A New Training Opportunity from Health DATA The Data & Democracy Performing a Community Assessment Train the Trainer Course in Humboldt This is a free opportunity to LEARN & TEACH others how to obtain and use community and research data to benefit YOUR organization and build healthy communities! • Learn how to access, collect, and use data about your community • Learn how to document and communicate the needs of your community • Learn how to teach others to plan and conduct a community assessment to inform policies and programs impacting your community This free course is currently being offered in Humboldt Representatives of Humboldt community-based organizations serving underserved populations are invited to apply. Training Day 1: Thursday April 23, 2009 Schedule: Day 2: Friday April 24, 2009 Day 3: Friday May 1, 2009 Regional Convening of Course Graduates: June 2009 Time: 8:30am to 4:30pm Location: Humboldt Area Foundation – Conference Room Address: 373 Indianola Road, Bayside CA 95524 Application deadline is ***Monday, April 13, 2009, 5PM*** You must apply to participate. Submit early. Seating is limited. Apply online at: http://www.surveymonkey.com/s.aspx?sm=uT94KrrAAVUIn0eRVmn23w_3d_3d Data & Democracy is made possible through a grant from The California Endowment, with additional support from Kaiser Permanente. For more information visit us online at http://www.healthpolicy.ucla.edu/HealthDATA/index.html or contact us at email@example.com or 310-794-0983. Data & Democracy Train the Trainer Course is offered in the Humboldt area in partnership with Area 1 Agency on Aging, Community Health Alliance of Humboldt – Del Norte, The California Center for Rural Policy, and the following organizations: California Black Health Network, California Black Women’s Health Project, California Center for Rural Policy, California Pan Ethnic Health Network, California Partnership, Community Health Alliance of Humboldt – Del Norte, Insure the Uninsured Project, and Latino Coalition for a Healthy CA Purpose The purpose of the Data & Democracy “Performing a Community Assessment” Train the Trainer Course is to develop the skills of community-based experts to increase the ability of communities to obtain, understand, and apply data to program development and policy advocacy. Our goal is to produce knowledgeable advocates who put their data and research knowledge into action to build healthy communities. Course requirements Participants of the Data & Democracy Train-the-Trainer course will be required to: • Submit a Memorandum of Understanding (MOU) affirming your commitment to complete course requirements listed below. The MOU must be signed by you and your supervisor and submitted prior to the first day of the course. • Attend the entire three (3) day training course and complete all assignments. • Conduct at least one (1) community assessment workshop in their community within six weeks of completing the training course. • Complete a workshop audience profile prior to the third day of the course. • Attend one (1) regional convening to participate in additional skill building clinics and share experiences conducting workshops. Participant benefits Participants of the Train the Trainer course will receive: • Expert training on how to collect and use community-based data to build healthy communities through policy and advocacy. • Course binder containing copies of the Performing a Community Assessment curriculum, Trainer’s Guide and Toolkit, training materials, and community assessment planning worksheets. • CD ROM containing electronic files of the curriculum, training materials, worksheets, and workshop slides. • Access to the Data & Democracy Online Workstation to obtain technical assistance, data and training tools, networking opportunities with peers to learn and share resources. • On-call technical assistance from Health DATA staff. • Curriculum workbooks, certificates of completion for community workshop participants, sign-in sheets, and evaluation forms for your community workshop. • $125 stipend to support your workshop. • A Trainer Certificate of Completion upon completing all course requirements. Eligibility criteria Executive directors, program managers and coordinators, advocates, grant managers, community organizers, and community volunteer leaders are encouraged to apply. Eligibility criteria include: • Applicant must be a staff or volunteer representative of a community-based non-profit organization serving low-income, immigrant, homeless, and/or underserved racial/ethnic minorities such as African American, American Indian, Asian, Pacific Islander, and Latino populations. Priority will be given to applicants serving populations in the Humboldt area. • Applicant must commit in advance to completing all course requirements. • Space is assigned on a first come, first serve basis to applicants who meet the above criteria. Up to 2 individuals per organization will be accommodated. How to Apply Apply online at http://www.surveymonkey.com/s.aspx?sm=uT94KrrAAVUIn0eRVmn23w_3d_3d or complete the attached application form and fax to Health DATA at 310-794-2686, attention Jazmin Zane. Applicants will receive a course registration confirmation via e-mail, and a username and password to access the online WorkStation which contains the MOU to be signed by applicant and supervisor. MOU must be submitted prior to start of course. Courses fill up fast. Apply early! Data & Democracy Train the Trainer Course Application Due Monday, April 13, 2009, 5 PM Apply Online at: http://www.surveymonkey.com/s.aspx?sm=uT94KrrAAVUIn0eRVmn23w_3d_3d TO APPLY BY FAX: Complete this 2-page application form and fax it to 310-794-2686, attn: Jazmin Zane. All applicants will receive course registration confirmation via email. Once you confirm your spot, you will receive directions on how to access the MOU, which must be signed by a supervisor (or board chair) and submitted prior to the start of course on April 23rd, so please provide current email address. Your name: Title/Role: Organization: Address: City: Zip: Phone: Fax: Email: Do you have any specific meeting needs? (i.e., wheelchair accessibility, large print materials, dietary restrictions, etc…) Before completing this application, please complete the following checklist to be sure you understand the Train the Trainer course requirements: I can attend all 3 days of the Humboldt course: Thursday April 23, Friday April 24, and Friday May 1, 2009. I will plan and conduct a workshop based on what I learned for staff, partners, or volunteers in my organization or community within 6 weeks following day 3 of the course. My supervisor will support my participation in the 3-day course, planning and conducting my community assessment workshop, and my attending the Regional Convening. My supervisor’s name and contact information is: (Note: if you are the Executive Director, CEO, or lead person of your organization, you must identify your Board Chair or someone above you as your supervisor. You CANNOT identify yourself as the supervisor) Name: Title: Email: Phone: If notified I have been accepted into the course, I will complete and submit the MOU prior to April 23rd, the first day of the course. After acceptance into the course, if I cannot meet all course requirements, I will notify Health DATA immediately. Please tell us about yourself and your organization. This information will help us to identify and meet your training needs. Your answers to these questions are NOT used to determine course eligibility. 1. What area(s) does your organization serve? (please 5. What is the size of your organization, including full- and check all that apply) part-time staff? (please check one) Los Angeles County or surrounding areas 1-5 staff The Inland Empire or surrounding areas 6-10 staff Fresno County or surrounding areas 11-20 staff Humboldt County or surrounding areas More than 20 staff Other: _________________________ 2. How would you describe your organization? (please 6. What is your organization’s annual budget? (please check all that apply) check one) 501(c)3 status non-profit Less than $100,000 per year Community-based or grassroots $100,000 to $250,000 per year Private or incorporated $250,000 to $500,000 per year Academic institution $500,000 to $1,000,000 per year Municipal/County dept of health or other public office More than $1,000,000 per year State dept of health or other public office Hospital, clinic, or other service provider Other:____________________ 7. Do you have experience with training groups of people (e.g., providing a workshop)? (please check one) I have trained groups many times I have trained groups a few times I do not have experience with training groups 3. What is the focus of your organization? (please check all 8. Do you have experience with collecting health-related that apply) or other types of data? (please check one) Advocacy/Public policy a lot of experience Care/Service delivery some experience Consulting little or no experience Health outreach/Promotion/Education Program planning/Implementation 9. Do you have experience with analyzing health-related Research/Evaluation or other types of data? (please check one) Volunteer a lot of experience Other:______________________ some experience little or no experience 4. What target populations are served by your organization 10. Do you have experience with using health-related or or program? (please check all that apply) other types of data to inform organizational, programmatic, Spanish monolingual or advocacy decisions? (please check one) Low-income a lot of experience Immigrant some experience Homeless little or no experience African American American Indian 11. Do you have experience with conducting a community Asian-Pacific Islander needs assessment? (please check one) Latino I have previously worked on a community needs Non-Latino White assessment myself Other community: ___________________ I have had contact with others in my organization who have conducted a community needs assessment I have little or no previous experience with or contact with those conducting a community needs assessment Participants accepted into the course will receive their registration confirmation via email. For more information, contact Health DATA at firstname.lastname@example.org. Or visit us online at http://www.healthpolicy.ucla.edu/HealthData/index.html.
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