APPLETREE Annual Performance Report (APR)

APPLETREE Performance Measures

Att4e APPLETREE APR Template 20200325

APPLETREE Annual Progress Report (APR)

OMB: 0923-0057

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Attachment 4e. APPLETREE Annual Performance Report (APR) Template


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Form Approved

OMB No. 0923-0057

Exp. Date 07/31/2019





RFA-TS20-2001

ATSDR’s Partnership to Promote Local Efforts to Reduce Environmental Exposure (APPLETREE)



Annual Performance Report (APR)







Name of Jurisdiction/Agency Submitting Plan: Click to enter text

Point of Contact for Correspondence: Click to enter text

Email: Click to enter text

Phone: Click to enter text















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ATSDR estimates the average public reporting burden for this collection of information as 2 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0923-0057).



Executive Summary

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Performance Measures

Performance Measures:

Table 1. Process Performance Measures

Performance Measure

Component/

Strategy

Quantitative and/or Qualitative Results

Target, if applicable

Proportion of activities completed from work plan

1/A

Click to enter text

80% (standard)

Proportion of site-specific assessments completed from work plan

1/A

Click to enter text

Click to enter text

Number of internal and/or external capacity building opportunities engaged to expedite release of assessments and educational products

1/A

Click to enter text

Click to enter text

Assessment that defines the childcare landscape and identifies needs*

1/B

See CSPECE Reporting Supplement

N/A

Number of partnerships identified to help prevent exposure*

1/B

See CSPECE Reporting Supplement

Click to enter text

Choose Safe Places for Early Care and Education Pilot Plan*

1/B

See CSPECE Reporting Supplement

N/A

Number of MOUs and/or letters of intent from partners demonstrating long-term commitment to program**

1/B

See CSPECE Reporting Supplement

Click to enter text

Completion of sustainability plan**

1/B

See CSPECE Reporting Supplement

N/A

Identification of key implementation barriers, facilitators, and lessons learned

2

Click to enter text

N/A








Table 2. Outcome Performance Measures

Performance Measure

Component/

Strategy

Quantitative and/or Qualitative Results

Target, if applicable


Number of health education and/or community involvement activities completed to disseminate information to partners, stakeholders, and community members.

1/A

Click to enter text

Click to enter text

Number (and percentage) of public health recommendations made by recipients that are accepted by stakeholders

1/A

Click to enter text

Click to enter text

Number (and percentage) of public health recommendations made by recipients that are adopted (implemented) by stakeholders within performance period

1/A

Click to enter text

Click to enter text

Number (and percentage) of sites with decreased or eliminated exposures based on recommendations that are adopted (implemented) by stakeholders

1/A

Click to enter text

Click to enter text

Number of partners indicating commitment to help prevent exposures in ECEs*

1/B

See CSPECE Reporting Supplement

Click to enter text

Identified barriers, facilitators, and lessons learned from pilot process*

1/B

See CSPECE Reporting Supplement

N/A

Execution of enhanced/expanded program**

1/B

See CSPECE Reporting Supplement

N/A

Number of infrastructure enhancements implemented**

1/B

See CSPECE Reporting Supplement

Click to enter text

Number (and percentage) of ECEs referred to program that make changes because of identified issues***

1/B

See CSPECE Reporting Supplement

Click to enter text

Number of policy, systems, and/or environment changes to support prevented exposures***

1/B

See CSPECE Reporting Supplement

Click to enter text

Description of effective practices, policies, and processes for preventing exposures***

1/B

See CSPECE Reporting Supplement

N/A

*Intended only for previously NOT funded under TS17-1701; those previously funded may delete

**Intended only for previously funded under TS17-1701; those NOT previously funded may delete

***Intended for both previously funded and not funded under TS17-1701







Table 3. State-Specific Performance Measures

Performance Measure

Component/

Strategy

Quantitative and/or Qualitative Results

Target, if applicable

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Add additional rows as necessary















Evaluation


Table 4. Evaluation Design and Data Collection:

Component: Click here to enter text

Strategy: Click here to enter text

Activity (What activity is in the logic model?): Click here to enter text

Describe the activity in less than 200 words: Click here to enter text

Evaluation Question

What do we want to know?

Indicator

How can we measure the answer?

Data Source(s)

Where do we get the data?


Data Collection & Analysis Methods

How do we get the data?

Question:

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Select one:

Process question

Outcome question


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Select at least one:

Data already exist

Collecting new data

If collecting new data:

Survey

Interview or focus group

Observation

Other_____________


When will data be collected:
At one point in time (cross-sectional)

Baseline/follow-up format

Retrospective post

Pre/mid/post

Other, specify:______


How are you analyzing data:


Add additional rows as necessary





  • Description of results for reporting period considered significant: Click to enter text

  • Changes to Evaluation Plan: Click to enter text

  • Barriers during reporting period: Click to enter text

  • Facilitators during reporting period: Click to enter text

  • Conclusions: Click to enter text


*Copy Table 4 and bullets for to report out on each component/strategy as necessary.









Successes

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Work Plan

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Challenges

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CDC Program Support to Awardee

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