Community Health Planning and Policy Development (CHPPD) Section Priorities Survey

Please take five minutes to answer these questions candidly. The information you provide will be used to identify and match section members’ interests and expertise with action plans for this 2010 year and upcoming years. Thanks in advance for your time and contributions.

Question Title

1. Which of the following CHPPD Section Policy Priorities would you be willing to work on with a team because of your interest or expertise? (Select up to three)

	1	2	3
Built Communities	Built Communities 1	Built Communities 2	Built Communities 3
Community Health Improvement	Community Health Improvement 1	Community Health Improvement 2	Community Health Improvement 3
Community-Based Participatory Research	Community-Based Participatory Research 1	Community-Based Participatory Research 2	Community-Based Participatory Research 3
Data Systems/Geographic Information Systems	Data Systems/Geographic Information Systems 1	Data Systems/Geographic Information Systems 2	Data Systems/Geographic Information Systems 3
Health Equity	Health Equity 1	Health Equity 2	Health Equity 3
Health Information Technology	Health Information Technology 1	Health Information Technology 2	Health Information Technology 3
Health Reform/Quality of Health Care/Certificate of Need	Health Reform/Quality of Health Care/Certificate of Need 1	Health Reform/Quality of Health Care/Certificate of Need 2	Health Reform/Quality of Health Care/Certificate of Need 3
Social Determinants of Health	Social Determinants of Health 1	Social Determinants of Health 2	Social Determinants of Health 3
Vitamin D Education and Research	Vitamin D Education and Research 1	Vitamin D Education and Research 2	Vitamin D Education and Research 3

Other (please specify)

Question Title

2. Which of the following topics (identified at the March 16 CHPPD Section Conference call) would you be MOST willing to work on in 2010? Please select only one choice.

Be part of the CHPPD Section Rapid Response Team who provides written comments on specific federal regulations (e.g. Healthy People 2010, Obesity Task Force, Health Reform etc)

Organize a learning institute sessionon how GIS can be used for policy development and planning

Organize a session or write a proposed policy on how to evaluate planning efforts

Plan and facilitate one business meeting on the topic of "community sustainability"

Write an APHA proposed policy or organize an invited session on menu labeling,

Write an APHA proposed policy or organize an invited session on Social justice/Social determinants of health (power, poverty, education, etc.)

Write an APHA proposed policy or organize an invited session on zoning

Write an APHA proposed policy or organize an invited session related to obesity prevention

Write an APHA proposed policy or organize an invited session related to smoke free laws

Other (please specify)

Question Title

3. Which of the following activities are you most inclined to work on because of your interest or expertise? (Select up to three)

	1	2	3
Contributing to the newsletter	Contributing to the newsletter 1	Contributing to the newsletter 2	Contributing to the newsletter 3
Coordinating a webinar	Coordinating a webinar 1	Coordinating a webinar 2	Coordinating a webinar 3
Coordinating an oral presentation/poster session for the annual meeting	Coordinating an oral presentation/poster session for the annual meeting 1	Coordinating an oral presentation/poster session for the annual meeting 2	Coordinating an oral presentation/poster session for the annual meeting 3
Developing a policy statement	Developing a policy statement 1	Developing a policy statement 2	Developing a policy statement 3
Developing and evaluating an advocacy network	Developing and evaluating an advocacy network 1	Developing and evaluating an advocacy network 2	Developing and evaluating an advocacy network 3
Helping to maintain the website	Helping to maintain the website 1	Helping to maintain the website 2	Helping to maintain the website 3
Raising funds for specific projects	Raising funds for specific projects 1	Raising funds for specific projects 2	Raising funds for specific projects 3
Serving a leadership role	Serving a leadership role 1	Serving a leadership role 2	Serving a leadership role 3

Other (please specify)

Question Title

4. If in the US, which region do you work in? If you are not from one of the US states, please identify your country.

Region I: CT, ME, MA, NH, RI, VT

Region II: NJ, NY, Puerto Rico, Virgin Islands

Region III: DE, MD, PA, VA, WV, Washington DC

Region IV: AL, FL, GA, KY, MS, NC, SC, TN

Region V: IL, IN, MI, MN, OH, WI

Region VI: AR, LA, NM, TX, OK

Region VII: IA, KS, MO, NE

Region VIII: CO, MT, ND, SD, UT, WY

Region IX: AZ, CA, HI, NV (American Samoa, Guam, Northern Mariana Islands, Trust Territory of the Pacific Islands)

Region X: AK, ID, OR, WA

Country outside the United States

Country (please specify)

Question Title

5. What is your primary role in community health(Choose one)?

Administrator

Advocate

Consultant

Educator

Outreach coordinator

Philanthropist

Planner

Policy Developer

Regulator

Researcher

Student

Other (please specify)

Question Title

6. How long have you been affiliated with the CHPPD Section?

This is my first year

More than one year, but less than five years

5 - 10 years

More than 10 years

Question Title

7. Please let us know how we can contact you.

First Name:

Last Name:

Email:

Contact Phone Number: