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				General
				Feedback | 
		
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				Time
				to complete: 
					15
					minutes. Less if the language can be clarified/simplified a
					little. 
					5-10
					minutes7
					minutes15
					minutes10
					minutes | 
				Projected
				time to complete the survey will stay the same at 10 minutes or
				less 
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				How
				clear and easy to understand are the survey instructions and
				questions? 
					Consider
					removing “postal” unless we are surveying Canadians.
					
					Consider
					bullets to make it more digestible and more likely it will be
					read. Consider simplifying “other data sources (e.g.,
					Medicaid data)” etc. 
					Generally
					easy to understand; but for the question where they asked about
					estimating the proportion with disorders, some of the
					terminology (elimination disorders, obsessive compulsive and
					related disorders, people might not know what the related
					disorders are), might need to give more examples.EasyFairly
					clear | Deleted
					"postal" as all locations outside of Continental US
					(e.g., Micronesia, Palau, Guam) use ZIP Codes.Bulleted
					the two sentences in Survey Purpose.Elaborated
					elimination disorder by adding examples. Elaborated the
					disorders related to obsessive-compulsive disorder by adding
					examples. 
					N/AN/A
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				Were
				there any issues with the flow, formatting, layout, or appearance
				of the survey? If so, please explain. 
					Group
					practice questions together and then move on to the "you"
					questions.There
					was one question where answers need to add up to 100% that might
					be frustrating to complete. Also, if patients have comorbid
					disorders, it would add up to more than 100%. Would consider
					simplifying this.NoThere
					are a series of questions that ask what proportion of patients
					were screened, diagnosed, and referred. It took me reading it a
					few times before I realized they were different questions. It
					would help to italicize or underline those words (screen,
					diagnose, refer).Some
					of the response item lists were long. I suggested grouping one
					such list into categories. 
					 | Order
					retained to maintain logical flow.Question
					asks about primary/principal diagnosis, not comorbid disorders.N/ABolded
					text to differentiate the questions. 
					Responses
					are ordered as related groups/categories. 
					
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				Did
				you experience any technology difficulties when accessing and/or
				taking the survey? If so, please explain. 
					NoNoNo | 
				N/A | 
		
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				Please
				provide any additional comments or suggestions to improve the
				survey (e.g., unnecessary or missing questions or response
				options; spelling/grammatical errors; sensitivity issues).  
					None
					otherOverall,
					there are A LOT of open-ended % questions. I worry that you are
					going to get a lot of missing data, as those kinds of questions
					are a bit more stressful for people to answer. Consider a
					different way to ask this – give people % categories or a
					% slider, maybe?You
					have the definition of a Behavioral Health Disorder at the top
					of each page – do you need it on every page, or is it
					possible to have it as a footnote, a little “info”
					icon, or a call out box on the side? It took me a minute to
					realize that I was re-reading something I’d already read
					and that it was not a new instruction. | N/AWe
					have used an input field instead of categories or a slider to
					allow for responding with more precision, which is important for
					statistical analyses. Also, we have revised to focus on numbers
					of patients rather than percentage.Revised
					to present definition of behavioral health disorder on the page
					of its first mention.
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				Survey
				Question Feedback | 
		
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				Please
				enter your: 
				 First
				Name: 
				 Last
				Name: 
				 Primary
				Practice Postal or ZIP Code: 
				 Email
				address used for receiving communication from [insert PMHCA
				program name] program: 
				 
					Is
					it possible to say this more plainly? “Email addresses
					will only be used to track survey administration and
					completion.” And, why wouldn’t the name do that?
					Could you just say “Email addresses are used for internal
					tracking only.” or something? 
					 | Because
					some individuals may have multiple email addresses, we request
					here the email address that specifically links the respondent
					with the PMHCA program that they are associated with for survey
					completion tracking. Revised language as recommended. 
					
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				Please
				select the primary type of health professional that best
				describes you. 
					You
					might consider adding “Child and Adolescent Psychiatry”
					like you do for the ped[iatric] subspecialty? This is also a
					subspecialty so they may not perceive “other specialist”
					as an opportunity to capture that.This
					is a long list – consider grouping them by heading or
					something (Physician/advanced practice professional/other…or
					something like that). | Revised
					as recommended. 
					The
					list is presently grouped conceptually without lengthening
					further with headings: The physicians are the first 6,
					assistants the next 2, nurses the next 4, and behavioral health
					practitioners the final 3.
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				Which
				PMHCA program services or trainings have you utilized or
				participated in during the last 12 months? Select all that apply. 
					Is
					there a natural hierarchy to these services? Could you possibly
					simplify this so that it isn’t “utilize or
					participated” and “services or trainings”? I’m
					not sure the providers will see a difference between utilizing
					and participating so maybe get rid of a verb there. | Revised
					to “used”. Kept “used” and
					“participated” per HRSA’s feedback. 
					
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				For
				the purpose of this survey, Behavioral Health Disorder is defined
				as common, recurrent, and often serious mental health and
				substance use disorders that affect an individual’s
				behavioral health, defined as the ability to cope with life
				stressors, actualize their abilities, learn well, work
				productively, and contribute to the community. 
					Would
					this section benefit from definitions that could be found by
					hovering over a ? Is there a more straightforward way to say
					“actualize their abilities”? Is it necessary to say?
					It seems redundant with all the examples that follow in the
					sentence. 
					 Is
				it possible to make this text into 2 sentences? Is “often
				serious” necessary information? 
				 | Revised
					definition. 
					
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				Approximately
				how many patients between the ages of 5 and 21 years do you see
				per week on average? 
					Move
					this to after the practice questions. | Retained
					here as a reference for screening, diagnosis, and referral
					questions that follow.
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				Which
				type of behavioral health screenings does your practice conduct
				with patients between the ages of 5 and 21 years? 
					Ask
					both practice questions first and then move on to the “you”
					questions. | Retained
					here to lead in to "you" screening questions.
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				In
				the past 30 days, what percentage of the patients you saw between
				the ages of 5 and 21 years were screened for behavioral health
				disorders (either by you or by other practice staff)? Your best
				estimate is fine. By screening, we mean using a question guide or
				screening tool (e.g., PHQ-9) intended to identify behavioral
				health disorders. 
					Could
					it just say “In the past 30 days, approximately what
					percentage…..screened using a question guide or tool by
					you or a member of your staff”  In this context it is
					probably not necessary to specify that the tool is intended to
					identify BH disorders. Consider using approximately instead of
					the additional complete sentence about best estimate…. | JBS
					and HRSA agreed to use “disorder”. 
					
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				In
				the past 30 days, which behavioral health disorders did your
				practice screen for among patients (5-21 years)? Select all that
				apply. 
					Is
					it necessary to state the ages over and over again?I
					don’t understand why these two skip pattern questions
					display differently based on answers to the two screening
					questions. For example, if I click general/multidimensional,
					then you ask me about screening with the PHQ9 (used as an
					example), which the question also defines as a specific
					screening. In general, this list is quite long and might benefit
					from some cutting and/or grouping. | We
					have repeated the ages in each question for clear reference for
					the respondent.Removed
					examples in the following question to minimize/avoid any
					confusion. 
					
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				In
				the past 30 days, what percentage of your patients (ages 5-21
				years) did you personally diagnose with a behavioral health
				disorder? Your best estimate is fine. 
					Probably
					not necessary to keep repeating “personally” over
					and over again especially if you group the practice questions
					first.By
					this, do you mean an incident diagnosis, or should it include
					patients with a prior diagnosis that you’ve seen for a f/u
					visit in the past 30 days? | “Personally”
					retained because some questions are at the individual level,
					while some are at the practice level.Question
					solicits the number personally diagnosed in the past 30 days, so
					30-day incidence.
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				Of
				your patients (ages 5-21 years) that you personally diagnosed
				with a behavioral health disorder, what percentage of primary
				diagnosis fell into the following categories? Your best estimate
				is fine. 
					Consider:
					“Of the patients you diagnosed with a BH d/o in the last
					30 days what is the approximate percentage diagnosed with each
					of the following.”  What do you want them to do if they
					diagnosed more than one condition in the same patient since you
					require it to add up to 100? You could rephrase: Of all the BH
					diagnoses you made in the past 30 days what is the approximate
					percentage of each of the following diagnoses? And allow it to
					add up to at least 100%.This
					is a little tricky, because you’re requiring that people
					take their prior answer % and then translate that into a set of
					answers that have to add up to 100. You could either add some
					language to the question to make it clear that numbers have to
					add up to 100, give an example (e.g., “For example, if you
					answered 10% above, the next question requires that you specify
					the distribution of diagnoses for that 10% blah blah) | The
					question focuses on primary/principal, not comorbidities.Knowing
					the number diagnosed is not necessary; respondents need only
					identify the percentage diagnosed in each category. The survey
					application will validate totals and prompt if < 100%.
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				What
				percentage of your behavioral health care referrals for patients
				(ages 5-21 years) resulted in a visit to a behavioral health
				specialist within 90 days of you referring them? 
					Have
					you defined behavioral health specialist somewhere? Consider
					inserting an e.g. | Revised
					as recommended. 
					
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				Before
				participating in the PMHCA program, on average what percentage of
				your patients (ages 5-21 years) did you personally screen for
				behavioral health disorders? Your best estimate is fine. 
					During
					what period of time? The year before they started participating?
					The 30 days before?  What are you asking them to average? Per
					month? There has to be a way to simplify this. Maybe “In
					the year prior to joining the PMHCA program, what percentage of
					patients did you screen for BH d/o per month?” or
					something. This is a problem throughout this section.Consider
					putting another intro sentence to flag that now we’re
					asking you about BEFORE you participated in the program. You’ve
					got people answering a lot of % questions and they might be more
					focused on that than on reading the nuances of the questions. | Period
					of time is an estimate of care before participating in PMHCA.Bolded
					the text that highlights that we are asking “before
					participation in the program”. 
					
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				How
				much has the PMHCA program helped address the unmet behavioral
				health care needs of your child and adolescent patients? 
					Why
					unmet? What if it just makes it easier, more efficient, more
					effective to meet the bh needs of my patients (still asking
					about my individual patients or the practice?) What if there was
					a response: there was no unmet need? Here you say child and
					adolescent instead of giving the ages. Less painful than the
					recurring parenthetical. | Revised.
					Question now asks how much PMHCA helps to better address
					behavioral health care needs. Kept parenthetical for
					consistency. 
					
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				Is
				there anything else you would like us to know about the impact of
				PMHCA program? 
					I
					know it’s an impact study but is it necessary to use that
					word in the question? Isn’t anything they write here an
					impact? Maybe just “your experience” or “the
					effect”? “How else has participating in the PMHCA
					program affected your practice?” | "Impact"
					used for consistency.
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