2024 NCCHA Annual Meeting Call for Programs

To Submit Your Proposal:


  1. After you have completed your proposal on the Program Submission Worksheet, cut and paste the information from the worksheet into this online form. Please note: You will need to complete this online form in one sitting.
  2. You will be asked to attach your Program Submission Worksheet with Primary Presenter Bio/Disclosure as well as a Co-Presenter Bio/Disclosure Form for each of your co-presenters as the last step before submitting your proposal. These documents should be attached in Word format, not PDF.
  3. All speakers are required to submit a copy of their curriculum vitae/resume (below).



Required fields are indicated by a red asterisk“*"

General Information

The title of the proposed program should reflect the content of that program. While cute titles may sound clever, they tend to detract from the professionalism of the conference and make it harder to determine what will be presented.

Program Design

Program Design Guidance


Briefly describe the overall reason for developing your program. Develop your statement by answering the following questions:


A. What is the problem your program will address (include your intended audience/participants)? Ask yourself, what is the difference between what your intended participants currently know and are doing and what they should know and do. The gap between these practices is the problem to be addressed. The intended participants can be stated broadly or specifically (i.e., campus health professionals, primary care providers, administrators)


B. How was this problem discovered?

Reference specific data, guidelines, expert sources, etc. See additional guidance in the link above for potential sources.


C. As a result of attending this program, what will participants know (facts, information) and/or know how to do (skills, strategies, judgments) that will impact their practice/behavior and contribute to resolving the problem?


Example:

Forty-six percent of college student health centers use an integrated care model, up from 26% in 2007 (Readden, JACH, 2019), a trend that continues to grow. Through informal surveys and peer discussion via the ACHA listserv, a significant number of campus health professionals have expressed that the process of gaining buy-in, designing, and implementing an integrated care model has proven challenging and they do not feel fully prepared. After this session, participants will have thorough knowledge of change leadership, services that can be offered in an integrated system, and technology needs, as well as the ability to apply strategies to develop an integrated culture and a DEIJA framework. Participants will be prepared to design and implement an integrated health and wellness model on their campus.

Learning Objectives and Content

Instructions for Writing Learning Objectives


Learning objectives should:

1.    Specifically state what the learner will know or be able to do upon completion of the program, completing the sentence “After this session, attendees should be able to…”.

2.    Directly align with fulfilling the expected changes in knowledge or skills that were described in your needs statement above.

3.    Begin with a measurable verb, contain only one verb, and address only one action.


Note: If the presentation will address mental health issues, please ensure this is reflected in the learning objectives.


Selecting Verbs


Use measurable verbs from the lists below depending on if the objective’s intent is for the attendee to show a gain in knowledge (to know facts or information) or a gain in competence (to know how to do something, such as a skill or application of a strategy or judgment).


Knowledge Verbs: Define, Describe, Discuss, Distinguish, Explain, Identify, Indicate, List, Outline, Recognize, Select


Competence Verbs: Analyze, Apply, Assess, Create, Compare, Design, Develop, Evaluate, Execute, Implement, Interpret, Plan, Prepare, Use


AVOID the following verbs: Appreciate, Become aware of, Explore, Familiarize, Know/Know how, Improve, Learn, Understand

                                

Learning Objective #1

After this session, attendees should be able to:


Example: Describe three change theory models.

List the specific content that you will present for this learning objective.


Example:

•    Kotter's Model of Change

•    Transformational leadership theory

•    Lewin's change management

•    McKinsey's 7-S model, etc.

What percentage of the total session time will this objective take? (I.e., 25%, 33%, 50%).


The total of all objectives should equal 100%.

%

List all presenters (first and last name) who may contribute to this objective.

Learning Objective #2

After this session, attendees should be able to:


List the specific content that you will present for this learning objective.


What percentage of the total session time will this objective take? (I.e., 25%, 33%, 50%).


The total of all objectives should equal 100%.

%

List all presenters (first and last name) who may contribute to this objective.

Learning Objective #3 (optional)

%

Learning Objective #4 (optional):

%

Learning Objective #5 (Optional)

%

Teaching Methods*

Design the program based on how best to accomplish the learning objectives. Other than lecture and slides/visuals, which active learning strategies will be incorporated into your presentation? Select all that apply.

Provide references used to develop your program content and that support your learning objectives.


Content can be based on:


•    Peer-reviewed journal(s)/resource(s)

•    Clinical guidelines, public health practice guidelines

•    Expert or expert group resource(s) (i.e., books, articles, websites)

•    Textbooks

•    Best practices or new and emerging issues

•    Research reports


Full citations are requested, but at minimum, provide complete source titles with their publication/organization name, web url, volume no., etc., so that sources can be easily located.


Example 1:

Correct: Seaquist, E.R. (2014). Addressing the Burden of Diabetes. JAMA, 2014, Vol. 311, No. 2:62267-2268.

Incorrect: JAMA article on Diabetes


Example 2:

Correct: University of Michigan Sleep Disorders Centers, https://medicine.umich.edu/dept/sleep-disorders-centers

Incorrect: Research from Michigan on Sleep Disorders

Program Overview

Target Audience*

Who will benefit from attending this program? Select all that apply.

Provide a short (75 words), descriptive abstract of your presentation that will be inserted VERBATIM in conference materials. Please be concise and clear with your description. If your presentation will address original research, please specify.

DEIJA Programming Guidance


Does your program address diversity, equity, inclusion, justice and/or accessibility? If it is clear in the session title, abstract, and/or learning objectives how your session addresses DEIJA, you can skip this question. If it is not clear, describe how it explores or addresses systemic barriers that impede marginalized populations from achieving health outcomes. These systems may include, but are not limited to social, economic, demographic, cultural, or geographic policies, processes, and practices that create barriers for specific populations.

Pharmacology Content*

Will your presentation include content related to pharmacology? Check yes or no and, if yes, please ensure that your objectives and content validate the pharmacology component.

Pharmacology Percentage

If yes, please select the estimated percentage of session content related to pharmacology.

Primary Presenter Bio and Disclosure Form

Complete the following fields for the Primary Presenter.


Note: All disclosures that are determined by the ACHA/NCCHA Program Planning Committee to be relevant relationships will be shared with the participants/learners in meeting materials and prior to the start of the educational activity.

As you would list them after your name (e.g., APN, LPC, CHES)

Primary Presenter Qualifications

Please provide complete information in this section, as presenter qualifications factor heavily in the decision-making process of the program planners and continuing education reviewers.

As you prepare your bio statement, please do not put “See CV” or other attachment. Consider the following when preparing your response:


  • Clearly state your content expertise related to the topic of your presentation.
  • Include relevant academic appointments, involvement in professional organizations, and/or awards/honors received.
  • Specify the number of years you’ve been working on the program initiative, topic area, or specialty.
  • Describe your involvement in implementation of research, initiative, topic area, or specialty.
  • Indicate whether you have presented on this topic before. (If you would like to submit your CV for specifics, you can upload on the online form.)


Example: I have been working as a Psychologist in our Counseling Center for five years. My dissertation was on identity development among trans students. In my current role I primarily work with trans students, and I serve as the Co-Investigator of this study. I have presented about this research on-campus and at other national conferences.


I am qualified to give this specific presentation because:

List your completed academic degree(s), the institution where the degree was earned, and major or specialty area.


Example: PhD; ABC University; Clinical psychology

List any current certifications

Conflict of Interest (COI) Disclosure

Policy

NCCHA is obligated to the organizations that grant us CE accreditation/approval to ensure that all educational activities are developed and presented with independence, objectivity, and scientific rigor. It is our responsibility to ensure that they are free from promotion of specific goods or services, and that they are free from actual or potential bias.


All faculty/presenters/authors/planners are required to disclose all financial relationships with any ineligible companies (defined below) that you have had over the past 24 months, regardless of the amount and regardless of whether you view the financial relationships as relevant to the education. The Program Coordinator will identify and mitigate, as appropriate, any relevant relationships and the presence or absence of relevant financial relationships for all persons in control of content will be disclosed to the participants/learners before the learner engages in the education.


Please note: The identification of financial relationships with ineligible companies does not necessarily mean that you are unable to participate in the planning and implementation of this educational activity. Rather, the accreditation standards require that relevant financial relationships are mitigated before you assume your role in this activity.

Conflict of Interest Attestation*

I have read, fully understand, and agree to adhere to the Conflict of Interest Disclosure Guidelines as outlined above and below.

Disclosure Form Required by The Standards for Integrity and Independence in Accredited Continuing Ed

Information You Need to Know to Disclose Your Financial Relationships with Ineligible Companies


Why We Ask:

As an accredited provider, we require your assistance to comply with accreditation guidelines and help us create high-quality Accredited Continuing Education (ACE) that is independent of industry influence. To participate in this educational activity, all individuals who have the ability to influence and/or control the content of this ACE activity must disclose all financial relationships with all ineligible companies over the past 24 months. ACCME defines ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. For more information and examples see: https://accme.org/faq/what-accmes-definition-ineligible-company


What to Disclose:

● There is no minimum financial threshold; you must disclose all financial relationships, regardless of the amount, with ineligible companies as described above; only disclose your own financial relationships, not those of your spouse or life partner.

● You must now disclose all financial relationships with ineligible companies over the past 24 months regardless of whether or not you view the relationships as relevant to the ACE activity. Reviewers will determine if the information you provide is relevant to the topics of the ACE activity in which you will participate.

● You must disclose all financial relationships with ineligible companies over the past 24 months even if the relationships have now ended.


If the reviewers determine that the financial relationships create a conflict of interest, the reviewers will determine the appropriate method of mitigation. Mitigation may involve, but is not limited to, an independent review of the content you develop (if you are a planner, other methods will be utilized).


Many healthcare professionals have financial relationships with ineligible companies as defined above. By identifying financial relationships and taking steps to mitigate the potential for conflict of interest of those that are relevant, we will work together to create a protected space to learn, teach, and engage in scientific discourse free from the influence from organizations that may have an incentive to insert commercial bias into education.


Please disclose all financial relationships that you have had in the past 24 months with ineligible companies (see definition above). For each financial relationship, enter the name of the ineligible company and the nature of the financial relationship.

Content Related to Company*

If you indicated the name of company above, does the CE content over which you have control contain information about healthcare products or services of the ineligible companies you identified?

Off-Label Use of Drugs*

Will your presentation include discussion of off-label, experimental, and/or investigational use of drugs, devices, medical procedures, or interventions?

By typing my name below, I am providing my electronic signature indicating that all the information entered in this Program Submission Form is accurate. I further attest that I will not promote any products, goods, or services, or bias the educational activity in any manner.

1. Program Submission Worksheet* Attach your Program Submission Worksheet that includes your Primary Presenter Bio/Disclosure in Word format (not PDF). Be sure to sign and date the worksheet before submitting it.


2. Co-Presenter Bio/Disclosure Form(s)* Attach a Co-Presenter Bio/Disclosure Form for each co-presenter. The document name should begin with the presenter’s LAST NAME. The forms must be signed and dated and submitted as Word documents.


3.Curriculum vitae/resume

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