Download:
pdf |
pdfr
PRC IS: Center -Center Home
Page 1 of 1
N~VQn~j Cent~r for Chronic Di5e~$!! Preventiof'l ..no Health Promotion
PREVENTION
RESEARCH CENTERS:!c)
Pitt.InformntionSystem
PRC IS
MvPRC
Log-Out
~
* Required
+ Performanc
Welcome
State University of New York at Albany
Prevention Research Center
Select the fiscal year'
Select one
Form Approved OMB NO.: 0920-0650
Expiration Date: 11/30/2007
Public reporting burden of this collection of information is estimated to average 4.25
hours per response (interim report), including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or
sponsor, and a person is not required to respond to a collection of information unless it
displays a currently valid OMB control number. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to CDC/ATSDRReports Clearance Officer; 1600 Clifton Road NE, MS
D-24, Atlanta, Georgia 30333; ATTN: PRA(0920-0650)
Privac~ Polic~ I Accessibilit~
PRCH9me I New~ I C9ntg<:tU~
CDC Home I ~
I Health Togics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
u ruteQSt~t e ~ Dep~r1;mentot He~.lt0 ~nQHYm~n$e rvi.!;e~
Centers for Disease Control and Prevention
Djvi.~iQOofAQYl.t~nQCQmmYnjtYHeQ
I.to
http://qa.nccd.cdc.gov/myPRCAdnrin/default/Center_Home.aspx
8/21/2006
TA..-Q-~of)
Cef'\~r
PRC IS: Center -Edit General Infonnation
Page 1 of2
N~tiGryn! Center for Chrpmt {)1%;@~$f1
Prev@nt1onand H@a!t!1Promc,!I{)f!
: :1
:: '::::
.."'.'
::
E;: EAR:,::
H :, ENTER'"
PRE: V ENTION
no..
" f " rm,\"OoI"" e":"""
F".. I ""P..",.~."..",\
SAF~~."~"\.T"'~~"'~O"\.~
@Yes
~
C
m'
: :
S:\:' @
:\:?
C.
\
:~
* Required
+ Performance Indicator
\
State University of New York at Albany
Prevention Research Center
PRe IS
MyPR;(;
.Center In fQrffiQtlQfi
HeJp
2005-2006
Edit General Information
.PrQjects
.PrQQ\J~t~
.ReQuired
c
R S
Office
Reports
mailing
General Information
address
5-Year Goals
Address line 1 *
An!1J,!~W_Q.r~P1Qn
Log-Out
Address line 2
Cente.r$tQff
Select one
City,* State,* ZIP*
Overnight
CommunitY
~_Qmmlt!;e~~
National Community
~Qmmltte~_(N_~.c.l
Rep.r~~l}t~tjYe$
mailing address
PQd;I}~.r~
Same as office mailing address?*
No
Address line 1
Health Priorities
Research Agenda
~YQ1YQtjQnPlQ.n
Address line 2
City, State, ZIP
Select one
"
Ext.
Telephone
Fax
Website
NCC region
Northeast
NCC regional
Ralph Fucillo (Harvard University)
director
Community description*
Briefly describe the partnering
community the center focuses on
I-Mission
Briefly state the center's mission
d8/21/2006
~
Organizational
Chart
To upload a copy of the center's organizational chart, enter the
entire path of the organizational chart file or click the 'Browse'
*
button.
Entire
Date organizational
chart
Can the organizational
.~cf\
\
aYes
6row~e
path and file name
last revised?
chart be shared
(mm/dd/yyyy)
with
other
PRCs?
No
~.>
P.rjY~(;YPQ.li..(;Y
I AG(;e$~.i.bj.l.ity
PRCHQmeI New$ I CQntQ~tU$
CDCHome I Sea[~b I Heal!;b.IQPJ~$A::.z
This page was last reviewed on 10/17/2005
Quality Assurance Build
VnitedState$PepartmeotQfHealth
aodHymaoServJ.ce$
Center$ for Di$ea$e Control and Prevention
National Center for Chronic Disea$e Prevention and Health Promotion
PiY)$J.90QfAdy)taodCQmm yoJ.tyHea.lth
3
8/2.1/2006
r
PRC IS: Center -List 5-Year Goals
Page 1 of 1
liationa! Center fnr Chronic D1sea~ I>reve"tion and Health Promotion
PREVE~TION
PRC Information
PRe IS
System,'
State University
!
RESEARCH CENTERS;j @
""
* Required
+ Performance Indicator
HeJp
of New York at Albany
2005-2006
Prevention Research Center
MyPRC
.C~nte.rlnfQ.rm~tiQn
5-Year Goals
.Projects
Evaluation Goals
.PrQQy~t~
.ReQuired
General Information
Add Goal
S-Year Goals
ReQorts
Annugl..WQ.rkPt~n
Log-Out
Collaboration
and Partnership
A~g!
Goals
~_e:_IJ~1f
Community:
~mJ!11tt;ee~
Communication
Goals
and Dissemination
National CommunitY
Add Goal
CQmmJ.ttee.(N~g
RePre$ent~tiYe$
~gd;O_eI~
Health Priorities
Infrastructure
Goals
Add Goal
Research Aaenda
~_vQJ'ygtlQoP!~n
Training and Education Goals
AQQGQ~J
,--)
Privac~ Polic~ I Accessibilit~
PRCHQmeI New~ I CQnt.a(;t.U~
CDC Home l ~
I Health ToQics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
Vnit §q ~t Qte?P epQrtment9fH§Ql tb Q.ndHumQ
n. ~erv .!.~e?
Centers for Disease Control and Prevention
P.iY.!.?!.909fAdY..I.t?!OgG9mmun.i!;YHe
Q.ltb
8/21/2006
Page 1 of :l
PRC IS: Center -Add 5-Year Goal
!-i.atrooo! Center fOTChrooic Disease ?~1I'~tJon and Health Promotron
PREVENTION
RESEARCH
Pitt !nformation System
SAF-,R-
(
PRC IS
My P~(;
.Cen~e.rlnfQ.rm~~iQn
,"
.1,'
"co."
CENTERS.1,@
~,
"
* Required
+ Performance Indicator
2005-2006
State University of New York at Albany
Prevention Research Center
Add 5-Year Goal
.Projec~s
.PrQQY~~
.ReQuired
Log-Out
General Information
Evaluation
Program Component
Rgports
HeJp
5-Year Goals
Goal Statement
AnnyaJ.Work Plan
Briefly describe one of the center's 5-year goals.*
C~nw~~ff
CommunitY
CQffim.!tt;~~~
National Community
Comm..i.t1;ee(NCC)
Repr.~~entQt)Ye~
P-~[!;M~
Select one
Health Priorities
Research Agenda
~yq)-Y-.aj;jonP-IQn
~J
Privacy Policy I Accessibility
PRc.HQm~
I N~w~I c.Qn!;Q!;!;\)~
CDC Home I ~
I Health ToQics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
Un.itedSt:9te~P e pgrJ;ment9 f He:9.1
t h:9ndHv m gO$e rv.i!;;e
~
Centers for Disease Contr91 gnd Preventi9n
National Center for Chronic Disease Prevention and Health Promotion
Pjv.i~jQ09fAdu.ltgodC9mmvojtYHeg.!.th
--
.5
~
Page 1 of
PRC IS: Center -Add 5-Year Goal
l'iationai
CErnter .fur Chronic
Disease
Prevention
al1d Health
PTomQtiQI1
" I "
PREVENTION RESEARCH CENTERS'@
PRCInform.,tion SY$tem,
PRe IS
MvPRC
.Centerlnformgtion
'
.ReQuired
2005-2006
Add 5-Year Goal
Log-Out
Program Component
Reports
He!p
State University of New York at Albany
Prevention Research Center
.!?:rojects
.Products
-,,---
* Required
+ Performance Indicator
Collaboration and Partnership
Goal Statement
General Information
5-Year Goals
AnD\Jg..! WorkP..I.gn
C:~DJ;gLStgff
Community
C:.Q!I!m.!tt~~
National Community
(:;omm.J.ttee(N(:;g
Repre$enj;gj;jye$
pg_!:!;n~r_~
Health Priorities
Research Agenda
fY~YQj;jonp!.gn
'-
J
Privacv Policy I Accessibility
PRkt!9me I New?I C90tg!;tU?
CDC Home! ~
I Health Togics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
United$ tgte~De pgrtment9l Heg.lt hgn dHY mg0 Serv i Ge~
Centers for Disegse Control gnd Prevention
National Center for Chronic Disease Prevention and Health Promotion
Djvj~j9n9f Ady.ltgodC9mmyo.ityHeg.lth
~
8/21/2006
r
~
PRC IS: Center -Add 5-Year Goal
NatiGnaf Center
Page 1 of 1
Tr>rChronic
Disease
PRtEVE~TION
Pitt:: Informiitlon
PRC IS
MyPR,(;
.C~nterillfQrm?!ti..Qn
I>revel1tiol) al1d Heatth Promotfof1
f
'.
RESEARCH CENTER&@
SY$t~
! .,
r
* Required
+ Performance Indicator
Help
2005-2006
State University of New York at Albany
Prevention Research Center
Add 5-Year Goal
.Projects
.PrQq.\J(;;t~
.ReQuired Regorts
Log-Out
Program Component
Communication
and Dissemination
General
5-Year
Goal Statement
Information
Goals
AnnyalW9rk Plan
Briefly describe one of the center's 5-year goals.*
'<;;_e(11~S:@ff
Community
h~lT1JI!ltt~~_$
National
CommunitY
C9mmlttee(N.<;;g
Repre~e(1tgt)Ye$
~rtner~
Status'
Select one
Health
Priorities
Research
Agenda
EYgJ~t19QP!Qn
\..)
Privac~ Polic~ I Accessibilit~
PRCH9me I New$ I C9nt:9!;;tU$
CDC Home I ~
I Health TORicsA-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
Uill t e d$ ta te$ Pep a..!:tme n.tQL Healto a ndH ym an. $ervl~ e$
Centers for Disease Control and Prevention
National Center for Chroni~ Disease Prevention and Health Promotion
PlYj$jQnQ f Ady.l t and(;; Qmm ynlty He a Ito
7
8/21/2006
~
Page 1 of 1
PRC IS: Center -Add 5-Y ear Goal
Natmr«ai Center fur Chronic Disease I"'revemivn and Health PifornDtIC.!1
."
PREVE~TION
51'1'"'"
RESEARCH CENTERS"lj~
PRCInformation $Y$t;em
PFtC IS
MyPR_C
.C~nt~IillfQrm~tlQn
.~
.p[Qqy!;t~
.ReQuired
Log-Out
;/~"
* Required
+ Performance Indicator
He.lQ
2005-2006
State University of New York at Albany
Prevention Research Center
Add 5-Year Goal
General Information
Infrastructure
Program Component
Rej;!orts
I
5-Year Goals
Goal Statement
Aoo\Ja.JWorkPlan
Briefly describe one of the center's 5-year goals.*
(:_eIl_\;g.L.st9ff
CommunitY
CQrI1-rDlt.te.-e~
National Community
(:Qmm..ittee(N(:C)
Repre~entgtjve~
~r!;J)_er~
Status
*
Select one
Health Priorities
Research Agenda
~YQ.J.y~tjQnp!qn
'--
J
Privac¥ Polic¥ I Accessibility
PR~HQmeI New$I ~Qnt~!;;~U$
CDCHome I ~
I Health Togics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
U.n.itgq$tQtg$pgpQ.rtmgntofHgQ)thQnqH~mg.n.$grv.i(;g$
National
Center$ for Di$ea$e Control and Prevention
Center for Chronic Di$ea$e Prevention
and Health
Promotion
PjY.!.$.io
n. of A q!J.1.t
gOq(;; om m yo.it y H ea.1.th
?
8/21/2006
1
PRC IS: Center -Add 5-Year Goal
Page 1 of 1
National Center for Chronic; O~a5e
Prevention and Health Promo1;ion
'.
j '.
PREVE~TION RESEARCH CENTERS;~
PRCInformation SY$~0m
PRe IS
MvPRC
.C~ot~.rJof9.rm9tjQO
State University
'.~'.
of New York at Albany
* Required
+ Performance Indicator
He'p
2005-2006
Prevention Research Center
Add 5-Year Goal
.Pr9jects
.PrQdy~t~
.ReQuired
Log-Out
Program
Component
Training and Education
General
Information
S-YearGoals
Reports
Goa I Statement
Ann!JalWorkP.li!f1
Briefly describe one of the center's 5-year goals.*
CentgrSt9_ff
Community
CQ!I!-1JJj_tte.e~
National Community
CQmm..it;tee(NCQ
Repr~~ef1ti!t;ives
~~Jj,D~I~
Status
Select one
Health
Priorities
Research
Agenda
~_'Lqj!JQt;i.Qf1P.li!f1
\..
Privac¥ Poli~
.J
I Accessibilit¥
PRCHQme I New~ I CQnta(;tU~
CDC Home I ~
I Health Togics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
P !y )$jQOQfAd!'! 1.t gOd<; Qmm!'! 0i ty H~g Ith
8/21/2006
~
PRCIS: Annual Work Plan
National
Page
Center
for OIronic
PREVENTION
()j;seaSE Prevefltion
PACInformntionSy.~m
","
PRe IS
PTomotioll
\
1 j
\~
1.
* Required
+ Performance Indicator
RESEARCH CENTERS\I~
\
He.!p
State University of New York at Albany
Prevention
MvPRC
f)fld H~aith
of
2005-2006
Research Center
.c.enteIlofQrm~tiQn Annual Work Plan
.Projects
.PrQqYct~
.ReQuired Reoorts
Add Objective
Evaluation Objective:s
Loa:Out
If
Collaboration
Objectives
and Partnership
Add Qbje!;;tiye
General Information
5-Year
Goals
Annual
Work Plan
~_~t~ff
CommunitY
CQmm'!te.e:~
National
and Dissemination
Community
Add QbjectJ.ve ~Qmmjttee(N~g
Representatives
Objectives
PQ!j;fl.-er_~
Health
Infrastructure
Objectives
AqqQbje~tjve
Priorities
Research
Agenda
~y~.!_!!~t!'QDPtQD
'-
Training and Education Objectives
Priyacy
~
Add Qpje!;;1;1.ve
PolicY I Accessibility
PRCHQm~I N~w$ I CQntg(;tU$
CDC Home I ~
I Health Togics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
!.In.iteq ~t9t e~Qep9,rtment QfHe~1.
ttJ_~nq_H!'!
m9n~e_rvlGe~
Centers for Disease Control and Prevention
P)Yi.~)QnQf.Aq
U.lt90qCQmm!,!o i.tyHe9lttJ
\0
http://qa.nccd.cdc.gov/myPRCAdmin/CenterInfo/Center WorkPlan_List. aspx
8/21/2006
~
Page 1 of~!
PRC IS: Center -Annual Work Plan
N6tjQ~1 Center for Chronic Ci$Ei',,-;ePreventioo an(:i Health Pf:omotiQn
'
PREV~~T~ON RESEARCH CENTERS~@
PRCInformation SY$t.~m
f
PRe IS
MvPRC
.c.ente.rlnfQrm~ti..Qn
,
State University of New York at Albany
Prevention Research Center
.Bgquired Regorts
Log-Out
Help
2005-2006
Add Work Plan Obje(:tive
.Projects
.PrQq\J!;t~
* Required
+ Performance Indicator
Relationship
General Information
to Evaluation Goal
5-Year Goals
Select which 5-year goal the objective relates to.
Annual Work Plan
~II1?-r.S_~~ff
Select one
CommunitY
~~e_~
Objective
National CommunitY
Commi.ttee(NCQ
Repre~eotQtjYe$
Briefly state the objective that supports the goal (include a
measurable and specific intended outcome).*
~!1!leI~
Health Priorities
Research Aaenda
EY~l\J.9tiQDPlQQ
)
Expected date of completion
Select one
Status'
Se:1ect one
Anticipated
(yyyy)
Challenges
Briefly describe any anticipated
*
address them.
challenges and the plans to
Privacy PolicY I Accessibilitv
PRCHQm~I N~w$ I CQntg!;;tU$
cr~;J:!£Illg I ;~,~~rQt
I t&!!!!;b_~[QJili:~A::Z
This page was last reviewed on 3/13/2006
Quality Assurance Build
8/21/2006
Page 1 of
PRC IS: Center -Annual Work Plan
\)-
tiatiQrlai Center for Chronic DiseaSE Preventiorl and Heatth Promotion
PREVE~TION
PRC Information
PRC IS
MyPRC
.C~ote.r.JnfQr.m~tj.Qn
SY$tem
RESEARCH CENTERS @
:C
* Required
+ Performance Indicator
Help
2005-2006
State University of New York at Albany
Prevention Research Center
Add Work Plan Object:ive
.Projects
.Pr9QY(;t~
Relationship
to Collaboratiol1l
and
Partnership
General
Goal
.ReQuired Reports
Log-Out
Select which 5-year goal the objective relates to.*
Information
5-Year
Goals
Annual
Work
Plan
~~~~ff
Select one
CommunitY
!;;;Qm_mjttee~
NationalCommunitv
Objective
CQmm..ittee{NCQ
Repre§ent!!tive§
Briefly state the objective that supports the goal (include a
measurable and specific intended outcome).*
P-~rtl1er§
Health
Priorities
Research
Aaenda
~~g1J,J~_tlQ!J__PJ.?!D-
Expected date of completion
Select one
Status
Select one
Anticipated
(yyyy)
Challenges
Briefly describe any anticipated challenges and the plans to
address them.*
Privac¥ Policy I Accessibility
PRCHQmeI New$I CQnt~~tUs
Q&lliJ:n!:.1
;i'~;!!~~.
~jl:'!illl!£~~~,:l
This page was last reviewed on 3/13/2006
Quality Assurance Build
Vn!t~d~ tg te§P e pg rtm e nt Qf!::!~gIt b g nd!::!ymg n ~e [vi..~e §
8/21/2006
.
r-.catroncai
Cente%for Chronic Disea!if! Prevention canoHe:...!thPromotion
PREVENTION
RESEARCH
CENTERSc
PRCInforma"tion Sy_~m
SAFf;R
@
~"
,
PRC IS
~_YPRC
* Required
+ Performance Indicator
HeJp
2005-2006
State University of New York at Albany
Prevention Research Center
.c.ent~.rlQfQ(m_gtiQn Add Work Plan Objective
.Projects
.P!:Q-Q_Y~~
Relationship
to Communication
and Dissemination
Goal
.R~guired ReDorts
Log-Out
Select which 5-year goal the objective relates to
Select one
Objective
Briefly state the objective that supports the goal (include a
measurable and specific intended outcome).*
Expected date of completion
Select one
(yyyy)
Status'
\5
Page 1 of 2
PRC IS: Center -Annual Work Plan
Nation3! t:enter for Chronic Di.se3se Prevention and Hea,ith ?romotiQn
PREVE~TION
RESEARCH CENTERS
PRC lnform~tton
SY$tQm
(PRe
IS~
'\
~-YPR(;
.CenterlofQrmQt!Qo
@
C
..
* Required
+ Performance Indicator
He!.Q
2005-2006
State University of New York at Albany
Prevention Research Center
Add Work Plan Objec'tive
.Projects
.PrQ_q!,!~t_~
.ReQuired
Log-Out
Relationship
to Infrastructure
General Information
Goal
S-Year Goals
Reports
Select which 5-year goal the objective relates to.
Annual Work Plan
Cgn1.eI--~!;.aff
Select one
CommunitY
CQrnrnjtt~e$
National Community
C9mm.il;tee(NCg
Repre$enl;!!l;.ive$
Briefly state the objective that supports the goal (include a
measurable and specific intended outcome).*
pqrtner~
Health Priorities
Research Aaenda
fY~JJ!9J;19B_P@D
\..J
Select one
Expected date of completion
Status
"'
Anticipated
Briefly
Select
Challenges
describe
address them.
(yyyy)
*
any anticipated
challenges
Priyac¥
and the plans to
Policy
I Accessibilitv
PRC Home I r~ewsI C90tQ!:;tV~
~;J;;!~;_ti!~:!1~I ;~;~!I!~t1-1 \:j£~;!!\;hI;!~li!;~'-1!.:l
This page was last reviewed on 3/13/2006
Quality Assurance Build
It{
v m1;~
Q$ 1;~
1;~$P~p~.r1;OJ~
0.1;9f H~~I1;b~D9H~ OJ
~n. $~fV.i~~$
8/21/2006
(
PRC
IS: Center- Annual Work Plan
Page 1 of 2
N$tiona! Center for Chronk Di$~a5e Prevention and Hearth Promotion
PREVEt:iTION
PRC tnform~tton
PRC IS
MYPRC
.CenterJnf9rmatjQiJ
.Projects
.PrQdy~t$
.Reguired
$iY$,tem
c
",'
RESEARCH CENTER~\@
" ! .
* Required
+ ~erfor:man!:~ Indicator
Help
State University of New York at Albany
Prevention Research Center
2005-2006
Add Work Plan Objective
Relationship
Geqeral Information
to Training and Education Goal
5-Year Goals
ReQorts
Select which 5-year goal the objective relates to.
Log-Out
Annual Work Plan
C!:c~[_S:tQ1f
Select one
Communi~
C_Qmml!;t~~
/
National Communi~
CQmmJttee<'NCQ
'---
(;
state the objective that supports the goal (include a
measurable and specific intended outcome).*
Repre$eotatiVe$
P-~~~
Health Priorities
Research Agenda
~.v~J!J~!;lQo_P-lgn
Expected date of completion
Select one
Status
Select one
Anticipated
(yyyy)
Challenges
Briefly describe any anticipated challenges and the plans to
*
address them.
Privacy: Policy: I Accgssibilitv
PRCH9!T..~I N~w~ I C9ntg~tV~
!;I;:~:~t'-QJTh~
I ~e;~!;:-t!j !:!J.o~L[(;~_~L~
This page was last reviewed on 3/13/2006
Quality Assurance Build
is
Vo)!;eQ$!;:Q!;e?Pe
P9.r!;ment9fHe9 l!;hi1oQHYmi1n$ervjG~?
8/21/2006
"IJ
~
State University of New York at Albany
Prevention Research Center
2005-2006
Add Staff Person
General InformatiQn
Select from
staff
5-Year Goals
Select one
An!J-Y.gjW-Qrk_~l9_!J
-OR
-Enter
a new staff
person below.
Center Staff
Communit~
!;;_Qmm!tt;e.e§
First name'
National Communit¥
!;;QmmIt;t;ee.(N!;;Q
Repre$entgt;iye$
Middle name
pg[!;_oe:r§
Last name
Health Priorities
Research Agenda
Degrees
Affiliation
~ygly.QJ;ign._~!gO
*
,--)
*
Telephone
Ext.
Fax
E-mail*
Roles
Which roles does the staff person have at the center level?*
0 Director
0 Principal investigator
DCo-principal
investigator
D Co-director
D Deputy director
D Investigator
D Research scientist
DAdministrative
0
0
0
0
Communications contact
Data manager
Evaluation lead
Information system contact
0 Graduate Student
0 Researcn Coordinator
0 ,9_th~!{spec!fybelow)
support
Staff Person Participation
In which
of these
",: r 11" ,""It '"~..
","
, .t""
.'.~
activities
is the staff person
most likely to
' 0"
0 Evaluation
lCo
0 Collaborations and partnerships
8/21/2006
~
PRC IS: Center -Add Center Staff
Page2 of:!
0 Resea rch
DCommunication
and dissemination
0 I nfrastru ctu re
DTraining
and education
0 Not applicable
PrjvQr,YPQJ1~y
I A~~e~~jQ.iJ.jty
PRCHome I New$ I Contg~tV$
CDC Home I Se~r!;;tJI He~JttJTQPJ.!;;~k.z.
This page was last reviewed on 10/17/2005
Quality Assurance Build
Vo.i.t~QStgt~$P~pgrtm~ot
Ngtiongl
Qf...H~g.l.tognQHumgn $~rYj!:;~$
Cent~r$ for Disegse Control god Pr~v~otioo
Center for Chronic Disegse Prevention
gnd Heglth
Promotion
PlY j$j90Qf AQUI.t gOQC 9m mu ojty H~g.l.to
\7
8/21/2006
Page 1 of 2
PRC IS: Center -Add Community Committee
Natj~n,,1 Cel1ter for Chronic Disease P'reve(\tion and Health Promotion,
PREVENTION
RESEARCH
CENTERS;,IJ:;)!
PRCInformation
System
SAFJ;R
PRe IS
MyPRC
"; I j'
~
* Required
+ Performance Indicator
H~lp
2005-2006
State University of New York at Albany
Prevention Research Center
.CenteIJof9Im9ti.QO
.Projects
.Proquct$
Add Community
Committee
G.en.ern!.lnlQLm~tiQo
.Beguireq Regorts
5-Year Goals
!"9:g:Q~t
Aon~_~J_WQrkP!.~o
ken~-.SJ;-a-ff
Community
Committees
Name'
/
was this community committee
u~j\~
J
"
/fJ~\COmmlttee
~
Select one
established?*
(yyyy)
N~tlQn91!:;;QmmYoi.ty
!:;;Qmmjtte:e:(N!:;;Q
.Re:pt:e~e:nt?tlve:s
~r~
!:!e:g!!;hPrlQf.i.!;le-.$
Number of members?*
Research Aaenda
Evaluation
Plan
)
Committee Composition
Which perspectives
*
center?
do the committee
0 Academia
D Advocate of health issue
D Business sector
DCommunity
coalition
0 Community health center or
clinic
D Community resident
0 Community-based
organization
0 County or local government
agency
0 County or local health
department
OCultural organization
0 Environmental agency
0 Faith-based organization
0 Federal government agency
0 Foundation
0 Healthcare or medical
prt:;1fessional
orga~izQuoP
1'- 1 '.'(1::,.1
\
f"' ( '~i' ( \r" r C1/"
I
'
,_.. I
"..I!.I,
,Cl
0 Hospital
.r'
'
,
.c
members bring to the
Dlndian
Health Service (IHS)
0 Labor union
0 Managed care
DMedia
0 National nonprofit
organization
D Public health practitioner
0 Research center
0 School or school-based
organization
0 State government agency
0 State health department
0 State; county or local
nonprofit organization
DTraining center
DTribal government agency
DTribal health department
0 Youth agency
( '\
.)
::'
.p' E'-(\;"
~'".I
'"JI .I"C t' I\ &', }
-i
-,
l
\l:r)
8/21/2006
>RC
~
IS: Center -Add Community Committee
Page 2 of 2
Activities
0
0
0
Identifying national; regional; or local health priorities and
health disparities within the partnering community
Facilitating communication and collaboration between the
center and the partnering community or other partners
Establishing the center research agenda
Identifying or approving research projects to be implemented
in the community
Developing or implementing the center evaluation activities
Developing or implementing the center training; technical
assistance; and mentoring activities
Developing or implementing the center communication and
dissemination activities
Conducting advocacy activities
Providing or obtaining funding
0
9th~!(~pe~!fybeI2w}
0
0
0
0
0
0
Committee
Guidelines
To upload a copy of the committee guidelines, enter the entire
path of the guidelines file or click the 'Browse' button.+
Entire path and file name
Date guidelines
last revised?
Can the guidelines
(mm/dd/yyyy)
be shared
with other PRCs?
OVesONo
PriY~!;;YPQ.lj!;;y
I A!;;!;;e$$jpj)jty
PRCH9me I New? I C9Dtq(;1;V?
CPCH_QmeI $eaIGh I Health TopiG$A-Z
Thi$ page wa$ la$t reviewed
on .10/.17/2005
Quality A$$urance Build
United States DeDartment of Health and Human Services
Centers for Disease Control and Prevention
Ng t i Qngl <;~nterfQr<; _orQ0l!;; Dj~eg~ePre Vent.l.QOg 00 He g)to PrQmQt1 QO
D jv.l.~jQOQf A Q\J.!.
t ~O9 <;Qm m-\JoJty He9.!.to-
q
8/21/2006
~
State University of New York at Albany
Prevention Research Center
Add National Community Committee
2005-2006
(NCC) Representative
General
First name'
5-Year
Middle name
Goals
A_no-v_§.!_W9IkP.!§.!:!
Ce[l1eI~Sj;gff
*
Last
Information
name
Communit~
~gmmlt;t~~_~
Affiliation*
National Community
Committee (NCC)
Representatives
Ext.
Telephone
Fax
P§J::tO-.e:r~
E-mail*
*
Type
Health
0 Primary C) Alternate
Priorities
.Research
Aaenda
~Y_~Jl'p~[I
'--"""
, ,J
Privacv Policv I Accessibility
PRc.HQm~ I N~W$ I (;;Q.QtqctV$
CDCHome I ~
I Health TORicsA-Z
This page was last reviewed on 10/26/2005
Quality Assurance Build
Un.i.t~g$.t:9te~ p~p:9[!;men!;Qf H~:9.!.!;hanQHY_man$~rYl(;e~
Centers for Disease Control and Prevention
Division
of
Adult
.,"
and
Communih,
Health
8/21/2006
(
PR~IS
.,'\
MvPR;(;
.c.enterJDfQrm~tiQD
State University
of New York at Albany
Add Partner
.prQi~(;t~
General Information
.PrQquct~
.Reguireq
I.Qg-Qyt
2005-2006
Prevention Research Center
ReRort~
Partner type*+
0 Individual 0 Organization
5:::Ye~.rGQa!$
Ao.n!J~.J.WQIkP.la[]
If organization, enter name
~~[_~t~ff
Community
CQmmj!;t~e$
When was this partnership established?*+
Select one
(yyyy)
National Communit~
!:;;Qmmlttee(NCg
R~pr~$~[]t~tiY§$
How would the center and partner characterize their
relationship?+
Partners
Health Priorities
R§$§~.r!;bAge[]ga
Select one
EVql!J~tjon P1an
'--
)
Perspectives
Which perspectives
does the partner bring to the center?*+
DAcademia
0 Advocate of health issue
0 Business sector
0 Community coalition
0 Community health center or
clinic
0 Community resident
0 Community-based
organization
0 County or local government
agency
0 County or local health
department
0 Cultural organization
0 Environmental agency
0
0
0
0
Faith-based organization
Federal government agency
Foundation
Healthcare or medical
professional organization
0 Healthcare provider
0 Indian Health Service (IHS)
0 Labor union
0 Managed care
DMedia
0 National nonprofit
organization
DPublic health practitioner
0 Research center
0 School or school-based
organization
0 State government agency
0 State health department
0 State; county or local
nonprofit organization
OTraining center
OTribal government agency
DTribal health department
OYouth agency
D 9~~~rSspeci fYbe\o~)
1:=:]
Ho~;piti3;
Activities
?/
In which center activities is the partner engaged?*+
8/21/2006
PRC IS: Center -Add Partners
0
Page2 0£2
0
0
Identifying national; regional; or local health priorities and
health disparities within the partnering community
Facilitating communication and collaboration between the
center and the partnering community or other partners
Establishing the center research agenda
Identifying or approving research projects to be implemented
in the community
Developing or implementing the center evaluation activities
Developing or implementing the center training; technical
assistance; and mentoring activities
Developing or implementing the center communication and
dissemination activities
Conducting advocacy activities
Providing or obtaining funding
0
gthe!(spec!fybe!owl.
0
0
0
0
0
0
PrjVg~Y ~QI.i(;Y I A(;(;e~$jb.i.lity
PRC Home I ~
I Contact U~
c.Dc.H--2me I Segr~h I Heg.lth TQpj~$A-?
This page was last reviewed on 10/26/2005
Quality Assurance Build
\)ill teQ $t9t ~$Pe p9rt m~nt Qi He9.1
t h 909 H!Jm9n$ ~rv .iG~
$
~ot _erUQ[-Pl~~_~_~~--<;;-Qot.r
Q.I_90QPr~Y~JJl
tQn
DivisiQO QfAdult and CQmmunitv Health
~d8/21/2006
PRC IS: Center -Add Health Priority
Nation~1 Centi;rfor
Page 1 of~~
Chronic Disease Prevention and Hft:ait:h Promotion
"
c~
PREVE~TION
Pitt: Information
(
~
.
RESEARCH CENTERS@
Sy$tom
* Required
+ Performance Indicator
Help
\
PRC IS
1
MyPRC
.C~nt_~.rJ.n_fQrm9!;i.Q[]
State University of New York at Albany
Prevention Research Center
2005-2006
Add Health Priority
.PrQj~~!;$
.Produ!;t$
.ReQuired
General Information
Enter one of the center's health priorities.
5-YearGO:Q'~
ReRorts
AnDYg'W9rk
Health priority*+
!"Qg:Q~t
P!.:Qn
~~_s.~ff
CommunitY
C9mmjttgg~
How did the idea for this health priority originate?*+
Nati9nal CommunitY
C9ffi.ffijj;J;ge(NCC)
Repre~gntgtivg~
pg~-Qg.r~
-II"eltl,
PrieFi~i8S-
Re$g:Qr~hAgenQg
()
~i;\
Data Sources and Documents
~Y:Q.l.Ygti9nP.lgn
Which data sources and documents were used to support the
prioritization of this topic?*
National
data sources
Behavioral Risk Factor Survey Surveillance (BRFSS)
Centers for Medicare and Medicaid Services (CMS)
Guide to Clinical Preventive Services recommendations
Guide to Community Preventive Services recommendations
0
Health Plan Employer Data and Information
0
0
0
Healthy People 2010
National Ambulatory Medical Care Survey
National Health and Nutrition Examination
0
National Health Interview
0
0
0
0
0
National Hospital Discharge Survey (NHDS)
Peer Review Organization/Quality
Improvement Organization
Pregnancy Risk Assessment Monitoring System (PRAMS)
Technical report national agency
U.S. Bureau of Census Data
0
n
Vital Statistics
Youth Risk Behavior Surveillance System (YRBSS)
0
county
J
and documents
0
0
0
0
State,
'--
Sets (HEDIS)
Survey (NHANES)
Survey (NHIS)
or local data sources
and documents
Behavioral Risk Factor Survey Surveillance
(BRFSS)
8/21/2006
Page 2 of2
PRC IS: Center -Add Health Priority
'3)
0
Community
needs or assets assessment conducted by PRC
0
0
0
Report or data provided by the partnering community
Youth Risk Behavior Surveillance System (YRBSS)
Other state report (specify below)
D Other local report (specify below)
0
Other (specifY below)
~
-/
Prjyq<;YPQ!J..<;y
I A<;<;e$$jpj)jj;y
P_RCHQme
I New$ I CQnJ;:Q!;;J;U$
CPCHQm~ I $~9r!;;hI H~9.1.th
TQP'!'!;;$A-2
This page
was last reviewed
Quality Assurance
on 10/17/2005
Build
U ojte q$t gte~ Depgrtm entQf.H eg.lt h~nqH~ m~n ~e fVj(;e ~
Centers for Disease Control and Prevention
Djvj~j 90 QfAq~jt~Oq~9mm~n
itYHe~.lth
8/21/2006
PRC IS: Center -Edit ResearchAgenda
Page 1 of 2
* Required
+ Performance Indicator
H~lp
(
'"
PIC IS
MvPRC
.(;;e!]!;e.rl!]fQrm~!;J.Qn
.prQj~(;t$
.PrQoucts
.R~auired
State University of New York at Albany
Prevention Research Center
2005-2006
Edit Research Agenda
General Information
Overall Research Agenda
Regorts
~-Y~a.rGQgJ$
Briefly describe the overall center research agenda.*+
~Qg~Qyt
Ann.~gJ.WQ.rkPjgn
~.S.!;2ff
CommunitY
CQmmitt;~~$
National Communit~
CQmmjtt~~(NCg
R~pr~$ent~tlve$
Partner Involvement
~q[t_r)~r~
Health Prioritle$
.0
0
Assessing the needs or assets of the partnering
0
Communicating the research agenda to the community
partners
Identifying or selecting research topics
Planning the research agenda
Other (specify below)
0
0
0
community
-~_Q,a~r,.h
or
Aga"rl~ ~
Evalugtion Plan
\..
!
Evidence of Partner Input
Where can evidence be found of partner input into the activities
listed above?*+
0 Letters of support
0 Retreat summary
0 Meeting minutes
0 Memorandum of
understanding
DOther
(specify below)
Pr.ivqGYPQIi.GY
I AGG@~~jbll.jtY
PR~HQm@I N@w~I ~QntQ!;tU~
~~1:fQ!!1g I $@qrGhI H@qJth
TQpjG~A-b
Thi!; i:)i1~lewi:!slast revic'/1/ed on 11J/17f!'OO~~
t:!uallty J\ssura nce BI;iid
Un .it e Q St ~ t e $ De p~r!;m en t9f
H e~ 1.tha .Q.QHYmaBS e [V.ice$
Center$ for Di$ea$e Control anQ Prevention
N~tional
Center
for <;;hronic Dj$e~$e Prevention
~nd H~~jth
D.i.v!$.i9n9f AQ~Jt~nQ<;;9mmY
n.it;y H~~)th
~5--
Promotion
8/21/2006
(
PFtCIS
MyPRC
.PrQje~t~
.PrQqu~ts
!"Q9:Qyt
of New York at Albany
2005-2006
Prevention Research Center
.Ceote:r.lofQrm11tiQo
.Required
State University
Edit Evaluation
Community
Plan
Committee
General Information
Involvement
2::Y§Q.rG9g..l~
ReRorts
In which center evaluation
committee involved?*+
0
0
0
0
0
0
0
0
plan activities is the community
Annyg..lW9rkPIgQ
(;;_e_!lterSJ;gff
Collecting data for the evaluation
Communicating results to the community or partners
Communicating results in publications or presentations
Developing or refining the PRC logic model
Developing the evaluation plan
Recruiting or engaging other partners in implementing the
evaluation
Recruiting or engaging other partners in planning the
evaluation
Other (specify below)
Communit¥
(;;Qmmjttee~
National Communit~
CQmmit;tee(N(;;(;;)
Rep.re~eot~tive~
eqrt~~
Health Prioritie~
Research Aaenda
Evaluation Plan
'"
)
Evidence of Community Committee Input
Where
can evidence
the center
evaluation
be found
of community
input
into
0 Retreat summary
0 Other {specify below)
0 Letters of support
0 Meeting minutes
0 Memorandum of
understanding
Evaluation
committee
plan?*+
Plan
To upload a copy of the center evaluation
plan, enter the entire
path of the evaluation
plan file or click the 'Browse' button.*+
Entire
path and file name
Date evaluation
plan last revised
Can the evaluation
aYes
Ler9W$e
I
(mm/dd/yyyy)
plan be shared with other PRCs?
(~)No
Evaluation
Name
Plan Files
Size
Revised
\,JI\.lP?
,l~i._\~r~':t.._;'J;;'J.._p.'~n,pi:if
~:55 (1:2../28.,'2004
Logic Model
Share
f\1
Delete
D
db
8/21/2006
~
Page 2 of 2
To upload a copy of the center logic model and narrative,
the entire path of the file or click the 'Browse' button,*+
Entire path and file name
Date logic model
/
)
~fOW$e,
last revised
Can the logic model
enter
(mm/dd/yyyy)
be shared
with other
PRCs?
,~,
\, Yes \_) No
Logic Model
Files
Name
Size
QYrJQgJ~mQdel_fm9L,pdf
15 K 05/05/2004
Revised
Share
Delete
y
D
Pr.ivaGYPQ.!.jGY
I AGG~~~.ipj!.ity
PRhH9meI New~I c.Qnt~~tV~
CP!;;H_Qme
I $e11[!;;h
I He11J.tb
TQpj!;;$A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
United States Department of Health and Human Services
.c-e:m~L~fQ.r_~_~.c.9D tr:QL~_lJdPr:~-Y~[1_ti9.n
Djy j~jQIJ Qf A.gy..!tgDdCQ m m y ojtyH ~~.!.
to
;;;;)-7
8/21/200<:.
Prevention
Research Centers
PRC Information
System
r
[I
PRCIS: Projects- Edit GeneralInformation
Page 1 of 2
National Cef'!ter for Chronic D1seascePrevention and Hea~th Promot1on
PREVE~TION
5"'Fr;R"'~J\..T"'~""'~QP..~ PRC Information
PRe IS
M_yPR_C
.Cent_erJDfoIm9tion
.Projects
.proq\.!ct$
RESEARCH CENTERS@
SY$tem
HeJp
State University of New York at Albany
Prevention Research Center
Educational
2005-2006
Resources Video Project
General Information
Edit General Information
Proj~!;;tGO9.1$
.ReQuired Regorts
!"Qg:()yt
* Required
+ Performance Indicator
AnO\J9JWQrk P.l90
Title*
Educational Resources Video Project
Principal
investigator
F\Jnding
D9t:QSQ\J.rGe$~
FO!;;\J$Area$
Other Project
Type
Start date
CQO~!;;t$
PQP\J.I:Qt)QoSt\JQied
*
June
2005
November
2005
End date
KeywQ.rQ$
CQmm\Jolty
CQmm..ittee$
P9rtoer$
Is the project
a research
O\Jt!;;ome$ &
AQY90Ge$
project?*
(:JVes (~No
Prod\Jct$
If yes, indicate the type of research.
'"-oJ
0 Determinant
0 Intervention
0 Dissemination
D,Q~he!{specify below)
If yes, indicate level of prevention.
D Primordial
DPrimary
DTertiary
0 Other (specify below)
DSecondary
Project
description
Briefly describe the project.
PriVq!;y PQJjcy I AccessibjJjty
PRCHome I ~
I .(;;.Qn~
?-i
CDC Home I $eQI~h I H~Q.l.thIQpj~$A-Z
8/21/2006
"',
~
PRC IS: Project -Add Project Goal
Page 1 of 1
t'fatk1nal Cente%for ChrQrnc J)j$~a$e PrevfJntion and HfJa.JthPromQ1;ion
PREVE~TION
PRCInf()rm~ti<>f1
Sys;tem
(
PReIS
MYPRC
.C~ot~rJofQI.m_~j;jQo
.Projects
.PrQg!J!;;t~
* Required
+ Performance Indicator
RESEARCH CENTERS'~
~
Help
State University of New York at Albany
Prevention
Educational
2005-2006
Research Center
Resources Video Project
G_engrgIJof9.rmgt..i9D
Add Project Goal
Project Goals
.ReQuired ReQorts
Log-Out
cAl)mJ~LW_9r~_PJ_~n
Goa I Statement
~9_o.~
Briefly describe one of the project goals.*
Funding
Data Sources
Focus Areas
Po~ulation
&
Studied
KeYW_Qrd~
Expected date of completion
*
(;;2-rru:I1_Y-o.!!;y
Selec
(yyyy)
~ommittee?
p-qrtD_~
Status *
Outcomes &
cAJ;!YQ~§
Products
\..J
Privg(;vPo.!i(;YI A(;(;e$$..ip).i..itv
PRCHome I ~
CPCHome
I Contact Us
I Seg.r~h I Heg..l.thTQpj~~A-Z
This page was last reviewed
on 10/17/2005
Quality Assurance Build
United States Deoartment
of Health and Human Services
~_~[)ter~f.QLPj~9c~
~_~QntrQLB-D_c:1e
reY_enti911
Division of Adult and Community Health
8/21/2006
Project -Annual Work Plan
Page 1 of 2
NaTro"al Cent£;;rfor Chronic Disealila Prevention ~!1d Health Promotio"
PREVE~TION
RESEARCH CENTERS
PRC Information
SY$t~m
r-~.
PIC IS
MyPRC
.C~nte.rJnfQ.rm~tiQn
.Projects
.PrQqYGt~
'""
,
@
c"'"
State University of New York at Albany
Prevention Research Center
Educational
Resources Video Project
Gener~.!.illfoIm~tjQD
Add Work Plan Objective
>RCIS:
Relationship
Help
2005-2006
Proiect Goals
.ReQuired Regorts
Log-Out
* Required
+ Performance Indicator
to Project Goal
Annual Work Plan
~II_~~~
Select which project goal the objective relates to.'
Funding
Select one
Data Sources &
Focus Areas
PoQulationStudied
KeYWOId?
Objective
Briefly state the objective that supports the goal (include a
measurable and specific intended outcome).*
~Qmm.Y_nj!;y
~o~fIljttee~
P~_[\;ner~
Outcomes &
A.-<;l~(!~~
Products
"'"-LJ
Expected date of completion
Status
*
Anticipated
Select one
(yyyy)
Select 0
Challenges
Briefly describe any anticipated challenges and the plans to
address them.*
PrjVg~YP9J'!;Y
I ,~~!;;~$~jbjJ.ity
~'F"Ct;Qm~ J N~w~ I <=Q!J.t;~~t!,;i~;
CDCHomeI $eQ.r!;;h
I H~QJth.IQP)!;;$A~.z
This page was last reviewed on 3/13/2006
Quality Assurance Build
3
IS: Projects -Add Project Contact
(
>RC
~
PReIS
"\
M_YPRC
.<;;~_DterJnfQrmgti.Qn
.Projects
Page 1 of2
State University of New York at Albany
Prevention Research Center
Educational
2005-2006
Resources Video Project
.Pr9g!'!Gt~
.Required Regorts
Generg'
..Information
Add Project Contact
Project Goals
Log-Out
Annual Work Plan
Contacts
ryndlnQ
Data Sources &
fQ~!,!L~
First name*
Middle
Pogulation Studied
Keyword~
name
Last name
*
CQmm!'!ni~
Committees
Degrees
~~rj;J:1..f:r~
Affiliation*
QJJ~-~S"&'
A~
Ext.
Telephone*
~[Qq\!(;t~
Fax
,
J
E-mail*
Contact
Select one
Type'
Roles
Which
role does the staff
person
0 Principal investigator
0 Co-principal investigator
0 Investigator
0 Project director
have at the project
level?*
0 Project manager
0 Research Coordinator
0 Graduate Student
0 Other (specify below)
Prjv~!;:YP9!1~YI A!;:~g~~jpilltv
Pt\,c.H!;:!!D~~
i N~,~'~Y~
I ~Qnr;~!!;;tU~
CDC Home I $eQ[!;h I He:Qtth.I9Pj!;$A:.?
3~
This page was last reviewed on 10/17/2005
Quality Assurance Build
8/21/2006
~
Page 1 of 1
PRC IS: Projects -Add Funding Source
(
--,
PIC IS
MyPRC
.Center
l.nf9rmqti.9n
"\ ,
2005-2006
State University of New York at Albany
Prevention Research Center
Educational
Resources Video Project
.Projects
.ReQuired
Log-Out
G~o~r~!ln.f9rm~t;.I9D
Add Funding Source
.Pr9d!,l~t~
Proiect G9als
ReDOrts
~JJ~y:!-Q[ls,J!lgn
Source of funding*
~ontacts
Select one
Funding
Data Sources
Focus Areas
If source above is 'Other', specify below
&.
PoQulatlonStudied
KeywQrQ~
Yearly amount
~ommunjt.v
Committees
Enter the amount of yearly funding dollars.
P~!t;D~.r~
Outcomes &.
AQ~~n~~~
Products
\.)
PriYQ(;YPQ.!.\!:;y
I A(;(;~$$jbj\i!;y
PRCHQme I ~
CO~tI~
I CQntQ(;tU$
I S~ar(;hI H~a..l!;h.IQpjG~.A-Z
Thl$ page wa$ la$t reviewed
Qn 10/17/2005
Quality A$$uran(;e Build
Unjt ~Q$:tg te $Qe pgrtm ent Qf H~9It h ~n dHy m~n. $:erv iGe$
~en_te.~-.fQ[Q~~~.<:;Qn.\;[Q1-.an~~~I]
Division of Adult and Communi tv Health
33
8/21/2006
0
PRC IS: Projects -Edit Data Sources & Focus Areas
"
(
State
University
of New York
at Albany
PRCIS
2005-2006
Prevention
MYPR~
.C~_ot~rillf9ImatLQn
.Projects
.Pr90V(;ts
.Required
Research
Educational
Center
Resources Video Project
G~o~r?J1QfQrmatiQO
Edit Data Sources 81.Focus Areas
Proiect Goals
Regorts
!.99~QYt
Aooy?LWQrkPI?_o
Data Sources
CQota!;t~
Which data sources were used to support the development
of the
project?
~
Oata !uur~~s
&"
FocusAreas
D Guide to Clinical Preventive Services
PQPqJq1;jQQStyqi~q
D Guide to Community
Ke:ywQrd~
Preventive Services
CQmmyoity
D Healthy People 2010
tv
Funding
CQmmJ.!;!;e:e~
D Other national data source (specify below)
0
0
P?rtoeI~
Outcomes &
Ad.Y~nGe~
Other state data source (specify below)
Products
'--
Other local data source (specify below)
)
Focus areas
Which focus areas relate to the project (as listed in Healthy
People 2010, Guide to Clinical Preventive Services, and Guide to
Community
Preventive
Services)?*
0 Access to quality care
0
0
Arthritis; osteoporosis;
back conditions
Cancer
0
Chronic kidney disease
0
Diabetes
0
chronic
Disability and secondary
conditions
0 Educational and community-based
programs
0 Environmental health
F:~ 1"" 11y\.It!''''.!:1
...1- r' "' 11"'
--I
1._",1,
0
Medical product safety
0
Mental health and
mental illness
Nutrition and
overweight
0
0
Occupational
and health
0 Oral Health
safety
0
Physical fitness and
activity
0 Public health
infrastructure
0 Respiratory diseases
t'~ J c' I"""J " lll '" tr ~ T"" n 'tt ""
cjsf~ases
~,:",("",".I'
1
Food safety0
0
Social determinants
Health communication
0
Substance abuse
30/
8/21/200()
~
Page 2 of 2
PRC IS: Projects -Edit Data Sources & Focus Areas
0
Heart disease and stroke
0 Tobacco use
0
Human Immunodeficiency Virus
(HIV)
Immunization and infectious
diseases
0 Vision and hearing
Injury and violence prevention
D. Other state focus
a rea(spec..ifybe)o~)
0
0
D Maternal;
infant; child health
D Other national focus
area (specify below)
0
Other local focus
area (specify below)
PRCHome I ~
CQ!::__1::!_9_me
I $~q[~b
I Contact Us
I l::!~qltbTQpj~~A~.z
This page was last reviewed on 10/17/2005
Quality Assurance Build
Un)t~d$tQt~§ P~PQr1;m~nt
Qf...HeQ1.thQndH\JmQn..$~rvj<;e$
c.enter.§lQrPj$_~g~e~QntrQL:Qngpr event!'Qn
Division of Adult and CommunitY Health
'35"
8/21/2006
~
PRC IS: Projects -Edit Population Studied
(--;;-;;-'~
M~ PRC
.Center
Information.
"--
Page1 of2
State University
of New York
Prevention
Research
Center
Educational
..
Video
Resources
at Albany
2005-2006
ProJect
.PrQje~t$
.Products
Edit
Population
Geoerg.lJO.f9rmgti9o
Studied
.ReqYJregRePQr!;$
Log-Out
Which of the following
of the project?
best characterizes the sample population
~
'('\(I\Ri~dII '
Aooual
W9rk Plan
~-9ntg~_t$
Data Sources
&
FQ~!,I~-Ar.eg$
0 Hispanic or Latino
0 Not Hispanic or Latino
*
G9als
EyoQl!}Q
Ethnicity*
Race
P(9ject
D Unknown at this time
D No specific focus on ethnicity
Age group
Studied
Ke~words
C;gmmyolty
Committees
(Check all that apply)
DAfrican American or Black
DAmerican Indian or Alaska
Native
DAsian
0 Native Hawaiian or Other
Pacific Islander
Population
0 White
U Unknown at this time
P9-rtoer~
LJ No specific focus on race
p:[~g!,!(;t~
Qy_t~Q_me$_~
AgY_Qn~e.$
\..'.ccJ
*
0 Infant
DChild
D Adolescent
DAdult
0 Older adult
D Unknown at this time
[j No specific focus on age
group
[j ,9the!.\?pec!fybelow)
Sex'
OMen or boys
[] Women or girls
EJ Unknown at this time
Setting
LJ No specific focus on sex
LJ,Qthe!(spec!fybelow}
or site*
0 City
0 County or parish
0 Medical or clinica1 site
LJ Rural Area
DSchool
DTribal nation
0 Urban area
DWorksite
0 Unknown at this time
0 No specific focus on setting or
site
Dqtherjspec)fybelow)
3G
8/21/2006
Page 2 of
PRC IS: Projects -Edit Population Studied
Study sample size
Underlying
population
size
Prjyg!;YpQIJ.!;y
I A!;!;e$$jpj1.i.1;y
PR(;;HQm~I N~w$ I (;;QotqGtU$
CDCHome I $eQ[!:;oI tleQ.!.toIop.i.!:;$A::l
This page was last reviewed on 10/20/2005
Quality Assurance Build
\)ojtedSt9te $Pep9rt m entQfHe9Jto90d H~m9.nServj~e$
National
Centers for Disease Control 90d PreventiQo
Center for Chronic Disease Prevention
and Health
Promotion
PjYi$jQOQf.Ad~.lt90dCQ
mm~o.i.!;YHe9Jto
37
8/21/2006
~
PRC IS: Projects -Add Keywords
(
Page 1 of 1
-"", State University of New York at Albany
Prevention Research Center
2005-2006
PRe IS
,
MvPRC
.Center lof9rm9ti9n
.Projects
.er~gy(;t~
Educational
Resources Video Project
G ~-IJ~f9U n f Qf!Il- 9_tiQO
Project Goals
.ReQuired Regorts
Log-Out
A_IJDJJ.-Q.L_W2rk_PlaD
Add Keyword
(;;QO!;9_C_t~
To search for CDC keywords, enter three or more letters of a
word and click 'Search' button.
Funding
Data Sources &
Focus Areas
PoDulation Studied
phrase'
Keywords
kQr!:1JI1_lJ11j!;y
~rn_!Illtl~e~
~~
Outcomes &
AgY9_IJC~_~
progucts
,--J
Priyg!;;YPQ.lJ!;;y
I A'!;;~~~i..b.i..ljty
PRC !::!om~ I ~
I Contg!;;t Us
GQ_c._!:I-9m~
I $~g.r!;;h I H~g)thIQpj'~A-Z
This page
was last reviewed
on 10/17/2005
Quality Assuran!;;e Build
Un j1;gg S 1;:Q1;g
$ Rgp ~ rt mgntQ f. Hgg..lth gng Hym 9 oS g(Y j~ g $
~~~-Q.I~~~Q!~M-.P
re ve n tlQ!:!
Djvisjon of Adult and CommunitY Health
3D
8/21/2006
~
~
Page of2
NatlQpe! Center for Chronic Disease Prevention «nd Health Promotion
PREVE~TION
PRCI.nfom1act.onSystem
PRe IS
M_YPRC
.PrQducts
.Required Regorts
CENTERS
f/;)
...~
State University of New York at Albany
Prevention Research Center
.C~n!;e.rlo_fQ.r_m~!;i.Qn
.Projects
RESEARCH
Educational
* Required
+ Performance Indicator
Help
2005-2006
Resources Video Project
Add Community
G~n~rqJl[}f9r.mQt.iQn
Committee
Pr9ject G9als
~-D_~Y.QLWQr.!s~@J)
!",Q9::Qyt
C_Qn!;g~!;~
Funding
Data Sources &
Focus Areas
Pogulation Studied
K~YW9r.d~
When did the community committee and the center start working
t 0get~er~~cthi~pr9je ct?
Selectone ;.iii'
(yyyy)
~_III.mYI!.ity
~Qmmlt!;g~~
PQr.tner.~
Outcomes &
~qYQn!;;e~
Number of members
Products
'-Committee
J
Compo!;ition
Which perspectives
do the committee
members bring to the
project?
DAcademia
0 Advocate of health issue
0 Business sector
DCommunity
coalition
0 Community health center or
clinic
DCommunity
resident
DCommunity-based
organization
0 County or local government
agency
DCounty or local health
department
0 Cultural organization
0 Environmental agency
DIndian Health Service (IHS)
0 labor union
0 Managed care
DMedia
0 National nonprofit
organization
D Public health practitioner
0 Research center
0 School. or school-based
organization
0 State government agency
0 State health department
~ \-iea:trlc,are':II medi.t::c.1
0 State; county or local
.nonprofit organization
DTraining center
DTribal government agency
[]Ti'i'-;al h~i:I~~h1:!E~p,:)'trl;e'1t
0 't'outh a.~EI\c\j'
professional organization
0 Healthcare provider
0 Other (specify below)
0 Faith-based organization
0 Federal government
.3gency
["~ ~l)lJnl:"util:)"':
3{
0 Hospital
8/21/2006
PRC IS: Projects -Add Community Committees
Page2 of2
Activities
In which project activities is the community
committee
engaged?
0
0
Conceptualizing the project
Selecting the project
0
0
0
0
0
0
Establishing project goals and objectives
Developing and planning the project
Conducting or implementing project activities
Evaluating the project
Communicating or disseminating project activities and results
Other (specify below)
PrjY~~YPQJ.i~Y
I A~~e$$jbj.!jt.y
PRCHome I ~
I Contact Us
~O_~r1J.e: I S~Qr(;hI H~Q.!.th.IQpj(;~A::1
This page was last reviewed
on 10/17/2005
Quality Assurance Build
United Stgte$Pepqrtrnent
Qf Heqlth qnd l-j\JrnqnServj~e$
(;;~!:1tgr-~
fQr Q [$~9~__!;:_Qn!;rQ.!_q!:1g
_Pr~ven!:lQn
Division
Qf Adult
gnd Comrn\Jnit~
Heglth
8/21/2006
~
PRC IS: Projects -Add Partner
Page 1 of2:
N~tj;QnajCenter for Chronic Dise;}sePrevention :an.dHe;althPromotion.
PREVENTION
PRC Inform~tion
r
PIC IS
'"
,
MY~R(;
.!;;enterJnformgtlQn
.PrQqlJ~ts
.Required
CENTERS
@C
State University of New York at Albany
Prevention Research Center
Educational
.Projects
RESEARCH
System
:~:~~~~anceIndicator
Heip
2005-2006
Resources Video Project
Gen_er~I..JnfQrm~tJQn
Add Partner
Project Goals
Recorts
A!JnQq'WQr.~_e@n
!"Og-Qyt
~Qnt~-<;!:_$
Fundinq
Data Sources &
Focus Areas
Partner type .0
Individual 0 Organization
Population Studied
KeywQrd$
If organization, enter name
When did the partner and center start working together on the
project?
Select one
.How
(7)\) e-\& e-
-
would
Outcomes &
AdY~n4~$
Prgducts
(yyyy)
the center
~mYn~y
~mltte.e~
Partners
~.
and partner
characterize
J
their
relationship?
Select one
Perspectives
Which
perspectives
does the partner
DAcademia
0 Advocate of health issue
0 Business sector
0 Community coalition
0 Community health center or
clinic
DCommunity
resident
0 Community-based
organization
0 County or local government
agency
0 County or local health
department
0 Cultural organization
0 Environmental agency
bring to the project?
0
0
0
0
0
Indian Health Service (IHS)
Labor union
Managed care
Med ia
National nonprofit
organization
0 Public health practitioner
0 Research center
0 School or school-based
organization
0 State government agency
U j=ai1th,-oasedorgarJizatiorl
0 State health department
0 State; county or local
r!on~)r,:.fit ol"g'ani,:,3ti:)n
o'.rrairling Ct?nter
0 Federal government
DTribal
0 Foundation
agency
government
agency
OTribal health department
~,
8/21/2006
~
PRC IS: Projects -Add Partner
Page 2 of 2
0 Healthcare or medical
professional organization
0 Healthcare provider
DYouth agency
DOther
(specify below)
0 Hospital
Activities
In which project activities is the partner engaged?
0
0
0
0
0
0
0
Conceptualizing the project
Selecting the project
Establishing project goals and objectives
Developing and planning the project
Conducting or implementing project activities
Evaluating the project
Communicating or disseminating project activities and results
0
Other (specify below)
Privacy Policy I Accessibility
PRCH9me I New$ I <;QntQ~!;U$
CDCHome I ~
I Health Tooics A-Z
This page was last reviewed on 10/17/2005
Quality Assurance Build
United
States De p artment
Centers for Disease
of Health and Human Services
Control and Prevention
Promotion
Djy i.~jOQof Ad!,!..!t9ndComm!'!n
ityHeg..!th
8/21/2006
Page 1 of 2
IS: Projects -Edit Outcomes & Advances
N3tio~1 Center for Chronic Dlse3se Prevenl:ion ano He311:hP,omotion
PREVEt:iTION
PAC Information
"
(
PRC
PRCIS
MyPR<;
.c.en!;_eI_t.of9rm~!;_LQn
State
CENTERS
@
~
System
University
Prevention
RESEARCH
of New York
Research
Educational
at Albany
2005-2006
Center
Resources Video Project
.Projects
Edit Outcomes-
.PrQQY(;!;$
.ReQuired
* Required
+ Performance Indicator
Help
GenergJlofQrmgtiQn
& Advances
-Project Goals
Reoorts
p..IlJlY~l.WQ[~Plgn
I.Qg-Qyt
Expected Outcomes in Community,
Health
Practice, Policy, and
C~llt~g$
Funding
Data Sources &
What are the expected outcomes for the project?
Focus Areas
Pogulation Studied
KeywQ[q$
~mmMolt.Y
Commit1;.~e~
P~[!:_1ler.5
-OYt~g~8S
gt
Ad";aAeeS
-
Actual Outcomes in Community,
Health
\)J.6e-
Practice, Policy, and
-
Products
lJ
Which has been an outcome of the project?*
0 Change in health status or
bei:1avior
0 Change in physical
environment
DChange in clinical practice
0 Change in public health
practice
0 Change in sociocultural
environment
0 Enhanced community
capacity
0 Policy change
D Uptake of intervention
D Not applicable at this time
DOther(specifY
below)
Actual Outcome Description
Briefly describe each outcome checked above. (Include specific
community or communities affected, numbers reached or served,
and time frame of outcome.)
Lfj
8/21/200(;
RC
~
IS: Projects -Edit Outcomes & Advances
Methodological
Page2 of 2
and Theoretical
Advances
The project furthered the field of prevention research by
developing, testing, or disseminating which of the following?*
0
0
0
0
Guidelines
Measures
Methods
Models
Methodological
D Procedures
D Theories
D Not applicable at this time
D9ther(specifybelow)
and Theoretical
Advances Description
Briefly describe each methodological
checked above.
and theoretical
advance
~rjvac.Y~QU1;Y
I Ac.1;e:$$jpJ.lity
PRCHQme I New$ I CQntgGtV$
CDC Home I SeQr~h I HeQ..!.thTopi.~$A-?
This page
was last reviewed
Quality Assurance
on 10/17/2005
Build
UnJ.
I;e d$ I;gl;e $p e Pg! I;menl; Qf..He g.!.
I;h g ndHY m g n $e rvJ.(;e$
Center$ fQr Di$ea$e CQntrQI and PreventiQn
NatiQna.J Center fQr ChrQni(; Disea$e PreventiQn and Health
Promotion
P1Y1.$ionQfAdy.!.l;gnd CQmmynlty Hegll;h
~~
8/21/2006,
r
PRC IS: Projects -Products
Page 1 of 1
Natj
the PRC IS will look with the
Training
Data Entry fields will go he~.,.."
/'""\1{ )
,
I Contacts
r;-ro
Page 1 of 1
-~"
(
PReiS)
MYPRC
.Centerlnf9rm9tiQD
.PI~
.Products
(~::::=~~~~5)
2005-2006
University
of New York at Albany
Prevention Research Center
Interim Report
'-
InterimReport
Dule: May 12
Step
Status
1.
Review 2005-2006 Center Goals t
Obiectives & Activities
Complete
2.
Review 2005-2006 Project Goals,
Obje!;;tJve$&A!;;tiv.itie$
Complete
3.
I rgD~f~r J nIQrm gt)Qn. tQ.200 6=4OO?
Incomplete
4
Review 2006-2007 Center Goals,
Objectives & Activities
Incomplete
5.
Review 2006-2007
Project
Objectives
& Activities
Incomplete
View I Finalize
Goals,
Print Report
J
DRAFT: Past Due
PnYg~YPQJ.i~y
I A~~e$$jbjJ..ity
PR<;t!Qme I New$ I CQ.n.tQ~tU$
(;:-Pk_lj~m~I Segr~h I t!eg.!tb..IQP1~$A::Z
Thi$ pgge wa$ la$t reviewed
Quality A$$urance
on 3/29/2006
Build
United States DeDartment of Health and Human Services
~gntg ~fQIQ isg_~s
~ C.Qntr_Q.!..ao_Q_Pr
~~I:1J;lQO
NQtiQI:1QI.Center
.fQrChrQn.i~P.i$eQsePreYent.iQnQndHeQ\thPrQrnQt.iQn
P.iY.i
$iQnQf.Ad\!Jt QndCQrnrn\!1:1
ity HgQJ.th
S-7
http://qa.nccd.cdc.gov/myPRCAdmin/reports/Overview.aspx
State
6.
8/21/2006
File Type | application/pdf |
Author | tlp6 [ TLP6-158680 ] |
File Modified | 2006-09-25 |
File Created | 2006-08-22 |