HOPE Health & Wellness:Parent Needs Assessments SY 22-23

Health Needs Survey SY 23

Thank you completing the SY 22-23 Parent Survey. This brief survey will ask for information and your opinions about the health needs of children who attend HOPE Elementary School and their families. Your answers will help us plan, so that our work is most suited to this community. Your input will also help us learn the best ways to deliver health services at our clinic, located at the school. This survey will take about 10 minutes to complete.

If your child attends this school, you may complete the survey. If you have any questions about the survey or would like information about the results, please feel free to contact Sheila Harmon at 312-996-4656. A full report will be sent to the Principal and to the Local School Council. Again thank you for taking this survey.

Please answer each question by checking the box next to your answer. There are no right or wrong answers to any question. This information is confidential: your name and your child's name will not be included in your answers.

Question Title

* 1. In your family, how often does your child see a doctor or nurse for a CHECK-UP? (Check the one that applies)

One time each year

Several times a year

Every other year

When my child is going into a grade, where a check-up is required

Not very often

Never

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* 2. If you answered "Not very often, or never", what are the reasons that your child does not see a doctor or nurse? (Check all the answers that apply)

We don't have a regular doctor or nurse practitioner

I don't know where to go for a check-up

It's too costly to go, for only a check-up

I can't find a clinic that accepts my insurance

I don't have insurance for this

Our clinic or doctor is too far away

I don't have transportation

I don't think it's necessary to go every year

I take my child when he or she is sick

I don't like the doctors or nurses in my area (not friendly, long wait; etc.)

This doesn't apply to me

Anything else?

Question Title

* 3. Usually, how many times a year do you take your child for a medical appointment, sick or well? (Please check only one answer)

Once a year for an annual check-up

Only when my child is sick

Often due to a chronic medical problem (asthma, diabetes, sickle cell, etc.)

I can't find a clinic that accepts my insurance

Question Title

* 4. When you take your child for a healthcare appointment, how far d you have to travel to get there?

Not very far (within blocks or walking distance)

Moderately far (I have a short ride to get there)

Far (it takes me a while to get there and I may take more than one mode of transportation)

Very far (It takes a long time to get there)

Question Title

* 5. If your child needs medical care on a WEEKDAY between the hours of 9a-5p, where you would go? (Check the one you most frequently use)

My doctor's office

My community clinic, where I see anyone who is available

The school health center at my school

A clinic located at the hospital

An urgent care clinic or walk in clinic

An emergency room

A drugstore clinic (Walgreens, CVS)

Anywhere else?

Question Title

* 6. Do you worry about any of the following things related to getting medical care for your child? (Check all that apply)

Clinic hour are not good for me

Cost

Difficult to get an appointment

Don't have a regular doctor

Don't like the place that we go

Don't want my child to miss school

Don't want to miss work

Insurance concerns

Long wait times

Too far away

Uncaring/unfriendly environment

Question Title

* 7. In your opinion, what are some of the strengths, qualities or characteristics of your child or children?

Good at being friends

Smart

Good at dancing

Good at problem solving

Hard working

Good at sports

Good at music

Good at art

Kind

Organized

Honest

Creative

Leadership

Other (please specify)

Question Title

* 8. Does your child have any of the following illnesses or conditions? (Check all that apply)

Asthma

Allergies

Behavior problems

Cavities/Problems with teeth

Colds

Diabetes

Ear aches/infections

Feel afraid

Worrying alot

Feed sad alot

Hearing problems

High Blood Pressure

Lead poisoning

Learning problems

Sexually Transmitted Disease/Infection

Sick all the time

Sickle Cell

Stomach aches

Skin problems/infections

Vision problems

Question Title

* 9. Do you or your child have any of the following concerns/needs?

Alcohol Use/Abuse

Eating Disorders

Fights often

Gets hurt often

Smoking

Overweight

English is a second language

Concerned about the COVID-19 Virus

Not enough food

Needs glasses

Needs immunizations

Not enough exercise

Often feel stressed

Poor diet

Is being bullied or physically abused

Unstable housing

History of abuse or neglect

Trouble paying bills

Neighborhood feel unsafe

Parenting concerns

Often disciplined at school

Community violence

Difficulty getting a job

No reliable/lack of transportation

Family problems

Other (please specify)

Question Title

* 10. Would you be comfortable with you, or your child seeing a doctor or a nurse over the computer (over video like Facetime, Skype) where the doctor or nurse is in a different office from the clinic location?

Yes

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* 11. Has your child seen a dentist in the past 12 months?

Yes

Don't recall

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* 12. Has your child seen a specialist in the past 12 months?

Yes

Don't recall

List specialists

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* 13. Has your child or family received help from a social worker, psychologist, or other mental health professional in the past 12 months?

Yes

Don't recall

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* 14. Does your child have an IEP or 504 plan on file at the school?

Yes

Don't know or recall

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* 15. Is your child frequently absent from school for any of the following reasons

A chronic illness (asthma, diabetes, sickle cell diease, etc)

Tiredness or oversleeping

Feeling sad or unhappy with school

Fear or safety concerns

Other (please specify)

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* 16. Have you ever tried to get tested for COVID-19?

Yes (proceed to question 17)

No (proceed to question 18)

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* 17. If yes, were you able to find a convenient place to receive testing?

Yes, very convenient

Yes, somewhat convenient

Not convenient, or convenient

No, somewhat inconvenient

No, very inconvenient

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* 18. To your knowledge, do you have or have you had a positive test for COVID-19?

Yes (proceed to question 19)

No (proceed to question 20)

Don't know

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* 19. If "Yes", describe the level of care you received, or are receiving:

Did not seek medical care

Received medical care, but was not hospitalized

Was hospitalized

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* 20. Do you personally know anyone in your family, group of friends, or community networks who became seriously ill, or died as a result of COVID-10?

Yes

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* 21. Have you received a COVID-19 Vaccine?

Yes

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* 22. Do you plan on getting the COVID-19 Vaccine?

Yes

Not sure

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* 23. Did you know that you, your family members, and friends who are eligible for the COVID vaccine, can get it at the health center free of charge?

Yes

Question Title

* 24. In your own words, what do you think is the biggest problem children face in the community, where your child's school is located? This may be a health problem or any other problem that concerns you. A brief answer will be fine.

Question Title

* 25. Who does your child live with most of the time? (Check only one answer)

Parents

Grandparents

Another adult relative (i.e., sister, brother, aunt, cousin)

Friends/Classmates

Friend(s) of family

Other (please specify)

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* 26. How many of your children are enrolled in this school?

5 or more

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* 27. What are the things that you like most about your life:

My family

Neighborhood

My health

Having enough to eat

My friends

My child's school

My job

My pets

Question Title

* 28. When you have a problem, do yo have other adults that you can go to for help? (check all that apply)

Parent(s)

Other family member(s)

Teacher

Social Worker

I don't have an adult I feel like I can talk to

Other (please specify)

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* 29. What language is primarily spoke in your home?

English

Spanish

Other (please specify)

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* 30. How does your child get to school?

Walks

Bikes

Ride share services (Lyft, Uber)

Public transportation

Driven by car

Question Title

* 31. When you to take your child for a healthcare appointment, about how long do you have to wait to be seen? (Check one)

Less than 30 minutes

Between 30 minutes and 1 hour

More than 1 hour

More than 2 hours

No answer or prefer not answer

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* 32. What kind of insurance do you have for your child? (Check all that apply)

No insurance

Private HMO

I don't know

Medicaid

Other private insurance

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* 33. What kind of insurance do you have for your child? (Check all that apply)

Black

Asian

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

White

Hispanic

Prefer not to answer

Question Title

* 34. What is your Zipcode?

60612

Other (please specify)

HOPE Health & Wellness:Parent Needs Assessments SY 22-23

Health Needs Survey SY 23

Question Title

* 1. In your family, how often does your child see a doctor or nurse for a CHECK-UP? (Check the one that applies)

Question Title

* 2. If you answered "Not very often, or never", what are the reasons that your child does not see a doctor or nurse? (Check all the answers that apply)

Question Title

* 3. Usually, how many times a year do you take your child for a medical appointment, sick or well? (Please check only one answer)

Question Title

* 4. When you take your child for a healthcare appointment, how far d you have to travel to get there?

Question Title

* 5. If your child needs medical care on a WEEKDAY between the hours of 9a-5p, where you would go? (Check the one you most frequently use)

Question Title

* 6. Do you worry about any of the following things related to getting medical care for your child? (Check all that apply)

Question Title

* 7. In your opinion, what are some of the strengths, qualities or characteristics of your child or children?

Question Title

* 8. Does your child have any of the following illnesses or conditions? (Check all that apply)

Question Title

* 9. Do you or your child have any of the following concerns/needs?

Question Title

* 10. Would you be comfortable with you, or your child seeing a doctor or a nurse over the computer (over video like Facetime, Skype) where the doctor or nurse is in a different office from the clinic location?

Question Title

* 11. Has your child seen a dentist in the past 12 months?

Question Title

* 12. Has your child seen a specialist in the past 12 months?

Question Title

* 13. Has your child or family received help from a social worker, psychologist, or other mental health professional in the past 12 months?

Question Title

* 14. Does your child have an IEP or 504 plan on file at the school?

Question Title

* 15. Is your child frequently absent from school for any of the following reasons

Question Title

* 16. Have you ever tried to get tested for COVID-19?

Question Title

* 17. If yes, were you able to find a convenient place to receive testing?

Question Title

* 18. To your knowledge, do you have or have you had a positive test for COVID-19?

Question Title

* 19. If "Yes", describe the level of care you received, or are receiving:

Question Title

* 20. Do you personally know anyone in your family, group of friends, or community networks who became seriously ill, or died as a result of COVID-10?

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* 21. Have you received a COVID-19 Vaccine?

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* 22. Do you plan on getting the COVID-19 Vaccine?

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* 23. Did you know that you, your family members, and friends who are eligible for the COVID vaccine, can get it at the health center free of charge?

Question Title

* 24. In your own words, what do you think is the biggest problem children face in the community, where your child's school is located? This may be a health problem or any other problem that concerns you. A brief answer will be fine.

Question Title

* 25. Who does your child live with most of the time? (Check only one answer)

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* 26. How many of your children are enrolled in this school?

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* 27. What are the things that you like most about your life:

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* 28. When you have a problem, do yo have other adults that you can go to for help? (check all that apply)

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* 29. What language is primarily spoke in your home?

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* 30. How does your child get to school?

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* 31. When you to take your child for a healthcare appointment, about how long do you have to wait to be seen? (Check one)

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* 32. What kind of insurance do you have for your child? (Check all that apply)

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* 33. What kind of insurance do you have for your child? (Check all that apply)

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* 34. What is your Zipcode?

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* 35. Is there anything else, that you would like for us to know?