2017 MSM PRC Community Health Needs & Assets Assessment Survey

Transcription

1 2017 MSM PRC Cmmunity Health Needs & Assets Assessment Survey The Mrehuse Schl f Medicine Preventin Research Center is cnducting a Cmmunity Health Needs and Assets Assessment. As a neighbrhd resident f Neighbrhd Planning Units (NPUs) T, V, X, Y, and Z, yur pinin abut the health cncerns and resurces in yur cmmunity is imprtant t us. The infrmatin yu give will help us develp health prmtin prgrams and imprve preventin educatin services that can benefit yu and yur family. Please take fifteen minutes f yur time right nw t cmplete this survey. Remember, there are n right r wrng answers and the infrmatin yu prvide will nt be used t identify yu. Please tell us what yu think. Befre we begin have yu cmpleted this survey already? t Sure 1 Which cmmunity d yu live in? (Check One) Adair Park High Pint Suth River Gardens Amal Heights Jyland Summerhill Ashview Heights Just Us Sylvan Hills Atlanta University Center Lakewd Lakewd Heights The Villages at Carver Betmar La Villa Blair Villa/ Ple Creek Leila Valley Mechanicsville Nrwd Manr The Villages at Castleberry Hill Thmasville Heights Brwns Mill Park Orchard Knb West End Capitl Gateway Peplestwn Westview Capitl View Capitl View Manr Chsewd Park Perkersn Pittsburgh Plar Rck Other (Please Specify) Glenrse Heights Rebel Valley Frest Dn't Knw Hammnd Park Rsedale Heights Harris Chiles Suth Atlanta

2 2 What Neighbrhd Planning Unit (NPU) d yu live in? T V X Y Z Other (Please Specify) Dn't Knw 3 What is yur zip cde? WE WOULD LIKE TO HEAR MORE ABOUT HEALTH CONCERNS IN YOUR COMMUNITY. 4 What are the tp three health issues my cmmunity needs t knw mre abut? (Rank nly three health issues by writing a 1 in the bx next t the first pririty, the secnd pririty 2, and the third pririty 3 ). My cmmunity needs t knw mre abut: Asthma Cancer Diabetes Envirnmental Health (e.g., air pllutin, landfills, litter) Heart Disease High Bld Pressure HIV/AIDS Men s Health Mental Health Nutritin Obesity Physical Disability Secnd-r Third-hand smke Sexually Transmitted Diseases r Infectins (e.g., Chlamydia, Herpes, Gnrrhea, Syphilis ) Strke Substance Abuse Teen Pregnancy Vilence Preventin Wmen s Health Other (Please List) Ranking 2

3 5 Fr each f yur tp three chices, please tell us why the health issues yu chse are imprtant. 6 What d yu think are the causes f the health issues/cncerns yu identified? 7 What d yu think shuld be dne t slve these health issues/cncerns? 8 Please rank the tp three health issues yu wuld like t learn mre abut fr yurself. (Rank nly three health issues by writing a 1 in the bx next t the first pririty, the secnd pririty 2, and the third pririty 3 ). Fr my OWN health, I want t learn mre abut: Asthma Cancer Diabetes Envirnmental Health Heart Disease High Bld Pressure HIV/AIDS Men s Health Mental Health Nutritin Obesity Physical Disability Secnd- r Thirdhand smke Sexually Transmitted Diseases r Infectins Strke Substance Abuse Teen Pregnancy Vilence Preventin Wmen s Health Other (Please List) Ranking 3

4 9 Fr each f yur tp three chices, please tell us why the health issues yu chse are imprtant fr yu. 10 What are the tp three plicy, system, r envirnmental issues that need t be addressed in my cmmunity t imprve health? (Rank nly three issues by writing a 1 in the bx next t the first pririty, the secnd pririty 2, and the third pririty 3 ). Fr my COMMUNITY, I want the fllwing t be addressed: Access t Health Insurance Access t Healthy Fds Access t the Internet/Technlgy Access t Physical Activity Access t Quality Healthcare Services Child Care Emplyment Health Educatin Husing Mental Health Treatment Pverty Public Educatin System Racism Sexism Substance Abuse Transprtatin Yuth Emplyment Yuth Engagement (e.g., Recreatin Centers) Other (Please List) Ranking 11 Fr each f yur tp three chices, please tell us why the plicy, system r envirnmental issues yu chse are imprtant. 4

5 NOW, WE WOULD LIKE TO KNOW WHAT HEALTH PROGRAMS AND SERVICES ARE AVAILABLE TO YOU 12 Are there any health prgrams in yur cmmunity (e.g. walking clubs, weight lss prgrams)? (Please List) Dn t knw 13 Have yu attended any health prgrams in yur cmmunity? (Please List) 14 The Mrehuse Schl f Medicine Preventin Research Center has a number f cmmunity health prgrams fr cmmunity members. We wuld like yur input n hw t let peple knw abut these prgrams. Where d yu think the tp three places are t invite cmmunity members t hear abut these prgrams? (Please Select 3 Chices) Churches Cmmunity Events Daycare Centers Health Clinics Neighbrhd Businesses Neighbrhd Centers (Please specify name) Neighbrhd Meetings Public Assistance Office Rental Offices Schl Meetings Other (Please List) 15 D yu have health insurance? (Skip t questin 18) 16 If s, what? (Check all that apply) Insurance thrugh a current r frmer emplyer r unin Insurance purchased directly frm an insurance cmpany Medicare, fr peple 65 and lder, r peple with certain disabilities Medicaid, Medical Assistance, r any kind f gvernment-assistance plan fr thse with lw incmes r a disability TRICARE r ther military health care VA (including thse wh have ever used r enrlled fr VA health care) Indian Health Service Grady Health card Any ther type f health insurance r health cverage plan nt listed (Please List) 17 If ther, is yur health insurance public r private? Public Private 5

6 18 D yu have supplemental insurance (i.e., additinal insurance that pays directly t the insured such as AFLAC)? 19 D yu have a primary care dctr? 20 D yu participate in any f the fllwing activities t prevent pr health? Eat healthy fds Exercise daily n a regular basis Receive annual flu sht See the dentist fr rutine dental exams See the dctr fr annual physical exams Take a daily multivitamin r mineral supplement Take children t receive scheduled shts (immunizatin) Other (Please list) 21 D yu primarily seek health care in an emergency rm? 22 Where d yu usually get health care? (Check all that apply) Grady Memrial Hspital Gd Samaritan Lakewd Health Center (Lakewd Avenue) Suth Fultn Medical Center (Carver High Schl Campus) Suth Fultn Medical Center (Cleveland Avenue) Suthside Medical Center (Ridge Avenue) Atlanta Medical Piedmnt Private physician (Please List Lcatin) Urgent Care (Please List Lcatin) Veterans Administratin Hspital (VA) where, hme remedies nly Other (Please List) 23 Hw ften d yu usually get health care at the lcatin(s) abve? Annually Mnthly Quarterly Weekly Other (Please specify): 6

7 24 What services/resurces are available in yur cmmunity? (Check all that apply) Cmmunity clinic Cunseling Services Hme health Hspital Private clinic Urgent Care YMCA (r ther cmmunity center) Other (Please List) NOW, WE WOULD LIKE TO KNOW THE BEST WAY TO SHARE HEALTH SERVICE AND RESOURCE INFORMATION WITH YOU 25 What are the three best ways t share health infrmatin with yu? Please rank yur tp three chices (Write "1" next t the chice that is the best, 2 the secnd best, and 3 the third best way). Attend Church Events Attend Cmmunity Events E-News Bulletin/E-Health Cards Facebk Flyers Health Clinics Health Fairs Instagram Internet Lcal Newspapers Neighbrhd Meetings Phne Psters Radi Prgrams Schl Meetings Televisin Prgrams Twitter Wrd f Muth Other (Please List) Ranking 26 Please share any ther ideas r cmments abut health cncerns fr yu and yur cmmunity. 7

8 NOW, WE WOULD LIKE TO KNOW ABOUT MORE ABOUT YOU 27 What is yur age? (Check One) years years years years years 65 years r lder 28 What is yur gender? Male Female Transgender 29 Are yu Hispanic r Latin? 30 What d yu cnsider yur race t be? (Check all that apply) American Indian r Alaskan Native Asian Black/African-American Native-Hawaiian r Other Pacific Islander White Other (Please Specify) 31 Nw thinking abut yur physical health, which includes physical illness and injury, fr hw many days during the past 30 days was yur physical health nt gd? 32 Nw thinking abut yur mental health, which includes stress, depressin, and prblems with emtins, fr hw many days during the past 30 days was yur mental health nt gd? 8

9 33 D yu have a substance use issue? 34 What Neighbrhd Planning Unit (NPU) d yu wrk in? T V X Y Z Other (Please Specify) Dn't Knw 35 What is yur ttal family husehld incme in a year? Under $10,000 $10,001-$25,000 $25,001-$40,000 $40,001-$55,000 $55,001-$75,000 $75,001-$100,000 Over $100,000 I prefer nt t disclse my incme. 36 Please indicate yur marital status. Single, Never Married Infrmally Married r Living with a Permanent Partner Married Divrced Widwed I prefer nt t disclse this infrmatin. 37 Please indicate yur sexual rientatin. Bisexual Gay Hetersexual Lesbian Other (please specify) I prefer nt t disclse this infrmatin. 9

10 38 Please tell us mre abut the children in yur husehld (please check all that apply). Reside with children under 6 years ld Reside with children 6 t 17 years ld children under 18 years ld in the husehld. I prefer nt t disclse this infrmatin. 39 Please indicate yur husehld size. 1-persn husehld 2-persn husehld 3-persn husehld 4-persn husehld 5-persn husehld 6-persn husehld 7-r-mre-persn husehld I prefer nt t disclse this infrmatin. THANK YOU FOR TAKING TIME TO COMPLETE THIS SURVEY! If yu have any questins r cncerns, please cntact the Mrehuse Schl f Medicine Preventin Research Center (MSM PRC) at Mrehuse Schl f Medicine Preventin Research Center. (2017). Cmmunity health needs and assets assessment. [Survey] 10