Community Health Workers

Exit Survey

In the last year have you or a family member used the services provided by a community health worker?

No

Yes

What type of service was provided?

Education on how to effectively self-manage a health condition

Service coordination for referral

Navigate the health and human services system

Provide Direct Services

How did you assess the current Community Health Worker?

Community Health Clinic

Home visit

Hospital

Primary Care Provider

Was the care you received culturally appropriate?

Yes

No

Somewhat

Did the health care worker provide you with accessible health education and information?

Yes

No

Somewhat

How much time did the health care worker spend with you?

30 minutes

45 minutes

1 hour

Greater than 1 hour

Did the health care worker develop and maintain a relationship with you during the visit?

Yes

No

Somewhat

How would you describe the health care worker's attitude?

Where there any problems associated with linguistic or cultural differences?

Yes

No

Communication aids were provided

Interpreter present

Do you believe that the health care worker acts as an advocate on your behalf in communicating your health concerns and needs to your health care provider?

Yes

No

Somewhat limited