0920-24EZ Evaluation Work Plan Template

Form Approved

OMB 0920-xxxx

Exp. 0x/xx/2027

Instructions

Evaluation Workplan Template

1. All awardees are required to evaluate 1 to 2 strategies or interventions per year. You must complete and submit an evaluation plan template two months before you plan to start the evaluation. The evaluation plans must:

   • Be based on the CDC Framework for Evaluation in Public Health

   • Include an evaluation approach that engages the Steering Committee in planning and implementation

   • Include all evaluation questions

   • Include quantitative outcome measures

   • Include evaluation methods and tools

   • Describe how you will share evaluation findings with communities and populations of interest in a way that meets their needs

CDC requests that your evaluation plan include an Evaluation Narrative and Evaluation Workplan. This document provides a description of each.

2. The Evaluation Narrative describes your plan for evaluating each of your selected strategy or intervention activities. Focus your evaluation on select strategies or interventions that are: (a) innovative, and (b) of high interest to your regions. The evaluation should fill a gap in the evidence base using methods and measures that will allow the results of the evaluation to be disseminated and ultimately aggregated with other studies in the literature.

• All strategies or interventions are required to be evaluated.

• Suggestions for the content and format of your narrative are provided below. Please note that CDC is expecting at least this level of detail in your plans and thus using this format will help ensure you provide the evaluation information required by CDC.

3. Complete one Evaluation Workplan for each evaluation objective. The evaluation objectives will specify your goal in undertaking the evaluation activities. A sample Workplan is provided below. Evaluation plans are required and will become part of the Performance Monitoring activities.

Public reporting burden of this collection of information is estimated to average 480 minutes 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. 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-xxxx).

Evaluation Narrative

Your Evaluation Narrative provides the background information needed to understand your approach to evaluating the strategy or intervention. The Narrative and Workplan together should provide sufficient detail for CDC to assess: (a) the value of the evaluation, (b) the feasibility of the plan, (c) how the impact of strategies or interventions will be evaluated, (d) the methodology, sampling, and instruments you will use, and (e) the staff involved in conducting your evaluation. Your Evaluation Narrative should include:

1. Selected strategies or intervention(s). Briefly summarize the activities being evaluated. Note whether the activities are evidence-based or innovative.

2. Evaluation questions. Articulate your questions and the specific indicator(s) associated with each question. Also, include whether the indicator is associated with a short, intermediate, or long-term outcome, and how answering the evaluation question will help to fill gaps in the evidence base.

3. Target population and sampling plan. Describe plans to assess the impact of your strategy or intervention within your region and indicate how your sampling plans will ensure that the subpopulations are adequately represented. If statistical power computations were performed, briefly describe them.

4. Data collection plan and timeline. Describe the anticipated strategy or intervention timeline and note how your baseline and follow-up data collections are aligned with that timeline. Describe how often the data will be collected. Your data collection timeline should ensure, to the extent possible, the evaluation data capture the impact of the strategy or intervention activities.

5. Evaluation staffing plan. Identify, by name and position, the individuals who will be working on the evaluation. Also provide a Point of Contact for the evaluation and include contact information (phone, address, email) for that individual. Describe the evaluator(s) affiliation and relationship to the awardee (e.g., staff, contractor, in-kind, research assistant).

6. Intervention logic model. The logic model should include the long-term outcomes of strategy or intervention effectiveness and increased use in implementation.

7. Instruments, sampling plans, and power calculations. All these documents should be attached.

8. Interpretation. Describe who will be involved in drawing, interpreting, and justifying conclusions. Also, describe how these individuals and groups will be involved in the process of interpretation and dissemination.

9. Technical assistance and training needs. Indicate any areas for TA or specific requests for training.

CDC will assist you with developing and implementing your Evaluation Narrative and Workplan, if needed.

EVALUATION WORKPLAN

Date:

Region:

Strategy or Intervention:

Evaluation Objective (SMART format):

Evaluation Question What question are you seeking to answer? What do you want to learn from the evaluation?				Lead Staff and Key Partners Who is responsible for data collection? Who is assessing and analyzing the data?
Indicator How will success be measured? What variable	Data Source From where is the data being collected?	Frequency of Collection How often is the data	Evaluation Methods What evaluation method is appropriate to answer		Analysis Method with Standard Comparison	Reportable Milestone Activities Describe any reportable	Timeline Initiation- Completion
is being measured or		being collected?	the evaluation question?		What data analysis	milestone activities.	What is the timeline for
collected to answer the					method will be applied to		answering the evaluation
evaluation question?					this question		question?
					(quantitative, qualitative,
					or mixed methods)?

Definitions for use in this document:

Evaluation Objective: a measurable change in supportive policy, systems, or environment that affects healthy behavior. Objective must be SMART. Objective should include a reference to any high-burden populations or communities being specifically targeted (if appropriate).

Evaluation Question: a question that guides the methods and tools used to collect data to understand the problem under investigation.

Indicator: the variable that is being measured or collected to answer the evaluation question. It is specific, observable, and measurable accomplishment or change that shows the progress made toward achieving a specific output or outcome.

Data Source: the data being collected or existing data that can be used to assess the effectiveness of the strategy or intervention (e.g., administrative records, surveillance systems, surveys).

Frequency of Collection: the rate at which the data is collected.

Evaluation Methods: covers the conceptualization of the evaluation and approach which will be used to understand the extent of the change and the reasons why it happened.

Analysis Method with Standard Comparison: the techniques used to measure and evaluate the outcomes.

Reportable Milestone Activities: An agreed upon list of key events or actions between the Project Officer and the site that will be implemented. Key events, if possible, should be specific, measurable, and sufficient in quantity such that their completion should lead to the accomplishment of the outcome objective.

Timeline: The timeframe for which Milestone Activities will be initiated and completed.

Lead Staff: Staff member with responsibility for ensuring the completion of the Milestone Activity. Staff must be an FTE of the funded organization.

Key Partner: Partner organization (either funded or unfunded) who will play a significant role in accomplishing the Milestone Activity.