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Your Role[*Required]

Community Partner
Academic Partner
Patient Partner

What best describes your organization?[*Required]

Academic
Community Coalition
Community Health Center
Faith-Based
Foundation / Philanthropic
Government - Public Health
Government - Other
Health Care Organization
Neighborhood Assocation
Non-Profit Service Provider
Other
Not affiliated with an organization (interested community member)

Your Experience/Expertise (Topics). Please indicate if you have experience and/or expertise in the following topics (check all that apply).[* Required]

Alcohol / Substance Abuse
Access to Health Care
Built Environment
Cardiovascular Disease
Cancer
Chronic Disease
Community Health
Cultural Competency
Diabetes
Disabilities
Domestic Violence
Environmental Health
Health Behavior
Health Care Quality
Health Disparities
Health Promotion / Disease Prevention
Health Literacy / Numeracy
Infectious Disease
Injury / Violence
Maternal / Child Health
Men's Health
Mental Health
Nutrition / Food Security
Obesity
Occupational Health
Oral Health
Rehabilitation
School Health
Social Determinants of Health
Women's Health
Health Policy / Health Economics
HIV / AIDS
Health Services Research
Other

Your Experience/Expertise (Methods). Indicate if you have experience and/or expertise in the following methods or approaches (check all that apply.)[* Required]

Action Research
Advocacy
Asset Mapping / GIS
Epidemiology
Case Studies
Coalition Building
Community Based Participatory Research
Community Needs Assessment
Community Organizing
Focus Groups
Interviewing
Participant Observation
Participatory Evaluation
Photovoice
Policy Analysis
Program Evaluation
Qualitative Research
Quantitative Research
Randomized Trials
Social Marketing
Surveys
Statistical Analysis
Intervention Studies
Behavioral Methodology
Other

Your Experience/Expertise (Specific Populations). Indicate if you have experience and/or expertise working with any of the specific populations listed below (check all that apply).[* Required]

Adolescents
African-American
Asian
Children
Homeless
Immigrant / Refugee
Latino
LGBTQ
Low-Income
Men
Native Americans
Seniors
Uninsured
Women
Native American / American Indian
Pacific Islander
Veterans
Employee
Other

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