CountyName:
POLICY,SYSTEMS,ENVIRONMENTAL(PSE)CHANGECOLLABORATIVEACTIVITIESINVOLVINGSNAP-ED(FY16)
OCTOBER1, 2015TO SEPTEMBER30,2016
Instructions:ThisformisdesignedtoreportthenumberandtypeofchangesassociatedwithPSEactivities,andtocapturequalitativeevidencetounderstandhowchangesoccurred.Pleaseusethis formtoreporttheadoptionandreachassociatedwitheachSNAP-EdPSEactivity.OneformshouldbecompletedforeachoftheFormDMulti-Level/PSEActivitiesproposedbyyourcountyinFY16.EmailcompletedformalongwithotherreportingdocumentstoXaiXiong()nolaterthanOctober19,2016.
DescriptiveTitleforthisEffortorActivity: IsthiseffortnewforyourprojectinFY16?
Yes
No(Dateprojectbegan:)
Howmanysites(partners)ororganizationsareinvolved?
Number=
Atwhatstageisthisproject?
RelationshipBuilding
Identificationofopportunities
InProgress/Ongoing-PartnershipsareinplaceandactivitiesareunderwayComplete
Listthenamesofpartneringsites/organizations(ActualorPlanned):
[Addasmanylinesasappropriate.Contributioncolumnisoptional]
PartnerOrganizationName / OrganizationTypeorSector / ContributiontotheProjectexample:GoodmanCommunityCenter / AfterSchool/YouthPrograms / ProgramandMeetingSpace
Describetheintendedoutcomesoftheactivity.Howwereyousuccessfulormadeprogress?
Describeanyunintendedoutcomes(positiveorchallenges)oftheactivity.Howhavethese outcomeschangedyourstrategyoractivities?
Whatpolicy,systems,orenvironmentalchangesoccurredasaresultoftheactivity?
TypeofChangeAdoptedorImplemented[ExamplesBelow: Pleasedeleteexamples.Includeonlychanges
andoutcomesassociatedwithyourproject] / Domainofenvironmentalsetting
[Ifapplicable, specify:Eat,learn,live,play,shop,orwork.Clicktoview settingdefinitions.] / NumberofChanges
[Example–sugarsweetenedbeveragesremovedfrommenusat3schools
=3changes.] / Estimated Reach
[Total#ofPeopleTotal#SNAP-Edeligible.]
[Example– 100
youth,50SNAP-Edeligible] / Evidence
Listtype and add attachmentsif appropriate.
[Describethedataorevidencethatdocumentsthechange.Thismaybe meetingminutes,awrittenpolicy,photographicevidence,etc.]
PolicyChanges
Improvementinhoursofoperation/timeallottedformealsorfoodservice.
Policiesforworkingparents.
Rulesforfoodsserved inmeetingsorin classrooms.
Standardsforhealthiereatingacrosstheorganization.
SchoolWellnessorchildcarewellness policy.
SystemChanges
Changeinmenus(variety,quality, offeringlighterfares).
Removingsugar-sweetenedbeveragesfromchildren’smenus.
Improvementsinfreewateraccess,taste,quality,smell,ortemperature.
Restrictionstouseoffoodasrewardsorduringcelebrations.
Changeinfoodpurchasingspecificationtowards healthierfoods.
Prioritizingfarm-to-table/increaseinfreshorlocal produce.
Enhancedtrainingonmenudesignand healthycookingtechniques.
Useofstandardized,healthyrecipes
Collectingexcess wholesomefoodtodonatetocharitable organizations.
Environmental
Improvementsin layoutordisplay offood(smarterlunchrooms.
Ediblegardens(establish, reinvigorate,ormaintainfoodgardens.
Lactationsupportsordedicatedlactationspace
Healthiervendingmachineinitiatives
Promotion(Marketing)
Pointofpurchase/ distributionprompts.
Menulabelingwithcalorie,fat,sodium,addedsugarcounts
Vendingmachinelabeling(e.g.calories,trafficlight colorcoding)
Increasedawareness ofthechangesby targetaudiences.
Other (WI Specific)
Other(WISpecific)FoodprocurementpoliciesforSafehealthyFoodPantryProject.
Improvedcapacity ofaschoolgardenthroughpartnershipwithMasterGardeners.
HealthyRetail Related
BackpackNation
Other,specify
HowwouldyoudescribetheroleofSNAP-EdCoordinator(oreducatorsifapplicable)intheProject?
(i.e.Initiatedandledproject,consultedonproject,etc)?Indicatenameofposition(coordinatororeducator)andpertinentrole.
KeyProjectPersonnel(ListSNAP-EdColleagues,OtherExtensionColleagues,andKeyIndividualsfromPartnerOrganizations.(**Maybeusedforfollow-upviapartnersurveys,interviews)
Name / Organization / Role / TimeExample:JohnSmith / HappyDaySchool / Principal,ChairofWellnessofCommittee / 3hrs/Mo(estimated)
Example:MaryBrow / UWEXFamilyLiving / ConsultedonStrategiesforreachingouttoworkingagents / 10hours(estimated)
AttachEvidenceofChange:Photos,MeetingMinutes,MediaCoverage,Etc.
[Notrequired,butrecommended]
Briefly describe how this Activity linked to, reinforced, or informed related SNAP-Ed direct educational
programminginyourcounty.
**Ifyoucompletedanannualpartnershipself-assessment,pleasesummarizetheresults[OPTIONALforFY16]:
**Ifyoucompletedkey-informantinterviews,focusgroups,rippleeffectmappingactivities,orother partnership/coalitionprocessorimpactanalysis,pleasedescribetheresultshere:
[OPTIONALforFY16]