Assessment: Assessment section must include a comprehensive assessment of the community in which the at-risk population resides, including, but not limited to:
Demographic characteristics
Age trends: 0-5, 6-14, 15-24, 25-44, 45-64, >65
Gender analysis
Race analysis
Marital status, family structure, household structure
Income, unemployment
Occupational trend analysis
Educational attainment
Population trends or differences with state and national data – Demographics
Overall population growth or decline – density effects

Health risk behaviors of the community.
Smoking, drug use, seatbelt usage, etc.
Health status of the community (health statistics)
Vital statistics
Birth rates
Death rates
Causes of death in a community
Mortality trends and analysis
Infant mortality trend analysis
Smoking
Screening participation
Exercise patterns
Diet and nutritional data
Obesity/overweight
Insured, underinsured, uninsured
Health care system
Provider ratios
Hospital bed ratios
Long term access
Specialty providers
Population of Interest: Based on the assessment information, please identify a population of interest. Use this section to add additional information that will prove there is a problem.

Population specific morbidity and mortality data.
Population specific health statistics not listed in the above section.
Developmental stressors of the population that contribute or detract from the health behavior of the population.
Internal and external stressors of the population that increase or decrease their risk for health problems.

Planning

Planning section must include an analysis of the population of interest’s strengths and deficits in relation to the community’s characteristics and the internal and external stressors of the population, and should include,

List community strengths in relation to the population of interest
List prioritized community weaknesses the population of interest
Epidemiological triad reflecting in depth analysis of the priority deficit. Include factors that influence each part of the triad
ONE long-term outcome, with goal statement and realistic measurable criteria, reflecting an improvement in, or resolution of the priority deficit. Must be written in SMART format.
Must relate to the priority weakness
Provide a descriiption how you intend to achieve the long term goal – programming, additions to the community, etc.