2022 Community Health Needs Assessment Community Survey

CHI St. Vincent is in the midst of its triannual Community Health Needs Assessment (CHNA) process. You are invited to participate in a survey that will help identify the key areas of focus for our community health improvement efforts over the next three years.  The survey consists of 20 questions and will take approximately 10 minutes to complete.  

Survey results are shared in aggregate form in the final assessment report, and relevant quotes from your survey may be used to solidify data points. However, information that could reveal your individual identity will not be shared in association with any data points or quotes included in the final report. 

Thank you for taking the time to complete this survey! 
1.When you are sick or have a concern about your health, where do you most often go for help? (Please select only one option).
2.Thinking of the location you selected above, how far from your home do you typically travel to get there?
3.How often do you get medical "checkups" or physical exams (including mammograms, Pap smears, colonoscopies, prostate screenings, etc.)? (Please select only one option)
4.Thinking back over 12 months before COVID-19 hit (before April 2020), how often did you face the following situations?
Never
Rarely
Sometimes
Often
Always
Not applicable
Put off seeing a doctor for medical concerns?
Go without recommended tests for a medical concern?
Go without recommended treatments for a medical concern?
Go without a prescription or without needed medications?
5.In the 12 months since COVID-19 hit (April 2020 - present), how often did you face the following situations?
Never
Rarely
Sometimes
Often
Always
Not applicable
Put off seeing a doctor for medical concerns?
Go without recommended tests for a medical concern?
Go without recommended treatments for a medical concern?
Go without a prescription or without needed medications?
6.As a result of COVID-19, are you or people in your household currently having any of the problems listed below? (Please select all that apply)
Every community’s health needs are impacted by several socio-economic, physical, environmental, and medical factors. Think about the community you live in. In order to better understand which of the following factors have the greatest impact on your community, please rate its magnitude of impact using the following scale. Please select only one option for each factor.

“Strongly disagree this is an issue”, “Disagree this is an issue” “Neutral or Not applicable”, “Agree this is an issue”, and “Strongly agree this is an issue".
7.Which of the following socioeconomic factors have the greatest impact on the community?(Required.)
Strongly disagree this is an issue
Disagree this is an issue
Neutral
Agree this is an issue
Strongly agree this is an issue
Lack of access to and education about prenatal care
Lack of access to affordable childcare
Lack of access to appropriate mental health services and resources
Lack of substance addiction recovery programs
Lack of before- and after-school activities for students
Lack of summer lunch programs for youth
Lack of services for seniors such as adult daycare
Lack of home-health services for seniors
Lack of access to healthy food
Lack of access to exercise and other physical activities
Lack of access to affordable/safe housing
Limited household income/presence of poverty
Presence of domestic violence/trauma
Presence of child abuse/neglect
8.Which of the following physical environment factors have the greatest impact on quality of life?(Required.)
Strongly disagree this is an issue
Disagree this is an issue
Neutral
Agree this is an issue
Strongly agree this is an issue
Poor air quality
Poor water quality
Unsafe neighborhoods
Food insecurity
Limited means of transportation
Inadequate housing
Unaffordable living or housing costs
9.What are the biggest health issues in the community?(Required.)
Strongly disagree this is an issue
Disagree this is an issue
Neutral
Agree this is an issue
Strongly agree this is an issue
Infant health and/or mortality
Adolescent health
Asthma/Breathing problems
Cancer
Dental care
Diabetes
High blood pressure
Heart disease
Hepatitis C
HIV/AIDS
Mental Health (Depression, Counseling, etc.)
Obesity
Sexually Transmitted Diseases (STDs)
Smoking/Vaping/Tobacco Use
Substance abuse (alcohol, drugs)
Teen pregnancy
10.Which of the following factors are potential barriers that impact accessing or receiving health care services in the community?(Required.)
Strongly disagree this is an issue
Disagree this is an issue
Neutral
Agree this is an issue
Strongly agree this is an issue
Lack of access to primary care and/or preventive services
Lack of access to preventive health education or information
Lack of access to specialty care
Under-supply of providers in community
Lack of available providers (that accept new patients)
Lack of insurance
High costs of care (copay, deductible, etc.)
Language barriers between provider and patient
Patient does not have a primary care doctor and/or does not understand the benefit of seeing a provider
Patient does not know where to go for different medical services
Patient could not find time due to other responsibilities (job, childcare, etc.)
Patient could not get an appointment
Patient does not have reliable transportation to medical appointments
Patient does not trust the provider and/or local health system
Patient does not like going to a doctor
11.Which of the following population groups would you consider to be the most vulnerable in your community? (Please select your top three choices).(Required.)
12.To the extent of your knowledge, are there any programs or community organizations that currently help mitigate the negative impacts of these various detrimental factors? Please list program or organization names.
13.Are there any other areas of concerns surrounding community needs that have not been addressed in this survey? (Please explain).
The following questions capture some personal information purely for understanding the demographic makeup of the community. 
14.Please indicate which of the following best represents your community affiliation. (Please choose only one option).(Required.)
15.Please type in your primary county of residence.(Required.)
16.Please type in your primary zipcode of residence.(Required.)
17.How long have you lived in your current residence/county?(Required.)
18.What is your age?(Required.)
19.How would you describe the gender you identify with?(Required.)
20.Are you of Hispanic, Latino or Spanish origin(Required.)
21.How would you describe the race you identify with?
Current Progress,
0 of 21 answered