Indian Country Journey to Health ECHO

Cardea Services

Questions about this evaluation? Email info@cardeaservices.org.

We hope you found this educational offering both interesting and informative. Your anonymous responses will be used to plan future educational activities.

1. Please enter your unique identifying number using your birth month (mm), last two numbers of your cell phone number, and the first letter of your middle name. This number will be used to compare survey responses while keeping your responses anonymous.

Example: 0989S
Birth Month: September
Phone Number: 012-345-6789
Middle Name: Smith

3. How satisfied are you with this learning activity? *This question is required.

Very satisfied	Satisfied	Unsatisfied	Very unsatisfied
Very satisfied	Satisfied	Unsatisfied	Very unsatisfied

4.  As a result of this learning activity, how has your knowledge on this topic changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

5. How likely are you to make one change in practice based on what you learned in this activity. *This question is required.

Very likely	Likely	Unlikely	Very unlikely
Very likely	Likely	Unlikely	Very unlikely

Please describe any changes you plan to make in the work that you do. *This question is required.

Why are you unlikely to make a change? *This question is required.

Please enter an 'other' value for this selection.

6. As a result of this learning activity, I am able to... *This question is required.

Space Cell	Strongly agree	Agree	Disagree	Strongly disagree
Identify and refer patients to culturally appropriate, and strength-based support services.	Identify and refer patients to culturally appropriate, and strength-based support services.: Strongly agree	Identify and refer patients to culturally appropriate, and strength-based support services.: Agree	Identify and refer patients to culturally appropriate, and strength-based support services.: Disagree	Identify and refer patients to culturally appropriate, and strength-based support services.: Strongly disagree
Identify examples of holistic care practices that contribute to strength, resilience, and well-being.	Identify examples of holistic care practices that contribute to strength, resilience, and well-being.: Strongly agree	Identify examples of holistic care practices that contribute to strength, resilience, and well-being.: Agree	Identify examples of holistic care practices that contribute to strength, resilience, and well-being.: Disagree	Identify examples of holistic care practices that contribute to strength, resilience, and well-being.: Strongly disagree

7. Please indicate your likelihood to engage in the following activities BEFORE completing this ECHO. *This question is required.

Space Cell	Very likely	Likely	Unlikely	Very unlikely
Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Very likely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Likely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Unlikely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Very unlikely
Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Very likely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Likely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Unlikely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Very unlikely

8. Please indicate your likelihood to engage in the following activities AFTER completing this ECHO. *This question is required.

Space Cell	Very likely	Likely	Unlikely	Very unlikely
Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Very likely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Likely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Unlikely	Within 2 months of participating in this training, I plan to integrate at least one reflective practice to counteract the influence of individual behavior and assumptions (for example: implicit or explicit bias) in my relationships with patients.: Very unlikely
Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Very likely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Likely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Unlikely	Within 1 month of participating in this training, I plan to communicate with at least one professional outside of my discipline in order to support comprehensive patient care (for example: social workers, mental health counselors, chemical dependency counselors, peer support counselors, pharmacists, nurses, or other medical providers).: Very unlikely