Your summary must address all the questions below:

• Brief description of LHD- location, demographics of population served in your community
• Describe public health issue
• Goals and objectives of the proposed practice
• How was the practice implemented/activities
• Results/Outcomes (list process milestones and intended/actual outcomes and impacts.
  • Were all of the objectives met?
  • What specific factors led to the success of this practice?
• Public Health impact of practice
• Website for your program, or LHD.

750 Word Maximum

A Model Practice must be responsive to a particular local public health problem or concern. An innovative practice must be (1) new to the field of public health (and not just new to your health department) OR (2) a creative use of an existing tool or practice, including but not limited to use of an Advanced Practice Centers (APC) development tool, The Guide to Community Preventive Services, Healthy People 2020 (HP 2020), Mobilizing for Action through Planning and Partnerships (MAPP), Protocol for Assessing Community Excellence in Environmental Health (PACE EH). Examples of an inventive use of an existing tool or practice are: tailoring to meet the needs of a specific population, adapting from a different discipline, or improving the content.

• Statement of the problem/public health issue
• What target population is affected by problem (please include relevant demographics)
  • What is the target population size?
  • What percentage did you reach?
• What has been done in the past to address the problem?
• Why is the current/proposed practice better?
• Is current practice innovative? How so/explain?
  • Is it new to the field of public health
    OR
  • Is it a creative use of existing tool or practice:
    What tool or practice did you use in an original way to create your practice? (e.g., APC development tool, The Guide to Community Preventive Services, HP 2020, MAPP, PACE EH, a tool from NACCHO’s Toolbox etc.)
• Is the current practice evidence-based? If yes, provide references (Examples of evidence-based guidelines include the Guide to Community Preventive Services, MMWR Recommendations and Reports, National Guideline Clearinghouses, and the USPSTF Recommendations.)

2000 Word Maximum

The LHD should have a role in the practice’s development and/or implementation. Additionally, the practice should demonstrate broad-based involvement and participation of community partners (e.g., government, local residents, business, healthcare, and academia). If the practice is internal to the LHD, it should demonstrate cooperation and participation within the agency (i.e., other LHD staff) and other outside entities, if relevant. An effective implementation strategy includes outlined, actionable steps that are taken to complete the goals and objectives and put the practice into action within the community.

• Goal(s) and objectives of practice
• What did you do to achieve the goals and objectives?
  • Steps taken to implement the program
• Any criteria for who was selected to receive the practice (if applicable)?
• What was the timeframe for the practice
• Were other stakeholders involved? What was their role in the planning and implementation process?
  • What does the LHD do to foster collaboration with community stakeholders? Describe the relationship(s) and how it furthers the practice goal(s)
• Any start up or in-kind costs and funding services associated with this practice? Please provide actual data, if possible. Otherwise, provide an estimate of start-up costs/ budget breakdown.

5000 words maximum

Evaluation assesses the value of the practice and the potential worth it has to other LHDs and the populations they serve. It is also an effective means to assess the credibility of the practice. Evaluation helps public health practice maintain standards and improve practice. Two types of evaluation are process and outcome. Process evaluation assesses the effectiveness of the steps taken to achieve the desired practice outcomes. Outcome evaluation summarizes the results of the practice efforts. Results may be long-term, such as an improvement in health status, or short-term, such as an improvement in knowledge/awareness, a policy change, an increase in numbers reached, etc. Results may be quantitative (empirical data such as percentages or numerical counts) and/or qualitative (e.g., focus group results, in-depth interviews, or anecdotal evidence).

• What did you find out? To what extent were your objectives achieved? Please re-state your objectives.
• Did you evaluate your practice?
  • List any primary data sources, who collected the data, and how (if applicable)
  • List any secondary data sources used (if applicable)
  • List performance measures used. Include process and outcome measures as appropriate.
  • Describe how results were analyzed
  • Were any modifications made to the practice as a result of the data findings?

2000 Words Maximum

Sustainability is determined by the availability of adequate resources. In addition, the practice should be designed so that the stakeholders are invested in its maintenance and to ensure it is sustained after initial development (NACCHO acknowledges that fiscal challenges may limit the feasibility of a practice's continuation.)

• Lessons learned in relation to practice
• Lessons learned in relation to partner collaboration (if applicable)
• Did you do a cost/benefit analysis? If so, describe.
• Is there sufficient stakeholder commitment to sustain the practice?
  • Describe sustainability plans

1500 Words Maximum