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  2. 2011
  3. February
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  5. Outreach Council Survey
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Hello:
You are invited to participate in the Kansas Health Institute survey of Outreach Council members. This survey will help us learn more about Medicaid/Healthwave enrollment outreach in Kansas, as part our work as contracted evaluators. Approximately 45 people will be asked to complete this survey that asks questions about your role and how the Outreach Council functions. It will take approximately 15 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn about your experience as an Outreach Council member.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Emily Meissen-Sebelius, at the Kansas Health Institute at 785-233-5443, or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
First, we would like to ask you a few demographic questions.



Gender.
What is your sex?
 
Male
 
Female
 
 
 
Age. In what year were you born?
   
 
 
 
Ethnicity.
Which of the following categories best describes your ethnicity?
 
Hispanic or Latino
 
Not Hispanic or Latino
 
 
 
Race.
Which of the following categories best describes your race?
 
Black or African American
 
Asian
 
Native Hawaiian or other Pacific Islander
 
American Indian or Alaskan Native
 
White
 
Other
 
 
 
Education.
Which of the following best describes the highest level of education you have completed?
 
Doctorate degree (for example: PhD, EdD)
 
Professional degree (for example: MD, DDS, DVM, LLB, JD)
 
Master's degree (for example: MA, MS, MEng, MEd, MSW, MBA)
 
Bachelor's degree (for example: BA, AB, BS)
 
Associate degree (for example: AA, AS)
 
High school graduate for example: GED)
 
No schooling completed
 
Other
 
 
Next are some general questions.


What is your profession?

 
Health Care
 
Social Services
 
Public Health
 
Public Service
 
Retail
 
Service Industry
 
Other
 
 
 
How many months have you been serving on the Outreach Council?

 
< 3
 
3-5
 
6-11
 
12 or more
 
 
How many years have you lived in this community?

 
< 5
 
5-9
 
10-14
 
15-19
 
20 or more
 
 
Section 3. Outreach Council and Members Roles and Functions.
Strongly agree Somewhat agree Neutral Somewhat disagree Strongly disagree No opinion
The purpose of the Outreach Council is clear.
I value the purpose of the Council.
I understand my role.
As a Council member, I recieve adequate guidance from the outreach worker
 
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