2013 Community Health Needs Assessment Report - Terrebonne ...
2013 Community Health Needs Assessment Report - Terrebonne ...
2013 Community Health Needs Assessment Report - Terrebonne ...
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TGMC<br />
<strong>2013</strong> <strong>Community</strong> <strong>Health</strong> <strong>Needs</strong> <strong>Assessment</strong> <strong>Report</strong><br />
30<br />
Table 5. <strong>Community</strong> <strong>Health</strong> <strong>Needs</strong> Survey Tool<br />
2012 COMMUNITY HEALTH NEEDS ASSESSMENT (TER1019)<br />
Hello, I am _____ with Strategic Marketing & Research. We are helping one of the local<br />
hospitals conduct a research study on the health care needs of <strong>Terrebonne</strong> Parish residents.<br />
This survey is part of a project studying ways to improve the health care and health<br />
education services for our community.<br />
[IF NECESSARY, READ]: Your number has been chosen randomly to be included in the<br />
study, and we’d like to ask some questions about things that may affect your health. Your<br />
answers will be kept completely confidential.<br />
S1<br />
Do you or does any member of your household work for a local hospital?<br />
Yes [THANK & DISCONTINUE]<br />
No<br />
S2 Are you under or over the age of 65?<br />
1=Under 65 years<br />
0=Refused<br />
2=65 years and older [NOT to exceed 80]<br />
S3<br />
May I have your Zip code?<br />
City of Houma (n=250)<br />
1=70360<br />
2=70361<br />
3=70363 99=Other [THANK &<br />
TERMINATE]<br />
4=70364<br />
South <strong>Terrebonne</strong> (n=75)<br />
North <strong>Terrebonne</strong> (n=75)<br />
5=70343 (Bourg) 10=70352 (Donner)<br />
6=70344 (Chauvin) 11=70356 (Gibson)<br />
7=70353 (Dulac) 12=70359 (Gray)
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