2017 Reaching for Excellence Application



2020-2021Vanguard Award Application FORMTEXT ?Deadline: November 22, 2019General InformationFor any Texas school or school district with a current health project that has previously received the Awards for Excellence Discovery award within the previous two years and has measurable outcomes. The project must align with one or more of the ten components of the CDC’s Whole School, Whole Community, Whole Child (WSCC) model. Selected applicants will receive funding to expand and sustain the health project and be required to submit reports and a program evaluation. Please review the full application and attached toolkit prior to filling out the application.Name of Project: FORMTEXT ?????Project Coordinator’s Name: FORMTEXT ?????Project Coordinator’s Title: FORMTEXT ?????Project Coordinator’s Phone Number: FORMTEXT ?????Alternate Phone Number: FORMTEXT ?????Project Coordinator’s Email Address: FORMTEXT ?????Alternate Email Address: FORMTEXT ?????Enter “X” to select how you learned about the Awards for Excellence in Texas School Health.?DSHS Friday Beat e-newsletter?DSHS School Health Program Website?Conference, Workshop, or Meeting?Colleague?Other: FORMTEXT ?????? We want to be considered for the Award of Achievement sponsored by the Texas Pediatric Society Foundation for successfully decreasing adolescent obesity by promoting nutrition and physical activity in middle or high schools.This application is for a ?School district ?School campusDistrict InformationSchool campus applicants may skip this section.Name of School District: FORMTEXT ?????Superintendent Name: FORMTEXT ?????District Tax Identification Number: FORMTEXT ?????County: FORMTEXT ?????District Street Address: FORMTEXT ?????City: FORMTEXT ?????Zip Code: FORMTEXT ?????School Campus Information School district applicants may skip this section. FORMTEXT ?Name of Campus: FORMTEXT ?????Principal Name: FORMTEXT ?????Campus Street Address: FORMTEXT ?????City: FORMTEXT ?????Zip Code: FORMTEXT ?????Summary (30 points) FORMTEXT ?Provide a summary of your project. Describe the project’s main goal, results, current status, and your plans for the project. How do the actual results compare to the anticipated results? Have any of the goals, objectives, or project plans changed since receiving the Discovery award? If so, how? FORMTEXT ?????List the measurable objectives of the project below. An example of a SMART objective and template may be found here.Assess (10 points) FORMTEXT ?Include any new information from surveys, interviews, or assessments you used to identify a continued need for this project. FORMTEXT ?????Explain any changes or updates in how this project aligns with the WSCC model components. FORMTEXT ?????Plan (15 points)Include the most current logic model, road map, or other visual framework for your project. You may use the template and refer to logic model definitions and an example located here.Collaboration (20 points) FORMTEXT ?Explain the SHAC’s role in project expansion and sustainability. FORMTEXT ?????Describe what individuals (by position) and groups in the school will do to help with project sustainability. FORMTEXT ?????Describe what individuals (by position) and community organizations outside the school will do to help with project sustainability. FORMTEXT ?????Act (15 points) FORMTEXT ?How has this program been marketed or promoted throughout the school district and community since receiving the Discovery award? How has the community improved? FORMTEXT ?????How will community feedback be used to achieve project sustainability? FORMTEXT ?????Evaluate (25 points)Helpful evaluation definitions may be located here.Referring to the logic model/road map, explain how you will assess the activities and outputs to determine whether the project was implemented as intended. FORMTEXT ?????How will you determine if the project affected the target population? FORMTEXT ?????What role will stakeholders play in evaluating the project? FORMTEXT ?????How have the objectives been re-evaluated since first beginning this project? How has the evaluation affected the project? FORMTEXT ?????Document project accomplishments below including information from new surveys, interviews, participation or satisfaction rates, etc. FORMTEXT ?????Expand/Sustain (20 points)How has the program grown since receiving the Discovery Award? FORMTEXT ?????Justify why the project will need to be continued in the future. FORMTEXT ?????What activities/strategies are a priority to sustain? FORMTEXT ?????What are some barriers experienced during program implementation and evaluation, and how may they be overcome in the future? FORMTEXT ?????What is the plan to ensure stable project funding in the future? FORMTEXT ?????Proposed Budget (15 points) FORMTEXT ??Funding provided by the Vanguard award is intended to support the expansion and sustainability of the health project. Detail how you will use the money if your project is selected. ** FORMTEXT ?????List the materials you will need for your project, quantities and estimated cost. How will these items help achieve the project’s goals? FORMTEXT ?????**Funding may not be used to purchase gifts, promotional items, door prizes, or entertainment. Contact DSHS if you have any questions regarding eligible items.Award Disbursement Information(This information will only be used if project is selected)Make check payable to (school or district name only): FORMTEXT ?????Payee mailing address (this address will be used when mailing the check): FORMTEXT ?????Signature of Project Coordinator or Authorized Signatory________________________________________Date________________If you have questions, contact the Texas Department of State Health Services’ School Health Program at SchoolHealth@dshs. or (512) 776-7279. FORMTEXT ?Award Application ToolboxLogic Model/Road Map Definitions and ExampleA logic model represents how your project or program is intended to work; you may also know it as a road map, program framework, or model of change. It should list activities that promote measurable changes and positive results in your school ponents for your logic model may include:Project resources: human resources, time, funding, supplies, and other items used in planning, implementing, and evaluating the programActivities: project promotion, campaigns, or trainings leading to program outputs or interventionsOutputs: include frequency or duration indicating whether activities were performed as intendedShort-term outcomes: changes in knowledge, attitudes, skills, or increased awarenessMid-term outcomes: behavioral and environmental changes such as increased program participationLong-term outcomes: risk reduction, improved quality of life, or chronic disease prevention Example:Template:Project ResourcesActivitiesOutputsShort-term OutcomesMid-term OutcomesLong-term OutcomesSMART Objectives ExampleSpecificMeasurableAttainableRelevantTimelyWhen?How Much?Who?What?Example: By February 2020At least 100StudentsWill have used the campus walking trail.Evaluation DefinitionsThe purpose of a process evaluation is to determine if the project was implemented as intended. This type of evaluation is conducted by assessing the activities and output components of the logic model.The purpose of an outcome evaluation is to determine if the project had any effects on the target population over time. This type of evaluation is conducted by assessing the outcome components of the logic model/roadmap. ................
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