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Thank you in advance for participating in this Communities Needs Survey. Your responses help us understand how we can best support the behavioral health and well-being of all the children, youth, and families living in our local rural communities.

Families in rural communities can sometimes face barriers in accessing services their families need to be healthy, happy, and well. Kutztown Strong wants to hear and understand your family's needs.

Please respond to the following survey questions on behalf of your family.  Your responses are completely confidential and anonymous. 

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* 1. If you would like your school social worker to contact you, please enter your phone number and/or e-mail address here. You can also provide your first name if you would like.

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* 2. Please tell us about your family.

  Strongly Disagree Disagree Neither Agree or Disagree Agree Strongly Agree
The future looks good for our family.
In our family, we take time to listen to each other.
There are things our family does that are special just to us.
Sometimes it feels like my/our child(ren) misbehave just to upset me/us. 
Sometimes it feels like I/we are always telling the kids(s) "no" or "stop".
I/we have frequent power struggles with the kids(s).
How I/we respond to our child(ren) depends on how I/we are feeling.
Our family has people in our life that believe in us.
Our family has people in our life who give us advice, even when it is hard to hear.
When our family is trying to work on achieving a goal, we have friends who will support us.
When our family needs someone to look after the kid(s) on short notice, we can find someone we trust.

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* 3. Our family has people we trust to ask for advice about (check all that apply):

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* 4. In which school district do you currently reside?

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* 5. In which school(s) do you currently have children enrolled?

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* 6. The following questions are about how your family experiences the community and school district where you currently reside.

  Strongly Disagree Disagree Neither Agree or Disagree Agree Strongly Agree
Our family feels like our community understands us.
Our family feels like our school district understands us.
When our family is trying to achieve positive change, we feel supported by our community.
When our family is trying to achieve positive change, we feel supported by our school district. 
When our family talks to people in our community about a problem we are encountering, we feel heard and understood.
When our family talks to people in our school district about a problem we are encountering, we feel heard and understood.

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* 7. Sometimes it's hard for families to afford everything they need. For the following questions, please check all the apply.

In the past month, was your family unable to pay for:

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* 8. In the past year, has your family:

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* 9. Our family has trouble affording what we need each month.

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* 10. Our family is able to afford the food we want to feed our family.

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* 11. Please tell us about your household. In total, how many people live in your household?

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* 12. How many in your household are . . .

  0 1 2 3 4 5 6 7 8 more than 8
children under the age of 18?
children 18 and over?
fulfilling the role of parent?
fulfilling the role of grandparent?
fulfilling the role of aunt or uncle?
fulfilling the role of niece or nephew?
not yet of age to begin school?
attending elementary school?
attending middle school?
attending high school?
attending college or trade school?
over 18 and NOT attending college or trade school?

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* 13. Household Demographic Information.

How do you identify?

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* 14. What is your age (in years)

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* 15. What is the primary language spoken in your home?

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* 16. What races/ethnicities are most representative of your household?
Please check all that apply.

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* 17. What is your relationship status?

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* 18. What is your family's housing status?

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* 19. Total Household Income

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* 20. What is your highest level of education?

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* 21. What is the highest level of education in your household?

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* 22. Which of the following (if any) do you or your family currently recieve?
Please check all that apply.

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* 23. The pandemic has been difficult for many households.
Please tell us about your family's health.

  0 1 2 3 4 5 6 7 8 more than 8
How many adults (age 18 or over) are currently experiencing good or excellent physical health?
How many adults (age 18 or over) are currently experiencing fair or poor physical health?
How many adults (age 18 or over) are currently experiencing good or excellent mental health?
How many adults (age 18 or over are currently experiencing fair or poor mental health?
How many children (age 18 or under) are currently experiencing good or excellent physical health?
How many children (age 18 or under) are currently experiencing fair or poor physical health?
How many children (age 18 or under) are currently experiencing good or excellent mental health?
How many children (age 18 or under) are currently experiencing fair or poor mental health?

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* 24. Please tells us about the areas in your family's life that are difficult.

  a little difficult somewhat difficult moderately difficult very difficult extremely difficulty N/A
Financial Management
Accessing out of school or after school programs
Accessing behavioral or mental health counseling/services
Accessing parks and recreation
Accessing housing in safe, crime free neighborhoods
Accessing child care
Accessing dental care
Accessing transportation
Accessing physical health care
Accessing assistance with rent our housing
Securing food and nutrition
Securing employment
Accessing senior services or elderly concerns
Acquiring education or job training skills
Acquiring accurate information, counsel, or services for legal concerns
Acquiring accurate information, counsel, or services for Immigration concerns
Acquiring accurate information, counsel, or services for drug/alcohol concerns

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* 25. Which of the following service agencies in your area are you familiar with?

  Do not know of them Heard of them Used their services in past 12 months Used service in past 5 years N/A
Brandywine Heights Community Task Force
Concern
Fleetwood Food Pantry
Friend, Inc.
Kutztown Community Partnership
Kutztown Strong
Manna Food Pantry
Meals on Wheels/Berks Encore
Oasis Afterschool Program
Pre-K Counts
Topton Community Food Pantry
VFW/American Legion
YMCA
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