2017 Application for Region XXX
Evidence-Based Public Health (EBPH): A Course in Chronic Disease Prevention & Health Promotion
Introduction
The Evidence-Based Public Health Course is presented annually by the Prevention Research Center in St. Louis (PRC) in collaboration with the National Association of Chronic Disease Directors (NACDD) and the Centers for Disease Control and Prevention (CDC). The primary target audience for the course is the membership of NACDD; others who are interested will be accepted on a space-available basis. This year, training is being offered for state teams by NACDD region. NACDD has grant funding to sponsor approximately 20-25 persons to attend each course, providing support for travel, lodging, and meals for teams of 3-4 from each state in the targeted region.
The course will be held in St. Louis from [date] at the Knight Center on Washington University’s main campus for chronic diease prevention and health promotion practitioners in Region XX states [name states]. More details on logistics to follow.
The Purpose
The Regional approach was chosen to build evidence-based decision-making capacity within and among the network of chronic disease prevention and health promotion practitioners (hereafter referred to as CDPN) in a specific geographic region. The purpose of a team approach is to help build a critical mass of EBPH-trained public health practitioners in each state. You will be asked about your plans for utilizing the training in your setting in the application (below).
Team Composition
Teams should be strategically selected. The expectation is that team members will be in positions of influence in their unit, and that collectively—and in colloboration with colleagues—the team can improve evidence-based practice in their respective state health departments. Below is a list of suggested positions from which you might select team members.
1. Chronic Disease/ Health Promotion Program Director(s)
2. CDPN Program Managers/ Coordinators. This includes categorical and/or domain program managers and directors, as well as deputy or assistant directors.
3. CDPN Epidemiologists, Biostatisticians, Analysts, Planners and Evaluators
4. Other CDPN Staff (that don’t fit the categories above)
5. Other key State Health Department Staff, not clearly identified as CDPN staff
6. CDPN Program Partners. This includes partners whose collaboration contributes to the implementation, success and sustainability of your programs/ policies, e.g., university partners.
7. Other, Non-Health Department Staff. This includes other partners and colleagues who may be accepted as course participants, but are not eligible for funding from NACDD or who are self funded. These will be accepted on a space-available basis.
Please complete the following pages.
1. Applicant Information
State:
Contact Person:
Title:
Address:
E-mail:
Phone:
Chronic Disease Director/ NACDD voting member (if not listed as contact person): ______
2. The EBPH team you propose sending to training
Team Member** Name, email, phone / Agency of employment / Educational background/ degrees / Primary Program or Domain Area / Position (Title/ Role) / Length of time in this position / # of staff supervised1.
2.
3.
4.
Alternate(s)
(optional)
Self-pay (pending space available)
**May propose up to four for scholarship. Final number will be determined based on funds available
3. Regarding your proposed state team
Please describe rationale for the choice of these team members, e.g., the past and current working relationships and skills sets of the identified team members, and how this combination has/will contribute to improving evidence-based practices and infrastructure throughout your state/region. (Limit to 150 words).
4. Rationale for EBPH training
a. Briefly describe your agency’s interest in EBPH training, anticipated benefits of the course, and how you/your team might use this information in your work. For example, does EBPH training enhance your state’s public health priorities, initiatives or training efforts currently underway?
b. What is your assessment of your agency’s level of readiness to adopt evidence-based practices?
c. If you have had experience or training in EBPH, please describe, including key successes and barriers.
5. Support
What supports exist to ensure application of EBPH skills and practices in your work unit (e.g., existing partnerships, key leadership/agency capacity, financial resources, relevant accreditation or training resources, etc.)? (Limit to 150 words).
6. Plans for application/ dissemination
Please describe your initial plans for applying what you learn in this course in your work unit/ state/ region. That is, how might you share course information, train others, affect practice, etc.? (Limit to 150 words. May use bulleted statements).
7. Please provide any additional information / comments that you think would be helpful to our understanding of your agency. (Limit to 150 words).
8. Please list those who participated in the planning and/or preparation of this application (name, title, affiliation).
10. Certification of Commitment
Each participating state must perform or support the following:
Assemble a core team to attend training who will:
· attend the full 3 ½-day training in St. Louis in August
· participate in pre- and post-course evaluations
· develop plans for supporting evidence-based practice in your state/ region that might include training others, mentoring, revising agency practices/ programs, etc.
· collaborate with NACDD and other state and regional efforts to promote evidence based training and practice
I have reviewed the project application and fully support the project aims of training our state’s team in order to build individual skills and also contribute to furthering evidence-based practice in our setting.
Printed Name of State Chronic Disease Director (or NACDD voting member):Signature:
Date:
(Month) / (Day) / (Year)
Please complete this application at your earlier convenience and no later than xxx. Email it to Carol Brownson, . Feel free to contact Carol at 314-378-5765 with any questions.
THANK YOU!
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