Understanding Evidence Part 1: Best Available Research Evidence--A Guide to the Continuum of Evidence of Effectiveness Survey

Form Approved
OMB No. 0920-0847
Exp. Date 02/28/2013

Public reporting burden of this collection of information is estimated to be 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 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 this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, GA 30033; Attn: PRA (0920-0847).

Please answer all questions as indicated.

1

How many years experience do you have with violence prevention?

I have no experience with violence prevention

Less than a year

1 to 5 years

6 to 10 years

11 or more years

2

What area of violence prevention do you have experience with (choose all that apply)?

Child maltreatment

Intimate partner violence

Sexual violence

Suicide

Youth violence

Other, please specify

3

Which of the following agencies/categories best describes where you work?

Federal government

State government

State level, non-governmental organization

Local, county, or tribal government

University or college

School or school system

Hospital or healthcare system

Faith-based organization

Media, marketing, or public relations

Community-based organization

Advocacy organization

Other, please specify

4

What is your current occupation? Please specify.

5

When you look for violence prevention information, where do you go?

Books

Brochures, pamphlets, etc.

Organizations

Family

Friend/co-worker

Health care providers

Internet

Library

Magazines

Telephone information number (1-800-number)

Do not look anywhere

Other, please specify

6

This product has improved or will improve the way I work to prevent violence.

Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
*This product has improved or will improve the way I work to prevent violence. Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable

7

I have used or plan on using this product in a training.

Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
*I have used or plan on using this product in a training. Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable

8

I have used or plan on using this product in the development of a policy.

Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
* I have used or plan on using this product in the development of a policy. Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable

9

How are you using this product in your everyday practice?

10

What was most useful about this product?

11

How could this product be improved?