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Delta THRIVE Covid-19 and Vaccination Confidence Survey

Project Information

You are being asked to participate in a project initiated by Delta Thrive to provide evidenced-based information relative to COVID-19 and vaccinations.

. The goal of the Delta Thrive Project is to dispel myths and misinformation relative to COVID-19 and vaccinations and to provide information relative to the disease to bring awareness and decrease the incidence rate of COVID-19 related health disparities particularly among individuals who reside in certain sectors of the population in the Mississippi Delta. The project also aims to increase vaccination confidence among citizens in the identified population.

METHODS AND PROCEDURES:

The project will consist of various forms of programming such as media communications, informational sessions and workshops and other interventive methods to spread awareness of COVID-19, related illnesses and vaccination. If you agree to participate, you will complete a questionnaire relative to knowledge of COVID-19, health disparities and vaccinations and participate in other programming efforts.

You may ask questions at any time during the project and are free to contact the Delta Thrive project leaders or advisory board should any questions arise about participation in the project.

RISKS AND DISCOMFORTS:

We expect no risks or discomfort for participants in this project. However, it is possible that you may feel somewhat uneasy answering the questions involved relative to COVID-19, especially if there have been personal experiences with COVID-19 and related illnesses.

BENEFITS:

The information obtained in this project may not directly benefit you. However, the results may provide needed information about COVID-19, health disparities and its effects on certain sectors of the population and awareness of further interventive efforts that may be needed to promote vaccine confidence.

CONFIDENTIALITY OF RECORDS:

All information obtained during this project is private. That is, we protect the privacy of people by withholding their names and other personal information from all persons not connected to this project. Material collected as a part of the project will be stored in a locked file cabinet inaccessible to everyone except for the project director and evaluation team.

VOLUNTARY PARTICIPATION:

Taking part in this project is completely voluntary. You may refuse to answer any specific question or participate in any part of the programming within the project. Participants may withdraw from participation in the project at any time without penalty or prejudice.

PARTICIPATION CONSENT:

I have had the purposes and procedures of this project explained to me and have had the opportunity to ask questions.
1.Do you agree to the consent requirements outlined above?
2.What is your age?
3.What is your primary spoken language?
4.What is your gender?
5.What is your Race/Ethnicity?
6.What is your highest level of education?
7.What County do you reside in?
8.What is your zip code?
9.Do you have any of the following conditions?
10.Do you have any of the following conditions? (Select all that apply.)
11.To your knowledge, do you have, or have you had COVID-19?
12.If "yes," describe the level of care you received, or are receiving.
13.Do you personally know anyone in your family, group of friends, or community networks who became seriously ill or died because of COVID-19?
14.Have you received the COVID-19 vaccine?
15.What makes it difficult for you to get a COVID-19 vaccine? Select all that apply.
16.Did you receive a vaccine product that requires only one dose or two doses?
17.How likely are you to recommend getting the COVID-19 vaccine to others?
18.Where did you receive the most recent dose of the COVID-19 vaccine?
19.How concerned are you about getting COVID-19? If vaccinated, how concerned were you about getting COVID-19?
20.What would motivate you to get vaccinated? If you are vaccinated, what motivated you to get vaccinated? (Select all that apply.)
21.Do you think most of your friends and family will get a COVID-19 vaccine, if it is recommended for them?
22.How much do you trust the public health agencies that recommend/recommended you get a COVID-19 vaccine? Would you say you trust them?
23.Have you seen or heard any information about COVID-19 vaccines (e.g. on the news, on social media, or from friends and family) that you could not determine were true or false?
24.If you are vaccinated, prior to getting vaccinated, did you see or hear any information about COVID-19 vaccines (e.g. one the news, on social media, or from family and friends) that you could not determine were true or false?
25.How do you feel about the amount of information on COVID-19 vaccines that you are getting?
26.Select your top 3 most trusted sources of information about COVID-19 vaccines:
27.As it relates to my health, my doctor provides a good explanation of my illness.
28.During the past year, my doctor has checked my understanding of my illness and how to properly take care of myself.
29.My doctor(s) take time with me and listen carefully to my concerns about my health.
30.Overall, I have good communication and relationship with my doctor.
31.My doctor(s) involves me in the process of making decisions about my health.
Current Progress,
0 of 31 answered