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Social Change, Innovation and Leadership (SOCIAL) Initiative Application for Leaders

SOCIAL Initiative: Working together to advance systems change

Thank you for your interest in this special opportunity.

PASWHA has developed an implementation-science project to promote Social Change, Innovation And Leadership [SOCIAL] in your work with older people living with HIV/AIDS. The purpose of this SOCIAL Initiative is to build strong cross-sector, cross system partnerships to support older people living with HIV/AIDS by educating, coaching and consulting with community leaders and helping to replicate an implementation-science based framework to promote transformational change in communities.  

We will select and partner with Leaders from 8 organizations serving older clients living with HIV.

Please complete this application by September 1, 2023.

We will make our selection of leaders within the following week.
1.Name
2.Email address
3.What is your position in your organization?
4.Address of your Organization
5.How long have you been employed by your organization? 
6.Are you a PASWHA member
What are your priority systems to connect with to eliminate the barriers you described? Please rank the following systems by your interest in collaboration with them (1 = low interest in collaboration, 4 = high interest in collaboration)
7.Aging Services and Systems (example: Area Agency on Aging)
0 Low Interest
4 High Interest
8.Housing Service Systems (example: access to low income housing assistance)
0 Low Interest
4 High Interest
9.Faith Based Systems (example: churches) 
0 Low Interest
4 High Interest
10.Mental Health Systems (access to counseling)
0 Low Interest
4 High Interest
11.Thinking about the area of your strongest interest, what barriers have you experienced for your aging clients living with HIV to work with this system in your community? 
12.Do you believe change is needed?
0 No, it is not needed
10 Yes, and it is a priority that needs to happen immedidately
13.Do you believe change will happen
0 No, never
10 Yes, of course
14.How easy is it for you to create a culture and space to collaborate and partner with other organizations for change to happen?
0 Easy as pie
10 Extremely difficult
15.Could you describe what contributors influenced your response above? 
16.Can you share with us a little about who you have in mind to participate with you in this program in your own organization and community? For instance, which organizations or people do you need to connect with in order to improve the priority systems of care you rated above.
17.Why do you want to be a part of this opportunity focused on social change innovation?
Thank you so much for sharing your interest with us. We will be reviewing these responses and sending out further details via email within the next few weeks.

Once you are selected to participate in this initiative, you will need to submit the following application materials:
1. Contact information
2. Confirmation of participation 
3. MOU signed by your organizational director and SOCIAL Initiative leader
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