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  1. Mortality in Puerto Rico after Hurricane Maria: Household Survey Instrument
    Source: Harvard University, Harvard T.H. Chan School of Public Health
    Date Published: 5/29/2018
    Format: PDF
    Annotation: To develop a more accurate estimate of deaths attributed to Hurricane Maria in Puerto Rico, a team led by Harvard T. H. Chan School of Public Health epidemiologists conducted a randomized community household survey in Puerto Rico in 2017-2018. Respondents were asked about displacement, infrastructure loss, and causes of death. The survey instrument can be found in Section I of the Supplementary Appendix in Kishore N, Marques D, Mahmud A, et al. Mortality in Puerto Rico after Hurricane Maria. N Engl J Med. DOI: 10.1056/NEJMsa1803972. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Easy
    Population: All/Anyone
    Length: 10 items with subparts
    Time to Complete: 10 minutes
    Administered by: Lay interviewer
    Language: English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Citation (s):
    Kishore N, Marques D, Mahmud A, Kiang MV, Rodriguez I, Fuller A, Ebner P, Sorensen C, Racy F, Lemery J, Maas L, Leaning J, Irizarry RA, Balsari S, Buckee CO. Mortality in Puerto Rico after Hurricane Maria. N Engl J Med. 2018 May 29. doi: 10.1056/NEJMsa1803972. PMID: 29809109. Subscription not required.
    Free/Publicly Available: https://www.nejm.org/doi/full/10.1056/NEJMsa1803972

    Contact information:
    Dr. Caroline O. Buckee, Harvard T.H. Chan School of Public Health, cbuckee@hsph.harvard.edu
    Includes Research Tools: Yes.
    ID: 17405. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  2. Emergency Nutrition Assessment (ENA)
    Source: Action Against Hunger (ACF) (ACF)
    Date Published: 7/9/2015
    Format: Text
    Annotation: The purpose of the Emergency Nutrition Assessment (ENA) for Standardized Monitoring and Assessment of Relief and Transitions (SMART) is to make nutrition assessments and mortality rate calculations in emergency situations as easy and reliable as possible. It focuses on the most important indicators (anthropometric and mortality data), checks the plausibility of the entered data, and gives out an automatic report. Since the software cannot explain why children are malnourished or mortality rates are high, the results of the survey have to be complemented with other information (e.g., from the Food Security part of ENA or discussions with key informants); collection of this additional information on the household level has a high risk to reduce the quality of the anthropometric and mortality data. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Population: All/Anyone
    Administered by: Specialist/Doctor/Expert
    Language(s): English, French, Spanish
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    Amagai T, Ichimaru S, Tai M, Ejiri Y, Muto A. Nutrition in the Great East Japan Earthquake Disaster. Nutr Clin Pract. 2014 Oct;29(5):585-94. Epub 2015 Jan 22. PubMed PMID: 25606634. https://www.ncbi.nlm.nih.gov/pubmed/25606634. Subscription required.

    Amagai T, Ichimaru S, Tai M, Ejiri Y, Muto A. Disaster Nutrition in the Great East Japan Earthquake Disaster. Nutr Clin Pract. 2014 Jul 23. doi: 10.1177/0884533614543833. Epub 2014 Jul 25. PubMed PMID: 25057050. https://www.ncbi.nlm.nih.gov/pubmed/25057050. Subscription required.

    Tursich M, Neufeld RW, Frewen PA, Harricharan S, Kibler JL, Rhind SG, Lanius RA. Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis. Transl Psychiatry. 2014;4:e413. doi: 10.1038/tp.2014.56. Epub 2014 Jul 23. PubMed PMID: 25050993; PubMed Central PMCID: PMC4119223. https://www.ncbi.nlm.nih.gov/pubmed/25050993. Subscription not required.

    Contact information:

    Institution: Action Against Hunger Canada/Action contre la Faim Canada
    Address: 720 Bathurst St., Suite 500, Toronto, ON, M55 2R4, Canada
    Includes Research Tools: Yes.
    ID: 12907. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  3. 2015 Bastrop County CASPER (Community Assessment for Public Health Emergency Response) Questionnaire
    Source: Centers for Disease Control and Prevention (CDC) (CDC)
    Date Published: 4/23/2015
    Format: PDF
    Annotation: The survey instrument used in the 2015 Community Assessment for Public Health Emergency Response (CASPER) in Bastrop, Texas, consisted of questions addressing several areas of concern for local emergency management and public health officials involved in the disaster response and recovery efforts for a wildfire. A similar instrument was also previously administered in 2011 in Bastrop, Texas. Subject areas included structural damage to the residence, access to basic services such as utilities, access to medical care, physical and mental health status, evacuation behaviors, wildfire-related communications, and pet and livestock issues, preparedness, and recovery. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Easy
    Flesch-Kincaid Reading Level: 5.7
    Population: Residential/Workplace
    Length: 33 questions
    Administered by: Lay Interviewer
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    Kirsch KR, Feldt BA, Zane DF, Haywood T, Jones RW, Horney JA. Longitudinal Community Assessment for Public Health Emergency Response to Wildfire, Bastrop County, Texas. Health Secur. 2016 Mar-Apr; PubMed PMID: 27081889. https://www.ncbi.nlm.nih.gov/pubmed/27081889. Subscription not required.

    Contact information:

    Contact person: Jennifer Horney, PhD
    Institution: Texas A&M University
    Address: Epidemiology and Biostatistics, 1266 TAMU
    College Station, TX 77843
    E-mail: horney@sph.tamhsc.edu
    Includes Research Tools: Yes.
    ID: 12945. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  4. About NIOSH (National Institute for Occupational Safety and Health) and the Respirator Use Questionnaire: About NIOSH-Approved Disposable N95 Respirators; Respirator Use Questionnaire, New Orleans, Louisiana
    Source: National Institute for Occupational Safety and Health [Centers for Disease Control and Prevention] (CDC NIOSH) (CDC NIOSH)
    Date Published: 2015
    Format: Text
    Annotation: The National Institute for Occupational Safety and Health (NIOSH) is working with people on behalf of the State of Louisiana to encourage and explore public use of masks and respirators. This survey targets those who have experienced hurricanes living in New Orleans. Questions relate to disaster experience, health, visual evaluation, and demographics. NIOSH aims to promote cautionary tools such as masks among certain populations to minimize public inhalation of mold and other contaminants. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Easy
    Flesch-Kincaid Reading Level: 6.1
    Population: High Risk/Special/Unique Populations
    Length: 23 questions
    Administered by: Lay Interviewer
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Contact information:
    Centers for Disease Control and Prevention, 800-CDC-INFO.
    Includes Research Tools: Yes.
    ID: 11420. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  5. Administered Employee Health Questionnaire
    Source: Disaster Research Response Program [National Institutes of Health] (DR2) (DR2)
    Date Published: 2015
    Format: Text
    Annotation: This is a Medicare Initial Enrollment Questionnaire (IEQ) for employees. Survey includes questions relating to identification and demographic information, health history, home environment, work environment, and external responsibilities of individuals. This questionnaire was developed to assess and monitor health changes of administered employees. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting:
    Flesch-Kincaid Reading Level: 8
    Population: Adults only
    Length: 73 questions
    Administered by: Lay Interviewer, Specialist/Doctor/Expert
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Includes Research Tools: Yes.
    ID: 11429. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  6. Protocol for Sampling Floor Dust
    Source: Disaster Research Response Program [National Institutes of Health] (DR2) (DR2)
    Date Published: 2015
    Format: Text
    Annotation: This dust sampling protocol is intended to help guide those interested in dust collection. This protocol includes a clear methodology for sampling dust particles, and an associated data collection sheet. This resource was identified by the href="https://dr2.nlm.nih.gov/" target="_blank">NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting:
    Flesch-Kincaid Reading Level: 6.5
    Population: Residential/Workplace
    Administered by: Self Administered/Self Report
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available
    Includes Research Tools: Yes.
    ID: 11430. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  7. Proximity to Natural Gas Wells and Reported Health Status: Results of a Household Survey in Washington County, Pennsylvania
    Source: National Institute of Environmental Health Sciences [National Institutes of Health] (NIEHS) (NIEHS)
    Date Published: 8/2014
    Format: PDF
    Annotation: This Community Assessment for Public Health Emergency Response (CASPER) questionnaire was used in a community near natural gas wells in Pennsylvania. This assessment of reported health symptoms and health status is based on questions drawn from publicly available surveys. Symptom questions, covering a range of organ systems that had been mentioned in published reports, asked respondents whether they or any household members had experienced each condition during the past year. The health assessment also asked a number of general yes/no questions about concerns of environmental hazards in the community, such as whether respondents were satisfied with air quality, water quality, soil quality, environmental noise, odors, and traffic, but did not specifically mention natural gas wells, hydraulic fracturing, or other natural gas extraction activities. The survey was pretested with focus groups in the study area in collaboration with a community-based group and revised to ensure comprehensibility of questions. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Easy
    Flesch-Kincaid Reading Level: 5.7
    Population: Residential/Workplace
    Length: 78 questions
    Administered by: Lay Interviewer
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    Rabinowitz PM, Slizovskiy IB, Lamers V, Trufan SJ, Holford TR, Dziura JD, Peduzzi PN, Kane MJ, Reif JS, Weiss TR, Stowe MH. Proximity to natural gas wells and reported health status: results of a household survey in Washington County, Pennsylvania. Environ Health Perspect. 2015 Jan;123(1):21-6. PubMed PMID: 25204871. https://www.ncbi.nlm.nih.gov/pubmed/25204871. Subscription not required.

    Contact information:

    Contact person: P.M. Rabinowitz
    Institution: University of Washington School of Public Health, Department of Environmental and Occupational Health
    Address: 1959 NE Pacific St., F551 Health Sciences Center, Box 357234, Seattle, WA 98195
    Phone: 206-685-2654
    E-mail: peterr7@uw.edu
    Includes Research Tools: Yes.
    ID: 12943. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  8. WTC (World Trade Center) Health Registry Hurricane Sandy Survey
    Source: City of New York, Department of Health and Mental Hygiene (NYC DOHMH) (NYC DOHMH)
    Date Published: 12/2013
    Format: PDF
    Annotation: The World Trade Center (WTC) Health Registry is studying the impact of Hurricane Sandy, a second major disaster, on the physical and mental health of Registry enrollees. This survey was sent to approximately 4,500 enrollees who lived in flood zones and to an equal number of enrollees who didn't. The survey will enable the Registry to assess changes in post-traumatic stress symptoms among both groups since post-traumatic stress disorder (PTSD) was last measured in 2011-2012. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Difficult
    Flesch-Kincaid Reading Level: Grade 6.7
    Population: Residential/Workplace
    Length: 83 multi-part questions
    Administered by: Self Administered/Self Report, Lay Interviewer
    Language(s): English and Spanish
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    Currently, there are no research publications containing the use of this questionnaire or detailing data gathered from use of the World Trade Center (WTC) Hurricane Sandy Questionnaire. Ongoing data collection and analyses using this tool are currently in the process of being conducted by the WTC Health Registry Workgroup. (April 3, 2014)

    Contact information:

    Institution: WTC Health Registry
    New York City Department of Health and Mental Hygiene
    Address: 42-09 28th Street, CN 6W
    Queens, NY 11101-4132
    Phone: 347-396-2801 or toll-free 866-NYC-WTCR (866-692-9827)
    Fax: 347-396-2893
    Email: wtchr@health.nyc.gov
    Includes Research Tools: Yes.
    ID: 7828. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  9. Hurricane Sandy Assessment Survey
    Source: Icahn School of Medicine at Mount Sinai (ISMMS) (ISMMS)
    Date Published: 2013
    Format: PDF
    Annotation: This assessment survey may help collect and organize standardized information on potential occupational and environmental health risks during cleanup operations. It has been used as part of safety training assessment processes to identify relevant job hazard analyses (JHAs) based on the current Hurricane Sandy HASP (Occupational Safety and Health Administration's Health and Safety Plan). This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Moderate
    Flesch-Kincaid Reading Level: 5.7
    Population: Adults only
    Length: 47 questions
    Administered by: Lay Interviewer, Specialist/Doctor/Expert
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Contact information:
    Contact person: Alice Freund
    Institution: Mount Sinai School of Medicine
    Email: alice.freund@mssm.edu
    Includes Research Tools: Yes.
    ID: 11421. From: Disaster Lit®a database of the U.S. National Library of Medicine.

  10. Community Health Assessment Following Mercaptan Spill: Appendices A, B, C, and D
    Source: Centers for Disease Control and Prevention, National Center for Environmental Health (CDC NCEH) (CDC NCEH)
    Date Published: 11/30/2012
    Format: PDF
    Annotation: This Community Assessment for Public Health Emergency Response (CASPER) questionnaire was used in a community following a Mercaptan spill in Alabama. Prior to each interview, the teams completed a tracking form (Appendix A) to record the outcome of every interview attempt. This information served as the basis for calculating the response rates. In the event that field teams encountered a household with urgent needs that presented an immediate threat to life or health, they were to encourage or assist the household to call emergency services (911). In the event that calling 911 was not appropriate, the teams would complete a confidential referral form (Appendix B). After gaining verbal consent (Appendix C), one eligible household member (18 years of age or older) from the family was selected to speak for all household members when responding to the questionnaire (Appendix D). Appendices A, B, C, and D can be found on pages 28 to 41 of the resource. This resource was identified by the NIH Disaster Research Response Program (DR2) for researchers looking for pre- and post-disaster data collection instruments.

    Ease of Use in Disaster Setting: Easy
    Flesch-Kincaid Reading Level: 6.8
    Population: Residential/Workplace
    Length: 28 questions
    Administered by: Lay Interviewer
    Language(s): English
    ...[more] [less]
    Type: Guideline/Assessment Tool
    Access Notes: Free/Publicly Available

    Citation(s):
    Behbod MB, Parker EM, Jones EA, Bayleyegn T, Guarisco J, Morrison M, McIntyre MG, Knight M. Eichold B and Yip F. Community health assessment following mercaptan spill: Eight Mile, Mobile County, Alabama, September 2012, J Public Health Management Practice, 2014, 20(6), 632-639. PubMed PMID: 24253404. https://www.ncbi.nlm.nih.gov/pubmed/24253404. Subscription not required.

    Contact information:

    Organization: Alabama Department of Public Health, Division of Infectious Diseases and Outbreaks, Bureau of Communicable Disease
    Address: RSA Tower, 201 Monroe Street, Suite 1450, Montgomery, AL 36104
    Phone: 334-206-5971; After hours (24/7): 1-800-338-8374
    Fax: 334-206-3734

    Appendix D: Household Questionnaire
    MS Word
    PDF
    Epi Info file (XML)
    Epi Info Instructions

    Includes Research Tools: Yes.
    ID: 12942. From: Disaster Lit®a database of the U.S. National Library of Medicine.

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