Epidemiology Section of
APHA
Public Health Practice Award 2011
Nomination Form for Individuals and Organizations
In recognition of the importance of state, local and community-based public health action, the Epidemiology Section has developed the Public Health Practice Award.
This award is designed to showcase an organization or individual responsible for a program or project resulting in improved public health. For awards given to an individual, preference is given to early-career individuals.
Eligibility Criteria: Organizations or individuals may be nominated. All nominations for consideration must demonstrate measurable relevance to public health improvement. An individual nominee must be within 10 years of their terminal degree. An organization may be in existence for any length of time.
Examples of projects that may merit such an award include the improvement of disease surveillance, creative pre- and post-intervention assessments, innovative ways of improving study participation, and/or communication of epidemiologic measures to the participating community. Programs or projects may also be national or international in scope. Nominees need not necessarily have a degree in epidemiology, although the application of epidemiologic methods must be clear. Individuals and organizations will be judged in separate categories. Awardees will receive a nominal monetary award and an inscribed clock with world map that signifies the temporal importance of their work within a global context. Awards will be presented at the Annual APHA Meeting.
Deadline for receipt of nominations: 5 May 2011, 5:00 p.m.
Review Criteria:
1. Relevance to public health
2. Measurable public health impact
3. Role of the project or individual in improving public health
4. Use of epidemiologic methods
5. Innovation
Name of Nominee and/or Program: ______________________________________
Nominee Address and E-mail: _____________________________________________________________
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Documents to Attach to this form:
For Organization-based Nominations:
1. Written letter of support for the organization. In your letter, state in what capacity you are acquainted with the organization. In addition, clearly state the measurable improvement in public health. Why is this organization innovative in promoting the public’s health? What were the key indicators and how were they used?
2. The responses below to the ‘Public Health Practice Award Nomination Questionnaire for Organizational Nominations.’
3. Supporting documentation (not required, limited to 25 pages)
For Early-Career Individual Nominations:
1. CV or biosketch
2. Relevant publications (if any)
3. Written letter of support including information on the specific role of this individual. In what capacity are you acquainted with the nominee? In addition, clearly state the measurable improvement in public health the nominee has made. Why or how has this individual made a difference in public health practice? How has practice changed as a result of this individual’s work?
4. Supporting documentation (not required, limited to 10 pages)
Please include your contact information, below, so the Awards Committee may contact you if necessary.
Name:________________________________________________
Address:______________________________________________
Phone:______________________ E-mail:________________________
Nominations should be mailed, emailed or faxed to:
Kristopher Fennie, MPH PhD
APHA Epidemiology Section Awards Co-Chair
Yale University School of Nursing
PO Box 9740
New Haven, CT 06536
Phone: (203) 785-2057 Fax: (203) 737-4480 E-mail: kristopher.fennie@yale.edu
A confirmation e-mail or letter will be sent upon receipt of all materials.
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APHA Epidemiology Section Public Health Practice Award Nomination Questionnaire for Organization-Based Nominations
We would like to know about the specific project conducted by this organization that led to public health improvement. Please answer the following questions to the best of your ability.
1. What were the dates (years and months) this project was conducted? ______/______ to ______/______
2. What was the total budget for this project? ________________ Dollars (if other than dollars, please state)
3. Is this budget based on a granted amount? _____yes _______no
4. What was the target population?__________________________________
5. What was the chief health outcome? ____________________________
6. How was this health outcome assessed? ___________________________
7. What was the adverse exposure assessed (if any)? _____________________________
8. How was this adverse exposure assessed (if any)? _____________________________
9. If an intervention was conducted to improve a health outcome, please state
a. the type of intervention: ______randomized trial _______educational/training program
b. the target groups for intervention(s): ___general public ____health educators __ other, please state:
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c. If applicable, please state number of persons in the general public receiving the intervention_________
10. In one sentence, please state the chief public health impact (if any) of the organization or project you are nominating, or fill in the blanks
For example: “During the existence of this project, a 20% reduction in the prevalence of childhood obesity occurred within the target population during the two year period.” OR “This project resulted in a 45% increase in the number of age-eligible women screened for breast cancer in a three month period.” OR “Over the last 10 years, our project resulted in the successful remediation of lead-based paints in over 200 homes, resulting in lower serum lead levels.”
This project resulted in a decrease/increase in the____ number or percent of cases OR ____ number or percent of adverse exposures OR ____ number or percent of disease screenings during a _________ month OR __________year time frame.
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11. A measurable public health impact was evident in primary data collected by the organization and could be verified by other existing surveillance information available at the city, county, state and/or national level:
_____yes ______no _____don’t know _____not applicable
if yes, then state the source of the existing surveillance information: _____________________
12. Briefly, why do you feel the public health improvement in the target population is directly attributable to the work of this organization?
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