March of Dimes Folic Acid Campaign Survey

Strengthening the March of Dimes Folic Acid Campaign: Assessment of Past Efforts and Recommendations for the Future

This on-line survey is part of an assessment of selected aspects of the Folic Acid Campaign and is directed to State Folic Acid Council Members

This on-line questionnaire contains questions using text boxes, check boxes, and pop-up list boxes containing pre-selected options. Required fields are marked with red asterisks (*). You must provide an answer for these fields in order to properly submit the questionnaire.

Please provide the following contact information:

	*First Name:
	*Last Name:
	*Organization:
	*Address:
	Room/Suite#:
	*City:
	*State/Zip code:	/
	*Phone: (please include area code)
	Fax: (please include area code)
	*E-mail:
	*How long in current position?

I. Organization of the State Folic Acid Campaign

*1. In what state are you involved as a member of a March of Dimes State Folic Acid Council?

2. Do you serve as a (please check all that apply):

		Chairperson of the Council
		Vice-Chairperson or Co-Chairperson of the Council
		Evaluation and Surveillance Committee Member
		Community Action Committee Member
		Professional Education Committee Member
		Mass Media Committee Member

3. What individuals or groups are represented on your Council in addition to the March of Dimes? (check all that apply)

		Birth defects registry		Obstetric physician
		State ACOG		Pediatric physician
		State AAP		Elected official
		State AWHONN		Perinatal consortium/council
		State HMHB		Academic institution
		Other NCFA organization		Family planning agency
		Pharmacy association		Managed care organization
		Local health department		Public relations/communications expert
		Nursing association		Consumer
		Community health center		Faith community
		State health department		Other
		Business community

4. Identify the category which best describes your primary affiliation?
(please choose one)

		Birth defects registry		Obstetric physician
		State ACOG		Pediatric physician
		State AAP		Elected official
		State AWHONN		Perinatal consortium/council
		State HMHB		Academic institution
		Other NCFA organization		Family planning agency
		Pharmacy association		Managed care organization
		Local health department		Public relations/communications expert
		Nursing association		Consumer
		Community health center		Faith community
		State health department		March of Dimes
		Business community		Other

5. Number of official members on the Council:

6. Please estimate the total collective financial support provided in cash by Council members during 1999, 2000, and 2001:

7. Please estimate the total collective financial support provided in-kind by Council members during 1999, 2000, and 2001:

8. Please estimate the percent of Council meetings attended by representatives from the following groups within the past year:

Groups

Percent of Meetings Attended

Birth defects registry

90% or more

75%

50%

25%

10% or less

State ACOG

90% or more

75%

50%

25%

10% or less

State AAP

90% or more

75%

50%

25%

10% or less

State AWHONN

90% or more

75%

50%

25%

10% or less

State HMHB

90% or more

75%

50%

25%

10% or less

Other NCFA organization

90% or more

75%

50%

25%

10% or less

Pharmacy association

90% or more

75%

50%

25%

10% or less

Local health department

90% or more

75%

50%

25%

10% or less

Nursing association

90% or more

75%

50%

25%

10% or less

Community health center

90% or more

75%

50%

25%

10% or less

State health department

90% or more

75%

50%

25%

10% or less

Business community

90% or more

75%

50%

25%

10% or less

Obstetric physician

90% or more

75%

50%

25%

10% or less

Pediatric physician

90% or more

75%

50%

25%

10% or less

Elected official

90% or more

75%

50%

25%

10% or less

Perinatal consortium/council

90% or more

75%

50%

25%

10% or less

Academic institution

90% or more

75%

50%

25%

10% or less

Family planning agency

90% or more

75%

50%

25%

10% or less

Managed care organization

90% or more

75%

50%

25%

10% or less

Public relations/communications expert

90% or more

75%

50%

25%

10% or less

Consumer

90% or more

75%

50%

25%

10% or less

Faith community

90% or more

75%

50%

25%

10% or less

March of Dimes

90% or more

75%

50%

25%

10% or less

Other

90% or more

75%

50%

25%

10% or less

9. How are members most often recruited to join the Council? (please choose one)

		Formal invitation from the March of Dimes
		Formal invitation from another Council member
		Open invitation based on interest
		Other

10. How often are Council meetings held? (please choose one)

		Monthly
		Every other month
		Quarterly
		Every six months
		On an "as needed" basis

11. Please identify which of the following are and are not your responsibilities as a Council member with respect to the Folic Acid Campaign, and if they are, whether or not you have attained success within these responsibilities.

	Areas of Responsibilities	Rate of Success
	Represent my constituents to the Council
	Share information from the Council with my constituents
	Coordinate activities of my organization with those of the Council
	Work with other Council members in the development and implementation of collaborative Campaign activities
	Secure funding for Folic Acid Campaign activities
	Other

12. What do you perceive as the three major current goals of the Council? Are these goals in the process of being achieved?

Goal #1:

In the process of being achieved?

Goal #2:

In the process of being achieved?

Goal #3:

In the process of being achieved?

13. If any of the goals have not yet been achieved, why? (check all that apply)

		Inadequate time, but on the way to success
		Inadequate time, and will not achieve success
		Goals were not realistic
		Goals were unclear
		Inadequate resources
		Insufficient group commitment to the goal
		Inadequate time to meet goals
		Inconsistent participation of Council members
		Other

14. What types of activities were used to implement the Campaign?
Estimate the percent of total Campaign effort devoted to each individual activity (Example: 30% of all our Campaign activity was devoted to community presentations). All your answers should add up to no more than 100%.

Campaign Activity

Percent of Effort

Presentations to health professionals (conferences, grand rounds, seminars)

100%

75-99%

50-74%

25-49%

1-24%

Community presentations (food stores, health fairs, adult education, parent groups)

100%

75-99%

50-74%

25-49%

1-24%

Material Distribution (mass mailings, community placement)

100%

75-99%

50-74%

25-49%

1-24%

Securing & distributing vitamins

100%

75-99%

50-74%

25-49%

1-24%

Placement of articles in community & professional publications

100%

75-99%

50-74%

25-49%

1-24%

Mass media activities (TV, radio, print)

100%

75-99%

50-74%

25-49%

1-24%

Legislative advocacy for increased Folic Acid or surveillance funding

100%

75-99%

50-74%

25-49%

1-24%

Materials development (video, Web site, brochures)

100%

75-99%

50-74%

25-49%

1-24%

Evaluation surveys

100%

75-99%

50-74%

25-49%

1-24%

Securing funding or donations for campaign activities

100%

75-99%

50-74%

25-49%

1-24%

Other

100%

75-99%

50-74%

25-49%

1-24%

15. Please identify any areas of unmet needs affecting the Council: (check all that apply)

		Setting goals
		Engaging and sustaining participation in the group
		Planning the work of the group
		Organizing the work of the group
		Implementing the work of the group
		Evaluating the work of the group
		Working with other groups with similar interests

16. Did you find the National Council helpful or important in developing your State Council?

		Yes
		No

II. MOD's Folic Acid Campaign

17. What resources did Council agencies/organizations contribute to the MOD's Folic Acid Campagn? (check all that apply)

		Financial		Public support
		Influence (brokered attention/help from others for the Campaign)		Printing
		Materials		Marketing consultation
		Integrated Campaign into their organization's activities (e.g., distributed materials, articles, in newsletter)		Provided media time
		Sponsored Campaign events		Other

18. What contributions do individual members make to the Campaign?
(check all that apply)

		Expertise in issues related to birth defects
		Expertise in planning and organizing health education efforts
		Knowledge of the target populations
		Knowledge of additional partners and resources to assist in the effort
		Skill in helping group work together effectively
		Marketing and public relations
		Other

19. What benefits do you feel Council members receive as a result of the MOD Folic Acid Campaign? (check all that apply)

		Increased knowledge of issues related to folic acid intake
		Increased knowledge of other organizations working on issues important to me
		Better understanding of how to plan and organize health education efforts
		Improved coordination with other agencies and organizations
		Other

20. What are your criteria for assessing the success of the MOD's Folic Acid Campaign? (check all that apply)

		Participants are able to learn more about other organizations
		Additional resources for folic acid awareness were generated
		Meetings were efficiently managed
		Achievement of Council objectives
		It helped my work
		Other

21. How would you rate the overall success of the MOD's Folic Acid Campaign thus far?

		Very Successful
		Generally Successful
		Did Some Useful Things
		Not a Good Use of Time or Resources
		Don't Know

22. What campaign efforts do you feel were most effective in relation to the outcomes you wanted to achieve?

23. Is the State Council mechanism useful in promoting the MOD's agenda, such as the Folic Acid Campaign?

		YES, State Councils are effective partners to the MOD and should be continued
		NO, State Councils are ineffective partners to the MOD and should be discontinued
		The role of the State Councils should be changed
		Don't know

24. If you answered question #23 that the role of the State Councils should be changed, please tell us in what way(s) it should be changed?

25. What changes should be made in the overall Campaign in the future to strengthen effectiveness?

26. Is there anything else you would like to say about your experience with the Campaign that we have not asked?

27. If we have any further questions, may we contact you?

		Yes
		No