Column 1

Column 2

United States of America

[Name of other country goes here]

Name of the public health organization.

[Can be a national, state, or local agency]

[Can be a national, state, or local agency]

Describe the mission/purpose of the public health organization.

[Your response goes here. Include a hyperlink to where you found this information.]

[Your response goes here. Include a hyperlink to where you found this information.]

Name 3 top officials in the organization. What are their qualifications and primary responsibilities within the organization?

[Your response goes here. Include hyperlinks to where you found this information.]

[Your response goes here. Include hyperlinks to where you found this information.]

Name the specific program or intervention in each country’s organization that you are reviewing. State the purpose of the program/intervention. Describe how it works to influence outcomes for the public health challenge you selected?

[Your response goes here. Include hyperlink(s) to where you found this information.]

[Your response goes here. Include hyperlink(s) to where you found this information.]

Describe the place(s) where the intervention takes place? (for example, you might include geographical locations, co-location with other agencies, online, etc.)

[Your response goes here. Include hyperlink(s) to where you found this information.]

[Your response goes here. Include hyperlink(s) to where you found this information.]

What professionals are involved the intervention? (name the professions, not specific people)

What are their roles? (job functions)

[Your response goes here. Include hyperlink(s) to where you found this information.]

[Your response goes here. Include hyperlink(s) to where you found this information.]

Name the other groups collaborating with the public health organization in the intervention. What are their roles? (relationship to the organization you selected, are they partners, sharing the same or a similar mission, are they a funder, etc.)

[Your response goes here. Include hyperlink(s) to where you found this information.]

[Your response goes here. Include hyperlink(s) to where you found this information.]