100 Million Healthier Lives Member Survey Question Title * 1. I represent (mark all that apply): Myself An organization (school, business, nonprofit, faith-based organization, etc) A community A federal or municipal agency A network Other (please specify) Question Title * 2. I am engaged in 100 Million Healthier Lives as a (mark all that apply): Leadership Team Hub Council Hub member 100 Million Healthier Lives Member SCALE community member Pathway to Pacesetter community member Health Equity & Prosperity Assembly attendee Other (please specify) Question Title * 3. How long have you been engaged with 100 Million Healthier Lives? 0-6 months 7-12 months >1 year Question Title * 4. How would you rate the value of being part of 100 Million Healthier Lives for you? Changing my life, really amazing Really good, makes my work so much better OK, pretty good Not helpful Terrible Question Title * 5. Where are you finding real value in 100 Million Healthier Lives so far? (Mark all that apply) Relationships and connections across the movement Hope, inspiration, motivation Feeling like I am not alone, that I’m part of a movement Learning about and/or connecting with the bright spots – places and programs that are showing how to make it work and getting outcomes! Access to capacity building supports (SCALE, Pathway to Pacesetters) Core principles, ways of leading (leading from within, leading together, leading for outcomes, leading for equity) Access to technology tools and support (Measure What Matters, Map of the Movement, Website, Bright Spot library, etc) The opportunity to innovate with others on complex problems Other (please specify) Question Title * 6. How many meaningful connections have you made as a result of 100mlives? 0 1-5 6-10 11-15 >15 Other (please specify) Question Title * 7. How many new collaborations have you formed as a result of 100 Million Healthier Lives? 0 1-3 4-6 7-10 >10 Other (please specify) Question Title * 8. How do you receive information and updates about 100mlives? (Mark all that apply) Newsletter Social Media (Twitter, Facebook, LinkedIn, HealthDoers) 1:1 Email Word of mouth Website Momentum Calls Other (please specify) Question Title * 9. What 100 Million Healthier Lives supports do you use to accelerate your work in improving health, wellbeing and equity? (Mark all that apply) Measure What Matters Platform Bright Spot/Improvement Library Momentum Calls Map of the Movement Ways of Being Leadership Framework Social Media Website Other (please specify) Question Title * 10. My suggestions for improving 100 Million Healthier Lives are: Question Title * 11. I would like to be more involved by: (please put your name below) Becoming a member Becoming a champion, getting other people or groups involved Improving health, wellbeing, and equity in my life, organization, community or network Getting our work on the measurement platform, bright spot library, etc Connecting with local funders or sponsors Other (please specify) Question Title * 12. Optional Name (optional) Organization (if any) Email (optional) Question Title * 13. I attended the 2016 100 Million Healthier Lives Fall Gathering Yes No Question Title * 14. I would rate the Fall Gathering as (please feel free to add details in the comment box) Outstanding Very good OK Not great Terrible Other (please specify) Done