Key Takeaways

  • ACL grantees implementing the Tool Kit for Active Living with Chronic Conditions must use the CDSME data collection forms.

  • Find guidance for entering data for this program into the National CDSME Database. 

  • If you have questions, please contact Angelica Herrera-Venson ( 

Tool Kit for Active Living with Chronic Conditions Data Collection Guidance Administration for Community Living (ACL) grantees implementing the Tool Kit for Active Living with Chronic Conditions (Tool Kit) intervention must collect the required program data by way of ACL’s data collection forms. Here's some guidance on how to do that.

Data Collection Forms

  • Omit Attendance Log and Program Information Cover Sheet
  • Use the Participant Information Survey 

Recommended Process

  1. Mail the Participant Information Survey to Individuals expressing interest in the Tool Kit
  2. Receive the completed Participant Information Survey
  3. Mail the Tool Kit to the participant.

Proram research has demonstrated that individuals who first complete a data collection form are more likely to review the contents of the Tool Kit when compared with those individuals who are mailed the Tool Kit without any up-front commitment.

Post-Test Question

  • There are post-test questions on the Participant Information Survey. These question can be omitted from the Participant Information Survey sent prior to the distribution of the Tool Kit.
  • You may wish to send a follow-up satisfaction survey by mail or online and include the post-test question here.
  • To link responses to the post-test question to the baseline demographic data collected via the Participant Information Survey, be sure that the Participant ID matches for both surveys. The Participant ID can be pre-marked on the satisfaction survey prior to distributing.

Data Entry

In lieu of the Program Information Cover Sheet, the program name at the top of the Participant Information Survey should read “Tool Kit for Active Living with Chronic Conditions” to allow data entry staff to easily identify the intervention type.

When entering this workshop into the National CDSME Database, select the program name in the drop-down menu on the Workshop Form Field. On the Workshop Form Field, you only need to indicate the start date, as end dates will vary. Presumably, the start date will be the same date that the participant was mailed the Tool Kit.

To enter attendance data on the Participant Form in the National CDSME Database, indicate a “1” in the “# of Encounters” field and skip the “Is Completed” question.

Tracking Participants and Completers

  • Mail-only toolkits (no phone): Count individuals that receive a toolkit as participants only. No measure of completion required. 
  • Mailed toolkit (with optional weekly phone sessions): Individuals that attend at least one session are participants. Individuals that participate in 4/6 phone sessions are completers.