First Ride, Safe Ride Survey

VDH: First Ride, Safe Ride Program

In 2010, the Virginia Department of Health launched the First Ride, Safe Ride Program. This program was designed to support health care providers with child passenger safety guidance, printed resources, and staff training.

Please take this 5-minute survey to inform VDH of your experience with the First Ride, Safe Ride Program. This information will be used to further improve the program.

Question Title

* 1. Please identify the organization that you represent.

Hospital (please share dept. name in the "other" field)

Pediatrics

Family Practice

Obstetrics

Other (please specify)

Question Title

* 2. Have you or your organization received free First Ride, Safe Ride printed materials from the Virginia Department of Health during 2010-2011?

Yes, I have received a sampling of the materials but I have not yet placed an order.

Yes. I have actively shared the resources with parents.

No. I have not received any materials from VDH, but I would like more information about them.

No. I am not interested in receiving the printed materials (please explain).

Comments

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* 3. If you have shared the First Ride, Safe Ride resources with parents, please rate your perceived response from them. Choose all that apply.

Parents have responded positively to the resources

Parents have responded negatively to the resources

Unsure

Comments

Question Title

* 4. Please rate your opinion of the quality and content of each resource that you have received and used.

	Excellent	Good	Adequate	Poor	Unacceptable	N/A
First Ride, Safe Ride Patient Booklet/DVD	First Ride, Safe Ride Patient Booklet/DVD Excellent	First Ride, Safe Ride Patient Booklet/DVD Good	First Ride, Safe Ride Patient Booklet/DVD Adequate	First Ride, Safe Ride Patient Booklet/DVD Poor	First Ride, Safe Ride Patient Booklet/DVD Unacceptable	First Ride, Safe Ride Patient Booklet/DVD N/A
First Ride, Safe Ride Health Care Provider Guidebook	First Ride, Safe Ride Health Care Provider Guidebook Excellent	First Ride, Safe Ride Health Care Provider Guidebook Good	First Ride, Safe Ride Health Care Provider Guidebook Adequate	First Ride, Safe Ride Health Care Provider Guidebook Poor	First Ride, Safe Ride Health Care Provider Guidebook Unacceptable	First Ride, Safe Ride Health Care Provider Guidebook N/A
First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm)	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) Excellent	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) Good	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) Adequate	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) Poor	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) Unacceptable	First Ride, Safe Ride Web Page - (www.vahealth.org/injury/safetyseat/healthcareprovider.htm) N/A

Comments

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* 5. Please identify any additional printed child passenger safety-related materials that you would find useful for educating parents.

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* 6. Would you be interested in hosting a free 2-hour child passenger safety workshop (that provides two nursing contact hours) for you and your staff to learn more about child passenger safety?

Yes, I would like to schedule a workshop in the future

Maybe, I would like more information

No, We have already provided this workshop to our staff

No, this would not be helpful to our staff

Other (please specify)

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* 7. Overall, the First Ride, Safe Ride Program has helped me to better educate parents about child passenger safety.

Strongly Agree

Agree

Disagree

Strongly Disagree

N/A

Question Title

* 1. Please identify the organization that you represent.

Question Title

* 2. Have you or your organization received free First Ride, Safe Ride printed materials from the Virginia Department of Health during 2010-2011?

Question Title

* 3. If you have shared the First Ride, Safe Ride resources with parents, please rate your perceived response from them. Choose all that apply.

Question Title

* 4. Please rate your opinion of the quality and content of each resource that you have received and used.

Question Title

* 5. Please identify any additional printed child passenger safety-related materials that you would find useful for educating parents.

Question Title

* 6. Would you be interested in hosting a free 2-hour child passenger safety workshop (that provides two nursing contact hours) for you and your staff to learn more about child passenger safety?

Question Title

* 7. Overall, the First Ride, Safe Ride Program has helped me to better educate parents about child passenger safety.

Question Title

* 8. Please share your suggestions to improve the child passenger safety program.