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  1. COVID-19 Experiences (COVEX)
    Source: Columbia University
    Date Published: 5/2020
    Format: PDF
    Annotation: The COVID-19 Experiences (COVEX) questionnaire was developed by investigators from the Division of Child and Adolescent Psychiatry at Columbia University/New York State Psychiatric Institute for use in our ongoing and new research studies and by affiliated clinical settings to document the experiences of research participants and patients in the time of the COVID-19 pandemic. COVEX can be administered either as an interview or as a self-report measure. It is being translated in other languages.

    Section 1: COVID-19 Symptoms & Diagnoses Section 2: Vulnerability to COVID and Direct Exposure Section 3: Living Situation Section 4: Employment/School Changes Section 5: Worries, Mental Health Changes Section 6: Problems and Support during COVID-19 outbreak Section 7: Coping Section 8: Pregnancy-Related Questions (optional) Section 9: Media Use

    Questions Adapted From: The following measures were adapted for the development of this survey:
    * Harkness, A. (2020). The Pandemic Stress Index. University of Miami.
    o Section 5 (7a, 7b, 7c, 7j)
    o Section 6 (2, 3)
    * Kroenke, K. & Spitzer, R.L. (2002). The PHQ-9: A new depression and diagnostic severity measure.
    o Section 5 (1a-1i, 4a-4i)
    * Kroenke K, Spitzer RL, Williams JB, Monaha PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317-25.
    o Section 5 (1j, 1k, 4j, 4k)
    * [KFF Coronavirus Poll (conducted March 11-15, 2020)], (KFF, [March 17, 2020]), (http://files.kff.org/attachment/Topline-KFF-Coronavirus-Poll.pdf
    , accessed March 31, 2020)]
    o Section 5 (8, 9)
    * Featherstone, J. D., Bell, R. A., & Ruiz, J. B. (2019). Relationship of people's sources of health information and political ideology with acceptance of conspiratorial beliefs about vaccines. Vaccine, 37(23), 2993-2997.
    o Section 9 (4)

    Population: Adult Workers
    Adults and Teens
    Adults Only
    Children/Teens Only
    High Risk/Special/Unique Populations
    Pregnant or Lactating Women
    Residential/Workplace
    Length: ~189 questions
    Time to Complete: 30 minutes (interview format)
    Mode of Administration: Face-to-face
    Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Lay Interviewer
    Self Administered
    Language(s): English, Spanish, Portuguese


    COVID-19 Experiences (COVEX): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX.pdf
    COVID-19 Symptoms & Diagnoses: Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Symptoms.pdf
    Vulnerability to COVID and Direct Exposure: Substance Use; Exposure https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Vulnerability.pdf
    Changes in Living Situation due to COVID: Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Living_Situation.pdf
    Changes in Employment/School due to COVID: Employment; Education https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Employment_Education.pdf
    Worries, Mental Health Changes due to COVID: Mental Health; Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Worries.pdf
    Problems and Support during COVID-19 outbreak: Resources; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Problems.pdf
    Coping with COVID: Mental Health; Positive Impacts https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Coping.pdf
    Pregnancy-Related during COVID: Current Pregnancy; Past Pregnancy https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Pregnancy.pdf
    Media Use during COVID: Media Use; Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/Fisher_COVEX_Media.pdf
    ...[See more] [See less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Link to Spanish language translation: https://disasterinfo.nlm.nih.gov/content/files/COVEX_Final_SpanishVersion_rev.pdf
    Link to Portuguese language translation: https://disasterinfo.nlm.nih.gov/content/files/COVEX_pt_Brazil_Portuguese_v1.1_july2020.pdf

    Contacts:
    Lead Tool Developers Contact Information:
    Dr. Prudence Fisher (prudence.fisher@nyspi.columbia.edu)
    Dr. Cristiane Duarte (cristiane.duarte@nyspi.columbia.edu)
    New York State Psychiatric Institute & Columbia University Irving Medical Center

    Available Formats: PDF

    Citation Fisher, P.W., Desai, P., Klotz, J., Turner, J.B., Reyes-Portillo, J.A., Ghisolfi, I., Canino, G., and Duarte, C.S. (2020) COVID-19 Experiences (COVEX).
    Includes Research Tools: Yes.
    ID: 22357. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  2. 2020 American Life Panel Survey on Impacts of COVID-19
    Source: RAND Corporation
    Date Published: 5/2020
    Format: PDF
    Annotation: This four-page technical documentation report describes a survey fielded through the RAND American Life Panel (ALP) to assess the effects of the coronavirus disease 2019 pandemic on individuals and households across a variety of topics. This report provides a technical description of the survey, including a description of the ALP, the objectives of the survey, and information about the fielding of the survey.

    The ALP is a nationally representative internet panel that has been recruited almost entirely through random digit dialing. To ensure that the panel is representative, respondents who do not have access to the internet are provided with a netbook computer and an internet subscription free of cost. This allows the flexibility and lower cost of an internet panel while still representing the segment of the population that does not have internet access. Panel members are invited to participate in online surveys once or twice per month on average. They are compensated financially for each survey to increase response rates and representativeness. The ALP began in 2006; since then, almost 550 surveys have been fielded on a variety of topics, including financial decision-making, health behaviors, retirement decision-making, numeracy, long-term care use, elections, and subjective well-being.

    Three times per year, all panel members are asked to complete a survey that contains demographic information and questions about their employment status, household composition, health status, well-being, and health insurance. The responses to these questions are automatically added to all data collected in the panel, saving time and reducing respondent burden. Additional information on the technical aspects of the ALP is provided in Pollard and Baird (2017)."
    Questions Adapted From: Several questions were taken or adapted from prior surveys; details are provided in the technical survey documentation available at https://www.rand.org/pubs/research_reports/RRA308-1.html

    Population: Adults only
    Length: 64 questions (for some questions, respondents are presented with a table and asked to choose a response for each item in the table. Each table is counted as one question)
    Time to Complete: 20 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    RAND American Life Panel Survey: Impacts of COVID-19 Full Questionnaire: https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19.pdf
    Subjective Wellbeing: Attitudes; General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Wellbeing.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Mental_Health.pdf
    Disruption to routine behaviors: Overall Impact; Daily Impact https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Routine.pdf
    Health Care: Health Care; General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Health_Care.pdf
    Experience with COVID-19: Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Experience.pdf
    Information and Trust: Sources of information about COVID-19; Knowledge; Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Information.pdf
    Common ingroup identity: Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Identity.pdf
    Financial well-being: Economic Impact; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Information.pdf
    Online shopping and delivery: Resources; Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Shopping.pdf
    Schooling: Education https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Schooling.pdf
    Employment: Employment https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Employment.pdf
    Domestic Conflict: Conflict https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Conflict.pdf
    Political Affiliation: Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19_Affiliation.pdf
    ...[See more] [See less]
    Authors: Carman, Katherine Grace; Nataraj, Shanthi
    Type: Guideline/Assessment Tool
    Access Notes: Link to Technical Documentation: https://www.rand.org/pubs/research_reports/RRA308-1.html
    Link to April 2020 Survey Results https://www.nlm.nih.gov/dr2/RAND_ALP_COVID_2020_April_results.pdf
    Link to May 2020 results https://www.rand.org/content/dam/rand/pubs/research_reports/RRA300/RRA308-1/RAND_RRA308-2-v2.pdf
    Link to August 2020 results https://www.rand.org/content/dam/rand/pubs/research_reports/RRA300/RRA308-1/RAND_RRA308-8.pdf

    Free/Publicly Available

    Citations: Carman, Katherine Grace and Shanthi Nataraj, 2020 American Life Panel Survey on Impacts of COVID-19: Technical Documentation, Santa Monica, Calif.: RAND Corporation, 2020. https://www.rand.org/pubs/research_reports/RRA308-1.html

    Contact information: RAND Corporation, Katherine Grace Carman, kcarman@rand.org
    Includes Research Tools: Yes.
    ID: 22408. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  3. COVID-19 Healthcare Personnel Study (CHPS)
    Source: Columbia University
    Date Published: 5/2020
    Format: PDF
    Annotation: The CHPS is a longitudinal survey of all licensed health professionals in New York state. The research focuses on how the pandemic has affected the personal and professional lives of the state's healthcare providers, as well as identifying interventions which may help mitigate it effects. This survey instrument represents the project's baseline assessment effort. The domains of interest include social and professional demographic questions, including health care specialization and practice areas; exposure to COVID-19; availability and access to personal protective equipment related to COVID-19 exposures; reluctance to treat COVID-19 patients; mental health impacts of COVID-19; and allocation of scarce resources and triage decision-making.

    Population: Adult Workers
    Length: 100 items
    Time to Complete: Approximately 20 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English
    ...[See more] [See less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    COVID-19 Health Care Personnel Study Baseline Survey (2020). Guohua Li, David Abramson, Charles DiMaggio, Christina Hoven, Ezra Susser, and Howard Andrews

    Available Formats: PDF

    Contact Information: Dr. Guohua Li, MD DrPH, Columbia University Department of Epidemiology Email: gl2240@cumc.columbia.edu
    Dr. Charles DiMaggio, PhD MPH, NYU Grossman School of Medicine Email: Charles.DiMaggio@nyumc.org
    Dr. David Abramson, PhD MPH, NYU School of Global Public Health Email: david.abramson@nyu.edu
    Includes Research Tools: Yes.
    ID: 24218. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.

  4. JHU COVID-19 Community Response Survey
    Source: Johns Hopkins University, Bloomberg School of Public Health
    Date Published: 4/25/2020
    Format: PDF
    Annotation: The goal of this toolkit is to provide a set of standardized quantitative and qualitative assessments to harmonize data collection efforts and facilitate comparisons of the impact of the novel coronavirus (COVID-19), and promote collaborations across research efforts. This is intended to be a dynamic resource that will evolve as the epidemic does. These modules were created with a broad sample in mind. The goal was to develop a set of modules that could be applied to multiple populations with some minor tweaks. They can be used cross-sectionally or longitudinally and are designed for a newly selected sample (e.g., include information on basic demographics). The survey asks questions about possible exposure to the virus, experiences with testing and treatment, and some questions about how life has changed as a result of COVID-19 and the preventive measures that have been put in place.

    Population: Adults only
    Length: 148 items
    Time to Complete: 20-30 minutes
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English

    COVID-19 Community Response Survey: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD.pdf

    Knowledge and attitudes toward COVID19: Knowledge; Perceived Threat https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Perceived_Threat.pdf
    COVID19 symptoms and testing experience: Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Diagnosis.pdf
    COVID19 and Co-morbidities and care engagement: Health Care; Chronic Health Conditions https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Health.pdf
    COVID19 and Mental health impacts: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Mental_Health.pdf
    COVID19 impact and pandemic stress: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Impact.pdf
    COVID19 and Social distancing: Social Distancing; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Social_Distancing.pdf
    COVID19 and Violence and trauma: Violence; Fear of Violence https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Violence_Trauma.pdf
    COVID19 and Substance use: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Substance_Use.pdf
    COVID19 and Sexual behavior: Sexual Behavior https://www.phenxtoolkit.org/toolkit_content/PDF/JHU_C4WARD_Sexual_Behavior.pdf
    ...[See more] [See less]
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Free/Publicly Available
    Contact Information: Shruti Mehta, PhD, MPH, Professor and Deputy Chair Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health: smehta@jhu.edu
    Includes Research Tools: Yes.
    ID: 22096. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  5. Social Psychological Survey of COVID-19: Coronavirus Perceived Threat, Government Response, Impacts, and Experiences Questionnaires
    Source: University of Montana
    Date Published: 4/13/2020
    Format: PDF
    Annotation: The authors of this eleven-page document developed, factor-analyzed, and validated these questionnaires across three COVID-19 studies. Participants were recruited via Amazon’s Mechanical Turk (a common recruitment tool in the social sciences). They were from the United States and came from every region of the U.S. in numbers proportional to the populations in those regions. Newly-selected participants completed the survey once online in a cross-sectional design. The sample had typical Mechanical Turk characteristics for age (range = 20 to 76, mean age = 41), gender (48% female), and race/ethnicity (largest groups were White/European-American = 78%, Asian = 9%, and Black/African-American = 7%). The method they followed was to use Exploratory Factor Analyses in Study 1, then use Confirmatory Factor Analyses in Studies 2 and 3 to hone the questionnaires. They further validated the questionnaires by showing they had expected correlations with other important variables (e.g., political ideology). This work offers researchers a battery of social psychological questionnaires to measure coronavirus-related phenomena for the duration of the pandemic in U.S. participants.

    The collection tool includes a sample consent form, research protocol, instruction manual, preliminary testing and pilot data, results, as wells as the Survey/Questionnaire.

    Population: Multiple Groups
    Length: 89 questions
    Administered by: Self Administered/Self Report
    Language(s): English
    ...[See more] [See less]
    Type: Guideline/Assessment Tool
    Access Notes: Permission/Request required

    Citation: Conway, L. G., III, Woodard, S. R., & Zubrod, A. (2020, April 7). Social Psychological Measurements of COVID-19: Coronavirus Perceived Threat, Government Response, Impacts, and Experiences Questionnaires. Direct Access: https://psyarxiv.com/z2x9a/.

    Contact Information: Access to these scales on Qualtrics can be obtained by e-mailing Dr. Lucian Gideon Conway, III (University of Montana) at luke.conway@umontana.edu.
    Includes Research Tools: Yes.
    ID: 21726. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  6. Online Community Involvement in COVID-19 Research and Outbreak Response: Early Insights from a UK Perspective: Report 14
    Source: Imperial College London
    Date Published: 4/3/2020
    Format: PDF
    Annotation: The Patient Experience Research Centre (PERC) at Imperial College London is developing research to explore and understand people’s views about, experiences of, and behavioral response to the COVID-19 outbreak in the United Kingdom and elsewhere. To guide that effort and to help inform COVID-19 research and responses more broadly, PERC launched an online community involvement initiative detailed in this 31-page report that sought rapid, early insight from members of the public and aimed to establish a network for ongoing community engagement.

    Population: Adults and teens
    Language(s): English, Mandarin, Japanese, Spanish, French, Arabic, Italian
    ...[See more] [See less]
    Authors: Pristera, Philippa; Papageorgiou, Vasiliki; Kaur, Meerat; Atchison, Christina; Redd, Rozlyn; et al.
    Type: Guideline/Assessment Tool
    Access Notes: Direct link to document: https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-04-03-COVID19-Report-14.pdf
    Find report summaries in Arabic, French, Italian, Japanese, Mandarin, and Spanish on this page.

    Free/Publicly Available

    Contact Information: Patient Experience Research Centre (PERC) at Imperial College London, Helen, Ward at h.ward@imperial.ac.uk
    Includes Research Tools: Yes.
    ID: 21620. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  7. Impact of Coronavirus on Life in America
    Source: Kaiser Family Foundation (KFF)
    Date Published: 4/2/2020
    Format: Text
    Annotation: This web page details the results of the latest Kaiser Family Foundation Health Tracking poll, conducted March 25-30, 2020, which found that as many cities and states were issuing public health guidance requiring social distancing or shelter-in-place measures, seven in 10 Americans (72 percent) said their lives have been disrupted “a lot” or “some” by the coronavirus (COVID-19) outbreak. The vast majority of the public say U.S. policy should be prioritizing the slowing down of the spread of the coronavirus rather than the U.S. economy.

    Population: Adults only
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English
    ...[See more] [See less]
    Authors: Kirzinger, Ashley; Kearney, Audrey; Hamel, Liz; Brodie, Mollyann
    Type: Guideline/Assessment Tool
    Access Notes: Link to Topline and Methodology: http://files.kff.org/attachment/Topline-KFF-Health-Tracking-Poll-Early-April-2020.pdf


    Permission/Request required

    Contact Information: Henry J. Kaiser Family Foundation
    Includes Research Tools: Yes.
    ID: 21679. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  8. National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) COVID-19 Questionnaires
    Source: National Institutes of Health (NIH)
    Date Published: 4/2020
    Format: Text
    Annotation: The National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) COVID-19 Task Force led the development of the ECHO COVID-19 questionnaires. The Task Force, co-chaired by ECHO investigators Tracy Bastain, PhD, and Carrie Breton, PhD, of the Keck School of Medicine at the University of Southern California, and comprised of 21 additional cohort investigators, as well as representatives from the ECHO NIH Program Office, Coordinating Center (CC), Data Analysis Center (DAC), and Person-Reported Outcome (PRO) Core, developed questionnaires for pregnant women and caregivers, children ages 0 to 12 years old (via parent report), and adolescents ages 13 years and older (via self-report). The purpose of these questionnaires is to assess the impact of being infected with and living during the time of the COVID-19 outbreak. Questionnaire content includes original items developed by the Task Force, as well as modified items from existing surveys and source materials listed in the access notes.

    Population: Adults and teens, High Risk/Special/Unique Populations
    Length: 70 questions
    Administered by: Self Administered/Self Report
    Administered by: Parent/Teacher
    Language(s): English, Spanish

    ENLGISH:
    COVID-19 Questionnaire - Adult Primary Version: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Primary.pdf

    COVID-19 Infection - Adult Primary Version: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Primary_Infection.pdf
    Impacts of the COVID-19 Outbreak - Adult Primary Version: Social Impact, Employment and Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Primary_Impact.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Current - Adult Primary Version Current: Pregnancy and Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Primary_Pregnancy_Current.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Recall - Adult Primary Version: Past Pregnancy and Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Primary_Pregnancy_Recall.pdf

    COVID-19 Questionnaire - Adult Alternate Version: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Alternate.pdf
    COVID-19 Infection - Adult Alternate Version: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Alternate_Infection.pdf
    Impacts of the COVID-19 Outbreak - Adult Alternate Version: Social Impact and Employment https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Alternate_Impact.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Current - Adult Alternate Version: Current Pregnancy and Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Alternate_Pregnancy_Current.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Recall - Adult Alternate Version: Past Pregnancy and Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Adult_Alternate_Pregnancy_Recall.pdf

    COVID-19 Questionnaire - Child Parent-Report Version: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Parent.pdf
    COVID-19 Infection - Child Parent-Report Version: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Parent_Infection.pdf
    Impacts of the COVID-19 Outbreak on the Child Enrolled in ECHO: Social Impact and Education https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Parent_Report_Impacts.pdf

    COVID-19 Questionnaire - Child Self-Report Primary Version: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Primary.pdf
    COVID-19 Infection - Child Self-Report - Primary Version: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Primary_Infection.pdf
    Impacts of the COVID-19 Outbreak - Child Self-Report - Primary Version: Social Impact, Education and Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Primary_Impacts.pdf

    COVID-19 Questionnaire - Child Self-Report Alternate Version: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Alternate.pdf
    COVID-19 Infection - Child Self-Report - Alternate Version: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Alternate_Infection.pdf
    Impacts of the COVID-19 Outbreak - Child Self-Report - Alternate Version: Social Impact and Education https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_Child_Self_Report_Alternate_Impacts.pdf

    SPANISH:
    COVID-19 Questionnaire - Adult Primary Version (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultPrimary_Spanish.pdf
    COVID-19 Infection - Adult Primary Version (Spanish):General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultPrimary_Infection_Spanish.pdf
    Impacts of the COVID-19 Outbreak - Adult Primary Version (Spanish): Social Impact; Employment; General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultPrimary_Impacts_Spanish.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Current - Adult Primary Version (Spanish): Current Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultPrimary_Pregnancy_Current_Spanish.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Recall - Adult Primary Version (Spanish): Past Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultPrimary_Pregnancy_Past_Spanish.pdf

    COVID-19 Questionnaire - Adult Alternate Version (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultAlternate_Spanish.pdf
    COVID-19 Infection - Adult Alternate Version (Spanish):General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultAlternate_Infection_Spanish.pdf
    Impacts of the COVID-19 Outbreak - Adult Alternate Version (Spanish): Social Impact; Employment; General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultAlternate_Impacts_Spanish.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Current - Adult Alternate Version (Spanish): Current Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultAlternate_Pregnancy_Current_Spanish.pdf
    Impacts of the COVID-19 Outbreak on Pregnancy - Recall - Adult Alternate Version (Spanish):Past Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_AdultAlternate_Pregnancy_Past_Spanish.pdf

    COVID-19 Questionnaire - Child Parent-Report Version (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildParentReport_Spanish.pdf
    COVID-19 Infection - Child Parent-Report Version (Spanish): General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildParentReport_Infection_Spanish.pdf
    Impacts of the COVID-19 Outbreak on the Child Enrolled in ECHO (Spanish): Social Impact; Past Pregnancy https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildParentReport_Impacts_Spanish.pdf

    COVID-19 Questionnaire - Child Self-Report Primary Version (Spanish): Full Questionnaire
    COVID-19 Infection - Child Self-Report - Primary Version (Spanish): General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildPrimary_Infection_Spanish.pdf
    Impacts of the COVID-19 Outbreak - Child Self-Report - Primary Version (Spanish): Social Impact; Past Pregnancy; General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildPrimary_Impacts_Spanish.pdf

    COVID-19 Questionnaire - Child Self-Report Alternate Version (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildAlternate_Spanish.pdf
    COVID-19 Infection - Child Self-Report - Alternate Version (Spanish): General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildAlternate_Infection_Spanish.pdf
    Impacts of the COVID-19 Outbreak - Child Self-Report - Alternate Version (Spanish): Social Impact; Past Pregnancy https://www.phenxtoolkit.org/toolkit_content/PDF/ECHO_ChildAlternate_Impacts_Spanish.pdf
    ...[See more] [See less]
    Authors: Bastain, Tracy; Breton, Carrie
    Type: Guideline/Assessment Tool
    Access Notes: ECHO COVID-19 Questionnaire Cover Page and References: https://www.nlm.nih.gov/dr2/ECHO_COVID-19_Cover_Page_References.pdf
    ECHO COVID-19 Questionnaire Adult Primary Version Form C19-aPV: https://www.nlm.nih.gov/dr2/C19-aPV_COVID-19_Questionnaire-Adult_Primary_Version_20200409_v01.30.pdf
    ECHO COVID-19 Questionnaire Adult Alternate Version Form C19-aAV: https://www.nlm.nih.gov/dr2/C19-aAV_COVID-19_Questionnaire-Adult_Alternate_Version_20200410_v01.31.pdf
    ECHO COVID-19 Questionnaire Child-Parent Report Form C19-cPR: https://www.nlm.nih.gov/dr2/C19-cPR_COVID-19_Questionnaire-Child_Parent-Report_Version_20200409_v01.30.pdf
    ECHO COVID-19 Questionnaire Child Self-Report Primary Version Form C19-cPV: https://www.nlm.nih.gov/dr2/C19-cPV_COVID-19_Questionnaire-Child_Self-Report_Primary_Version_20200608_v01.31.pdf
    ECHO COVID-19 Questionnaire Child Self-Report Alternate Version Form C19-cAV: https://www.nlm.nih.gov/dr2/C19-cAV_COVID-19_Questionnaire-Child_Self-Report_Alternate_Version_20200608_v01.31.pdf

    Spanish Language Questionnaires:
    COVID-19 Questionnaire - Adult Primary Version: Full Questionnaire Spanish https://www.nlm.nih.gov/dr2/C19-aPV_Spanish_COVID-19_Questionnaire-Adult_Primary_Version_20200409_v01.30.pdf
    COVID-19 Questionnaire - Adult Alternate Version: Full Questionnaire Spanish https://www.nlm.nih.gov/dr2/C19-aAV_Spanish_COVID-19_Questionnaire-Adult_Alternate_Version_20200410_v01.31.pdf
    COVID-19 Questionnaire - Child Parent-Report Version: Full Questionnaire Spanish https://www.nlm.nih.gov/dr2/C19-cPR_Spanish_COVID-19_Questionnaire-Child_Parent-Report_Version_20200617_v01.30.pdf
    COVID-19 Questionnaire - Child Self-Report Primary Version: Full Questionnaire Spanish https://www.nlm.nih.gov/dr2/C19-cPV_Spanish_COVID-19_Questionnaire-Child_Self-Report_Primary_Version_20200608_v01.31.pdf
    COVID-19 Questionnaire - Child Self-Report Alternate Version: Full Questionnaire Spanish https://www.nlm.nih.gov/dr2/C19-cAV_Spanish_COVID-19_Questionnaire-Child_Self-Report_Alternate_Version_20200608_v01.31.pdf

    Freely publicly available
    Contact information: Duke University, Dr. Brian Smith, Echocc@duke.edu
    Includes Research Tools: Yes.
    ID: 21805. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  9. COVID-19 Questionnaire on Impact of and Barriers to Stay at Home, Self-isolation, and Quarantine for Vulnerable Populations
    Source: University of California, San Francisco (UCSF)
    Date Published: 3/25/2020
    Format: PDF
    Annotation: This is a self-report, administered questionnaire collected via REDCap (Research Electronic Data Capture system) to assess experiences with non-pharmaceutical public health interventions to mitigate community transmission of COVID-19 such as stay-at-home/shelter-in-place, self-isolation, and quarantine on high-risk populations (primarily those who are low-income, non-U.S. born, or for whom English is a second language). The questionnaire covers several key domains, including 1) Demographics; 2) Health Literacy; 3) Perceived Stress for the individual and household; 4) Health Risk Belief; 5) Access to healthcare, including telehealth; 6) Barriers to self-isolation; 7) Changes in socioeconomic status; and 8) Unmet social needs. Special attention is paid to determinants rooted in education, income, safety, food security, and housing.

    Population: Adults Only
    Length: Eight sections, approximately 100 questions
    Time to Complete: 45 minutes
    Mode of Administration: Face-to-face
    Telephone
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English, Spanish, Mandarin, Cantonese

    COVID-19 Questionnaire on Impact of and Barriers to Stay at Home, Self-Isolation, and Quarantine for Vulnerable Populations: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Impact_and_Barriers.pdf

    Demographic: Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Demographics.pdf
    Health Literacy: Health Literacy https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Health_Literacy.pdf
    Perceived Stress Scale (Adult): Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Perceived_Stress_Adult.pdf
    Perceived Stress Scale (Child): Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Perceived_Stress_Child.pdf
    Health Risk Belief: Knowledge; Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Perceived_Health_Risk.pdf
    Access To Covid19 Care And Care For Chronic Conditions: Knowledge; Telehealth; Technology Use https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Access.pdf
    Covid19 Impact And Barriers To Self-Isolation: Sources of information about COVID-19; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Self_Isolation.pdf
    Part II. AHCM Screening Tool https://www.phenxtoolkit.org/toolkit_content/PDF/UCSF_COVID19_Questionnaire_Screening.pdf
    ...[See more] [See less]
    Type: Guideline/Assessment Tool
    Access Notes: Permission/Request required

    Available Formats: PDF

    Contact Information:
    Neeta Thakur, MD MPH and Priya B. Shete, MD MPH
    Division of Pulmonary and Critical Care Medicine
    University of California, San Francisco, and San Francisco General Hospital
    Email: neeta.thakur@ucsf.edu or priya.shete@ucsf.edu
    Includes Research Tools: Yes.
    ID: 23633. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.

  10. International Assessment of COVID-19-related Attitudes, Concerns, Responses and Impacts in Relation to Public Health Policies (iCARE) study
    Source: Montreal Behavioural Medicine Centre (MBMC)
    Date Published: 3/24/2020
    Format: Text
    Annotation: This 11-page survey is for a study to explore the global awareness, attitudes, and adoption of recommended (and in some cases mandated) preventive measures and behaviors to slow the spread of the COVID-19 virus. The survey information will be provided to health authorities so that they can adapt the dissemination and implementation of future prevention measures to optimize public health interventions in an effort to reduce the global burden of COVID-19. See more details about the research: https://mbmc-cmcm.ca/covid19/research/

    Population: All/Anyone
    Length: 43 questions
    Time to Complete: 20 minutes
    Administered by: Self Administered/Self Report
    Languages: English, multiple languages https://mbmc-cmcm.ca/covid19/
    The iCARES Collaborator Documents webpage provides access to data dictionaries, methodology paper, timelines, Survey Waves, and more. https://osf.io/nswcm/

    COVID-19 International Survey (CIS): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/MBMC_CIS.pdf
    Social Distancing and Hygiene - [COVID Specific]: Social Distancing and Hygiene https://www.phenxtoolkit.org/toolkit_content/PDF/MBMC_CIS_SocialDistancing.pdf
    Concerns of Infection - [COVID Specific]: Perceived Threat https://www.phenxtoolkit.org/toolkit_content/PDF/MBMC_CIS_Concerns.pdf
    Sources of information about COVID-19: Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/MBMC_CIS_Information.pdf
    ...[See more] [See less]
    Authors: Lavoie, Kim; Bacon, Simon
    Type: Guideline/Assessment Tool
    Access Notes: Find more about the study at: http://mbmc-cmcm.ca/covid19/

    Citations: Presentations and Publications: https://mbmc-cmcm.ca/covid19/research/pubs/

    Free/Publicly Available
    Contact Information: covid19study@mbmc-cmcm.ca; Montreal Behavioural Medicine Centre, Dr. Kim Lavoie at kim.lavoie@mbmc-cmcm.ca; Dr. Simon Bacon at simon.bacon@mbmc-cmcm.ca
    Includes Research Tools: Yes.
    ID: 21680. From: Disaster Lit®a database of the U.S. National Library of Medicine.

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