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HomeMy WebLinkAbout20052572.tiff RESOLUTION RE: APPROVE TASK ORDER OPTION TO RENEW LETTER #2 FOR THE COLORADO PHYSICAL ACTIVITY AND NUTRITION PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with Task Order Option to Renew Letter#2 for the Colorado Physical Activity and Nutrition Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, commencing September 21, 2005, and ending September 20, 2006, with further terms and conditions being as stated in said task order, and WHEREAS, after review, the Board deems it advisable to approve said task order, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that Task Order Option to Renew Letter#2 for the Colorado Physical Activity and Nutrition Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said task order. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 31st day of August, A.D., 2005. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: !E≥\ 2n)7 /��,,( if %William H. rke, Chair Weld County Clerk to the ;.$� tt% ' 7 VAN: 01 BY: % y WA� A M. ile, Pro-Tem Deputy Clerk to the Boa New c, Da ' E. Lon AP AS TO FO Robert D. Masden my Att ey EXCUSED Glenn Vaad Date of signature: �y 2005-2572 / ` HL0032 (la` . tL r.36-vr 5_)J 0�I -4 -L7$- ritMemorandum TO: William H. Jerke, Chair Board of County Commissioners ' C FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment COLORADO DATE: August 22, 2005 J W\ SUBJECT: Task Order Option to Renew Letter for the Colorado Physical Activity and Nutrition Program Enclosed for Board review and approval is Task Order Option to Renew Letter Number Two between the Colorado Department of Public Health and Environment (CDPHE) and Weld County for the Colorado Physical Activity and Nutrition Program also known as the Health and Human Services Steps Grant. This renewal is for year three of a five year grant to prevent and reduce obesity, diabetes and asthma in Weld County. The goals are to increase physical activity, improve nutrition, educate on screening and management of diabetes and asthma, and reduce tobacco use and exposure. The four focus areas are schools, the health care system, the community, and worksites. Weld County Department of Public Health and Environment staff members are working in partnership with a large community consortium and Weld County School District Six to accomplish these goals. This option to renew letter will provide funding of$495,658 for the time period September 21, 2005 through September 20, 2006. I recommend your approval of this task order option to renew letter. Enc. 2005-2572 August 3,2005 TASK ORDER OPTION TO RENEW LETTER Task Order Option to Renew Letter Number 2, Contract Routing Number 06 FLA 00652 State Fiscal Year 2005-2006 Colorado Physical Activity and Nutrition Program This Task Order Option to Renew Letter is issued pursuant to section F of the Master Contract identified by contract routing number 05 FAA 00054 and paragraph C.5 of the Task Order identified by contract routing number 04 FLA 00154 and contract encumbrance number PO FLA PPG0400154, as amended by Task Order Option to Renew Letter Number 1 with contract routing number 05 FLA 00312. This Task Order Option to Renew Letter is between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY for the use and benefit of Weld County Health Department. The Task Order, as amended, if applicable, is referred to as the"Original Task Order". This Task Order Option to Renew Letter is for the renewal term of September 22,2005,through September 21,2006. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is Four Hundred Ninety Five Thousand Six Hundred Fifty Eight Dollars,($495,658.00)for an amended total financial obligation of the State of ONE MILLION TWO HUNDRED NINTY ONE THOUSAND FOUR HUNDRED SIXTY SEVEN DOLLARS. This is an increase of Four Hundred Ninety Five Thousand Six Hundred Fifty Eight Dollars,($495,658.00)of the amount payable from the previous term. The Scope of Work and Budget for this renewal term is incorporated herein by this reference, made a part hereof,and attached hereto as"Attachment B-1". Paragraphs A and C1 of the Original Task Order are modified accordingly. All other terms and conditions of the Original Task Order are reaffirmed. This Task Order Option to Renew Letter is effective upon approval by the State Controller, or designee,or on September 21,2005,whichever is later. Please sign,date, and return all 4 originals of this Task Order Option to Renew Letter by September 1,2005,to the attention of:Rachel Oys,Colorado Department of Public Health and Environment,Mail Code PSD-COPAN- A5,4300 Cherry Creek Drive South,Denver,Colorado 80246. One original of this Task Order Option to Renew Letter will be returned to you when fully approved. BOARD OF COUNTY COMMISSIONERS STATE OF COLORADO OF WELD COUNTY on behalf of Weld County Bill Owens,Governor Health Department (a political subdivision of the state of Colorado) By: "1—‘74K1,.,,/( By: 77 ame: William H. Jerke For th xecuti a Director , ems% Chair DEPARTMEN OF PUBLIC HEALTH f 1`c. j.. _i_ % 84-6000813 B AND ENVIRONMENT 8/31/ OS 1cirn ! ATTEST: (GRAM APPROVAL: q4i ♦ /J !' -Nit N N ALL CONTRACTS MUST BE PPROVED BY THE STATE CONTF OLLER CRS 24-30-202 requires that the State Controller approve all state contracts.This contract is not valid until the State Controller,or such assistant as he may delegate,has signed it.The contractor is not authorized to begin performance until the contract is signed and dated below.If performance begins prior to the date below,the State of Colorado may not be obligated to pay for the goods and/or services provided. TE CONTROLLER: Leslie M. hene It WELD COUNTY DEPARTMENT OF By: PUB i�C HEALT� 1(A- AND EN IT Date: IV„v_�ext Revised:07/01/04 BY: Mark E. Wallace, MD, MPH•Dlrectot Attachment B-1 COMMUNITY ACTION PLAN - YEAR THREE GOAL 1: INFRASTRUCTURE GOAL 2: COMMUNITY GOAL 3: HEALTHCARE SYSTEMS GOAL 4: SCHOOLS GOAL 5: WORKSITES Program Goal 1 — INFRASTRUCTURE - Maintain and ex i and the existin r coordinated Ste s to a Healthier Colorado Program infrastructure in Weld County Annual Infrastructure Objective lA: By September 21, 2006, the Weld County Steps Project will maintain and enhance staffing to 4.50 full-time employees. (Baseline: 3.25 FTE) Strategy Action Steps Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain Full-Time Project Coordinator. Project X X X X Position is filled. Coordinator (PC) 2. Maintain Full-Time School Health Coordinator. School X X X X Position is filled. Health Coordinator 3.Maintain two Full-Time Health Educators. PC X X X X Positions arc filled. 4.Maintain Part-Time Administrative Assistant. PC X X X X Position is filled. . Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain Full-Time Project Coordinator. ' PC X X X X Position is filled. 2. Maintain Full-Time School Health Coordinator. SHC X X X X Position is filled. 3.Maintain two Full-Time Health Educators. PC X X X X Positions are filled. 4.Maintain Part-Time Administrative Assistant. PC X ! X _ X X Position is filled. Page 1 of 45 Attachment B-1 Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Maintain Full-Time Project Coordinator. PC X X X X Position is filled. 2. Maintain Full-Time School Health Coordinator. SHC X X X X Position is filled. 2. Maintain two Full-Time Health Educators. PC X X X X Positions are filled. 3.Maintain Part-Time Administrative Assistant. PC X X X X Position is filled. Annual Infrastructure Objective IB: By September 21, 2006, the Weld County Steps Project will maintain one contract for program evaluation services. (Baseline: One contract with John Snow Research and Training Institute) Ert _ i . ria YEAR 3 Strategy I Action Steps Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain program contract with John Snow Research and Staff John Snow X X X X Copy of completed evaluation contract. Training Institute(JSI)for program evaluation services. Community Research and Training Institute(JSI) Project Coordinator (PC) Steps Staff la.JSI will assist with the development of Staff JSI X X X X Copy of evaluation tools developed. strategy level evaluation tools. Community PC Steps Staff lb.JSI will assist with the quarterly,mid year, Staff JSI X X X X Completed copies of quarterly, mid year, and and year-end progress reporting. Community PC year-end progress reports. Steps Staff lc. JSI will participate in Steps evaluation Staff JSI X X X X Evaluation conference call notes. conference calls. Community PC Steps Staff Id. JSI will assist in the development of the Staff JSI X X X Completed copy of year four action and year four action and evaluation plans. Community PC evaluation plans. Steps Staff > s Strategy Target Group Lead Role Time Line Evaluation Indicator(s) Page 2 of 45 Attachment B-1 Q1 Q2 Q3 Q4 1, Maintain program contract with John Snow Research and Staff PC Training Institute(JSI)or other appropriate contractor for Community Steps Staff program evaluation services. sn . miff Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Maintain program contract with John Snow Research and Staff PC Training Institute(ISI)or other appropriate contractor for Community Steps Staff program evaluation services. Annual Infrastructure Objective 1C: By September 21, 2006, necessary Weld County Steps Staff will participate in at least 20 staff development opportunities as appropriate. (Baseline: Four national Steps conferences, eight statewide trainings/meetings, and eight statewide/regional professional development opportunities) � �-�� -. Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Q1 Q2 Q3 Q4 Indicator(s) 1.Necessary Steps staff will attend at least two national Steps Steps Staff Project X X X X Meeting Agenda #of meetings Meetings. Coordinator Participant List attended. (PC) Steps Staff 2. Steps Project Coordinator and School Health Coordinator Steps Staff PC X X X X Meeting Agenda #of meetings will each attend at least six coordinator meetings in School Participant List attended. Denver. Health Coordinator (SHC) Rocky Mountain Center for Health Promotion (RMC) 3a. Project Coordinator will attend at least six Steps Staff PC X X X X Meeting Agenda #of meetings statewide Steps Project Coordinator Participant List attended. Meetings. Page 3 of 45 Attachment B-1 3b.School Health Coordinator will attend at Steps Staff SHC X X X X Meeting Agenda #of meetings least six statewide Steps School Health Participant List attended. Coordinator Meetings. 3.Necessary Steps staff will attend at least four regional or Steps Staff Steps Staff X X X X Meeting Agenda #of meetings statewide Steps trainings and/or meetings. Participant List attended. 4. Steps staff will meet weekly with Health Promotion Steps Staff Steps Staff X X X X Meeting Agenda #of meetings Supervisor. Participant List attended. 5. Steps staff will attend at least two team retreats. Steps Staff PC X X Retreat Agenda Attendance at retreat. Steps Staff 5a. Steps staff will plan and attend at least Steps Staff PC X Retreat Agenda Attendance at retreat. one team building retreat. Steps Staff 5b. Steps staff will plan and attend at least Steps Staff PC X Retreat Agenda Attendance at retreat. one planning retreat. Steps Staff y F, " R 4i-rj...- YiY.: t� ti.sp M?v Sy111? .Q'�u i«W��� �rwt� � ._75f��lC� ..+t at Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Necessary Steps staff will attend at least two national Steps Steps Staff PC X X X X #of meetings attended. Meetings. 2. Steps Project Coordinator and School Health Coordinator Steps Staff PC X X X X #of meetings attended. will attend at least six coordinator meetings. SHC 3.Necessary Steps staff will attend at least four regional or Steps Staff PC X X X X #of meetings attended. statewide Steps trainings and/or meetings. .. . ARC ZZ 1 ..n Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Necessary Steps staff will attend at least two national Steps Steps Staff PC X X X X #of meetings attended. Meetings. 2. Steps Project Coordinator and School Health Coordinator Steps Staff PC X X X X #of meetings attended. will attend at least six coordinator meetings. 3.Necessary Steps staff will attend at least four regional or Steps Staff PC X X X X #of meetings attended. statewide Steps trainings and/or meetings. Annual Infrastructure Objective 1D: By September 21, 2006, the Weld County Steps Project will maintain and enhance the Community Consortium structure by developing a leadership team with representation from each of the five workgroups (Asthma Information and Support Workgroup, Coordinated School Health Team, Diabetes Coalition Workgroup, Physical Page 4 of 45 Attachment B-1 Activity and Nutrition Workgroup, and Tobacco Coalition Workgroup). (Baseline: One Community Consortium, 0 Leadership Team,five workgroups) - a as � tiw •- YEAR. ' �� Strategy I Action Steps Target Group Lead Role Time Line Data Source Evaluation QI Q2 Q3 Q4 Indicator(s) 1. Maintain and expand Community Consortium(CC) by at Community Project X X X X Current Consortium #of members least ten additional members. Members Coordinator Membership List. maintained from Year (PC) 2. Steps staff Recruitment Contact #of new members List. recruited. la. Develop a list of representatives who will Community PC X X X X Recruitment Contact #of new members be invited to participate. Members Steps staff List. recruited. I 2.Provide at least two professional development opportunities Consortium PC X X X X Professional #of sessions for consortium members. Partners Steps staff development session provided. sign-in sheet. #of participants at each session. Satisfaction survey. Results of satisfaction survey. Both forms to be developed. 2a. Recruit two professional speakers and/or Consortium PC X X Professional #of sessions trainers and provide at least two Partners Steps staff development session provided. professional development opportunities for Professional sign-in sheet. #of participants at the consortium. Trainers each session. Satisfaction survey. Results of satisfaction survey. Both forms to be developed. 3. Establish a Leadership Team(LT)with at least five Consortium PC X X Invitation list. Establishment of members, one member from each workgroup. Partners Steps staff leadership team. Member list. Level of participation of team. 3a. Invite key leaders to join the Leadership Consortium PC X Invitation list. Establishment of Team and serve for a one-year period. Partners Steps staff leadership team. Level of participation of team. Page 5 of 45 Attachment B-1 3b. Develop a schedule of Leadership Team Consortium PC X X X X Schedule of meetings #of meetings attended meeting dates and provide technical Partners by each team member. assistance(TA)to LT members as they List of TA provided to #of TA sessions work on all Steps activities. team provided to team. 3c.Review progress on grant objectives. Leadership Team PC X X X X Progress on grant Steps staff objectives reviewed. 3d.Assist with planning for year four. Leadership Team PC X X Steps staff Evaluation comments: Data collection tools used to assess strategies under objective ID:Current Consortium membership list, recruitment contact list, professional development session sign-in sheet,satisfaction survey,schedule of meetings,and list of TA provided to team. k Strategy I Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain and expand Community Consortium by at least ten Community members PC X X X X additional members. Steps Staff 2. Provide at least two professional development opportunities Consortium members PC X X X X for members. Steps staff 3. Maintain and expand the Leadership Team by at least five Consortium partners PC X X X X additional members. Steps staff ti Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Maintain and expand the Community Consortium by at Community members PC X X X X least ten additional members. Steps staff 2.Provide at least two professional development opportunities Consortium members PC X X X X for members. Steps staff 3. Maintain and expand the Leadership Team by at least five Consortium partners PC X X X X additional members. Steps staff Page 6 of 45 Attachment B-1 Program Goal 2: Reduce asthma, diabetes and obesity through the promotion of nutrition, physical activity, tobacco cessation, and prevention of tobacco use and ex i osure in the COMMUNITY. Annual Community Objective 2A: By September 21, 2006, at least one million exposures to informational messages on the prevention/management of asthma, diabetes, obesity and associated risk factors will be completed. (Baseline:660,000 exposures) p } Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Increase Awareness of the benefits of increased fruit and Weld Residents Project X X X X Instrument Number: #of educational vegetable consumption in at least four venues. Coordinator O2ASI messages on fruit and (PC) vegetable consumption. #of exposures to messages. la. Participate in and promote the local Weld Residents PC X X Instrument Number: #of educational farmers market at least once a month, from Health O2AS1 messages on fruit and May through October, as a place to Educator vegetable increase fruit and vegetable consumption. (HE) consumption. #of exposures to messages. lb. Incorporate at least five messages on fruit Spanish speaking PC X X X X Instrument Number: #of messages aired and vegetable consumption into the KGRE Weld Residents Physical O2AS 1 on radio. Spanish Radio Media Campaign. Activity and #of exposures to Nutrition messages. Workgroup (PAN) Community Partners Ic. Provide fruit and vegetable point of Weld Residents PC X X X X Instrument Number: #of venues prompts decision prompts in at least ten community Grocery Stores PAN O2ASla provided. locations where fruits and vegetables are Farmers Markets Community #of prompts sold. Partners distributed. #of exposures to messages. Page 7 of 45 Attachment B-1 Id.Provide fruit and vegetable informational Churches PC X X X X Instrument Number: #of churches materials to at least five churches. Weld Residents PAN O2ASla materials provided. Community #of materials Partners Survey on fruit/veggie distributed. consumption barriers. #of exposures to Form to be developed. messages. Evaluation comments: Instrument Number: O2AS I will collect information on the type of message,place message was presented, target population of message, and number of people exposed and Instrument Number: O2AS I a will collect information on site names, number of site prompts and materials provided,number of prompts and materials distributed, and number of people exposed. Shoppers will be surveyed on barriers to fruit/vegetable consumption at the farmers market to determine im act. 2. Increase awareness of the importance of increased physical Weld Residents Health X X X X Instrument Number: #of educational activity in at least three venues. Youth Educator O2AS2 messages physical (HE) activity. #of exposures to messages. 2a. Incorporate at least four VERB messages Youth HE X X X X Instrument Number: ft of publications in at least ten school and community youth O2AS2 messages appear. publications. #of VERB messages provided. #of exposures to messages. 2b. Incorporate at least five messages on Spanish speaking PC X X X X Instrument Number: #of messages aired physical activity into the KGRE Spanish Weld Residents Community O2AS2 on radio. Radio Media Campaign. Partners ft of exposures to messages. 2c. Implement Steps media campaign through Weld Residents Policy X Instrument Number: #of print ads , at least three outlets such as print ads, Studies Inc. O2AS2 information and bench Steps website, and bench ads. (PSI) ads provided. PC ft of hits on the Steps website #of exposures to ads. Evaluation comments: Instrument Number: O2AS2 will collect information on the type of message, place message was presented, #of hits on the Steps website, target population of message, and number of people exposed. 3. Increase public awareness about the importance of triggers, Weld Residents Health X X X X Instrument Number: ft of educational such as secondhand smoke, in managing asthma in at least Educator O2AS3 messages provided five venues. (HE) about asthma. Tobacco #of exposures to Workgroup messages. (TWG) Asthma Workgroup (AWG) 3a. Incorporate at least 10 articles and/or Weld Residents HE X X X X Instrument Number: # of articles printed messages into Weld County newspapers. TWG O2AS3 and distributed. AWG #of exposures. Page 8 of 45 Attachment B-1 3b. Incorporate at least three articles and/or Weld Residents HE X X X X Instrument Number: #of churches or messages in church newsletters or TWG 02AS3 community community publications. AWG publications printing articles. #of articles printed and distributed. #of exposures. 3c. Incorporate at least four messages on the Spanish speaking HE X X X X Instrument Number: #of messages aired KGRE Spanish Radio Station. Weld Residents Community 02AS3 on radio. Partners #of exposures to messages. 3d. Incorporate at least four messages on a Weld Residents HE X X X X Instrument Number: #of messages aired local English language radio station. TWG 02AS3 on radio. AWG #of exposures to messages. 3e.Coordinate at least one outdoor media Weld Residents HE Instrument Number: #of exposures to campaign in the Greater Greeley area. TWG 02AS3 messages. AWG Evaluation comments: Instrument Number: 02AS3 will collect information on the type of message,place message was presented, target population of message, and number of exposures. 4. Provide informational messages about preventing and Weld Residents PC X X X X Instrument Number: #of educational managing diabetes in at least three venues. Diabetes 02AS4 messages provided Coalition about diabetes (DC) prevention and/or management. #of exposures to messages. 4a. Coordinate at least one outdoor media Weld Residents PC X X X X Instrument Number: Campaign developed. campaign in the Greater Greeley area. DC 02AS4 #of educational messages provided #of messages aired on radio. #of exposures to messages. #of booklets requested. 4b.Recruit bilingual Spanish speaking Spanish speaking PC X X X X #of bilingual Spanish diabetes prevention/management Weld Residents Community speaking diabetes professionals to participate in at least four Partners prevention KGRE Radio Station diabetes prevention DC professionals programs. recruited. Page 9 of 45 Attachment B-1 4c. Incorporate at least four Paso a Paso Spanish speaking PC X X X X Instrument Number: #of programs aired. printed media ads in local Spanish Weld Residents Community O2AS4 #of exposures to publications promoting the prevention of Partners messages. type 2 diabetes. Evaluation comments: Instrument Number: O2AS4 will collect information on the type of message,place message was presented,target population of message, number of exposures. Strategy [ Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 { 1.Increase awareness of fruit and vegetable consumption in at Weld Residents (PC least six venues. 2. Increase awareness of the importance of physical activity Weld Residents PC through at least five venues. 3. Increase public awareness about the importance of asthma Weld Residents PC management in at least eight venues. 4. Increase awareness about preventing and managing Weld Residents PC diabetes in at least six venues. _ a_„ h m . .. - . ._ _ ... _ .. � _ _ ARC= Strategy I Target Group _ Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Increase awareness of fruit and vegetable consumption in at (PC least ten venues. 2. Increase awareness of the importance of physical activity PC through at least 10 venues. 3. Increase public awareness about the importance of asthma PC management in at least 12 venues. 4. Increase awareness about preventing and managing PC diabetes in at least 10 venues. Annual Community Objective 2B: By September 21, 2006, at least 1,000 Weld County Residents will participate in prevention/management activities associated with asthma, diabetes, obesity, and/or associated risk factors. (Baseline: 500) •• s 1,,.: - a „{ fir{ 1"k r ma''±h,*�.'-""i -:1.JJI'�R s.. S�. ,. Strategy i Action Steps Target Group Lead Role Time Line QI Q2 Q3 Q4 Data Source Evaluation Indicator(s) Page 10 of 45 Attachment B-1 I. Provide at least 24 opportunities to learn about proper Weld Residents Project X X Instrument Number: #of opportunities nutrition. Coordinator O2BS1&2 provided to learn about (PC) nutrition. Health #of participants in each Educator nutrition opportunity. (HE) #of venues. la. Offer cooking/nutrition classes on fruits Weld Residents PC X X Instrument Number: #of classes offered. and vegetables in at least 10 venues such as HE 028S1&2 #of participants. recreation centers, senior centers, or Contract churches. Instructor lb.Provide fruit and produce tours in at least Weld Residents PC X X Instrument Number: #of tours. 10 local grocery stores. HE O2BS 1&2 #of participants. Community Survey on barriers to #of stores. Partners fruits/vegetable consumption. Form to be developed. Ic. Sponsor at least one class quarterly on Weld Residents PC X X X X Instrument Number: #of classes offered. diabetes and obesity prevention. HE 02B51&2 #of participants. Contract Instructor Evaluation comments:Instrument Number: O2BS 1&2 will collect information on the site name,number of participants in each learning opportunity,number of cooking/nutrition classes offered,number of grocery store tours offered, and number of classes offered on diabetes and obesity prevention. 2. Provide at least 13 opportunities to learn about physical Weld Residents Project X X X X Instrument Number: #of opportunities activity for Weld County Residents. Coordinator O2BS1&2 provided to learn about (PC) physical activity. Health #of participants in each Educator learning opportunity. (HE) 2a. Implement at least four senior physical Weld Senior PC X X X X Instrument Number: #of opportunities activity opportunities such as pedometer or Residents HE O2BS1&2 implemented. mall walking programs. YMCA #of participants in each opportunity. 2b. Coordinate with community partners to Weld Residents PC X X Instrument Number: #of activities or implement four community physical HE O2BS1&2 opportunities activity events/opportunities such as Latina Community coordinated. Youth conference, Fun Run, Relay for Partners Participant evaluation #of participants. Life, Summer Olympics. of intervention—Form Participant evaluations. to be developed Page 11 of 45 Attachment B-1 2c.Implement at least two VERB physical Tweens Health X X Instrument Number: #of tweens impacted. activity events. Educator O2BS l&2 (HE) Recreation Centers Boys and Girls Clubs Weld County School District 6 2d. Implement TV Turn Off week campaign Weld Residents PC X X Instrument Number: Type of alternate with at least 3 activities such as story HE O2BS1&2 activity times,baby animal days at Plum Farm, Community #of children clinic visits. Partners participating #of parents/caregivers participating Evaluation comments: Instrument Number: O2BS1&2 will collect information on the site name,number of participants in each physical activity learning opportunity, number of physical activity interventions,number of community events promoted,number of youth impacted, and the type of alternate activity, number of children participating,and number of parents/caregivers participating. 3. Provide at least 10 asthma prevention/management learning Weld Residents HE X X X X Instrument Number: #of opportunities activities for Weld County Residents. Asthmatics O2BS3 provided to learn about asthma prevention/management #of participants in each learning opportunity. 3a. Coordinate at least six asthma information Adults and children HE X X X X Instrument Number: #of information and and support group meetings. with asthma and Asthma O2BS3 support group parents Workgroup meetings. (AWG) #of participants. #of support groups. 3b.Assist with the coordination of at least two Head Start HE X X X X Instrument Number: #of Wee Wheezer Wee Wheezer asthma education programs. AWG O2BS3 Programs. #of participants. Wee Wheezer Session evaluations of Participant programs. Evaluation. 3c. Provide at least two Spanish language Spanish Speaking HE X X Instrument Number: #asthma management asthma management learning activities Residents AWG O2BS3 activities offered. such as Wee Wheezers. #of participants. Evaluation comments: Instrument Number: O2BS3 will collect information on the site name, number of participants in each asthma prevention/management learning opportunity, number of Wee Wheezers programs offered, number of Spanish language classes offered, and the number of participants reached in each of these activities. A participant evaluation will be used for each Wee Wheezer program offered. Page 12 of 45 Attachment B-1 4.Provide at least 16 diabetes prevention/management Weld Residents PC X X X X Instrument Number: #of opportunities learning activities for Weld County Residents. Diabetics HE O2BS4 provided to learn about Diabetes diabetes Workgroup prevention/management ' (DWG) #of participants in each learning opportunity. 4a.Provide at least four Dining With Diabetes Weld Residents PC X X X X Instrument Number: #of classes offered. educational classes in English. HE O2BS4 #of participants. Contract Educators 4b.Provide at least four diabetes screening Weld Residents PC X X X X Instrument Number: #of screening and and education events. American O2BS4 education events Diabetes collaborated on. Association #of people exposed to Community education. Partners #of people screened. 4c.Provide at least four Spanish language Spanish Speaking PC X X X X Instrument Number: #of diabetes diabetes prevention/management learning Residents Contract O2B54 prevention/ opportunities such as Small Steps/Big Educators management activities Rewards. offered. #of participants. Evaluation comments: Instrument Number:O2BS4 will collect information on the site name,number of participants in each diabetes prevention/management learning opportunity,number of Dining with Diabetes classes offered,number of people educated and screened,number of Spanish language classes offered,number of English language classes offered,and the number of participants reached in each of these activities. ...c ',:'s ,N v�1,` s� nq,".: J ` S t. [\--''''''' r f '.a.' -7*,t--? !:.tir `+-7 z�-. -r•• x -` ' .. ,.. YEAR 4 w Strategy I Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Provide at least 30 opportunities to learn about proper nutrition. 2. Provide at least 15 physical activity opportunities for Weld County Residents. 3.Provide at least 15 asthma prevention/management learning activities for Weld County Residents. 4.Provide at least 20 diabetes prevention/management learning activities for Weld County Residents. - ..... . - _ µ,..44S! •.,.`.�'S:.0,5 *0t�r�.-., ,,,, j.,r.. ' S'' AR, S v,,r" n:,_ wY J 44"-y `;Z . '" • • Strategy I Target Group F Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Provide at least 40 opportunities to learn about proper Page 13 of 45 Attachment B-1 nutrition. 2. Provide at least 20 physical activity opportunities for Weld County Residents. 3.Provide at least 20 asthma prevention/management learning activities for Weld County Residents. 4.Provide at least 25 diabetes prevention/management learning activities for Weld County Residents. Annual Community Objective 2C: By September 21, 2006, implement at least three Active Community Environment activities. (Baseline: One activity) AR. Strategy ` Action Steps Target Group Lead Role Time Line Q1 Q2 Q3 Q4 Data Source Indicator(s) 1. Implement the second annual Active Community Developers Project X X X X Instrument Number: #of participants at Environment(ACE) workshop in Weld County. Planners Coordinator O2CS1&2 ACE Training. Builders (PC) Government Community Training evaluation Training evaluations. Officials Partners form to be Parks and developed. Recreation 1 a.Convene a work group to plan the training Developers PC X Meeting Agenda. #of meetings on Active Community Environment. Planners Community #of participants. Builders Partners Participant List. Government Officials Parks and Recreation lb.Determine date and location for the Developers PC X Progress report(first Meeting date. workshop. Planners Community quarter). Meeting location. Builders Partners Government Officials Parks and Recreation _ lc. Develop agenda and invite speakers. Developers PC X X X Workshop Agenda #of speakers Planners Community Speaker List identified and Builders Partners confirmed. Government Officials Parks and Recreation Page 14 of 45 Attachment B-1 Id.Promote the event using at least three Developers PC X X #of hold the date different methods(hold the date postcards, Planners Community postcards, flyers flyers,and print media). Builders Partners distributed. Government Officials Parks and Recreation le. Host the workshop in Weld County on Developers PC X Instrument Number: #of participants at Active Community Environment. Planners Community O2CS1&2 ACE Training. Builders Partners #of community Government Training evaluation partners participating Officials form to be developed in the planning. Parks and Recreation Training evaluations 2. Develop at least one community resource booklet to Community PC X X X X Instrument Number: Number of resource promote Active Community Environment assets. Members O2CS1&2 booklets requested and distributed. 2a. Include information on City of Greeley Community PC X X X X #of bike trails, bike trails, walking trails, and green areas. Members walking trails,and green areas included. 2b. Include information on upcoming local Community PC X Instrument Number: #of local physical physical activity events such as Bike to Members O2CSI&2 activity events Work Week and community races/walks. promoted. 2c.Distribute booklets to 500 individuals, Community PC X X #of booklets organizations,and/or community groups. Members distributed. 3. Complete at least one walkability assessment. Community PC X X X Walkability Walkability Members assessment form assessment completed. 3a.Meet with at least three community groups Community PC X X X Meeting Meeting held. or organizations to determine where the Members agenda/minutes Location determined. assessment will be completed. 3b.Review results of assessment and Community PC X Results reviewed. determine next steps for making changes. Members Evaluation comments: Instrument Number: O2CS1&2 will collect information on#of participants at ACE Training, #of community partners participating in the community planning for an active community, #of resource booklets requested and distributed, #of local physical activity events promoted. Other data collected includes walkability assessment,meeting agenda/minutes and results of assessment. Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) QI Q2 Q3 Q4 1. Implement the third annual Active Community Developers PC X Environment(ACE) workshop in Weld County. Planners Community Builders Partners Page 15 of 45 Attachment B-1 Government Officials Parks and Recreation 2.Participate in at least ten community meetings on Active Weld County PC X X X X Community Environment activities. Residents Community Planners Partners Builders 3. Complete at least two walkability assessments. Weld County PC X X X X Residents Community Planners Partners Builders Strategy 1 Target Group I Lead Rote Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Implement the fourth annual Active Community Developers PC X Environment(ACE)workshop in Weld County. Planners Community Builders Partners Government Officials Parks and Recreation 2. Implement at least three additional ACE activities. Weld County PC X X X X Residents Community Planners Partners Builders Annual Community Objective 2D: By September 21, 2006, promote the 2007 Youth Risk Behavior Survey (YRBS) by presenting on the 2005 YRBS to the five participating schools. (Baseline: 0 presentations) Strategy Action Steps Target Group Lead Role Time Line Data Source Indicator(s) Q1 Q2 Q3 1. Q4 1.Present data to five participating schools in at least three Administrators Project X ' X X X Instrument #of presentations different venues. Teachers Coordinator Number: provided. Parents (PC) O3S1&2 #of people exposed Students Health per presentation. School Board Educator Members (HE) School Health Coordinator (SHC) , Page 16 of 45 Attachment B-1 la.Host at least four presentations during Administrators PC X X X Instrument #of presentations back to school nights,principal meetings, Teachers HE Number: provided. and/or school assemblies. Parents SHC O3S1&2 #of people exposed Students per presentation. lb.Attend and report information to at least School Board PC X X X one school board meeting. Members HE SHC 2. Obtain signed consent forms for the 2007 YRBS. Parents PC X Instrument #of 2007 YRBS Students HE Number: consent forms SHC 03S1&2 received. la.Attend back to school and registration Parents PC X #of back to school ' nights at five targeted high schools. Students HE and registration nights attended. Evaluation comments: Instrument Number: 03S1&2 will collect information on the number of presentations provided,number of people reached per presentation,and number of consent forms received. 'ytyi' f Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Conduct the Youth Risk Behavior Survey in Weld County Administrators PC School District Six. Teachers HE Parents SHC Students -.:7,,,,.-.# _tea .c a •3ub y- .'{, �`ir ..;,�.. 1, ""6' �...f `y`'., _ ,d , Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Present 2007 Youth Risk Behavior Survey Data to schools Administrators PC and community members. Teachers HE Parents SHC Students Page 17 of 45 Attachment B-1 Program Coal 3: Reduce asthma, diabetes and obesity through the promotion of nutrition, physical activity, tobacco cessation, and prevention of tobacco use and ex iosure in the HEALTHCARE SYSTEMS. Annual Healthcare Objective 3A: By September 21, 2006, implement at least five integrated diabetes, asthma, and obesity activities with at least three healthcare sites in Weld County. (Baseline: 0 activities) s.+,a _n Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Assess the needs of healthcare providers using at least two Healthcare Providers Health X X X X Needs assessment Needs assessment different methods. Educator tool. results. (HE) Asthma Form to be developed. Workgroup (AWG) Diabetes Workgroup (DWG) la. Schedule monthly meetings with the Health Department HE X X X X Meeting minutes. #of meetings. Health Department Director to discuss Director healthcare provider needs. lb.Conduct at least ten key informant Healthcare Providers HE X #of key informant interviews or host a focus group to Health interviews conducted. determine healthcare provider needs. Department #participating Director healthcare providers AWG in focus group. DWG Results from key informant interviews or focus group. 2. Develop a plan that includes at least five activities, to Healthcare Providers HE X X X Plan for addressing Plan for addressing address healthcare provider needs as determined by the needs AWG needs of training and needs of training and assessment. DWG resources for resources for providers. providers completed. #of plans distributed to healthcare providers. Page 18 of 45 Attachment B-1 2a.Review results of key informant Healthcare Providers HE X Progress report. Results reviewed. interviews. Health Department Director AWG DWG 2b. Identify at least five activities to be Healthcare Providers HE X #of activities implemented with healthcare providers. AWG identified. DWG 3.Develop a binder for healthcare providers that includes at Healthcare Providers HE X X X Instrument Number: Binder created. least 12 resources for asthma,diabetes,obesity,physical Community O3BS1,2&3 activity,nutrition, and tobacco. Consortium (CC) 3a.Diabetes:CDC recommended programs, Healthcare Providers HE X X X Instrument Number: #materials included. Small Steps,Big Rewards,Small Changes DWG O3BS1,2&3 Make a Big Difference,Colorado Clinical Diabetes Guidelines Collaborative(CCGC), Way to Coalition Go Kids. 3b.Asthma: Colorado Clinical Guidelines Healthcare Providers HE X X X Instrument Number: #materials included. Collaborative(CCGC),Asthma Action AWG O3BSI,2&3 Plans. 3c.Nutrition: 5 A Day,Dietary Guidelines, Healthcare Providers HE X X X Instrument Number: #materials included. Portion Size. Physical O3B51,2&3 Activity and Nutrition Workgroup (PAN) 3d. Physical Activity: Walking programs Healthcare Providers HE X X X Instrument Number: #materials included. (Colorado On The Move),physical activity PAN O3BS 1,2&3 prescription pads,ACE booklet. 3e.Obesity:Weight management programs, Healthcare Providers HE X X X Instrument Number: #materials included. BMI assessments. PAN O3BS1,2&3 Colorado Physical Activity and Nutrition Program (COPAN) 3f.Tobacco: Quitline/QuitNet,You Can Quit. Healthcare Providers HE X X X Instrument Number: #materials included. Tobacco O3BS 1,2&3 Workgroup TWG) Page 19 of 45 Attachment B-1 4. Distribute binders to at least ten healthcare providers. Healthcare Providers HE X X Instrument Number: #binders distributed. CC 03BS1,2,3&4 #of healthcare providers. 4a. Schedule meetings with at least 10 Healthcare Providers HE X X Instrument Number: #of meetings held. healthcare providers. CC 03 BS 1,2,3,&4 5.Provide healthcare provider best practice training. Healthcare Providers HE X X X X Instrument Number: #trainings offered. CC 03BS 1,2,3,4&5 Training evaluation. Training sign in sheet. Forms to be developed. 5a. Distribute information about upcoming Healthcare Providers HE X X X X Instrument Number: opportunities. CC 03BS 1,2,3,4&5 5b. Host at least one training for healthcare Healthcare Providers HE X X X X Instrument Number: #of participants providers. CC 03BS1,23,4&5 Training evaluation results. 5c.Offer continuing medical education Healthcare Providers HE X X X X CME credits offered. (CME)with North Colorado Medical North Center. Colorado Medical Center 5d.Promote other opportunities for healthcare Healthcare Providers HE X X X X Instrument Number: #and type of other providers as available. North 03BS1,2&3 opportunities Colorado provided. Medical Center Evaluation comments: Data collection tools used to assess strategies under objective 3A: Meeting agenda, meeting minutes, focus group results-plan developed based on focus groups,schedule of meetings,and number of activities implemented based on plan. Evaluation comments: Instrument Number:038S1,2,3,4&5 will collect information on the number of materials distributed on programs/interventions,#of provider meetings scheduled,number of training opportunities promoted,number of trainings offered and number of participants. ;f-+ +"�+ ..., '� �e' � '•,e "q ^'e a.a- tip+ x4 ra •• �+ t r... s • -tF. .45i .", � Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Complete a follow-up assessment to determine usability Healthcare Providers HE X #of assessments. and/or usefulness of information provided in Year 3. CC 2. Implement at least five activities for healthcare providers. Healthcare Providers HE X X X X #of activities. CC 3. Collaborate with local medical society to host at least one Healthcare Providers HE X X X Training held. healthcare provider professional development opportunity. CC #of participants. Medical Society Page 20 of 45 Attachment B- ti Strategy I Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Conduct at least 15 key informant interviews. Healthcare Providers HE X X #of key informant interviews. CC 2. Implement at least five activities for healthcare providers. Healthcare Providers HE X X X X #of activities. CC Page 21 of 45 Attachment B-1 Program Goal 4: Reduce asthma, diabetes and obesity through the promotion of nutrition, hvsical activity, tobacco cessation, and prevention of tobacco use and exposure in SCHOOLS Annual School Objective 4A: By September 21, 2006, Weld County School District 6 (WCSD6) will maintain one district level Coordinated School Health Team with at least five members, and implement at least five district level activities. (Baseline: One district level Coordinated School Health Team; one district level activity) . _.,. . _ YEAR 3 .Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain district level Coordinated School Health Team School Staff DCSHT X X X X Current DCSHT #of members (DCSHT)with at least five members. School Health Membership list. maintained from Coordinator(SHC) Year 2. Rocky Mountain Contact list. #of new members Center for Health recruited. Promotion(RMC) la.Recruit new team members, as necessary. Staff DCSHT X X X X Recruitment #of new members SHC Contact List. recruited. lb.Establish a regular meeting schedule. Staff DCSHT X Meeting minutes. #of meetings. SHC #of members attending lc.Establish at least 2 district goals. Staff DCSHT X X #of goals SHC established. 2.Implement a School Wellness Policy(SWP)in WCSD6 Students DCSHT X X X X Policy tracking #of surveys that addresses nutrition education and standards and Staff SHC form(Instrument returned. physical activity goals. Nutrition Director Number: (ND) O4AS3&4) Brief phone survey: Policy Implementation Survey. Form to be developed. Page 22 of 45 Attachment B-1 2a.Identify stakeholders from the school Students DCSHT X Stakeholders list. Establishment of district and form a SWP task force. Staff SHC SWP task force. ND Colorado Physical Activity and Nutrition Program (COPAN) 2b.Develop a plan that includes at least two Students I COPAN X Plan for Development of activities for community involvement with Staff Teachers involvement. plan. the SWP. Students #of activities. Administrators Food Service Staff Board Members Parents Community Members DCSHT SHC ND 2c.Evaluate existing school system policies Students COPAN X Policy tracking #of surveys such as physical activity/education, Staff Teachers form(Instrument returned. vending machines,healthy foods on Students Number: campus,or nutrition education. Administrators O4AS3&4 Survey Food Service Staff Form to be Board Members developed. Parents Community Members DCSHT SHC ND 2d. Develop and establish guidelines for Students COPAN X X Criteria for SWP. Establishment of policies included in the SWP. Staff Teachers SWP guidelines. Students Administrators Food Service Staff Board Members Parents Community Members DCSHT SHC ND Page 23 of 45 Attachment B-1 2e. Develop an implementation plan for SWP. Students COPAN X Implementation of Development of Staff Teachers SWP. implementation Students plan for SWP. Administrators Food Service Staff Board Members Parents Community Members DCSHT SHC ND _ 2f Establish evaluation indicators for the Teachers COPAN X X List of evaluation Consensus on the SWP. Students Teachers indicators. established Administrators Students evaluation School Food Service Administrators indicators. Staff Food Service Staff Board Members Board Members Parents Parents Community Members Community Members DCSHT SHC ND 2g. Obtain necessary approval for District Six Board DCSHT X Approval by implementation of SWP. Members and SHC School District Administration. ND Board and Administration. Evaluation comments: Instrument Number: O4AS2 will collect information which school have returned the Policy Implementation Survey and which schools are implementing School Wellness Policy related to fitness&nutrition. 3.Provide technical assistance for the six Coordinated School CSH Teams DCSHT X X X X SHI action plans. Amount of Health(CSH)Teams on implementation of School Health SHC technical Index(SHI) action plans. Instrument assistance Number: O4AS3 provided. 3a. Review SHI plans for six CSH Teams. CSH Teams DCSHT X X X X #of SHI plans SHC reviewed. 3b. District will provide technical assistance CSH Teams DCSHT X X X X that may include attending meetings, SHC providing resources,hosting professional development. Evaluation comments: Instrument Number: O4AS3 will track the completion of the SHI action plan with each CSH Team. Page 24 of 45 Attachment B-1 4.Assess and expand the management/support system for Students DCSHT X X X X Survey of current #of surveys students with asthma and/or diabetes. Staff Health Educator(HE) management/support completed. SHC system for students with asthma and/or #of systems diabetes. updated based on current guidelines. Form to be developed. 4a. Review school district action plans. Students DCSHT X Results of action plan #of action plans Staff HE review. reviewed. SHC 4b.Provide information to students, staff, and Students DCSHT X X X X Instrument Number: #of asthma parents about the importance of using Staff HE O4AS4 management plans asthma/diabetes management plans. SHC on file at school Nurses health clinic. #of diabetes management plans on file at school health clinics. #of people informed. 4c. Coordinate Breathe Better Bus visits for at Students DCSHT X X X X Instrument Number: #of Breath Better least two schools. Staff HE O4AS4 Bus visits. SHC #of students exposed. 4d.Provide asthma screenings for students in Students DCSHT X X Instrument Number: #of asthma at least two CSH schools. Staff HE O4AS4 screening SHC provided. #of students screened. 4e. Host at least one training for staff on Students DCSHT X X X X Training needs Results of needs asthma and diabetes in schools. Staff HE assessment for assessment. SHC asthma/diabetes management. Form to be developed. Evaluation comments: Instrument Number: O4AS4 will track the#of asthma and diabetes management plans on file at school health clinics, #of Breath Better Bus visits and #of students exposed,#of asthma screening provided,#of students screened. Other data collection tools used to assess strategies under objective 4A Survey of current management/support system for students with asthma and/or diabetes and Training needs assessment for asthma/diabetes mana•ement 5. Implement at least two district level staff wellness Staff DCSHT X X X X Instrument Number: #of activities activities. District Staff O4A567&8 implemented. Wellness Committee #of participants. SHC Page 25 of 45 Attachment B-1 5a. Maintain and enhance district staff Staff DCSHT X X X X Current district staff #of members wellness committee with at least five District Staff wellness committee. maintained from members. Wellness Committee Membership list. Year 2. SHC #of new members Contact list. recruited. 5b. Develop at least two district-wide goals in Staff DCSHT X X X Instrument Number: #of goals the area of staff wellness. District Staff 04AS6,7&8 developed. Wellness Committee SHC 5c. Implement at least two district activities Staff DCSHT X X X Instrument Number: #of activities based on goals. District Staff 04AS6,7&8 implemented Wellness Committee based on goals. SHC Evaluation comments: Instrument Number: 04AS5 will track#of activities implemented,#of participants,#of goals developed, and#of activities implemented based on goals. 6.Provide materials to at least nine schools to increase Students State Tobacco X X X X Instrument Number: #of schools compliance with tobacco free school laws. Staff Education and 04A56,7&8 receiving Prevention Program materials. (STEPP) HE SHC 6a. Provide signage to school administrators Students STEPP X X X X Instrument Number: #of signage in at least nine schools. Staff HE 04A56,7&8 provided to school SHC administrations. 6b.Provide educational materials to at least Students STEPP X X X X Instrument Number: #of schools who nine schools. Staff HE 04A56,7&8 received SHC materials. #of materials distributed. Evaluation comments: Instrument Number: 04AS6 will track#of signage provided, #of schools who received materials,and#of materials distributed. 7. Provide at least three professional development Nutrition ND X X X X Professional Results of needs opportunities for nutrition services staff. Services Staff DCSHT Development needs assessment. SHC assessment for #of opportunities nutrition services staff. provided. #of participants. Form to be developed. 7a.Recruit nutrition services staff to attend Nutrition ND X X X X Instrument Number: ft of schools that conferences such as the annual Colorado Services Staff DCSHT 04AS6,7&8 received materials Department of Education Conference. SHC and/or training on one of the listed training opportunities. 7b. Host at least two opportunities for Nutrition ND X X X X Contact list. #of staff professional development if no others are Services Staff DCSHT Conference attending available. SHC registration. opportunities. Page 26 of 45 Attachment B-1 Evaluation comments: Instrument Number: O4AS will track#of nutritional materials provided, #of schools that received materials and/or training, and#of materials distributed. 8. Collect physical activity data in PE classes in at least fifty Elementary Physical Education X Instrument Number: #of schools. percent of elementary schools. (Data to be collected is the schools Liaison(PEL) O4AS8 #of students. amounts of time students are engaging in moderate University of Pre-post student intensity physical activity during PE class time.) Northern Colorado Pre-post fitness fitness data. Kinesiology assessment form. Department Staff Form to be developed. (UNC) SHC 8a. Review assessment tool. Elementary PEL X Assessment tool schools UNC reviewed. SHC 8b.Complete assessments in at least fifty Elementary PEL X X X Instrument Number: #of schools. percent of elementary schools. schools UNC O4AS9&l0 #of students. SHC Pre-post student Pre-post fitness fitness data. assessment form. Form to be developed. 8c. Analyze data collected from assessments. Elementary PEL X X Data analyzed. schools UNC SHC Evaluation comments: Instrument Number: O4AS8 will track#of school and#of students completing physical activity assessments. 9.Based on physical activity assessment results,provide Elementary PEL X X X X Professional Results of needs elementary physical education teachers with at least two school PE UNC Development needs assessment. professional development opportunities. teachers SHC assessment for PE #of professional teachers. development opportunities Form to be developed. provided. #of PE teachers attending. 9a. Host at least one professional development Elementary PEL X X Instrument Number: #of schools that opportunity if none are available. school PE UNC O4AS9&10 received materials teachers SHC and/or professional development opportunities based on results. 9c. Recruit elementary PE teachers to attend at Elementary PEL X X Contact list. #of staff least one professional development school PE UNC Conference attending opportunity. teachers SHC registration. professional development opportunities. Evaluation comments: Instrument Number: O4AS9&10 will track#of schools that received materials and/or professional development opportunities based on results. Page 27 of 45 Attachment B-1 .. h Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain and enhance district Coordinated School Health Staff DCSHT X X X X Team. SHC RMC 2. Maintain a School Wellness Policy(SWP)in WCSD6 that Students SHC X X X X addresses nutrition education/physical activity goals and Staff ND nutrition standards. DCSHT _ 3.Provide technical assistance to all CSH Teams on CSH Teams DCSHT X X X X implementation of School Health Index(SHI)action plans. SHC 4. Expand the management/support system for students with Students DCSHT X X X X asthma and/or diabetes. Staff HE SHC 5. Implement at least two district level staff wellness Staff DCSHT X X X X activities. District Staff Wellness Committee SHC 6.Provide materials to at least nine schools to increase Students State Tobacco X X X X compliance with tobacco free school laws. Staff Education and Prevention Program HE SHC 7. Provide at least three professional development Nutrition Services ND X X X X opportunities for nutrition services staff. Staff DCSHT SHC 8. Collect physical activity data from PE classes in at least Middle schools PEL X fifty percent of middle schools. UNC SHC 9. Based on results of physical activity assessments,provide Middle school PE PEL X X X X middle school physical education teachers with at least two teachers UNC professional development opportunities. SHC w .- r: , :-- mii, pw ..�,. n ':'{ A - •rz'p, :'w ,� .n- t_ .cs.:.:. at ;c, , y' , t"y„i' 4=; "iq, y+" -✓• yk!"Ft'# 2 ^� -v � �%' - - c c.. ::. -r+ ^r'l.a2a moo .: K `a�pu tr'.. Strategy I Target Group Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1.Maintain and enhance district Coordinated School Health I Staff J DCSHT X X X X Page 28 of 45 Attachment B-1 Team(DCSHT). SHC RMC 2.Maintain a School Wellness Policy(SWP)in WCSD6 that Students DCSHT X X X X addresses nutrition education/physical activity goals and Staff SHC nutrition standards ND 3. Provide technical assistance to all CSH Teams on CSH Teams DCSHT X X X X implementation of School Health Index(SHI)action plans. SHC 4. Expand the management/support system for students with Students DCSHT X X X X asthma and/or diabetes. Staff HE SHC 5. Implement at least two district level staff wellness Staff DCSHT X X X X activities. District Staff Wellness Committee SHC 6.Provide materials to at least nine schools to increase Students State Tobacco X X X X compliance with tobacco free school laws. Staff Education and Prevention Program HE SHC 7. Provide at least three professional development Nutrition Services ND X X X X opportunities for nutrition services staff Staff DCSHT SHC 8. Collect physical activity data from PE classes in at least High schools PEL X fifty percent of high schools. UNC SHC 9. Based on results of physical activity assessments,provide High school PE PEL X X X X high school physical education teachers with at least two teachers UNC professional development opportunities. SHC S. =..... .. .�.... ...a •-a. a ': ro.4°.a. � ^i .e - Annual School Objective 4B: By September 21, 2006, Weld County School District 6 (WCSD6) will maintain three Coordinated School Health Teams and establish at least three new Coordinated School Health Teams with at least six members per team. (Baseline: Three Coordinated School Health Teams with at least six members per team.) Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Indicator(s) QI jQ2 Q3JQ4 — Page 29 of 45 I Attachment B-i 1.Maintain three Coordinated School Health(CSH)teams. Franklin Middle CSH teams X X X X Current CSH #of members Cameron Elementary School Health Team maintained from Heiman Elementary Coordinator(SHC) Membership list Year 2. #of new Contact list members recruited. la. Establish quarterly meeting schedules. Franklin Middle CSH teams X Meeting minutes #of CSH Team Cameron Elementary SHC members Heiman Elementary attending. lb. Identify lead staff for each team and CSH Franklin Middle CSH teams X Lead staff component. Cameron Elementary SHC identified. Heiman Elementary lc.Provide technical assistance to all three Franklin Middle CSH teams X X X X Technical #of TA sessions teams as needed. Cameron Elementary SHC assistance provided. Heiman Elementary tracking form Form to be developed 2. Establish at least three new CSH teams. School Staff Three new CSH X X X X Current CSH #of new teams Team members Rocky Mountain Membership List recruited. Center for Health Promotion(RMC) Recruitment #of CSH teams SHC Contact List established. 2a. Establish training/meeting schedules. Staff Three new CSH X Meeting minutes #of meetings. Students teams #of CSH Team RMC members SHC attending. 2b. Identify lead staff for each CSH team and Staff Three new CSH X Lead staff component. Students teams identified. SHC 2c.Provide technical assistance for trainings Staff Three new CSH X X X X Technical #of TA sessions and meetings. Students teams assistance provided. RMC tracking form SHC Form to be developed Evaluation comments:Data collection tools used to assess strategies under objective 4B: Current CSH Team Membership List,Recruitment Contact List, Meeting minutes, Technical assistance tracking form to track#of TA sessions provided. 3. Develop an action plan for each new CSH team based on Staff SHC X X X X Three new CSH #of CSH actions the results of the School Health Index(SHI). Students Three new CSH team action plans plans completed. teams Instrument Number: O4BS3&4 Page 30 of 45 Attachment B-1 3a. Complete SHI. Staff Three new CSH X Instrument #of SHI Students teams Number: components RMC O4BS3&4 completed. SHC 3b. Create action plans based on SHI results. Staff Three new CSH X X Instrument #of action plans Students teams Number: created based on RMC O4B53&4 SHI results. SHC Evaluation comments: Instrument Number: O4BS3&4 will track the completion of the CSH Team action plan with each new CSH Team, #of SHI components completed, # of action plans created based on SHI results, and#of activities implemented. 4.Implement action plans,based on School Health Index Staff CSH teams X X X X Instrument Assessment, in at least six CSH teams. Students SHC Number: O4B53&4 4a. Implement at least one building level Staff CSH teams X X X X Instrument #and type of intervention in the area of asthma, diabetes, Students Health Educator Number: activity CSH or tobacco. (HE) O4B53&4 team participate SHC in related to district goals. 4b. Implement at least four building level Staff CSH teams X X X X Instrument #of schools that physical activity opportunities such as Students SHC Number: participate in Take 10!,VERB,President's Challenge or O4BS3&4 physical activity intramural activities. opportunities. Take 10! #of students to Teacher participate. Evaluation- Stipend Request 4c. Implement at least four building level Staff CSH teams X X X X Instrument #of schools that nutrition opportunities such as 5 A Day,3 Students SHC Number: participate in A Day,Healthy Foods on Campus, or O4B53&4 nutrition Vending Machine Guidelines. education opportunities. #of students to participate. 4d. Implement at least four building level staff Staff CSH teams X X X X Instrument #of schools that wellness opportunities such as health SHC Number: participate in assessments,health fair, cooking classes, O4BS3&4 staff wellness nutrition education, or physical activity opportunities. classes. ft of staff to participate. Evaluation comments: Instrument Number: O4B53&4 will track the completion of action plans created based on SHI results,#and type of activity CSH teams participate in related to district goals, ft of schools that participate in physical activity opportunities, #of students who participate, #of schools that participate in nutrition education opportunities, #of students who participate, #of schools that participate in nutrition education opportunities, #of students who participate, #of schools that participate in staff wellness opportunities, #of staff who participate. Other data collection tool to be used: Take 10! Teacher Evaluation-Stipend Request. Page 31 of 45 Attachment B-1 5. Offer at least one professional development opportunity for CSH teams SHC X X X X Instrument #professional twelve CSH Teams team leaders. (Opportunities could HE Number: O4BS7 development include the Colorado Association of Health,Physical opportunities. Education,Recreation and Dance State Conference or #of team leaders Active Community Environment Workshop.) attending. 5a.Determine existing opportunities. CSH teams SHC X X HE CSH teams 6.Promote at least four physical activity/nutrition education Staff SHC X X X X Instrument #of non-CSH programs in at least five non-CSH schools such as the Students HE Number: O4BS7 schools that Integrated Nutrition Program, 5 A Day,3 A Day,Take participate in 10!,TV Turn Off,Walk to School; or VERB. Take 10! physical activity Teacher /nutrition Evaluation- education Stipend Request opportunities. #of students that participate. 6a.Provide program information to at least Staff SHC X X X X Instrument #of materials five non-CSH schools. Students HE Number: O4BS7 distributed to CSH teams I schools. Evaluation comments: Instrument Number: O4B56 will track the#of schools that participate in physical activity/nutrition education opportunities,#of students who participate, #of material distributed to schools about programs. Other data collection tool to be used: Take 10! Teacher Evaluation-Stipend Request,#professional development opportunities,and#of team leaders attending. A ��� e krt 5""" >c* .r-w' .s-.' "y,.. _ " Liles 4 rr :, en..:,:, ter' .�..�.,•_':' ,._' r . Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Maintain six Coordinated School Health(CSH)teams Six CSH teams CSH teams X X X X SHC 2. Establish at least three new CSH teams. Staff Thee new CSH X X X X teams RMC SHC 3.Develop an action plan based on the results of the School Staff SHC X X X X Health Index. Students CSH teams 4. Implement action plans based on School Health Index Staff CSH teams X X X X Assessment. Students SHC 5.Offer at least two professional development opportunities CSH teams SHC X X X X to CSH teams. HE 6.Promote at least four physical activity/nutrition education Staff SHC X X X X programs in at least five non-CSH schools such as the Students HE Integrated Nutrition Program, 5 A Day,3 A Day,Take 10!, TV Turn Off,Walk to School,or VERB. Page 32 of 45 Attachment B-I .gam . sr �gj�+.7_-. - .�sP'" 3' `U.- j'' .1. - ; y. A'•Yi 'f' .'10R.., T -rh _ - Strategy I Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Maintain nine Coordinated School Health(CSH)teams Nine CSH teams CSH teams X X X X SHC 2. Establish at least three new CSH teams. Staff Three new CSH X X X X teams RMC SHC 3.Develop an action plan based on the School Health Index Staff SHC X X X X results. Students Three new CSH teams 4. Implement action plans based on School Health Index Staff CSH teams X X X X Assessment in CSH schools. Students SHC 5. Offer at least two professional development opportunities CSH team members SHC X X X X to CSH Teams. HE 6. Promote at least four physical activity/nutrition education Staff SHC X X X X programs in at least five non-CSH schools such as the Students HE Integrated Nutrition Program, 5 A Day, 3 A Day,Take 10!, TV Turn Off,Walk to School,or VERB. Page 33 of 45 Attachment B-1 Program Goal 5: Reduce asthma, diabetes and obesity through the promotion of nutrition, s hysica I activity, tobacco cessation, and prevention of tobacco use and exposure in WORKSITES Annual Worksite Objective SA: By September 21, 2006, implement coordinated worksite wellness programs in at least 10 worksites in Weld County. (Baseline: 0). Strategy Action Steps Target Group Lead Role Time Line Data Source Evaluation Indicator(s) Ql Q2 Q3 Q4 I.Recruit at least 10 worksites. Employees Health Educator(HE) X X X X Instrument #of worksites Wellness Staff Physical Activity and Number: recruited. Nutrition Workgroup O5AS1&2 (PAN) la.Meet with at least 10 worksites to HR Staff HE X X X X Baseline Wellness #of meetings determine interest in implementing Upper PAN programming held. coordinated worksite wellness Management assessment. programs. Form to be developed. lb. Sponsor at least two presentations Upper HE X X X X Presentation sign- #of presentations for upper management about the Management HEALTHBREAK, Inc. in sheets. held. importance of worksite wellness. PAN Satisfaction #of participants. Survey. Results of Both forms to be Satisfaction developed. Survey. 2. Provide technical assistance to at least 10 worksites HE X X X X Amount of TA in all areas of coordinated worksite wellness. PAN provided. Colorado Physical Activity and Nutrition Program(COPAN) 2a.Determining baseline for wellness Employees HE X X X X Baseline Wellness #of assessments programming. Wellness Staff PAN programming completed. COPAN assessment. Form to be developed. Page 34 of 45 Attachment B-1 2b. Creating and maintaining worksite Employees HE X X X X Baseline Needs #of TA sessions wellness teams. Worksite PAN Assessment. provided. Champion COPAN Worksite Wellness Checklist. Technical Assistance Tracking Form. Forms to be developed. 2c. Identifying data collection needs. Employees HE X X X X Employee Interest Wellness Staff PAN Survey. COPAN Instrument Number: O5AS1&2 2d.Developing operating plans. Wellness Staff HE X X X X Request Tracking j Senior Managers PAN Form. Human Resource HEALTHBREAK, Inc. (Instrument Managers Number: O5AS1&2) 2e. Identify appropriate interventions Employees HE X X X X Employee Interest using an employee interest survey Wellness PAN Survey and/or similar tool. Committee COPAN Instrument Number: O5AS1&2 &2 2f. Identifying incentives for Wellness HE X X X X Resource and employees. Committee Wellness Committee incentives lists. • PAN COPAN 2g. Identifying evaluation tools. Wellness HE X X X X List of Evaluation Committee Project Evaluation Tools: Pre/post survey of physical activity levels. Pre/post survey of fruit&vegetable intake. Participant evaluation of interventions. Instrument Number: O5AS1&2 Page 35 of 45 Attachment B-1 3. Encourage at least 10 worksites to join the Wellness Upper HE X X X X #of worksites Councils of America(WELCOA). Management PAN joining WELCOA. 3a. Provide WELCOA information to Upper HE X X X X Instrument #of worksites at least 10 worksites. Management Number: receiving Wellness Staff O5AS1&2 WELCOA information. Evaluation comments:Needs assessments will be conducted each year for Years 3,4, 5 and results compared over time. Additionally,TA follow-up reports will be provided annually to ascertain the impact of TA provided to the Wellness Committees. These programs will be summarized in the semi annual and annual reports. The Wellness Team follow-up survey will try to ascertain to what extent each worksite has developed or maintained it's wellness team. Instrument Number: O5A51&2 will collect information on Number of Employees,#of Lunch Presentations Provided,#of TA Sessions Provided, Site is developing or has a Wellness Team #of Employee Interest Surveys Completed Type of Intervention Requested, Type of Fitness Challenge Requested, Type of Nutrition Program Requested,Number of Employees Participating,Type of Data Collected, #of Resources Provided, Evaluation Tools Provided. %.1/21: .:ry �. ,_ . *^ YEAR 4 Strategy I Action Steps �¢ Target Group Lead Role Time Line Evaluation Indicator(s) QI Q2 Q3 I Q4 1.Recruit at least 10 new worksites. Employees HE X X X X Wellness Staff PAN 2.Provide technical assistance to at least 10 worksites Employees HE X X X X in all areas of coordinated worksite wellness. Wellness Staff PAN COPAN 3. Encourage at least 10 worksites to join the Wellness Upper HE X X X X Councils of America(WELCOA). Management PAN � 4 k- Strategy I Action Steps Target Group I Lead Role Time Line Evaluation Indicator(s) Q1 Q2 Q3 Q4 1. Recruit at least 10 new worksites. Employees HE X X X X Wellness Staff PAN 2. Provide technical assistance to at least 10 worksites Employees HE X X X X in all areas of coordinated worksite wellness. Wellness Staff PAN COPAN 3. Encourage at least 10 worksites to join the Wellness Upper HE X X X X Councils of America(WELCOA). Management PAN Page 36 of 45 Attachment B-1 Annual Worksite Objective SB: By September 21, 2006, implement at least one worksite wellness activity in at least 20 worksites. (Baseline: Four) Strategy I Action Steps Target Group Lead Role Time Line Data Source Indicator(s) Q1 Q2 Q3 Q4 1. Recruit at least 20 new worksites. Employees Health Educator X X X X Chamber membership #of new worksites (HE) list. recruited. Chamber meeting participant lists. la. Invite new worksites to monthly Employees HE X X X X Attendance record #of workgroup Worksite Workgroup meetings. Wellness Staff from meetings. meetings. #of participants at each meeting. lb.Provide new worksites with a list of Employees HE X X X X Training sign-in #of workshop Worksite Wellness Training Wellness Staff HEALTHBREAK, sheets. opportunities. opportunities. Inc. Satisfaction Survey. #of participants in Forms to be training opportunities. developed. 2. Provide at least 20 worksites with the resources Employees HE X X X X Instrument Number: #of resources necessary to implement at least one of the following Wellness Staff PAN O5BS2 provided. programs/interventions: Colorado Physical Activity and Nutrition Program (COPAN)Worksite Task Force 2a. Diabetes awareness, education and Employees with HE X X X X Instrument Number: #of diabetes management: Diabetes at work, Diabetes Diabetes Coalition O5BS2 resources. ADA Risk Assessments. Colorado Diabetes #of referrals to Control and website. Prevention Program #of events offered through worksite. 2b. Healthy Eating at Work:Meeting Employees HE X X X X Instrument Number: #of materials Well(guidelines for offering healthy PAN O5BS2 distributed. foods at meetings,seminars and COPAN Worksite #of events offered catered events), 5 A Day or other Task Force through worksite. nutrition education resources. 2c. Physical Activity at Work: Employees Health Educator X X X X Instrument Number: #of materials President's Challenge, walking PAN O5BS2 distributed. programs(Colorado On The Move), COPAN Worksite #of events offered StairWELL to Better Health. Task Force through worksite. #of participants. Page 37 of 45 Attachment B-1 2d.Tobacco:Awareness, education and Employees HE X X X X Instrument Number: #of materials resources such as Quitline or Tobacco O5BS2 distributed. Quitnet. Workgroup #of events offered PAN through worksite. 2e.Asthma management and support: Employees HE X X X X Instrument Number: #of materials Indoor Air Quality. Asthma Workgroup O5BS2 distributed. Colorado Asthma #of Program management/support classes offered through worksite. Evaluation comments: Instrument Number: O5BS2 will collect information on#of resources provided, #of diabetes resources, #of referrals to website, #of events offered through worksite,#of management/support classes offered through worksite. r,. Strategy I Action Steps Target Group Lead Role Time Line Data Source Indicator(s) QI I Q2 Q3 I Q4 1. Recruit at least 20 new worksites. Employees HE X X X X Chamber membership #of new worksites PAN list. recruited. Chamber meeting participant lists. 2.Provide at least 20 worksites with the resources Employees HE X X X X Instrument Number: #of resources necessary to implement at least one program or Wellness Staff PAN O5BS2 provided. intervention in the areas of physical activity, COPAN Worksite nutrition, asthma,diabetes,and tobacco cessation. Task Force t: YEAR ct --x S ,, .4: 17. ... Strategy I Action Steps Target Group Lead Role Time Line Data Source Indicator(s) QI Q2 Q3 Q4 I. Recruit at least 20 new worksites. Employees HE X X X X Chamber membership #of new worksites PAN list. recruited. Chamber meeting participant lists. 2. Provide at least 20 worksites with the resources Employees HE X X X X Instrument Number: #of resources necessary to implement at least one program or Wellness Staff PAN O5BS2 provided. intervention in the areas of physical activity, COPAN Worksite nutrition,asthma,diabetes,and tobacco cessation. Task Force Page 38 of 45 Attachment B-1 WE o tikfrIEN Buici ktlus Ti'T AT1t N A.PERSONNEL TOTAL$196,540 A. PERSONNEL Percent of #of Position Personnel Annual Salary Time Months cost Project Coordinator Position Open $45,076 100% 12 $45,076 Health Educator Anna McConnell, MS $45,039 100% 12 $45,039 School Health Coordinator Monica Owsichek, RD $48,000 100% 12 $48,000 Health Educator Kristen Dodge, MPH $44,384 100% 12 $44,384 Administrative Assistant Adrianna Chavez $28,082 50% 12 $14,041 Total Position Costs $196,540 Justification:The Project Coordinator will be responsible for overall grant management including budget management, evaluation/reporting of project activities, and grant re-application. The Project Coordinator will oversee and provide direction for the School Health Coordinator,Community/Worksite and Healthcare Health Educators, and Administrative Assistant. The Project Coordinator will be the primary liaison with Colorado Department of Public Health and Environment Steps Staff and Policy Studies Inc. In addition, Project Coordinator will maintain the Steps Consortium and oversee all action plan activities. The Project Coordinator will participate in all required national and state level trainings. The School Health Coordinator will be responsible for the school budget monitoring,evaluation/reporting on school work plan activities, and grant re-application. The School Health Coordinator will be responsible for the coordination and implementation of school-specific activities. In addition, the School Health Coordinator will maintain the district level Coordinated School Health Team and all building-level Coordinated School Health Teams. The School Health Coordinator will participate in all required national and state level trainings. The Health Educator for Worksite Wellness and Community for will be responsible for the coordination and implementation of worksite wellness programs and community-specific activities. The Health Educator will oversee the Physical Activity and Nutrition Workgroup maintenance and recruitment. The Health Educator will coordinate all YRBS related activities. The Health Educator will participate in all required state level trainings. The Health Educator for Healthcare will oversee the Diabetes Coalition and Asthma Workgroup maintenance and recruitment. The Health Educator will be responsible for coordination and implementation of healthcare/provider related activities, assist with coordination of school based asthma and diabetes prevention and management activities, and with YRBS related activities. The Health Educator will participate in all required national and state level trainings. The Administrative Assistant is responsible for responsible for overall program efficiency and facilitation, such as grant writing assistance, travel arrangements, receipt and invoice tracking, meeting arrangements, correspondence (meeting minutes, newsletters, and mailings), maintaining databases, and purchasing supplies. Page 39 of 45 Attachment B-1 B.FRINGE BENEFITS TOTAL $47,488 B. FRINGE BENEFITS Fringe cost Position by Personnel Cost Percent of Fringe position Project Coordinator Position open $45,076 31.97% $14,411 Health Educator Anna McConnell, MPH $45,039 31.97% $14,399 School Health Coordinator Monica Owsichek, RD $48,000 0.00% $0 Health Educator Kristen Dodge, MPH $44,384 31.97% $14,190 Administrative Assistant Adrianna Chavez $14,041 31.97% $4,489 Total Fringe Costs $47,488 Justification:Fringe benefits are calculated at 31.97%of total salaries for positions.No fringe benefits are figured for School Health Coordinator—Fringe is paid by school district. C.TRAVEL TOTAL$11,628 C.TRAVEL Estimated Destination Travelers Trip cost Two National Steps grant Project Coordinator and meetings School Health Coordinator $3,053 Total Out-of-State Travel $3,053 Out-of State Travel is calculated at: airfare = $425.00; lodging and per diem = $150/day; and ground transportation $38.25 per trip. 3 Regional Trainings at CDPHE Steps Staff $1,543 1 Statewide Training Steps Staff $1,391 6 School Health Coordinator Meetings School Health Coordinator $960 6 Project Coordinator Meetings Project Coordinator $408 In-town Staff Mileage All Staff $4,273 Total In-State Travel $8,575 Page 40 of 45 Attachment B-1 Justification: Program Coordinator and School Health Coordinator will travel to Atlanta, GA. for national Steps meetings/conferences. Steps staff will travel to Denver for three regional meetings and to Breckenridge for a state Steps meeting. The School Health Coordinator and Project Coordinator will travel to bi monthly meetings in Denver. Local travel is estimated at 925 miles per month for 5 people at $.385 per mile for all program activities or 185 miles/person/month. E.EQUIPMENT TOTAL$2,500 D. EQUIPMENT Anticipated Item cost 1 Laptop Computer with Software $2,500 Total Equipment $2,500 Justification: 1 laptop computer will be purchased for the Health Educator to replace the old desktop PC. E.SUPPLIES TOTAL$61,850 E. SUPPLIES Anticipated Item cost General Office Supplies $3,800 Worksite Wellness resources/materials $1,000 5-A-Day Educational Materials/Training $500 Turn off TV Event Materials $500 Active Community Environment Promotional Materials $2,000 Obesity/Nutrition Education Materials $500 Diabetes Educational Materials $500 Dining with Diabetes Food/Materials $1,000 Asthma Educational Materials for community $1,000 Asthma Educational Materials for schools $2,000 Clinical Guidelines for Asthma $1,000 Binders for Healthcare education materials $500 Fitness Gram $1,800 Meeting Expenses for all consortium, work group meetings, training $2,000 Asthma School Nurse Training $500 District Coordinated School Health Meeting Expenses (4 meetings) $250 Diabetes Training (school nurses/health clerks) $100 Two Nutrition Staff Trainings (Diabetes, New Dietary Guidelines, 3 A Day, 5 A Day) $400 x 2 $800 Professional Development for Physical Education Teachers - Fitness gram (Registration & Substitutes x 16 teachers) $3,000 Breckenridge Training for 3 New CSH Teams (Hotel -$100 x 10 rooms x 2 nights = $2000) (Mileage - 335 miles x 6 people x 38.5 = $600) (Stipends- $100 x 2 days x 20 staff= $4,000) (Food - $25 x 2 days x 20 staff$1,000) $7,600 6 CSH Teams -School Health Index Action Plan Budgets (6 x $1000) $6,000 Page 41 of 45 Attachment B-1 Physical Activity/Nutrition Education programs for non-CSH schools, such as Take 10! or 5 a Day $2,000 Quarterly CSH Team Meetings (6 School Teams) (1/2 day Substitutes 5 teachers/team x $45 x 4 meetings x 6 teams (Meeting expenses- $25/meetinq x 4 meetings x 6 teams) $6,000 Active Community Environment Workshop ($2500) Health Care Provider training ($2000) $4,500 Media - Diabetes Campaign ($2600) -VERB Youth Campaign ($1000) - Radio campaign for diabetes, asthma, physical activity and nutrition in Spanish ($4700) - Fruit and vegetable consumption and Farmers Market($1500) - Asthma Campaign ($3200) $13,000 Total Supplies $61,850 Justification: Media and marketing costs include ad production, radio airtime, bus and bench ads, city and school newspaper spots, newsletters, brochures, flyers, posters and educational materials to publicize and implement Steps to a HealthierUS and its activities VERB, 5-A-Day, Dining with Diabetes, Wee Wheezers, etc, with the community, schools, worksites and healthcare providers. General office supplies include paper supplies, copies and printed materials for all education programs and activities, print cartridges for black and white and color printers, all office supplies such as pens, pencils, packets, binders, and postage. Meeting expenses include materials, binders, space rental and food for consortium, workgroup and all other community, healthcare, and worksite wellness and school district meetings. Stipends and substitute teacher pay will be provided to participating Coordinated School Health Team members for meetings, professional development activities and training. Professional development is also included for nutrition service employees in school district. Focus group expenses include incentives for participants, space rental, and facilitator fees. Training expenses include space rental, speaker fees and workshop materials, and food expenses for the Active Community Environment workshop and healthcare provider workshop. F.CONTRACTUAL TOTAL$92,595 F. CONTRACTUAL Contract Contract Amount Program Evaluation -JSI $31,295 BRFSS- CDPHE Health Statistics Division $40,000 Health Educator to teach DWD, nutrition $1,800 2 Community Promotora Diabetes Educators -$800 stipend for training and to teach 4 classes $1,600 Breathe Better Foundation screenings-2 $2,400 Physical Education Assessment Stipends for UNC Students ($10/hour x 6 students x 35 hours) $2,100 6 CSH Team Leader Stipends (6 x$400) $2,400 American Lung Association Breath Better Bus - 5 school visits x $800/visit $4,000 Healthcare provider focus group $1,500 Professional Player speaker fees $1,500 HEALTHBREAK, Inc. for 5 worksites $4,000 Page 42 of 45 Attachment B-I Total Contractual $92,595 Justification Steps Program Evaluation. Name of Contractor—John Snow Research and Training Institute(JSI). Method of Selection—Weld County Department of Public Health and Environment worked with the Contractor on several grant evaluation projects. Period of Performance—September 21, 2005- September 20, 2006. Scope of Work—Assist with development of strategy level evaluation tools; participation in Steps staff conference calls; assist with quarterly, mid-year and year end progress reporting; assist with year four action and evaluation plans. The BRFSS Over sample for Weld County, a requirement of the grant, will be conducted by Colorado Department of Public Health and Environment. Health Educator/Registered Dietitian. Name of Contractor—Teri Sieg, RD, CDE. Method of Selection—Member of the Diabetes Coalition, Diabetes Educator at Banner Health/NCMC and in private practice. Scope of Work-Teach quarterly classes for the community on nutrition, physical fitness and diabetes. Community Promotora Diabetes Educators. Name of Contractor-Ofelia Oresco and one to be hired. Method of selection - She is currently working with the Cancer Prevention program at Weld County Department of Public Health and Environment and trained Promotora. Scope of work— Recruit participants and conduct diabetes education in participant's homes. School Asthma Screening Name of Contractor- Breathe Better Foundation. Method of Selection - Selected through the Colorado Allergy and Asthma Centers and State Asthma Coalition. Period of Performance-School year- September through May. Scope of Work- Conduct 2 asthma screenings at 2 elementary schools. Physical Education Assessment Stipends for University of Northern Colorado students. Name of Contractor—Not selected yet, they will be UNC Kinesiology students. Method of Selection—Selected by UNC Kinesiology Professor and School Health Coordinator at beginning of 2005-2006 school year. Period Performance—October through December and March through May, this will depend on students and physical education teacher schedules. Scope of Work—Expectations for the UNC students are to perform physical education assessments during physical education classes at Weld County School District 6. Assessments will be done twice, once at the beginning of the year and once at the end of the school year. Coordinated School Health team leader stipends. Name of Contractor— Not selected yet, they will be CSH team members. Method of Selection—Appointed/Selected by each of the 6 CSH Teams. Period Performance—September—October(the grant period). Scope of Work—Expectations for the Team Leaders are to help their team make forward progress on the approved School Health Index Action Plan. The Team Leaders will work with their team to: 1. Communicate team progress to School Health Coordinator. 2. Coordinate team meetings (date, time, location, food, substitutes, agenda, meeting minutes 3. Manage team budget. 4. Team leader stipends will be paid twice per year: $200.00 in December and $200.00 in May. Page 43 of 45 Attachment B-1 School Asthma Education Name of Contractor—American Lung Association Method of Selection - Selected through the Colorado Allergy and Asthma Centers and State Asthma Coalition. They have the only mobile bus for asthma education in the state. Scope of Work-The Breathe Better Bus will visit at least 2 schools to provide asthma education with 6 hand-on learning stations about including tobacco and other environmental triggers. Healthcare Provider Key Informant Interviews or Focus Group Name of Contractor- Not selected yet. It might be working with the Colorado Clinical Guidelines Collaborative. Method of Selection—to be determined. Period of Performance—to be determined. Scope of Work-Assess the needs of the healthcare community. Professional Sports Players Name of Contractor- Colorado Chill Women's Professional Basketball. Method of Selection - Proven ability to serve as role models by presenting physical activity and nutrition education to the Latina Youth Leadership Conference. Scope of Work- Provide at least 2 players at the Latina/Latina youth. Attendance 250-300 eighth grade students. Technical Assistance for 5 worksites by HEALTHBREAK. Name of Contractor- Kathy Knudsen, President of HEALTHBREAK, Inc. Method of Selection - Referred to Weld Steps Staff from Steps Program Manager, Taralyn Jensen. Period of Performance - September 22, 2005 to September 21, 2006. Scope of Work- Kathy will provide two presentations to six Weld County Worksites' CEO's and provide four training sessions to the wellness staff of these worksites. The training sessions will focus on various wellness topics including: development of wellness committees, creation of an operating plan, implementation of wellness programming, program incentives, etc. G.CONSULTANTS none H.OTHER none I.TOTAL DIRECT CHARGES TOTAL $412,601 I.TOTAL DIRECT COSTS Total A. Total Personnel Costs (includes Statistical Distribution) $196,540 B. Total Fringe Costs $47,488 C. Total Travel Costs $11,628 D. Total Equipment Costs $2,500 E.Total Supplies Costs $61,850 F. Total Contractual Costs $92,595 G. Total Consultants Costs $0 H. Total Other Costs $0 Total Direct Costs $412,601 J.INDIRECT COSTS TOTAL$83,057 Page 44 of 45 Attachment B-1 J. INDIRECT COSTS Category Total Indirect Rate Indirect Calculation A. Total Personnel Costs $196,540 20.13% $39,564 B. Total Fringe Costs $47,488 20.13% $9,559 C. Total Travel Costs $11,628 20.13% $2,341 D.Total Equipment Costs $2,500 20.13% $503 E. Total Supplies Costs $61,850 20.13% $12,450 F.Total Contractual Costs $92,595 20.13% $18,639 G. Total Consultants Costs $0 20.13% $0 H. Total Other Costs $0 20.13% $0 Total Indirect Costs $83,057 Justification:A 20.13%indirect rate is applied to all direct costs. 1.TOTAL REQUEST TOTAL$495,658 K.TOTAL REQUEST Total Direct Costs $412,601 Total Indirect Costs $83,057 Total Other $495,658 Page 45 of 45 Hello