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APPENDIX E QUESTIONNAIRE: SURVEY OF HEALTH SERVICES RESEARCH PERSONNEL CONDUCTED BY THE NATIONAL RESEARCH COUNCIL

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OMB No. 68S-78005 Approval Expires March 19 79 . t SURVEY OF HEALTH SERVICES RESEARCH PERSONNEL CONDUCTED BY THE NATIONAL RESEARCH COUNCIL THE ACCOMPANYING LETTER requests your assistance in this survey of health services research personnel. PLEASE READ THE INSTRUCTIONS carefully and answer by printing your reply or entering an "X" in the appropriate box. PLEASE R ETU RN the completed form in the enclosed envelope to the Commission on Human Resou roes, JH638, National R esearch Council, 2101 Constitution Ave., NW, Washington, D.C. 20418. NOTE: ALL INFORMATION YOU PROVIDE WILL BE TREATED AS CONFIDENTIAL AND USED FOR STATISTICAL PURPOSES ON LY. . . _ .. __ 1 Date of Birth | 2 State or Foreign 3 Citizenship | 4 Sex Ma. Day Year l Country of Birth USA Non-USA | Male Female Specify 1 ~ 20 1 0 20 (9) (10-] I) (12-13) 1 (14-15) (16) (17-18) 1 (19) (~7) ID (8) CD 5 What is your racial background? O O American I ndian or Alaskan Native 1 0 Asian or Pacific islander 2 0 Black 3 0 White (20) 5a Is your ethnic heritage Hispanic? O O Yes 1 0 No (21) 6 List in the table below all COLLEGIATE and GRADUATE DEGREES, excluding honorary degrees, that have been awarded to you. Use We enclosed SPECIALTIES LIST for ~ degree specified. Major Field Institution Granted {Use Specialties List) Type of Degree ~ Ma. Yr. ~ ame ~ No. Name | Ci y State . . . Bachelor's l l l l . . . Master's l l l l l . ther Degree l l l l l l pecify l l l _| l ._ l ther Degree l l l l l i pecify l | | . I . . . .. 169

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~~'Y1PLOYMENT on AC=EMIC AFFlCD`IION _ Instructions: Please answer Questions 7 through 1 t with respect to your PRINCIPAL employment or academic affiliation as of OCTOBER15, 1977. - Which BEST describes your PRINCIPAL employment or academic status as of OCTOBER 15~, 19777 {Check only ONE) O Fult-time degree candidate 5 0 Unemployed and seeking employment O Holding postdoctoral appointment 6 ~ Unemployed and NOT seeking emDIovment n Employed full~time {excluding postdoctoral appointment} O Employed part-time {excluding postdoctoral appointments 7 O Retired 8 n Other status, specify- 8 What is the name and location of your PRINCIPAL employer/academic affiliation? . Name of I nstitutionJ~gan~zation City (70) State 9 Which category below best describes the type of organization of your PRINCIPAL employer/academic affiliations (Check only ONEJ US IVERSITY BUSINESS 1 0 Medical school 11 0 Self~mployed 2 0 tJniversity-owned or "affiliated 120 Pharmaceutical firm teaching hospital 13 0 Other business or industry (including 3 ~ Other health professional school, insurance companies) ~ _ _ . 4 0 Faculty of arts and sciences O Other, specify- OTHER EDU(:A7JONAL INSTITUTION 6 O 4year college 7 0 2-year college or technical school 8 0 Other, specify GOVE RNMENT 9 0 Federal government (including national laboratory and military) 10 0 State or local government, specify- 10 From the Degree and Employment Spec - Ities List enclosed, enter both the number and title of the scientific specialty most cfiosely related to your principal employmentIpostd~ toral appointment. Write in your specialty if it is not OR the list. . Number Title of Specialty (9-1 l) 170 OTHER SECTORS 14 0 Hospital (other than those included above} 15n Clinic t 6 0 Nonprofit organization (other than those included above) 17 0 Other type of employer, specify- (77-78) tl Approximately what percent of your time do you devote to each of the following activities? Research/deYelopment % ( ~ 2-] 3) Teaching Administration/management . % (16-~) % (14-} 53 Consulting Professional services (other than consulting) Other, specify_ % (~-19) % (20-2 ~ ) _ % (22-233 100 %

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| HEALTH SERVICES RESEARCH: TRAINING l DEFINITION: Health services research examines the organization and performance of the health care system so that sound health care policy may be developed. Through the application of quantitative and systematic research methods, health services research seeks to increase the efficiency and effectiveness of the health care system to make me products of biomedical and behavioral re- search available promptly and equitably. 12 Have you eve' been or are you currently engaged in health services research ~ Ed above? O YES 2 0 NO Rf NO, you have completed dais questionnaire BEANIE YOU for your participation (24) in this survey. J 13 Have you had or are you currently engaged in any TRAII`JING in health services research (e.g., academic course work, dissertation studies, postdoctoral appointments, workshops}? 1 CI YES 2 O NO (2 s) (If NO, please proceed to Question 18J - 14 In what year did you BEGIN this training in health services research? 19 (26~27) t5 From the columns below, check ONE BOX in Column ~ which identifies your FIRST TRAINING experience in health services research, and ONE BOX in Column B which identifies the PRIMARY SOURCE OF SUPPORT for that training. Column A TYPE OF TRAINING {Check only ONE) TIdESIS/ACADEMIC ~.OURSEWORK 1 0 MA/MS 2 0 Ph.D. 3 0 Other degree, specify ACADEMIC EMPLOYMENT 4 0 Research assistant 5 0 Research associate 6 0 Instructor 7 0 Professor 8 0 Other, specify OTHER ACADEMIC 9 0 Postdoctoral appointment t O O Other, specify GOVERNMENT 1 1 0 Employment-training 12 0 On-the-job training 131~ Other, specify- BIJSI NESS/INDUSTRY 140 Employment-training 15 0 On-thejob training 16 0 Other, specify- OTHE R t7 0 Specify (2 ~29) 171 Column 8 PRIMARY SOURCE OF SUPPORT {Cheek only ONE) FEDERAL GOVERNMENT 1 0 Research Want 2 0 Research contract 3 Ofeilowship 4 0 Traineesh~p O Over, specify. I NSTI TUTIObJISTATE 6 0 Research !pnt/contract 7 0 Fellowship/traineeship 8 0 Teaching assistantship 9 0 Other, specify PRIVATE FOUNDATION 10 O Research ~ant~contract 11 0 Fellowship 12 0 Other, specify OTEtE R t 3 CI Specify- (30-31 )

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16 If federal support had NOT been available, which of the following would you have sought as a PRIMARY SOURCE OF SUPPORT to finance your heals services research training? {Check only ONE: ~ ~ Did not receive federal support 2 0 Other federal training grant/fellowship 3 0 f ederal research granticontract 4 0 University or state funds (including teaching assistantship} 5 C Personal resources (savings, income, family assistance, etc.) 6 0 Commercial loans 7 0 Other sources, specify- 8 0 Would not have pursued health services research training 17 Using the categories below, check ONE BOX in Column A which best characterizes the SPECIALTY AREA of your health #rv~ research training, and ONE BOX in Column B which rep~e#na the PRIMARY RESEARCH APPROACH reamed. Column A SPECIALTY AREA (Check only ONE) ~ O Health Personnel 2 0 Mental Health Personnel 3 a Ambulatory Care Centers 4 0 Child Health Services 5 ~ Dental Health Services 6 0 Emergency Hea1th Services 7 0 Health Services for me Disadvantaged 8 ~ I ndian Health Services 9 0 Long-term Care O O Nursing Heady Services 1 1 O Pharmacy-related Health Services 12 0 Rural Health Care Services 13 0 Alcoholism Prevention Programs O14 Drug Abuse Prevention Programs 15 0 Mental Health Services 16 0 Inflation and Cost Containment 170 Health Insurance to 0 Quality Assurance of Health Care Practice/Practi tioners 19 0 Quality Assurance of Health Services 20 0 Health Facilities {including organ iation and utilization) 21 0 Legal Aspects of Health Ogre {including regulatory studies) 22 0 Health Politics 23 0 Community Studies related to Health 24 0 treat Education 25 0 Sociobehavioral Aspect of Health Care (including compliance) 26 0 Health Services Design and Development {including technology transfer} 27 0 Other, specify_ _ (33-34) Column B PR t MAR Y R ESEAR CH APPR OACH fiCheck only ONE) 1 Cl Health Statistics 2 0 Statistical Indicators {including heals status indicators) 3 ~ Computer Models 4 0 Case Studies 5 0 Clinical Studies 6 0 Social Experimentation 7 0 Survey Research 8 0 Evaluation Research (including program evaluation) 9 0 Technology Assesment 10 ~ Decision Analysis-- Policy Analysis 12 ~1 Other, specify- (3s-36) The remaining sections explore me EMPLOYMENT experiences of health services research personnel. If you are CURRENTLY a degree candidate or hold a postdoctoral appointment, please check me box below. O Degree Candidate/Postdoctoral (37) {You have comp/e~d this questionnaire. THANK YOU for your participation in Is sun,.ey.J (32)

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~ HEALTH SERVICES RESEARCH: CURRENT EMPLOYMENT {0~15,1~} Instructions: Please answer Questions 18 through 23 with respect to your principal employment as of October 15, 1977. 18 What percent of your TOTAL WORK TIME did you devote to heady services research? As. {if ZERO, please proceed to Question 24) (38 39) 19 If you devoted ANY of your time to health #dices research, specify She PRIMARY and SECONDARY activities in which you were employed as a heard, services researcher as of October 15, 1977. {Check only ONE in each columns Health services R & D Teaching of health services research. Administrat~on/management of health services research C4~su sting (health services research) Other;ipecify_ 1 0 2 r7 PRIMARY SECONDARY {Check only ONEJ {Check only ONEJ ~ O 2 0 3 0 4 0 ~ O (4o) 3 0 O 5 0 (41) 20 Which of the following federal agencies, if any, supported or sponsored your work in heath service' research? fiCheck a/1 that app/yJ 1 O No federal support 2 O ADAMHA (National Institute of Mental Health, National Institute on Alcohol and Alcoholism, and National Institute on Drug Abuse) 3 0 OSH (National Center for Heals Services Research, National Center for Health Statistics) 4 0 N I H (National I nstitutes of Health } _ 5 ~ VA (Veterans Administration) 6 a Other federal agency, please specify __ (4247) 21 Briefly describe Me PRIMARY research problem on which you were working: 22 If you devoted ANY of your time to health services research, indicate the PRIMARY AREA below. {Check only ONEJ SPECIALTY AREA {Check only ONEJ 1 0 Health Personnel 2 0 Mental Health Personnel 3 0 Am bu latory Care Centers 4 0 Child Health Services 5 0 Dental Health Services 6 0 Emergency Health Services 7 0 Health Services for We Disadvantaged 8 Qlndian Heals Services 9 0 Long-term Care 100 Nursing Heals Semices 11 0 Pharmacy-related Realm Services 12 0 Rural Health Care Services t3 0 Alcoholism Prevention Programs 14 0 Drug Abuse Prevention Programs _ ~ 5 ~ Nlental Health Services 16 0 Inflation and Cost Containment 170 Health Insurance ~ 73 8 0 Quality Assurance of Health Care Practice/Practitioners 19 0 Ouality Assurance of Realm Services 20 0 Heals Facilities {including organization and utilization} 210 Legal Aspects of Health Gore (including regulatory studies} 22 0 Health Politics 23 0 Community Studies related to Health 24 0 1 lealth Education 25 0 Sociobehavioral Aspects of Health Care {including compliance) 26 0 Health Services Design and Development (including technology transfer) 27 Cl Other, specify- (48-49)

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23a In your opinion, is formal, specialized training Ibeyond basic science training) necessary to conduct health services research? 1 O YES 2 O NO (so) b If YES, what is the minimum level of training necessary to conduct health services research adequately in your opinion? fiCheck only ONE} 1 0 Postdoctoral training in health services research 2 0 Doctoral training in health services research 3 0 Master's level Gaining in health services research 4 0 Nondegree training in health services research, specify S O Over, specify . . _ , _ . . (51) I REALM "RVIC" RICH: FOLIATION it. . . . . . . ~ . . . . . . . 24 In which YEAR did you FIRST ENGAGE in health services research? 1Q (52-53) 25 Were you engaged In head services research in: _. 196~64 t O Yes 2 0 No (s 1965-69 1 ~1 Yes 2 ~ No tss 1970-74 1 O Yes 2 ~1 No (56) 197~76 t C] Yes 2 0 No (so) 26 If yew were not engaged in health services research in OCTOBER, 1977, BUT CONDUCTED such research at some time prior to that date: O NOT applicable (say a. Specify the PRIMARY REASON for the fact that you were not engaged in heals services research in Oc- tober, 1977. {Check only ONE) 1 0 New research interests 2 0 Inappropriate job setting 3 0 Lack of proper training 4 0 Other, specify.- ~ss) b. If you were given--the opportunity to repenter health ser- vices research, what is the primary factor which would facilitate such an entrance? ~ O Available research support 2 0 Opportunity for advanced research training 3 0 Appropriate job setting 4 O Income potential 5 Cl Other, specify- (60, 27 What is the BASIN: SALARY. "soc~ated with your principal employment? (Round to the nearest thousand} $ _per year (6~-63) S. peracademicyear(9-10months) (64-66) reincludes your salary before deductions for income tax, social security, retirement, etc., but DOES NOT include bonuses, overtime summer teaching, consulting or over payment for professional work. 28 Please indicate the total number of booIcs/articles you have had published for each category specified. AT ANY TIME J ~ 975-77 Total No. of Total No. of Total No. of Health Services Total No. of Health Services Publications Research Publications Publications Research Publications Books (~10) (3 ~-12) (~3-~4) (I 5-1, Articles (-I) _ (~-~) {You have completed this questionnaire. THANK YOU for your participation in this survey. J 174 - (23-24) (25-2

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DEGREE ANG MATHEMATICAL "IENCES OC,0 A ~gebr. OTC} Anely~is ~ Functional Ansfysis Q20 - Gaoma~ry 030 - Logic 040 ~ u mt,.r Thecr V 052 P'obab'I ty 055 Math. Stat~stics (see atso 544, 670, 725, 729) 060 - Topology 0432 - Ooerat~ons Resea~rch (~e alca d7R) 085 ~G 091 098 094 - ApP I fed Matt~emat~cs Comb~r~atorics & f ~nite Mathemetics - Physical Mathematics MatHematics, General Mathematics, Other. COMPUTER SCJNCES 07t - TH.QRY 072 - S~fT`~ere SYsterns 073 !-ar-..~are SYstems O74. ~ntettigon'Systems 07g Coputer Scie~ces, OtHer PHYSICS & AStRONOMY 101 - Astronomy 102 - Ast~ochys,cs 110 A~c - 'c ~ Motecular~qc,cs 120- Ele:sromagne~is t30. Mec-~.cs ~ 32 ^~oust,cs 134 P.;~;ds 13~ - ~,as_e Phys~cs 1 35 ~ r, cs 13& ~ ~e- - ai Pl~ys~cs 140 Eleme~arv Parr~cies t 5C hi uclea, Ss~uctu re 160 So'~c Stete 198 ~ Phys cs 5e~e~a! 1ag - Ph~s-s, Othe.. CHEM1STR Y EMPLOYMENT SPECIALTIES LIST ENGINEERING 400 - Aeronautical ~ Astronsutical 410 - Aoricu Itural 415 - Biom~ical 420 - Civil 430 - Chemical 435 - Ceramic 440- Elactrical 445 - Elactronics 450 Industrial ~ Menufacturing 455 - Nuclear 460 - E ngi necring Mechen ics 465 - Engineering PHYsics 470 - MachJnical 475 - Matellurgy ~ Phys. Met. Engr. 476 - sY"~ns D - ign ~ Systems Schnca (se. siso 072, 073, 074} 478 - Operations Re - arct' (~ sIso 082 479 fuel Tachnolo'ly ~ Pctrol. En''r. 410 Sanitery B. E nvironmentel 486 - Mining 497 - Matar'alsScience Engr. 498 - Engin~ring, General 499 - Engineering, Other. AGRICULTURAL SCIENCES 500. Agronomy 501 Agriculturat Economics 5{t? - An~me' t~usbandry 504 - f ish & W~tdlife 505 - Fores~ry 506 - ~orticuiture 507 - Soils ~ Soi' Scicnce 5t 0 Anirnat Science B' Animal ~utrition 511 - Phytopathology 517 Food Science & Tectinology (see also 573) 5113 Agr~culture, Genere, 5?g - Agriculture, Other. MEDICAL SCIENCES 520 200- Ana!~t,ca' 522 210- ~norganic 524 215 Synt~et~c i norgenic ~ Organometailic 526 220- 0~3anic 527 225 - SYnthet~c Orgenic & Mature' Products 528 230- Nuc~ear ?~0.Physcal 536 2J.5 - Q'~ant~m 250 Theo~et.ca' 538 255 StrVCtU,8t 539 - Medical Sc~ences Other 260- Ag,~cul~ure! ~ Food 265 Thermodynami~s ~ Meterial Properties 270- Phermacauticat 275 - Potyrners 280 - BioeMemistry (~ee also 540) 285 - Chemice' OYnamics 298 Chem~strY, Gene,~t 299 - Chemittry, Other. EARtH, ENVIRONMENTAL AND MARI~IE SCIENCES 30t - M~~6rJ~O5J\~~ ~etrology 305 - Geoctlern~st~y 310 - Strat~graphy. Sedimentation 320 Peleontology 330 - Structurel Cicotogy 341 - Geopt~ysics (Sol'd Ea rh) 350 - C;eo~norph ~ Glacial G.ology 391 - Applied Geot. Geah E ngr. ~ Econ. Gcol. 395 Fue' Tech. & Petrol. Engr. (see sIso 479) 360 - ~yorology ~ Wate, R - ources 370 Oceenogrept~y 3g7 - Ma~ine Sciences, Other ~ ~ I - AtmosDneric Physics 6, Chemistry 382 - Atmospheric Dynamics 38 3 - At mospher ic S ciences, OtHer ~ 388 - Env onmente'Scienc" G-nerel (se. also 480, 528) 399 - E n vi ro n menta ~ S c ienc - , Other ' 39i3 Earttl Scieneas, Genere' 399 - Eartn ScienCes, Other PSYCHOLOGY 600 - Clinice' 610 - Coun~l ing ~ Guidence 620 - Devalopmcntel & Gerontologic~t 630 - Eduenion 635 - Schoot Psycho logy 641 - Experimentat 642 - Comperative 6~13 - Physiological 650 - t ndustrial ~ Pcrsonnal 660 - Personalilv, 670 - Peychotnetrics (~ also 055, 544, 725, 729) 680 - Socis' 698 - Psycilology, General 699 - Psychology, Other. SOCIAL SCIENCES 700. Anthropology 703 - Archeology 708 - Communications. 709 - ~ inguistics 7 ~ O - Sociology ?20 E conomics (tee also 501 ) 725 Economerric' t~e sIso 055, 5 - , 670, 729) 729 Social Stetistics (s e also 055, S44, 670, 725) 740 - Geography 7~15 - Are. Stud ies ~ 751 - Political Science 752 - Public Administration 755 - Internationd Relations 770 - Urban 8. Regionsi Planning 775 - ~istory & Philosophy of Science 798 - Socist Sciences, Gcnere' 799 - Social Sciences, Other HIJMANtTlES - Medicine ~ Surgery - Public Health 8. EpiJamiology - V.terinery Medicine - Hosp~tal Administration - ~ursing - Perasitology - Environmente. Health - PatHotogy PHarmacolo9y Phermacy - Med ical Scienc:~ Ger,.~. BIOLOGICAL SCIENCES 540 El~ochemistrY (s" a150 280) 542 - Biophysics 543- 8iomathematics 544- Biometrics, Biostatistics ( - a also 055, 670, 725, 729) 545 - Anatomy 5~6 - Cytology 547 - E mUrYO 109Y 548 - Immunology 550- Botany 560 - Ecology 562 ~'rdrobiology 564 - 1~ ;:rob iology ~ Bacteriology 566 - Physiology, Animal 567 - Physiology, Plant 569 - Zoology 570 - Genetics 571 - Enton~olo9Y 572 - Molecular Biology 57 3 - Food Sci~ce ~ Technolo,~y 1~ also 517 ) 574- BeHavio,JEttlology 576 - Nutrition th Dietatics 578 - Biologica' Sciences, Generel 579 - 8iologice1 Scienc - , Ott~er. 802 - ~istory 8. Criticism of Art 804- History, American 805 - H istory, E uropeen 806 - History, Other. 808 American S tud ies 830 ~usic 831 - SP6.Ch ~S a Dramasic Art (se. also 885) 833 Religion (see also 881 ) 834 - Philosophy 836 comPerative Litereture 878 - Humenities, General 879 - Humeniths, Other. 891 - ~ ibrary & Archivel Sciences LANGUAGES & LITERATURE 811 - American 812 - Engli~h 821 - Germen 822 R ussis n 823 French 824 - S pan ish & P ortugue" 826 Itaiian 827 - Cl~icel. 829 Other Languages. EDUCATION & OTHER PROFESSIONAL FIELDS g38 - Education 80t Art, Applied 88 1 - TheolollY (~e 81so 833) 882 Busine# Administratior 883 - Home Economict 884 - Journalism 885 Sp~ch 1& Hcering Scicaces (~ ~so 8311 886 - Law, Jurtsprudencc 887 Social Work 897 Prof~ional F ;dd, Other 899 - OTHER FIE LDS. 17 5 ~tdentify the specific field in the space on the questionnaire.

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