2011-2012 Grant Application for the Healthy Schools Program

2011-2012 Grant Application for the Healthy Schools Program Application Deadline September 28, 2011 by 3:00 pm Mail, Fax or Email Completed Grant Application to: Linda Graves, M.Ed. Prevention Specialist/Physical Activity & Nutrition Tacoma-Pierce County Health Department Fax: (253) 798-6450 lgraves@tpchd.org 3629 South D Street, MS 1063491 Tacoma WA 98418-6813

Healthy Schools Grant Program 2011-2012 I. Background Information The Tacoma - Pierce County Health Department s mission is to safeguard and enhance the health of the communities of Pierce County. Active living, healthy eating and preventing tobacco use are three of the most important factors in maintaining a healthy lifestyle and reducing the risk factors associated with chronic disease. Rates of childhood obesity in Pierce County are higher than the Washington State obesity rate. Twenty-five percent of high school students are overweight or obese with the root causes of obesity stemming from too little exercise and too many calories consumed. According to 2010 Healthy Youth Survey, approximately 20% of Pierce County 12th graders used cigarettes. About 50 youth begin using tobacco every day in Washington State. Youth are at risk for starting to use tobacco products due to the tobacco industry marketing to youth, tobacco products being accessible and youth being exposed to secondhand smoke. Implementing proven school-based health interventions is effective in improving students academic achievement, well-being and quality of life. Building partnerships between public health agencies and schools is one of the primary strategies to reduce health risks among youth. II. Purpose of the Grant The Healthy Schools Grant is intended to 1) support schools and school districts that have the desire to focus on reversing the obesity epidemic through increased opportunities for physical activity and healthy eating and 2) support schools and school districts to implement tobacco curriculum that focus on preventing and reducing tobacco use and/or strengthening current tobacco policies. The funding will support applicants that demonstrate the ability to make sustainable changes in student health using a policy, systems and environmental change approach. III. Whom May Apply Eligible applicants are all Pierce County schools and school districts. IV. Estimated Range of Awards The Health Department will award grants of up to $5,000 at the school building level and up to $10,000 at the district administration level. In addition to funding, awardees will receive technical assistance and resources from Health Department staff to implement identified strategies. V. Application Process & Timeline 1. Letter of Intent: It is requested (but not required) that prospective applicants submit a letter of intent (LOI). Complete and submit the LOI on page 13 by September 9, 2011. 2 H ealthy Schools Grant Program Application

The LOI will assist the Health Department in arranging for an adequate number of reviewers to ensure a complete and thorough review and ranking of all grant applications in a timely manner. 2. Due Date: All applications must be received by 3:00 pm on September 28, 2011 to be eligible for consideration. Submit applications by mail, fax or email to: Linda Graves, M. Ed. Tacoma-Pierce County Health Department 3629 South D Street, MS 1063491 Tacoma WA 98418 Fax: (253) 798-6450 lgraves@tpchd.org 3. Confirmation of Receipt of Application: Applicants will receive an email confirming receipt of their application. 4. Review: Applications will be reviewed by a committee and evaluated using a standardized scoring tool. Members of the review committee will include representatives from the Health Department, community members, local organizations and state agencies working on initiatives to support healthy eating, active living and youth tobacco prevention and control. 5. Award Announcement: Award notifications are expected to be made by October 10, 2011. VI. Grant Awardee Requirements 1. Contracts: The Health Department funding cycle starts in January and ends in December. Therefore, all awardees will sign two contracts with separate statements of work and separate budgeted costs for 2011 and 2012. 2. Grant Period: Awardee contracts will be developed using applicants proposed workplan activities, timelines and budget proposal. It is anticipated that 2011 project activities will be authorized to begin on November 14, 2011 or after signature of the contract by both parties, whichever occurs later and continue through December 31, 2011. The 2012 grant period will begin January 1, 2012 and end July 15, 2012. 3. Reporting: Awardees will be required to submit three bi-monthly progress reports for the periods ending December 31, 2011, February 29, 2012 and April 30, 2012. Each report shall be submitted to the Health Department within 15 days after the end of the noted reporting periods. By July 15, 2012, awardees will be required to submit a final report that provides a comprehensive description of all project activities and outcomes, including the work accomplished in 2011. Reporting templates will be provided by the Health Department. 4. Payment: Awardees will be reimbursed after completion of the 2011 project activities upon submission of the first bi-monthly progress report and an invoice for the work through December 31, 2011 by January 15, 2012. For reimbursement of the 2012 project activities, see the table below. 3 H ealthy Schools Grant Program Application

Project activities accomplished in: Invoice and bi-monthly progress report to be submitted by: November, & December, 2011 January 15, 2012 January & February, 2012 March 15, 2012 March & April, 2012 May 15, 2012 May & June, 2012 July 15, 2012 (Final progress report) 5. Site-visits: Health Department contract manager(s) will conduct monthly sitevisits/meetings with awardees. 6. Project Data: Awardees will collect data for project activities on a pre and post basis. Assessment tools will be provided by the Health Department. Pre and post Body Mass Index (BMI) measurements are required for all physical activity and/or nutrition projects. 7. Restrictions: a. Funds can only be used for related program and policy activities. b. Equipment costs must not exceed 25% of the total proposed costs. c. Funds cannot be applied to costs incurred before the contract start date, or signature by both parties, whichever occurs later. VII. Application Requirements All documents listed below must be completed and submitted to the Health Department by 3:00 pm on September 28, 2011. 1. Cover Page (page 6) 2. Project Narrative (pages 7-8) 3. Workplan, Timeline and Evaluation (page 11) Note: page 9 provides instructions and page 10 provides a sample workplan, timeline and evaluation worksheet. 4. Budget Narrative (page 12) Proposed use of these funds must be based on childhood obesity or youth tobacco prevention strategies known to be effective. Applicants must select at least one project goal from the list provided in Question 1 of the Project Narrative. Note the Sample Activities and Expenditures on pages 14-16 to assist with workplan development. VIII. Technical Assistance Health Department staff will be available to answer questions in completing the Healthy Schools Grant Program application. Please contact: 4 H ealthy Schools Grant Program Application

For Physical Activity and Nutrition Projects: Linda Graves, M.Ed Prevention Specialist lgraves@tpchd.org (253) 798-3817 OR For Youth Tobacco Prevention Projects: Samantha Yeun Prevention Specialist syeun@tpchd.org (253) 798-2931 5 H ealthy Schools Grant Program Application

Cover Page NOTE: The information below must be submitted with all applications. School/District Name Street Address City, State Zip Code Telephone Number Contact Name Contact Email Address Date Amount of Request (up to $5000 per school & up to $10,000 per district) Estimate the Number of Students to be Reached Percentage of Students Receiving Free or Reduced Lunch For School Level Applications Only Principal Name Principal Email Address Required - Principal Signature For District Level Applications Only Superintendent Name Superintendent Email Address Required - Superintendent Signature 6 H ealthy Schools Grant Program Application

Project Narrative 1. IDENTIFY PROJECT GOAL. Below is a list of project goals that are based on strategies proven to be effective and would be eligible for Healthy Schools Grant Program funding. Choose one or more from the following list. Increase the number of students walking or biking to school by developing systems that promote Safe Routes to School. Improve the healthfulness of school meals. Execute school wellness policies that have been written, but are not yet implemented. Develop joint use agreements that allow the community to use school properties for shared benefit (e.g. community gardens, use of the gym by community members, etc.). Develop and adopt policies that require organizations to offer healthy foods and physical activity as a component of programming. Develop a School Health Advisory Council (SHAC) that meets regularly, completes a school health assessment and develops an action plan to improve a minimum of two physical activity and/or nutrition policy, systems or environmental change strategies. Strengthen tobacco-free policies at the school/district level. Incorporate evidence-based tobacco prevention curriculum into classroom activities. 2. PROBLEM STATEMENT AND PROJECT SUMMARY. Please explain what your proposed project is and how you will use the grant funding to implement these strategies (including a brief description of the project describing why it is needed). 7 H ealthy Schools Grant Program Application

3. PROJECT IMPACT AND TARGET POPULATION. Explain how this project will address the problem stated above and who the project will benefit, including the number of students impacted. 4. PROJECT READINESS. Describe why you feel your project will be successful and why you feel that your school/district is prepared to do the proposed work (i.e. past experience, strong leadership, identified health champions, other funding sources or partnerships). 5. SUSTAINABILITY. We are interested in providing seed money to jump start projects that are most likely to be sustained after the grant is over. Please explain how you will sustain your project or outcomes. 8 H ealthy Schools Grant Program Application

Workplan, Timeline and Evaluation Complete the table on page 11. See sample template provided on page 10. Note: for each project goal being proposed, you must submit a separate workplan, timeline and evaluation worksheet and a budget narrative with your application. Program Goal State your program goal as identified in Question 1. Workplan Activities and Steps Provide the major activities and specific steps needed to achieve your program goal. See the Sample Activities and Expenditures on pages 14-16 to assist with your workplan development. Timeline Project activities may occur between November to December 2011 and January to June 2012. Note: please consider your district/school processing procedures and timeline for grant signatures, board approval (if required), hiring of staff (if proposed), purchasing goods and services, etc. Evaluation Each project should use simple evaluation tools to measure the impact that the project activities had on healthy eating, physical activity and/or tobacco prevention. Ideally, each project would achieve one or more of the following measurable outcomes: An increase in the number of minutes per day that students are physically active An improvement in healthy eating, as evidenced by an increase in fruit and vegetable intake The development of a wellness team, completed assessment and plan of action Prevention and reduction of tobacco use among students Strengthen and/or implement existing tobacco policies Describe your anticipated measurable outcomes as related to your stated project goal in Question 1. Additionally, explain the evaluation techniques you will use to measure your success (i.e. pre/post surveys, questionnaires sign in sheets, food diaries, etc). Note, it is acceptable to measure outcomes other than the ones indicated above as long as they relate to your project goal. 9 H ealthy Schools Grant Program Application

SAMPLE WORKPLAN, TIMELINE AND EVALUATION TEMPLATE WORKPLAN TIMELINE EVALUATION Activities Steps Implementation Timeline Measurable Outcome(s) How Outcome(s) will be Measured Convene a leadership group Recruit members from staff, parents and students (post flyers, school newsletter articles, emails, staff meetings, all school announcements, etc.) November 2011 Hold kick-off meeting November 2011 Conduct walking audit Hire coordinator to lead audit December 2011 Design walk to school program Implement walk to school program Request support from Health Department Promote walking audit to students, staff and parents December 2011 January 2012 Conduct audit January 2012 Analyze results and identify solutions February 2011 Hold meetings to develop program Request support from Health Department February-March 2012 February 2012 Implement program March 2012 Outcome #1: The number of students who walk to school will increase by 15%. Outcome #2: 50% of students participating in the project will increase the number of minutes they are physically active by 25%. Outcome #3: The BMI of students will decrease. Outcome #1: Measure the number of students who are walking to school using student questionnaires before and after the project. Outcome #2: Measure the number of minutes that students are walking to school using student questionnaires before and after the project. Outcome #3: Measure height and weight of participating students before and after the project. 10 H ealthy Schools Grant Program Application

WORKPLAN, TIMELINE AND EVALUATION TEMPLATE (PLEASE COMPLETE) WORKPLAN TIMELINE EVALUATION Activities Steps Implementation Timeline Measurable Outcome(s) How Outcome(s) will be Measured 11 H ealthy Schools Grant Program Application

Budget Narrative Use the following template to develop a project budget. Additional lines may be added as necessary. Make sure that expenditures align with the restrictions listed at the beginning of this application. The budget must align with activities that were identified in your Workplan and provide a clear description for each activity for which funding is being requested. * Do not include in-kind funding amounts within 2011, 2012 or TOTAL Funding Amount cells. Insert rows/columns as needed. BUDGET ITEM DESCRIPTION 2011 Funding Amount PERSONNEL Project Coordinator Fringe Benefits In-Kind*: Other: Other: OTHER DIRECT COSTS Office Operations 2012 Funding Amount TOTAL Funding Amount Communications/Marketing Meeting Expenses Evaluation Expenses Minor Equipment Project Space Supplies: In-Kind*: Other: PURCHASED SERVICES Consultants INDIRECT COSTS Indirect Costs TOTAL FUNDING REQUEST: 12 H ealthy Schools Grant Program Application

Healthy Schools Program Letter of Intent (LOI) I would like to notify the Health Department of my intent to submit a proposal for Healthy Schools Program funding. I understand that the LOI will assist the Health Department in arranging for an adequate number of reviewers to ensure a complete and thorough review and ranking of all grant applications in a timely manner. I understand that I may return this Letter of Intent to the Health Department no later than 3:00 pm on September 9th, 2011. If sent via US Mail, it should be addressed to: Tacoma-Pierce County Health Department Attention: Samantha Yeun 3629 South D Street, MS 1062491 Tacoma WA 98417-6813 If faxed, it should be sent to: Attention: Samantha Yeun (253) 798-6450 Below is/are the project goal(s) that my school/district intends to apply for: Increase the number of students walking or biking to school by developing systems that promote Safe Routes to School. Improve the healthfulness of school meals. Execute school wellness policies that have been written, but are not yet implemented. Develop joint use agreements that allow the community to use school properties for shared benefit (e.g. community gardens, use of the gym by community members, etc.). Develop and adopt policies that require organizations to offer healthy foods and physical activity as a component of programming. Develop a School Health Advisory Council (SHAC) that meets regularly, completes a school health assessment and develops an action plan to improve a minimum of two physical activity and/or nutrition policy, systems or environmental change strategies. Strengthen tobacco-free policies at the school/district level. Incorporate evidence-based tobacco prevention curriculum into classroom activities. Name (Print): Mailing Address: School/District: Email: Phone: Date: 13 H ealthy Schools Grant Program Application

Sample Project Activities and Expenditures for the Healthy Schools Grant Program Below is a list of project goals that are based on strategies proven to be effective and would be eligible for Healthy Schools Grant Program funding. Examples of activities and project expenditures have been provided to assist with your workplan development. Please note this list is not exhaustive and you may choose to propose additional activities and project expenditures in your application as long as they support required project goal(s). If you have any questions, please contact Linda Graves at lgraves@tpchd.org or Samantha Yeun at syeun@tpchd.org Project Goals Examples of Supporting Activities Examples of Project Expenditures Increase the number of students walking or biking to school by developing systems that promote Safe Routes to School. Hold an informative kick-off meeting with interested parents and staff about Safe Routes to School programs Conduct a walking/bicycling audit Identify issues that create barriers to walking; such as poor community design and safety considerations Create solutions to increase the number of children walking to school; such as, improving the safety of routes, promoting Walking School Bus programs, and providing education to staff and parents Design and implement a Walk to School program Provide a stipend to the group leader or group members to conduct a walking or bicycling audit Purchase equipment such as crossing guard materials and signage Support education and/or marketing campaigns for students, staff and parents Provide incentives and marketing materials for a Walk to School program Improve the healthfulness of school meals. In conjunction with an advisory group, develop nutrient standards for school meals that exceed current meal planning standards Work with school food service staff to pilot healthy menus Host trainings for food service staff in support of healthy preparation techniques Utilize media and marketing strategies to promote new menus to school staff, teachers, students and parents Implement new healthy menu items Hire a nutrition consultant to design new healthy menus Provide funding to train food service staff on new menu preparation and recipe testing Purchase promotional materials (i.e. menu boards, posters, newsletters and incentives) to encourage program participation among students, staff and parents Execute school wellness policies that have been written, but have not yet been implemented. In conjunction with a school wellness council, conduct an assessment to determine current compliance of various components of district wellness policies Monitor and evaluate the implementation of the current wellness policy Provide healthy snacks, child care, transportation and copies of the wellness policy for wellness council attendees Provide a stipend to wellness council members to support attendance at meetings

Determine steps needed to implement a new policy successfully Implement an existing policy Develop tools to assist with policy implementation Hire a contractor to assist with the development of tools or provide technical assistance Develop joint use agreements that allow the community to use school properties for shared benefit (e.g. community gardens, use of the gym by community members, etc.). Convene a committee to identify shared goals, needs and interests between schools and the community Develop a detailed plan and a formal agreement or policy between the school and district that would include maintenance, operations, liability, ownership and costs Work with a local after school programming group such as the YMCA or Boys and Girls Club to allow programming without space charges Support community meetings by paying for child care, transportation and healthy foods Provide a stipend for committee members to develop a detailed written plan Provide travel costs to meetings Hold community forums Develop and adopt policies that require organizations to offer healthy foods and physical activity as a component of programming. Develop a written policy that requires physical activity breaks throughout homework time, tutoring sessions, academic enrichment offerings and afterschool clubs Complete an inventory of all food currently served and develop healthy food guidelines Purchase a best practice after school curriculum (i.e. SPARK Active Recreation, Catch Kids Club, etc.) Provide a stipend to a group or parent leader who leads new standards development for physical activity and healthy foods Develop a School Health Advisory Council (SHAC) that meets regularly, completes a school health assessment and develops an action plan to improve a minimum of two physical activity and/or nutrition policy, systems or environmental change strategies. Convene a wellness committee who meets regularly Complete the school health index Develop a plan of action based on the areas identify within the school health index Implement a minimum of two physical activity and/or nutrition policy, systems or environmental change strategies. Provide a stipend to a SHAC coordinator who leads the process Provide stipend to SHAC committee members to complete the School Health Index and develop an action plan Provide healthy snacks, child care, transportation and materials for SHAC meetings 15 H ealthy Schools Grant Program Sample Activities and Expenditures

Strengthen tobacco-free policies at the school/district level.. Incorporate evidence - based tobacco prevention curriculum into classroom activities. Create an advisory group to strengthen tobacco use & tobacco possession policies on the school grounds at the district and building levels Develop and adopt policies to include tobacco lesson in every grade at the building/district level Develop and adopt policies that discourage social acceptability of the use of tobacco and drugs through enforcement and education at the district and building levels by promoting strong no tobacco use attitudes among students and teachers Recommended tobacco prevention curriculum includes: Life Skills www.lifeskillstraining.com/structure.php The Project ALERT www.projectalert.com/assets/0/180/pa-overview.pdf The Great Body Shop www.thegreatbodyshop.net Science, Tobacco & You www.magnet.fsu.edu/education/teachers/curricula/scie ncetobaccoyou.html Tar Wars www.tarwars.org Teen Tobacco & the Media www.depts.washington.edu/thmedia Tobacco Free Kids Club of Pierce County www.tpchd.org Provide a stipend for advisory group committee members Hire an outside contractor to assist with the development of tools or provide technical assistance Provide healthy snacks for meeting attendees Purchase the curriculum Training cost to implement the curriculum Prepare and incorporate lesson into existing health class/activities Provide a stipend for a speaker/trainer to teach or conduct activities related to the curriculum Purchase supplies related to the curriculum being implemented 16 H ealthy Schools Grant Program Sample Activities and Expenditures