Surveys and other Resources

Survey Instruments:

Feel free to utilize the survey instruments (acknowledging your source) - Let us know if you have any questions. Thank you!

The purpose of this study was to better understand Kaiser Permanente Medicare members who have concerns about accessing the food they need. We also wanted to learn if Kaiser Permanente successfully connected members to food resources in their communities.

View survey instrument (pdf): Food for Our Members - Wave I
View item/question sources (pdf): Survey Resources - Waves I & II

Wave II was a follow-up survey to the Kaiser Permanente Food for Our Members study. This survey was administered 3 months after Wave I and was administered to those who completed the Wave I survey.

View survey instrument (pdf): Food for Our Members - Wave II
View item/question sources (pdf): Survey Resources - Waves I & II

Kaiser Permanente Colorado (KPCO) teamed up with community partner, Hunger Free Colorado (HFC) to survey Kaiser Permanente members who had been contacted by HFC upon referral from KPCO.

View survey instrument (pdf): Food for Our Members - (HFC)

Item/question sources (pdf): Available Soon!

The purpose of this study was to capture a range of social and economic needs, including living situation, housing, food, utilities, childcare, debts, medical needs, transportation, stress, and social isolation. The yellow highlighted areas indicate responses considered positive screenings and items that may require referral, advice, or an alteration of how care is provided.

Usage: Commercial licensing or commercial distribution of the Your Current Life Situation (YCLS) questionnaire is not permitted. No charges for use, reproduction or distribution of the YCLS are permitted.

View survey instrument (pdf): Your Current Life Situation (YCLS)


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