Form #1 Web-based Survey

Attachment A - SURVEY

Form Approved
OMB No. 0935-0179
Exp. Date 7/31/2014

Agency for Healthcare Research and Quality

Healthcare Providers/ Educators Customer Satisfaction and Needs Assessment

Survey Questionnaire
Version 5

Public reporting burden for this collection of information is estimated to average 10 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

Figure 1: Schematic of the Health Educator Customer Satisfaction and Needs Assessment Survey Branch Pattern

SECTION 1:

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Question

Measurement Scale

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Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program Web site

How familiar are you with the following:

	Extremely familiar	Moderately familiar	Somewhat familiar	Not at all familiar
Agency for Healthcare Research and Quality (AHRQ)
AHRQ’s Effective Health Care Program

How familiar are you with comparative effectiveness research (CER), also sometimes called patient-centered outcomes research (PCOR)?

• Extremely familiar

• Moderately familiar

• Somewhat familiar

• Not at all familiar

Options 1 & 2, go to Q3.

Option 3 & 4, skip to Q4

How often do you use the following sources to obtain information about comparative effectiveness research or PCOR?

	Daily or almost daily	At least once a week	Two to three times a month	About once a month	A couple of times a year	Never. I don’t use this as a source
AHRQ Effective Health Care Program Web site
Federal government agencies (other than AHRQ)
General Web site searches
Peer-reviewed published literature
Private sector organizations
Professional associations

Please specify any specific sources/organizations you have found useful to you (e.g., journals, government agencies, etc.)____________

Section 2 – Respondent Characteristics and Health Educator Screener

2. Question

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What type of health care practitioner are you? Select the option that best characterizes your role.

• Care manager/case manager

• Certified health education specialist (CHES)

• Clinical psychologist

• Clinical social worker

• Community health worker

• Diabetes educator

• Health care navigator/patient navigator

• Nurse

• Nurse practitioner

• Pharmacist

• Physician assistant

• Physician, generalist

• Physician, specialist (Please specify specialty)

• Physical Therapist

• Registered dietician

• Respiratory therapist

• Other

(Please specify specialty or other occupation category)_____________________

How many years have you been in your current occupation?

• Less than 2 years

• 3 to 9 years

• 10 to 19 years

• 20 to 25 years

• 26+ years

In what kind of setting do you practice the majority of the time?

• Ambulatory/office-based care setting

• Behavioral health care setting

• Community health care setting

• Federally qualified health center/public

• Home care

• Hospital-based setting

• Long term care facility

• Pharmacy setting

• Substance use/abuse treatment center

Other (Please specify)______________________

Approximately what percentage of the patients in your practice setting has a chronic disease? (Estimating is fine)

• 0-10%

• 11-25%

• 26-50%

• 51-75%

• >75%

• Do not know

Is English your first language

• Yes

• No

If no, what is your first language? ___________________

Approximately what percentage of the patients you work with is uninsured, underinsured, or underserved?

• 0-10%

• 11-25%

• 26-50%

• 51-75%

• >75%

• Do not know

Do your job responsibilities include educating patients or providing health education to patients or their caregivers?

• Yes – this is my primary job responsibility

• Yes – this is part of my job responsibilities

• No – not part of my job responsibilities

First two options skip to question 11.

For “Not at all,” skip to end of survey.

Section 3 – Screener about type of health education provided by respondent (e.g., helping patients with clinical decisionmaking or just general health promotion, etc.)? Note, this questions attempts to further target individuals who would potentially benefit from AHRQ PCOR/CER information.

Question

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Do your job responsibilities include helping patients make decisions about their health care or educating patients about their available options for treatment or other interventions (e.g., screening or diagnostic procedures)?

• Yes – this is my primary job responsibility

• Yes – this is part of my job responsibilities

• No – not part of my job responsibilities

First two options skip to question 12.

For option 3 “No” skip to end of survey.

Section 4 – Screener for the type of health educator (e.g., someone involved in diagnosing/treating or other). Used to determine which branch of the survey the respondent will take.

4. Question

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Do your job responsibilities include diagnosing illness, treating illness, writing prescriptions, or making referrals to other health care providers?

• Yes

• No

Yes, go down path 5A

No, go down path 5B

Section 5A/5B Common Path – AHRQ Health Educator Tools and Resources

The Agency for Healthcare Research and Quality’s (AHRQ) is the lead Federal agency charged with improving the quality of health care for all Americans.

AHRQ conducts and synthesizes evidence on the effectiveness and comparative effectiveness of treatments and health care interventions for many health conditions. AHRQ also translates this information into tools and resources for clinicians and patients that can be used when making health care decisions.

AHRQ Tools and Resources for Patients and Clinicians

Which of the following AHRQ Effective Health Care Tools have your used in the past year? (Select all that apply)

• AHRQ Effective Health care Web site

• Clinician summaries

• CME modules

• Consumer summaries

• Faculty slide decks

• Mobile applications from the AHRQ EHC Web site

• Patient decision aids

• Research reviews or syntheses

• Spanish language Consumer summaries

• Viewed or participated in the EHC Web conference series

• Web casts

How useful would it be to you, considering the time you have to spend with patients, to have the following tools?

	Very useful	Somewhat useful	Not very useful	Not at all useful	I don’t use these types of tools
Clinician summaries on specific topics of interest
Mobile applications
Patient summaries (in English) on specific topics of interest
Patient summaries (in Spanish) on specific topics of interest
Slide decks on specific topics of interest
Patient decision aids (in print format) that I can print and share with patients
Patient decision aids (in electronic format) that I can share with patients in my sessions on an electronic tablet or other handheld device
Patient decision aids in Spanish
Video shorts (stand-alone)
Video shorts (Web based)
Audio tapes/CDs (stand-alone)
Audio tapes/CDs (Web based)

If you could have any other tools to share with patients, what would they be?

Open ended

Are there any other languages would you like to have tools translated into?

Open ended

The following is a list of AHRQ’s priority conditions.

How useful to you would it be to have patient educational information or decisions aids on each of the following topics?

	Very useful	Somewhat useful	Not very useful	Not at all useful	Not a topic I address
Breathing Conditions
Cancer
Developmental Delays, ADHD, Autism
Diabetes
Digestive System Conditions
Genitourinary Conditions
Gynecology
Heart and Blood Vessel Conditions
Infectious Disease and HIV/AIDs
Mental Health
Muscle, Bone, and Joint Conditions
Nonclinical Topics
Ophthalmologic Conditions
Pediatrics
Pregnancy and Childbirth
Renal Disease
Other conditions/topics (please specify)__________________

AHRQ – Effective Health Care Program Continuing Education

Would you participate if accredited continuing education modules or workshops were available on how to use AHRQ decision aids and tools?

• Definitely

• Probably

• Possibly

• Probably not

• Definitely not

Section 5A – Questions for clinicians who treat or diagnose patients and are involved in education related to helping patients make decisions about the treatment or intervention options

12. Question

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Shared decisionmaking is a process where both the patient and clinician share information, participate in the decisionmaking process, and agree on the best strategy for treatment.

The clinician provides personalized information, tools, and/or decision aids to help the patient understand available treatment options, and encourages the patient to consider his or her personal values in making treatment-related decisions.

Using the definition above, how often do you involve your patients in a decisionmaking process regarding their care?

• All the time

• Most of the time

• Occasionally

• Rarely

• Never

Options 1-4 proceed to question 20.

Options 5 (Never), proceed to section 7

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For each of the following situations, how often do you involve patients in decisionmaking or educational discussions related to their care:

	All the time	Most of the time	Occasionally	Rarely	Never
Changing their lifestyle behaviors
Deciding on their medicines (e.g., blood pressure, cholesterol, depression)
Whether or not to undergo cancer screening tests (e.g., colon, breast, prostate)
Having surgery (e.g., back surgery, knee or hip replacements)
Choosing between various cardiac procedures
Managing chronic conditions
Having an MRI or CT Scan
Other (please specify) _________________________

When you engage in shared decisionmaking with patients, how do you typically do it?

Please select all that apply.

• At the point of care, through one-on-one conversations with the patient

• At the point of care with family or other caregivers present

• By phone before their visit

• Directing patients to a Web site that provides patient decision aids online prior to their visit

• Directing patients to a Web site that provides patient decision aids online after their visit

• In a group setting

• Some other way (please specify)__________________

Section 5B – Questions for healthcare professionals who do NOT treat or diagnose patients but are involved in education related to helping patients to understand their treatment or intervention options

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Question

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How often do your interactions with patients include education to help them or their caregivers understand the options available for their care?

For example, helping them to understand technical information about their condition, the harms and benefits associated different medicines, or procedures they may be considering.

• Always

• Almost always

• Occasionally

• Almost never

• Never

Options 1-4 proceed to question 20.

Option 5, proceed to section 7

How often do your decisionmaking or educational discussions with patients/caregivers relate to each of the following situations:

Helping them to….

	All the time	Most of the time	Occasionally	Rarely	Never
Change their lifestyle behaviors
Better understand their medicines (e.g., blood pressure, cholesterol, depression)
Better understand the harms and benefits of various cancer screening tests (e.g., colon, breast, prostate)
Better understand the harms and benefits of having surgery (e.g., back surgery, knee or hip replacements)
Better understand the harms and benefits of various cardiac procedures
Learn how to manage chronic conditions
Better understand the harms and benefits of having various imaging procedures (e.g., MRI or CT Scan)
Other (please specify)

When you engage in educational discussions with patients, how do you do it?

Please select all that apply.

• Through one-on-one conversations with the patient in my practice setting

• In the clinic during their regular visits, with family or other caregivers present

• In a group setting

• In a community setting

• In the patients home

• By phone before an office visit

• By phone after an office visit

• Directing patients to a Web site that provides patient decision aids online prior to their visit

• Directing patients to a Web site that provides patient decision aids online after their visit

• Some other way (please specify)

Section 5A/5B Common Path – Shared Decision Making/Patient Education Questions

Which of the following elements would you say are part of your role in helping patients who are confronted with options regarding their care?

Please select all that are relevant to you.

• Assessing factors that might influence the patient’s decisionmaking

• Assessing the patient’s understanding of options and evidence

• Clarifying the patient’s preferred option

• Discussing the patient’s decision support needs and resources

• Determining the patient’s preferred role

• Providing educational resources, including patient decision aids

• Encouraging the patient to select their preferred option

• Coaching patients to discuss their preferences with their clinicians/health care providers

• Screening or planning for barriers to implementation of possible care options

How much time per visit are you able to spend with individual patients educating them or discussing options related to medical treatments, procedures, or medicines?

• 3 minutes or less

• 4 to 5 minutes

• 6 to 10 minutes

• 11 to 15 minutes

• More than 15 minutes

To what extent are you encouraged by your organization to educate patients or to help them better understand their options for treatments or interventions related to their clinical care?

• To a great extent

• Neither encouraged nor discouraged

• Not at all

How often do the following situations prevent you from fully engaging patients as much as you would like in the decisionmaking process or educating them about health care options?

	All the time	Most of the time	Occasionally	Rarely	Never
Not having enough time for detailed discussions with patients
Patients/caregivers having difficulty understanding the information
Not having access to trusted sources of information that can be used in this process
Patients not being interested or confident in participating in this process
Coming from a different culture
Not speaking the same language
Other reasons(Please specify other reasons) __________________________

How often do you use the following with patients or caregivers to help them understand their health conditions, or their various treatment or intervention options?

	All the time	Most of the time	Occasionally	Rarely	Never
Culturally-appropriate materials
Interactive Web-based decision aids
Pamphlets/print decision aids
Plain language pamphlets/print decision aids
Low literacy level pamphlets/print decision aids
Spanish or other language pamphlets/print decision aids
Videos/DVDs
Web sites
Other (please specify)

How useful have you found the following types of tools when educating patients or caregivers, or when helping them to make decisions about their care?

	Very useful	Some-what useful	Not very useful	Not at all useful	Don’t use this type of tool
Culturally-appropriate materials
Interactive Web-based decision aids
Pamphlets/print decision aids
Plain language pamphlets/print decision aids
Low literacy level pamphlets/print decision aids
Spanish or other language pamphlets/print decision aids
Videos/DVDs
Web sites
Other (please specify)

How often do you use the following approaches to obtain information about, or gain access to, patient decision aids?

	All the time	Most of the time	Occasionally	Rarely	Never
My organization purchases the tools from a commercial vendor
I access the tools from my own searches of information on the Web and order them
I receive email alerts from government Agencies or Professional Societies about their availability and share them with my practice staff for their consideration
Someone else in my organization obtains this information
Other (please specify)

What is your preferred way for learning about available tools and resources that you can share with patients about specific treatments or interventions?

• Email alerts from a trusted source

• Text message alerts from a trusted sources on my handheld device

• Searching for information only when I need it

• Through evidence based clinical practice guidelines

• Other (please specify) ________________

Section 5A/B Previous training questions

What types of training, if any, have you received regarding patient education or shared decisionmaking?

• I took a course while still in school

• I have taken one continuing education (CE) modules that pertained to this topic

• I have taken multiple CE modules that pertain to this topic

• My organization has provided training to relevant staff

• On-the-job training

• I have had no formal training

• Other (please specify) ________________

Based on the training you have received for providing patient education or shared decisionmaking, how often would you say that you apply what you learned in practice?

• All the time

• Most of the time

• Occasionally

• Rarely

• Never

First three option move to question 18

Later two option move to question 17

If you answered rarely or never to the previous question, please explain why.

Open ended

What about your training did you find valuable in helping you to apply shared decisionmaking approaches in practice?

Open ended

How valuable would you find each of the following topics in a training course on educating patients about their health care options

	Very valuable	Some-what valuable	Not very valuable	Not valuable at all
How to communicate technical information about health care options with patients
How to discuss harms and benefits of various health care options
How to address different cultural sensitivities of my patients
How to convey information to patients with who speak little English
How to convey information about likely outcomes of different health care options
How to engage patients to better understand their preferences and values
Where I can find and access information that would be useful to me in my practice
Other topics that would be valuable (Please specify)_____________________

Are you involved in training other health care professionals about how to communicate or educate patients or their caregivers?

• Yes, frequently

• Yes, sometimes

• No, this is not part of my job responsibilities

If yes, go to question 36.

If no, end survey

Section 6: Questions for trainers of other health care professionals or others about shared decisionmaking

In your training of other health care professionals related to patient education and/or shared decisionmaking, how important are the following competencies:

	Very important	Somewhat important	Not very important	Not important at all	Don’t know
Communicating technical information about health care conditions with patients
Communicating harms and benefits of various health care options
Communicating information about likelihoods of outcomes for different health care options
Cultural sensitivity
Delivering messages using clear health communication (health literacy/plain language)
Patient engagement strategies to better understand their preferences and values
Knowing how to find trusted sources of information
How to respect patients’ decisions
Maximizing patients opportunities to make decisions
How to listen to patients
Sharing the right information to help patients make more informed decisions
Other competency (Please specify and rate importance) _____________________
Other competency (Please specify and rate importance) _____________________
Other competency (Please specify and rate importance) _____________________

In your training of other health care professionals related to patient education and/or shared decisionmaking, how useful have you found the following tools to be:

	Very useful	Somewhat useful	Not very useful	Not at all useful	Don’t know. I don’t use this type of tool
Personal stories
Role-playing scenarios
Short videos of example scenarios
Slides
Worksheets
Other
Other (Please specify)_______

SECTION 7: Health care professionals whose job includes patient education/shared decisionmaking, but who do not currently practice it.

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In your own opinion, how important is shared decisionmaking in medical decisions with patients

• Very important

• Somewhat important

• Not very important

• Not important at all

You noted that your interactions with patients “never” include education to help them or their caregivers understand the options available for their care.

Which of the following best characterizes the reasons for your response (select all the apply)

• My patients/caregivers expect me to provide them with the best recommendation based on my knowledge, experience, and medical training

• My patients/caregivers have difficulty understanding the information

• Not having enough time for detailed discussions with patients

• Not having access to trusted sources of information that can be used in this process

• My patients are not interested or confident in participating in this process

• Most of my patients come from a different culture

• Most of my patients don’t speak English

• I don’t believe that patients are able to make the best choice if given the option

• I worry about legal issues if patients don’t follow my recommendations and then blame me later on if their condition worsens

• I don’t feel comfortable having these kinds of discussions with my patients

• My organization does not encourage or support this type of activity

• I don’t have the training or knowledge about how to do this well.

• I don’t have access to useful patient decision aids that I could use to assist in this process

END SURVEY – Thank you for taking time to complete this survey.

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