Get Success Story Data Collection Tool. Doh - Cdc

This guide provides a comprehensive walkthrough for filling out the Success Story Data Collection Tool developed by the Department of Health and the CDC. It aims to support users in documenting impactful success stories related to public health initiatives effectively.

Follow the steps to complete the form accurately and efficiently.

1. Press the ‘Get Form’ button to access the Success Story Data Collection Tool. Once you have the form open, review the entire document to familiarize yourself with its contents.
2. Fill in the contact information, including the contact name, email, office number, and cell phone number. This information is crucial for any follow-up or inquiries regarding the success story.
3. Provide details about the employer or organization name. This helps to attribute the success story appropriately and gives context to the program.
4. Proposed title of the success story: Craft a title that is engaging and clearly reflects the program's name. This should draw the audience's attention.
5. Focus/theme of the story: Describe the central theme or focus of your success story, such as collaboration, advocacy, or community initiatives.
6. Point of view: Ensure the story is told from the perspective of those who benefited from the program. Specify if it will be from a participant, family member, or friend.
7. Identify the intended audience for your story. This helps tailor the narrative to meet their interests and needs.
8. Provide background information related to the success story, including the time period of achievement, location, and target group of the program.
9. Include the contact information of one participant to interview for richer details. This should include their name, address, and telephone number.
10. Explain how the success was achieved. List the actions taken, the people involved, the duration, estimated costs, funding sources, and partners. Consider what details are necessary for replication of your program.
11. Discuss the environmental context and any barriers faced during the program's implementation. Describe how these barriers were overcome.
12. Outline key results or implications of the success. This may include impacts on participants, the program, community, or environment.
13. If available, include a quote from a participant or partner that strengthens the narrative. Ensure to provide their complete contact information and a signed release form.
14. Detail the program's impact. Describe changes in norms, access to practices, and the number of people who benefited from the program. Note any unexpected results.
15. Next steps: Indicate what future actions are needed to continue the efforts initiated by the program.
16. Lessons learned: Reflect on key successful elements and identify areas for improvement or different approaches if given another chance.
17. Publication information: Indicate if a photo and program logo are available to include with the submission. Attach the photo and consent form if applicable.
18. Finalize your submission by signing the form and dating it. This signifies agreement to allow the program's information to be used for developing a success story for various communications.
19. Once completed, save the changes made to the form. You may also download, print, or share the form as required.

Start filling out your Success Story Data Collection Tool online today to share your impactful story.