Call for Collaboration - Living with a Life-limiting Illness: Access to Care and Related Experiences (CC-LLLI-ACRE)

Organization Information (PRE) - Question identifier:PRE_R01

Thank you for taking the time to answer a few questions about how you could help Statistics Canada in our efforts to gather new data about palliative care through an upcoming initiative called Living with a Life-Limiting Illness: Access to Care and Related Experiences.

The purpose of this initiative, to be launched in the fall of 2024, is to provide national data on the care experiences of individuals with life-limiting illnesses and their unpaid caregivers, as well as their access to care and support services.

We would appreciate your collaboration to encourage participation in this initiative by helping us reach out to people living with a serious illness and their caregivers and sharing a link to the questionnaire when the study is launched.

By "serious illness" we are referring to life-limiting illnesses, diseases or conditions that cannot be cured and will ultimately shorten a person's life.

Organization Information (PRE) - Question identifier:PRE_R05

The following questions will help us gain a better understanding of the clients your organization serves and how your help might increase participation in the study.

Organization Information (PRE) - Question identifier:PRE_Q05

How would you describe your organization?

• 01: Hospital
• 02: Hospice
• 03: Disease Treatment Centre
• 04: Long-Term Care Facility
• 05: Community Organization
• 06: Palliative Care Organization
• 07: Other
• 08: No connection to those who are living with a serious illness or those who care for them

Organization Information (PRE) - Question identifier:PRE_Q10

How is your organization willing to help promote and share our initiative on experiences and access to care for those living with a serious illness and their caregivers?

All necessary content for the promotional activities mentioned below will be provided by Statistics Canada.

Note: Press the help button (?) for additional information.

Select all that apply.

• 1: Send a dedicated email about the questionnaire to clients or patients
• 2: Distribute invitation cards directly to clients or patients
• 3: Include promotional material in an electronic newsletter
• 4: Post promotional material on your website
• 5: Post promotional material on a bulletin board
• 6: Other
• 7: My organization is not able to help

Organization Information (PRE) - Question identifier:PRE_Q15A

How many clients do you usually serve in a month?

Number of clients

Min = 0; Max = 999999

Note: Press the help button (?) for additional information.

Organization Information (PRE) - Question identifier:PRE_Q15B

How many clients do you usually serve in a month?

Note: Press the help button (?) for additional information.

• 9: DK

Organization Information (PRE) - Question identifier:PRE_Q25

Who can you help us contact?

Note: Press the help button (?) for additional information.

Select all that apply.

• 1: Adults with a serious illness
• 2: Children 15 years old and above with a serious illness
• 3: Children less than 15 years old with a serious illness
• 4: Unpaid caregivers for someone (adult or child) with a serious illness
• 5: Families of those with a serious illness
• 6: Other

Organization Information (PRE) - Question identifier:PRE_R30

We will provide your organization with promotional materials, such as an email template, invitation cards, posters, a handout, and social media content.

Organization Information (PRE) - Question identifier:PRE_Q30

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
First name

Long Answer Length = 25

Organization Information (PRE) - Question identifier:PRE_Q35

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Last name

Long Answer Length = 30

Organization Information (PRE) - Question identifier:PRE_Q40

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Organization

Long Answer Length = 80

Organization Information (PRE) - Question identifier:PRE_Q45

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Job Title

Long Answer Length = 80

Organization Information (PRE) - Question identifier:PRE_Q50

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Email

Long Answer Length = 254

Example: user@example.gov.ca

Organization Information (PRE) - Question identifier:PRE_Q55

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Telephone number (including area code)

Long Answer Length = 10

Example: 123-123-1234

Organization Information (PRE) - Question identifier:PRE_Q60

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Street or address

Long Answer Length = 60

Example: 999, 1st avenue

Organization Information (PRE) - Question identifier:PRE_Q65

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
City

Long Answer Length = 60

Example : Ottawa

Organization Information (PRE) - Question identifier:PRE_Q70

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Province or territory

• 10: Newfoundland and Labrador
• 11: Prince Edward Island
• 12: Nova Scotia
• 13: New Brunswick
• 24: Quebec
• 35: Ontario
• 46: Manitoba
• 47: Saskatchewan
• 48: Alberta
• 59: British Columbia
• 60: Yukon
• 61: Northwest Territories
• 62: Nunavut

Organization Information (PRE) - Question identifier:PRE_Q75

Who is the primary contact we should follow up with when the questionnaire is ready to be launched?
Postal code

Long Answer Length = 6

Example : A9A 9A9

Organization Information (PRE) - Question identifier:PRE_Q80

Would you like to receive an email notification when the results of this initiative are published?

• 1: Yes
• 2: No

Organization Information (PRE) - Question identifier:PRE_R85

Thank you for taking the time to answer our questions.