Reporting Guidelines

APhA-ASP

Generation Rx

REPORTING GUIDELINES

Reporting Cycle:

January 1, 2015– December 31, 2015

Due Date:

January 5, 2016at 11:59pm (PST)

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

REPORTING GUIDELINES

APhA-ASP will recognize chapters that implement a GenerationRx program in their local community. Events may be conducted at any time throughout the reporting cycle. Chapters must use the following reporting guidelines to participate in this award program. These guidelines outline how your chapter should write its report on the project(s) that were implemented as part of the GenerationRx program. Your chapter should also include photographs, videos, and examples of unique supporting materials from your projects and events.

Remember to answer all questions with honesty and integrity. The APhA-ASP GenerationRx Awards Selection Committee will review the report, and may ask for supporting documentation or further clarification to aid in its decision.

Please complete and submit the following sections of the APhA-ASP GenerationRxReporting Guidelines that outline your Chapter’s activities from January 1, 2015to December 31, 2015:

•Section I: Chapter Contact Information

•Section II: Essay

•Section III: Chronological List

•Section IV: Generation RxExecutive Summary

•Section V: ReportSubmission and Advisor Signature

CRITERIA FOR AWARD SELECTION

Collaboration (20 points):

What is the extent of collaboration with other organizations?(e.g. state and local pharmacy organizations, local health departments, community pharmacies, law enforcement, school districts, senior citizens groups, community organizations, local addiction/mental health groups, student health organizations, etc.)

Participation (20 points):

How many student pharmacists, college of pharmacy faculty and staff, and additional pharmacists were involved in planning or implementation?

Originality (25 points):

How creative, innovative, and original were projects and programs related to Generation Rx?

Outcome (35 points):

What effect did the project have in your community? How many people were surveyed, educated, or affected through this project?

NATURE OF THE AWARDS

The APhA-ASP Generation RxAwards Selection Committee may consist of the following individuals:

APhA-ASP Communications Standing Committee (1-2)
APhA-ASP Education Standing Committee (1-2)
APhA-ASP Policy Standing Committee (1-2)
APhA-ASP National Executive Committee (1-2)
APhA Institute on Alcoholism & Drug Dependencies

Leaders or Advisory Committee Members (or alternative meeting planners) (1-2)

APhA Student Development Staff Member (1)
Cardinal Health Foundation Representatives (1-2)

The following recognition will be given:

National Generation Rx Recognition Program

Eleven winning chapters will be recognized during the APhA Annual Meeting & Exposition at the APhA-ASP Opening General Session. Winning chapters will receive the following recognition:

Generation Rx National Award - $1,000
Generation Rx 1st Runner-Up Award -$750
Generation Rx 2nd Runner-Up Award -$500
Generation Rx Region 1 Award - $250
Generation Rx Region 2 Award - $250
Generation Rx Region 3 Award - $250
Generation Rx Region 4 Award - $250
Generation Rx Region 5 Award - $250
Generation Rx Region 6 Award - $250
Generation Rx Region 7 Award - $250
Generation Rx Region 8 Award - $250

APhA Institute on Alcoholism & Drug Dependencies (or alternative meeting)

Opportunity for 2 students from each of the 1st, 2nd, and 3rd place chapters to attend the APhA Institute on Alcoholism & Drug Dependencies(June3-6, 2016).
Meeting travel, housing, registration, and incidentals included within prize.
Chapter representatives would present a posteron their project, as well as conduct a PowerPoint presentation/workshop.

Student Pharmacist Magazine

Generation Rxsection of July/August issue will include a report from the 1st, 2nd, and 3rd place chapter projects.

All decisions made by the Generation Rx Awards Selection Committee are final.

ENTRY REQUIREMENTS

Report Submission

Reports must be submitted by 11:59pm PST on January 5, 2016.
Reports, forms, photographs,supporting materials, and videos will only be accepted electronically via each Chapter’s Dropbox folder. (See instructions below.)
Send an email to with the Report Submission and Advisor Signature (Section V) page attached to notify APhA Staff that the report has been submitted.

Formatting & Style

Reports may only be submitted as a Word document or PDF.
Reports should be double-spaced using a 10-point, Arial font, with 1” margins(left and right).
The header of each page of your report must contain your Chapter’s Name.
The end of the report essay must contain word count.
The footer of each page must contain Page X of Y.
Files must be labeled as “Chapter Name Generation RxReport.doc or .pdf”.

SUPPORTING MATERIALS

Photographs

Photographs must be submitted electronically through the Chapter’s Dropbox folder and must be labeled “Chapter Name GRx Pic #.jpg” (i.e. “U Arizona GRx Pic 1.jpg” or “SDSU GRx 2.jpg”). Photographs should be submitted separately of the text document of the report. Once photographs have been submitted electronically to APhA, the Association reserves the right to use these photographs in APhA publications, marketing materials, and during APhA meetings.Up to 10 photographs may be submitted.

Supporting Materials

Additional supporting materials developed by your chapter (original documents/materials only) may be included to illustrate the activities described in your essay. All supporting materials must be scanned and submitted electronically to the Dropbox folder as a PDF. Files must be labeled “Chapter Name GRx SM #.pdf” (i.e. “U Arizona GRx SM 1.pdf” or “SDSU GRx SM 4.pdf”). Up to 10 supporting materials may be submitted.

Videos

Chapters are encouraged to submit their original videos (created by the Chapter) used to promote, market, or educate fellow students, faculty, patients, and the community regarding Generation Rx. Chapters may also provide links to media coverage regarding Chapter-specific programs; however, videos may not be reviewed until January/February due to the review cycle of the Generation Rx Awards Selection Committee. Therefore, it is encouraged that each Chapter obtain a copy of the video, as links to local news are deleted after time.

Due to the large size of video files, the Generation Rx Awards Selection Committee will only accept the URL, title, and 35 word synopsis of the video on the ReportSubmission and Advisor Signaturepage (Section V).We encourage you to upload your videos to your chapter, school or college of pharmacy, YouTube, or other online video-sharing Web sites.APhA Student Development Staff may request the original file. Once videos have been submitted electronically to APhA, the Association reserves the right to use or link these videos in APhA resources, marketing, and during APhA meetings.Please do not submit your Chapter’s PharmFlix Video. This is a separate competition and will not be reviewed by the APhA-ASP Generation Rx Awards Selection Committee. Up to 2 videos may be submitted with the report.

CHAPTER DROPBOX FOLDERS

In an effort to improve file transmission, security, and ease of uploading reports, APhA-ASP will only accept reports, forms, photographs, supporting materials, and videos via each Chapter’s Dropbox Folder. Dropbox is a Web-based file hosting service that uses networked storage to enable users to store and share files and folders with others across the Internet using file synchronization.

In May 2012, each Chapter President and Chapter Advisor received an email invitation from the Account to join a Dropbox Folder with the Chapter’s Name (example: University of Arkansas for Medical Sciences – Chapter Reports). The Chapter President andChapter Advisorare responsible for sharing the Chapter Folder with the necessary Chapter Executive Committee Members and Chapter Patient Care Project Chairs.

Each Chapter is responsible for all of the files, forms, photographs, supporting materials, and videos uploaded to the Dropbox folder. Please only use this as a method to transmit your files to APhA, and not as your folder to store all of the original files. After the submission date, all files will be moved from the Dropbox Folder to APhA’s server. Therefore, please keep your original files stored elsewhere.

Create the following folderfor Generation Rx Reports in the main folder of your Dropbox Account, “Generation Rx”.

Do not create sub-folders under the Generation Rx folder. The Generation Rx Awards Selection Committee and Student Development Staff have found that multiple folders (while it may assist you with organizing the file) leads to reports, forms, photographs, supporting materials, and videos either not being submitted, missed, or not copied over to APhA’s server correctly.

Please place the Report Submission and Advisor Signature page (Section V) in the Generation Rx folder.

Once completed, one copy of the completed Report Submission and Advisor Signature page (Section V) should be sent via email to , with the subject line “Chapter Name –Generation Rx Reports”, notifying the Generation Rx Awards Selection Committeeand APhA Staff that you have uploaded your report, forms, photographs, supporting materials, and videos to your Chapter’s Dropbox folder. Only one form per chapter should be submitted. The deadline for submitting this form via email is January 5, 2016 at 11:59pm PST.

If you need assistance, have questions, or need more information, please contact Keith Marciniak, APhA Senior Director of Student & New Practitioner Development by phone (800) 237-APhA ext. 7595, or via email at .

As a reminder, all reports must be received via the Chapter’s Dropbox Folder by 11:59pm (PST) on January 5, 2016. Dropbox provides a time/date stamp on each file. Files with a time/date stamp after the deadline will not be accepted.

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

SECTION I: CONTACT INFORMATION

School or College of Pharmacy Name:

APhA-ASP Chapter President Name:

APhA-ASP Chapter President E-Mail Address:

APhA-ASP Chapter Advisor Name:

APhA-ASP Chapter Advisor E-Mail Address:

Generation RxStudent Coordinator:

Generation RxStudent Coordinator E-Mail Address:

By signing this agreement, I attest that the following hold true to the best of my knowledge:

I understand the laws of my state and am confident that participation in Generation Rx iswithin the guidelines of the law and has not violated any laws of my state (if applicable).

I have ensured that all students participating in Generation Rx are properly trained with the knowledge of prescription drug abuse and misuse required for community outreach and education.

I have followed the guidelines of Generation Rx and will submit all necessary documentation when needed. I understand that data submitted may be included for publication in aggregate with data collected from other APhA-ASP Chapters’ projects as well.

I hereby state that the following materials are the work of our Chapter’s members and the activities represented in this report are an accurate portrayal of the work our Chapter has completed.

Signature of Student Coordinator:Date:

DEADLINE:Entries must be submitted electronically via the APhA-ASP FTP site no later than11:59pm PST on January 5, 2016.

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

SECTION II: ESSAY

Please describe the planning, implementation, and outcomes of your chapter’s Generation Rx activities, specifically highlighting the significance of your accomplishments and how they affected your chapter members, community, and/or the profession of pharmacy. Please do not list dates of events, activities, and programming, as this is already addressed by the chronological list.

Information provided in the essay may include, but is not limited to:

Planning
Committee structure indicating chair, vice chair
Chapter member recruitment and participant training
Details of Generation Rx planning sessions
Your Chapter’s Goals and Objectives for Generation Rx

Implementation
Promotion of the activities, including media coverage and materials unique to your Generation Rx program
Education and information provided to the public (e.g. teens, parents, educators, local community groups, elementary school children, etc.)
Collaboration with the community and other professional health care organizations for your Generation Rx program
How your activities met the goals and objectives of Generation Rx
Innovative or unique aspects of your Generation Rx program
Explanation of your project sites and settings

Outcomes
Describe the impact yourGeneration Rxprogram had on student pharmacists, the profession of pharmacy, and most importantly the public you served
Describe how your chapter achieved its goals and any possible improvements that could be made for next year

Report Essays may not exceed 2000 words. If your essay exceeds 2000 words, only the first 2000 will be submitted to the Awards Selection Committee.

A final word count is required at the end of the report essay.

The footer of each page must contain Page X of Y.

Files must be labeled as “Chapter Name Generation RxReport.doc or .pdf”.

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

SECTION III: CHRONOLOGICAL LIST

Please include a chronological list of all Generation Rx activities that occurred during the January 1, 2015 – December 31, 2015reporting cycle. The list should not be lengthy, but a brief record of all chapter projects, community programs, meetings, and activities related to Generation Rx. Activities may include, but are not limited to, health fairs, community centers, school districts, education programs, chapter meetings, committee meetings, executive committee meetings, legislative or policy events, community service projects, professionalism programming, American Pharmacists Month programming, social events, etc.

There is no word limit (except for the brief synopsis – less than 50 words) or page limit for the Chronological List. The following template must be used for the Chronological List:

Presentation/Activity/Event/Meeting/Project(s):
Date(s):
Location(s):
Target Audience:
Promotional Materials:
Faculty and Staff Present:
Additional Pharmacists (non-faculty) Present:
Chapter Members Present:
AdultsAttended Presentation(s)/Event(s):
Adults Reached Through Education/Presentation(s):
Teens Attended Presentation(s)/Event(s):
Teens Reached Through Education/Presentation(s):
Children Attended Presentation(s)/Event(s):
Children Reached Through Education/Presentation(s):
College Students Attended Presentation(s)/Event(s):
College Students Reached Through Education/Presentation(s):
Individuals Reached Through Public Relations:(TV, Newspaper, Radio, Social Media, etc.)
Event Held in Collaboration with:
Event Type:Indicate whether the event is a new program or continuation of a previous initiative
Estimate of the Total Number of Hours for Project Planning:
Total Number of Hours of Event:Indicate the duration of the event (cumulative for multiple dates)
Synopsis (less than 50 words for each activity listed):

Please see APhA-ASP Chapter Achievement Awards guidelines (Appendix A) for additional information/examples on creating the chronological list. The guidelines provide examples of how to list an individual event, month long program, and reoccurring events. The guidelines can be found online in the APhA-ASP AwardsScholarships section of

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

SECTION IV: EXECUTIVE SUMMARY

The APhA-ASP Generation Rx Awards Selection Committee and APhA Staff request that you complete both the form below and our online data form to submit your Chapter’s Generation Rx Executive Summary. The online data form will assist our staff to aggregate the results from all APhA-ASP Chapters in an expedited manner.

To complete the online form, please visit:

School or College of Pharmacy Name:

______Total number of Generation Rx presentations conducted.

______Total number of non-presentations (activities/events/projects) conducted.

______Total number of medication take-back events conducted.

______Total number of hours spent planning events/projects.

______Total number of hours spent conducting events/projects.

______Total number of individuals reached through education.

______Total number of adults educated.

______Total number of teens educated.

______Total number of children educated.

______Total number of college students educated.

______Total number of individuals that attended presentation(s)/event(s).

______Total number of individuals reached through public relations initiatives.

______Total number of student pharmacists involved in all projects.

______Total number of faculty and staff involved in all projects.

______Total number of pharmacists (non-faculty) involved in all projects.

APhA Academy of Student Pharmacists Patient Care Programs

Generation Rx

SECTION V: REPORT SUBMISSION AND ADVISOR SIGNATURE

Place an “X” next to the documents and the number (if applicable) next to the photographs, supporting materials, and videos your chapter has submitted.Once completed, this form should be sent via email to , with the subject line “Chapter Name – Generation Rx Report”, notifying the APhA-ASP Generation Rx Awards Selection Committee and APhA Staff that you have uploaded your report, forms, photographs and supporting materials to your Chapter’s Dropbox folder. In addition, please upload this document to the Dropbox folder.

___Generation Rx Chapter Report (contact information / essay / chronological list / executive summary)

___ Photographs (Number: ___)

___ Supporting Materials (Number: ___)

___ Videos (Number: ___)

Video Title:

URL:

Synopsis (less than 35 words):

Video Title:

URL:

Synopsis (less than 35 words):

CHAPTER ADVISOR SIGNATURE

“As the Chapter Advisor, I hereby state that the following materials are the work of our Chapter’s Members and the activities represented in this entry are an accurate portrayal of the work our Chapter has completed.”

APhA-ASP Chapter: (print name)

Signature of Chapter Advisor:Date:

DEADLINE: Entries must be submitted no later than 11:59pm PST on January 5, 2016.

Generation Rx APhA-ASP Reporting Guidelines – Updated 12/1/2015 –Page 1 of 10