Recipient Evaluation Year 4 Sustainability and Action Re

Form Approved

OMB No. 0920-xxxx

Exp. Date XX/XX/20XX

DRAFT

[INSERT NOFO HERE]

Recipient Evaluation Deliverable Guidance & TA Tool

Year 4-Sustainability and Action Report Guidance

Note:Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-20HP) Public reporting burden of this collection of information is estimated to average 8 hours per response, 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.

Each year [INSERT NOFO HERE] recipients are required to submit a different evaluation deliverable that reports the findings from the previous year’s evaluation for the specific core area outlined in the [INSERT NOFO HERE] Evaluation and Performance Measurement Plan Guidance. In Year 4, recipients are required to submit a Sustainability and Action Report that describes the evaluation core area of Sustainability. Developing this report allows recipients to undergo a thoughtful evaluative process that should precede sustainability planning for strategies that they wish to continue implementing.

This report should include a Strategy Overview and a Strategy Action Report for each strategy evaluated. This reporting deliverable is due to CDC on [INSERT DUE DATE HERE]. Specific instructions for submission will be provided prior to that date. The reporting deliverable will require up to 8 hours to complete.

The Strategy Overview (1 page) can be presented for each evaluated strategy or as a general overview if your evaluation questions and findings cut across all evaluated strategies. It should include:

(Table 1 in TA Tool)

• Activities within the selected strategy: Describe the activities that were evaluated for the selected strategy. (This can be taken from previous evaluation deliverables).

• Collaborators/Partners and roles: Describe how the identified collaborators and partners played a role in creating sustainability for the activities under this strategy.

• Intended outcomes: Describe the intended outcomes of the strategy and whether the activities to date are helping to meet these outcomes.

• Summary of efficiencies: Describe how implementation of the strategy affected efficiencies within your state health department, related to infrastructure, management, partners, and financial resources.

• Summary of effectiveness: Describe the extent to which you have been effective in implementing the selected strategy. This includes the reach of the strategy, steps taken to expand reach, early outcomes, and a description of the facilitators and barriers.

The Strategy Action Report (1 page for each strategy evaluated) should include:

(Table 2 in TA Tool)

• Activities evaluated: List the activities you evaluated for this strategy.

• Benchmarks tracked: Describe what indicators related to monitoring the strategy you tracked over the course of the previous four (4) years.

• Progress towards outcomes: Describe the progress you made in tracking benchmarks and meeting intended outcomes through the end of Year 4 for the strategy evaluated.

• Evidence of impact: State the level of impact: A - Strategy has Evidence of Impact; B – Strategy Shows Promise but Requires Mediation; C – Strategy has No Evidence of Impact. If A or B please describe evidence. If C stop here.

• Supports for sustainability: Describe the supports needed to continue implementing this strategy (if applicable).

• Action to be taken: Describe what steps should be taken to continue future implementation for this strategy (if applicable).

Table 1. Strategy Overview

Note: You may choose to present the required information in three separate tables for each of the evaluated strategies or, if your evaluation questions and findings cut across all three evaluated strategies, you may present the required information only once in one table.

Strategy/Strategies:
Topic	Description
Activities within the selected strategy	Describe the activities that were evaluated for the selected strategy. (This can be taken from previous evaluation deliverables).
Collaborators/Partners and Roles	Describe how the identified collaborators and partners played a role in creating sustainability for the activities under this strategy.
Intended outcomes	Describe the intended outcomes of the strategy and whether the activities to date are helping to meet these outcomes.
Summary of efficiencies	Describe how implementation of the strategy affected efficiencies within your state health department, related to infrastructure, management, partners, and financial resources. (This information can be taken from your Year 2 Efficiency/Strategy Map).
Summary of effectiveness	Describe the extent to which you have been effective in implementing the selected strategy. This includes the reach of the strategy, steps taken to expand reach, early outcomes, and a description of the facilitators and barriers. (This information can be taken from your Year 3 Effectiveness Brief).

Table 2. Strategy Action Report

Strategy 1:
Activities evaluated		Benchmarks tracked	Progress towards outcomes	Evidence of impact	Supports for sustainability	Action to be taken
List the activities you evaluated for this strategy.		Describe what indicators related to monitoring the strategy you tracked over the course of the previous four (4) years.	Describe the progress you made in tracking benchmarks and meeting intended outcomes through the end of Year 4 for the strategy evaluated.	State the level of impact: A – Strategy has Evidence of Impact; B – Strategy Shows Promise but Requires Mediation; C – Strategy has No Evidence of Impact If A or B please describe evidence If C stop here.	Describe the supports needed to continue implementing this strategy (if applicable).	Describe what steps should be taken to continue future implementation for this strategy (if applicable).

Strategy 2:
Activities evaluated		Benchmarks tracked	Progress towards outcomes	Evidence of impact	Supports for sustainability	Action to be taken
List the activities you evaluated for this strategy.		Describe what indicators related to monitoring the strategy you tracked over the course of the previous four (4) years.	Describe the progress you made in tracking benchmarks and meeting intended outcomes through the end of Year 4 for the strategy evaluated.	State the level of impact: A – Strategy has Evidence of Impact; B – Strategy Shows Promise but Requires Mediation; C – Strategy has No Evidence of Impact If A or B please describe evidence If C stop here.	Describe the supports needed to continue implementing this strategy (if applicable).	Describe what steps should be taken to continue future implementation for this strategy (if applicable).

Strategy 3:
Activities evaluated		Benchmarks tracked	Progress towards outcomes	Evidence of impact	Supports for sustainability	Action to be taken
List the activities you evaluated for this strategy.		Describe what indicators related to monitoring the strategy you tracked over the course of the previous four (4) years.	Describe the progress you made in tracking benchmarks and meeting intended outcomes through the end of Year 4 for the strategy evaluated.	State the level of impact: A – Strategy has Evidence of Impact; B – Strategy Shows Promise but Requires Mediation; C – Strategy has No Evidence of Impact If A or B please describe evidence If C stop here.	Describe the supports needed to continue implementing this strategy (if applicable).	Describe what steps should be taken to continue future implementation for this strategy (if applicable).