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Use this form to submit an entry to the database. Complete all fields, if possible. Instructions are indicated by these symbols: Fields with a red symbol are character-limited for the purpose of generating a success story pdf, where applicable.

Click here for instructions and writing tips and for a Word template you can use to draft your submission in advance. When ready to enter, cut and paste your text from the template into the form below. Use the icon for fields with multiple lines of text. All entries are reviewed by the administrator before online publication.


Entry Type
State / Territory


Title of Entry





Funding Source
Part 1: Funding source statement on entry

A statement about funding will appear on your final entry. Please select all that apply.
CDC
NACDD
State/local sources
Private sources
Part 2: Specific Funding Source

CDC Funding - please specify
(1305) State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health
(DP14-1422) State and Local Public Health Actions to Prevent Obesity, Diabetes and Heart Disease
DP09-9010301PPHF11 Prevention and Public Health Fund Coordinated Chronic Disease Prevention and Health Promotion Program Department of Health and Human Services
Preventive Health and Health Services Block Grant
CDC-RFA-DP12-1210, State Public Heath Approaches to Improving Arthritis Outcomes
DP11-1113-National Organizations to Support Arthritis Programs and Policy
Other CDC Funding
NA
   
Other Federal funding - please specify
AHRQ FDA
ATSDR HRSA
CMS IHS
DOT USDA
   
Other
State Funding Private Funding
Local Funding Don't Know
NACDD Funding


Domain Addressed
Epidemiology & Surveillance
Environmental Approaches
Health System Strategies
Community-Clinical Linkages


Public Health Issue

↑ Character limit: 750

Project Objective(s)

Program Action

↑ Character limit: 750

Data/Other Information Collected

Impact / Accomplishments

↑ Character limit: 750

Challenges/Lessons Learned

Next Steps

Web Link (if available).

↑ Please enter one web address per line. Character limit 100.

Supports the National Diabetes Prevention Program
Yes
State Contact Information
Name

Agency

Phone

Email


Image Upload



↑ Please only upload image files (.png, .gif, .jpg, .jpeg) with a maximum width and height of 400px.