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  1. HAALSI COVID Survey: Bi-Directional Associations between Cognitive Function and COVID-19 in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)
    Source: Harvard University
    Date Published: 5/10/2021
    Format: PDF
    Annotation: This survey instrument will be fielded among the existing cohort from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), using a Computer-Assisted Telephone Interview (CATI). the survey is intended to collect information on the health, economic, and social impact of the COVID-19 pandemic on older adults in Agincourt, South Africa. The survey is funded by a supplement grant at the National Institute of Aging (NIA), which aims to assess the bi-directional associations between cognitive function and COVID-19 in HAALSI.

    Questions Adapted From: Adapted from similar surveys conducted by other Health and Retirement Survey (HRS) sister studies, including HRS, SHARE, LASI, and ELSA. Questions are also adapted from the main HAALSI survey and the South African Population Research Infrastructure Network (SAPRIN) survey.
    Population: Adults Only
    Length: 74 questions
    Time to Complete: Approximately 20 minutes
    Mode of Administration: Telephone
    Administered by: Professional Interviewer
    Language(s): English, Shangaan    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/HAALSI_COVID_survey.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information: Harvard University and the University of Witwatersand haalsi@hsph.harvard.edu
    Includes Research Tools: Yes.
    ID: 24246. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  2. C4R COVID-19 Questionnaire: Collaborative Cohort of Cohorts for COVID-19 Research
    Source: Columbia University
    Date Published: 1/2021
    Format: PDF
    Annotation: The purpose of this questionnaire is to ascertain data on COVID-19 testing, self-reported COVID-19 diagnoses and hospitalizations, symptoms, recovery, re-infection, and vaccination. It also assesses the impact of the pandemic on access to healthcare, finances, health-related behaviors, social interactions, and mood. This questionnaire can be administered to individuals with no prior COVID assessments as well as those with prior COVID assessments. If prior assessments are available, text is provided to guide the interviewer to gather new information.

    Questions Adapted From: Please see page 2 of the questionnaire.
    Population: Adults only
    Mode of Administration: Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Professional Interviewer
    Self Administered
    Specialist/Doctor/Expert
    Trained Lay Examiner/Interviewer
    Language(s): English, Spanish, Chinese    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/C4R_Wave%202_Questionnaire_Final.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Find information about Data collection for the Collaborative Cohort of Cohorts for COVID-19 Research (C4R): https://c4r-nih.org/content/data-collection
    Redcap data dictionary and codebook are available upon request.

    As part of the NIH NHLBI CONNECTS program, the C4R observational study is collecting participant data and samples to better understand COVID-19 and the associated symptoms and side effects. Find more information on the CONNECTS component of the C4R study: https://nhlbi-connects.org/secure/study/6.

    Citation(s):
    C4R Investigators (2020). C4R Questionnaire.

    Available Formats: PDF

    Contact Information: c4r@cumc.columbia.edu
    Includes Research Tools: Yes.
    ID: 24223. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  3. NHLBI-CONNECTS Common Data Elements (CDE): COVID-19 Therapeutic Trial Common Data Elements
    Source: National Heart, Lung, and Blood Institute [National Institutes of Health] (NHLBI)
    Date Published: 12/16/2020
    Format: PDF
    Annotation: This document describes recommended data elements for all therapeutic clinical trials for COVID-19. With the multitude of COVID-19 research being conducted, a common set of data elements is essential for efficiency in the study design process, increased power for discovery through aggregated data, and improved accountability for generalizability and reproducibility. This set of data common data elements (CDEs) is being developed in collaboration with the NHLBI-CONNECTS Study Design Core and NHLBI-funded research networks such as SIREN and PETAL. Trials funded through NHLBI-CONNECTS will implement these CDEs and make their data available through NHLBI's BioData Catalyst data access and compute environment.

    Includes Common Data Elements From: Yes
    Population: Adults only
    Length: 277 questions
    Language(s): English    ...[See more] [See less]
    URL: https://nhlbi-connects.org/common_data_elements
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information: info@nhlbi-connects.org
    Includes Research Tools: Yes.
    ID: 24228. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  4. Recommendations for Common Data Elements for COVID-19 Studies Including Pregnant Participants
    Source: National Institute of Child Health and Human Development [National Institutes of Health] (NICHD)
    Date Published: 12/15/2020
    Format: Text
    Annotation: We present a battery of recommended biomedical and psychosocial common data elements (CDEs) and measures that, when combined across datasets, can improve our collective understanding of COVID-19 in pregnant and lactating women and their neonates. Experts across eight large pregnancy cohort studies developed these recommendations for use by any planned or upcoming COVID-19 study that includes women of reproductive age or pregnant women. We encourage researchers to include some or all of these measures, which cover key medical and psychosocial domains relevant to pregnancy and childbirth, into their studies to maximize the potential for data harmonization while continuing to advance their own study goals.

    Common biomedical data elements and measures aim to accelerate our understanding of the clinical course of the disease and its effects on pregnant women and their neonates, which will continue to evolve as treatments and vaccines become available. Here we highlight CDEs and measures across seven domains, which include: Baseline Maternal / Pregnancy Characteristics; Maternal COVID-19 Treatment; Maternal Outcomes; Obstetric / Pregnancy Outcomes; Neonatal Characteristics; Neonatal COVID-19 Testing; and Early Neonatal Outcomes. Recommendations assume that information from all patient visits (e.g., prenatal visits, COVID-19 testing, and delivery) can be collected via medical chart or downloaded data from electronic health records.

    Common psychosocial data elements and measures aim to advance our understanding of the psychological, behavioral, and social effects of the virus and the pandemic on pregnant women and their neonates. Here we highlight CDEs and measures across six domains, including: Socioeconomic Status, Housing, and Emergent Financial Strain; Medical Care; Impact on Parenting; Stressful Life Events; Maternal Mental Health; and Health Related Behaviors.

    Questions Adapted From: The majority of the recommended CDEs are already in use in ongoing COVID-19 studies, as indicated below and in footnotes throughout.

    Biomedical: Adapted from Maternal Fetal Medicine Unit (GRAVID) COVID-19 and Delivery Case Report Forms with additional input from the Study of Pregnancy and Neonatal Health (SPAN) and other ongoing or planned studies.

    Psychosocial: The source for each question is provided in the footnotes.

    A full list of sources used is as follows:

    ­ 2020 COVID-19 Household Pulse Survey https://www.census.gov/data/experimental-data-products/household-pulse-survey.html    ;
    ­ All of Us Research Program: COVID-19 Participant Experience Survey (COPE) https://www.nlm.nih.gov/dr2/COPE_Survey_NIH_All_of_Us_Clean_4.27.20.pdf;
    ­ Brief Resilient Coping Scale (from MACS-WIHS Baseline COVID-19 Abbreviated Questionnaire) https://www.nlm.nih.gov/dr2/MACS-WIHS_questionnaire_BLCOVID-040620.pdf;
    ­ Columbia COVID-19 Questionnaire http://www.columbiamedicine.org/divisions/kiryluk/study_covid19.php;
    ­ Coronavirus Health Impact Survey (CRISIS) https://www.nlm.nih.gov/dr2/CRISIS_Parent_Caregiver_Follow_Up_Current_Form_V0.3.pdf;
    ­ Coronavirus Perinatal Experiences-Impact Survey (COPE-IS) https://www.nlm.nih.gov/dr2/COPE-Impact_Survey_Perinatal_Pandemic_Survey.pdf;
    ­ Environmental Influences on Child Health Outcomes (ECHO) COVID-19 Questionnaire https://www.nlm.nih.gov/dr2/C19-aPV_COVID-19_Questionnaire-Adult_Primary_Version_20200409_v01.30.pdf;
    ­ Everyday Discrimination Scale (Short version) https://scholar.harvard.edu/files/davidrwilliams/files/measuring_discrimination_resource_june_2016.pdf;
    ­ GAD 7 https://med.dartmouth-hitchcock.org/documents/GAD-7-anxiety-screen.pdf;
    ­ Impact of Event Scale-6 https://www.researchgate.net/publication/26250275_Brief_measure_of_posttraumatic_stress_reactions_Impact_of_Event_Scale-6;
    ­ Infant Feeding Practices Study II https://www.cdc.gov/breastfeeding/data/ifps/questionnaires.htm;
    ­ Intimate Partner Violence ACOG Practice Bulletin https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/02/intimate-partner-violence ;
    ­ JHU Community Response https://www.nlm.nih.gov/dr2/JHU_COVID-19_Community_Response_Survey_v1.3.pdf ;
    ­ MACS-WIHS Baseline COVID-19 Abbreviated Questionnaire https://www.nlm.nih.gov/dr2/MACS-WIHS_questionnaire_BLCOVID-040620.pdf;
    ­ National Health and Nutrition Examination Survey (NHANES), Demographics Module, 2019-2020 https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/questionnaires.aspx?BeginYear=2019;
    ­ PhenX: Health Reform Monitoring Survey 2015 https://www.phenxtoolkit.org/protocols/view/11502;
    ­ PhenX: 6 item standard measure from USDA Economic Research Service https://www.phenxtoolkit.org/protocols/view/270301#tabsource;
    ­ PhenX: Edinburgh Postnatal Depression Scale (EPDS) https://www.phenxtoolkit.org/protocols/view/241401;
    ­ PhenX: Panel Study of Income Dynamics (PSID), 2007 https://www.phenxtoolkit.org/protocols/view/11301;
    ­ PhenX: Pregnancy Risk Assessment Monitoring System (PRAMS) https://www.phenxtoolkit.org/protocols/view/720901;
    ­ Pittsburgh Hill / Homewood Research on Neighborhood Change and Health (PHRESH) https://drive.google.com/file/d/1q9DOJGNT7oe_KGMUXFCi73vIu57W3D3O/view;
    ­ Postpartum Bonding Questionnaire https://sundspsykologerna.se/files/Brockington-et-al-2006-PBQ-validation-pdf.pdf;
    ­ RAND American Life Panel Impact of COVID-19 Survey https://www.phenxtoolkit.org/toolkit_content/PDF/RAND_ALP_COVID19.pdf;
    ­ Stanford COVID-19 Community Outcomes (COCO) Survey https://drive.google.com/file/d/1zHnqLG-I8Htl6SdhyFxuJzP_qYRFPgKi/view;
    ­ Study of Pregnancy and Neonatal Health (SPAN) https://www.nichd.nih.gov/about/org/diphr/officebranch/eb/SPAN: Attained measures via personal communication

    Population: Adult Workers
    Adults and Teens
    First Responders, Emergency Medical Services (EMS) Personnel, Police/Fire Departments
    Military
    Pregnant or Lactating Women

    Length: There are a total of 121 questions within the tool, 49 of which fall under Biomedical data elements, and 72 of which fall under Psychosocial data elements

    Time to Complete: Approximately 20 minutes to complete all questions included in the Psychosocial measure.

    Mode of Administration: Face-to-face
    Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone

    Administered by: Lay Interviewer
    Professional Interviewer
    Self Administered
    Specialist/Doctor/Expert
    Trained Lay Examiner/Interviewer

    Special Considerations: The recommendations herein are not meant to be distributed as one comprehensive questionnaire, but rather represent the recommended measures for collecting information regarding the most important data elements to assess in relation the effects of COVID-19 on pregnant women and their neonates. We encourage researchers to include some or all of these measures into their studies to maximize the potential for data harmonization while continuing to advance their own study goals.

    Language(s): English    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/Recommendations for Common Data Elements for COVID-19 Studies Including Pregnant Women.docx
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    "Promoting Data Harmonization to Accelerate COVID-19 Pregnancy Research", February 2021. https://disasterinfo.nlm.nih.gov/content/files/NIHPromotin%20DataHarmonizationAccelerateCOVID19PregnancyResearchBiomedicalPsychosocialBiospecimens_vF.pdf

    Available Formats: TEXT

    Contact Information: Caroline Signore, NICHD, signorec@mail.nih.gov; Nahida Chakhtoura, NICHD, Nahida.chakhtoura@nih.gov; Jessica Gleason, NICHD, Jessica.gleason@nih.gov; Stephen Gilman, NICHD, Stephen.gilman@nih.gov
    Includes Research Tools: Yes.
    ID: 24206. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  5. ISARIC Global COVID-19 Follow Up Study Protocol
    Source: International Severe Acute Respiratory and emerging Infection Consortium (ISARIC)
    Date Published: 11/17/2020
    Format: Text
    Annotation: The ISARIC COVID-19 Long term protocol & Case Report Form (CRF) survey is designed to follow up adults and children with COVID-19 over time. It can be used for one off or serial follow up of patients post-hospital discharge and for people who were not hospitalized. It is designed to enable patient self-assessment or clinical led assessment, via post, telephone, online or in-clinic visit for wide dissemination and inclusion using limited resources. It can be combined with sampling and further diagnostics. 

    Includes Common Data Elements From: No
    Population: Patients included in the ISARIC/WHO clinical characterisation study, with a confirmed COVID-19 diagnosis post-discharge at serial intervals
    Language(s): English    ...[See more] [See less]
    URL: https://isaric.org/research/covid-19-clinical-research-resources/covid-19-long-term-follow-up-study/
    Type: Study Design/Protocol
    Access Notes: Free/Publicly Available

    Available Formats: Text

    Contact Information: ncov@isaric.org
    Includes Research Tools: Yes.
    ID: 24242. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  6. ISARIC Global COVID-19 Case Report Form (CRF) Survey
    Source: International Severe Acute Respiratory and emerging Infection Consortium (ISARIC)
    Date Published: 11/17/2020
    Format: Text
    Annotation: The ISARIC COVID-19 Long term protocol & Case Report Form (CRF) survey is designed to follow up adults and children with COVID-19 over time. It can be used for one off or serial follow up of patients post-hospital discharge and for people who were not hospitalized. It is designed to enable patient self-assessment or clinical led assessment, via post, telephone, online or in-clinic visit for wide dissemination and inclusion using limited resources. It can be combined with sampling and further diagnostics. 

    Includes Common Data Elements From: No
    Population: Patients included in the ISARIC/WHO clinical characterisation study, with a confirmed COVID-19 diagnosis post-discharge at serial intervals
    Length: 12 sections
    Language(s): English    ...[See more] [See less]
    URL: https://isaric.org/research/covid-19-clinical-research-resources/covid-19-long-term-follow-up-study/
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: Text

    Contact Information: ncov@isaric.org
    Includes Research Tools: Yes.
    ID: 24243. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  7. National Social Life, Health, and Aging Project (NSHAP) COVID-19 Study: Survey Questionnaire
    Source: NORC at the University of Chicago (NORC)
    Date Published: 9/14/2020
    Format: PDF
    Annotation: This is a brief self-report questionnaire that probes how the coronavirus pandemic has changed older adults' lives. It is designed to be administered via web survey, phone interview, or paper-and-pencil mail-back instrument. The questionnaire was designed for respondents in the National Social Life, Health and Aging Project (NSHAP) (https://www.norc.org/Research/Projects/Pages/national-social-life-health-and-aging-project.aspx ), on whom considerable background information is already available. This questionnaire is thus limited to assessing specific domains in which respondents may have been affected by the coronavirus pandemic, and includes: (1) COVID experiences, (2) health and health care, (3) job and finances, (4) social support, (5) marital status and relationship quality, (6) social activity and engagement, (7) living arrangements, (8) household composition and size, (9) mental health, (10) elder mistreatment, (11) health behaviors, and (12) positive impacts of the coronavirus pandemic. Questions about engagement in racial justice issues since the death of George Floyd in police custody were also added to facilitate analysis of the independent and compounding effects of both the COVID-19 pandemic and reckoning with longstanding racial injustice in America.

    Questions Adapted From:
    The following questions were adapted from the Health and Retirement Study (HRS) 2020: COVID experiences (Q1-3), health care (Q6), job and finances (Q10), social support (Q13-16), social relationship quality (Q20), and living arrangements (Q32-33, 35-36).
    The following questions were adapted from previous National Social Life, Health and Aging Project (NSHAP) rounds: physical health (Q4), marital status (Q17) and relationship quality (Q18), mental health (Q39-40, 44-48), elder mistreatment (Q49-50), and health behaviors (Q52, 54-55, 57, 59).
    Items about social activity and engagement (Q21-24, 26-29) were adapted from the National Health and Aging Trends Study (NHATS) COVID-19 Questionnaire. o An item about change in marital quality (Q19) was adapted from the Monmouth University Poll.
    Two items (Q42-43) were adapted from the Generalized Anxiety Disorder 2-item scale. Citation: Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317-25.
    Items about the positive impacts of the pandemic (Q60-61) were adapted from the Coronavirus Health Impact Survey (CRISIS) and the COVID Response Tracking Study.
    Items about household composition and size (Q37-38) were also adapted from the COVID Response Tracking Study.
    Includes Common Data Elements From: Health and Retirement Study, National Health and Aging Trends Study, National Social Life Health and Aging Project, COVID Response Tracking Study, Monmouth University Poll, Coronavirus Health Impact Survey
    Population: Adults Only
    Length: 62 items
    Time to Complete: 20-25 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Self Administered
    Trained Lay Examiner/Interviewer
    Language(s): English

    Data Dictionary: https://disasterinfo.nlm.nih.gov/content/files/NSHAP_COVID19_Study_Data%20Dictionary.pdf    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/NSHAP_COVID19%20Study_Instrument.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information: NORC at the University of Chicago, Dr. Louise Hawkley, hawkley-louise@norc.org
    Includes Research Tools: Yes.
    ID: 24240. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  8. Hidden Impact of COVID-19 on Children: A Global Research Series
    Source: Save the Children International
    Date Published: 9/10/2020
    Format: PDF
    Annotation: This global study, with several documents, reveals the hidden impacts of COVID-19 pandemic response measures that are impacting children’s health, nutrition, education, learning, protection, well-being, family finances, and poverty.

    Population: Adults and teens (NOTE: it’s ages 11 and up, actually)
    Length: approximately 100 questions
    Time to Complete: 25 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Parent/Teacher; Self Administered
    Language(s): English; Albanian; Amharic; Arabic; Bangla; Burmese; Dari; Filipino/Tagalog; French/ Hindi; Iindonesian; Korean; Khmer; Lao; Mongolian; Mindanao; Nepali; Pashto; Portuguese; Serbian; Sinhala; Spanish; Tamil; Thai; Urdu; Vietnamese
    Access The Global Research Series reports, findings, and data: https://resourcecentre.savethechildren.net/library/hidden-impact-covid-19-children-global-research-series
    URL: https://resourcecentre.savethechildren.net/node/18174/pdf/methods_3_-_edited_1.pdf
    Type: Report
    Access Notes: Free/Publicly Available

    Contact: Please contact the research team (attn: Melissa Burgess or Silvia Mila Arlini) at evidence.aro@savethechildren.org with any questions
    Includes Research Tools: Yes.
    ID: 23693. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  9. Coronavirus Victimization Distress Scale (CVDS)
    Source: Fordham University
    Date Published: 8/2020
    Format: PDF
    Annotation: The Coronavirus Victimization Distress Scale (CVDS) is a brief self-report questionnaire developed by Fordham University's Center for Ethics Education and Applied Developmental Psychology Program as part of the Pathways to Health Study. The CVDS assesses bully and cyberbully victimization distress results from being viewed as having coronavirus. Questions include distress about being verbally and physically bullied, treated rudely or unfairly, verbally taunted in public, and cyberbullied because of coronavirus.

    Population: Adults and Teens
    Ethnic/Religious Groups
    Sexual or Gender Minorities
    Length: 5 items
    Time to Complete: Less than 5 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English    ...[See more] [See less]
    URL: https://www.fordham.edu/download/downloads/id/14918/coronavirus_covid-19_victimization_distress_scale_cvds.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information:
    Celia B. Fisher, Ph.D.
    Center for Ethics Education
    Fordham University
    Email: Fisher@fordham.edu

    Administrator:
    Lori Merone
    Email: lmerone@fordham.edu
    Includes Research Tools: Yes.
    ID: 23535. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  10. COVID-19: Documenting Challenges Faced by California Families with Children 0-5 Years Old on WIC
    Source: University of California, Davis
    Date Published: 8/2020
    Format: PDF
    Annotation: This is a mixed-method, interviewer-administered tool to (1) identify barriers that WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) participants in California are experiencing in using WIC food benefits (e.g., access to WIC-eligible foods); and (2) identify additional short-term unmet basic needs (e.g., food and housing insecurity, as well as access to unemployment benefits, healthcare, childcare, and social support while required to remain at home) of low-income families during the COVID-19 pandemic.

    Questions Adapted From: U.S. Household Food Security Survey Module, USDA ERS: Q43
    COVID-19 Community Outcomes (COCO) Needs Assessment, Stanford University: Q1, Q4
    The Epidemic Pandemic Impacts Inventory (EPII): Q10a
    Patient Health Questionnaire-2 (PHQ-2): Q48
    Population: Adults Only
    Length: 55 questions
    Time to Complete: 30-35 minutes
    Mode of Administration: Telephone
    Administered by: Professional Interviewer
    Language(s): English; Spanish

    IRB Application https://disasterinfo.nlm.nih.gov/content/files/WIC_COVID_IRB.pdf

    COVID-19 Documenting Challenges Faced by California Families with Children 0-5 Years Old on WIC: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC.pdf
    COVID Impacts: Diagnosis; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Impacts.pdf
    WIC participation and enrollment: Federal Assistance https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Participation.pdf
    WIC services: Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Services.pdf
    Shopping for WIC foods: Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Foods.pdf
    General food shopping: Food Security; Dietary Intake https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_General_Food.pdf
    Immigration status: Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Immigration.pdf
    Mental health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Mental_Health.pdf

    COVID-19 Documenting Challenges Faced by California Families with Children 0-5 Years Old on WIC (Spanish): Full Questionniare https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Spanish.pdf
    COVID Impacts (Spanish): Diagnosis; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Impacts_Spanish.pdf
    WIC participation and enrollment (Spanish): Federal Assistance https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Participation_Spanish.pdf
    WIC services (Spanish): Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Services_Spanish.pdf
    Shopping for WIC foods (Spanish): Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Foods_Spanish.pdf
    General food shopping (Spanish): Food Security; Dietary Intake https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_General_Food_Spanish.pdf
    Immigration status (Spanish): Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Immigration_Spanish.pdf
    Mental health (Spanish): General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UCANR_WIC_Mental_Health_Spanish.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/WIC_COVID_Interview_guide_ENGLISH.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Link to Spanish survey: https://www.nlm.nih.gov/dr2/WIC_COVID_Interview_Guide_SPANISH.pdf

    Citation(s):
    Ritchie, LD & Whaley, SE (2020). COVID-19: Documenting Challenges Faced by California Families with Children 0-5 Years Old on WIC.
    Research Brief: Ritchie L, Vital N, Au LE, Gosliner WA, Meza M, Anderson CE, Strochlic R, Plank K, Tsai M, Martinez CE, Olague C, Rios A, Lee DL, Hecht CE, Whaley SE. WIC Especially Critical during the COVID-19 Pandemic: Voices of Participants in Los Angeles County. UC ANR Nutrition Policy Institute. Public Health Foundation Enterprise, Women Infants and Children (WIC). The David and Lucille Packard Foundation. January 2021.
    https://ucanr.edu/sites/NewNutritionPolicyInstitute/files/342602.pdf

    Available Formats: PDF

    Contact Information:
    Lorrene Ritchie, PhD, RD
    Director and Cooperative Extension Specialist, Nutrition Policy Institute
    University of California Division of Agriculture and Natural Resources
    Email: lritchie@ucanr.edu
    Includes Research Tools: Yes.
    ID: 23584. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  11. Survey Tool and Guidance: Rapid, Simple, Flexible Behavioural Insights on COVID-19
    Source: World Health Organization, Regional Office for Europe
    Date Published: 7/29/2020
    Format: PDF
    Annotation: This 42-page document provides guidance to Member States in the WHO European Region that wish to conduct behavioral insights studies related to COVID-19. This tool is evidence-informed; can be regularly applied; is flexible to adjust to the changing situation; and follows high ethical standards....[See more] [See less]
    URL: https://apps.who.int/iris/handle/10665/333549
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Contact information: Katrine Habersaat (habersaatk@who.int) or Martha Scherzer (scherzerm@who.int)

    Direct link to document: https://apps.who.int/iris/bitstream/handle/10665/333549/WHO-EURO-2020-696-40431-54222-eng.pdf?sequence=1&isAllowed=y
    Link to resource in Russian: https://apps.who.int/iris/handle/10665/333550
    ID: 23230. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  12. COVID-19 Survey for Workers
    Source: University of California, Davis
    Date Published: 7/16/2020
    Format: PDF
    Annotation: The purpose of this COVID-19 survey is to facilitate a rapid research response to the COVID-19 pandemic that will describe the affected population of frontline workers, their vulnerabilities, and their most urgent needs; and identify critical unmet needs and compare across geographic areas, types of facilities, job types, and sociodemographic characteristics.

    Population: Adult Workers
    Length: 80 questions
    Time to Complete: 15-20 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Self Administered
    Language(s): English, Spanish


    Survey for Workers: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers.pdf
    Covid-19 Infection: General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Infection.pdf
    The Workplace: Employment; Personal Protective Equipment; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Workplace.pdf
    Demographics: Personal Demographics; Chronic Health Conditions https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Demographics.pdf
    Changes to your life since COVID-19: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Life_Changes.pdf
    Financial situation: Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Financial.pdf
    Living situation: Personal Demographics; Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Living_Situation.pdf
    Knowledge about COVID-19 protection measures: Attitudes; Knowledge
    https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Knowledge.pdf
    Pregnancy: Current Pregnancy; Past Pregnancy https://www.phenxtoolkit.org/toolkit_content/PDF/UCD_Workers_Pregnancy.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/UCD_COVID-19_Survey_for_Workers.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Public survey available: https://redcap.ucdmc.ucdavis.edu/redcap/surveys/index.php?s=AXALYRE8RF
    Available Formats: PDF

    Contact Information:
    University of California, Davis
    Natalie Nardone, nlnardone@ucdavis.edu
    Includes Research Tools: Yes.
    ID: 23745. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  13. Impact of the Novel Coronavirus (COVID-19) on Patients with Cancer
    Source: Stanford University
    Date Published: 7/13/2020
    Format: PDF
    Annotation: The purpose of this study is to understand the spread of the COVID-19 and the impact on patients with cancer. Specifically, we want to understand how COVID-19 has impacted patient's lives and their cancer care. The objective is to enhance our knowledge of the evolving COVID-19 pandemic among patients with cancer. The data collected in this survey will help to understand how cancer care is being affected for patients with cancer and potential ways to mitigate this impact.

    Population: Adults Only
    Length: 74 Questions
    Time to Complete: 5-10 minutes
    Mode of Administration: Face-to-face
    Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Lay Interviewer
    Professional Interviewer
    Self Administered
    Specialist/Doctor/Expert
    Trained Lay Examiner/Interviewer
    Language(s): English, Spanish, Vietnamese

    Impact of the novel Coronavirus (COVID-19) on Patients with Cancer: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/Impact.of.COVID19.on.Patients.with.Cancer.pdf
    Overall Cancer Care: Health Care; Chronic Health Conditions https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_on_Patients_with_Cancer_Overall_Care.pdf
    Care Delays or Interruptions (due to COVID-19 pandemic): Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_on_Patients_with_Cancer_Care_Delays.pdf
    Challenges Due to COVID-19 Pandemic: Overall Impact; Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_on_Patients_with_Cancer_Challenges.pdf
    Novel Coronavirus Testing: Status; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_on_Patients_with_Cancer_Testing.pdf
    Demographics: Personal Demographics; Health History https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_on_Patients_with_Cancer_Demographic.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Impact_of_COVID19_on_Patients_with_Cancer.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Programmed online survey link: https://stanforduniversity.qualtrics.com/jfe/form/SV_ctKS6ZSMYdEYoXX
    Available Formats: PDF

    Contact Information:
    Manali I. Patel, MD, MPH, MS
    Email: manalip@stanford.edu
    Stanford University School of Medicine
    Includes Research Tools: Yes.
    ID: 23056. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  14. COVID-19 Impact Survey
    Source: National Alzheimer’s Coordinating Center (NACC)
    Date Published: 7/2/2020
    Format: PDF
    Annotation: The COVID-19 Impact Survey was used to gather data on the effect of the pandemic on participants enrolled in the clinical cores of the National Institute on Aging (NIA) Alzheimer's Disease Research Centers, a population of mostly older Americans with cognitive status ranging from normal to mild cognitive impairment to dementia (resulting from Alzheimer's disease and a range of other etiologies). An additional survey was created for the co-participants.

    Questions Adapted From: N/A
    Population: Adults Only
    Length: 21 questions for the participant, 10 for the co-participant
    Time to Complete: 15 minutes for participant, 10 minutes for co-participant
    Mode of Administration: Face-to-face
    Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Self Administered
    Specialist/Doctor/Expert
    Trained Lay Examiner/Interviewer
    Language(s): English

    COVID-19 Impact Survey: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/NACC_COVID.pdf
    COVID-19 Impact Survey - Participant: Diagnosis; General Mental Health; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/NACC_COVID_Participant.pdf
    COVID-19 Impact Survey - Co-participant: General Mental Health; Overall Impact; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/NACC_COVID_Coparticipant.pdf
    COVID-19 Technology Accessibility Survey: Technology Use https://www.phenxtoolkit.org/toolkit_content/PDF/NACC_Covid_Tech_Survey.pdf    ...[See more] [See less]
    URL: https://www.alz.washington.edu/NONMEMBER/NACCFormsAndDoc.html
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available; Direct link to document: https://www.alz.washington.edu/NONMEMBER/Covid-impact-surveys.pdf

    Available Formats: PDF

    Contact Information: National Alzheimer's Coordinating Center, Elizabeth Robichaud, naccmail@uw.edu
    Survey originally developed by the ADRC Clinical Task Force, Allan Levey, MD, PhD, Chair
    Includes Research Tools: Yes.
    ID: 23179. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  15. Health and Retirement Study: Questionnaire on Your Everyday Life and Well-being
    Source: University of Michigan
    Date Published: 7/2020
    Format: PDF
    Annotation: As a longitudinal study with rich measurement across a large number of social, health, and economic domains, the Health and Retirement Study (HRS) was designed to capture the impact of unexpected societal events, even without additional measurement specific to the event. To complement these longitudinal measures, HRS has developed several areas of content specifically in response to the coronavirus pandemic designed to dovetail with existing assessment. Information on lifestyle and psychosocial functioning is collected through a self-administered questionnaire (SAQ). Additional questions in the psychosocial SAQ were added to the 2020 wave of data collection. These questions obtain information on lifestyle, personal relationships, work, and feelings in response to the pandemic. These questions cover five subtopics: 1) pandemic-specific concerns related to health, finances, friends and family, and the future; 2) changes in social contact with family and friends, including social support given and received and changes in relationship quality; 3) impact on activities, including pandemic-specific behaviors such as wearing a mask, washing hands, social distancing, and using hand sanitizer; 4) additional questions about work status that indicate if the respondent was an essential worker and whether or not they could work at home during the pandemic; and 5) emotional well-being, resilience, and coping during the pandemic.

    Population: Adults only
    Length: 78 questions
    Mode of Administration: Pen and Paper
    Administered by: Self Administered
    Language(s): English

    Health and Retirement Study: Questionnaire on Your Everyday life and Well-being: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_HRS_SAQ.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_HRS_SAQ_Mental_Health.pdf
    Perceptions: Attitudes; Employment https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_HRS_SAQ_Perceptions.pdf
    Risk Reduction Behaviors: Social Impact; Daily Life https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_HRS_SAQ_Behaviors.pdf
    HRS 2021 Survey “Perspectives on the Pandemic”: https://disasterinfo.nlm.nih.gov/content/files/HRS_2021_COVID_MAILOUT_IRB_APPROVED_210427.pdf
    HRS 2021 Survey “Perspectives on the Pandemic” Cover page: https://disasterinfo.nlm.nih.gov/content/files/HRS_2021_COVID_MAILOUT_COVERPAGE_210427.pdf    ...[See more] [See less]
    URL: https://hrs.isr.umich.edu/sites/default/files/meta/2020/core/qnaire/online/2020_SAQ_v13.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Web page for questionnaires: https://hrs.isr.umich.edu/data-products/covid-19
    Web page for documentation, including a codebook: https://hrs.isr.umich.edu/documentation

    Available Formats: PDF

    Contact Information:
    David Weir,
    Director of Health and Retirement Study
    Email: dweir@umich.edu
    Includes Research Tools: Yes.
    ID: 23765. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  16. National Health and Aging Trends Study (NHATS) COVID-19 Questionnaires
    Source: Johns Hopkins University, Bloomberg School of Public Health
    Date Published: 6/20/2020
    Format: PDF
    Annotation: This set of questionnaires was used in a supplemental mail study of the National Health and Aging Trends Study (NHATS) conducted in 2020. The questionnaires aim to assess experiences during the COVID-19 outbreak of: 1) NHATS participants (ages 70 and older) and 2) the up to two adult family members and friends who helped NHATS participants the most during the outbreak. Two types of mail questionnaires were administered: 1) questionnaires designed for NHATS participants or their proxy respondents (SP / proxy) and 2) questionnaires designed for adult family members and friends (FF) who helped NHATS participants. The SP questionnaires includes 13 sections. Topics cover symptoms of COVID-19, measures taken to limit spread of the virus, and changes during the pandemic in the NHATS participants' living situation, contact with family and friends, productive activities (e.g., work, volunteering, caregiving), grocery shopping, health care, finances, wellbeing and daily activities. Participants were also asked to provide contact information for the two adult family members or friends who helped most during the outbreak. The FF questionnaire includes 17 sections, many of which align with the sections in the SP/Proxy questionnaires. In addition, the FF questionnaire asks about the FF's relationship with the NHATS participant, help given to the NHATS participant before and during the outbreak and reasons for helping. For those who helped for health or functioning reasons, three additional sections about caregiving are included: time spent helping the NHATS participant, dementia caregiving (if help is memory related) and helping challenges and supports.

    Questions Adapted From: Symptoms of COVID-19 module (questions 5-9 in SP/proxy questionnaire and 15-19 in FF questionnaire) is adapted from MESA, common symptom questions are adapted from CDC definitions; Measures to Limit Spread of COVID-19 questions (question 12 in SP/proxy questionnaire and 22 in FF questionnaire) are adapted from MESA; Questions 13-16 on assisted Living in SP questionnaire is adapted based on AHCA guidance; Questions 17, 18, 21, and 22 in SP/Proxy questionnaire aligned with items in the HRS COVID telephone module; Questions 27-28 in SP/Proxy questionnaire and 50-51 in FF questionnaire aligned with HRS COVID SAQ; Questions 29-30 in SP/Proxy questionnaire aligned with HRS COVID SAQ and life space constriction items in the simplified version of Stalvey et al. (1999); Questions 33-34 in the SP/Proxy questionnaire aligned with content in NHATS. Questions 35-36 in the SP/Proxy questionnaire and 48 in the FF questionnaire aligned with HRS COVID SAQ; Questions 37-40 on changes in grocery shopping in the SP/Proxy questionnaire aligned with content in NHATS; Questions 41-45 on changes in health care in the SP/Proxy questionnaire are adapted from NSOC III (HC module) and HRS COVID telephone module; Question 46 in the SP/Proxy questionnaire and 29 in the FF questionnaire are adapted from HRS COVID telephone module; Questions 47-48 in the SP/Proxy questionnaire 30-31 in the FF questionnaire are adapted from PSID shutdown / COVID19 module; Questions 49-52 in the SP/Proxy questionnaire aligned with HRS COVID SAQ; Question 57 in the SP/Proxy questionnaire and 38 in the FF questionnaire are adapted from PTSD-8 (Hansen et al. 2010); Question 33 in the FF questionnaire aligned with PHQ2 and GAD in NHATS (HC); Question 53 in the SP/Proxy questionnaire and question 34 in the FF questionnaire aligned with NHATS (HC); Questions 60-69 on changes in daily activities in the SP/Proxy questionnaire aligned with NHATS (SC, MO, HA, DT, MC modules); Questions 32, 44, 49, 59-66, 71-76, and 78-79 in the FF questionnaire aligned with NSOC (HC, DI, AC, and CA module); Questions 53-58, and 67-70 in the FF questionnaire aligned with NHATS (SC, MO, HA, DT, MC, HA, and CP modules). References: Stalvey, B., Owsley, C., Sloane, M.E., Ball, K. (1999) The Life Space Questionnaire: A measure of the extent of mobility of older adults. Journal of Applied Gerontology 18: 479-498. Hansen, M., Andersen, T. E., Armour, C., Elklit, A., Palic, S., & Mackrill, T. (2010). PTSD-8: a short PTSD inventory. Clinical practice and epidemiology in mental health: CP & EMH, 6, 101.
    Population: Adults Only
    Length: 69 questions for the Sample Person (SP) Questionnaire, 63 questions for the Proxy Questionnaire, and 79 questions for the Family Members and Friends (FF) Questionnaire.
    Time to Complete: Approximately 20 minutes
    Mode of Administration: Pen and Paper
    Administered by: Self Administered
    Language(s): English (SP/proxy and FF questionnaires), Spanish (SP questionnaire)    ...[See more] [See less]
    URL: https://www.nhats.org/sites/default/files/2021-01/NHATS%20R10%20COVID-19%20Questionnaires.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information: Vicki A. Freedman, Institute for Social Research, University of Michigan, vfreedma@umich.edu; Judith Kasper, Johns Hopkins Bloomberg School of Public Health, jkasper1@jhu.edu.
    Includes Research Tools: Yes.
    ID: 24245. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  17. COVID-19 Experiences Among South African Adolescent Girls and Their Mothers
    Source: University of Illinois at Chicago, School of Public Health
    Date Published: 6/18/2020
    Format: PDF
    Annotation: This tool was developed to measure experiences during the COVID-19 pandemic among South African adolescent girls (ages 15-19 years) and their mothers/caregivers within the IMARA (Informed, Motivated, Aware and Responsible Adolescents and Adults) study. It addresses psychological experiences (e.g., stress) and coping strategies, as well as effects of COVID-19 on mother-daughter relationships, living situations, sexual risk behaviors (e.g., frequency of sexual intercourse, drug/alcohol use), and health practices (e.g., adherence to medication). It is designed to be completed via self-report, either in person or over the telephone.

    Questions Adapted From: -Q1 is from the COVID-19 Exposure and Family Impact Survey (CEFIS), developed by The Center for Pediatric Traumatic Stress
    -Qs 2-12 are adapted from the COVID-19 Questionnaire Child Self-Report Primary Version, Environmental Influences on Child Health
    Population: Adults and Teens
    Length: 23 questions
    Time to Complete: 7-8 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Telephone
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English; Xhosa

    COVID-19 Experiences among South African Adolescent Girls and their Mothers: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UIC_COVID19Experiences_SouthAfricanAdolescentGirlsAndMothers.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UIC_COVID19_Experiences_Mental.pdf
    Personal and Family Impacts: Family Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UIC_COVID19_Experiences_Impact.pdf
    Risk-Reduction Behaviors: Substance Use; Sexual Behavior; Housing Security https://www.phenxtoolkit.org/toolkit_content/PDF/UIC_COVID19_Experiences_Risks.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/COVID19Experiences_SouthAfricanAdolescentGirlsAndMothers_18June2020.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Word version: https://www.nlm.nih.gov/dr2/COVID19Experiences_SouthAfricanAdolescentGirlsAndMothers_15June2020.docx
    Link to Appendix A: https://disasterinfo.nlm.nih.gov/content/files/AppendixB4A14May2020_updated.docx

    Available Formats: PDF

    Contact Information: Dr. Geri Donenberg
    Center for Dissemination and Implementation Science
    University of Illinois at Chicago
    Email: gerid@uic.edu
    Includes Research Tools: Yes.
    ID: 22689. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  18. Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) COVID-19 Survey Protocol
    Source: National Institute on Drug Abuse (NIDA)
    Date Published: 6/18/2020
    Format: PDF
    Annotation: This document is the protocol for the "Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) Survey of COVID-19 Risks/Effects, Substance Use, and HIV/AIDS Survey" (https://dr2.nlm.nih.gov/search/?q=22690). The protocol provides the background, study design, preliminary studies, recruitment and participant sampling, study procedures, data collection and measurements, and analytic strategy....[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/C3PNO_COVID-19_Supplement_Protocol.pdf
    Type: Study Design/Protocol
    Includes Research Tools: Yes.
    ID: 24241. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  19. Vanderbilt Child Health COVID-19 Poll: A National Survey of the Well-being of Parents and Children During COVID-19
    Source: Vanderbilt University Medical Center (VUMC)
    Date Published: 6/5/2020
    Format: Text
    Annotation: The Vanderbilt Child Health COVID-19 Poll was fielded from June 5 to June 10, 2020, using the Ipsos KnowledgePanel, a large online research panel created using probability-based address sampling of U.S. households. Households without internet at the time of recruitment were provided with an internet-enabled tablet. Participants in KnowledgePanel receive nominal periodic incentives to participate. For this survey, we included parents in KnowledgePanel with at least one child in the household younger than 18 years old. Eligible participants were randomly selected from the standing panel, sent an email notification, and sent a subsequent reminder three days later. This survey had a 50% completion rate, with a total of 1,011 responses. Survey weights were designed to provide national estimates of parents with children less than 18 years of age, accounting for differential nonresponse. Benchmarks for survey weighting were obtained from the 2019 March Supplement of the Current Population Survey for all variables, except for language proficiency, which was obtained from the 2018 American Community Survey.

    Questions Adapted From: Questions on food security (Q1, Q4), enrollment in food assistance programs (Q2, Q5), and health insurance (Q3, Q6) were adapted from the National Survey of Children's Health.
    Population: Adults Only
    Length: 14 questions
    Time to Complete: 10 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Special Considerations: Households without internet at the time of recruitment were provided with an internet-enabled tablet.
    Language(s): English

    Vanderbilt Child Health COVID-19 Poll: A National Survey of the Wellbeing of Parents and Children During COVID-19: Economic Insecurity; Health Care; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/Vanderbilt_Child_Health_COVID19.pdf
    URL: https://www.nlm.nih.gov/dr2/Vanderbilt_Health_COVID-19_Poll.docx
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation:
    Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey
    Stephen W. Patrick, Laura E. Henkhaus, Joseph S. Zickafoose, Kim Lovell, Alese Halvorson, Sarah Loch, Mia Letterie, Matthew M. Davis
    Pediatrics Jul 2020, e2020016824; DOI: 10.1542/peds.2020-016824. https://pediatrics.aappublications.org/content/146/4/e2020016824?cct=2287
    Available Formats: Text

    Contact Information:
    Stephen Patrick, MD, MPH, MS
    Director, Vanderbilt Center for Child Health Policy
    Vanderbilt University Medical Center
    Stephen.patrick@vumc.org

    Survey conducted by:
    Ipsos
    Global Market Research and Public Opinion Specialist
    https://www.ipsos.com/en
    Includes Research Tools: Yes.
    ID: 23255. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  20. COVID-19 and Telemental Health Service Use Survey: Telemental Health Service Use
    Source: University of North Carolina at Chapel Hill (UNC)
    Date Published: 6/2020
    Format: PDF
    Annotation: The COVID-19 and Telemental Health Service Use Survey was developed to help researchers and clinicians better understand how COVID-19 has affected the mental health of respondents, and their telemental health service use. Telemental health services include the use of voice call, video call, text messaging, mobile app, web-based formats (e.g., website, email), internet support group, or chat room to receive mental health treatment or counseling. The Institutional Review Board of the University of North Carolina at Chapel Hill provided the study a notification of exemption from further review (IRB Study #20-1588).

    Population: Adults Only
    Length: 26 items
    Time to Complete: 8 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    COVID-19 and Telemental Health Service Use Survey: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_CTHSUS.pdf
    Tele mental health services Use: Mental Health Treatment; Telehealth https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_CTHSUS_Use.pdf
    Tele mental health services Satisfaction: Telehealth; Mental Health Treatment Feedback https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_CTHSUS_Satisfaction.pdf
    Tele mental health services Concerns: Telehealth; Mental Health Communications https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_CTHSUS_Concern.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/CTHSUS_Telemental_Health_Service_Use.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information: Terika McCall, PhD, MPH, MBA
    Carolina Health Informatics Program
    100 Manning Hall
    Chapel Hill, NC 27599-3360
    tmccall@unc.edu
    Includes Research Tools: Yes.
    ID: 22688. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  21. International Sexual Health And REproductive (I-SHARE) Health Survey during COVID-19
    Source: Academic Network for Sexual and Reproductive Health and Rights Policy [Ghent University] (ANSER)
    Date Published: 6/2020
    Format: Text
    Annotation: I-SHARE is a cross-sectional, multi-country study on sexual and reproductive health well-being in the time of the COVID-19 crisis. The survey instrument is online-based, administered by local organizations in participating countries (34 countries to date), and designed to assess the impact of social distancing measures on sexual risk behaviors, intimate partner violence, and access to essential reproductive health services. The data collected from the survey are divided into the following sections: socio-demographics, compliance with social-distancing measures, couple and family relationships, sexual behavior, access to contraceptives, access to reproductive health services, abortion, sexual and gender-based violence, female genital mutation/cutting and early/forced marriage (optional), HIV/STI, mental health (optional), and nutrition (optional). The survey is for individuals 18 years or older, with some sections specifically for women.

    Population: Adults Only
    Length: 13 sections, 152 questions
    Time to Complete: 15-20 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English, Italian, Portuguese, Arabic, Latvian, Russian, German, Spanish, Bahasa Melayu, Czech, Danish, French, Khmer, Swedish; find over 35 translations of the survey: https://www.dropbox.com/sh/m2r9vpwv2g6asqb/AAAcMwakH2Xi512iEaKJJtR0a?dl=0)

    I-SHARE Health Survey during COVID-19: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19.pdf
    Socio-demographics: Locational Demographics; Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Sociodemographics.pdf
    Compliance with social distancing measures: Social Distancing; Economic Impact; Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Compliance.pdf
    Couple and family relationships: Family Impact https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Relationships.pdf
    Sexual behavior: Sexual Behavior https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Sexual_Behavior.pdf
    Access to contraceptives: Pregnancy History; Contraceptives; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Contraceptives.pdf
    Access to reproductive health care: Current Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Reproductive_Care.pdf
    Abortion: Abortion; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Abortion.pdf
    Sexual and gender based violence: Violence; Partner Dynamics https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Violence.pdf
    Female genital mutilation/early or forced marriage: Early Marriage; Female Circumcision https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Forced_Marriage.pdf
    HIV/STI: HIV https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_HIV.pdf
    Mental health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Mental_Health.pdf
    Nutrition: Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/I-SHARE_COVID19_Nutrition.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/I-SHARE_Survey.xlsx
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Associated protocol: https://www.nlm.nih.gov/dr2/I-SHAREProtocol19June2020.pdf
    Link to study website: https://ishare.web.unc.edu

    Available Formats: Text

    Citations:
    Hlatshwako TG, Shah SJ, Kosana P, Adebayo E, Hendriks J, Larsson EC, Hensel DJ, Erausquin JT, Marks M, Michielsen K, Saltis H, Francis JM, Wouters E, Tucker JD. Online health survey research during COVID-19. Lancet Digit Health. 2021 Feb;3(2):e76-e77. doi: 10.1016/S2589-7500(21)00002-9. PMID: 33509387. https://pubmed.ncbi.nlm.nih.gov/33509387/

    Michielsen K, Larrson EC, Kågesten A, Erausquin JT, Griffin S, Van de Velde S, Tucker JD; I-SHARE Team. International Sexual Health And REproductive health (I-SHARE) survey during COVID-19: study protocol for online national surveys and global comparative analyses. Sex Transm Infect. 2021 Mar;97(2):88-92. doi: 10.1136/sextrans-2020-054664. Epub 2020 Oct 20. PMID: 33082232. https://pubmed.ncbi.nlm.nih.gov/33082232/

    Contact Information:
    Kristien Michielsen
    Ghent University
    Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER)
    Email: kristien.michielsen@ugent.be

    Joseph D. Tucker
    University of North Carolina at Chapel Hill
    London School of Hygiene and Tropical Medicine (LSHTM)
    Email: jdtucker@med.unc.edu
    Includes Research Tools: Yes.
    ID: 23308. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  22. International Sexual Health And REproductive (I-SHARE) Health Survey during COVID-19: Study Protocol for Online National Surveys and Global Comparative Analyses
    Source: Academic Network for Sexual and Reproductive Health and Rights Policy [Ghent University] (ANSER)
    Date Published: 6/2020
    Format: PDF
    Annotation: COVID-19 may have a profound impact on sexual behaviors, reproductive health, and social life across the world. Shelter-in-place regulations that have extended across the globe may influence condomless sex, exacerbate intimate partner violence, and reduce access to essential reproductive health services. Population-representative research is challenging during shelter-in-place, leaving major gaps in our understanding of sexual and reproductive health during COVID-19. This International Sexual Health And REproductive (I-SHARE) study protocol manuscript describes a common plan for online national surveys and global comparative analyses.

    Methods: The purpose of this cross-sectional study is to better understand sexual and reproductive health in selected countries during COVID-19 and facilitate multi-national comparisons. Participants will be recruited in selected countries through an online survey. The survey link will be disseminated through local, regional, and national networks. In each country, a lead organization will be responsible for organizing ethical review, translation, and survey administration. The consortium network provides support for national studies, coordination, and multi-national comparison. We will use multi-level modeling to determine the relationship between COVID-19 and condomless sex, gender-based violence, access to reproductive health services, HIV testing, and other key items. This study protocol defines primary outcomes, pre-specified subanalyses, and analysis plans.

    The I-SHARE study examines sexual and reproductive health at the national and global level. We will use multi-level modeling to examine country-level variables associated with outcomes of interest. This will provide a foundation for subsequent online multi-country comparison using more robust sampling methodologies.

    Population: Adults Only
    Language(s): English    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/I-SHAREProtocol19June2020.pdf
    Type: Study Design/Protocol
    Access Notes: Free/Publicly Available
    Associated Survey: https://www.nlm.nih.gov/dr2/I-SHARE_Survey.xlsx
    Link to study website: https://ishare.web.unc.edu

    Available Formats: PDF

    Contact Information:
    Kristien Michielsen
    Ghent University
    Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER)
    Email: kristien.michielsen@ugent.be

    Joseph D. Tucker
    University of North Carolina at Chapel Hill
    London School of Hygiene and Tropical Medicine (LSHTM)
    Email: jdtucker@med.unc.edu
    Includes Research Tools: Yes.
    ID: 23309. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  23. TILDA COVID-19 Self-Completion Questionnaire
    Source: Trinity College Dublin
    Date Published: 6/2020
    Format: PDF
    Annotation: This Self-Completion Questionnaire (SCQ) was developed to collect information from participants of The Irish Longitudinal Study on Ageing (TILDA) on the experiences of community-dwelling older adults aged 58 years and older during the COVID-19 pandemic in the Republic Of Ireland. TILDA is a longitudinal cohort studies of community-dwelling older adults that began in 2009. A full description of TILDA and its program of research to date can be accessed at https://tilda.tcd.ie/. The survey was administered in June 2020 and data collection will conclude in September 2020.

    Questions Adapted From: The questionnaire includes items used in earlier rounds of TILDA and as such are largely harmonized with other aging cohort studies in the Health and Retirement Study (HRS) family of studies that include the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE).
    Population: Adults only
    Length: 81 questions
    Time to Complete: 30 to 40 minutes
    Mode of Administration: Pen and Paper
    Administered by: Self Administered
    Language(s): English

    The Irish Longitudinal Study on Ageing (TILDA) COVID-19 Self-Completion Questionnaire: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA.pdf
    Activities During Covid-19: Home Life; Social Distancing https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Activities.pdf
    Health Behaviors: Social Impact; Substance Use; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Health_Behaviors.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Mental_Health.pdf
    Work: Employment; Economic Impact https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Work.pdf
    State Assistance and Care Giving: Federal Assistance; Home Lifehttps://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_State_Assistance.pdf
    Health Care: Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Health_Care.pdf
    Media: Media Use; Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Media.pdf
    Age Discrimination: Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_Age_Discrimination.pdf
    COVID-19 Impact: General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_COVID19_Impact.pdf
    General Impact: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/TCD_TILDA_General_Impact.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Covid-19_Shorter_SCQ-FINAL.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information:
    Dr. Mark Ward
    The Irish Longitudinal Study on Ageing (TILDA)
    Trinity Central
    152-160 Pearse Street A 
    Trinity College Dublin, the University of Dublin
    Dublin 2, D02 R590, Ireland
    Email: wardm8@tcd.ie
    Includes Research Tools: Yes.
    ID: 23665. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  24. Pain Management Collaboratory (PMC) Coronavirus Pandemic (COVID-19) Measures: Version 2.0
    Source: Yale University
    Date Published: 5/20/2020
    Format: PDF
    Annotation: This 7-item self-report instrument is intended for individuals who are participating in ongoing clinical research during the coronavirus pandemic. It was developed to quantify changes in psychosocial, functional, and financial factors that may influence clinical research participation and clinical research study outcomes. The domains measured include: (1.) Access to Healthcare, (2.) Social Support, (3.) Finances, (4.) Ability to Meet Basic Needs, (5.) Mental and Emotional Health as well as a participant (subjective) experience of personal and family exposure to coronavirus. It was designed to quickly assess, in a minimally-burdensome manner, the positive and negative aspects of the pandemic on multiple mediating factors that may impact study outcomes.

    This instrument has a 3-month look back which can be adjusted to fit the study design. The tool is intended to be delivered at multiple time points (baseline and follow-up) to measure changes over time.

    This instrument was developed by researchers for the Pain Management Collaboratory (PMC) which involves 11 pragmatic trials studying non-pharmacological approaches to pain management (e.g. physical therapy, chiropractic care, meditation) in military personnel and veterans; however, this instrument was written broadly enough to be used with any adult population involved in clinical research.


    Questions Adapted From: The Phenotype and Outcome Work Group, within the Pain Management Collaboratory Coordinating Center (PMC3), is comprised of representatives from 11 pragmatic pain trials. The PMC3 collected COVID-related questionnaires from public sources, published instruments, and investigators within the Collaboratory. The Work Group members then met to review the resources compiled by PMC3, identified the key domains of interest, selected a question/response structure proposed for use by three PMC trial groups, revised the language within each question item until a consensus was obtained, and drafted the final instrument. This instrument has been approved by the Steering Committee for harmonized use of across PMC trials.
    Population: Adults Only
    Length: 7 items
    Time to Complete: <5 minutes
    Mode of Administration: Online (e.g., computer-assisted interview); Pen and Paper; Telephone
    Administered by: Self Administered
    Language(s): English

    Pain Management Collaboratory (PMV) Coronavirus Pandemic (COVID-19) Measures: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/Yale_PMV_Covid19.pdf
    URL: https://www.nlm.nih.gov/dr2/PMC_COVID_19_Measures_v2.0_052020_clean.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Contact Information:
    Yale University
    Pain Management Collaboratory Coordinating Center
    Email: painmanagementcollaboratory@yale.edu
    ID: 23059. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  25. Coping with COVID Through Nature: Evidence from Breast Cancer Patients
    Source: Michigan State University (MSU)
    Date Published: 5/18/2020
    Format: PDF
    Annotation: In order to increase physical activity and reduce chronic stress on a population level, researchers and city planners are exploring features of the built environment, including access to urban green space that may promote healthy lifestyles. Parks serve as places to engage in physical activity (PA) in direct contact with nature -- called "green exercise" -- which has been shown to lower perceived stress and risk of chronic disease. In addition, research indicates that passive exposure to green space (e.g., visual, as in the sight of plants and trees, and auditory, as in birdsong) may lower stress. However, many adults may experience barriers to getting outdoors, visiting parks, and engaging in PA during COVID-19 lockdowns, particularly people with compromised immune systems like those living with cancer. Exploring both how and why physical activity and outdoor behaviors have changed can help us to further understand the decision-making process and potential interventions that will benefit the health and well-being of breast cancer patients.

    Questions Adapted From: Questions about usage of outdoor spaces were both novel and adapted from University of Minnesota and Kansas State University surveys on outdoor activities during COVID-19. Perceived stress scale from Cohen (Cohen, S., T. Kamarck, and R. Mermelstein, A global measure of perceived stress. Journal of Health and Social Behavior, 1983. 24: p. 385-396). Quality of life questions from PROMIS (Hays, R.D., et al., Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation, 2009. 18(7): p. 873-880). Symptom experience from Cleeland (Cleeland, C.S., Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr, 2007(37): p. 16-21).

    Population: Adults Only
    Length: 150 questions, including health and demographic questions
    Time to Complete: 20 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    Coping with COVID through nature: Evidence from breast cancer patients and the output from the intake form: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC.pdf
    Community Impacts: Physical Activity; Community Access https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC_Community.pdf
    Environmental Factors: Nature Appreciation https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC_Enrvironmental.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC_Mental_Health.pdf
    Cancer Impact: Non-COVID-19 Symptoms and Medicines https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC_Cancer.pdf
    Personal Demographics: Personal Demographics; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/MSU_CWC_Demographics.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Pearson_MSUSurvey_18MAY2020.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Permission/Request required

    Citation(s):
    Licensing required for the MDAIS questions only. All other questions freely available.

    Available Formats: PDF

    Contact Information: Amber Pearson
    Michigan State University
    apearson@msu.edu
    Includes Research Tools: Yes.
    ID: 22691. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  26. Psychological Stress Associated with the COVID-19 Crisis
    Source: Stanford University
    Date Published: 5/14/2020
    Format: PDF
    Annotation: Unique questions and the standardized Perceived Stress Scale are used to assess psychological stress due to remote work during the COVID-19 crisis. The purpose is to measure the level of stress during this time and characterize it according to location, gender, income, and other factors. It includes confidential survey questions about homeschooling, dependent care, full-time remote work, and social distancing.

    Population: Adults only
    Length: 37 questions
    Time to Complete: 8-10 minutes
    Administered by: Self Administered
    Language(s): English, Spanish French, Italian, Japanese, Chinese

    Psychological Stress During COVID-19 Crisis: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19.pdf
    COVID-19 related Lifestyle Change: Daily Impact https://www.phenxtoolkit.org/toolkit_content/PDF/Stanford_COVID19_Lifestyle.pdf
    Data Dictionary - https://disasterinfo.nlm.nih.gov/content/files/Data_Dictionary.zip
    Consent Form - https://disasterinfo.nlm.nih.gov/content/files/Consent_form_COVID-19_survey.docx
    Research Protocol – https://disasterinfo.nlm.nih.gov/content/files/Research_Protocol.zip    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Psychological_Stress_Associated_with_the_COVID-19_Crisis_14.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Free/Publicly Available
    Programmed online survey link: https://www.abslab.stanford.edu/

    Preliminary testing and pilot data: Datasets: https://redivis.com/SUL/datasets/1914
    Citations: Articles accepted for publication since submission of the application: https://disasterinfo.nlm.nih.gov/content/files/ArticlesForPublicationAdamson.pdf

    Contact information: Maheen Mausoof Adamson: madamson@stanford.edu
    Includes Research Tools: Yes.
    ID: 22198. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  27. Coronavirus Anxiety Scale
    Source: Christopher Newport University (CNU)
    Date Published: 5/14/2020
    Format: PDF
    Annotation: Basic information
    The coronavirus anxiety scale (CAS) is a self-report mental health screener of dysfunctional anxiety associated with the coronavirus crisis. Because a significant number of people experience clinically significant fear and anxiety during an infectious disease outbreak, the CAS was developed to help clinicians and researchers efficiently identify cases of individuals functionally impaired by coronavirus-related anxiety.

    Psychometric properties
    Independent studies of adults residing across the United State have demonstrated that the CAS is a reliable instrument (αs > .90), with solid factorial (single-factor; invariant across sociodemographics) and construct (correlated with anxiety, depression, suicidal ideation, and drug/alcohol coping) validity. The diagnostic properties of the CAS (90% sensitivity and 85% specificity) are comparable to related screening instruments, such as the Generalized Anxiety Disorder-7.

    Scoring and interpretation
    Each item of the CAS is rated on a 5-point scale, from 0 (not at all) to 4 (nearly every day), based on experiences over the past two weeks. This scaling format is consistent with the DSM-5’s cross-cutting symptom measure. A CAS total score ≥ 9 indicates probable dysfunctional coronavirus-related anxiety. Elevated scores on a particular item or a high total scale score (≥ 9) may indicate problematic symptoms for the individual that might warrant further assessment and/or treatment. Clinical judgement should guide the interpretation of the CAS results.

    Length: 5 questions
    Administered by: Self Administered/Self Report
    Language(s): English, Brazilian Portuguese, Hebrew, Korean, Polish, Portuguese, Romanian, Spanish, Turkish, Urdu
    Special Considerations: COVID-19

    Coronavirus Anxiety Scale (CAS): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/Coronavirus_Anxiety_Scale_CAS.pdf
    URL: https://sites.google.com/cnu.edu/coronavirusanxietyproject/home
    Type: Guideline/Assessment Tool
    Access Notes: Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies. https://www.tandfonline.com/doi/full/10.1080/07481187.2020.1748481

    Contact Information:
    Dr. Sherman Lee: sherman.lee@cnu.edu
    Includes Research Tools: Yes.
    ID: 22203. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  28. Obsession with COVID-19-Scale
    Source: Christopher Newport University (CNU)
    Date Published: 5/14/2020
    Format: PDF
    Annotation: Basic information
    The Obsession with COVID-19 Scale (OCS) is a self-report mental health screener of persistent and disturbed thinking about COVID-19. Because the COVID-19 crisis affects nearly every aspect of a person’s life, the OCS was developed to help clinicians and researchers efficiently identify cases of individuals functionally impaired by their COVID-19 related thinking patterns.

    Psychometric properties
    The OCS was developed on two large samples of adults (n = 775; n = 398) residing across the United States. The OCS is a reliable instrument (αs > .83), with solid factorial (single-factor) and construct (correlated with coronavirus anxiety, spiritual crisis, alcohol/drug coping, extreme hopelessness, and suicidal ideation) validity. The diagnostic properties of the OCS (81% to 93% sensitivity and 73% to 76% specificity) are comparable to related screening instruments, such as the General Health Questionnaire (GHQ).

    Scoring and interpretation
    Each item of the OCS is rated on a 5-point scale, from 0 (not at all) to 4 (nearly every day), based on experiences over the past two weeks. This scaling format is consistent with the DSM-5’s cross-cutting symptom measure. An OCS total score ≥ 7 indicates probable dysfunctional thinking about COVID-19. Elevated scores on a particular item or a high total scale score (≥ 7) may indicate problematic symptoms for the individual that might warrant further assessment and/or treatment. Clinical judgement should guide the interpretation of the OCS results.

    Length: 4 questions
    Administered by: Self Administered/Self Report
    Language(s): English, Hebrew, Korean, Polish, Romanian, Turkish, Urdu

    Obsession with COVID-19 Scale (OCS): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CNU_OCS_Obsession.pdf
    URL: https://sites.google.com/cnu.edu/coronavirusanxietyproject/home
    Type: Guideline/Assessment Tool
    Access Notes: Citation: Lee, S. A. (2020). How much "Thinking" about COVID-19 is clinically dysfunctional? Brain, Behavior, and Immunity. https://www.sciencedirect.com/science/article/pii/S0889159120306826?via%3Dihub

    Contact Information:
    Dr. Sherman Lee: sherman.lee@cnu.edu
    Includes Research Tools: Yes.
    ID: 22204. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  29. Telling Our Stories in the Age of COVID-19
    Source: Cornell University
    Date Published: 5/6/2020
    Format: PDF
    Annotation: Overarching Goal: This study is intended to better understand the day-to-day impact of the novel coronavirus on the lives of the global public. Using regular journal entries along with several open- and close-ended questions specific to the impact of COVID-19, we aim to understand personal experiences of the global pandemic as it occurs in real time. We are specifically interested in situational changes, COVID-19 exposure and experience, COVID-19-related concerns, daily mood changes, and perceived impact, mental health impact, and use of social media.

    Study Population: As of May 6, 2020, participants represent 29 countries and 35 states within the United States. At the current time, respondent age range is 18-82 (mean = 44.8) and largely female (89.29%; 9.2% male). There is considerable variation in where people are living (this was check all that apply): 38% are with a spouse/partner, 18% with children <18, 10.2% with adult children, 10.7% with parents, 4.9% with roommates, and the rest in variations on this basic arrangement. Neither socioeconomic status (SES) nor race/ethnicity data was collected.

    Study Design: All participants have been recruited using principal investigator networks, organizational partner (Cornell University and Jed Foundation) publicity, and paid advertisements on Facebook in a number of regions around the world and within the United States. Participants enter the study through an online portal (https://www.covid-stories.com/    ) and are sent an initial survey where living context data are gathered. After signing up, participants receive a daily link to a short survey that assesses change since previous participation in a right of domains. Twice a week, respondents are sent a slightly modified version of the daily survey to assess mental health impact and social media use.

    Population: Adults only
    Length: 34 questions
    Administered by: Self Administered/Self Report
    Language(s): English

    Supporting material:
    Aims, protocol and sample descriptives https://disasterinfo.nlm.nih.gov/content/files/Aims_protocol_sample.docx
    Codebook https://disasterinfo.nlm.nih.gov/content/files/Codebook.xlsx
    Consent form https://disasterinfo.nlm.nih.gov/content/files/Autoethnography%20_Consent_Form.docx
    Daily Journal https://disasterinfo.nlm.nih.gov/content/files/Daily_Journal.docx
    Weekly Journal https://disasterinfo.nlm.nih.gov/content/files/Weekly_Journal.docx
    Initial Storytelling Journal Entry https://disasterinfo.nlm.nih.gov/content/files/Initial_Covid-19_Storytelling_Journal_Entry.docx
    Art Entry https://disasterinfo.nlm.nih.gov/content/files/COVID-19_Art_Entry.docx

    PHENX links:
    Telling our stories in the age of COVID-19 (TOSC): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Telling_our_stories_in_the_age_of_COVID-19.pdf
    COVID-19 Situational and Contextual Factors: Employment; Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/CU_TOSC_Situational.pdf
    COVID-19 Regional Restriction Status: Government Response https://www.phenxtoolkit.org/toolkit_content/PDF/CU_TOSC_Restrictions.pdf
    COVID-19 Concerns About Health, Finances, and Overall Impact: Health Care; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/CU_TOSC_Concerns.pdf
    COVID-19 Health Status: Status; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/CU_TOSC_Health_Status.docx.pdf
    COVID-19 Impact: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CU_TOSC_Impact.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Telling_our_stories_in_the_age_of_COVID-19_Questions.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Free/Publicly Available

    NOTE: The document at the provided URL includes specific survey domains and measures that are a compendium of all items used across the three surveys (the initial survey, the daily survey, and the twice-a-week survey). Non-COVID-19 specific measures appear at the bottom of the measure list.

    Link to Study Website: https://www.covid-stories.com/

    Contact information: Janis Whitlock, MPH, PhD, Cornell University: Jlw43@cornell.edu
    Includes Research Tools: Yes.
    ID: 22127. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  30. Coronavirus Impact Scale
    Source: Johns Hopkins School of Medicine
    Date Published: 5/2/2020
    Format: PDF
    Annotation: The Coronavirus Impact Scale was developed by Joan Kaufman and Joel Stoddard. It asks 12 questions, and is used to rate how COVID-19 has changed a person's life.

    Population: All/Anyone
    Length: 12 questions
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English, Spanish, French Canadian

    Coronavirus Impact Scale French Canadian Language: https://disasterinfo.nlm.nih.gov/content/files/Coronavirus%20Impact%20Scale%20-%20French%20Canadian%20-%20sondage%20mieux-%C3%AAtre.pdf
    Coronavirus Impact Scale Slovene Language: https://disasterinfo.nlm.nih.gov/content/files/Coronavirus%20Impact%20Scale%20-%20Slovene%20-%20LESTVICA%20VPLIVA%20KORONAVIRUSA.pdf
    Coronavirus Impact Scale Spanish: https://disasterinfo.nlm.nih.gov/content/files/Coronavirus%20Impact%20Scale_Spanish.pdf
    Coronavirus Impact Scale Manual: https://disasterinfo.nlm.nih.gov/content/files/COVID-19%20Impact%20Scale%20Manual.pdf
    Coronavirus Impact Scale REDCap Instrument (English): https://disasterinfo.nlm.nih.gov/content/files/instrument.csv    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/Coronavirus%20Impact%20Scale.pdf
    Authors: Kaufman, Joan; Stoddard, Joel
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Contact Information: Joel Stoddard, MD MAS, at joel.stoddard@cuanschutz.edu, Joan Kaufman, PhD., at joan.kaufman@kennedykrieger.org
    Includes Research Tools: Yes.
    ID: 21816. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  31. ABCD COVID-19 Impact Measure
    Source: University of California, San Diego (UCSD)
    Date Published: 5/2020
    Format: PDF
    Annotation: The COVID-19 Impact Measure was created to be administered to the participants of the NIH-sponsored Adolescent Brain and Cognitive Development (ABCD) longitudinal study of 11,880 diverse community youth enrolled at age 9-10 in 2016-2018 (i.e., birth years 2006-2009) at 21 research sites around the United States. The ABCD sample (63% White, 20% Latinx, 16% Black, 12% more than one race, 2% Asian, <1% American Indian, <1% Pacific Islander; half female) was targeted to match U.S. demographics as defined by the American Community Survey and is being followed until at least age 20. ABCD will send all currently enrolled participants (age range: 11-13) and their parent/guardian the opportunity to complete the ABCD COVID-19 questionnaires. The questionnaires will be administered once a month for four months. Each participant and their parent/guardian will be emailed a unique secure link to the parent and child forms to complete the survey in REDCap. Compensation will be provided upon receipt of the completed form. These measures were developed by a workgroup consisting of ABCD investigators with expertise in adolescent development, mental health, sleep, physical activity, substance use, and disaster response, and the electronic surveys underwent preliminary testing via expert review and pilot testing with adults and children.

    Note the Parent Measures contain the English and Spanish wording. The Parent Measure appears in two parts to accommodate parents who have more than one child in the ABCD Study (our design intentionally oversampled identical twins): Part 1 consists of questions that pertain to parent and family factors; Part 2 consists of questions pertaining to each child they have in the study. ABCD's COVID-19 research sends the measure multiple times over several months in 2020; to reduce participant burden, some items have skip-out branching logic and other items are given at one or two survey administrations and other items are administered each time (noted in comments in the measure PDFs).

    Domains included in the measure:
    * Family Situation: Home composition, economic impact, illness, parent support
    * Youth's Schooling: quality, quantity, methods, and supervision
    * Youth's Routine and Sleep
    * Relationships: friends and family
    * COVID Attitudes and Adherence (to public health directives)
    * Mental Health and Stress: depression, anxiety, worry, post-traumatic stress
    * Substance Use: alcohol, vaping of nicotine and cannabis, other intoxicants
    * Screen Use: for school, socializing, other reasons
    * Media Exposure to COVID-19
    * Physical Health: activity, food access, COVID-19 symptoms

    Population: Adults Only
    Children/Teens Only
    Length: ~85-90 items (Youth)* ; ~80-90 items (Parent) *Note: both measures have skip-out branching logic and not all questions may be asked to all participants.
    Time to Complete: 10-15 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English, Spanish (Parent)

    ABCD COVID-19 Impact Measure - Parent Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent.pdf
    Family Situation: Economic Insecurity; Avoidant Behaviors https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Family.pdf
    Youth's Schooling: Education https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Schooling.pdf
    Youth's Routine and Sleep: Physical Activity; Sleep Changes https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Routine.pdf
    Relationships: Family Impact; Hygiene; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Relationships.pdf
    COVID Attitudes & Adherence: Conflict; Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Attitudes.pdf
    Mental Health & Stress: Mental Health; Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Mental_Health.pdf
    Substance Use: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Substance_Use.pdf
    Screen Use: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Screen_Use.pdf
    Media Exposure to COVID-19: Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Media_Exposure.pdf
    Physical Health: Symptoms; Diagnosis; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Parent_Physical_Health.pdf

    ABCD COVID-19 Impact Measure - Youth Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth.pdf
    School Schedule: Education https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_School.pdf
    Youth's Routine and Sleep: Sleep Changes https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Routine_and_Sleep.pdf
    Parents/Guardians: Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Guardians.pdf
    Relationships: Family Impact; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Relationships.pdf
    Mental Health & Stress: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Mental_Health_Stress.pdf
    Substance Use: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Substance_Use.pdf
    Media Exposure to COVID-19: Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Media.pdf
    Screen Use: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Screen_Use.pdf
    Physical Health: Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/UCSD_ABCD_Youth_Physical_Health.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/ABCD_COVID-19_Impact_Measure-Parent.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available Youth Survey: https://www.nlm.nih.gov/dr2/ABCD_COVID-19_Impact_Measure-Youth.pdf
    Available Formats: PDF
    Contact Information:
    Susan Tapert, PhD.
    abcd-covid@ucsd.edu
    Includes Research Tools: Yes.
    ID: 22354. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  32. 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]
    URL: https://www.nlm.nih.gov/dr2/COVEX_05_13_20_FINAL_V1.pdf
    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.
  33. Coronavirus Disability Survey (COV-DIS)
    Source: University of Michigan
    Date Published: 5/2020
    Format: PDF
    Annotation: The Coronavirus Disability Survey (COV-DIS) was developed by the University of Michigan Center for Disability Health and Wellness in order to learn about the experiences of persons with disabilities (PWD) during the novel coronavirus (COVID-19) pandemic. The psychometric properties of the COV-DIS have not yet been established, but will be disseminated publicly in the future. The objective of the COV-DIS is to provide critical data on the experiences of PWDs during the COVID-19 pandemic. The risk of many adverse health and disability outcomes is elevated in PWDs. The COV-DIS specifically measures general and psychological well-being, difficulty performing activities and instrumental activities of daily living, employment and financial challenges, and difficulty accessing transportation and information. The COVID-19 pandemic and legally mandated social distancing measures have the potential to exacerbate challenges in each of these domains for the population at large, but particularly for PWDs. Data that are acquired using the COV-DIS may be helpful for attending to the needs and challenges faced by PWDs during the current pandemic, as well as for planning for responses to future waves of COVID-19 and other high-impact societal stressors.

    Questions Adapted From: Several items on the COV-DIS were adapted from survey items from the Understanding America Study (UAS), the Osteoporotic Fractures in Men (MrOS) Study, and the Study of Muscle, Mobility, and Aging (SOMMA) with permission from study investigators, as well as from the RAND 36-item Short Form Survey, and the Patient Health Questionnaire-2.

    Population: Adults only
    Length: 32 questions
    Mode of Administration: Telephone
    Email
    Administered by: Self Administered/Self Report
    Lay Interviewer
    Language(s): English

    Coronavirus Disability Survey (COV-DIS): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02.pdf
    General health: Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Health.pdf
    Depressive symptoms: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Depression.pdf
    Social isolation: Social Impact; Daily Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Social_Isolation.pdf
    Coronavirus infection/exposure: Status; Perceived Threat https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Infection.pdf
    Daily activities: Daily Impact; Daily Life https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Daily.pdf
    Access to medical care: Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Medical_Care.pdf
    Employment and financial impact: Employment; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Employment.pdf
    Transportation and information access: Daily Impact; Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UMich_COV-DIS_v02_Transportation.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Coronavirus_Disability_Survey_COV-DIS_UMich.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF

    All materials associated with the COV-DIS are made freely and publicly available at no cost. While not required, we encourage COV-DIS users to register using the following web address:https://umich.qualtrics.com/jfe/form/SV_38Wbm81ILp4VzOB

    Contact information: Sara Weiss, MPH, weisssar@med.umich.edu

    Full citation: Ehrlich JR, Bernard A, Weiss S, Stein JD, Ulin S, D’Souza C, Riddering A, Edwards P, Meade M, McKee M. (2020). The COV-DIS: Coronavirus Disability Survey
    Includes Research Tools: Yes.
    ID: 22358. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  34. AURORA-COVID Impact Survey (AURORA-CIS)
    Source: University of North Carolina at Chapel Hill (UNC)
    Date Published: 5/2020
    Format: PDF
    Annotation: The AURORA-CIS is a newly designed short survey to learn and understand the impact of the coronavirus (COVID-19/SARS-CoV-2) pandemic on the trauma survivors currently enrolled in the AURORA Study. This supplementary survey was created to assess the additional impact of the pandemic on the mental health outcomes of the study participants beyond that which could be associated with the traumatic event that led to their emergency room visit. There are four questions asked weekly and an additional fifth question included every month. All questions appear at the end of the participants' regularly deployed weekly smartphone-based flash survey.

    The AURORA Study is a 12-month longitudinal study that represents a major national initiative to improve the understanding, prevention, and treatment of post-traumatic neuropsychiatric sequelae. Five thousand participants who present to the emergency department (28 sites) for evaluation after trauma exposure, meet screening and eligibility criteria, and consent to the study will undergo a brief emergency department assessment of trauma-related, psychosocial, neurocognitive, and biological factors. Participants will be discharged with ecological monitoring, and will complete physiologic, biologic, neurocognitive, symptom, and health outcome assessments during one-year follow-up. Subsamples of study participants will undergo in-person deep phenotyping at two weeks and six months, consisting of biologic collection, functional magnetic resonance imaging (fMRI), and psychophysical evaluation. The COVID survey items will be administered to both existing and newly enrolled participants. No pilot testing for the questions was done.

    Population: Adults only
    Length: 5 questions
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    AURORA-COVID Impact Survey (AURORA-CIS): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_AURORA-CIS.pdf
    Financial impact of COVID-19: Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_AURORA-CIS_Financial.pdf
    Health impact (self and loved ones) of COVID-19: Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_AURORA-CIS_Health_v2.pdf
    Worry about COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_AURORA-CIS_Worry.pdf
    Employment status due to COVID-19: Employment https://www.phenxtoolkit.org/toolkit_content/PDF/UNC_AURORA-CIS_Employment.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/AURORA-COVID_Impact_Survey_AURORA-CIS.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Available Formats: PDF
    Contact Information:
    Suraj Chandy Oomman: surajoomman@med.unc.edu or auroracoordinator@med.unc.edu;
    Includes Research Tools: Yes.
    ID: 22360. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  35. 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]
    URL: https://www.nlm.nih.gov/dr2/RAND_ALP_COVID_Survey_Instrument_May2020.pdf
    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.
  36. C3PNO COVID-19 Survey: Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) Survey of COVID-19 Risks/Effects, Substance Use, and HIV/AIDS
    Source: National Institute on Drug Abuse (NIDA)
    Date Published: 5/1/2020
    Format: PDF
    Annotation: C3PNO fosters collaborations and data sharing across the National Institute on Drug Abuse (NIDA) cohorts. C3PNO manages and stimulates the use of the NIDA longitudinal cohorts and addresses high priority research on HIV/AIDS in the context of substance misuse.

    In response to the COVID-19 pandemic, NIDA crafted a cross-cutting survey of COVID-19 related risk behaviors and effects. Find the associated protocol: https://dr2.nlm.nih.gov/search/?q=24241

    Questions Adapted From: Various sources and original questions
    Population: Adults and Teens
    High Risk/Special/Unique Populations
    Multiple Groups
    Other
    Sexual or Gender Minorities
    Substance users, those at risk for or living with HIV/AIDS, men who have sex with men
    Length: Up to 65 questions but much shorter for non-active substance users
    Time to Complete: 15 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Telephone
    Administered by: Self Administered
    Trained Lay Examiner/Interviewer
    Special Considerations: May be conducted by interviewer but designed primarily for online survey
    Language(s): English

    C3PNO COVID-19 Survey: Full survey https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19.pdf
    Demographics: Employment; Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Demographics.pdf
    COVID-19 Topics: Overall Impact; General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Topics.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Mental_Health.pdf
    Healthcare and HIV: Health Care; HIV https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Health_Care.pdf
    Relationships: Sexual Behavior https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Relationships.pdf
    Substance Use: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/C3PNO_COVID-19_Substance_Use.pdf
    C3PNO Cross-Cohort Assessments https://disasterinfo.nlm.nih.gov/content/files/C3PNO%20COVID-19%20Survey%20Measures_Compendium_042820.xlsx
    C3PNO mSTUDY Remote Consent Form: https://disasterinfo.nlm.nih.gov/content/files/C3PNO_mSTUDY%20Cohort_COVID19_Remote%20Visit_Consent.pdf WORD version: https://disasterinfo.nlm.nih.gov/content/files/C3PNO_mSTUDY%20Cohort_COVID19_Remote%20Visit_Consent.docx
    Version 2:
    C3PNO COVID19 Supplement Survey REDCap Data Dictionary Codebook: https://disasterinfo.nlm.nih.gov/content/files/C3PNO%20COVID19%20Supplement%20Survey%20_%20REDCap.pdf
    C3PNO COVID19 Supplement Survey Codebook https://disasterinfo.nlm.nih.gov/content/files/C3PNO COVID-19 supplement survey codebook_091820.xlsx
    C3PNO COVID-19 Supplement Round II Survey Flow https://disasterinfo.nlm.nih.gov/content/files/C3PNO_COVID-19_Supplement_Round_II%20(1).docx
    C3PNO COVID-19 Supplement Round II QSF https://disasterinfo.nlm.nih.gov/content/files/C3PNO_COVID-19_Supplement_Round_II%20(1).qsf
    C3PNO COVID-19 Supplement Survey Data Dictionary 2020-09-29 https://disasterinfo.nlm.nih.gov/content/files/C3PNOCOVID19SupplementSurvey_DataDictionary_2020-09-28.csv    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/C3PNO_COVID-19_Supplement_Survey_for_DR2_and_PhenX_Repositories.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Permission/Request required; Codebook: https://www.nlm.nih.gov/dr2/C3PNO_COVID-19_supplement_survey_codebook.xlsx; The Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) project website: https://www.c3pno.org/C3PNOWebApplication

    Available Formats: PDF

    Contact Information: Pamina Gorbach, Dr. PH (UCLA)
    C3PNO Principal Investigator
    pgorbach@ucla.edu
    Includes Research Tools: Yes.
    ID: 22690. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  37. 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]
    URL: https://disasterinfo.nlm.nih.gov/content/files/COVID_1_Codebook.pdf
    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.
  38. Longitudinal Aging Study in India - Diagnostic Assessment of Dementia (LASI-DAD) Genomics Study: Monitoring the Health and Socioeconomic Impacts of COVID-19 : RTI COVID-India
    Source: University of Southern California (USC)
    Date Published: 4/29/2020
    Format: PDF
    Annotation: LASI-DAD is the first and only nationally representative and publicly available dataset on late-life cognition and dementia in India. We have drawn a sample of over 4,000 community-residing older adults 60+ years of age from 19 states in India, representing 91.6% of India's ethnically diverse population. We will target one randomly selected adult male and one randomly selected adult female for each household.

    Study Parameters: The survey will draw on the 4,096 LASI-DAD households. We will target one randomly selected adult male and one randomly selected adult female for each household. The survey will take 15 minutes and will be administered via phone calls according to the following schedule: a first round, soon to be conducted in May 2020 and every two months thereafter for one year. We will randomly space interview slots over each two-month-long survey wave to facilitate time series analysis of responses to changes in the health and policy environment.

    As we plan to re-interview the same respondents over a one-year time period, we will monitor the course of the pandemic carefully and adapt the instrument, as needed, to ensure that it is filling high-priority knowledge gaps. At the same time, we aim to make changes judiciously to ensure that we have a high-quality time-series of central variables.

    India is an ethnically and linguistically diverse country. To ensure national representation and high-quality data collection, the instrument and consent are translated into 12 languages: Hindi, Kannada, Malayalam, Gujarati, Tamil, Punjabi, Urdu, Bengali, Assamese, Odiya, Marathi, and Telugu. All interviews will be conducted in respondents' local languages to ensure respondent comprehension and comfort.

    Preliminary Testing: We conducted a pilot to verify phone contact rates for the LASI-DAD sample in March 2020. The aim of this pilot is to examine the feasibility of Computer Assisted Telephone Interview for the sample. A first wave of 1,587 households had phone numbers collected between October 2017 and May 2018; we called 51 of these households and were able to get in touch with 25 (49%); the remaining 2,503 households had numbers collected during October 2018 or later. We called 49 of these households and got in touch with 40 (82%). This pilot was conducted over a few days and did not use back-up phone numbers on file with households; these contact rates are therefore lower bounds and suggest that getting in touch with 75-80% of the full sample is feasible.

    We then pretested the instrument in April 2020. The aim of the pretest is to assess the time required for the instrument administration, as well as to evaluate how respondents respond to the question contents. We conducted the pretest in six local languages with a sample size of 29 households, 58 interviews. After the pretest and debriefing, we refined the instrument for the survey rollout.

    Population: Adults only
    Length: 34 items
    Time to Complete: 15 minutes
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English, Hindi, Kannada, Malayalam, Gujarati, Tamil, Punjabi, Urdu, Bengali, Assamese, Odiya, Marathi, and Telugu

    This instrument has been developed in two stages; it was first pushed out the baseline interview in May 2020 during the lockdown period, and then further refined with additional content: https://disasterinfo.nlm.nih.gov/content/files/RTI_India_instrument.docx
    RTI India Interviewer Manual https://disasterinfo.nlm.nih.gov/content/files/RTI_India_round6manual_final.docx

    Longitudinal Aging Study in India – Diagnostic Assessment of Dementia (LASI-DAD): Full Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD.pdf
    COVID19-related knowledge and behaviors: Social Distancing; Hygiene; Knowledge https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD_Knowledge.pdf
    COVID19 and Health care and food security: Health Care; Symptoms; Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD_Health.pdf
    COVID19 and Economic Effects: Economic Impact https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD_Economic.pdf
    COVID19 and Discrimination and (mis) information: Sources of information about COVID-19; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD_Discrimination.pdf
    COVID19 and Mental Health, coping and wellbeing: Mental Health; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/LASI-DAD_Mental_Health.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/LASI-DAD_covid_instrument_4.29.2020.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Free/Publicly Available
    Contact Information: Help@lasi-dad.org
    Includes Research Tools: Yes.
    ID: 22098. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  39. COVID-19: Impact of the Pandemic and HRQoL in Cancer Patients and Survivors (IPHCPS)
    Source: University of Miami (UM)
    Date Published: 4/29/2020
    Format: PDF
    Annotation: This is a brief, self-report, online-based questionnaire administered via REDCap (Research Electronic Data Capture system) to assess: (1) experiences during the COVID-19 pandemic (e.g., exposure, risk factors, testing, isolation, seropositivity, hospitalization, loss of family or friends); (2) COVID-19-specific psychological distress (e.g., fear, anxiety and depressive symptoms); (3) health, financial, and social disruptions; (4) perceived benefits and social support; (5) health related quality of life (HRQoL) in a convenience sample of cancer patients and survivors; and (6) the extent to which resiliency factors, such as social support and perceived benefits, moderate the effects of COVID-19 experiences on COVID-19-specific psychological distress and HRQoL.

    Domains or modules included in survey: I. COVID-19 Experiences. The first section includes 19 questions related to experiences during the COVID-19 pandemic such as exposure, risk factors, testing, isolation, seropositivity, hospitalization, loss of family or friends, loss of income, as well psychosocial experiences related to COVID-19-like fear, anxiety, and depression symptoms (questions 1-19). II. COVID-19 Psychosocial and Practical Experiences. Subscales: COVID-19-Specific Distress (Emotional and Physical Reactions) -- emotional and physical impact of the COVID-19 pandemic (questions 1 through 13). Health Care Disruptions and Concerns (Concerns About Medical Care) -- how the COVID-19 pandemic has impacted general and cancer-related care, as well as health care concerns specific to the pandemic (questions 14 through 17). Disruption to Daily Activities and Social Interactions -- how the pandemic has impacted routines, social activities, and interactions (questions 18 through 23). Financial Hardship -- how the COVID-19 pandemic has affected finances and created and/or exacerbated financial hardships (questions 24 through 28). Perceived Benefits -- how experiences with the pandemic have led to any perceived benefit or positive contribution (questions 29 through 34). Functional Social Support -- availability and use of social resources during the pandemic (questions 35 through 38). Perceived Stress Management (Ability to Manage Stress) -- ability to implement skills to manage pandemic related stressors (questions 39 through 43).

    Scoring: Available upon request. Ongoing psychometric analyses.

    Population: Adults only
    Length: 69 questions
    Administered by: Self Administered/Self Report
    Language(s): English

    Impact of the Pandemic and HRQoL in Cancer Patients and Survivors (IPHCPS): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL.pdf
    COVID-19 Specific Distress (Emotional and Physical Reactions): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Distress.pdf
    COVID-19 Health Care Disruptions and Concerns (Concerns About Medical Care): Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Health_Care.pdf
    COVID-19 Disruption to Daily Activities and Social Interactions: Daily Life https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Disruption.pdf
    COVID-19 Financial Hardship: Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Financial.pdf
    COVID-19 Perceived Benefits: Positive Impacts https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Perceived_Benefits.pdf
    COVID-19 Functional Social Support: Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Social.pdf
    COVID-19 Perceived Stress Management (Ability to Manage Stress): Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UMiami_HRQoL_Stress.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/COVID-19_IMPACT_HRQOL_QUESTIONNAIRE_FINAL.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Free/Publicly Available

    Associated protocol: https://www.nlm.nih.gov/dr2/Impact_of_the_Pandemic_HRQoL_in_Cancer_Patients_and_Survivors.pdf (https://dr2.nlm.nih.gov/search/?q=22131)

    Contact Information: Frank J. Penedo, PhD Professor, Departments of Psychology and Medicine, University of Miami/Associate Director, Sylvester Comprehensive Cancer Center: frank.penedo@miami.edu
    Includes Research Tools: Yes.
    ID: 22130. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  40. COVID-19: Well-Being and HRQoL in Cancer Patients and Survivors: Protocol
    Source: University of Miami (UM)
    Date Published: 4/29/2020
    Format: PDF
    Annotation: Cross-sectional study protocol. Sociodemographics: Age -- 18 years or older. Gender -- Nonspecific. Race/ethnicity -- Nonspecific; however, the participant needs to be fluent in English or Spanish. Geographical region: Miami, Florida, and Houston, Texas. Targeted population: ICD-10 confirmed cancer diagnosis for cancer patients or survivors who had an oncology visit within the University of Miami Miller School of Medicine (UM/MSOM) Sylvester Comprehensive Cancer Center health system in the past five years. Study links patient demographic and clinical data via the health system’s electronic data warehouse and uses the survey "Impact of the Pandemic and HRQoL in Cancer Patients and Survivors (IPHCPS)" to assess impacts of COVID-19.

    Population: Adults only
    Language(s): English    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Impact_of_the_Pandemic_HRQoL_in_Cancer_Patients_and_Survivors.pdf
    Authors: Penedo, Frank; Antoni, Michael
    Type: Study Design/Protocol
    Access Notes: Free/Publicly Available

    Associated survey: https://www.nlm.nih.gov/dr2/COVID-19_IMPACT_HRQOL_QUESTIONNAIRE_FINAL.pdf (https://dr2.nlm.nih.gov/search/?q=22130)
    Includes Research Tools: Yes.
    ID: 22131. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  41. 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]
    URL: https://www.nlm.nih.gov/dr2/JHU_COVID-19_Community_Response_Survey_v1.3.pdf
    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.
  42. COVID-19 Exposure and Family Impact Survey (CEFIS)
    Source: Center for Pediatric Traumatic Stress [Children's Hospital of Philadelphia, Nemours A.I. duPont Hospital for Children]
    Date Published: 4/22/2020
    Format: PDF
    Annotation: The COVID-19 Exposure and Family Impact Survey (CEFIS) was developed using a rapid iterative process in late March/early April 2020. At that time, the COVID-19 pandemic was impacting most, if not all, American families to some extent. Communities were coming under "stay at home" orders, schools were closing, and health and financial implications of the COVID-19 pandemic were unfolding.
    Various aspects of the COVID epidemic are likely to impact families and may influence the findings of research in pediatric health. CEFIS was designed to be used in ongoing and new studies where COVID-19 may influence study outcomes. It conceptualizes exposure to potentially traumatic aspects of COVID-19 and assesses the impact of the pandemic on the family. CEFIS should be completed by caregivers. Each caregiver can complete CEFIS. It is available in English and Spanish.

    Population: Adults only
    Residential/Workplace
    Length: 37 questions
    Administered by: Parent/Teacher
    Language(s): English, Spanish

    COVID-19 Exposure and Family Impact Survey (CEFIS): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_v2.pdf
    Family Exposure items: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_Exposure_v2.pdf
    Family Impact items: Family Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_Impact_v2.pdf

    COVID-19 Exposure and Family Impact Survey (CEFIS) - Adolescent/Young Adult https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA.pdf
    Family Exposure items - Adolescent/Young Adult: Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA_Exposure.pdf
    Family Impact items - Adolescent/Young Adult: Family Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA_Impact.pdf

    COVID-19 Exposure and Family Impact Survey (CEFIS) (Spanish): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_Spanish_v2.pdf
    Family Exposure items (Spanish): Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_Exposure_Spanish_v2.pdf
    Family Impact items (Spanish): Family Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_Impact_Spanish_v2.pdf

    COVID-19 Exposure and Family Impact Survey (CEFIS) - Adolescent/Young Adult (Spanish) https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA_Spanish.pdf
    Family Exposure items - Adolescent/Young Adult: Overall Impact (Spanish) https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA_Exposure_Spanish.pdf
    Family Impact items - Adolescent/Young Adult: Family Impact (Spanish) https://www.phenxtoolkit.org/toolkit_content/PDF/CPTS_CEFIS_AYA_Impact_Spanish.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/CEFIS_COVID_questionnaire_English_42220_final.pdf
    Type: Guideline/Assessment Tool
    Access Notes: COVID-19 Exposure and Family Impact Survey (English) https://www.nlm.nih.gov/dr2/CEFIS_COVID_questionnaire_English_42220_final.pdf
    COVID-19 Exposure and Family Impact Survey (Spanish) https://www.nlm.nih.gov/dr2/CEFIS_COVID_questionnaire_Spanish_42220_final.pdf

    COVID-19 Exposure and Family Impact Survey (CEFIS) Adolescent and Young Adult Version (English) https://www.nlm.nih.gov/dr2/CEFIS-AYA_English_051820_final_sample.pdf
    COVID-19 Exposure and Family Impact Survey (CEFIS) Adolescent and Young Adult Version (Spanish) https://www.nlm.nih.gov/dr2/CEFIS-AYA_Spanish_051820_final_sample.pdf

    CEFIS is available for use without charge through the Center for Pediatric Traumatic Stress (CPTS). CEFIS is available as a REDCap survey. We ask that you register with us before using it and provide us with information about your use and share de-identified data with us to that we can refine the measure. We will provide a REDCap data dictionary to facilitate this process. There are no normative data or clinical cutoffs available at this point. Interested users should contact Gabriela Vega (Gabriela.Vega@nemours.org).

    Available Formats: PDF
    Contact Information: Nemours Children's Health Center
    Anne Kazak: Anne.Kazak@nemours.org
    Includes Research Tools: Yes.
    ID: 22041. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  43. Mental Health Impact of COVID-19 Pandemic on NIMH Research Participants and Volunteers Protocol
    Source: National Institute of Mental Health [National Institutes of Health] (NIMH)
    Date Published: 4/20/2020
    Format: PDF
    Annotation: This protocol provides the rationale, background, objectives, design, methodology, statistical considerations, organization for the National Institute of Mental Health Psychosocial Impact of COVID-19 Survey: https://dr2.nlm.nih.gov/search/?q=22587
    Abbreviated title: MINH COVID Study    ...[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/20_M_N085_Research_Protocol.pdf
    Type: Study Design/Protocol
    Access Notes: Contact Information:
    Study team: NIMHResearchVolunteer@nih.gov
    Joyce Chung, MD, National Institute of Mental Health (NIMH) Intramural Research Program, joyce.chung@nih.gov
    Includes Research Tools: Yes.
    ID: 24225. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  44. Coronavirus Racial Bias Scale: Fordham University Pathways to Health Study
    Source: Fordham University
    Date Published: 4/14/2020
    Format: PDF
    Annotation: The Coronavirus Racial Bias Scale (CRBS) is a brief self-report questionnaire developed by Fordham University's Center for Ethics Education and Applied Developmental Psychology Program as part of the Pathways to Health Study. The CRBS assesses beliefs about how the coronavirus has negatively affected people of their race/ethnicity. Questions include beliefs regarding coronavirus-related increase in negative racial/ethnic public attitudes, racial/ethnic biases resulting in loss of employment and access to health services, and increases in racially charged social media and cyberbullying.

    Population: Adults and Teens; Ethnic/Religious Groups
    Length: 9 items
    Time to Complete: Less than 5 minutes
    Mode of Administration: Self Administered
    Language(s): English

    Coronavirus Racial Bias Scale (CRBS): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/Fordham_CRBS.pdf
    Mental Health: General Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRBS_Mental_Health.pdf
    Perceptions: Racial/Ethnic Disparities https://www.phenxtoolkit.org/toolkit_content/PDF/CRBS_Perceptions.pdf
    Daily Impact: Daily Impact https://www.phenxtoolkit.org/toolkit_content/PDF/CRBS_Daily_Impact.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Coronavirus_Racial_Bias_Scale_Fordham.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Contact Information:
    Celia B. Fisher, Ph.D.
    Center for Ethics Education
    Fordham University
    Fisher@fordham.edu

    Administrator: Lori Merone
    lmerone@fordham.edu
    Includes Research Tools: Yes.
    ID: 22497. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  45. Impact of COVID-19 on People Living with Rare Disease and their Families
    Source: Rare Diseases Clinical Research Network [National Center for Advancing Translational Sciences] (RDCRN)
    Date Published: 4/8/2020
    Format: PDF
    Annotation: This is a brief, self-report, online-based questionnaire administered via REDCap (Research Electronic Data Capture system) to:

    1) Estimate the proportion of patients who live with rare diseases who have been diagnosed with COVID-19 infection;
    2) Describe the characteristics of the COVID-19 presentation and the course of the infection (including treatment) among patients with rare diseases;
    3) Determine whether subgroups of patients defined by sociodemographic variables, geographic location, with particular rare conditions or comorbidity have been affected more frequently or have experienced increased severity of the infection;
    4) To learn about the potential interaction between specific treatment regimens and COVID-19 infection, and specifically whether certain antibiotic, immunosuppressive, or anti-inflammatory drugs are associated with the frequency of COVID-19 infection and its severity;
    5) Assess the extent to which the COVID-19 pandemic has affected the life of rare disease patients and their families, including their access to medical care and routine medication;to
    6) Learn about the main concerns that people who live with rare diseases and their families have with respect COVID-19, and determine how the RDCRN can respond by providing information and advice through its network of experts, its consortia, and in collaboration with patient advocacy groups;
    7) Allow follow-up for patients and families who agree to provide contact information, and linkage of information collected in the survey with data maintained by the RDCRN for patients enrolled in RDCRN research studies.

    Target population: all patients with rare diseases who live in the United States.

    Population: High Risk/Special/Unique Populations
    Time to Complete: 20 Minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    Impact of COVID-19 on People Living with Rare Disease and their Families: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/RDCRN.COVID-19.Survey.pdf
    Symptoms and Diagnosis: General Symptoms; Diagnosis; Treatment https://www.phenxtoolkit.org/toolkit_content/PDF/RDCRN_Impact_of_COVID19_Symptoms.pdf
    Health Care Access and Service Use During the Pandemic: Health Care; Status https://www.phenxtoolkit.org/toolkit_content/PDF/RDCRN_Impact_of_COVID19_Health_Care.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/RDCRN_COVID-19_Survey_08Apr20204.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Associated protocol: https://www.nlm.nih.gov/dr2/RDCRN_COVID19_Protocol_08Apr2020.pdf (https://dr2.nlm.nih.gov/search/?q=22514)
    Link to public survey: https://www.rarediseasesnetwork.org/covidsurvey

    Free/Publicly Available

    Available Formats: PDF

    Contact Information: Cincinnati Children's Hospital Medical Center, email: rd.covid19@cchmc.org
    Includes Research Tools: Yes.
    ID: 22513. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  46. Impact of COVID-19 on People Living with Rare Disease and their Families: Protocol
    Source: Rare Diseases Clinical Research Network [National Center for Advancing Translational Sciences] (RDCRN)
    Date Published: 4/8/2020
    Format: PDF
    Annotation: This is the protocol for the "Impact of COVID-19 on People Living with Rare Disease and their Families" (https://dr2.nlm.nih.gov/search/?q=22513). The survey is a brief, self-report, online-based questionnaire administered via REDCap (Research Electronic Data Capture system) to:

    1) Estimate the proportion of patients who live with rare diseases who have been diagnosed with COVID-19 infection;
    2) Describe the characteristics of the COVID-19 presentation and the course of the infection (including treatment) among patients with rare diseases;
    3) Determine whether subgroups of patients defined by sociodemographic variables, geographic location, with particular rare conditions or comorbidity have been affected more frequently or have experienced increased severity of the infection;
    4) Learn about potential interaction between specific treatment regimens and COVID-19 infection, and specifically whether certain antibiotic, immunosuppressive, or anti-inflammatory drugs are associated with the frequency of COVID-19 infection and its severity;
    5) Assess the extent to which the COVID-19 pandemic has affected the life of rare disease patients and their families, including their access to medical care and routine medication;
    6) Learn about the main concerns that people who live with rare diseases and their families have with respect to COVID-19, and determine how the RDCRN can respond by providing information and advice through its network of experts, its consortia, and in collaboration with patient advocacy groups; and
    7) Allow follow-up for patients and families who agree to provide contact information, and linkage of information collected in the survey with data maintained by the RDCRN for patients enrolled in RDCRN research studies.

    Population: High Risk/Special/Unique Populations
    Time to Complete: 20 Minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/RDCRN_COVID19_Protocol_08Apr2020.pdf
    Type: Study Design/Protocol
    Access Notes: Associated Survey Instrument: https://www.nlm.nih.gov/dr2/RDCRN_COVID-19_Survey_08Apr20204.pdf (https://dr2.nlm.nih.gov/search/?q=22513)

    Free/Publicly Available

    Available Formats: PDF

    Contact Information: Cincinnati Children's Hospital Medical Center, email: rd.covid19@cchmc.org
    Includes Research Tools: Yes.
    ID: 22514. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  47. COVID-19 and Perinatal Experiences (COPE) Study
    Source: New York University (NYU)
    Date Published: 4/7/2020
    Format: Text
    Annotation: This survey assesses the impact of the COVID-19 outbreak on the feelings and experiences of pregnant women and new moms.

    Population: Adults only
    Length: 87 questions
    Administered by: Self Administered/Self Report
    Language(s): English, Brazilian Portuguese, Dutch, French, German, Portuguese, Spanish

    Coronavirus Perinatal Experiences Impact Survey (COPE-IS): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS.pdf
    Prenatal Experiences of COVID-19 Current Pregnancy: Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Prenatal.pdf
    Perinatal Experiences of COVID-19:Past Pregnancy; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Perinatal.pdf
    Exposures and Symptoms: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Exposures.pdf
    Financial Impacts: Employment; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Financial.pdf
    Social Support Impacts: Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Social_Support.pdf
    Social Distancing and Restricted Activities: Social Distancing; Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Social_Distancing.pdf
    Coping and Adjustment: Mental Health; Substance Use; Dietary Intake https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Coping.pdf
    Emotional Impact: Stress; Sleep Changes; Daily Impact https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Emotions.pdf
    Health Background, Mental Health, and Substance Use: Health History; Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Health_Background.pdf
    Demographics:Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IS_Demographics.pdf

    COVID-19 - Coronavirus Perinatal Experience - Impact Update: https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IU.pdf
    Exposures and Symptoms:Symptoms; Exposure https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IU_Exposures.pdf
    Adjustments: Daily Life; Stress; Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/COS_COPE_IU_Adjustments.pdf    ...[See more] [See less]
    URL: https://osf.io/uqhcv/
    Authors: VanTieghem, Michelle; Thomason, Moriah; Graham, Alice; Sullivan, Elinor; Vatalaro, Tessa; et al.
    Type: Guideline/Assessment Tool
    Access Notes: Link to Coronavirus Perinatal Experiences Impact Survey (COPE-IS): https://www.nlm.nih.gov/dr2/COPE-Impact_Survey_Perinatal_Pandemic_Survey.pdf
    Link to Coronavirus Perinatal Experience - Impact Update (COPE-IU): https://www.nlm.nih.gov/dr2/COPE-Impact_Update_Perinatal_Pandemic_Survey.pdf


    IRB examples and REDCAP Baseline Survey Zip files in English and Spanish are available.

    Free/Publicly Available

    Contact Information: New York University (NYU), moriah.thomason@nyulangone.org
    Includes Research Tools: Yes.
    ID: 21878. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  48. Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MACS-WIHS)
    Source: National Heart, Lung, and Blood Institute [National Institutes of Health] (NHLBI)
    Date Published: 4/6/2020
    Format: PDF
    Annotation: The overarching aim of this application is to understand the impact of the coronavirus pandemic among U.S. men and women with or at risk for HIV infection. We propose to conduct bi-monthly telephone surveys with medical record abstraction for documentation/verification of COVID-19 incidence and clinical outcomes among men and women in the MACS and the WIHS.

    In order to collect key clinical and psychosocial data on the impact of coronavirus on existing study participants, study staff will attempt to conduct bimonthly remote semi-structured phone interviews with all existing WHIS and MACS participants until the end of the coronavirus pandemic. Ascertainment of key clinical events reported during interview – or via participant-initiated phone contact – will be attempted through collection of medical records. Key clinical events will include: Confirmed diagnosis of coronavirus; Medication prescribed for coronavirus treatment; and participant hospitalization as a result of coronavirus (confirmed) or respiratory distress.

    Population: Adults only
    High Risk/Special/Unique Populations
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English, Spanish

    MACS-WIHS Questionnaire: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS.pdf
    COVID-19 Symptoms, Testing, and Preventive Behaviors: Symptoms; Status; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Symptoms_testing_behaviors.pdf
    COVID-19 Impact on Daily Life: Daily Life; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Daily_Life.pdf
    COVID-19 Psychosocial Impact: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Psychosocial.pdf

    MACS-WIHS Questionnaire (Spanish): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_spanish.pdf
    COVID-19 Symptoms, Testing, and Preventive Behaviors (Spanish): Symptoms; Status; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Symptoms_testing_behaviors_spanish.pdf
    COVID-19 Impact on Daily Life (Spanish): Daily Life; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Daily_Life_spanish.pdf
    COVID-19 Psychosocial Impact (Spanish): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/MACS-WIHS_Psychosocial_spanish.pdf    ...[See more] [See less]
    URL: https://mwccs.org/covid-forms/
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF

    Contact Information: Christine Alden: calden@jhu.edu
    Includes Research Tools: Yes.
    ID: 22040. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  49. COVID-19 Impact on Health and Wellbeing Survey
    Source: UT Health Rio Grande Valley
    Date Published: 4/5/2020
    Format: PDF
    Annotation: The COVID-19 Impact on Health and Wellbeing Survey was designed to examine how mental health and wellbeing are impacted by shelter in home/place mandates. This survey was created as a result of collaborative efforts involving UTRGV Departments of Population Health & Biostatistics, Family Medicine, Psychological Sciences, and Sociology. The survey instrument was created using REDCap, is available in English and Spanish, was designed to be anonymous, and takes approximately 20-30 minutes to complete. Most survey sections, including demographics, ask specifically how daily living has been impacted by sheltering in place/home due to the COVID-19 pandemic.

    Population: Adults only
    Length: 174 questions
    Time to Complete: 20-30 minutes
    Administered by: Self Administered/Self Report
    Language(s): English, Spanish


    COVID19 Impact on Health and Wellbeing Survey (CIHWS): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS.pdf
    COVID19 related Depression: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Depression.pdf
    COVID19 related Anxiety/Stress: Mental Health; Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Anxiety.pdf
    COVID19 related Health literacy: Health Literacy https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Health_Literacy.pdf
    COVID19 related Trusted sources of information: Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Trusted_Sources.pdf
    COVID19 related Compliance: Social Distancing https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Compliance.pdf
    COVID19 related Financial stress: Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Financial.pdf
    COVID19 related Physical activity: Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Physical_Activity.pdf

    COVID19 Impact on Health and Wellbeing Survey (CIHWS) (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Span.pdf
    COVID19 related Depression (Spanish): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Depression_Span.pdf
    COVID19 related Anxiety/Stress (Spanish): Mental Health; Stress https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Anxiety_Span.pdf
    COVID19 related Health literacy (Spanish): Health Literacy https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Health_Literacy_Span.pdf
    COVID19 related Trusted sources of information (Spanish): Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Trusted_Sources_Span.pdf
    COVID19 related Compliance (Spanish): Social Distancing https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Compliance_Span.pdf
    COVID19 related Financial stress (Spanish): Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Financial_Span.pdf
    COVID19 related Physical activity (Spanish): Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/UTRGV_CIHWS_Physical_Activity_Span.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/COVID_Impact_on_Health_Wellbeing_Eng.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF

    Link to Survey in Spanish: https://www.nlm.nih.gov/dr2/COVID_Impact_on_Health_Wellbeing_Span.pdf
    Link to Description of Topics in Survey: https://www.nlm.nih.gov/dr2/COVID_Impact_on_health_wellbeing_Topics-5-2-20.docx
    Link to Study Sample Information: https://www.nlm.nih.gov/dr2/COVID_Impact_on_health_wellbeing_sample_Info.docx

    Contact Information: Candace Robledo, PhD, MPH: candace.robledo@utrgv.edu
    Includes Research Tools: Yes.
    ID: 22126. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  50. Psychosocial Impact of COVID-19 Survey
    Source: National Institute of Mental Health [National Institutes of Health] (NIMH)
    Date Published: 4/4/2020
    Format: PDF
    Annotation: This measure of psychosocial impact of COVID-19 was developed at the NIMH Intramural Research Program (IRP) in response to the COVID-19 pandemic. The protocol, titled Mental Health Impact of COVID-19 Pandemic on NIMH Patients and Volunteers, was launched in early April 2020. The study will describe the relationship between stressors related to COVID-19 and self-rated measures of mental health symptoms and distress among a range of participants including various patient populations and healthy volunteers. The secondary objectives are to determine whether existing mental health concerns moderates this relationship and to identify risk resilience factors among study participants regarding mental health impact of the COVID-19 pandemic. Participants are asked to repeat the survey every two weeks via the study website (https://nimhcovidstudy.ctss.nih.gov/).

    Questions Adapted From: Our survey stemmed from one that was originally written by Argyris Stringaris in March 2020 at the NIMH IRP, who went on to further develop the measure with our NIMH IRP colleague Kathleen Merikangas. They have since posted their survey on a website: crisissurvey.org. Our measure overlaps with the CRISIS survey for many of the items with a few exceptions. We developed it for use with adults (the original Stringaris measure was for adolescents). It does not have two versions (initial and follow-up), and does not include questions about demographics, mental health, or substance use symptoms.

    Population: Adults Only
    All/Anyone
    First Responders, Emergency Medical Services (EMS) Personnel, Police/Fire Departments
    High Risk/Special/Unique Populations
    Length: 45 items
    Time to Complete: 10 minutes
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): English

    Informed Consent https://disasterinfo.nlm.nih.gov/content/files/20_M_N085_Consent.pdf
    Factor Analysis Report https://disasterinfo.nlm.nih.gov/content/files/Factor_Analysis_Report_3.11.pdf

    Psychosocial Impact of COVID-19 Survey: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Psychosocial_Impact_of_COVID-19_Survey.pdf
    Psychological Impact: General Mental Health; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_Pyschosocial.pdf
    Social Distancing: Social Distancing https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_SocialDistancing.pdf
    Hopes and Dreams: General Mental Health; Attitudes https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_Hopes.pdf
    Health Concerns: General Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_HealthConcerns.pdf
    Daily Activities: Daily Life https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_DailyActivities.pdf
    Daily Functioning: Daily Life https://www.phenxtoolkit.org/toolkit_content/PDF/NIMH_DailyFunctioning.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Psychosocial_Impact_of_COVID-19_Survey.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: PDF

    Contact Information:
    Study team: NIMHResearchVolunteer@nih.gov
    Joyce Chung, MD, National Institute of Mental Health (NIMH) Intramural Research Program, joyce.chung@nih.gov
    Includes Research Tools: Yes.
    ID: 22587. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  51. 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]
    URL: https://www.kff.org/health-reform/report/kff-health-tracking-poll-early-april-2020/
    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.
  52. Questionnaire for Assessing the Impact of the COVID-19 Pandemic and Accompanying Mitigation Efforts on Older Adults (QAICPOA)
    Source: University of California, San Francisco (UCSF)
    Date Published: 4/2/2020
    Format: Text
    Annotation: This questionnaire was developed by expert opinion. It will be used in two studies: the Study of Muscle Mobility and Aging (SOMMA), a study that is currently enrolling men and women age 70 and older to determine the biologic role of muscle in development of mobility disability, and the Osteoporotic Fractures in Men (MrOS Study), an ongoing multicenter cohort study of healthy aging of older men, with a particular focus on osteoporosis. MrOS men were initially enrolled in 2000-2002 and are all now in their mid-80s or older. In each study, organizers hope to administer the questionnaire two or three times over the coming months, along with select other repeated data from the cohorts (e.g., fall incidence, mobility function, activity level).

    Population: Adults only; High Risk/Special/Unique Populations
    Length: 17 questions
    Administered by: Self Administered/Self Report; Trained Lay Examiner/Interviewer
    Special Considerations: Can be administered via self-report or telephone interview.
    Language(s): English

    MROS/SOMMA COVID-19 Social Impact Questionnaire: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/MROS.pdf
    Symptoms and Diagnosis: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/MROS_Diagnosis.pdf
    MROS/SOMMA Social Distancing and Hygiene: Social Distancing and Hygiene https://www.phenxtoolkit.org/toolkit_content/PDF/MROS_SocialDistancing.pdf    ...[See more] [See less]
    URL: https://www.qiacpoa.com/
    Type: Guideline/Assessment Tool
    Access Notes: Citation: Peggy Cawthon, MPH, PHD, Eric Orwoll, MD, Kristine Ensrud, MD, Jane A Cauley, DrPH, Stephen B Kritchevsky, PhD, Steven R Cummings, MD, Anne Newman, MD, Assessing the impact of the covid-19 pandemic and accompanying mitigation efforts on older adults, The Journals of Gerontology: Series A, https://academic.oup.com/biomedgerontology/article/75/9/e123/5822596

    Free/Publicly Available

    Contact Information: Peggy Cawthon at pcawthon@sfcc-cpmc.net
    Includes Research Tools: Yes.
    ID: 21681. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  53. California COVID-19 Health Surveys: Data and Charts
    Source: California Health Care Foundation (CHCF)
    Date Published: 4/1/2020
    Format: Text
    Annotation: This web page provides a series of short surveys to assess demand on California's health care system during the coronavirus pandemic.

    Population: Adults only
    Length: 2 items
    Administered by: Self Administered/Self     Report
    Language(s): English    ...[See more] [See less]
    URL: https://www.chcf.org/project/california-covid-19-health-surveys/
    Type: Guideline/Assessment Tool
    Access Notes: Link to COVID-19 California Tracking Polls https://www.chcf.org/collection/covid-19-california-tracking-polls/

    Contact Information: California Healthcare Foundation (CHCF)
    Includes Research Tools: Yes.
    ID: 21550. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  54. UnderStandingAmerica Study COVID-19 Surveys
    Source: Center for Economic and Social Research [University of Southern California Dornsife] (CESR)
    Date Published: 4/1/2020
    Format: PDF
    Annotation: The Understanding America Study (UAS) is a probability-based online panel of adult US residents that began in 2014. Over six years, the UAS has developed an extensive catalogue of questions and responses on a variety of topics related to social science, demography and health. Beginning in March 2020, the UAS started a high-frequency longitudinal data collection related to the COVID19 pandemic.

    Population: Adults only
    Length: 99 questions
    Time to Complete: 20 minutes
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English, Spanish

    Documentation links to codebooks, questionnaires, reports: https://uasdata.usc.edu/page/Covid-19+Documentation
    Data: information on how to access the data, etc. https://uasdata.usc.edu/page/Covid-19+Data
    Additional data can be found: https://covid19pulse.usc.edu/    ...[See more] [See less]
    URL: https://uasdata.usc.edu/page/Covid-19
    Authors: Bennett, Daniel; Bruine de Bruin, Wandi; Darling, Jill; Kapteyn, Arie; Thomas, Kyla
    Type: Guideline/Assessment Tool
    Access Notes: Citation(s): Publications: https://uasdata.usc.edu/page/Covid-19+Publications

    Permission/Request required

    Contact Information: Ms. Jill Darling (University of Southern California) at jilldarl@usc.edu; uas-l@usc.edu, TaniaGutsche (ProjectandPanelManager, Center for Economic and Social Research, University of Southern California) at tgutsche@usc.edu
    Includes Research Tools: Yes.
    ID: 21649. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  55. CoRonavIruS Health Impact Survey (CRISIS)
    Source: National Institute of Mental Health [National Institutes of Health] (NIMH)
    Date Published: 4/2020
    Format: Text
    Annotation: The CRISIS Survey is designed to enable researchers and care providers to examine the extent and impact of life changes induced by the COVID-19 epidemic on the mental health and behavior of individuals and families across diverse international settings. This data may enable the identification of pre-, peri, and post-COVID-19 demographic, social, and clinical predictors of both short- and long-term impairment and distress induced by COVID-19 and its sequelae. The survey is designed to allow for follow-ups on a regular basis, with recommended frequencies of twice monthly or monthly. To facilitate multicultural perspectives, translations in a broad range of languages are available. Download surveys in PDF or Word Format, via GitHub, or via REDCap.


    Population: All/Anyone
    Length: 99 questions
    Time to Complete: 12 minutes
    Administered by: Self Administered/Self Report
    Language(s): English, Brazilian Portuguese, French, German, Greek, Hebrew, Spanish, Swedish, Turkish

    CRISIS Surveys: Adult Self-Report Baseline Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult.pdf
    CRISIS Baseline Current Form- Background: Demographics; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Background.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Adult_Substance_Use.pdf

    CRISIS Surveys: Youth Self-Report Baseline Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth.pdf
    CRISIS Baseline Current Form- Background: Demographics; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Background.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_Youth_Substance_Use.pdf

    CRISIS Surveys: Parent/Caregiver Self-Report Baseline Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver.pdf
    CRISIS BaselineCurrent Form- Background: Demographics; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Background.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_Baseline_ParentCaregiver_Substance_Use.pdf

    CRISIS Surveys: Adult Self-Report Follow-up Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Adult_Substance_Use.pdf

    CRISIS Surveys: Youth Self-Report Follow-up Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_Youth_Substance_Use.pdf

    CRISIS Surveys: Parent/Caregiver Self-Report Follow-up Current Form: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver.pdf
    Coronavirus/COVID-19 Health/Exposure Status: Symptoms; Diagnosis; Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Status.pdf
    Life Changes Due to Coronavirus/COVID-19 Crisis: Life Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Life_Changes.pdf
    Daily Behaviors During COVID-19: Sleep Changes; Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Daily_Behaviors.pdf
    Emotions/Worries During COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Worries.pdf
    Media Use (e.g., mobile devices, media, etc.) During COVID-19: Media Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Media_Use.pdf
    Substance Use (e.g., tobacco, alcohol, other drugs) During COVID-19: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/CRISIS_FollowUp_ParentCaregiver_Substance_Use.pdf    ...[See more] [See less]
    URL: http://www.crisissurvey.org/download/
    Authors: Merikangas, K.; Milham, M.; Stringaris, A.
    Type: Guideline/Assessment Tool
    Access Notes: Link to Adult Self-Report Baseline https://www.nlm.nih.gov/dr2/CRISIS_Adult_Self-Report_Baseline_Current_Form_V0.3.pdf
    Link to Adult Self-Report Follow Up Form: https://www.nlm.nih.gov/dr2/CRISIS_Adult_Self-Report_Follow_Up_Current_Form_V0.3.pdf
    Link to Parent/Caregiver Baseline Form https://www.nlm.nih.gov/dr2/CRISIS_Parent_Caregiver_Baseline_Current_Form_V0.3.pdf
    Link to Parent Caregiver Follow Up Form: https://www.nlm.nih.gov/dr2/CRISIS_Parent_Caregiver_Follow_Up_Current_Form_V0.3.pdf
    Link to Youth Self-Report Baseline Form https://www.nlm.nih.gov/dr2/CRISIS_Youth_Self-Report_Baseline_Current_Form_V0.3.pdf
    Link to Youth Self Report Follow Up Form: https://www.nlm.nih.gov/dr2/CRISIS_Youth_Self-Report_Follow_Up_Current_Form_V0.3.pdf
    Link to Forms and background material on GitHub: https://github.com/nimh-comppsych/CRISIS

    Free/Publicly Available
    Contact Information: National Institute of Mental Health Intramural Research Program Mood Spectrum Collaboration, Dr. Kathleen Merikangas at merikank@mail.nih.gov
    Includes Research Tools: Yes.
    ID: 21767. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  56. Fear of COVID-19 Scale
    Source: Nottingham Trent University
    Date Published: 4/2020
    Format: PDF
    Annotation: The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals. Authors are from Nottingham Trent University, The Hong Kong Polytechnic University, Tabriz University of Medical Sciences, Baqiyatallah University of Medical Sciences, and Jönköping University.

    Population: Adults only
    Length: 7 items
    Administered by: Lay Interviewer
    Language(s): English, Persian, Farsi

    Fear of COVID-19 Scale: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/NTU_FCS.pdf
    URL: https://www.nlm.nih.gov/dr2/Fear_of_Covid-19_Scale_2020.pdf
    Authors: Ahorsu, Daniel Kwasi; Lin, Chung-Ying; Imani, Vida; Saffari, Mohsen; Griffiths, Mark D.; et al.
    Type: Guideline/Assessment Tool
    Access Notes: Citation: Ahorsu, D.K., Lin, C., Imani, V. et al. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addiction (2020). https://link.springer.com/article/10.1007%2Fs11469-020-00270-8

    Free/Publicly Available
    Contact Information: Nottingham Trent University, Dr. Mark Griffiths, Mark.Griffiths@ntu.ac.uk
    Includes Research Tools: Yes.
    ID: 21768. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  57. Epidemic–Pandemic Impacts Inventory (EPII)
    Source: University of Connecticut School of Medicine
    Date Published: 4/2020
    Format: PDF
    Annotation: The Epidemic–Pandemic Impacts Inventory (EPII; Grasso, Briggs-Gowan, Ford, & Carter, 2020) is a newly developed measure designed to study the impact of the coronavirus disease pandemic COVID-19 (and future epidemics/pandemics) on various domains of personal and family life. Items assess impact in areas that include: Work and Employment, Education and Training, Home Life, Social Activities, Economic, Emotional Health and Wellbeing, Physical Health Problems, Physical Distancing and Quarantine, Infection History, and Positive Change. Items follow a simple response set of Yes (me), Yes (person in home), No, and N/A. Although not yet evaluated, data collection is ongoing, and as of today, over 30 research teams (nationally and internationally) are incorporating the EPII into studies of various populations. Authors are from University of Connecticut School of Medicine and University of Massachusetts.

    Length: 92 questions
    Administered by: Self Administered/Self Report
    Language(s): English, Spanish, Brazilian Portuguese, Urdu

    Adaptations and Supplements available:
    Racial/Ethnic Discrimination Addendum
    Adolescent Adaptation
    Geriatric Adaptation
    Healthcare Supplement
    Mental Health Provider Supplement
    Prenatal Supplement
    Perinatal Labor and Delivery Supplement
    Infancy Supplement


    Epidemic – Pandemic Impacts Inventory (EPII): Full Inventory https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII.pdf
    Impact of COVID-19 on Work and Employment: Employment https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Work_Employment.pdf
    Impact of COVID-19 on Education and Training: Education and Training https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Education_Training.pdf
    Impact of COVID-19 on Home Life: Home Life and Conflict https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Home_Life.pdf
    Impact of COVID-19 on Social Activities: Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Social_Activities.pdf
    Impact of COVID-19 on Economic: Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Economic.pdf
    Impact of COVID-19 on Emotional Health and Well-Being: Mental Health and Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Emotional_Health_Well_Being.pdf
    Impact of COVID-19 on Physical Health Problems: Health Care and Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Physical_Health_Problems.pdf
    Impact of COVID-19 on Physical Distancing and Quarantine: Social Distancing and Hygiene https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Physical_Distancing_Quarantine.pdf
    Impact of COVID-19 on Infection History: Symptoms and Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Infection_History.pdf
    Impact of COVID-19 on Positive Change: Positive Impacts https://www.phenxtoolkit.org/toolkit_content/PDF/Grasso_EPII_Positive_Change.pdf    ...[See more] [See less]
    URL: https://health.uconn.edu/psychiatry/child-and-adolescent-psychiatry-outpatient-clinic/family-adversity-and-resilience-research-program/epii/
    Authors: Grasso, Damion J.; Briggs-Gowan, Margaret J.; Ford, Julian; Carter, Alice
    Type: Guideline/Assessment Tool
    Access Notes: Citation: Grasso, D.J., Briggs-Gowan, M.J., Ford, J.D., & Carter, A.S. (2020). The Epidemic – Pandemic Impacts
    Free/Publicly Available
    Contact Information: Dr. Damion Grasso at dgrasso@uchc.edu
    Includes Research Tools: Yes.
    ID: 21769. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  58. 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]
    URL: https://www.nih.gov/echo
    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.
  59. KSADS-COMP with COVID-Specific PTSD Trauma Screen Items
    Source: Kennedy Krieger Institute
    Date Published: 4/2020
    Format: PDF
    Annotation: The Schedule for Affective Disorders and Schizophrenia for School-Aged Children (KSADS) is a widely used and well validated diagnostic interview for children and adolescents. The PTSD trauma screen items from the KSADS-COMP have been revised to capture COVID-19-specific traumas.

    Population: Children/Teens Only
    Administered by: Self Administered/Self Report; Trained Lay Examiner/Interviewer; Parent/Teacher
    Language(s): English, Spanish, Danish, Dutch

    KSADS-COMP PTSD Screen items: Screen for K-SADS-COMP https://www.phenxtoolkit.org/toolkit_content/PDF/KSADS-COMP_PTSD_screen.pdf
    KSADS-COMP PTSD Screen items - Spanish: Screen for K-SADS-COMP https://www.phenxtoolkit.org/toolkit_content/PDF/KennedyKriegerInstute_CIS_Spanish.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/KSADS-COMP_PTSD_Trauma_Screen_Items_Revised.pdf
    Type: Guideline/Assessment Tool
    Access Notes: The KSADS-COMP is available at https://www.kennedykrieger.org/ksads-comp.

    Proprietary - Cost/Purchase required
    Citation Townsend L, Kobak K, Kearney C, et al. Development of Three Web-Based Computerized Versions of the Kiddie Schedule for Affective Disorders and Schizophrenia Child Psychiatric Diagnostic Interview: Preliminary Validity Data. J Am Acad Child Adolesc Psychiatry. 2020;59(2):309-325. doi: 310.1016/j.jaac.2019.1005.1009. Epub 2019 May 1018.
    Contact Information: Research Center for Child and Family TraumaticStress Kennedy Krieger Institute, Dr. Joan Kaufman, joan.kaufman@kennedykrieger.org; University of Colorado Anschutz Medical Campus, Dr. Joel Stoddard, joel.stoddard@cuanschutz.edu
    Includes Research Tools: Yes.
    ID: 21817. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  60. Pennington Biomedical COVID-19 Survey
    Source: Pennington Biomedical Research Center [Louisiana State University] (PBRC)
    Date Published: 4/2020
    Format: PDF
    Annotation: Scientists at Pennington Biomedical Research Center in Louisiana are conducting this research study to understand how COVID-19 is impacting health behaviors of people in the United States and around the world.

    Population: Adults only
    Length: 103 questions
    Time to Complete: 20 minutes
    Administered by: Self Administered/Self Report
    Language(s): English

    Pennington Biomedical COVID-19 Survey: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid.pdf
    Regional Social Distancing COVID-19 Mandates: Social Distancing https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Distancing.pdf
    Impacts of COVID-19 on Food Security: Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Food.pdf
    Worry about COVID-19 Infection: Diagnosis and Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Worry.pdf
    Impacts of COVID-19 on Employment: Economic Security https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Employment.pdf
    Impacts of COVID-19 on Changes to Physical Activity and Sedentary Behaviors: Physical Activity https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Activity.pdf
    Impacts of COVID-19 on Dietary Changes: Dietary Intake https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Dietary.pdf
    Impacts of COVID-19 on Sleep Changes: Sleep Changes https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Sleep.pdf
    Impacts of COVID-19 on Well-Being: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/PBRC_Covid_Well-being.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/PBRC_COVID_Survey_Domains.docx
    Authors: Redman, Leanne
    Type: Guideline/Assessment Tool
    Access Notes: Link to study: https://edc.pbrc.edu/surveys/?s=DKJJJNLLJ8
    Survey Diagram https://disasterinfo.nlm.nih.gov/content/files/Consort%20Diagram%20for%20Survey.jpg
    Protocol: https://disasterinfo.nlm.nih.gov/content/files/COVID-19%20And%20You_Submission%201_Protocol_03312020.docx
    REDCap File https://disasterinfo.nlm.nih.gov/content/files/COVID-19%20And%20You_Submission%201_REDCap%20Survey_03312020.pdf

    Free/Publicly Available
    Contact Information: Pennington Biomedical Research Center, Dr. Leanne Redman, Leanne.redman@pbrc.edu
    Includes Research Tools: Yes.
    ID: 21818. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  61. Pandemic Stress Index (PSI)
    Source: University of Miami (UM)
    Date Published: 4/2020
    Format: Text
    Annotation: The Pandemic Stress Index is a three-item measure of behavior changes and stress that individuals may have experienced during COVID-19 (coronavirus). The items presented are a "core" set of items that are recommended; however, additional population-specific items may be added depending on study/clinical needs.

    Population: Adults only
    Length: 3 questions
    Administered by: Self Administered/Self Report
    Language(s): English, Spanish

    COVID-19 Pandemic Stress Index (PSI): Overall Impact https://www.phenxtoolkit.org/toolkit_content/PDF/PSI_english.pdf
    URL: https://elcentro.sonhs.miami.edu/research/measures-library/psi/index.html
    Authors: Harkness, Audrey
    Type: Guideline/Assessment Tool
    Access Notes: Instruments are available in PDF or Word formats.
    Link to resource in English: https://elcentro.sonhs.miami.edu/research/measures-library/psi/psi-english/index.html
    Link to resource in Spanish: https://elcentro.sonhs.miami.edu/research/measures-library/psi/psi-spanish/index.html
    Link to PSI REDCap Instrument (zip file download): https://elcentro.sonhs.miami.edu/research/measures-library/psi/psi-redcap-instrument.zip
    Link to Measure Source Article: https://link.springer.com/article/10.1007/s10461-020-02862-w

    Free/Publicly Available

    Citation: Harkness, A., Behar-Zusman, V. & Safren, S.A. Understanding the Impact of COVID-19 on Latino Sexual Minority Men in a US HIV Hot Spot. AIDS Behav (2020). https://link.springer.com/article/10.1007/s10461-020-02862-w

    Contact Information: University of Miami (UM), elcentro@miami.edu
    Includes Research Tools: Yes.
    ID: 21875. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  62. COVID-19 Cannabis Health Questionnaire (CCHQ)
    Source: University of Miami (UM)
    Date Published: 4/2020
    Format: Text
    Annotation: The COVID-19 Cannabis Health Questionnaire (CCHQ) is a 25-item measure to assess cannabis use patterns, health risk behavior, and physical and mental health effects of the COVID-19 pandemic on medical and recreational cannabis users. The COVID-19 Cannabis Health Questionnaire (CCHQ) was developed from a multidisciplinary team: cannabis epidemiologist (Vidot) chronic disease epidemiologist (Messiah) and expert in psychometrics (Gattamorta). The purpose of the CCHQ is to assess cannabis access and use patterns, health risk behavior, and the physical/mental health impact of COVID-19 on medical and recreational cannabis users amid the ongoing pandemic. The CCHQ was created based on qualitative data and piloted in four states in the United States and Kingston, Jamaica. It currently being administered globally to collect epidemiologic data on the impact of COVID-19 on mental and physical health among adults that do and do not endorse cannabis use.

    Population: Adults only
    Length: 25 items
    Administered by: Self Administered/Self Report
    Language(s): English, Spanish

    COVID-19 - Cannabis Health Questionnaire (CCHQ): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG.pdf
    COVID-19 & Comorbidities: Chronic Health Conditions https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Comorbidities.pdf
    COVID-19 & Cannabis Use: Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Cannabis.pdf
    Economic Impact of COVID-19: Health Care; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Economic.pdf
    COVID-19 Symptoms, Diagnoses & Testing: Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Symptoms.pdf
    Worry about COVID-19 Infection: Perceived Threat https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Worry.pdf
    Coping Strategies COVID-19: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ENG_Coping.pdf

    COVID-19 - Cannabis Health Questionnaire (CCHQ) (Spanish): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP.pdf
    COVID-19 & Comorbidities (Spanish): Chronic Health Conditions https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Comorbidities.pdf
    COVID-19 & Cannabis Use (Spanish): Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Cannabis.pdf
    Economic Impact of COVID-19 (Spanish): Health Care; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Economic.pdf
    COVID-19 Symptoms, Diagnoses & Testing (Spanish): Symptoms; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Symptoms.pdf
    Worry about COVID-19 Infection (Spanish): Perceived Threat https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Worry.pdf
    Coping Strategies COVID-19 (Spanish): Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/Vidot_CCHQ_ESP_Coping.pdf    ...[See more] [See less]
    URL: https://elcentro.sonhs.miami.edu/research/measures-library/cchq/index.html
    Authors: Vidot, Denise
    Type: Guideline/Assessment Tool
    Access Notes: Instruments are available in PDF or Word formats.
    Link to questionnaire in English: https://elcentro.sonhs.miami.edu/research/measures-library/cchq/cchq-eng/index.html
    Link to questionnaire in Spanish: https://elcentro.sonhs.miami.edu/research/measures-library/cchq/cchq-esp/index.html

    Free/Publicly Available

    Contact Information: University of Miami (UM), elcentro@miami.edu
    Includes Research Tools: Yes.
    ID: 21876. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  63. COVID-19 Household Environment Scale (CHES)
    Source: University of Miami (UM)
    Date Published: 4/2020
    Format: Text
    Annotation: The COVID-19 Household Environment Scale (CHES) providers a tool for measuring important dimensions of family functioning, conflict, and cohesion. The CHES consists of 15 items for each of two subscales, Household Conflict and Household Cohesion, with a five-point rating scale. The CHES also has items to describe respondent demographics, household composition, and household-level COVID-19 exposure severity.

    Population: Adults only
    Length: 54 items
    Administered by: Self Administered/Self Report
    Languages: English, Spanish, Portuguese, Mandarin

    Cognitive Interview Participant Characteristics by Preferred Language https://disasterinfo.nlm.nih.gov/content/files/Cognitive%20Testing%20Data.docx
    Data Dictionary https://disasterinfo.nlm.nih.gov/content/files/Data%20Dictionary_CHES.pdf
    CHES Questionnairre English https://disasterinfo.nlm.nih.gov/content/files/ENG_CHES%20Questionnaire.pdf
    Consent Form https://disasterinfo.nlm.nih.gov/content/files/Informed%20Consent%20Cognitive%20Interview%20COVID-19%20Household%20Environment%20Scale_English.pdf
    Research Protocol https://disasterinfo.nlm.nih.gov/content/files/Research%20Protocol_CHES.docx


    COVID-19 Household Environment Scale (CHES): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_ENG_v2.pdf
    Demographics: Locational Demographics; Social Impact; Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Demographics_ENG_v2.pdf
    Household: Conflict; Daily Life; Household Togetherness https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Household_ENG_v2.pdf

    Escala de Ambiente Familiar Durante la Pandemia COVID-19 (Spanish): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_ESP_v2.pdf
    Demographics (Spanish): Locational Demographics; Social Impact; Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Demographics_ESP_v2.pdf
    Household (Spanish): Conflict; Daily Life; Household Togetherness https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Household_ESP_v2.pdf

    Escala de Ambiente Familiar Durante a Pandemia COVID-19 (Portuguese): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_PORT.pdf
    Demographics (Portuguese): Locational Demographics; Social Impact; Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Demographics_PORT.pdf
    Household (Portuguese): Conflict; Daily Life; Household Togetherness https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Household_PORT.pdf

    COVID-19 Household Environment Scale (CHES) (Mandarin): Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_MAND.pdf
    Demographics (Mandarin): Locational Demographics; Social Impact; Personal Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Demographics_MAND.pdf
    Household (Mandarin): Conflict; Daily Life; Household Togetherness https://www.phenxtoolkit.org/toolkit_content/PDF/Behar-Zusman_CHES_Household_MAND.pdf    ...[See more] [See less]
    URL: https://elcentro.sonhs.miami.edu/research/measures-library/ches/index.html
    Authors: Behar-Zusman, Victoria
    Type: Guideline/Assessment Tool
    Access Notes: Instruments are available in PDF or Word formats.
    Link to resource in English: https://elcentro.sonhs.miami.edu/research/measures-library/ches/ches-eng/index.html
    Link to resource in Spanish: https://elcentro.sonhs.miami.edu/research/measures-library/ches/ches-esp/index.html
    Link to resource in Portuguese https://elcentro.sonhs.miami.edu/research/measures-library/ches/ches-protuguese/index.html
    Link to resource in Mandarin https://elcentro.sonhs.miami.edu/research/measures-library/ches/ches-mandarin/index.html

    Link to CHES REDCap instrument (zip download file): https://elcentro.sonhs.miami.edu/research/measures-library/ches/ches-redcap-instrument.zip

    Free/Publicly Available

    Contact Information: University of Miami (UM), elcentro@miami.edu

    Citation: Behar-Zusman V, Chavez JV, Gattamorta K. Developing a Measure of the Impact of COVID-19 Social Distancing on Household Conflict and Cohesion. Fam Process. 2020 Sep;59(3):1045-1059. doi: 10.1111/famp.12579. Epub 2020 Aug 20. PMID: 32621755; PMCID: PMC7362045 https://pubmed.ncbi.nlm.nih.gov/32621755/
    Includes Research Tools: Yes.
    ID: 21877. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  64. CAIR (Complementary and Integrative Research Lab) Pandemic Impact Questionnaire (C-PIQ)
    Source: University of California, San Diego (UCSD)
    Date Published: 4/2020
    Format: PDF
    Annotation: This brief measure includes exposure, mental health impact, and growth related to the COVID-19 pandemic. The researchers also provide a brief measure with scoring which includes annotations for creating the subscale scores of exposure, mental health impact, and growth.

    CAIR-PIQ Complementary and Integrative Research Lab (CAIR) Pandemic Impact Questionnaire (PIQ): Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ.pdf
    COVID-19 Health Impacts: Symptoms; Status; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ_Health.pdf
    COVID-19 Negative Social and Behavioral Impacts: Labor Market; Economic Insecurity https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ_Negative.pdf
    COVID-19 Mental Health Impact: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ_Mental.pdf
    COVID-19 Impact on Sleep: Sleep Changes https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ_Sleep.pdf
    COVID-19 Positive Impacts: Positive Impacts https://www.phenxtoolkit.org/toolkit_content/PDF/CAIR_PIQ_Positive_Impacts.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/CAIR-PIQ_for_administration.pdf
    Authors: Lang, Ariel J.
    Type: Guideline/Assessment Tool
    Access Notes: Link to Measure with Scoring: C-PIQ: https://www.nlm.nih.gov/dr2/CAIR-PIQ_scoring.pdf

    Measure adapted from MacLean & Cloitre, 2020; CRISIS V0.2; and Taku, Cann, Calhoun & Tedeschi, 2008

    Contact: University of California, San Diego Dr. Ariel J. Lang ajlang@health.ucsd.edu
    Includes Research Tools: Yes.
    ID: 21923. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  65. Cyber-Abuse Research Initiative (CARI) COVID19 Impact on Domestic Abuse
    Source: NORC at the University of Chicago (NORC)
    Date Published: 4/2020
    Format: PDF
    Annotation: Through the collection of nationally representative information on the scope and nature of technology-facilitated abuse (both victimization and perpetration), survivors' help-seeking and access to services, and unmet needs, this study is designed to support the development of policies, protocols, programs, and services that limit the incidence of technology-facilitated abuse and strengthen law enforcement and victim services program responses to victimization with scientific data. The CARI study will be fielded in the summer of 2020, with longitudinal data collection planned. Given the current conditions resulting from the COVID-19 pandemic, items measuring interpersonal conflict and abuse in domestic settings have been prepared for the field.

    Basic study parameters (planned recruitment/administration summer 2020): Sociodemographics: Nationally representative sampling frame (https://amerispeak.norc.org/Pages/default.aspx    ) with oversamples of female, Black, and Hispanic respondents ages 18-35: Male Female Total White/other 920 1,300 2,220 Black 350 540 890 Hispanic 350 540 890 Total 1,620 2,380 3,500 Modality: AmeriSpeak respondents are free to specify their modality preference on each survey. NORC's data collection system supports both web and phone modes (optimized presentation for smartphone respondents). Among younger adults, the vast majority choose to respond via web modality. Design: Designed for longitudinal data collection. Currently funded for cross-sectional data collection. Preliminary Testing: Developed with review of researcher and practitioner experts in violence measurement; pretested with young adult survivors and with university students.

    Population: Adults only
    Length: 11 questions
    Administered by: Self Administered/Self Report
    Trained Lay Examiner/Interviewer
    Language(s): English

    Cyber-Abuse Research Initiative (CARI) COVID19 Impact on Domestic Abuse: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/Cyber_Abuse_Research_Initiative_COVID19_Impact_on_Domestic_Abuse.pdf
    Domestic Violence Victimization and Perpetration During COVID-19: Home Life; Conflict; Cyber-harassment https://www.phenxtoolkit.org/toolkit_content/PDF/OVW_CARI_Domestic_Violence.docx.pdf
    Help-Seeking and Fear of Violence During COVID-19: Help-seeking; Fear of Violence https://www.phenxtoolkit.org/toolkit_content/PDF/OVW_CARI_Help.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Impact_of_COVID-19_social_distancing_on_domestic_abuse-national_study.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Available Formats: PDF
    Contact Information: Elizabeth Mumford, Principal Research Scientist, NORC at the University of Chicago: Mumford-Elizabeth@norc.org
    Emily Rothman, Professor, Boston University School of Public Health: erothman@bu.edu
    Includes Research Tools: Yes.
    ID: 22039. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  66. COVID-19 Evaluation of Risk in Emergency Departments (Project COVERED)
    Source: University of Iowa (UI)
    Date Published: 4/2020
    Format: PDF
    Annotation: Project COVERED is a prospective enrolled-cohort analysis of 1,600 health care personnel (HCP) working in 20 U.S. emergency departments (EDs) with the following primary objectives: (1) to estimate the attributable risk of occupational acquisition of COVID-19 infection for ED HCP; (2) to identify patient-, provider-, facility-, and procedure-based risk factors associated with SARS-CoV-2 transmission to ED HCP; and (3) to determine the prevalence of symptomatic and asymptomatic COVID-19 infection. Secondary aims of the study include: (1) to measure how ED operations change in response to the COVID-19 pandemic; (2) to measure how organizational factors contribute to HCP well-being during the pandemic; and (3) to understand how HCPs are using PPE, and applying countermeasures to reduce transmission outside the workplace. Data are collected from participants and from facilities on a weekly basis during a planned 12-week observation period.

    Modules included in the surveys include: (1) Participant interest screening form; (2) Participant enrollment form/baseline participant survey; (3) Baseline facility form; (4) Weekly participant survey; (5) Weekly facility survey; (6) Endotracheal intubation/cardiac arrest form; (7) Patient information form; (8) Post-serology follow-up form (week 4); (9) Post-serology site PI organizational factors form; (10) Participant six-month follow-up survey; (11) Facility six-month follow-up survey; and (12) Baseline positive testing follow-up form. In addition to survey data, participants are providing serum serology and nasal PCR samples for testing every two weeks. Survey are all administered from a central REDCap system, and participants are sent survey requests by email and text message.

    The Data Collection forms link to Data Dictionary Codebooks.

    Population: Adult Workers
    Length: 611 questions
    Time to Complete: 12 weeks
    Mode of Administration: Online (e.g., computer-assisted interview)
    Administered by: Self Administered
    Language(s): Engilsh

    COVID-19 Evaluation of Risk in Emergency Departments: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED.pdf
    Participant Interest Screening Form: Participant Intake https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_Screening.pdf
    Participant Enrollment/Baseline Form: Participant Enrollment https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_Enrollment.pdf
    Facility Baseline Form: Critical Care Facilities https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Facility.pdf
    Participant Weekly Survey: Participant Weekly Survey https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_Weekly.pdf
    Facility Weekly Survey: Facility Weekly Survey https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Facility_Weekly.pdf
    Participant Endotracheal Intubation/Cardiac Arrest Event Form: Critical Care Participants https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_Intubation.pdf
    Facility Endotracheal Intubation/Cardiac Arrest Event Form: Critical Care Facilities https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Facility_Intubation.pdf
    Participant Post-Serology Follow-Up Form (Week 4): Participant Follow-Up https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_Post_Serology.pdf
    Facility Organizational Factors Post-Serology Form (Week 4): Facility Follow-Up https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Facility_Post_Serology.pdf
    Participant 6-Month Follow-Up Form: Participant Follow-Up https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Participant_FollowUp.pdf
    Facility 6-Month Follow-Up Form: Facility Follow-Up https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Facility_FollowUp.pdf
    Participant Baseline Positive-Test Follow-Up Form: Participant Follow-Up https://www.phenxtoolkit.org/toolkit_content/PDF/ICTS_COVERED_Positive_Test_FollowUp.pdf    ...[See more] [See less]
    URL: https://medicine.uiowa.edu/content/research-tools
    Type: Guideline/Assessment Tool
    Access Notes: Project website: https://medicine.uiowa.edu/content/covid-evaluation-risk-emergency-departments-covered-project

    Free/Publicly Available
    Available Formats: PDF

    Contact Information:
    Nicholas Mohr, MD, MS (nicholas-mohr@uiowa.edu)
    Project Leadership:
    Nicholas Mohr, MD (University of Iowa) and Dave Talan, MD (University of California-Los Angeles)

    Instrument Development Team:
    Nicholas Mohr, MD (University of Iowa)
    Dave Talan, MD (University of California-Los Angeles)
    Anusha Krishnadasan, PhD (University of California-Los Angeles)
    Karisa Harland, PhD (University of Iowa)
    Kelli Wallace, MS (University of Iowa)
    James Willey, MD (University of Iowa)

    Sponsor: Centers for Disease Control and Prevention (CDC)
    Includes Research Tools: Yes.
    ID: 22586. From: Disaster Lit®a database of the U.S. National Library of Medicine.
    REDCap: Yes.
  67. Impact of COVID-19 on Behaviors Across the Cancer Control Continuum in Ohio
    Source: Ohio State University (OSU)
    Date Published: 4/2020
    Format: PDF
    Annotation: This survey was created in April 2020, and first administered in June 2020. It is targeted to established cohorts who must be current residents of Ohio.

    Population: Adults Only
    Ethnic/Religious Groups
    Sexual or Gender Minorities
    Length: 131 questions
    Time to Complete: 30 minutes self-administered, 45 minutes interviewer-administered
    Mode of Administration: Online (e.g., computer-assisted interview)
    Pen and Paper
    Telephone
    Administered by: Professional Interviewer
    Self-Administered
    Language(s): English
    Data Dictionary https://disasterinfo.nlm.nih.gov/content/files/P1164ImpactOfCOVID19Ohio_DataDictionary_2021-02-26.csv

    Impact of COVID-19 on Behaviors across the Cancer Control Continuum in Ohio: Full Questionnaire https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19.pdf
    Symptoms, diagnosis, information sources: General Symptoms; Diagnosis; Sources of information about COVID-19 https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Symptoms.pdf
    Personal, family, daily life impacts: Employment; Home Life https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Personal.pdf
    Stress, anxiety, food or economic insecurity, sleep, mental health: General Mental Health; Economic Insecurity; Diagnosis https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Stress.pdf
    Social distancing behaviors: Social Distancing; Social Impact https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Social_Distancing.pdf
    Health, health care access during pandemic, cancer-specific questions: Health Care; Non-COVID-19 Symptoms and Medicines https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Health.pdf
    Healthful behaviors including physical activity, healthy diet, alcohol and drug use: Physical Activity; Dietary Intake; Substance Use https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Healthful_Behaviors.pdf
    Demographics: Personal Demographics; Locational Demographics https://www.phenxtoolkit.org/toolkit_content/PDF/OSUMC_Impact-COVID19_Demographics.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/Ohio_Impact_of_COVID-19_Project_Survey.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: TEXT

    Contact Information:
    Dr. Electra Paskett
    Ohio State University
    Email: electra.paskett@osumc.edu
    Includes Research Tools: Yes.
    ID: 22805. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  68. HERO Daily Experiences Index
    Source: Duke University
    Date Published: 3/30/2020
    Format: PDF
    Annotation: The goal is to develop a summary score and a set of indicator items that provide a snapshot of healthcare workers' daily experiences. The focus is on sleep, pain, fatigue, and emotional distress. Concepts Measured: Sleep Disturbance, Pain, Anxiety, Depressive Symptoms, Stress, Anger, and Fatigue.
    Survey developed using expert review and is administered online every two weeks.
    The HERO study is a longitudinal cohort of healthcare workers in the United States (N=7283: 47% 18-39 years old; 45% 40-59 years old; 8% 60+ years old; 84% white; 74% female; 80% hospital workers). See https://heroesresearch.org/    .

    Population: Adults only
    Adult Workers
    First Responders, Emergency Medical Services (EMS) Personnel, Police/Fire Departments
    Length: 7 questions
    Administered by: Trained Lay Examiner/Interviewer
    Language(s): English

    HERO Protective Equipment Survey: Personal Protective Equipment https://www.phenxtoolkit.org/toolkit_content/PDF/HeroesResearch_HPES.pdf
    HERO Daily Experience Index: Mental Health https://www.phenxtoolkit.org/toolkit_content/PDF/HeroesResearch_HDEI.pdf    ...[See more] [See less]
    URL: https://www.nlm.nih.gov/dr2/HERO_Daily_Impact_Index.pdf
    Type: Guideline/Assessment Tool
    Access Notes: HERO Registry Protective Equipment Survey: https://www.nlm.nih.gov/dr2/HERO_Protective_Equipment_Survey_2020.0409.pdf
    Permission/Request required.
    Available Formats: PDF
    Contact Information: Emily O'Brien: emily.obrien@duke.edu
    Includes Research Tools: Yes.
    ID: 22038. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  69. 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]
    URL: https://www.nlm.nih.gov/dr2/Questionnaire_COVID_v9_06012020.pdf
    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.
  70. Harvard Dataverse COVID-19 Data Collection
    Source: Harvard College
    Date Published: 2/2020
    Format: Text
    Annotation: This is a general collection of COVID-19 data deposited in the Harvard Dataverse repository. The list in this collection is maintained by the Harvard Dataverse data curation team (IQSS and Harvard Library). Researchers who deposit their related data into Harvard Dataverse will have their data linked to this collection, to increase discoverability of their data. The Harvard Dataverse Repository is a free data repository open to all researchers from any discipline, both inside and outside of the Harvard community, where you can share, archive, cite, access, and explore research data. Each individual Dataverse collection is a customizable collection of datasets (or a virtual repository) for organizing, managing, and showcasing datasets.

    Language(s): English    ...[See more] [See less]
    URL: https://dataverse.harvard.edu/dataverse/covid19
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Available Formats: Text

    Contact Information: support@dataverse.harvard.edu
    Includes Research Tools: Yes.
    ID: 24231. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  71. Household Pulse Questionnaire (HPQ)
    Source: U.S. Census Bureau
    Date Published: 2020
    Format: PDF
    Annotation: The Household Pulse Survey was conducted in two phases. Detailed technical documentation of both surveys, including Spanish versions, can be found here: https://www.census.gov/programs-surveys/household-pulse-survey/technical-documentation.html. The survey has been designed as an experimental endeavor by the Census Bureau in cooperation with five other federal agencies to provide critical, up-to-date information about the impact of the coronavirus (COVID-19) pandemic on the U.S. population. Question domains were contributed by the Census Bureau, Economic Research Service (ERS), Bureau of Labor Statistics (BLS), National Center for Health Statistics (NCHS), National Center for Education Statistics (NCES), and the Department of Housing (HUD) to measure employment status, consumer spending, food security, housing, education disruptions, and basic dimensions of health. Many of the questions that will be asked on this survey have been fielded on other surveys in the past. However some are new, designed to explore potential impacts associated with the COVID-19 pandemic. These latter questions have been and continue to be cognitively tested. Questions may be modified slightly based on findings in this process.

    Population: All/Anyone
    Length: 50 questions
    Time to Complete: 20 minutes
    Administered by: Self Administered/Self Report
    Language(s): English, Spanish

    COVID-19 Household Pulse Questionnaire: Full Survey https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS.pdf
    COVID-19 and Employment Stability: Employment https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS_Employment.pdf
    COVID-19 and Food Security: Food Security https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS_Food.pdf
    COVID-19 and Health: Mental Health; Health Care https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS_Health.pdf
    COVID-19 and Housing Security: Housing Security https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS_Housing.pdf
    COVID-19 and Education Disruption: K-12 Education Impact https://www.phenxtoolkit.org/toolkit_content/PDF/Census_HPS_Education.pdf    ...[See more] [See less]
    URL: https://www2.census.gov/data/experimental-data-products/household-pulse-survey/household-pulse-survey-questionaire.pdf
    Type: Guideline/Assessment Tool
    Access Notes: Household Pulse Survey Questionnaire (August 19, 2020 – September 14, 2020) Spanish: https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/Phase_2_Questionnaire_09_09_2020_Spanish.pdf

    Free/Publicly Available

    Available Formats: PDF

    Contact Information: Cassandra Logan, Survey Director, Census Bureau cassandra.logan@census.gov

    Coronavirus (COVID-19) Pandemic https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/Source-and-Accuracy-Statement-April-23-May-5-and-May-7-May12.pdf
    Household Pulse Survey User Notes https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020-Household-Pulse-Survey-User-Notes.pdf
    Household Pulse Survey: May 7 - May 12 https://www.census.gov/data/tables/2020/demo/hhp2.html
    Household Pulse Survey - Phase 2 August 19, 2020 - October 26, 2020 https://www.census.gov/data/experimental-data-products/household-pulse-survey.html
    Includes Research Tools: Yes.
    ID: 22014. From: Disaster Lit®a database of the U.S. National Library of Medicine.
  72. COVID-19: Documenting Challenges Faced by California Families with Children 0-5 Years Old on WIC Protocol
    Source: University of California, Davis
    Date Published: 12/19/2019
    Format: Text
    Annotation: This is the protocol for https://dr2.nlm.nih.gov/search/?q=23584. The purpose of the project is to: (1) identify barriers that WIC participants in Los Angeles County are experiencing in using WIC food benefits (e.g., access to WIC-eligible foods); (2) identify additional short-term unmet basic needs (e.g., food and housing insecurity, as well as access to unemployment benefits, healthcare, childcare, and social support while required to remain at home) of low-income families during the COVID-19 pandemic....[See more] [See less]
    URL: https://disasterinfo.nlm.nih.gov/content/files/WIC_COVID_IRB_protocol.docx
    Type: Study Design/Protocol
    Includes Research Tools: Yes.
    ID: 24226. From: Disaster Lit®a database of the U.S. National Library of Medicine.
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