs: Understand the different designs that are useful in program or policy evaluation.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Quantitative evaluation: Understand the uses of quantitative evaluation approaches (e.g., surveillance and/or surveys).

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Qualitative evaluation: Understand the value of qualitative evaluation approaches (e.g., focus groups, key informant interviews) including the steps involved in conducting qualitative evaluations.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Economic evaluation: Understand how to use economic data in the decision making process.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Action planning: Understand the importance of developing an action plan for how to achieve goals and objectives.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Community assessment: Understand how to define the health issue according to the needs and assets of the population/community of interest.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

  1. Communicating research to policy makers: Understand the importance of effectively communicating with policy-makers about public health issues.

Unimportant 0 1 2 3 4 5 6 7 8 9 10 Very Important

Not Available 0 1 2 3 4 5 6 7 8 9 10 Very Available

SECTION F: DISSEMINATIONOF EBDM

The next sections of the survey will help us understand readiness to support use of EBDM*. (EBDM rollover) For the following statements, please indicate the extent to which you agree or disagree.Please remember that your responses are anonymous and only summary findings that do not identify people, organizations, or states will be reported.

*Hover your mouse over blue text for definitions.

Your Experiences with EBDM

  1. I am provided the time to identify evidence-based programs and practices.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. I use EBDM* in my work. [rollover EBDM definition]

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. My direct supervisor expects me to use EBDM.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. My direct supervisor recognizes the value of management practices*(provide rollover) that facilitate EBDM.

*For example, asking for employee input, hiring well-trained staff, supporting learning, building partnerships, and using effective budget practices

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

  1. My performance is partially evaluated on how well I use EBDM in my work.

Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

Your Work Unit’s Support of EBDM