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tAdkP6i2IYPTIKZ4pNwUwT963Uk2BJTRjyXkcuX5TrxbCyB6CCbhBx9qieiCUTqrqySvfoubgyuIQDtE6X5bLwHrPSdfUwi6t687ZyVP78mDBdtJnre

The Duke Population Health Improvement Mapping Project is developing an interactive map to track and share population health improvement activities at Duke. We want to highlight the collaborative work you are conducting with local, regional, national, and international communities. The information you provide will help us better understand how Duke is working with community partners to improve the health of populations in Durham and around the world.

Thank you so much for all that you do to improve the health of our community.

Email address that all surveys for this record should be delivered to

Survey accessed date

M-D-Y

Please name the population health improvement project or program you are working on.

* must provide value

Which of the following Duke Health missions does your project align with?

* must provide value

Education

Research

Clinical/Service

Activity Type(s)

* must provide value

Care management

Clinical care

Community advisory board

Community engagement core

Community health care delivery

Community planning and engagement

Education

Informatics

Patient advisory council/board

Research

Study advisory group

Other

Please specify other activity type

* must provide value

Senior leader first name

* must provide value

Senior leader last name

* must provide value

Senior leader credentials (e.g. MD, PhD, MA, MS, etc.)

Senior leader phone number

Senior leader email

* must provide value

Please enter the Duke affiliation of the senior leader for this population health project.

Is there another senior leader of this project?

Yes No

reset

Senior leader first name

Senior leader last name

Senior leader credentials (e.g. MD, PhD, MA, MS, etc.)

Senior leader phone number

Senior leader email

Please enter the Duke affiliation of the senior leader for this population health project.

Is the senior leader the contact person for this project?

* must provide value

Yes No

reset

First name

* must provide value

Last name

* must provide value

Phone number

* must provide value

You entered the name of a person to contact but did not provide an email address or phone number.

Please provide an email address or phone number for the contact person.

Please mark all Duke schools, centers, and institutes affiliated with this project.

* must provide value

Duke Divinity School

Duke Law School

Fuqua School of Business

Nicholas School of the Environment

Pratt School of Engineering

Sanford School of Public Policy

School of Medicine

School of Nursing

Trinity College of Arts & Sciences

Other

Please enter the name of your center, institute, or department affiliation within the Duke Divinity School

Please enter the name of your center, institute, or department affiliation within the Duke Law School

Please enter the name of your center, institute, or department affiliation within the Fuqua School of Business

Please enter the name of your center, institute, or department affiliation within the Nicholas School of the Environment

Please enter the name of your center, institute, or department affiliation within the Pratt School of Engineering

Please enter the name of your center, institute, or department affiliation within the Sanford School of Public Policy

Please enter the name of your center, institute, or department affiliation within the Duke School of Medicine

Please enter the name of your center, institute, or department affiliation within the Duke School of Nursing

Please enter the name of your center, institute, or department affiliation within the Trinity College of Arts & Sciences

Please specify other Duke affiliation

* must provide value

Approximately what date did or will this project or program start?

* must provide value

M-D-Y

Approximately what date did or will this project or program end?
If the project is ongoing, meaning it has no end date, please specify below.

* must provide value

M-D-Y

This project is ongoing or has no end date.

* must provide value

Yes No

reset

How frequently is the project performed?

* must provide value

Daily

Weekly

Monthly

Quarterly

Biannually (twice a year)

Annually

Not Applicable

reset

Please provide us with a 150 word summary of the population health improvement project or program.

Here are things to consider for creating your summary:
• How does your program/project aim to improve population health?
• How does your program partner with Duke and community?
• What are your actual or anticipated population health outcomes?
• Describe your plans to extend or expand this program or project.
• What is the innovative nature of your program/project?
• What are the goals and objectives of your efforts?

* must provide value

Expand

If you have a website that describes your project or program, please enter it.

Do you allow others to come and speak to your group to gather input and suggestions on their community and population health improvement efforts?

Yes No

reset

Please mark all of the types of Duke partners for this project.

* must provide value

Faculty

Fellow

Postdoc

Staff

Student

Other

Please specify other Duke partner type

* must provide value

What health factors does this project aim/seek to address? Mark all that apply.

* must provide value

Asthma

Behavioral health

Cancer

Cardiovascular disease

Childhood development

COVID-19

Dementia

Diabetes

Education

Employment

Environmental health

Food / nutrition

Health policy / systems

Housing

Infectious conditions

Mental health

Obesity

Pregnancy

Sexual health

Smoking

Substance abuse

Transportation

Violence

Other

Please specify other health factor

* must provide value

What is the target population(s) of your project? Mark all that apply.

* must provide value

Adults

African Americans

Asians

Children

Elderly

Families

Hispanics

Homeless

Immigrants

LGBTQI

Men

Non-Hispanic black

Non-Hispanic white

Parents

Pregnant Women

Unemployed

Women

Young Adults

Youth

Other

Please specify other target population

* must provide value

Where is the target impact area of this project? Mark all that apply.

* must provide value

Local (Durham)

Regional (RTP)

State (NC)

National Region (South East US)

National (US)

International

Other

Please name the specific target area of impact for this project.

* must provide value

Please mark all Durham community partners involved with your project.

* must provide value

No Community Partners

100 Men in Black

African American Dance Ensemble

Alliance Behavioral Health

Alliance for Community Care

AME Zion Church

American Lung Association

Black Nurses

Boys and Girls Club

Healing with CAARE Inc.

Carolina Outreach

Center for Child and Family Health

Chinese American Family Association

Chinese Church

Church World Service

Community Health Coalition

DataWorks

Delta Sigma Theta

Dementia Inclusive Durham

Department of Social Services

Diaper Bank

Duke Connected Care

Durham City Government

Durham Connects

Durham County Department of Public Health

Durham County Government

Durham Crisis Collaborative

Durham Housing Authority

Durham Parks and Recreation

Durham Public Schools

Durham Tech

East Durham Children's Initiative

El Centro Hispano

El Hispano

First Calvary Baptist Church

Food Bank

Healthy Start Academy

Holton Career and Resource Center

Immaculata Catholic Church

Islamic Association

LGBTQ Center

Lincoln Community Health Center

Community Family Life & Recreation Center at Lyon Park

Morning Star Missionary Baptist Church

National Institute of Environmental Health Sciences

NC Central University

NC Health and Human Services

NC Refugee Health Program

National Institutes of Health (NIH)

Partnership for a Healthy Durham

Partnership for Seniors

Project Access

Red Cross

River Church

Senior PharmAssist

Student U

Together for Resilient Youth (TRY)

TROSA

Urban Ministries

VA Medical Center

Walltown Clinic

Walltown Ministerial Alliance

Watts Clinic

Y.O.G.A for Youth

Other

Please provide the name of any other Durham community partners involved with your population health effort.

* must provide value

What are the community sectors you partner with?

* must provide value

Business

Community Development

Education

Faith Community

Government

Health Care

Nonprofits

Philanthropy/Investors

Public Health

Other

Please specify other community sector

* must provide value

Does your project target any specific neighborhood?

* must provide value

Yes No

reset

Which neighborhood?

* must provide value

Does your project target any specific zip code(s)?

* must provide value

Yes No

reset

Which zip code(s)?

* must provide value

27278

27503

27517

27560

27572

27613

27701

27703

27704

27705

27706

27707

27708

27709

27710

27711

27712

27713

All of the above

Indicate the sources of funding that supports your population health improvement project or program. Mark all that apply.

* must provide value

Duke Health

Duke University

Private Foundation

Federal Grant

Governmental Agency

Donor

Volunteer

Other

Please specify other funding source

* must provide value

Do you know of any other faculty or staff at Duke that are leading Population Health Improvement efforts in Durham?

* must provide value

Yes No

reset

Please enter the name(s) and email address(es) of the faculty or staff members that you know are working on Population Health Improvement efforts in Durham.

* must provide value

Expand

After submitting this survey, you will be provided a link to a PDF copy of your survey responses. If, after reviewing your responses, you would like to change your answers to this survey, please contact Niasha Fray at niasha.fray@duke.edu.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.