Evaluation Plan Template
Provide a brief overview of your program that includes the following:
What do you plan to do?
Why is the program needed?
Who is the target population of this program?
What are the program’s objectives (SMART objectives)?
Stage of Program Development
In what stage of development is the program? (i.e., planning, implementation)
II. LOGIC MODEL
A logic model is a graphic depiction of the program and shows the logical relationships among the resources that
are invested, the activities that are implemented, and the benefits or changes that result from the activities. A logic
model includes the following components:
What resources are available to the program in terms of staff, money, space, time, partnerships,
Examples of resources: Diabetes self-management curriculum, trained health educators,
What activities are being undertaken (or planned) to achieve the outcomes?
Examples of Activities: Provide preventive dental services to children; conduct diabetes
screenings at health fairs; implement the CATCH program in elementary schools