The Center for Vision and Population Health Survey

We are asking your organization to complete an online survey to help the CVPH better understand how current partners and potential new partners are addressing vision and related health needs within their respective constituencies. We would also like to know how the CVPH could support you and your members/affiliates efforts. Please complete one survey per organization.

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* 1. Name of Organization

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* 2. Person completing this survey

Name

Title

Email Address

Phone Number

The following questions will help us understand your organization’s function, structure and population you serve.

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* 3. Which of the following describes your organization’s main focus (select one)

Vision and eye health

Public health, other than vision related

Health care, other than vision related

Aging services

Disability and rehabilitation services

Consumer groups

Other (please specify)

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* 4. Which of the following describes your organization’s points of interest (check all that apply)?

Vision and eye health

Public health, other than vision related

Health care, other than vision related

Aging services

Disability and rehabilitation services

Consumer groups

Other (please specify)

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* 5. What best describes your organization’s structure?

Nationwide organization

Nationwide organization with regional, state or local affiliates or members

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* 6. Describe your regional, state and/or local affiliates or members:

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* 7. Provide organization’s mission or link to mission.

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* 8. How is vision and eye health related to your mission?

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* 9. Which of the following population groups does your organization primarily serve, including: affiliates/members (check all that apply)

Children between the ages 0 to 17

Adults between ages 18 to 64

Adults age 65 and older

Individuals living below the Federal poverty level

Individuals with no health insurance

Individuals with chronic conditions and risk factors for vision disorders (such as diabetes, heart disease, smoking, obesity, etc.)

Individuals with a specific vision disorder or disease (such as refractive error, age-related macular degeneration, or glaucoma)

Individuals with low vision (visual acuity is 20/70 or poorer in the better-seeing eye and cannot be corrected or improved with regular eyeglasses)

Individuals who are legally blind

Individuals from a specific racial or ethnic Group (such as Caucasian, African American, Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islanders, or Hispanic or Latino)

Other (please specify)

The Center for Vision and Population Health at Prevent Blindness (CVPH) has been established as a national coordinating body for effective practices, state-level technical assistance, and programmatic interventions. We strive to provide the right resource, for the right person, at the right time, in the right way. The following question will help us determine how your organization aligns will the CVPH.

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* 10. In this question we ask you to please rate the importance of the Center for Vision and Population Health’s seven core functions based on your organizations mission, strategic plan, programs and activities:

	Not at all important	Important	Very important	No opinion	Would like more information on this function
Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health.	Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health. Not at all important	Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health. Important	Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health. Very important	Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health. No opinion	Support ongoing surveillance efforts, including the use of predictive analytics to determine the likelihood of future outcomes, and contribute to enhanced understanding of incidence, prevalence, and trend data about vision and eye health. Would like more information on this function
Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life.	Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life. Not at all important	Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life. Important	Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life. Very important	Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life. No opinion	Establish and strengthen a national multi-sector network of partner organizations for the purpose of increasing information sharing and collaboration, reducing redundancies, and coordinating projects and initiatives to improve eye health and vision- related quality of life. Would like more information on this function
Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information.	Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information. Not at all important	Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information. Important	Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information. Very important	Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information. No opinion	Create an online vision and population health resource repository to guide state and local program and policy development. This repository may include a variety of content, such as model programs, sample policies, and a foundation for peer-to-peer mentoring across states. The online resource repository would be continually updated with the emergence of new evidence-based best practices and information. Would like more information on this function
Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs.	Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs. Not at all important	Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs. Important	Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs. Very important	Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs. No opinion	Integrate and expand early detection initiatives (including patient education, vision screenings, and eye examinations) across diverse clinical and non-clinical settings, including but not limited to community health centers, public health programs, primary health care settings, adult and senior health programs, minority health programs, early intervention, and educational programs. Would like more information on this function
Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks.	Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks. Not at all important	Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks. Important	Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks. Very important	Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks. No opinion	Expand the amount of vision and eye health education provided to health care professionals, allied health care providers, community health workers, and age-specific networks. Would like more information on this function
Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health.	Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health. Not at all important	Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health. Important	Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health. Very important	Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health. No opinion	Identify and disseminate evidence-based interventions to promote vision and eye health, prevent injuries, and reduce inequities in vision and eye health. Would like more information on this function

The following questions will help us understand how your organization and the CVPH can work together.

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* 11. What information or services can the CVPH provide your organization, and/or your members/affiliates?

Guidance on available funding sources

Best practices

Educational seminars and webinars

Speakers bureau

Toolkits

Surveillance data

Professional development

Advocacy alerts related to vision and eye health

Contacts

Continuing Educational Units (CEUs)

If you checked CEUs, please identify what professions

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* 12. What other information or services can the CVPH provide your organization, and/or your members/affiliates?

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* 13. How could you participate in CVPH programs and activities? (Please check all areas of interest)

Serve on CVPH Advisory Committee or Sub-Committee

Serve on state and/or local vision and eye health partnerships

Advocate for vision and eye health policy

Attend educational seminars and webinars

Dissemination of vision and eye health educational materials

Promote and/or provide vision screenings

Invite the CVPH to participate in your organization’s events and activities

Make referrals to care vision services

Participate in pilots and clinical trials

Collect data

Other (please specify)

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* 14. How could your affiliates/members participate in CVPH programs and activities? (Please check all areas of interest)

Serve on CVPH Advisory Committee or Sub-Committee

Serve on state and/or local vision and eye health partnerships

Advocate for vision and eye health policy

Attend educational seminars and webinars

Dissemination of vision and eye health educational materials

Promote and/or provide vision screenings

Invite the CVPH to participate in your organization’s events and activities

Make referrals to care vision services

Participate in pilots and clinical trials

Collect data

Other (please specify)

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* 15. Please list vision and eye health topics that might benefit you and your members/affiliates/constituents:

The following questions will help us design and develop products, materials and information that your organization could share with your affiliates/members/constituents.

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* 16. How do you communicate with your affiliates/members/constituents? (Select all that apply)

Electronic newsletters

Mailings

Website

Online education (webinars)

Social media

Advocacy alerts

Regular printed magazines and journals

Regular electronic magazines and journals

Webinars

Podcasts

Press releases

Membership directories

Conferences

Please list the names, dates (2020) and locations of your organization’s national conferences.

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* 17. Please list any other ways you communicate with your affiliates/members/constituents

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* 18. What educational opportunities does your organization provide to your affiliates/members/constituents? (Select all that apply)

Educational resources for health educators

Educational resources for clinicians

Educational resources for patients

Professional development

Conferences

Webinars

Podcasts

Speakers bureau

Continuing Educational Units (CEUs)

If you checked CEUS, please identify what professions

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* 19. Please list any other educational opportunities your organization provides to your affiliates/members/constituents.

The following questions will help us understand how you use surveillance data related to vision and eye health and how the CVPH can help you access and use the data you need.

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* 20. Are you familiar with the CDC’s Vision and Eye Health Surveillance System (VEHSS) available online? The VEHSS brings together new and existing surveillance information on vision, eye health, and eye care.

Yes, I have used the VEHSS

Yes, but I have not used the VEHSS

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* 21. What sources does your organization use to access data on vision and eye health? (select all that apply)

Data from state or local health departments

Non-governmental organizations

Partner organizations provide data to us

Medicare or Medicaid

We collect our own data

We do not use data on vision and eye health

Analyze publically available surveillance data.

If you checked "publically available surveillance data." please specify the data source(s).

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* 22. Please list any other sources your organization uses to access data on vision and eye health.

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* 23. What types of vision and eye health data has your organization used in the past to inform policy or decision-making? (Select all that apply)

Prevalence and incidence data on blindness and vision impairment

Prevalence and incidence data on specific eye diseases

Data on utilization of eye care services

Social determinants of eye and vision health

Other (please specify)

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* 24. How would your organization like to access data on eye and vision health in the future?

Summary tables on regional or national prevalence, incidence, and utilization

Summary tables on state-level prevalence, incidence, and utilization

Summary tables on county-level prevalence, incidence, and utilization

Portal for downloading large data sets for analysis

Data visualizations and graphics at different levels of analysis (e.g. county, state)

Other (please specify)

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* 25. Would you like to receive regular updates from CVPH?

Yes (please provide your preferred email for this information).

If you have questions about this survey and/or the CVPH please contact Julie Grutzmacher at: jgrutzmacher@preventblindness.org

Thank you in advance for participating in this important survey.