Dear Community Member,

 

Your local hospital has asked the Center for Public Health Practice and Research (CPHPR) to conduct a Community Health Needs Assessment. This Center is within the Jiann Ping Hsu College of Public Health, Georgia Southern University. Your say is vital for this study. So, we are inviting you to complete this survey. The survey should take about 45 minutes to complete.

 

Your participation in this survey is voluntary. You must be 18 years old or older and you will not receive any financial or other payment.  Please note that the hospital will not have access to your actual responses. Your privacy will be guaranteed. All data will be held in a safe file by the lead investigator at Georgia Southern University. The data will be destroyed 3 years after this project is completed. All responses will be reported in a combined form, and no individual information will be reported. Your participation in this study will have no unfavorable effect on you or your relationship with the hospital. We also do not expect you suffer any discomfort or risk as a result of your participation in this study. However, if you do, you may stop participating at any time you wish.

 

If you have any questions or worries about this work, please contact Dr. Samuel Opoku. His telephone number is (912) 478-6985. This work is approved by the Georgia Southern University Institutional Review Board (H19028). If you have questions about your rights as a participant, you can call Georgia Southern University Office of Research Services Sponsored Programs at 912-478-5465.

 

Title of Work:  Community Health Needs Assessment

 

Investigators:   Bettye Apenteng, PO Box 8015, 8x2416 bapenteng@georgiasouthern.edu,

                          Samuel Opoku, PO Box 8015, 8x 6985, sopoku@georgiasouthern.edu,

                          Linda Kimsey, PO Box 8015, 8x 2008, lkimsey@georgiasouthern.edu

                          Charles Owens, PO Box 8015, (229)-322-8290, cowens@georgiasouthern.edu.

 

 

 

 

Completing this survey means you agree to participate in this work.

 

 

 

Thank you for participating 

 

For each statement below, check the box that best describes how you feel about your community:
 
 
 
 
 
 
 
 
In your opinion, what issues affect the quality of life in your community (Select all that apply).
What is the biggest substance abuse problem in this community? (Select all that apply)
Please check the box that best describes how you feel about health care in your community.
 
 
 
 
 
 
 
 
 
 
 
 
In your opinion, what are the causes of illness and death in this community? (Select all that apply)
In your opinion, what are the factors that negatively influence health and disease in your community as a whole? (Select all that apply)
In your opinion, what are the factors that influence health and diseases in children in your community? (Select all that apply)