Communities of Color Interest Form

Cystic fibrosis affects many people of different racial and ethnic backgrounds; however, we recognize that there has been a lack of adequate representation of Black, Hispanic, Asian, Middle Eastern, and other people of color within the CF community. In alignment with the CF Foundation's pledge to listen, learn, and act against racism and discrimination, the Community Voice team would like to better understand the needs of the people of color within the CF community.

It is our goal to develop a diverse and inclusive CF community that promotes equity. Community Voice would like to provide minority populations in this community with adequate and meaningful resources as well as a platform to hear from diverse voices. As a part of this group, members will have the opportunity to share their unique insights and participate in various projects across all topics, specifically those related to racial justice, diversity, inclusion, and equity.

Goals for this Opt-In List:

Identifying and addressing barriers to engagement for communities of color within the CF community
Developing a strategy to increase diversity in external/internal facing CF Foundation committees, boards, and workgroups
Improving information specific to people of color with CF
Increasing the engagement of communities of color within the CF community in CF research projects

We do not know what’s important to the entire CF community unless we hear from everyone affected by CF.

By filling out this survey, you agree to have your responses and your Community Voice profile read by the community voice team. If you have any questions or concerns, please contact communityvoice@cff.org.

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* 1. First Name

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* 2. Last Name

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* 3. Primary Email Address

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* 4. Phone Number

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* 5. Which of the following options apply to you?
Please select all that apply.

I am personally living with cystic fibrosis

I am the parent of someone living with cystic fibrosis

I am a caregiver of someone living with cystic fibrosis

I am the spouse/partner of someone living with cystic fibrosis

I have an immediate family member living with cystic fibrosis

I have lost a loved one to cystic fibrosis

None of these

Other connection not listed above (please specify)

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* 6. What is your racial or ethnic identity? (Select all that apply.)

African-American/Black

East Asian

Hispanic/Latinx

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Southeast Asian

White

None of the above, please specify...

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* 7. How much do you agree or disagree with the following statements?

	Strongly Agree	Somewhat Agree	Neither Agree nor Disagree	Somewhat Disagree	Strongly Disagree
It is important to me to have a voice in the CF community	It is important to me to have a voice in the CF community Strongly Agree	It is important to me to have a voice in the CF community Somewhat Agree	It is important to me to have a voice in the CF community Neither Agree nor Disagree	It is important to me to have a voice in the CF community Somewhat Disagree	It is important to me to have a voice in the CF community Strongly Disagree
I currently feel included in the CF community	I currently feel included in the CF community Strongly Agree	I currently feel included in the CF community Somewhat Agree	I currently feel included in the CF community Neither Agree nor Disagree	I currently feel included in the CF community Somewhat Disagree	I currently feel included in the CF community Strongly Disagree
I currently feel included in CF research	I currently feel included in CF research Strongly Agree	I currently feel included in CF research Somewhat Agree	I currently feel included in CF research Neither Agree nor Disagree	I currently feel included in CF research Somewhat Disagree	I currently feel included in CF research Strongly Disagree

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* 8. Which formats would you be comfortable discussing race/ethnicity and CF?
Select all that apply

Participating in Focus Groups with other CF community members

Participating in one-on-one interviews with CF Foundation staff

Participating in surveys

Speaking publicly about your personal experiences.

Sharing your personal experiences via blog posts, quotes, etc.

Participating via offline formats (i.e email only)

Serving on committees or working groups with other community members, researchers and/or CF Foundation staff

Comment

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* 9. What should the CF Foundation be aware of when working to better engage and meet the needs of your community? Do you have any ideas on how we can better address the needs of your community?

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* 10. Are you interested in learning more about the CF Foundation's external plans for addressing racial justice?

Yes

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* 1. First Name

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* 2. Last Name

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* 3. Primary Email Address

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* 4. Phone Number

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* 5. Which of the following options apply to you?Please select all that apply.

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* 6. What is your racial or ethnic identity? (Select all that apply.)

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* 7. How much do you agree or disagree with the following statements?

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* 8. Which formats would you be comfortable discussing race/ethnicity and CF? Select all that apply

Question Title

* 9. What should the CF Foundation be aware of when working to better engage and meet the needs of your community? Do you have any ideas on how we can better address the needs of your community?

Question Title

* 10. Are you interested in learning more about the CF Foundation's external plans for addressing racial justice?

* 5. Which of the following options apply to you?
Please select all that apply.

* 8. Which formats would you be comfortable discussing race/ethnicity and CF?
Select all that apply