University of New Mexico: Community Members Interview/End-of-Life Community Care Survey
This tool is designed in two formats. The interview format was developed for use with Focus Groups to identify concerns, issues, needs, and community actions/activities related to care when cure is no longer possible. The second format was developed as a survey to be filled out by the individual community members.
Evaluation Tool - Community Assessment
University of New Mexico
Health Science Complex
Palliative Care Office
MSC 11 6020
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone: (505) 272-4868
Fax: (505) 272-8572
Walter Forman MD
How the grantee used this instrument:
The one and a half-hour interview is conducted with representatives from community organizations and community leaders in small focus groups to help identify local strengths and barriers to improving care in the community at end-of-life. The survey was a method of inclusion for those unable to attend a focus group meeting.
community survey, needs assessment
To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.
Designed by the project staff for this project.
To view this tool:
Left click on the download link to view the PDF document in your Web browser. Right-click on the download link to save the document to your computer.
PDF 35 KB / 5 pages (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)
Posted August 2004
University of New Mexico overview page
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.