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  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
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