PROGRAM LOGIC MODEL WORKSHEET
INSTRUCTIONS - READ BEFORE USING: To create a logic model for a program or project, use the File, Save As commands in Word to save the
logic model worksheet as a new file, renaming the new file with a name that reflects the name of your project/program. To complete the logic model,
place the cursor within each of the boxes of the logic model worksheet (i.e., NAME, SITUATION, PRIORITIES, INPUTS, OUTPUTS, OUTCOMES,
ASSUMPTIONS, EXTERNAL FACTORS AND EVALUATION) and enter the appropriate information about your program/project in each box. If the
information you enter causes the worksheet to exceed one page in length, the logic model will automatically wrap over onto the next sheet.
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NAME OF PROGRAM/PROJECT: The Barriers of Immunization Within the Patient Population at Southeast Health Clinic
Goal statement:
This project seeks to decrease the number of unvaccinated patients at Southeast Health
Clinic by expanding access to and awareness about vaccines.
Objectives:
1. At the end of the practicum, I will carry out universal immunization on children to ensure that they are well integrated against the signs
and symptoms of preventable diseases while ensuring the best results are achieved.
2. At the end of my practice, I also aim at realizing a 95% coverage on vaccination targeting all the eligible patients within the area of
delegation at the time the third dosage is being issued.
3. I also aim at achieving the delivery of at least two immunization schedules a week for a period of 50 weeks within an year to diagnose all
the potential signs and symptoms to realize the best immunity around the facility.
SITUATION:
Immunization is important in preventing the quick and rapid transmission of various contagious diseases across the healthcare facility thus
safeguarding patients and other professionals. Immunization barriers are experienced by several low-income families and other minority groups
across the United States of America. The clinic should also play a crucial role in advocating for vigorous immunization as one of the best
preventive cares provided to patients (Brownson et al., 2017). In accordance, immunization is a focal area for Southeast Health Clinic to serve
low-income and minority groups living around the facility.
PRIORITIES:
Low income families and minority groups living within the locality of Southeast Health Clinic who face significant exposure to various
immunization barriers.
OUTPUTS OUTCOMES
INPUTS
Activities Participants Short-term Medium-term Long-term
1. Federal grants 1. Reviewing 1. Program Effective evaluation Lowered costs of Promotion of
2. Private prior officer and assessment of immunization on awareness about
donations research 2. Patients key development patients and improved immunization and
3. Clinic library 2. Conduct 3. Southeast areas. effectiveness on care vaccines.
and online interviews Health Clinic plan for patients.
databases on patients managers
Page 1 of 3
INSTRUCTIONS - READ BEFORE USING: To create a logic model for a program or project, use the File, Save As commands in Word to save the
logic model worksheet as a new file, renaming the new file with a name that reflects the name of your project/program. To complete the logic model,
place the cursor within each of the boxes of the logic model worksheet (i.e., NAME, SITUATION, PRIORITIES, INPUTS, OUTPUTS, OUTCOMES,
ASSUMPTIONS, EXTERNAL FACTORS AND EVALUATION) and enter the appropriate information about your program/project in each box. If the
information you enter causes the worksheet to exceed one page in length, the logic model will automatically wrap over onto the next sheet.
*********************************************************************************************************************
NAME OF PROGRAM/PROJECT: The Barriers of Immunization Within the Patient Population at Southeast Health Clinic
Goal statement:
This project seeks to decrease the number of unvaccinated patients at Southeast Health
Clinic by expanding access to and awareness about vaccines.
Objectives:
1. At the end of the practicum, I will carry out universal immunization on children to ensure that they are well integrated against the signs
and symptoms of preventable diseases while ensuring the best results are achieved.
2. At the end of my practice, I also aim at realizing a 95% coverage on vaccination targeting all the eligible patients within the area of
delegation at the time the third dosage is being issued.
3. I also aim at achieving the delivery of at least two immunization schedules a week for a period of 50 weeks within an year to diagnose all
the potential signs and symptoms to realize the best immunity around the facility.
SITUATION:
Immunization is important in preventing the quick and rapid transmission of various contagious diseases across the healthcare facility thus
safeguarding patients and other professionals. Immunization barriers are experienced by several low-income families and other minority groups
across the United States of America. The clinic should also play a crucial role in advocating for vigorous immunization as one of the best
preventive cares provided to patients (Brownson et al., 2017). In accordance, immunization is a focal area for Southeast Health Clinic to serve
low-income and minority groups living around the facility.
PRIORITIES:
Low income families and minority groups living within the locality of Southeast Health Clinic who face significant exposure to various
immunization barriers.
OUTPUTS OUTCOMES
INPUTS
Activities Participants Short-term Medium-term Long-term
1. Federal grants 1. Reviewing 1. Program Effective evaluation Lowered costs of Promotion of
2. Private prior officer and assessment of immunization on awareness about
donations research 2. Patients key development patients and improved immunization and
3. Clinic library 2. Conduct 3. Southeast areas. effectiveness on care vaccines.
and online interviews Health Clinic plan for patients.
databases on patients managers
Page 1 of 3
