1. Did you read the article written by Dianne McBrien, MD, FAAP, “Driven by Physician Survey Results: Family-Friendly Down Syndrome-Related Resources” featured in the October 2005 edition of AAP News (pg. 23)?
Yes / No / I don’t remember
2. Did you review the brochure insert, “Your Baby and Down Syndrome?”
Yes / No / I don’t remember
If you responded other than “yes,” please skip to question # 15.
3. Did you retain the brochure for use in your practice?
Yes / No
4. Have you shown or given this brochure to a family?
Yes / No
5. Have you accessed to print additional copies (PDF format)?
(full URL:
Yes / No
General Impressions
6. Would this brochure be helpful when discussing a child’s diagnosis with families?
Yes, absolutely
Yes, probably
I don’t know / Probably not
Absolutely not
7. Would this brochure be helpful when discussing a child’s health and development with families?
Yes, absolutely
Yes, probably
I don’t know / Probably not
Absolutely not
8. Is this brochure something you would keep on file to give to new parents or families new to your practice?
Yes, absolutely
Yes, probably
I don’t know / Probably not
Absolutely not
9. Would similar brochures about other genetic disorders help to educate families with a newly diagnosed child?
Yes, absolutely Yes, probably
I don’t know / Probably not
Absolutely not
10. Would you recommend this resource to (or make copies for) your colleagues?
Yes, absolutely
Yes, probably
I don’t know / Probably not
Absolutely not
Content/Subject Matter
11. Does the brochure cover all the important topics?
Yes
No / If “no”, what additional information should be added?
12. Would the brochure help families initiate discussion about their child’s health/ development with a physician?
Yes
No / If “no”, what addition or change might accomplish this?
13. Do you feel there are adequate resources listed in the brochure?
Yes
No / If “no”, what is the single most useful resource that should be added?
14. Do the references to the National Down Syndrome Society and National Down Syndrome Congress assure you of the credibility and reliability of the brochure content?
Yes, absolutely
Yes, probably
I don’t know / Probably not
Absolutely not
Access
15. How would you prefer to access resources like this brochure?
AAP website / Receive in the mail from AAP / National Down syndrome org. / Parent support org
Other, please list:
16. How ofen do you search the AAP website for parent/family materials ?
Regularly / Often / Sometimes / Rarely / Never
Comments
Completed questionnaires can be faxed/ mailed to Laura Schweers: fax – 323/644-8305
address – Childrens Hospital Los Angeles
Post Office Box 27980, MS#53
Los Angeles, CA 90027-0980