COVID-19 Exposure And Family Impact Survey (CEFIS)

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COVID-19 Exposure and Family Impact Survey (CEFIS)The COVID-19 Exposure and Family Impact Survey (CEFIS) was developed using a rapid iterativeprocess in late March/early April 2020.1 At that time the COVID-19 pandemic was impactingmost, if not all, American families to some extent. Communities were coming under “stay athome” orders, schools were closing, and health and financial implications of the COVID-19pandemic were unfolding.Various aspects of the COVID epidemic are likely to impact families and may influence thefindings of research in pediatric health. CEFIS was designed to be used in ongoing and newstudies where COVID-19 may influence study outcomes. It conceptualizes exposure topotentially traumatic aspects of COVID-19 and assesses the impact of the pandemic on thefamily. CEFIS should be completed by caregivers. Each caregiver can complete CEFIS. It isavailable in English and Spanish.CEFIS is available for use without charge through the Center for Pediatric Traumatic Stress(CPTS).2 CEFIS is available as a REDCap survey. We ask that you register with us before using itand provide us with information about your use and share de-identified data with us to that wecan refine the measure. We will provide a REDCap data dictionary to facilitate this process.There is no normative data nor clinical cutoffs available at this point. Interested users shouldcontact Gabriela Vega (Gabriela.Vega@nemours.org).Scoring Part 1 (Exposure) consists of 25 items (Yes/No responses) that measure the participants’“exposure” to COVID-19 and related events. The Exposure Score is a count of “yes”responses and may range from 0 to 25. Part 2 (Impact) consists of 12 items that measure the impact of COVID-19. 10 items usea four-point Likert scale rating impact on participant’s and family’s life; 2 items use a 10point distress scale. Higher scores denote more negative impact / higher distress. TheImpact Score (sum of items 26-37) may range from 12 to 60. Part 3 is an open-ended question so that participants can expand upon their experiencesand add effects of COVID not covered in the other questions.1The following contributed to the development of CEFIS. Nemours Center for HealthcareDelivery Science (Anne Kazak, Ph.D., ABPP; Kimberly Canter, Ph.D.; Thao-Ly Phan-Vo, M.D.,MPH; Glynnis McDonnell, Ph.D., Aimee Hildenbrand, Ph.D., Melissa Alderfer, Ph.D., CorinnaSchultz, M.D.); The Children’s Hospital of Philadelphia (Lamia Barakat, Ph.D.; Nancy KassamAdams, Ph.D.); Cincinnati Children’s Hospital Medical Center (Ahna Pai, Ph.D.); University ofPennsylvania (Janet Deatrick, Ph.D., FAAN). We appreciate the helpful feedback provided byDarlene Barkman and Kerry Doyle-Shannon. General inquires may be sent to Dr. Kazak(anne.kazak@nemours.org).2 CPTS has several COVID-19 related resources for patients, families and healthcare providers urces/covid19.html 2020 The Center for Pediatric Traumatic Stress4/22/20

Family NumberCaregiver 1 Caregiver 2Gender: M F OToday’s DateCOVID-19 Exposure and Family Impact Survey (CEFIS)Please tell us about your family’s experiences during the novel Coronavirus (COVID-19)pandemic. In answering these questions, please think about what has happened from March2020 to the present, due to COVID-19. By family we mean people who live in your household,extended family, and close friends who you consider “like family.”Part 1. Please answer Yes or No for each of the following statements.1. We had a “stay at home” order Yes No2. Our schools / child care centers were closed Yes No3. Our child/ren’s education was disrupted Yes No4. We were unable to visit or care for a family member Yes No5. Our family lived separately for health, safety or job demands Yes No6. Someone moved into (or back into) our home Yes No7. We had to move out of our home Yes No8. Someone in the family kept working outside the home (essential personnel) Yes No9. Someone in the family is a healthcare provider/first responder providing direct care Yes No10. We had difficulty getting food Yes No11. We had difficulty getting medicine Yes No12. We had difficulty getting health care when we needed it Yes No13. We had difficulty getting other essentials Yes No (if Yes, specify)14. We self-quarantined due to travel or possible exposure Yes No15. Our family income decreased Yes No16. A member of the family had to cut back hours at work Yes No17. A member of the family was required to stop working (expect to be called back) Yes No 2020 The Center for Pediatric Traumatic Stress4/22/20

18. A member of the family lost their job permanently Yes No19. We lost health insurance/benefits Yes No20. We missed an important family event or it was canceled (e.g., wedding, graduation, birth,funeral, travel [including vacation], other) Yes No21. Someone in the family was exposed to someone with COVID-19 Yes NoWho (e.g. myself, my child, my spouse, my parent, etc)22. Someone in the family had symptoms or was diagnosed with COVID-19 Yes NoWho23. Someone in the family was hospitalized for COVID-19 Yes NoWho24. Someone in the family was in the Intensive Care Unit (ICU) for COVID-19 Yes NoWho25. Someone in the family died from COVID-19 Yes NoWhoPart 2. COVID-19 may have many impacts on you and your family life. In general, how has theCOVID-19 pandemic affected each of the following?26. Parenting1Made it alot better2Made it alittle better3Made it alittle worse4Made it alot worse NotApplicable4Made it alot worse NotApplicable27. How family members get along with each other1Made it alot better2Made it alittle better3Made it alittle worse28. Ability to care for your child with [add illness/condition]1Made it alot better2Made it alittle better3Made it alittle worse 2020 The Center for Pediatric Traumatic Stress4Made it alot worse NotApplicable4/22/20

29. Ability to care for other children in your family1Made it alot better2Made it alittle better3Made it alittle worse4Made it alot worse NotApplicable30. Ability to care for older adults or people with disabilities in your family1Made it alot better2Made it alittle better3Made it alittle worse4Made it alot worse NotApplicable3Made it alittle worse4Made it alot worse NotApplicable3Made it alittle worse4Made it alot worse NotApplicable3Made it alittle worse4Made it alot worse NotApplicable3Made it alittle worse4Made it alot worse NotApplicable3Made it alittle worse4Made it alot worse NotApplicable31. Your physical wellbeing – exercise1Made it alot better2Made it alittle better32. Your physical wellbeing - eating12Made it aMade it alot betterlittle better33. Your physical wellbeing – sleeping1Made it alot better2Made it alittle better34. Your emotional wellbeing – anxiety1Made it alot better2Made it alittle better35. Your emotional wellbeing – mood1Made it alot better2Made it alittle better 2020 The Center for Pediatric Traumatic Stress4/22/20

36. Overall, how much distress have you experienced related to COVID-19?12NoDistress345678910ExtremeDistress37. In general, across all your children, how much distress have your children experiencedrelated to COVID-19?12345678910NoExtremeDistressDistressPart 3. Please tell us about other effects of COVID-19 on your child/ren and your family, bothnegative and/or positive. 2020 The Center for Pediatric Traumatic Stress4/22/20

Various aspects of the COVID epidemic are likely to impact families and may influence the findings of research in pediatric health. CEFIS was designed to be used in ongoing and new studies where COVID-19 may influence study outcomes. It conceptualizes exposure to potentially traumatic aspects of COVID-19 and assesses the impact of the pandemic .

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