2003 - 2004 CHA Update Summary Form - Part III

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  1. _____ a. Size of the health issue

    _____ b. Seriousness of the health issue

    _____ c. Whether intervention implemented were measurable

    _____ d. None of the above

    _____ e. Other: __________________________________

  2. _____ a. Local health department staff

    _____ b. Organizational partners

    _____ c. Community Leaders

    _____ d. None of the above

    _____ e. Other: __________________________________

  3. _____ a. MAPP (Mobilizing for Action through Planning and Partnerships; ( http://mapp.naccho.org/MAPP_Home.asp )

    _____ b. CDC's Framework for Program Evaluation ( http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm )

    _____ c. APEX-PH

    _____ d. Other:___________________

    _____ e. None

  4. _____ a. In providing input

    _____ b. Data collection

    _____ c. Data analysis

    _____ d. Part of a community health assessment team

    _____ e. None of the above

    _____ f. Other: __________________________________

  5.                              
  6. <_____1 _____2 ____3 _____4 _____5