Project Idea Form

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Project Idea Form

Please answer ALL of the questions below about your proposed project. Forms are submitted to Initiative Chairs then to the PPH Steering Committee for approval. If you have questions/concerns please contact Stefanie Cabaniss at 252-847-8265.
NOTE: There is a section at the bottom for feedback only.

Name

Phone Number

Specifics

This section will ask detailed questions about your proposal.

What project are you proposing?

Please provide a brief summary below of the proposed project that includes its purpose, target population, evidence of success thus far, and benefit to Pitt County

Funds required

Please list the dollar amount of funding required. Can include contract cost, materials, etc.

Evidence level

PPH is committed to the deliverance of evidence based interventions, programs, and initiatives. Please select an evidence level. If your proposal does not fit any description below please mark "other" and list why it should be selected for implementation *The randomized control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control) receiving an alternative. If you're not sure about the evidence level, but have a link to where you found the project idea, please select "other" and include the link.

Post-test only

Well conducted RCT's

Unpublished/lower quality RCT's

No idea, BUT I think this is a really good project :)

Pre/post testing no comparison

Case study

Expert opinon

Pre/post testing, weaker comparison

Quasi experiment, strong comparison

Other:

What is the time commitment?

How many people are needed to implement this work?

How much time can you commit to this project?

Planning, initial implementation of project and evaluation

Planning and initial implementation

I can participate in the planning portion

I cannot commit any time but would like to see this project implemented

Clear selection

Does it fit within a current initiative of PPH? If so, which one?

Healthy Lifestyles (includes Chronic Disease Prevention and Physical Activity/Nutrition)

Access to Care

Mental Health

Additional information

Use this section for additional information you feel is relevant

Is there anything else you would like to tell us about this project proposal?

Do you have suggestions for sustainability? If yes, please explain.

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