Healthcare Admin

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WorksheetWeek3.docx

Data Collection Worksheet Template

Name:

Statistical Information is from what City or County:

SECTION ONE: Data Collection

Demographics-Related Data

Indicators

Data from Your

Chosen Location

(City or County)

Data for US *

Data Source

(Cite appropriately)

Sampling Notes

Overall population of area of focus

Population under the age of 5

Population over the age of 65

Population of male and female

Ethnic backgrounds

Percentage of non-native speaking population/ households

Education levels

Income levels

Poverty level

HEALTH RELATED DATA

Indicators

Data from Your

Chosen Location

(City or County)

Data for US *

Data Source

(Cite appropriately)

Sampling Notes

Life expectancy

Infant mortality

10 diseases with the highest mortality (or prevalence)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

* International students – data from your country

References:

SECTION TWO: Proposal Outline - Final Project Initiative Proposal

Write 2-3 paragraphs comparing and analyzing your city or county data with US data (or your country).

State the health issue you are choosing for your population health initiative (one – two sentences):

Explain why you chose this health issue (one - two paragraphs):

Describe your chosen population. Be specific by providing demographics to fully explain your population (provide two – three sentences to explain why these demographics are important):

List and describe three objectives you hope to accomplish with your initiative (one sentence for each objective). Use the SMART topics as a guide. (SMART – specific, measureable, actionable, reasonable, time bound)

1.

2.

3.

Describe two – three activities you will use to accomplish each of these objectives (one – two sentences for each activity).

Directions: Write the activity on the line by the number and then use space underneath the number to provide specific discussion. Please be specific in describing the activity. For example, if you want to have a 10 K race, state details about the event.

Three Activities for Objective 1

1

2

3

Three Activities for Objective 2

1

2

3

Three Activities for Objective 3

1

2

3