Community Health Worker Policy Webinar Audience Feedback Survey

1. CHW Webinar: Audience Feedback Survey

Thank you for attending the CHW Best Practices Webinar on July 14, 2010, hosted by the CEED@chicago coalition. As we strive for excellence, we value your honest opinion and feedback. Please take a few minutes (approx 5 min.) to complete the brief survey that follows.

Thanks again!

Your colleagues at CEED

1. How satisfied were you with the overall quality of this Webinar?

How satisfied were you with the overall quality of this Webinar? Highly Satisfied

Satisfied

Unsatisfied

2. How would you rate the information presented during this Webinar?

How would you rate the information presented during this Webinar? Exceeded Expectations

As Expected

Below Expectations

3. Are you based in Illinois?

Are you based in Illinois? Yes

If not, please list your State

4. If you showed this Webinar to a group of people, how many people watched the Webinar at your site? Please enter a number (individual viewers can skip this question):

If you showed this Webinar to a group of people, how many people watched the Webinar at your site? Please enter a number (individual viewers can skip this question):

5. How could we improve this Webinar?

How could we improve this Webinar?

6. Does your organization employ or utilize CHWs? Are you a CHW?

Does your organization employ or utilize CHWs? Are you a CHW? YES, my organization employs CHWs; and YES, I am a CHW

YES, my organization employs CHWs; but NO, I am not a CHW

NO, my organization doesn't employ CHWs; but YES, I am a CHW

NO, my organization doesn't employ CHWs; and NO, I'm not a CHW

7. How are your CHW activities funded?

How are your CHW activities funded? Grants

Medicaid reimbursement

Foundation Awards(eg Keiser Foundation)

N/A

Other (please specify)

8. If CEED were to host a CHW Webinar series, which topics would most interest you? Please rank the topics in the order you find most interesting/useful.

	1st	2nd	3rd	4th	5th
Lessons from Ohio, Massachusetts, and Maryland	*If CEED were to host a CHW Webinar series, which topics would most interest you? Please rank the topics in the order you find most interesting/useful. Lessons from Ohio, Massachusetts, and Maryland 1st	Lessons from Ohio, Massachusetts, and Maryland 2nd	Lessons from Ohio, Massachusetts, and Maryland 3rd	Lessons from Ohio, Massachusetts, and Maryland 4th	Lessons from Ohio, Massachusetts, and Maryland 5th
Community Health Worker perspectives on policy & practice	Community Health Worker perspectives on policy & practice 1st	Community Health Worker perspectives on policy & practice 2nd	Community Health Worker perspectives on policy & practice 3rd	Community Health Worker perspectives on policy & practice 4th	Community Health Worker perspectives on policy & practice 5th
Passing CHW Medicaid reimbursement legislation: what will it take?	Passing CHW Medicaid reimbursement legislation: what will it take? 1st	Passing CHW Medicaid reimbursement legislation: what will it take? 2nd	Passing CHW Medicaid reimbursement legislation: what will it take? 3rd	Passing CHW Medicaid reimbursement legislation: what will it take? 4th	Passing CHW Medicaid reimbursement legislation: what will it take? 5th
CHW Cost effectiveness/benefit	CHW Cost effectiveness/benefit 1st	CHW Cost effectiveness/benefit 2nd	CHW Cost effectiveness/benefit 3rd	CHW Cost effectiveness/benefit 4th	CHW Cost effectiveness/benefit 5th
Best practices for CHWs in hospital and clinical settings	Best practices for CHWs in hospital and clinical settings 1st	Best practices for CHWs in hospital and clinical settings 2nd	Best practices for CHWs in hospital and clinical settings 3rd	Best practices for CHWs in hospital and clinical settings 4th	Best practices for CHWs in hospital and clinical settings 5th

Other suggestions (please specify)

9. Are you interested in working with CEED@Chicago's CHW subcommittee to address policies that develop and sustain CHWs?

Are you interested in working with CEED@Chicago's CHW subcommittee to address policies that develop and sustain CHWs? YES, I'm interested in CHW policy efforts in Illinois

YES, I'm interested in National CHW policy efforts

NO, sorry, I'm not interested

10. If you answered YES to the question above, or if you'd like to join the CEED coalition, please provide your information below and a member of the CEED team will contact you soon. Thanks!

If you answered YES to the question above, or if you'd like to join the CEED coalition, please provide your information below and a member of the CEED team will contact you soon. Thanks! Name:
Company:
City/Town:
State:
Email Address:
Phone Number:

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