o Who is your target population?
o Where is this intervention taking place?
o Will it take place one time or multiple times?
o How will you reach out to your target population?
How will you get your target population involved?
o What is the CH Nurses role in this intervention?
o Will you collaborate with anyone (e.g., physician's office, church, local resources, etc.?)
o Is anyone else involved besides yourself (C/PHN)?
If yes, are they paid or volunteers?
o What level(s) of prevention is your intervention addressing (primary, secondary and/or tertiary prevention)?