Form 0920 Core SIPP Annual Progress Report

Manage Cross-Cutting Indicators
Cross-Cutting Indicators

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Manage Cross-Cutting Indicators

Available

Last Check-Out

Core SIPP Base
1

Strategy Description

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Engage in Robust Data/Surveillance for Public Health Action

Available

A. Identify and use data sources to create occupant injury reports for use by
stakeholders (example)

Task Details

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Rubric
2

Strengthen Strategic Collaborations and Partnerships for Public Health Action

Available

+Add Activity
Rubric
3

Conduct Assessment and Evaluation for Public Health Action

Available

+Add Activity
Rubric
4.

Success Stories
+Add Success Story

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Last Check-Out

Core SIPP Base
1

Strategy Description

Edit Status

Engage in Robust Data/Surveillance for Public Health Action

Available

Last Check-Out

A. Identify and use data sources to create occupant injury reports for use by stakeholders
+Add Activity
Rubric
2

Strengthen Strategic Collaborations and Partnerships for Public Health Action

Available

+Add Activity
Rubric
3

Conduct Assessment and Evaluation for Public Health Action

Available

+Add Activity
Rubric
4

Success Stories

Core SIPP Enhanced
1

Strategy Description

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Implementation and Enhanced Evaluation

Available

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Last Check-Out

BASE
Overview
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Back to Task Details

Indicators

Previous Year Progress

Title [free text]
Topic Area [multi-select check list; optional for base, required for enhanced]

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Next Year Workplan

ACES
Transportation Safety
TBI
Optional Flex Topic
• Secondary/conditional check-list of topics not covered in NOFO [list of topics needed]
• "Other" option with write-in
• All Topic Areas
If more than 1 topic area selected above, please explain how you anticipate this activity will affect the multiple topics you selected [Free- text]
Description of Activity [free text]
Alignment with Logic Model Activities [multi-select check-list; element lists will be different for strategy 1 & 3]
• Identify data sources for surveillance of emerging injury topics of interest and disproportionately-affected populations
• Analyze data and produce surveillance products for topics of interest and disproportionately-affected populations
• Translate and disseminate products to community stakeholders and other partners to drive public health action
• Participate in a national learning community for robust injury data and surveillance methods
Progress [free text]
Status [drop-down, select 1 only]
• Not yet started - still planned, but not yet started​
• New - added since initial work plan submitted​
• Revised - revised since initial work plan submitted​
• Initiated - current timeframe for completion unknown​
• On track - on track to complete by due date​
• Completed - completed on time​
• Discontinued - no longer being addressed
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Mid-Year Progress

Public Health Actions
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List of PHA examples, other write in option [multi-select checklist list in Notes]

Overview

Indicators

Previous Year Progress

Mid-Year Progress

Next Year Workplan

+ Add Indicator
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Indicator Name [free text]
Description [free text]
Population(s) of Interest [free text]
Geographic Area [free text]
Type of Indicator [drop-down]
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Process
Short-term
Intermediate

• Select the short or intermediate outcome(s) that align with your indicator [conditional check-lists; if short term indicator is selected
above, a list of short-term outcomes becomes available to select the appropriate outcome(s). Same for intermediate. No conditional check-list for process]
Data Source [free text]

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• Unit [drop-down]
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Count
Percent
Proportion
Rate

• Values
• Anticipated Directionality [drop-down]
Increase
Decrease
Keep Stable
Notes [free text]
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BASE

Back to Task Details

Overview

Indicators

Previous Year Progress

Mid-Year Progress

For each sub-activity:
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Sub-Activity name [free text]
Description [free text]
Progress [free text]
Frequency of Sub-Activity [check-list]
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Year 1
Year 2
Year 3
Year 4
Year 5
Annual

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Not yet started - still planned, but not yet started
New - added since initial work plan submitted
Revised - revised since initial work plan submitted
Initiated - current timeframe for completion unknown
On track - on track to complete by due date
Completed - completed on time
Discontinued - no longer being addressed

• Status

• Responsible Party(ies) [free text]

Pre-populations across the workplan, mid-year, and previous year progress could be the same as it currently is for Core SVIPP

Next Year Workplan

BASE
Success Stories

Document Upload

Suggested Title [free text]
The Problem: Describe the problem identified [free text]
The Narrative: How was Core SIPP funding used to address the problem? [free text]
Outcomes and Impact: What outcomes (short-, intermediate- or long-term) resulted from your actions? [free text]
Lessons Learned (optional): What lesson(s) was learned that can help others with similar problems in the future? [free
text]
• Check if any of the following are being submitted to complement your story. Please upload your additional documents in
the Document upload tab.
• Press Release
• Project Photos
• Promotional Materials
• Publication (e.g., news story, journal article)
• Quote from Partner/Participant
• Sample of Materials Produced
• Testimonials
• Video/Audio Clip
• Website URL
• Other: Explain [write-in option, 200-character max]

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Rubric [based on current CIP:VIT tool]

STRATEGY 1
A. Plan includes description of how the plan was developed
Item not addressed at
all (worth 1 pt.)

Poorly addressed in
plan - item is
mentioned but little to
no detail or low-quality
information provided (2
pts.)

Moderately addressed
in plan - includes
information to some
degree, but
occasionally lacks detail
(3 pts.)

Adequately addressed
in plan - key
information may be
missing but is
satisfactory
(4 pts.)

Strongly addressed in
plan - includes in depth
and detailed
information
throughout (5 pts.)

B. Plan describes efforts to increase stakeholder inclusion in the development of the plan
Item not addressed at
all (worth 1 pt.)

Poorly addressed in
plan - item is
mentioned but little to
no detail or low-quality
information provided (2
pts.)

Moderately addressed
in plan - includes
information to some
degree, but
occasionally lacks detail
(3 pts.)

Adequately addressed
in plan - key
information may be
missing but is
satisfactory
(4 pts.)

Strongly addressed in
plan - includes in depth
and detailed
information
throughout (5 pts.)

ENHANCED: indicators and progress tabs will be the same as base
Overview
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•

Indicators

Previous Year Progress

Title [free text]
Topic Area [multi-select check list]

Next Year Workplan

Deliverables

ACES
Transportation Safety
TBI
Optional Flex Topic
• Secondary/conditional check-list of topics not covered in NOFO [list of topics needed]
• "Other" option with write-in
If more than 1 topic area selected above, please explain how you anticipate this activity will affect the multiple topics you selected [Free- text]
Description [free text]
Progress [free text]
Status [drop-down, select 1 only]
• Not yet started - still planned, but not yet started​
• New - added since initial work plan submitted​
• Revised - revised since initial work plan submitted​
• Initiated - current timeframe for completion unknown​
• On track - on track to complete by due date​
• Completed - completed on time​
• Discontinued - no longer being addressed
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Mid-Year Progress

Back to Task Details

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Public Health Actions [multi-select check list]

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CDC assistance necessary to complete this activity [free text]
Barriers or challenges associated with this activity[free text]

Assistance and Barriers

Enhanced
Overview

Indicators

Previous Year Progress

Mid-Year Progress

Next Year Workplan

Deliverables

+ Add Indicator
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Indicator Name [free text]
Description [free text]
Population of Interest [free text]
Type of Indicator [drop-down]
•
•
•
•

Process
Short-term
Intermediate
Long-term

• Select the short or intermediate outcome(s) that align with your indicator [conditional check-lists; if short term indicator is selected
above, a list of short-term outcomes becomes available to select the appropriate outcome(s). Same for intermediate. No conditional check-list for process]
Data Source [free text]

•
• Unit [drop-down]
•
•
•
•

Count
Percent
Proportion
Rate

• Values
• Anticipated Directionality [drop-down]
Increase
Decrease
Keep Stable
Notes [free text]
•
•
•

•

ENHANCED
Overview

Back to Task Details

Indicators

Previous Year Progress

Mid-Year Progress

Next Year Workplan

Recipients can use this tab to upload any relevant documents/deliverables for the enhanced component
Document Upload
• Can upload a Word, Excel, or PDF document
• Document Name

Deliverables