New Hope Baptist Church | Alter Activities Assessment Question Title * 1. Has memory loss or dementia affected you and/or a family member? Yes No Question Title * 2. If you selected yes to question 1, does the family member affected by memory loss or dementia attend New Hope Baptist Church? Yes No Question Title * 3. Are you and/or your family member interested in receiving Brain Health education? Yes No Question Title * 4. Are you and/or your family member interested in joining a dementia or caregiver support group? Yes No Question Title * 5. If interested in a dementia or caregiver support group, how often would you want meet? Weekly Biweekly Quarterly Annually Monthly Question Title * 6. Would you like to join the Health & Wellness Ministry to help serve those affected by dementia? Yes No Question Title * 7. What dementia-friendly initiatives do you think would be helpful for families affected by dementia? Select your top 3 choices o Develop a dementia and/or caregiving support group o Build a resource library online (i.e., Website) or within the church building o Develop a program to provide caregivers with a break o Adopt memory Sunday initiative to raise community awareness o Offer a simulated dementia experience session annually o Host a brain health education event to include youth & larger community o A quiet room within the church for participants to relax and/or watch service o Shorten length of worship service o Leadership training on supporting those with memory loss (e.g. Deacons, Ushers, Greeters and Ministerial Staff) o Modify order of worship service (I.e., Praise & worship, Prayer, Sermon, announcements) o Physical assistance in and out of building Question Title * 8. Of the suggestions, what is the preferred method to receive the educationalresources and communications about events? New Hope Baptist Church Website o New Hope Baptist Church\Social Media Pages (e.g. Facebook, Instagram) o Printed Handouts/Materials o Mailings o In Person (e.g., Resource library) Question Title * 9. Select the answer choice that best describes your knowledge about brain health? No knowledge of brain health or dementia o Little knowledge of brain health or dementia o Somewhat knowledgeable of brain health or dementia o Knowledgeable of brain health or dementia o Very knowledgeable of brain health or dementia Question Title * 10. If currently not attending New Hope, would implementing these activitiesencourage you and/or your family to attend New Hope? Yes No Done