Baltimore | Blitz the Barriers Prostate Health Celebration and Empowerment Summit Survey Thank you for taking a few moments to complete this brief survey. Your responses help us understand your needs and measure the impact of today's event. All responses are anonymous. (Knowledge & Awareness) How would you rate your current knowledge of resources and support services available to prostate cancer survivors and caregivers? Very Low Low Moderate High Very High (Community Connection) How connected are you to a community of others who share similar experiences with prostate cancer? Not at all connected Slightly connected Moderately connected Very connected Extremely connected (Confidence in Communication) How confident are you currently in discussing your needs and concerns with your healthcare team? Not at all confident Slightly confident Moderately confident Very confident Extremely confident (Emotional Well-being) How well are you currently coping with the emotional challenges related to prostate cancer (as a survivor or caregiver)? Very poorly Poorly Adequately Well Very Well (Goals & Expectations) What do you want to gain from today's event? (Select all that apply) New information/resources Emotional support Connection with others Practical coping strategies Other… Enter other… (Awareness of ZERO) How familiar are you with ZERO Prostate Cancer and the resources they offer? Never heard of ZERO Heard of ZERO but never used their resources Somewhat familiar with a few resources Very familiar and have used their resources
(Knowledge & Awareness) How would you rate your current knowledge of resources and support services available to prostate cancer survivors and caregivers? Very Low Low Moderate High Very High (Community Connection) How connected are you to a community of others who share similar experiences with prostate cancer? Not at all connected Slightly connected Moderately connected Very connected Extremely connected (Confidence in Communication) How confident are you currently in discussing your needs and concerns with your healthcare team? Not at all confident Slightly confident Moderately confident Very confident Extremely confident (Emotional Well-being) How well are you currently coping with the emotional challenges related to prostate cancer (as a survivor or caregiver)? Very poorly Poorly Adequately Well Very Well (Goals & Expectations) What do you want to gain from today's event? (Select all that apply) New information/resources Emotional support Connection with others Practical coping strategies Other… Enter other… (Awareness of ZERO) How familiar are you with ZERO Prostate Cancer and the resources they offer? Never heard of ZERO Heard of ZERO but never used their resources Somewhat familiar with a few resources Very familiar and have used their resources
