survey

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ASIAN AMERICAN NEEDS ASSESSMENT AND NETWORK

The purpose of this survey is to assess the needs among Michigan’s Asian communities for further networking. Our intent is to identify the needs of Asian Americans, and provide information and available resources which address these needs. Upon completion of this survey you or your agency will be listed in the Asian Center resource directory and or the Asian Center website. The ultimate goal of the Asian Center is to educate and empower Asian Americans, establish a state-wide information network, and provide culturally-appropriate resources relevant to the needs of the Asian community. Please feel free to visit the Asian Center website at http://asiancenter.8m.com. We thank you for your time and information.

Please answer each question to the best of your ability.

1. In your opinion, what is the greatest challenge Asian Americans face as a minority in Michigan?

2. What resources, if any, are available in your community to help Asian Americans deal with this problem?

   3. In your opinion, what are the top three health problems among Asian American communities in Michigan?



4. In your opinion, what resources are needed to deal with these Asian American health problems?

5. If you could do one thing to resolve problems in the Asian American communities of Michigan, what      would it be?



6. Which of these are problems in the Asian community? (Check all that applies)

a. cigarettes

b. Cigars

c. Smoking around children

d. Chew (spit) tobacco)

e. Smoking in the workplace

7. Are there any agencies in your community that provide culturally specific help to Asian Americans with tobacco cessation and prevention?    Yes No                                                                                                        If yes please list the Agency's Name and Address for network.

Please provide us with the name of your organization, a contact person, address of the organization, telephone, fax number, and E-mail address.

Name of organization:

Contact person:

Title:

Organization Address:

City: State: Zip:

Telephone:

Fax:

E-mail Address:

Check all that applies to your agency/organization:

a. non profit

b. for profit/business

c. community-based

d. clinic

e. hospitals

f. human/social services

g. educational

h. civic/social group or agency

i. faith or religious group or agency

j. cultural agency/group

What are the primary populations serviced by your organization?

Would your organization be interested in receiving information about tobacco prevention and cessation?     Yes No

Would you like to be listed on the Asian Center Resource Directory?   Yes No

Would you like to be listed on the Asian Center Website?   Yes No

Please return all materials in the SASE to:

The Asian Center

25 Commerce Ave. SW

Grand Rapids, MI 49503

Phone: 616-771-6559       Fax: 616-771-6570      E-mail: centera@gvsu.edu