Success Stories for Ending Health Disparities Survey

Thank you for being willing to share your CAA's success in addressing health disparities. We are currently collecting success stories that we can utilize in an upcoming application to the Robert Wood Johnson Foundation, specifically for their Awards for Health Equity program. While there a only a few awards given, the Community Action Network aligns very well with the criteria. To submit a strong application, we need success stories from the field.

As you know, we often need CAA success stories for other purposes and would like to use the information you submit here in other ways such as publications, eNews articles, speeches, meetings with funders, and on social media to share the impact of Community Action. We seek your permission as part of this collection tool to use the information in this way.

Please note that the answers will need to be short given the space in our grant application.

If you have any questions, please contact Denise Harlow at dharlow@communityactionpartnership.com.

Thank you!

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* 1. Provide examples of success in you work to change systems that impact health outcomes in one or more of the following areas: access to quality care, education, employment, income, community environment, housing, and public safety. Please be specific and limit your response to 250 words.

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* 2. Describe how your CAA's work has resulted in improved outcomes for those most affected by health disparities. Please be specific and limit your response to 250 words.

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* 3. The Partnership has permission to use this information and your organization's name in the 2016 RWJF Grant application noted above.

Yes

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* 4. Please check those other areas in which the Partnership has permission to use the information.

Social Media

Reports

Website

Other grant applications

Public Presentations

Information sharing with funders

Information sharing with policy makers

The Partnership only has permission to use this information for the grant application noted above.

Other (please specify)

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* 5. Contact Information

Name *

Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address for Contact *

Phone Number *

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* 6. Is your organization a:

Private, Nonprofit CAA

Public CAA

State Association

Don't Know

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* 7. Which best describes the community your organization serves? (check all that apply)

Rural

Urban

Suburban

Statewide

Single county

Multiple counites

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* 8. Which best describes your CAA's overall agency budget size?

Less than $3 million

$3 million-$5 million

$5 million-$10 million

$10 million-$20 million

$20 million-$30 million

$30 million-$50 million

More than $50 million

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* 9. Does your organization operate a Head Start Program?

Yes

Don't know

Success Stories for Ending Health Disparities

Introduction

Question Title

* 1. Provide examples of success in you work to change systems that impact health outcomes in one or more of the following areas: access to quality care, education, employment, income, community environment, housing, and public safety. Please be specific and limit your response to 250 words.

Question Title

* 2. Describe how your CAA's work has resulted in improved outcomes for those most affected by health disparities. Please be specific and limit your response to 250 words.

Question Title

* 3. The Partnership has permission to use this information and your organization's name in the 2016 RWJF Grant application noted above.

Question Title

* 4. Please check those other areas in which the Partnership has permission to use the information.

Question Title

* 5. Contact Information

Question Title

* 6. Is your organization a:

Question Title

* 7. Which best describes the community your organization serves? (check all that apply)

Question Title

* 8. Which best describes your CAA's overall agency budget size?

Question Title

* 9. Does your organization operate a Head Start Program?

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* 10. Are there other examples of success that do not fit above that you would like to share for us to have on file?