The Chronic Disease Self-Management Education Data Collection Tools released in May 2023 (OMB-approved that expire in 2026) include a Workshop Cover Sheet, which contains data points associated with program facilitators.

Modify options as needed

Be aware that you can modify and tailor this cover sheet to suit your grant’s needs.  For example, numbers 8, 10, 11, and 12 can be adjusted to reflect the evidence-based programs, languages, and funding sources that you’re using. You do not need to list every option if it does not apply to your program delivery. 

Facilitator information

To gather information on individual facilitators, you can take a few approaches to the forms when you have more than one facilitator, which will depend on how you collect your data. As a reminder, all grantees must deliver privacy and security training for any staff involved in the data collection or data entry process. Like participant-level data, facilitator data is expected to be protected and kept confidential during the entire data collection cycle.

Note that once the information about each facilitator is entered into the database, the facilitator’s profile is saved to your organization’s account. In subsequent workshop entries, you will be able to find and select facilitators already entered or enter new ones. You are not required to enter information for facilitators already in your account for every workshop unless it is a new facilitator not already in the database. 

Option 1: Collect All Facilitator Info on the Same Form

Collect data points on the same form. Rearrange the fields so that you view all Facilitator info in a logical order for as many Facilitators as you anticipate having for most workshops.

Facilitator/Leader 1 (name, phone, email)
Receive info from National CDSME Resource Center? Yes or No
Age: __years
Race
Ethnicity/Hispanic (yes/no)
Employment type (paid, volunteer, other)

Facilitator/Leader 2 (name, phone, email)
Receive info from National CDSME Resource Center? Yes or No
Age: __years
Race
Ethnicity/Hispanic (yes/no)
Employment type (paid, volunteer, other)

Facilitator/Leader 3 (name, phone, email)
Receive info from National CDSME Resource Center? Yes or No
Age: __years
Race
Ethnicity/Hispanic (yes/no)
Employment type (paid, volunteer, other)

Option 2:  Collect Separate Sheets/Pages for Each Facilitator

• Create a separate sheet/page for each Facilitator containing just their info (name, age, race/ethnicity, employment status).
• Combine the Facilitator sheet with the workshop cover sheet containing the rest of the class details (site name, start/end date, EBP name, workshop language, etc.). This could be accomplished by stapling the forms, if the program is in person; or using a common ID to combine these data electronically, if delivering the program remotely.
• Remember to keep these forms together when sending your workshop packet to the data entry person. 
• You could also choose to include some identifying information at the top of each Facilitator sheet (or electronic form) to ensure the Facilitator information is combined and the correct packet of data (e.g., evidence-based program name, Site name, and Start Date).

 Sheet 1: WORKSHOP DETAILS                                                  
•    Implementation Site name, address        
•    Evidence-based Program Name
•    Start/End Date 
•    Workshop Format: How program was delivered?
•    Workshop Language
•    Session 0? (Y/N)

Sheet 2: FACILITATOR 1
•    Facilitator/Leader 1 (name, phone, email)
•    Receive info from National CDSME Resource Center? Yes or No
•    Age: __years
•    Race
•    Ethnicity/Hispanic (yes/no)
•    Employment type (paid, volunteer, other)

Sheet 3: FACILITATOR 2
•    Facilitator/Leader 1 (name, phone, email)
•    Receive info from National CDSME Resource Center? Yes or No
•    Age: __years
•    Race
•    Ethnicity/Hispanic (yes/no)
•    Employment type (paid, volunteer, other) 

ETC.

Option 3: Collect Facilitator data prior to the workshop

You may collect facilitator data prior to the workshop, such as during facilitator training, enrollment, or through other convenings with the facilitator. This can also be done electronically through a registration or online system for tracking facilitator activity. In this approach, you only need the facilitator’s name on the workshop cover sheet. Once facilitators have been entered into HAPID®, data entry users simply have to search for them by name and select the appropriate facilitator associated with each subsequent workshop.