Community Health Needs Assessment (CHNA) & Community Health Improvement Plan (CHIP) Feedback Survey

Question Title

* 1. Please select the group that best describes your role:

MCDPH staff

County partner agency

Healthcare organization / hospital partner

Nonprofit / faith-based organization

Community volunteer / resident

City or County leadership (Board of Supervisors, City Council, etc.)

Other (please specify)

Question Title

* 2. How involved have you been in the CHNA/CHIP process?

Very involved (attended multiple meetings, contributed to data collection or strategy)

Somewhat involved (attended a meeting or provided feedback once)

Aware but not directly involved

Not aware until now

Question Title

* 3. How effectively did MCDPH communicate the purpose and goals of the CHNA/CHIP process?

Very effectively

Somewhat effectively

Not effectively

Not sure

Question Title

* 4. Where did you hear about the CHNA/CHIP process? (Select all that apply)

Press release or local news article

MCDPH Facebook or social media post

City Council or Board of Health presentation

Partner meeting or coalition

Word of mouth

All of the above

Other (please specify)

Question Title

* 5. How clear and timely were the updates provided throughout the process?

Very clear and timely

Somewhat clear and timely

Not really clear or timely

Did not receive updates

Question Title

* 6. How well did the CHNA/CHIP process represent diverse voices and communities?

Really well

Not sure

Needs improvement

Question Title

* 7. Did you read the final CHNA/CHIP reports?

Yes

If not, please share why you didn't read it.

Question Title

* 8. Which outreach methods were most effective? (Select all that apply)

In-person events (health fairs, community meetings)

Online survey or QR code

Paper survey at Libraries

Mobile Health Unit visits

Partner or coalition meetings

All of the above

Other (please specify)

Question Title

* 9. Were there barriers that prevented participation (i.e., technology, timing, location, language)?

Not sure

Yes / Please describe:

Question Title

* 10. The CHNA/CHIP process encouraged collaboration between MCDPH and community partners.

Strongly Agree

N/A

Strongly Disagree

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 11. The process allowed my organization or community group to have meaningful input in identifying priorities or strategies.

Strongly Agree

N/A

Strongly Disagree

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 12. MCDPH was responsive to partner and community feedback during the CHNA/CHIP process.

Excellent

Good

Fair

Poor

Question Title

* 13. Based on what you’ve seen or heard, how likely is it that the CHNA/CHIP process will lead to tangible improvements in community health?

Very likely

Not Sure

Not likely

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 14. What worked well about this CHNA/CHIP cycle that should continue next time?

Question Title

* 15. What could be improved in the next CHNA/CHIP cycle?

Question Title

* 16. Please share any additional thoughts, success stories, or observations.

Question Title

* 17. Which city or area do you primarily live or work in?

Kingman

Bullhead City

Lake Havasu City

Golden Valley

Colorado City

Other (please specify)

Question Title

* 18. Which best describes your age group?

Youth (under 18)

Adult (18–64)

Older adult (65+)

Prefer not to say

Question Title

* 19. How do you prefer to receive updates from MCDPH? (Select all that apply)

Email newsletter

Social media posts

Partner meetings

County website

My email address is: