EXCITE Activity 1 Reporting
Your Project Name
*
Please Select
AL AU Victory for Vaccination in Alabama
AL Voices for Vaccines
Alcorn State Extension Program Brave Vaccination Campaign
Alcorn State Extension Program Brave Vaccination Campaign
AR - UAPB Vaccinate with Confidence - Educating African American Adults to Increase their Vaccination Rate
AR-University of Arkansas System Division of Agriculture, Cooperative Extension Service-Vaccinate with Confidence
AS ASCC Community Health Project
AZ UA Health Education Literacy Project (HeLP)
CA UC ANR Promoting Health, Empowering Ethnic Communities
CO CSU Rural Community-Based Social Media Vaccine Promotion Project
CT UConn Strengthening Immunization Excitement
DE DSU Extension Collaboration on Immunization Teaching and Engagement (EXCITE)
DE UD Community Immunization Project
Don't Wait, Vaccinate! (West Virginia University)
EXCITE" The Return" TN, Tennessee State University, EXCITE Community Health Project
FL FAMU LOVE: Leveraging Organizations for Vaccine Engagement
FL UF EXCITE 1
GA FVSU Community Vaccination Education Project
IA_ISU_COVID-19 Vaccine Education Information Sessions
ID UI EXCITE Phase 1: Filling Immunization Education Gaps
Illinois UIUC Vaccine Champions Project
IN Purdue Spanish Speaking COVID Conversations
KS-KSU Extension Collaboration on Immunization Teaching and Engagement (KS-EXCITE) Vaccinate with Confidence
KY KYSU Successful Kentucky Immunization Project (SKIP - COVID)
KY UK Community Immunization Town Hall Project
LA SUAREC jAGs4Vax
LSU AgCenter COVID-19 Vaccination Education Project
MD UMD Protect Marylanders with Immunization Education and Engagement
MD UMES Extension Building Trust and Vaccine Confidence through Collaboration and Communication Strategies in the Tri-County Area of the Lower Eastern Shore of Maryland
ME UMaine Cooperative Extension Aroostook & Washington County Ag Vaccination Project
MI Bay Mills Community College's outreach to tribal communities to increase COVID-19 vaccine acceptability
MI Keweenaw Bay Ojibwa Community College’s COVID-19 vaccine education
MI Michigan State University Extension’s outreach to tribal communities to increase COVID-19 vaccine acceptability
MN - RLNC Student Vaccination Education
MN Extension Somali Grocery Stores as Vaccine Information Centers
MOLU Using a Griot Storyteller to Reduce COVID Vaccine Hesitancy in Rural and Urban Black Missourians
MS, MSU Strengthening Vaccine Education and Access in Mississippi
MT: MSU: Covid-19 Immunization Education Project
MU MUES - Building COVID-19 vaccine subject matter expertise among Extension field specialists in Missouri
NC NCA&T 1890 Extension COVID Response
NC NCSU - Me informo y Decido/I Get Informed and Decide: Extension COVID-19 Prevention and Vaccine Education for Farmworkers
ND - NDSU EXCITE
NE NICC Health Project
NE UNL Extension Collaboration on Immunization Teaching and Engagement
NE UNL Extension Collaboration on Immunization Teaching and Engagement (NE UNL EXCITE)
NH UNH Educating with Influencers
NJ Rutgers Cooperative Extension Immunization Education and Outreach
NM NMSU Dairy Producer Essential Workers Health Project
NV UNR Latinx Vaccine Education and Outreach Project
NY CCE Vaccination Education Initiative
OH, CSU and OSU: A joint Project Between the two Land Grant 1890 and 1862 Universities to Reduce COVID-19 Hesitancy in 15 Rural Ohio Counties (CENTRAL STATE FORM)
OH, Ohio State University and Central State University: A Joint Project Between the two Land Grant 1862 and 1890 Universities to Reduce COVID-19 Vaccine Hesitancy in 15 Rural Ohio Counties. (OHIO STATE FORM)
OK CMN EXCITE Vaccinate with Confidence
OK Langston University Restoring Community Confidence in Healthcare and Scientific Information Dissemination
OK OSU EXCITE Project
OR, Oregon State University, Promoting COVID-19 Vaccinations among Hard-to-Reach Populations in Oregon
PA Penn State Extension EXCITE
RI University of Rhode Island Vaccine Education Project
SC CU Vaccine Education and Promotion Initiative
Spirit Lake Tribe CCCC COVID Vaccination Project
TN UT Vaccinate with Confidence
TX Prairie View A& M University- Cooperative Extension Program Increasing Confidence in COVID Vaccines.
TX TAMU Understanding Messaging for COVID-19 Vaccination Confidence, Risk Assessment, and Intention in High Risk Faith-based Clergy and Congregants.
UGA: Building Vaccine Confidence in rural Georgia
UT, USU, Prevention Science Extension COVID-19 Education
VA VSU EXCITE1 Community Health Project
VA VT Vaccine Education EXCITE ACTIVITY 1
Vaccinate with Confidence Hawaii
VT UVM COVID Vaccination Education Project
WA WSU Teen Voices in Community Immunization Education
WI CMN Vaccination Education for Native Communities
WI UW-Madison Extension COVID-19 Vaccine Rural Farm Family and Farmworker Campaign
WV WVSU Don't Wait Vaccinate!
WY UWE Vaccine Up
Please choose your project from the dropdown. The project title is the same you used on your application.
What would you like to do today?
*
Submit Monthly Report
Make changes to contact information and submit monthly report
Which month are you reporting?
*
Please Select
June 2022
July 2022
August 2022
September 2022
October 2022
When are reports due? For example, a May 2021 Report is due by May 31 2021.
Do you anticipate finishing your work plan before your next monthly report?
*
Yes
No
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Job Title
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
Virgin Islands
Land-grant Institution
*
Please Select
Aaniih Nakoda College
Alabama A&M University
Alcorn State University
American Samoa Community College
Auburn University
Bay Mills Community College
Blackfeet Community College
Cankdeska Cikana Community College
Central State University
Chief Dull Knife College
Clemson University
College of Menominee Nation
College of Micronesia
College of the Muscogee Nation
Colorado State University
Cornell University
Delaware State University
Diné College
Extension Committee on Organization & Policy (ECOP)
Extension Foundation
Florida A&M University
Fond du Lac Tribal and Community College
Fort Berthold Community College
Fort Peck Community College
Fort Valley State University
Haskell Indian Nations University
Ilisagvik College
Institute of American Indian Arts
Iowa State University
Kansas State University
Kentucky State University
Keweenaw Bay Ojibwa Community College
Lac Courte Oreilles Ojibwa Community College
Langston University
Leech Lake Tribal College
Lincoln University
Little Big Horn College
Little Priest Tribal College
Louisiana State University System
Michigan State University
Mississippi State University
Montana State University
Navajo Technical University
Nebraska Indian Community College
New Mexico State University
North Carolina A&T State University
North Carolina State University
North Dakota State University Extension Service
Northern Marianas College
Northwest Indian College
Oglala Lakota College
Oklahoma State University
Oregon State University
Prairie View A&M University
Purdue University
Red Lake Nation College
Rutgers University
Saginaw Chippewa Tribal College
Salish Kootenai College
Sinte Gleska University
Sisseton Wahpeton College
Sitting Bull College
South Carolina State University
South Dakota State University
Southern University Ag Res. & Ext. Center
Southwestern Indian Polytechnic Institute
Stone Child College
Tennessee State University
Texas A&M University
The Ohio State University Extension
The Pennsylvania State University
Tohono O'odham Community College
Turtle Mountain Community College
Tuskegee University
United Tribes Technical College
University of Alaska Fairbanks
University of Arizona
University of Arkansas at Fayetteville
University of Arkansas at Pine Bluff
University of California
University of Connecticut
University of Delaware
University of Florida
University of Georgia
University of Guam
University of Hawaii at Manoa
University of Idaho
University of Illinois
University of Kentucky
University of Maine Cooperative Extension
University of Maryland
University of Maryland Eastern Shore
University of Massachusetts, Amherst
University of Minnesota
University of Missouri
University of Nebraska-Lincoln
University of Nevada, Reno
University of New Hampshire
University of Puerto Rico
University of Rhode Island
University of Tennessee
University of the District of Columbia
University of the Virgin Islands
University of Vermont Extension
University of Wisconsin-Extension
University of Wyoming
Utah State University
Virginia Polytechnic Institute & State University
Virginia State University
Washington State University
West Virginia State University
West Virginia University
White Earth Tribal and Community College
Point of Contact Name
*
First Name
Last Name
Point of Contact Email
*
example@example.com
What is the age range of your priority population?
*
Which of the following best describes the place where your priority population lives? Select all that apply.
*
A large city
Suburb near a large city
Small city or town
Rural area
What is the race of your priority population? Select all that apply.
*
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or other Pacific Islander
Other (specify)
Are individuals of Hispanic, Latino, or Spanish origin included in your priority population?
*
No, individuals of Hispanic, Latino, or Spanish origin are not included in my priority population
Yes, individuals of Hispanic, Latino, or Spanish origin are included in my priority population
Which of the following descriptors reflect your project’s priority population? Select all that apply.
*
Agricultural workers
College students
Extension personnel
Faith-based communities
Healthcare professionals
Low-resource individuals, families, or communities
Tribal communities
Rural communities
Communities of color
Other (specify)
Counties represented. Please begin typing your county and select all that apply.
*
Native American Reservations represented. Please begin typing Reservation name and select all that apply.
*
Back
Next
Save
Do you have a department or professional school within your academic institution to list as a project collaborator?
*
Yes
No
Provide a list of departments or professional schools (Examples: School of Pharmacy or School of Public Health) within your academic institution with whom you collaborate.
*
Select EXISTING academic institutions with whom you collaborate for this project.
Select NEW academic institutions with whom you collaborate for this project (if applicable).
Do you have an external academic institution to list as a project collaborator?
*
Yes
No
Provide a list of the academic institutions and departments or professional schools within that institution with whom you collaborate.
*
Do you have a healthcare or community partner to add a project collaborator? (If you need to add new collaborators whom you have not previously reported, click yes. If you don’t have new collaborarators to add, choose No.)
*
Yes
No
Provide a list of healthcare or other community partners with whom you collaborate for this project.
Which of the following project engagement activities were used during the last reporting period? Select all that apply.
*
Virtual Live Event
In-person Event
Radio
TV
Social Media
Instant Messages
Print Media
Direct Mailing
Direct Text Campaign
Email
Print Materials
Vaccination Clinic
Billboards
Website
No Engagement Activities to Report
Other (please describe)
How many virtual live event activities were provided?
*
How many individuals were reached at virtual live events?
*
ARCHIVED How many individuals were reached at virtual live events by county?
*
How many in-person events were provided?
*
How many individuals were reached at in-person events?
*
ARCHIVED How many individuals were reached at in-person events by county?
*
How many radio activities were provided?
*
How many individuals were reached through radio?
*
How many TV activities were provided?
*
How many individuals were reached through TV?
*
How many social media activities were provided?
*
How many individuals were reached through social media?
*
How many instant messages were provided?
*
How many individuals were reached through instant messages?
*
How many print media activities were provided?
*
How many individuals were reached through print media?
*
How many direct mailing activities were provided?
*
How many individuals were reached through direct mailing?
*
How many direct text activities were provided?
*
How many individuals were reached through direct text?
*
How many emails were provided?
*
How many individuals were reached through email?
*
How many print materials were provided?
*
How many individuals were reached through print materials?
*
How many vaccination clinic activities were provided?
*
How many individuals were reached at vaccination clinics?
*
ARCHIVED How many individuals were reached at vaccination clinics by county?
*
How many [other] activities were provided?
*
How many individuals were reached through [OTHER]?
*
Back
Next
Save
Have you DEVELOPED educational campaign products (assets) as part of your project? If you have provided these assets in a previous reporting period, you do not have to report them again.
*
Yes
No
Select educational campaign products (assets) DEVELOPED as part of your project.
*
Evaluation Tools
Image
Infographic
Slide Deck
Social Media Graphic
Survey Forms
Text/Image for Direct Mail or Email Campaigns
Text/Image for Print Media/Popular Press
Text for Instant Messenger Campaigns
Text for Talking Points or Radio Public Service Announcement
Video
Other (please describe)
Number of Evaluation Tools developed
*
Please upload Evaluation Tools DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Evaluation Tools DEVELOPED as part of your project.
Number of Images developed
*
Please upload Images DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Images DEVELOPED as part of your project.
Number of Infographics developed
*
Please upload Infographics DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Infographics DEVELOPED as part of your project.
Number of Slide Decks developed
*
Please upload Slide Decks DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Slide Decks DEVELOPED as part of your project.
Number of Social Media Graphics developed
*
Please upload Social Media Graphics DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Social Media Graphics DEVELOPED as part of your project.
Number of Survey Forms developed
*
Please upload Survey Forms DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Survey Forms DEVELOPED as part of your project.
Number of Text/Image for Direct Mail or Email Campaigns developed
*
Please upload Text/Image for Direct Mail or Email Campaigns DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text/Image for Direct Mail or Email Campaigns DEVELOPED as part of your project.
Number of Text/Image for Print Media/Popular Press developed
*
Please upload Text/Image for Print Media/Popular Press DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text/Image for Print Media/Popular Press DEVELOPED as part of your project.
Number of Text for Instant Messenger Campaigns developed
*
Please upload Text for Instant Messenger Campaigns DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text for Instant Messenger Campaigns DEVELOPED as part of your project.
Number of Text for Talking Points or Radio Public Service Announcement developed
*
Please upload Text for Talking Points or Radio Public Service Announcement DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text for Talking Points or Radio Public Service Announcement DEVELOPED as part of your project.
Number of videos developed
*
Please upload videos DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to videos DEVELOPED as part of your project.
Number of [other] developed
*
Please upload [other] DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to [other] DEVELOPED as part of your project.
ARCHIVED Please upload educational campaign products (assets) DEVELOPED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
ARCHIVED Provide links to educational campaign products (digital assets) DEVELOPED as part of your project.
Back
Next
Save
Have you ADOPTED educational campaign products (assets) as part of your project?If you have provided these assets in a previous reporting period, you do not have to report them again.
*
Yes
No
Select educational campaign products (assets) ADOPTED as part of your project.
*
Evaluation Tools
Image
Infographic
Slide Deck
Social Media Graphic
Survey Forms
Text/Image for Direct Mail or Email Campaigns
Text/Image for Print Media/Popular Press
Text for Instant Messenger Campaigns
Text for Talking Points or Radio Public Service Announcement
Video
Other (please describe)
Number of Evaluation Tools adopted
*
Please upload Evaluation Tools ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Evaluation Tools ADOPTED as part of your project.
Number of Images adopted
*
Please upload Images ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Images ADOPTED as part of your project.
Number of Infographics adopted
*
Please upload Infographics ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Infographics ADOPTED as part of your project.
Number of Slide Decks adopted
*
Please upload Slide Decks ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Slide Decks ADOPTED as part of your project.
Number of Social Media Graphics adopted
*
Please upload Social Media Graphics ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Social Media Graphics ADOPTED as part of your project.
Number of Survey Forms adopted
*
Please upload Survey Forms ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Survey Forms ADOPTED as part of your project.
Number of Text/Image for Direct Mail or Email Campaigns adopted
*
Please upload Text/Image for Direct Mail or Email Campaigns ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text/Image for Direct Mail or Email Campaigns ADOPTED as part of your project.
Number of Text/Image for Print Media/Popular Press adopted
*
Please upload Text/Image for Print Media/Popular Press ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text/Image for Print Media/Popular Press ADOPTED as part of your project.
Number of Text for Instant Messenger Campaigns adopted
*
Please upload Text for Instant Messenger Campaigns ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text for Instant Messenger Campaigns ADOPTED as part of your project.
Number of Text for Talking Points or Radio Public Service Announcement adopted
*
Please upload Text for Talking Points or Radio Public Service Announcement ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to Text for Talking Points or Radio Public Service Announcement ADOPTED as part of your project.
Number of videos adopted
*
Please upload videos ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to videos ADOPTED as part of your project.
Number of [other] adopted
*
Please upload [other] ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to [other] ADOPTED as part of your project.
Please upload educational campaign products (assets) ADOPTED as part of your project. If you have links to add, you may add those on the next question.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Provide links to educational campaign products (digital assets) ADOPTED as part of your project.
Back
Next
Save
In 2-3 sentences describe how your project is successfully promoting the uptake of COVID-19 vaccines.
*
In 1-2 sentences provide a brief description of your project that includes your primary engagement activities (ex: direct teaching, social media, print materials, mass media, ect.). This will be used as a description of your project on the public-facing EXCITE Map.
*
Save
Submit
Should be Empty: