Thank you for your interest in submitting your innovation for the Social Engagement Innovations Hub, a searchable clearinghouse of best practices and data-driven interventions, programs, and services promoting social connections across populations. Submitters will be notified if their submission is accepted and may be contacted for additional information.
Please note: To be considered, all questions must be filled out to the best of your ability. Contact info@committoconnect.org with any questions.

Identifying Information

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* 1. Contact Information

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* 2. Social engagement program, intervention, or service title:

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* 3. What year was the program implemented? 

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* 4. What is your organization type? (Select one that best fits)

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* 5. What type of intervention does this social engagement program address? Select all that apply.

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* 6. What type of geographic region does this social engagement program serve? Select all that apply.  

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* 7. What is the primary population(s) that this social engagement program serves?

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* 8. Select partners that are actively involved in the delivery of this social engagement program. Select all that apply.

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* 9. Does your social engagement program have a diversity focus? (Race/ethnicity, religion, culture, sexual orientation/gender, or other considerations.) If yes, please describe in the comment box below.

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* 10. What is your program’s funding source?

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* 11. Are you providing this program or service under contract with a health care entity (health plan, health system, etc.)? If yes, please share more in the comment box.

Submission Questions

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* 12. Provide a summary of the social engagement program being nominated, including any especially innovative program features and the target population of the program, in at least 250 words.

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* 13. Describe the social engagement innovation in this program in at least 100 words.

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* 14. Share in at least 75 words what, if any, partners you work with on this program and their role(s). If you selected multiple community partners on the prior page, please make sure you describe the roles of all partners selected.

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* 15. Describe the measurable social engagement outcomes the program has achieved, in at least 100 words.

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* 16. Is there a journal article in a peer-reviewed journal about this program? If so, please provide the link.

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* 17. Describe in at least 100 words any lessons learned to share with your peers implementing similar programs.

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* 18. Describe any materials your program developed to support replication. This may include policy and procedure manuals, data collection instruments, and training materials.

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* 19. Share in at least 100 words what resources others will need in replicating this program (e.g., costs, materials, staff time, etc.).

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* 20. Share the contact information (name, email address) for the individual who others may contact if they wish to learn more about the program.

Thank you for your submission to the Call for Social Engagement Innovations! We will be in contact if your program is selected to be featured in the Social Engagement Innovations Hub.

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