0990-0335_Attachment N_Summary of Revisions

Attachment N

Summary of Revisions Made to the Instruments and Study Procedures

Attachment N

SUMMARY OF CHANGES MADE TO THE SURVEY INSTRUMENTS AND STUDY PROCEDURES

General Population Instrument

1. Added Introduction: “I’d like to begin by asking you some questions about your health care and health information.”

2. Moved Q.17 to #1

3. Moved Q.18 to #2

4. Moved Q.19 to #4

5. Moved Q.16 to #5

6. Added New 2012 questions on social disparities

Now I will mention some things that may or may not put people at greater risk of having poor health. For each, please tell me if you think it is a major risk, a minor risk, or not a risk at all. (First) what about…(INSERT ITEMS,RANDOMIZE)?

READ IF NECESSARY: Is this a major risk, a minor risk, or not a risk at all for people having poor health?

[Randomize items:]

a. Being a racial or ethnic minority

b. Being female

c. Being physically disabled

d. Being mentally disabled

e. Being gay, lesbian, bisexual, or transsexual

f. Being overweight or obese

g. Having little or no physical activity or exercise

h. Having limited or no English-speaking ability

i. Having no health insurance

j. Having no or limited education

k. Being unemployed or under-employed

l. Living in poverty or under economic stress

m. Having inadequate or no housing

n. Living with little or no transportation

o. Living in an unsafe neighborhood (e.g., high crime, drug use, vandalism)

p. Living in neighborhoods exposed to physical hazards, such as excessive trash, air or water pollution, and toxic substances

1. MAJOR RISK

2. MINOR RISK

3. NO RISK AT ALL

8. (DON’T KNOW)

9. (REFUSED)

ASK IF RESPONDENT ANSWERS 1 OR 2 FOR ANY ITEM NEWQ1a-p: For people who may be at higher risk than others of having poorer health because of the reasons you just identified, are you aware of any organizations or groups within your community who are working to eliminate such health differences?

1. YES

2. NO

8. (DON’T KNOW)

9. (REFUSED)

7. Added New item #3

3. In the last year, have you heard or read anything about racial and ethnic disparities in health and health care in America?

1. YES  (IF YES, BRIEFLY DESCRIBE AND/OR PROVIDE EXAMPLES)

2. NO

8. Changed the numbering of all the items due to the above changes.

9. Added “(Select all that apply)” to Q.1 (previously Q.17)

10. Added new item # 25:

25. In general, how would you describe your own health? Would you say it is excellent, very good, good, fair or poor?

1. EXCELLENT

2. VERY GOOD

3. GOOD

4. FAIR

5. POOR

8. (DON’T KNOW)

9. (REFUSED)

Physicians Instrument

1. Added new introduction- “These first few questions ask about your practice and public health information.”

2. Added new item: Q.1

1. How would you describe the practice where you see most of your patients (i.e., your main practice)?

General hospital

Private practice

Teaching hospital

Local health department

Community health clinic

Campus health center

Other (Specify __________________________________________________________)

3. Added new item: Q.2

2. What percentage of your patients are (check only one percentage for each group):

Less than 10% 11- 25% 26-50% Over 50%

White:

Black or African American

Hispanic/Latino

Asian American/Pacific Islander

Other (Specify_______________)

4. Moved Q.18 to #3.

Also in the item (New Q.3), “healthcare” should be changed to “health care” in the item question- “In the last year, have you heard or read anything about racial and ethnic disparities in health and health care in America?”

Response options should be as follows:

Yes  (If yes, briefly describe__________________________________________)

No

5. Moved Q.19 to #4

6. Moved Q.17 to #5. Add comma after “i.e.” in response option 2- “language assistance services (i.e., bilingual staff, interpreter services)”

7. Deleted Q.16-

In terms of receiving quality health care services, how important do you view the following for patients whose cultural attributes or whose preferred language spoken differs from those of their physician?

a. The patient receives care that is provided in a manner compatible with their cultural

health beliefs and practices and preferred language.

Very important

Important

Moderately important

Of little importance

Unimportant

b. The organization/physician employs staff at all levels and across all disciplines who

receive ongoing education and training in culturally and linguistically appropriate service

delivery.

Very important

Important

Moderately important

Of little importance

Unimportant

c. The organization/physician offers language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English

proficiency at all points of contact, in a timely manner during all hours of operation.

Very important

Important

Moderately important

Of little importance

Unimportant

8. Changed the numbering of all the items due to the above changes

9. Changed wording of Q.5 (Previously Q.17) to “Does the organization where you currently practice offer the following (check all that apply):”

10. Replaced “people” with “doctors” in the intro preceding Q.21 (Previously Q.20) and replaced “are” with “is.”

11. Changed wording on pg.5 (Intro) to “For the next few questions, please think about African Americans in our country today.”

12. Changed wording on pg.11 (Intro) to “These last questions are designed to help us better understand the doctors who participate in our survey.”

Interview Scripts

1. Added items after script item S2:

FLUENT         Interviewer language observation: Is respondent a fluent English speaker?

1 Yes               IF YES CONTINUE INTERVIEW IN ENGLISH, GO TO S2TAPE

2 No                IF NO GO TO LANG2

lang2           Is any other language beside English spoken in your home?

1 YES (or does not understand the question in English)

2 NO

LANG3           Would you like to continue the interview in English or another language such as Spanish, CHINESE, Vietnamese, Korean?

1 Continue the interview in English (GO TO S2TAPE)

2 Spanish

3 chinese

4 vietnamese

5 korean

6 Some other language (note language and discontinue interview)

2. Add to the script a note for interviewers to alert respondent- “listen to the response options carefully. If you would like me to repeat them, please let me know.”

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