Public Health Strategy Implementation Evaluation Form
Public Health Strategy Implementation Evaluation Form
Public health strategy name
*
Implementation setting
*
Please Select
Community-wide
Local or regional public health agency
Healthcare system or clinic
School or educational setting
Workplace
Other
Implementation period start date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current implementation stage
*
Planning
Early implementation
Mid-implementation
Sustained implementation
Completed
How would you rate overall implementation progress?
*
Behind schedule
1
2
3
4
Ahead of schedule
5
1 is Behind schedule, 5 is Ahead of schedule
How consistently has the strategy been delivered as intended?
*
Not consistently
1
2
3
4
Very consistently
5
1 is Not consistently, 5 is Very consistently
How would you rate the strategy’s outcomes so far?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
What outcomes or changes have you observed?
*
What barriers have affected implementation? Select all that apply.
*
Insufficient funding or resources
Staffing or workforce capacity
Limited stakeholder engagement
Coordination or partnership challenges
Data or evaluation limitations
Policy or operational constraints
No significant barriers
Other
What recommendations would strengthen implementation or improve outcomes?
*
Submit evaluation
Should be Empty: