2019 CHNA Community Input Survey Materials

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Survey Materials

Link to Online Survey: http://bit.ly/AHECommunitySurvey

English Paper Survey

English Paper Survey with Polish specified under racial and ethnic group question

Spanish Paper Survey

Ukrainian Paper Survey

Polish Paper Survey

Chinese Paper Survey

Survey Flyer for Print

QR Code Flyer for Print

Using the QR Code for Androids and iPhones

Survey Purpose and Timeline

The Alliance for Health Equity is focusing on gathering input from populations with key insights on health equity needs that might otherwise be under-represented in needs assessments such as communities of color, immigrants, LGBTQ individuals, etc. The input received will help the Alliance for Health Equity decide which types of projects it will work on to improve community health. The survey is for respondents 18 and over.

Survey Dissemination Tips

Online Survey

We are trying to collect as many surveys ONLINE as possible to be more efficient with our time and move to data analysis faster.

  • For laptop and tablet use, bookmark the link to the survey to easily start a new survey.
    • IPHI has two tablets available to lend out for survey collection events, please contact Andi to coordinate.
  • When using a QR code, iPhones and Androids have different capabilities. Here is a how-to for assisting respondents in using the QR code.
  • If there is difficulty with the QR code, the link to the survey is short and easy to type out in a browser bar (http://bit.ly/AHECommunitySurvey).
  • If you are distributing the survey in an area where you know there will be little to no internet access, IPHI is able to provide an offline link to collect responses and directions on how to use the link.
    • Note: The link requires a day to generate, please reach out in advance to request an offline survey link.
Paper Survey
  • When sharing the paper survey with partner organizations, a few of the Alliance for Health Equity members have advice to make collecting responses easier on the organization:
    • Print out the surveys to reduce the amount of organizational resources needed to distribute the survey.
    • Drop the surveys off to the organization or bring them to a meeting you both will attend.
    • Offer a collection box for the completed surveys as to not clutter the organization’s area.
    • Offer to collect completed surveys or supply the organization with materials to send the completed surveys.
Dissemination Techniques
  • Send online survey link out in newsletters
  • Offer the survey in waiting rooms for health clinics and physician offices
  • Share survey with community advisory boards and community coalitions
  • Distribute survey at community events (i.e. health fairs, block parties, and holiday events)
  • Leverage volunteer groups to disseminate the survey in their communities
Marketing and Media
  • Dissemination Language:
    • Your voice matters! Take a short survey today to tell us about the health of your community: http://bit.ly/AHECommunitySurvey
    • Help create a plan to improve community health by taking this survey: http://bit.ly/AHECommunitySurvey
    • Our organization is working with the Alliance for Health Equity to understand what communities need to be healthy. We need your input: http://bit.ly/AHECommunitySurvey
    • We are trying to understand what communities in Chicago and Suburban Cook County need to be healthy. An important part of understanding community health needs is gathering feedback from community residents especially those who aren’t always included in surveys like communities of color, immigrants, LGBTQ individuals, etc. Your input will help the Alliance for Health Equity decide which types of projects it works on to improve community health. The information that we collect will be available to the public in early summer 2019 at allhealthequity.org
    • The Alliance for Health Equity is a group of over 30 hospitals, local health departments and community organizations in Chicago and Suburban Cook County that are working together to conduct a Community Health Needs Assessment (CHNA). Your input is very important and will help create a plan to improve community health. The survey should take about 5 minutes to complete. Your responses are anonymous, and you will not be asked your name. If you have any questions about the survey, please contact Andi Goodall at Andi.Goodall@iphionline.org or (312) 850-4744. More information about the CHNA process is available online at www.allhealthequity.org
  • We encourage Alliance partners to take photos and post them to their social media pages to spread knowledge of the survey. If you have any photos and would like to share them with IPHI, please send the photos to Andi by email.

IPHI staff is available to assist with survey dissemination for an event. We request that you share information about location, time, and space when requesting IPHI staff attendance. Due to capacity, IPHI staff will only be able to attend one event per hospital.

For any questions about the Community Input survey, please contact Andi Goodall at Andi.Goodall@iphionline.org

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