ARCHIVED - Population Health Fund Evaluation 2008 Final Report

 

APPENDIX A

FILE REVIEW PROTOCOL
(Projects completed between Oct. 1, 2005 and September 30, 2008)

Project ID:

Project Title

Start Date: (yyyy/mm/dd)

Completion Date: (yyyy/mm/dd)

Total allocation ($):

Funded through:

  • Grant
  • Contribution Agreement
  1. Purpose/Goal of Project (Check as many as apply):

    • Produce knowledge to support policy development
    • Produce knowledge to support program development
    • Take action to influence/change policy
    • Develop/implement community-based intervention/program
    • Other (specify)
  2. Determinants addressed (Check as many as apply):

    • Income and Social Status
    • Social Support Networks
    • Education
    • Employment/Working Conditions
    • Social Environments
    • Physical Environment
    • Personal Health Practices/Coping Skills
    • Healthy Child Development
    • Culture
    • Health Services
    • Gender
    • Biology and Genetic Enowment
  3. Project relates to:

    • Children and Adolescence
    • Early to mid-adulthood
    • Later life
  4. Name of Sponsoring organization:

    Sector(Circle one) Type(Circle one)
    1. Health
    2. Social Services
    3. Education (elem./HS)
    4. Education (post-sec.)
    5. Research/policy institute
    6. Justice/law enforcement
    7. Recreation
    8. Cultural
    9. Environmental
    10. Other (specify)
    1. Community not-for-profit
    2. Educational institution
    3. Professional Association
    4. Membership Association
    5. Municipal/local govt. & agents
    6. Provincial/Territorial govt. & agents
    7. Federal govt. or agents
    8. Private, for-profit
    9. Coalition
    10. Other(specify)
  5. Partnership Information:

    On the form attached at the end of this document, please list the partners involved in the project, indicate the sector to which they belong, the type of organization they are, and the role they played in the project.

  6. Did this project directly target community members, or was it aimed at intermediaries?

    • Community Members
    • Intermediaries (specify)
  7. Did this project specifically target an “official language minority?”

    Yes No

  8. Did this project specifically target vulnerable populations, directly or indirectly?

    Yes No

    If yes, which vulnerable populations? (Check only one)

    • Low income
    • Ethnic minorities
    • Recent immigrants
    • Aboriginal populations
    • People with disabilities
    • People engaging in identifiable risk behaviours (specify)
    • At risk youth
    • Other (specify)
  9. Were members of the target population involved in the decision-making related to this project?

    Yes No

    If yes, how were target population members involved? (Check as many as apply)

    • Focus group participation
    • Membership on advisory committee
    • Membership on steering committee/governing board
    • Involved as paid staff in implementing project
    • Involved as volunteers in implementing project
    • Other (specify)
  10. Did the final report contain information about volunteer involvement?

    • Yes
    • No

    If yes,

    • How many volunteers were involved?
    • What role did they play?
  11. Were documents or other things (e.g. audio or video materials) produced which could be suitable for dissemination?

    1 Yes 0 No

    If so, what type of materials were produced? (Circle 1 or 0 for each)

    Literature review 1 Y 0 N
    Policy Analysis 1 Y 0 N
    Research reports 1 Y 0 N
    Program manuals 1 Y 0 N
    Public awareness materials 1 Y 0 N
    Professional awareness materials 1 Y 0 N
    Bilingual materials 1 Y 0 N
    Other (specify) 1 Y 0 N

  12. Was there documentation of project outcomes?

    Yes No

    If yes, what type of outcomes?

    • Number of people reached
    • Satisfaction of target population/audience
    • Changes in knowledge of target population
    • Changes in attitude of target population
    • Changes in behaviour of target population
    • Changes in community indicators re determinants of health
    • Changes in health status of the population
    • Other (specify)

PARTNERSHIP INFORMATION

Name of partner organization

Sector

Type

Role of partner(please indicate by code; include comment/detail if you wish

Sector:

  1. Health
  2. Social
  3. Education(Prim,sec)
  4. Education(post-sec)
  5. Research/policy
  6. Justice/law
  7. Recreation
  8. Cultural
  9. Environmental
  10. Private
  11. Other (specify)

Type:

  1. Community not-for-profit
  2. Educational institution
  3. Professional Association
  4. Municipal/local govt.
  5. Prov./Territorial govt.
  6. Federal government
  7. Private business
  8. Coalition
  9. Other(specify)

Role:

  1. Funding
  2. In-kind resources
  3. Knowledge/expertise
  4. Access to/knowledge of target population
  5. Other (specify)

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