Healthy Yancey Community Interest Survey

Help Us To Help You and Our Communities

Healthy Yancey is collaborating with a number of other health related organizations to find out how we can help our communities. We need your help. Please take about 5 minutes and answer the following questions. Your answers are totally anonymous and you will not be contacted by anyone when you complete it.
Thank you for your time and help

Question Title

* 1. Which of the following topics would you or someone in your family like to know more about?

	Very Interested	Sort of Interested	Maybe Interested	Not Interested
Infant or Baby Care	Infant or Baby Care Very Interested	Infant or Baby Care Sort of Interested	Infant or Baby Care Maybe Interested	Infant or Baby Care Not Interested
Being a New Parent	Being a New Parent Very Interested	Being a New Parent Sort of Interested	Being a New Parent Maybe Interested	Being a New Parent Not Interested
Personal Budgets/Finances	Personal Budgets/Finances Very Interested	Personal Budgets/Finances Sort of Interested	Personal Budgets/Finances Maybe Interested	Personal Budgets/Finances Not Interested
Mental Illness/Wellness	Mental Illness/Wellness Very Interested	Mental Illness/Wellness Sort of Interested	Mental Illness/Wellness Maybe Interested	Mental Illness/Wellness Not Interested
Physical Health and Fitness	Physical Health and Fitness Very Interested	Physical Health and Fitness Sort of Interested	Physical Health and Fitness Maybe Interested	Physical Health and Fitness Not Interested
Family Problems and Changes	Family Problems and Changes Very Interested	Family Problems and Changes Sort of Interested	Family Problems and Changes Maybe Interested	Family Problems and Changes Not Interested
Developmental Disabilties (such as Autism, Down Syndrome)	Developmental Disabilties (such as Autism, Down Syndrome) Very Interested	Developmental Disabilties (such as Autism, Down Syndrome) Sort of Interested	Developmental Disabilties (such as Autism, Down Syndrome) Maybe Interested	Developmental Disabilties (such as Autism, Down Syndrome) Not Interested
Care for Aging Adults	Care for Aging Adults Very Interested	Care for Aging Adults Sort of Interested	Care for Aging Adults Maybe Interested	Care for Aging Adults Not Interested
End of Life Care and Coping with Death	End of Life Care and Coping with Death Very Interested	End of Life Care and Coping with Death Sort of Interested	End of Life Care and Coping with Death Maybe Interested	End of Life Care and Coping with Death Not Interested
Depression	Depression Very Interested	Depression Sort of Interested	Depression Maybe Interested	Depression Not Interested
Teen Health Issues	Teen Health Issues Very Interested	Teen Health Issues Sort of Interested	Teen Health Issues Maybe Interested	Teen Health Issues Not Interested
Cancer Care	Cancer Care Very Interested	Cancer Care Sort of Interested	Cancer Care Maybe Interested	Cancer Care Not Interested
Other Personal or Family Needs	Other Personal or Family Needs Very Interested	Other Personal or Family Needs Sort of Interested	Other Personal or Family Needs Maybe Interested	Other Personal or Family Needs Not Interested
Women's Health Issues	Women's Health Issues Very Interested	Women's Health Issues Sort of Interested	Women's Health Issues Maybe Interested	Women's Health Issues Not Interested

Other (please specify)

Question Title

* 2. How would you most like to receive additional information regarding these topics?

E-mail

Brochure in the Mail

On a Website

Meeting at a Community Center, Library or School

Meeting at a Church

Other ways

How else would you like to get information on these topics?

Question Title

* 3. How do you usually find out about events, activities or resources in your community?

	Most Often Way	Some of the Time	Least Likely Way	Hardly Ever if at All
Local Radio	Local Radio Most Often Way	Local Radio Some of the Time	Local Radio Least Likely Way	Local Radio Hardly Ever if at All
Local Radio Website	Local Radio Website Most Often Way	Local Radio Website Some of the Time	Local Radio Website Least Likely Way	Local Radio Website Hardly Ever if at All
Community Cable Channel	Community Cable Channel Most Often Way	Community Cable Channel Some of the Time	Community Cable Channel Least Likely Way	Community Cable Channel Hardly Ever if at All
Local Newspaper	Local Newspaper Most Often Way	Local Newspaper Some of the Time	Local Newspaper Least Likely Way	Local Newspaper Hardly Ever if at All
Local Newspaper Website	Local Newspaper Website Most Often Way	Local Newspaper Website Some of the Time	Local Newspaper Website Least Likely Way	Local Newspaper Website Hardly Ever if at All
Posters/Rack Cards Around Town	Posters/Rack Cards Around Town Most Often Way	Posters/Rack Cards Around Town Some of the Time	Posters/Rack Cards Around Town Least Likely Way	Posters/Rack Cards Around Town Hardly Ever if at All
Letters/Flyers in the Mail	Letters/Flyers in the Mail Most Often Way	Letters/Flyers in the Mail Some of the Time	Letters/Flyers in the Mail Least Likely Way	Letters/Flyers in the Mail Hardly Ever if at All
Other Internet Website	Other Internet Website Most Often Way	Other Internet Website Some of the Time	Other Internet Website Least Likely Way	Other Internet Website Hardly Ever if at All
School	School Most Often Way	School Some of the Time	School Least Likely Way	School Hardly Ever if at All
Church	Church Most Often Way	Church Some of the Time	Church Least Likely Way	Church Hardly Ever if at All
Friends or Relatives	Friends or Relatives Most Often Way	Friends or Relatives Some of the Time	Friends or Relatives Least Likely Way	Friends or Relatives Hardly Ever if at All
Doctor or Counselor	Doctor or Counselor Most Often Way	Doctor or Counselor Some of the Time	Doctor or Counselor Least Likely Way	Doctor or Counselor Hardly Ever if at All
Other Source	Other Source Most Often Way	Other Source Some of the Time	Other Source Least Likely Way	Other Source Hardly Ever if at All

List any other ways you get information

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* 4. If you wanted to attend an information session or support group meeting, what are some of the things that keep you from being able to attend?

Childcare

Lack of Transportation

Distance and Gas Prices

Work Schedule

Question Title

* 5. What time of day would you most likely be able to attend a meeting or information session on a topic of interest to you?

Mornings

Lunch Time

Afternoon

Late Afternoon

Evening

Weekends

Please tell us more if you have time issues

Question Title

* 6. If you would like to attend a group meeting on topics you are interested in, how much time would you be able to give to the meetings?

One Session

Weekly for a Month or So

Every Other Week for a few Months

Once a Month

Every Other Month

Depends on the Topic

Please tell us more about how you would like to attend sessions

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* 7. What are some of the things that you enjoy most about your community?

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* 8. What are some of the things that you would like to change in your community?

If you don't mind, please tell us a little more about you.

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* 9. What is Age

Teen

20-25

26-30

31-40

41-50

51-60

61-70

71-80

80+

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* 10. Race

White (non-Hispanic)

Black/African American

Native American

Latino/Hispanic

Other

Other (please specify)

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* 11. Gender

Male

Female

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* 12. How long have you and your family lived in Yancey County

For Generations

20+ Years

10+ Years

5-10 Years

Less than 5 Years