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RURAL HEALTH IMPROVEMENT ASSESSMENT SURVEY

You are invited to participate in a survey conducted by the Ohio Rural Health Association (ORHA). The purpose of this survey is to better understand maternal health, diabetes care, access to care, workforce challenges, and community health needs across rural Ohio.

Your participation in this survey is completely voluntary. You may choose not to participate or may stop at any time without penalty. Not all questions will pertain to everyone completing survey. We understand this. Please answer the questions that do pertain to you. You may select N/A on those that do not pertain to you.

If you agree to participate, you will complete a survey that will take approximately 15–20 minutes to complete.

There are minimal risks associated with participation in this survey. Some questions may ask about community challenges or healthcare access, which may cause minor discomfort.

There are no direct benefits to you. However, your responses will help inform the Ohio Rural Health Improvement Plan (2026–2030) and may contribute to improvements in rural healthcare services and policies.

Your responses will be kept confidential. Data will be reported in aggregate form only, and no identifying information will be shared. Any data collected will be stored securely and accessed only by authorized personnel. You will be able to optionally include your information in order to be selected as a gift card winner.

If you have questions about this survey, please contact:
Ohio Rural Health Association at executivedirector@ohioruralhealth.org


If you complete the survey, and provide your contact information, you will be entered into a raffle for a $10 Amazon gift card. Ten gift card winners will be randomly selected.
1.I agree
Respondent & Community Context
2.Which best describes your role?
3.Which setting best reflects your primary practice environment?
4.How would you describe your community?
5.Please list the county that you work in: _________live in:________
Community Conditions & Social Determinants
6.Which community conditions most impact health in your area? (Please select all that apply)
7.How significant is internet access as a barrier to healthcare?
Maternal Health
8.Does your community have local access to obstetric services?
9.What is the travel time (one way) for maternal care?
10.Which barriers to maternal care does your community experience? (Please select all that apply)
11.In your role, how frequently do you see maternal complications?
12.What is your confidence managing maternal emergencies?
13.What are common maternal complications you observe at your organization? (Please select all that apply).
14.When do complications most often occur in your patient population?
15.Which postpartum challenges are experienced by your patients? (Please select all that apply.)
16.How frequently do your patients use the emergency department/urgent care during postpartum?
Behavioral Health & Chronic Disease
17.What are the most urgent health issues in your region?
18.How would you rate your community’s behavioral health services?
Diabetes Access & Management
19.How significant is diabetes as a health concern in your community?
20.What challenges exist for diabetes management in your community? (Please select all that apply)
21.How would you rate the availability of diabetes education or diabetes management programs in your community?
22.What would most improve diabetes outcomes in your community? (Please select all that apply)
Disability Access & Inclusion Survey Section
23.How would you describe the prevalence of individuals with disabilities in your community in comparison to the rest of the state of Ohio?
24.What types of disabilities are most common in your community? (Please select all that apply)
25.How accessible are healthcare services for individuals with disabilities in your community?
26.How accessible is your community for individuals with disabilities?
27.In your community, what barriers do individuals with disabilities face when accessing healthcare? (Please select all that apply)
28.What level of disability competency (caring for individuals with disabilities) do healthcare professionals in your community have?
29.Which of the following accommodations for disabilities are commonly available when needed? (Please select all that apply)
30.How often do individuals with disabilities experience delays in receiving care in your community?
31.What services are most lacking for individuals with disabilities in your community? (Select all that apply
32.How well are individuals with disabilities connected to support services in your community?
33.What strategies would most improve healthcare access for individuals with disabilities? (Select all that apply)
34.How should disability access be prioritized in the Ohio Rural Health Improvement Plan?
Access to Care
35.Are there enough healthcare services in your county
36.For your healthcare, where do you go first for health care?
37.Please select the services you have used in past 12 months for your own healthcare
38.Travel distance to care (one way)
39.Travel time to care (one way)
40.In the past 12 months, were you unable to get care when needed?
41.Wait time for appointment (days): __________
42.How significant is workforce availability as a barrier to access to care in your community
43.What workforce challenges are most present in your community? (Select all that apply)
44.Which healthcare roles are most difficult to recruit in your community? (Select all that apply)
45.How long does it typically take to fill open healthcare positions in your community?
46.How do workforce shortages impact patient care in your community? (Select all that apply)
47.How adequate is the current healthcare workforce to meet community needs?
48.What strategies would most improve workforce capacity in your community? (Select all that apply)
49.How important is it to prioritize rural healthcare workforce development in the future
50.Is there anything else you would like to share?
51.Enter your Name and contact Information (optional)