Heroin Community Toolkit Evaluation Question Title * 1. In which county do you primarily work? County Please select one answer. If you work in multiple counties, please select the county which serves as your primary workplace. Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jackson Purchase Jefferson Jessamine Johnson Kenton Knott Knox LaRue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon Madison Magoffin Marion Marshall Martin Mason McCracken McCreary McLean Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer State Level Sites Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford Please select one answer. If you work in multiple counties, please select the county which serves as your primary workplace. County menu Question Title * 2. In what type of community do you live? City or urban community Suburban community Rural community Other (please specify) Question Title * 3. How strong is the sense of community in this neighborhood? Extremely strong Quite strong Moderately strong Slightly strong Not at all strong Question Title * 4. What is your primary job field? Job Position Appointed or Elected Official Appointed or Elected Official Job Position Attorney Attorney Job Position Corrections Corrections Job Position Educator Educator Job Position Judiciary Judiciary Job Position Legislator Legislator Job Position Medical Practitioner Medical Practitioner Job Position Mental Health worker Mental Health worker Job Position Pharmacist Pharmacist Job Position Public Health worker Public Health worker Job Position Substance Abuse Treatment Provider Substance Abuse Treatment Provider Job Position Substance Abuse Preventionist Substance Abuse Preventionist Job Position Other (please specify) Question Title * 5. What role do you play in local substance abuse prevention and treatment efforts in your community? I am a full time preventionist. I am a full time treatment provider I do not work in prevention or treatment full-time but it is part of my job duties I am involved with a local coalition or group that focuses on substance abuse prevention and treatment. I am not currently involved with any prevention or treatment efforts in my community. Other (please specify) Question Title * 6. What job fields represent the leaders in your local coalition efforts? Please mark all that apply Appointed or Elected Official Attorney Corrections Educator Judiciary Legislator Medical Practitioner Mental Health worker Pharmacist Public Health worker Substance Abuse Treatment Provider Substance Abuse Preventionist I do not know who the leaders are in my local coalition Other (please specify) Question Title * 7. Do you know if your community is currently focusing efforts on heroin or other opiate addiction? Yes No Not yet but there are plans to begin focusing some of our efforts in that direction Question Title * 8. Are you concerned about heroin in your community at this time? Yes No Not yet, but because of what's happening in other regions I do have concerns about the future Question Title * 9. Where did you first come in contact with/hear about the opiate toolkit? Received a hard copy in the mail A colleague received a hard copy and shared the contents with me A colleague received an electronic copy and shared the contents with me Accessed the materials via the KSPAN website Other (please specify) Question Title * 10. What piece(s) of the toolkit do you anticipate using within the next 12 months? Please select all that apply: "There is LIGHT even in the darkest places" pocket resource card template - reprint for local distribution Overdose facts pocket card templates - reprint for local distribution Overdose facts poster templates - reprint for local distribution Opiate guide booklet - for personal reference only Opiate guide booklet - reprint for local distribution I'm not sure yet - we're still doing needs assessment and planning I do not plan to use any pieces of the toolkit Other (please specify) Question Title * 11. Which of the following would you like to see more focus on/efforts to improve in Kentucky? Please select all that apply. Decreasing rates of substance abuse/addiction Decreasing overdose deaths More outreach and education around unsafe syringe practices among IV drug users Improving the public misperception about addiction and the related stigma Expanding legislation that supports the availability and use of Narcan (naloxone) to law enforcement and first responders Expanding legislation that supports availability and use of Narcan (naloxone) to the general public Improving channels of communication to connect treatment providers with those who need treatment Better funding for prevention-intervention-treatment infrastructure Other (please specify) Question Title * 12. How likely are you to recommend the use of the heroin toolkit to others? Extremely likely Very likely Moderately likely Slightly likely Not at all likely Comments Question Title * 13. What changes would most improve our heroin toolkit? Question Title * 14. Is there anything else that you'd like to share about your local prevention efforts or about your concerns regarding heroin/opiate addiction? Done