The AGS Foundationfor Health in AgingPublic Education Evaluation for Healthcare Professionals
Name:
Email:
1a. Are you an AGS Member?YesNo
1b. If your state has an affiliate branch of AGS, are you a member? YesNo
2. Professional Description:
a. What is your Medical Specialty?
3b. Are your board certified in your medical specialty?YesNo
4. If a Nurse, what is your education level and area of specialty practice? BSN without specialization MSN with specialization in geriatrics ANP GNP PhD
5. If another health care provider, what is your area of specialty practice?
6. In what practice do you spend a majority of your time? (select all that apply)
7. Would you classify your area as primarily:
8. What state do you practice in? AL AK AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA ME MD MI MN MO MS MT NE NC ND NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
9. What percentage of patients you see are age 65 and older? < 10% 11 - 25% 26 - 50% 51 - 75% 75% +
10. Are you aware that the AGS Foundation for Health in Aging publishes public education materials on health conditions for older adults? Yes No (If no skip to question 15)
11. If Yes, have you ever used any of the FHA public education materials? Yes No (If no skip to question 14)
12. If yes, Which ones? (select all that apply) Falls Diabetes Pain Memory Loss Osteoarthritis and Exercise Patient Education Forums Other 13. If Yes, How do you use these materials? Personal use Distribute to patients Teaching/giving lectures Other 14. If Yes, in what format do you use these materials? (Check all that apply) Printed copies I requested from the FHA Read online, off the FHA website Download off the FHA website, and print it out from my computer 15. How would you rate the content of the FHA public education material? Too simple About right Too difficult Not sure
12. If yes, Which ones? (select all that apply)
13. If Yes, How do you use these materials?
14. If Yes, in what format do you use these materials? (Check all that apply)
15. How would you rate the content of the FHA public education material?
16. Any additional comments or suggestions regarding the FHA public education resources?
AGS FOUNDATION FOR HEALTH IN AGING WEBSITE
17. How often do you refer people to the FHA website?
18. How easy do you find the FHA website to navigate?
19. What is your favorite feature on the FHA website?
20. Any additional comments or suggestions regarding the FHA website?
AMERICAN GERIATRICS PORTAL, MY AGS My AGS is an exciting new interactive Internet-based tool offered exclusively to AGS members free of charge. My AGS serves as an online window to the AGS and to other AGS members, enabling members to receive a variety of news and health care information and take advantage of other Internet services and opportunities. This new tool plays an integral role in everything the AGS does--from extended training and educational opportunities to better facilitation of AGS meetings.
21. Are you a member of the AGS portal, My AGS?YesNo. Why not?
22. If Yes, do you make the FHA patient education materials available on your patient interfacing website?YesNo
