description
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Thank you for your willingness to participate on the Montgomery County Overdose Data to Action (OD2A) Community Advisory Board (CAB). Please complete this brief survey so that we can track our progress in reducing opioid overdoses in our community. We intend to survey members periodically during their participation on the CAB so that we can hear about your experiences and recommendations for local OD2A activities and evaluations. This welcome survey is aimed at collecting basic contact and demographic information on CAB members as well as their goals and expectations while serving on the CAB., type: esriFieldTypeString
)
work_montco
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you currently work in Montgomery county, PA?, type: esriFieldTypeString
, Coded Values:
[no: No]
, [yes: Yes]
, [pns: Prefer not to say]
)
work_sud
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you currently work in the fields of substance abuse, prevention, treatment, or recovery?, type: esriFieldTypeString
, Coded Values:
[no: No]
, [yes: Yes]
, [pns: Prefer not to say]
)
work_areas
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Which specific areas of the county do you work in currently?, type: esriFieldTypeString
)
work_job
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What is your current primary job title?, type: esriFieldTypeString
)
work_diverse
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: How much experience do you have working with diverse and disproportionately impacted communities?, type: esriFieldTypeString
, Coded Values:
[none: None]
, [little: A little]
, [some: A moderate level]
, ...1 more...
)
exp_personal_opioid
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have personal lived/living experience with opioid use?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
exp_personal_sub
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have personal lived/living experience with substance use?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
exp_family_opioid
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have a family member with lived/living experience with opioid use?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
exp_family_sub
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have a family member with lived/living experience with substance use?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
goals
(
nullable: true, editable: true, defaultValue: null, length: 3000, alias: In a few sentences, please describe what you hope to accomplish while serving on the OD2A CAB., type: esriFieldTypeString
)
comments
(
nullable: true, editable: true, defaultValue: null, length: 3000, alias: Please enter any other comments/questions/concerns you may have about serving on the CAB., type: esriFieldTypeString
)