2015 RWJF CULTURE OF HEALTH PRIZE Phase I Instructions for Applicant communities

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Lynne Simpson
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2015 RWJF CULTURE OF HEALTH PRIZE Phase I Instructions for Applicant communities Please keep in mind that the RWJF Culture of Health Prize is a place-based prize that honors whole U.S.

1 2015 RWJF CULTURE OF HEALTH PRIZE Phase I Instructions for Applicant communities Please keep in mind that the RWJF Culture of Health Prize is a place-based prize that honors whole U.S. communities; submissions representing the work of a single organization or initiative will not be considered. The Phase I Application has five sections; each is listed and explained below. 1. Identify Your Community 2. Contacts for Your Application 3. Phase I Essay 4. Accomplishment Names 5. Accomplishment Summary 1. Identify Your Community For this section, you will: Name your community Enter your community s population size Indicate your community type (town, city, county/parish, tribe, or region) Select the state or territory where your community is located Enter the U.S. region where your community is located 2. Contacts for Your Application For this section, you will provide complete contact information for: A primary contact for your application An alternate contact for your application 3. Phase I Essay For this section, you will submit a brief essay. This essay may be up to 5 pages in length and must conform to the template provided. To begin your Phase I Essay: Download the template in the "Phase I Essay" section. Settings are as follows (please do not adjust the template): o Calibri, 11-point font, single spaced o 1-inch margins top/bottom o 1-inch margins right/left

2 Note that if the settings are changed, your submission will not be scored and you will not be considered for the Prize. Be sure to include the following information where called for in the document s header: o Community Name and State o Application ID# The Phase I Essay should have two main sections: Part 1: Introduction to our Community Part 2: Our Community s Four Accomplishments Guidance for Part 1: Introduction to our Community Suggested length = 1 page This is your opportunity to provide an overview of your community that touches on each of the following: Key physical, social, and economic characteristics Important historical and cultural considerations Vital assets and pressing needs When and what catalyzed collective action toward better health (such as an event, opportunity, or decision) Guidance for Part 2: Our Community s Four Accomplishments Suggested length = 4 pages (approximately one page per accomplishment) This is your opportunity to showcase four accomplishments specific policies, programs, or strategies that best reflect your community s response to identified needs and progress toward better health. When considering which accomplishments to include, please keep the following in mind: An accomplishment may be a relatively new or a well-established policy, program, or strategy. Your essay should convey the accomplishment s impact to date and/or expected future impact. An accomplishment may be an individual policy, program, or strategy or an integrated or closely-related collection of policies, programs, or strategies While judges recognize the tremendous value of planning and convening processes, communities should NOT consider coalition development, community health assessments, or improvement plans as accomplishments for this competition Keep in mind that judges will assess Phase I Essays for evidence across all six prize criteria, but will have a particular interest in the extent to which accomplishments reflect the first three criteria: o Defining health in the broadest possible terms Please note: because of their strong influence on health outcomes, judges have particular interest in accomplishments targeting social and economic factors. o Committing to sustainable systems changes and policy-oriented long-term solutions o Cultivating a shared and deeply-held belief in the importance of equal opportunity for health 2

3 To upload your finished Phase I Essay: Upload your Phase I Essay by selecting the "Upload document" button in the Uploaded Documents column. To maintain the original formatting, you should convert your Phase I Essay to PDF format prior to uploading. For additional information, please refer to Troubleshooting Tips link to the left. 4. Accomplishment Names For this section, you will provide brief names for each of the four accomplishments showcased in your Phase I Essay. Accomplishment names may be no more than 80 characters in length (including spaces) and must be more specific than the titles of the four health factors in the County Health Rankings model (i.e., Health Behaviors, Clinical Care, etc.). 5. Summary of Accomplishments For this section, you will submit a one-page summary of the four accomplishments showcased in your Phase I Essay. To begin your Summary of Accomplishments: Download the template in the "Summary of Accomplishments" section. Settings are as follows (please do not adjust the template): o Calibri, 11-point font, single spaced o 0.75-inch margins top/bottom/left/right Note that if the settings are changed, your submission will not be scored and you will not be considered for the Prize. Be sure to include the following information where called for: Community Name and State Application ID# Complete the template by providing the following information on each accomplishment: Accomplishment Name. Enter the same names as used in the Accomplishment Names section above. Each name may be no more than 80 characters (including spaces). Brief Description. Draw on your Phase I Essay content to provide an overview of each accomplishment. Each description may be no more than 500 characters (including spaces). Primary Health Factor Area(s). Underline the health factor area(s) (from the County Health Rankings model) that best reflect(s) each accomplishment. Approximate Year Initiated. For each accomplishment, enter the approximate year work began. To upload your finished Summary of Accomplishments: Upload your Accomplishment Summary by selecting the "Upload document" button in the Uploaded Documents column. To maintain the original formatting, you should convert your Summary of Accomplishments to PDF format prior to uploading. For additional information, please refer to Troubleshooting Tips link to the left. 3

4 2015 RWJF Culture of Health Prize Call for Applications Identify Your Community * * Indicates required Please identify your community by providing the following information Note: fields for entering requested information are located at the end of this section. Community Name: Name your community by using ONE of the following conventions: (maximum of 50 characters, including spaces). Town of City of County/Parish Tribe Region Population Size: Find your community s population size by clicking on the Determining Population Size link in the reference section at left. Enter your community s population size as a number (e.g., 240,323). Community Type: Indicate what type of community you represent. Town City County/Parish Tribe Region State/Territory: Select the state or territory where your community is located. Unites States Region: Find your community s U.S. region by clicking on the "U.S. Regions" link in the reference section at left. Enter as one of the following: Midwest Northeast South West U.S. Territory Your Community * Community Name * SAMPLE: Page 1 of 9 Population Size (numeric only) *

5 Community Type * State / Territory * United States Region * SAMPLE: Page 2 of 9

6 2015 RWJF Culture of Health Prize Call for Applications Contacts for Your Application * * Indicates required Please provide information for two contacts for your application. Note: For the "Agency/Organization Type" field, please enter ONE of the following types of agencies/organizations: Business Community Development Education Government Healthcare Nonprofit Philanthropy or Investor Public Health Other Applicant Contact 1 * Please provide contact information for one individual to serve as the primary contact for this application. * Confirm * First Name * Last Name * Agency/Organization Name * Agency/Organization Type * Address * Address (line 2) City * State/Territory * Zip / Postal Code * Phone Number * Cell Phone Extension Applicant Contact 2 * Please provide contact information for one individual to serve as an alternate contact for this application. * SAMPLE: Page 3 of 9 Confirm * First Name *

7 Last Name * Agency/Organization Name * Agency/Organization Type * Address * Address (line 2) City * State/Territory * Zip / Postal Code * Phone Number * Cell Phone Extension SAMPLE: Page 4 of 9

8 2015 RWJF Culture of Health Prize Call for Applications Phase I Essay * * Indicates required To Begin Download the template shown below. Follow the "Instructions for Applicant Communities" (see link to the left). Upload the completed template by selecting the "Upload document" button in the Uploaded Documents column. To Upload To maintain the original formatting, you must convert your document(s) to PDF format prior to uploading. For additional information, refer to Troubleshooting Tips link to the left. Description Templates Uploaded Documents Phase I Essay * For complete instructions, see the "Instructions for Applicant Communities" link to the left. Phase I Essay SAMPLE: Page 5 of 9

9 2015 RWJF Culture of Health Prize Call for Applications Accomplishment Names * * Indicates required In the spaces provided below, please provide brief names for each of the four accomplishments showcased in your Phase I Essay. Accomplishment names may be no more than 80 characters in length (including spaces) and must be more specific than the titles of the four health factors in the County Health Rankings model (i.e., Health Behaviors, Clinical Care, etc.). For additional information, see the "Instructions for Applicant Communities" link to the left. Accomplishment 1 1. Accomplishment Name: * Accomplishment 2 2. Accomplishment Name: * Accomplishment 3 3. Accomplishment Name: * Accomplishment 4 4. Accomplishment Name: * SAMPLE: Page 6 of 9

10 2015 RWJF Culture of Health Prize Call for Applications Summary of Accomplishments * * Indicates required To Begin Download the template shown below. Follow the "Instructions for Applicant Communities" (see link to the left). Upload the completed template by selecting the "Upload document" button in the Uploaded Documents column. To Upload To maintain the original formatting, you must convert your document(s) to PDF format prior to uploading. For additional information, refer to Troubleshooting Tips link to the left. Description Templates Uploaded Documents Summary of Accomplishments * For complete instructions, see the "Instructions for Applicant Communities" link to the left. Summary of Accomplishments SAMPLE: Page 7 of 9

11 Community Name and State: Applicant ID #: SAMPLE: Page 8 of 9 P a g e 1

12 2015 RWJF Culture of Health Prize Summary of Accomplishments Community Name: Application ID: Accomplishment Name Limit: 80 characters (including spaces) per accomplishment Brief Description Limit: 500 characters (including spaces) per accomplishment SAMPLE: Page 9 of 9 Primary Health Factor Area Underline the health factor area(s) that best reflect(s) each accomplishment Health Behaviors Clinical Care Social & Economic Physical Environment Health Behaviors Clinical Care Social & Economic Physical Environment Health Behaviors Clinical Care Social & Economic Physical Environment Health Behaviors Clinical Care Social & Economic Physical Environment Approximat e Year Initiated E.g., 2010

SAMPLE - PAGE 1 OF 16

SAMPLE - PAGE 1 OF 16 Evidence for Action: Investigator-Initiated Research to Build a Culture of Health Open Call for Proposals Eligibility Criteria* Instruction: Respond to the question below to indicate whether the applicant