2025 Parkview Community Health Needs Survey

These questions should only take about 5 - 10 minutes to complete. Your answers are confidential and will be reported only in combination with the answers of others. Your participation is voluntary; you may stop answering at any time or skip questions you do not wish to answer.

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* 1. Below are some health issues present in many communities. Please pick FIVE that you think pose the greatest concern for people who live in your community. (select only 5)

Cancers

Child Abuse/Neglect

Diabetes

Elder Care (Alzheimer's, dementia, falls, etc.)

Heart Disease & Stroke

Injuries, Violence & Safety

Kidney Disease or Kidney Failure

Mental Health & Mental Disorders

Oral Health

Obesity/Overweight

Reproductive Health (family planning, teenage pregnancy, etc.)

Respiratory/Lung Disease (asthma, COPD, etc.)

Sexual Health (HIV/AIDS, STDs, etc.)

Substance Use Disorder (alcohol, drugs, etc.)

Tobacco Use/Vaping

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* 2. What do you think are the FIVE most important issues affecting the quality of life and health of your community? (select only 5)

Access to mental health care and addiction services

Access to safe parks and recreation

Affordable and healthy food

Affordable quality childcare

Affordable housing

Differences in care based on race, ethnicity, gender identity, and sexual orientation

Having health insurance

Health education (nutrition, smoking cessation, weight management, CPR, etc.)

Number of healthcare providers in your area

Physical exercise

Prescription and co-pay costs

Preventive healthcare screenings (cancer, diabetes, high blood pressure, etc.)

Social isolation

Technology access (internet, email, etc.)

Transportation problems

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* 3. How would you rate your own personal health?

Very unhealthy

Unhealthy

Some what healthy

Healthy

Very Healthy

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* 4. Over the last two weeks, how often have you been bothered by:

	0 - Not at all	1 - Several days	2 - More than half the days	3 - Nearly every day
Little interest or pleasure in doing things?	Little interest or pleasure in doing things? 0 - Not at all	Little interest or pleasure in doing things? 1 - Several days	Little interest or pleasure in doing things? 2 - More than half the days	Little interest or pleasure in doing things? 3 - Nearly every day
Feeling down, depressed, or hopeless?	Feeling down, depressed, or hopeless? 0 - Not at all	Feeling down, depressed, or hopeless? 1 - Several days	Feeling down, depressed, or hopeless? 2 - More than half the days	Feeling down, depressed, or hopeless? 3 - Nearly every day
Feeling nervous, anxious or on edge?	Feeling nervous, anxious or on edge? 0 - Not at all	Feeling nervous, anxious or on edge? 1 - Several days	Feeling nervous, anxious or on edge? 2 - More than half the days	Feeling nervous, anxious or on edge? 3 - Nearly every day
Not being able to stop or control worrying?	Not being able to stop or control worrying? 0 - Not at all	Not being able to stop or control worrying? 1 - Several days	Not being able to stop or control worrying? 2 - More than half the days	Not being able to stop or control worrying? 3 - Nearly every day

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* 5. How much do you agree or disagree with each of the following statements: In the past 12 months, I had a problem getting the health care I needed for me or for a family member from any type of...

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Primary care provider (family doctor).	Primary care provider (family doctor). Strongly Disagree	Primary care provider (family doctor). Disagree	Primary care provider (family doctor). Neutral	Primary care provider (family doctor). Agree	Primary care provider (family doctor). Strongly Agree
Specialty care provider.	Specialty care provider. Strongly Disagree	Specialty care provider. Disagree	Specialty care provider. Neutral	Specialty care provider. Agree	Specialty care provider. Strongly Agree
Mental health or addiction services provider.	Mental health or addiction services provider. Strongly Disagree	Mental health or addiction services provider. Disagree	Mental health or addiction services provider. Neutral	Mental health or addiction services provider. Agree	Mental health or addiction services provider. Strongly Agree
Dentist.	Dentist. Strongly Disagree	Dentist. Disagree	Dentist. Neutral	Dentist. Agree	Dentist. Strongly Agree
Pharmacy.	Pharmacy. Strongly Disagree	Pharmacy. Disagree	Pharmacy. Neutral	Pharmacy. Agree	Pharmacy. Strongly Agree

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* 6. How much do you agree or disagree with each of the statements below:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to.	I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to. Strongly Disagree	I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to. Disagree	I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to. Neutral	I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to. Agree	I don’t know where to get services for myself when I am sad, depressed, or need someone to talk to. Strongly Agree
I have a place to receive medical care besides the emergency room.	I have a place to receive medical care besides the emergency room. Strongly Disagree	I have a place to receive medical care besides the emergency room. Disagree	I have a place to receive medical care besides the emergency room. Neutral	I have a place to receive medical care besides the emergency room. Agree	I have a place to receive medical care besides the emergency room. Strongly Agree
I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else).	I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else). Strongly Disagree	I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else). Disagree	I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else). Neutral	I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else). Agree	I can set up a video chat using my cell phone, computer, or another electronic device on my own (without asking for help from someone else). Strongly Agree
I have reliable internet or Wi-Fi at my house to use for video chats.	I have reliable internet or Wi-Fi at my house to use for video chats. Strongly Disagree	I have reliable internet or Wi-Fi at my house to use for video chats. Disagree	I have reliable internet or Wi-Fi at my house to use for video chats. Neutral	I have reliable internet or Wi-Fi at my house to use for video chats. Agree	I have reliable internet or Wi-Fi at my house to use for video chats. Strongly Agree

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* 7. Zip code where you live:

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* 8. County where you live:

Adams (IN)

Allen (IN)

DeKalb (IN)

Huntington (IN)

Kosciusko (IN)

LaGrange (IN)

Noble (IN)

Wabash (IN)

Wells (IN)

Whitley (IN)

Williams (OH)

Other (please specify)

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* 9. What is your age? (please enter numbers only)

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* 10. What is your race? (select all that apply)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Other

Prefer not to answer

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$20,000-$24,999

$25,000-$29,999

$30,000-$34,999

$35,000-$39,999

$40,000-$44,999

$45,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$149,999

$150,000 or more

Prefer not to answer

2025 Parkview Community Health Needs Survey

Question Title

* 1. Below are some health issues present in many communities. Please pick FIVE that you think pose the greatest concern for people who live in your community. (select only 5)

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* 2. What do you think are the FIVE most important issues affecting the quality of life and health of your community? (select only 5)

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* 3. How would you rate your own personal health?

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* 4. Over the last two weeks, how often have you been bothered by:

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* 5. How much do you agree or disagree with each of the following statements: In the past 12 months, I had a problem getting the health care I needed for me or for a family member from any type of...

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* 6. How much do you agree or disagree with each of the statements below:

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* 7. Zip code where you live:

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* 8. County where you live:

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* 9. What is your age? (please enter numbers only)

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* 10. What is your race? (select all that apply)

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* 11. What is your ethnicity?

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* 12. Do you identify as Amish?

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* 13. Do you identify as a person of Burma?

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* 14. What is your gender? (select only one)

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* 15. Which of the following best represents how you think of yourself?

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* 16. What kind of medical insurance or coverage do you have? (select all that apply)

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* 17. Considering all sources, which of the following best describes your total household income before taxes for 2023? (select only one)

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* 18. How many children younger than 18 years of age live in your household?