1. Background and Significance
§ A clear description of the need for services/program based on lit review
§ A detailed description of the area and population to be served
§ Review of existing programs that address this health problem
§ Construct a Logic Model of Problem that represents behavioral and environmental determinants of the health problem
2. Objectives and Outcomes
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§ Clearly state and justify your program’s goals and outcomes of interest: Health Outcomes, Behavioral and Environmental Change outcomes
§ Describe and justify your program’s Performance and Change Objectives
3. Theoretical Basis
§ Provide a clear theoretical basis for your chosen outcomes by identifying at least 2 applicable social/behavioral theories. Describe how the theories explain the problem and the potential solution.
§ Construct a Logic Model of Change that demonstrates your theory of change, or how you believe the health outcome will be improved through your program.
§ Discuss the relationship between the social/behavioral theories and your Logic Model of Change.
4. Program design and implementation plan
§ Describe where the program will take place and justify it as an appropriate setting for the program.
§ Clearly describe the activities your program will actually do in order to achieve the desired change in your program’s outcomes and objectives. Each activity should be related to part of your Logic Model of Change.
5. Conclusion
§ Re-iterate how your proposed program will resolve the public health problem at hand and address social and behavioral health determinants.
