Submit this form by completing all required fields and attaching evidence of need and related documents. The completed form can be submitted via email to dramos@ph.lacounty.gov or gdonatoni@ph.lacounty.gov, or by fax to (213) 639-6416. Online submission is also available through the LAC Department of Public Health's website. For physical submissions, mail the completed form to Los Angeles County Public Health Department, ATTN: CH LA Moms Program, 1234 Health St., Los Angeles, CA 90012. To ensure timely processing, it's advised to keep copies of all submitted documents and follow up with the department if needed.

The important dates for this form in 2024 and 2025 are February 15, 2024, for the campaign start date, and the ongoing deadline for continuous campaign implementations.

The purpose of this form is to apply for the Most Innovative Campaign category in the Public Health Communications Awards. This application highlights the 'Choose Health LA Moms' program, which assists postpartum women in Los Angeles County in achieving a healthy postpartum weight. By improving the mother's weight and health, the program positively impacts the overall health of the family, addressing an essential community need. Additionally, this form provides detailed instructions on the planning, implementation, and evaluation of the campaign. It showcases the innovative aspects of CH LA Moms, discusses the targeted population, and elaborates on how the program addresses health equity concerns. The form also allows applicants to provide evidence of need and justify their campaign's effectiveness in achieving its objectives. Lastly, this application facilitates the sharing of successful health interventions and encourages replication in other jurisdictions.

• 1. Contact Information: Includes fields for jurisdiction name, contact name, title, email address, phone number, and alternate contact details.
• 2. Jurisdiction Size: Checkbox options to indicate the population size of the jurisdiction.
• 3. Communications Campaign Details: Fields to provide information about the campaign name, brief overview, core objectives, and campaign duration.
• 4. Campaign Planning and Implementation: Questions to describe the purpose, development, and implementation of the campaign, along with evidence of need and health equity considerations.
• 5. Target Population and Reach: Details about the intended population and recruitment strategies.
• 6. Replication and Partnerships: Information on the potential for replicating the campaign in other jurisdictions and details about partnerships formed during the campaign.
• 7. Campaign Outcomes: Fields to describe the evaluation of the campaign and its outcomes.

Failing to submit this form may result in missed opportunities for recognition and support for your public health campaign. Ensuring timely submission is crucial for being considered for the Most Innovative Campaign award.

• Missed Recognition: Your innovative public health campaign will not receive the potential recognition it deserves.
• Lack of Support: Without submitting the form, your campaign might not gain the support and resources it needs for further development and implementation.

• 1. Applying for Awards: To secure the Most Innovative Campaign award.
• 2. Showcasing Campaigns: To present details about unique and effective public health campaigns.
• 3. Securing Support: To gain recognition and support from partners and grant providers.