Guidelines for Service Reporting

The sections that follow describe the fields that appear on the service reporting form and include explanations, instructions and sample real-world data. If you have any questions about how to fill out any part of the form that cannot be answered by reviewing these guidelines, please contact Debbie Atkinson, by telephone at 843-6892 or by e-mail at debbie_atkinson@unc.edu. Please print these instructions for future reference. Personal Information Basic identification information about the faculty member, staff member or student providing the service. Note: If the "SmartForm" option of the reporting form is enabled, personal information will be "remembered" and added automatically to each service report. Type of Service Options for this field are: External service - service to organizations, agencies or individuals off-campus, including other branches of the UNC system Internal service to the SPH - service on committees, task groups or advisory panels in and of the School of Public Health (including individual departments) Non-SPH internal service - service on committees, task groups or advisory panels in and of campus units other than the School of Public Health Research-related service - consultation, technical assistance or training (non-FTE only) provided to an agency or the public as part of a research project Paid consulting - any kind of service performed for pay. Persons reporting paid consulting activities should also submit the "External Activities for Pay" report to their departmental business office. Other - a service activity that does not fit one of the above categories Do not report activities related to academic or continuing education courses that earn FTEs. Benefit to the State Indicate by answering "yes" or "no" whether or not the service activity addresses the general education, health, or welfare of North Carolina citizens. Information About Organization Receiving Service Basic identification information about the organization, agency or group receiving the service. Please be as accurate and complete as possible. Name of Organization - Include enough information so that one organization cannot be confused with any other. Note: Please use only commonly recognized abbreviations. City, State, Country - Location at which the service was delivered. Kind of Organization - Check the one box that best describes the primary or basic nature of the organization. Options are: Business/Commercial - For-profit businesses or companies, or professional associations that represent such organizations. Examples: Winston-Salem Business Coalition Penn Power and Light Company Radian Engineering Inc. Community/Consumer/Advocacy/Philanthropic - Organizations (usually not-for-profit) that provide information and/or services to the general public around a specific topic or theme, or that are exclusively philanthropic. Examples: American Heart Association NC Child Advocacy Institute WK Kellogg Foundation Educational/Research - Organizations (usually not-for-profit) the primary purpose of which is to provide education and/or conduct research. Include in this category medical organizations that focus on research rather than patient care. Examples: NC Water Resources Research Institute (WRRI) Bowman Gray School of Medicine UNC-CH schools, departments and offices (including SPH) Government/Municipal - Official entities of government (excluding educational institutions) at any level. Include in this category any medical facilities that are part of or operated by any governmental unit. Examples: National Institutes of Health (NIH) UNC Hospitals Pitt County Health Department Hospital/Medical Center (non-governmental) - For profit or not-for profit hospitals, medical centers, clinics, etc. that focus primarily on patient care and that are not part of any governmental unit; also include in this category private medical practices. Examples: Duke University Medical Center Central Carolina Hospital Oak Ridge Hematology and Oncology Professional - Associations, societies and other organizations that represent or provide service to a specific profession. Examples: American Chemical Association American Public Health Association (APHA) American Academy for the Advancement of Science (AAAS) Scope of Organization - Check the one box that best describes the general location or distribution of the constituency that the organization usually serves. International - Organizations that provide services, programs or products to more than one country, that represent constituent members from several countries or a single foreign (non-US) country, or that are home-based in a country other than the US. Examples: Universita' di Torino International Society for Microbiology GlaxoSmithKline National - Organizations that provide services or programs for the entire US but not foreign countries. Examples: National Institute of Occupational Safety and Health (NIOSH) American Society of Civil Engineers American Cancer Society Single-state (including NC) - Organizations that provide services or programs to an entire state. Examples: NC DHHS New York State Department of Health Nebraska Association of Occupational Health Nurses Note: Include state public colleges and universities in this category. Multi-state - Organizations that provide services or programs in more than one state but not nation-wide. Examples: Midwest Society of Community Health Nurse Researchers Southeastern Society of Parasitology Rocky Mountain Academy of Occupational and Environmental Medicine Multi-county - Organizations that provide services or programs in more than one county but not state-wide. Examples: Orange-Durham Coalition for Battered Women Triad Sickle Cell Anemia Foundation Tri-County Community Health Center Single County - Organizations that provide services or programs in only one county. Examples: Person County Health Department Lee County Community-Based Public Health Initiative Coalition Edgecombe County Emergency Medical Services Project Local - Organizations that provide services or programs in a single community or at a local site. Examples: City of Burlington Chapel Hill Senior Center Carolina Meadows Information About Service Activity Date of Activity - Enter the month and year in which the service was provided. Did AHEC request this activity? - Check yes or no; do not leave blank. Current Status of Activity - Check one or two boxes to describe the activity. Check "New" if this is the first occurrence of the activity. Check "Continuing" for an activity that will be or has been ongoing (i.e., serving as an officer in an organization, or the editor of a scientific journal). Check "Completed" if this is the last occurrence of the activity. Nature of Activity - Check the one box that best describes the primary nature of the service activity. Advocacy/Testimony - Official service in active support of a particular cause, proposal, or point of view. Examples: Lobbied Congressional VA-HUD Committee on behalf of Superfund basic research program Served as expert witness in a lawsuit involving groundwater contamination by septic tank systems Gave court deposition concerning leukemia in nuclear workers Consultation - Service, usually one-time or short-term, to provide information, professional opinion, advice or recommendation, or technical expertise. Examples: Advised on the design of an epidemiological study of particulate air pollution Provided information on car seat laws as they relate to daycare programs Provided information on estuarine ecology to a Raleigh News and Observer reporter via telephone interview Educational Presentation - Service to teach or share information with an audience through a formal oral or written process. Examples: Taught two sessions on national training program in STD research at the University of Washington Wrote an article on "Adolescent Dating Violence" for newsletter of MCH Division of DHHS Participated in a panel discussion on HIV for public television station Note: Continuing education activities may be reported as service only if they are not eligible to earn FTEs for the School of Public Health. Grant Proposal Review - Service as a peer reviewer of the funding proposals of other individuals or organizations. Examples: Reviewed grants for NIEHS study section Reviewed proposals for Smart Start Initiative funding Manuscript Review/Editing - Service as a peer reviewer for an individual journal article, book, or publication in any other medium (such as a video, telecourse, etc.). Examples: Referee for the journal Biometrics Edited book on internal migration and urbanization Note: In general, work on one's own professional publications will not be counted as service. Journal publications sometimes result from consultation to organizations. In such cases, the consultation is reportable as service but work on the publication is not; however, a written report to the organization for which the consultation was performed is reportable. Organization Leadership - Service on committees or boards, as an officer of a professional or voluntary association, or as the editor or on the editorial board of a publication. Examples: President, Association of Teachers of Maternal and Child Health Editor, Advances in Water Resouces Member, UNC-CH Long-Range Planning Committee Note: Reportable leadership service includes service to the profession or to the non-professional community in a professional capacity. Policy/Program Planning, Development or Evaluation - Service more extensive, intensive, and/or process-oriented than simple consultation. Examples: Reviewed NC DHR Trauma Registry Program Assisted with strategic planning process at Pitt County Public Health Center Reviewed PhD program at Miami University Note: As used here, "program" does not refer to a schedule, agenda, or order of topics, business or speakers at a meeting. Research Presentation - Service to share information on one's own research with an audience through some formal oral process. Examples: Presented research poster at scientific meeting Prepared and presented paper on current research at annual meeting of professional society Note: General attendance, without presentation, at professional or association meetings should not be reported as service. Review or Evaluation of Colleague Performance - Service as a peer reviewer of the ability, performance or accomplishments of a colleague, usually as a part of a hiring or promotion and tenure decision-making process. Examples: Member of search committee for Injury Control Section Chief Peer review for tenure decision at Southern Methodist University Participated in a promotion review at Princeton University Other - Check this category only when none of the other choices describes the broad nature of the activity. Use the blank space provided to write in a unique descriptive category for the activity. Description of Activity - Provide complete description of activity, including details not covered by check boxes. Include any journal or book title, or the title of any article, presentation, workshop, etc. Hours of Service - Time spent in the service activity, divided into the following categories: Travel Time - Hours of time spent traveling to and from the activity, reported to the nearest half-hour Preparation Time - Hours of time spent preparing for the activity, reported to the nearest half-hour Delivery Time - Hours of time spent delivering or presenting the activity, reported to the nearest half-hour If you have any questions about how to fill out any part of the form that cannot be answered by reviewing these guidelines, please contact Debbie Atkinson, by telephone at 843-6892 or by e-mail debbie_atkinson@unc.edu. Before you begin the Service Reporting Form, collect all the information on your service as outlined above. If you have to stop the form to collect information, you may lose the information already entered. Reporting Form

Last updated January 23, 2008