Interview Guide: Resident and Family/Close Friend (Paire

WS-CDC DHQP Interview Guide

Form Approved

OMB Control No.: 0920-1154

Expiration date: 03/31/2026

Long-Term Care Facility (LTCF) Infection Prevention Measures

Division of Healthcare Quality Promotion (DHQP)

Discussion Guide for Interviews with LTCF Resident & Family Member

March 25, 2025 Final

Introduction; approx. 5 minutes

1. Welcome! Thank you for speaking with me today. My name is ___________. I’m an independent researcher with KRC Research.

2. The sole funder of today’s discussion is the Centers for Disease Control and Prevention—CDC. Our conversation today will focus on a health topic.

3. I’m a professional researcher, not a CDC employee or a subject matter expert on health topics. My role is to learn from you during our conversation over the next 45 minutes.

4. There are no wrong answers here. I am simply interested in your honest opinions and experiences. However, if you feel uncomfortable answering a particular question, you do not have to.

5. Because privacy is important, I’m going to share our Privacy Policy.

1. I will protect your privacy for today’s discussion, and nothing you say will be reported in association with your name. We will use first names only during the conversation. You may choose to use a nickname or any other name you prefer.

2. Your participation is voluntary—you do not have to answer anything you are uncomfortable with.

3. I am audio- and video recording for transcribing of our discussion. Because I am having several discussions like this one, it is important for me to have an accurate record of today’s conversation.

Warm-Up; approx. 2 minutes

6. Let’s start with introductions. Can you share…

   1. The name(s) you’d like to use for today’s conversation

   2. What state you currently live in

   3. How long you have lived at your care community

      1. CLARIFY:

         1. As a note, I will refer to anyone who lives in, works in, or visits your nursing home or long-term care facility as your “community.”

         2. When I say “community,” mean your “care community.”

   4. Any hobbies or activities that you currently enjoy doing

General Thoughts about Germs and Infections; approx. 6 minutes

During today’s conversation, most of our time will be spent talking about germs, infections, and how to protect your health in your care community.

[The resident] will be best suited to answer most questions, but we would also welcome feedback from [resident’s loved one].

7. How much do you think about germs and infections in your daily life? Why?

8. What are some ways germs might be spread from one person to another?

   1. What are some examples of how germs might spread in your care community?

9. Do you feel like you are at risk of getting any sort of infection? Why or why not?

10. Do you ever worry about getting an infection? How much: a lot, a little, or not much at all?

    1. What worries you most?

Discussion of Infection Prevention and Control Practices (IPC); approx. 14 minutes

Now, I’d like to move forward by asking you some questions about different measures that might be used to prevent the spread of germs or prevent infection.

11. What steps, if any, do you personally take to protect yourself from infections in your care community?

12. What steps does your care community take to protect you from infections?

    1. How confident are you that the steps your care community takes keep you safe from infections?

    2. What makes you feel [confident/not very confident]?

13. When you were deciding what nursing home or long-term care facility to live in…

    1. What factors did you consider?

    2. Did you consider their steps to prevent the spread of germs and infection, or was that less a priority?

       1. If yes, how did you get this information?

Now I’d like to talk about some specific actions that can help prevent or control infection.

14. Let’s think first about washing your hands or using hand sanitizer, using cleaning products on surfaces in the care community and your room, and using things like isolation gown, gloves, and masks. [IF MORE DETAIL REQUESTED, CAN SHARE MORE CONCRETE EXAMPLES: using cleaning sprays or wipes on surfaces that are touched often by many people, like handrails; wearing face masks around someone who is coughing; staff wearing gloves and gowns when entering certain rooms or when caring for wounds or changing linens.]

1. Have you seen any of these things done in your community? Which ones?

2. How frequently do you see these actions being done?

3. Do you do any of these things? Why? PROBE: data shows increased illnesses in the area, to protect self from harm, to protect others

4. Who else does these things in your care community? PROBE: Staff, visitors, residents

5. What are your feelings about how these things are done in your care community?

   1. How does it feel when you see staff doing these actions?

   2. How does it feel when you see other residents or visitors doing these actions?

6. Do you feel like these actions are helpful in preventing the spread of germs and infection in your care community? Why?

7. Should this be used more or less often in your care community? Why?

8. Do you have questions or things you don’t understand about these actions? What?

15. Now let’s think about another infection prevention measure: isolation of people who are sick or contagious, and special signs outside of rooms of someone who has an infection. [BELOW QUESTIONS ARE SIMILAR BUT NOT IDENTICAL TO THE PRECEDING SERIES] [IF MORE DETAIL REQUESTED, CAN SHARE MORE CONCRETE EXAMPLES: when special signs are placed outside of rooms of someone with an infection, when a person may need to stay inside their room until their infection is over, staff wearing gloves, gowns, or masks when entering certain rooms or when providing care.]

1. Have you seen any of these things done in your community? Which ones?

2. How frequently do you see these actions being done?

3. Have you had personal experience with this?

4. Have you seen others having personal experience with this?

5. What are your feelings about how these things are done in your care community?

   1. How does it feel when you see these actions being done?

6. Do you feel like these actions are helpful in preventing the spread of germs and infection in your care community? Why?

7. Should this be used more or less often in your care community? Why?

8. Do you have questions or things you don’t understand about these actions? What?

16. We’ve discussed measures that may be used to prevent infection. Have you ever discussed any of these measures with other care community residents or staff? What was discussed?

LTCF Assessment; approx. 5 minutes

17. Do you feel like your care community does too much, too little, or just the right amount to prevent infection among residents? Why?

18. Do you feel like there are any downsides or problems that come with measures designed to prevent infection? What are those downsides?

19. How do you feel about the atmosphere and appearance of your care community? How would you describe it?

    1. Does your community feel comfortable and homey? In what ways yes, and in what ways no?

    2. What would you change to make it feel that way?

    3. Sometimes there is a need to balance atmosphere and comfort with taking steps to keep residents and others safe. How do you feel about this balance in your care community?

20. We talked before about the use of hand sanitizer, cleaning products, and isolation gown, gloves, and masks. When you see these things being done, does that change the atmosphere of your care community? How so?

    1. Does the care community feel any more or less like a home? Why?

    2. Do you feel there’s too much of this, not enough, or the right amount?

    3. Do you feel comfortable asking about this, or asking for changes about this?

21. What protective measures do you see the staff taking that you think are most effective in protecting against germs and infection?

IPC Education; approx. 3 minutes

Now I’d like to ask a few questions about informational resources or education you may have received about protecting against germs and infection.

22. Has anyone in your care community talked to you about germs, infections, and ways to prevent them?

23. IF YES:

    1. What informational resource or education was provided?

    2. What did it cover? PROBE: Specific measures to prevent from infection

    3. Who provided it? PROBE: Nurses, administrative staff, outside educator, etc.

    4. What format was it in? A video? Printed handouts? A conversation?

    5. How useful was this information?

    6. Was it enough to help you understand the topic?

If no, is there someone in your community you rely on to provide answers?

7. Was any information confusing? What?

8. Is there any information your care community didn’t provide that you would like to know more about? What?

24. IF NO:

    1. What information would you like your care community to provide that could help protect you from germs and infection?

Family or Friend Involvement; approx. 3 minutes

For the next few questions, I would like to get feedback from both you and [family member] if possible.

25. Do you and visitors like family or friends ever talk about preventing infections together?

    1. What details or information have been discussed?

    2. Have you talked about ways to protect yourself or others against germs and infections?

    3. Have you talked about what your care community is doing to protect against germs and infections?

26. What information or education, if any, have visitors received about how to protect against germs and infection in your community?

IPC Information; approx. 5 minutes

27. Is there any other information about germs or infection that you would like to know more about?

    1. PROBE: germ spread, germ outbreaks, preventing infections, why certain preventive measures are taken?

    2. PROBE: specific infections that cause pneumonia, stomach bugs, urinary tract infections (UTI), or infections resistant to antibiotics?

28. How does your care community share information about preventing infection and reducing the spread of germs? What are staff members doing to get this information to you?

    1. PROBE: communicating an outbreak, sharing best practices, educating on specific infection prevention measures

29. If you wanted to learn more about preventing infections, where would you go for information?

    1. Who do you think would give you the most accurate information?

    2. IF STAFF NOT MENTIONED: Who in your care community would you ask for information about infection prevention?

30. Who or what source would you trust most for information about germs and infection prevention? Why?

    1. Who would you most trust within your care community? Why? PROBE: The leadership of the care community; medical staff such as doctors and nurses; therapists; support staff; etc.

    2. Who or what would you most trust outside your care community? Why? PROBE: Other healthcare professionals; CDC; public health departments; news outlets or publications

31. If you were to receive more information or education about preventing infections, what format would you want to receive it in? PROBE: printed materials, in-person information sessions, one-on-one conversations, videos, etc.

    1. Who would you like to share this with you?

Wrap Up; approx. 1 minute

Thank you for your insights. We’ll wrap up with a final question.

32. What other suggestions or comments do you have for CDC as it works to prevent infections in care communities like yours?

INTERVIEWER THANK AND DISMISS

Public reporting burden of this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS H21-8, Atlanta, Georgia 30333; ATTN: PRA 0920-1154