We are keeping an eye on [name the indicators] as a way of telling how we are doing as a community in addressing [priority issue] and build a community where [name your result]. We have also identified other data that is not currently available, but that we would like to develop to help us monitor progress on this result:

• Indicator 1
• Indicator 2
• Indicator 3

Partners in our Community Health Improvement Process: [Guidance: you can name and list your team structure and participating agencies in your CHIP process here or simply insert a link if you keep that information on a website. You can also link to partner websites like we have done for the WNC Healthy Impact item listed below. Confirm with your team members that they wish to be listed.]

• Partner 1
• Partner 2
• WNC Healthy Impact

Partners With a Role in Helping Our Community Do Better on This Issue: [Guidance: you can begin this list with the Whole Distance Exercise, but make sure you have asked key community partners who might not have been present for the exercise to contribute to this. Recommendation: do not list an organization/agency/individual on this public facing e-CHIP without talking with them and confirming that they would like to be listed. Offer to link to a website or publication that gives more information about partner organizations.]

• Partner 1
• Partner 2
• Partner 3

[Guidance: This section includes story you collect in different phases of your process:

• Phase 1: "Get Organized"--what underlying structures and processes are already in place in your community to address this prioritized issues and result
• Phase 2: "Convene (Whole Distance exercise)"--ask "What's helping?" and What's hurting?" (positive and negative influences on your health issue)
• Phase 3: "Address Data and Information Gaps"--gaps in existing programs and services]

The "Story Behind the Curve" helps us understand why the data on [state the indicator in plain language, e.g. adults with diabetes, children born addicted to drugs, or people dying from drug overdoses] is the way that it is in our community. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together.

What's Helping? These are the positive forces are work in our community and beyond that influence this issue in our community.

[Guidance: a prompting question can be, "Why are things as good as they are and not worse?" Ask "why?" multiple time to a single cause to get to root causes. Try to get input about what's help at the individual, organizational, environment and policy levels.]

• Example 1
• Example 2
• Example 3
• Example 4

What's Hurting? These are the negative forces are work in our community and beyond that influence this issue in our community.

[Guidance: a prompting question can be, "Why are things as bad as they are and getting in the way of things getting better? Try to get input about what's hurting at the individual, organizational, environment and policy levels.]

• Example 1
• Example 2
• Example 3
• Example 4

[This section will include:

• (A) Partner ideas of what works to do better, based on Story Behind the Curve and Partners/Who has a role to play to do better, from a Whole Distance exercise, (Phase 2: Convene action teams--Whole distance exercise)
• (B) What is currently working in your community (Phase 1: Get organized--Clarify current state of affairs)
• (C) Evidence-based strategies (Phase 3: Address data and information gaps)
• (D) What people most affected by the issue think work (Phase 3: Address data and information gaps

The sample headings and text below will help organize this information.]

The following actions have been identified by our [team/coalition/partners] and community members as ideas for what can work for our community to make a difference on [name issue].

(A) Actions and Approaches Identified by Our Partners These are actions and approaches that our partners think can make a difference on [name issue].

• Action/Approach 1
• Action/Approach 2
• Action/Approach 3
• Action/Approach 4
• Action/Approach 5

(B) What is Currently Working in Our Community These are actions and approaches that are currently in place in our community to make a difference on [name issue].

• Action/Approach 1
• Action/Approach 2
• Action/Approach 3
• Action/Approach 4
• Action/Approach 5 [Guidance: you can insert links to websites with more information on current actions and approaches in your community]

(C) Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on [name issue].

• Name of evidence-based strategy 1
• Name of evidence-based strategy 2
• Name of evidence-based strategy 3 [Guidance: you can insert links to websites where you learned about these interventions]

(D) What Community Members Most Affected by [name issue] Say These are the actions and approaches recommended by members of our community who are most affected by [name issue]

• Action/Approach 1
• Action/Approach 2
• Action/Approach 3
• Action/Approach 4
• Action/Approach 5 [Guidance: if you gather input in multiple ways, you can insert a table to organize this information]

[In this section, write a brief paragraph to describe how you prioritized this list to get to the selected actions listed as programs on this Scorecard.]