THT Case Study Questionnaire Question Title * 1. Contact Name Question Title * 2. Organization Name Question Title * 3. Email Question Title * 4. Name of Project or Initiative Question Title * 5. Please describe how you have used the THT or how you plan to use it in your work on this project or initiative(s) Question Title * 6. Please identify the applicable project type(s). (select all that apply) Comprehensive Plan Corridor Plan Small Area Plan Community Health Improvement/Action Plan Long Range Transportation Plan Feasibility Study Environmental study (NEPA/SEPA) Roadway/highway project Complete Streets project Safe Routes to Schools project Greenway or trail Other bicycle/pedestrian project Other (please specify) Question Title * 7. Which of the following best describes the scale of your project/initiative? (select one) Small scale/project limits Neighborhood Community Municipal/town Regional/Metropolitan Statistical Area Statewide Other (please specify) Question Title * 8. Who is the lead agency on your project/initiative? (select one) State Department of Transportation Metropolitan Planning Organization Transit agency Local government unit (transportation, planning) Other (please specify) Question Title * 9. What partner organizations/agencies have been or will be involved with your initiative? Question Title * 10. Please identify which of the 14 indicators provided to you in the email pertain to your project/initiative. (select all that apply) Alcohol-Impaired Fatalities Commute Mode Shares Complete Streets Policies Housing and Transportation Affordability (metro area level only) Land Use Mix (metro area level only) Person Miles Traveled by Mode (state level only) Physical Activity from Transportation (state level only) Proximity to Major Roadways Public Transportation Trips per Capita (state and urbanized area level) Road Traffic Fatalities by Mode Road Traffic Fatalities Exposure Rate Seat Belt Use (state level only) Use of Federal Funds for Bicycle and Pedestrian Efforts (state level only) Vehicle Miles Traveled (VMT) per Capita (state and urbanized area level) Question Title * 11. How was the THT and/or the indicators you identified useful to your project/initiative? Question Title * 12. Transportation affects health through several key pathways. Please identify which of the following pathways pertain to your project/initiative: (select all that apply) Access (to medical services, healthy foods, health and recreation opportunities, support networks, etc.) Air quality (emissions, asthma, etc.) Safety (related to transportation for drivers, pedestrians, bicyclists, etc.) Active Transportation (opportunities for physical activity through transportation – walking, biking) Equity Question Title * 13. In what ways is your organization/agency working to integrate health into transportation planning? (Select all that apply) Integrating health into organizational policies Including health in transportation planning goals Evaluating health impacts of plans and/or projects Conducting formal Health Impact Assessments Implementing other specific tools and data to assess health impacts from transportation Assigning dedicated staff to evaluate health impacts from transportation Collaborating with other agencies on health initiatives (County health departments, state health officials, others) Other (please specify) Question Title * 14. How do you or your organization address equity in your work? Question Title * 15. How supportive is your organization of future/ongoing use of the THT? (select one) Highly supportive Somewhat supportive Neutral Not supportive Question Title * 16. Are there any other comments that you have regarding your project or initiative(s) or your organization’s transportation and health efforts? Done