Brush, Book, Bed Collaborative Final Survey Brush, Book, Bed Collaborative Participant Final Survey Participant Information Expect this survey to take approximately 15 minutes to complete. The information you provide will be used to improve future Ohio AAP programs. You may denote "N/A" if you do not have an answer for any question, and use estimates or your best knowledge if needed. An * indicates a required field. Please provide your practice name: * Please provide your first and last name: Please provide your email (to receive ABP attestation link): Are you seeking Maintenance of Certification credit for your participation? Yes No Please rate the frequency with which your practice currently addresses the following at WCVs with families birth - 5 years of age. (Select a number from the scale below.) 0 = Does not apply / do not wish to answer; 1 = Never; 2 = Rarely (at least once a month); 3 = Sometimes (at least once a week); 4 = Most of the time (almost every well visit) Oral Health 0 1 2 3 4 Fluoride Varnish 0 1 2 3 4 Early Literacy 0 1 2 3 4 Using Books to Build Relationships 0 1 2 3 4 Sleep Routines 0 1 2 3 4 The Brush, Book, Bed Program 0 1 2 3 4 Please rate your degree of confidence in your ability to do the following items. Select a number from the scale below. 0 = Does not apply/Do not wish to answer; 1 = Not at all confident; 2 = Somewhat Confident; 3 = Moderately Confident; 4 = Confident; 5 = Very Confident Discuss oral health 0 1 2 3 4 5 Provide resources or referrals for families related to oral health 0 1 2 3 4 5 Discuss books and literacy as part of building a relationship 0 1 2 3 4 5 Provide resources or referrals for families related to early literacy 0 1 2 3 4 5 Discuss sleep routines with families 0 1 2 3 4 5 Discuss safe sleep for infants 0 1 2 3 4 5 Describe the Brush, Book, Bed Program 0 1 2 3 4 5 What was most helpful part of this project for improving your practice? Resources for Families (Books, Toothbrushes) Data Collection/Run Charts Increased Knowledge/Education Networking OtherOther What are your sustainability plans (select all that apply)? Continue using the changes made during this project WITHOUT modification Continue using the changes made during this project WITH modifications Add portions of the project into EMR No plans to use ANY portion of the project in the future OtherOther In regards to the amount of resources needed by your practice in this project (books, toothbrushes, etc.), was the number of resources: Lower than expected Higher than expected As expected OtherOther How did this project change the way you address the focus topics (oral health, early literacy, and sleep) in practice? What, if any, feedback did families provide on their experiences with this project? If you encountered barriers or challenges while implementing this project, what were they? How did you overcome them? Are there additional educational materials or resources you feel would improve this project for future waves? What are they? Please share if you have any additional feedback or comments. Submit If you are human, leave this field blank.
