Lake County CINH Intro Survey

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Lake County Connections IN Health Interest Survey

The Indiana Clinical and Translational Sciences Institute (CTSI), the Indiana Department of Health (IDOH), and the IU Simon Comprehensive Cancer Center (IUSCCC) have come together to strengthen their partnership to improve health in Indiana by forming Connections IN Health. This alliance unites the state’s health coalition development work, and the IUSCC’s community and engagement initiatives with that of Indiana CTSI. Connections IN Health is led by the Indiana CTSI’s Community Health Partnerships program, which works to improve health in Indiana through community-university partnerships and community-based health research.

Connections IN Health supports stakeholders, organizations, advocates, and residents as they come together to improve health and address chronic diseases. Connections IN Health facilitates collaboration within communities by connecting stakeholders with evidence-based practices, identifying funding sources, and addressing health equity for all.

Connections IN Health includes four statewide chronic disease initiatives:

The Indiana Joint Asthma Coalition (InJAC)
Cancer Control, Prevention and Equity
The Hoosier Health and Wellness Alliance (HHWA)
The Cardiovascular and Diabetes Coalition of Indiana (CADI)

Over the last decade, all four of the initiatives have made significant progress promoting local community health efforts. The Connections IN Health team’s primary goal is to further these health promotion efforts across the state, one county at a time.

Connections IN Health partners with statewide organizations, including Purdue Extension, which is involved in more than 60 health coalitions across the state and has educators in all 92 Indiana counties.

Our focus now is getting to know part of the Lake County community. Please take a moment to tell us about the successes and challenges that you've seen or experienced in any of the following neighborhoods in Gary: Downtown, Emerson, Tolleston, Midtown or West Side in the last few years.

Are you currently connected to Lake County, Indiana in any way for one of the following zip codes: 46402, 46404, 46406 or 46407 and/or one of the following neighborhoods in Gary: Downtown, Emerson, Tolleston, Midtown or West Side?

* must provide value

Yes

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We are currently interested in hearing about Lake County right now from any of the following zip codes 46402, 46404, 46406 or 46407 and/or one of the following neighborhoods in Gary: Downtown, Emerson, Tolleston, Midtown or West Side. If you live or work in or are part of an organization that serves these zip codes, we want to hear from you! Connections IN Health will be expanding to your community in early 2022. If you have any questions, please email us at cinh@iu.edu.

What Lake County ZIP Code or neighborhood do you live or work in or are part of an organization that serves?

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What are some successes the community that is part of the the zip code or neighborhood you entered above has had related to chronic disease (for example: cardiovascular disease, diabetes, stroke, asthma, cancer, health equity, physical activity, food insecurity, nutrition)?

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In which of these chronic disease areas has the community that is part of the the zip code or neighborhood you entered above experienced the most challenges? (Select all that apply)

Cardiovascular Disease

Diabetes

Stroke

Asthma

Cancer

Health Equity

Physical Activity

Food Insecurity

Nutrition

Other

Please describe 'Other'.

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First Name:		Last Name:
Phone Number:		Email Address:
Organization:

Which sector(s) do you represent?

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Health Care Systems

Community-Based Organizations

Local Government

Military

Educational Systems

Statewide or National Organizations/Associations

Businesses

Community Member

Other

Please describe 'Other' sector.

Are there any other community champions in the county that live or work in or are part of organizations that serve any of the following zip codes 46402, 46404, 46406 or 46407 and/or one of the following neighborhoods in Gary: Downtown, Emerson, Tolleston, Midtown or West Side that we should contact for more information?

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Yes

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First Name:		Last Name:
Organization:		Email Address:

First Name:		Last Name:
Organization:		Email Address:

First Name:		Last Name:
Organization:		Email Address:

First Name:		Last Name:
Organization:		Email Address:

If you would like to provide contact information for more than 4 community champions, please email us at cinh@iu.edu. Thank you!

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