Work Plan
Monitoring and Reporting System for the State Public Health Actions Cooperative Agreements
Att 4a. Workplan (Basic and Enhanced).xlsx
Basic Awardees Initial Work Plan
OMB: 0920-1059
Document [xlsx]
Download: xlsx | pdf
Basic Work Plan
Domain 2 Work Plan
Domain 3 Work Plan
Domain 4 Work Plan
Overview
Home PageBasic Work Plan
Domain 2 Work Plan
Domain 3 Work Plan
Domain 4 Work Plan
Sheet 1: Home Page
| 1305 Year 2 Work Plan | Form Approved OMB No. 0920-XXXX Exp. Date XX/XX/XXXX |
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| State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health | |||||||||||||||||||
| <Enter State Name> | |||||||||||||||||||
| Workbook Contents | |||||||||||||||||||
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| Instructions | |||||||||||||||||||
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| Public reporting of this collection of information varies from 1 to 12 hours per response, including the time for reviewing instructions, | |||||||||||||||||||
| searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. | |||||||||||||||||||
| An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a | |||||||||||||||||||
| currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of | |||||||||||||||||||
| information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, | |||||||||||||||||||
| Atlanta, Georgia 30333; ATTN:PRA (0920-XXXX). | |||||||||||||||||||
Sheet 2: Basic Work Plan
| Basic Component | ||||||||||||||
| WORK PLAN FOR BASIC | ||||||||||||||
| Strategy 1: Promote the adoption of food service guidelines/nutrition standards, which include sodium | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
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| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.1.01] Number of local education agencies that received professional development and technical assistance on strategies to create a healthy school nutrition environment | ||||||||||||||
| [B.1.02] Number of students in local education agencies where staff received professional development and technical assistance on strategies to create a healthy school nutrition environment | ||||||||||||||
| [B.1.03] Number of ECEs that develop and/or adopt policies to implement food service guidelines/nutrition standards, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [B.1.04] Number of children who attend ECEs that have developed and/or adopted policies to implement food service guidelines/nutrition standards | ||||||||||||||
| [B.1.05] Number of worksites that develop and/or adopt policies to implement food service guidelines/nutrition standards, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [B.1.06] Number of employees who work in worksites that have developed and/or adopted policies to implement food service guidelines/nutrition standards | ||||||||||||||
| [B.1.07] Number of community settings that develop and/or adopt policies to implement food service guidelines/nutrition standards, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [B.1.08] Number of persons who access community settings that have developed and/or adopted policies to implement food service guidelines/nutrition standards | ||||||||||||||
| Strategy 2: Promote the adoption of physical education/physical activity (PE/PA) in schools | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
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| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.2.01] Number of local education agencies where staff received professional development and technical assistance on the development, implementation or evaluation of recess and multi-component physical education policies | ||||||||||||||
| [B.2.02] Number of students in local education agencies where staff received professional development and technical assistance on developing, implementing or evaluating recess and multi-component physical education policies | ||||||||||||||
| [B.2.03] Number of state-level multi-component physical education policies for schools developed and adopted by the state | ||||||||||||||
| [B.2.04] Number of state-level recess policies for schools developed and adopted by the state | ||||||||||||||
| Strategy 3: Promote the adoption of physical activity (PA) in early care and education (ECE) and worksites | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
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| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.3.01] Number of ECEs that adopt strategies to increase physical activity | ||||||||||||||
| [B.3.02] Number of children who attend ECEs that adopt strategies to increase physical activity | ||||||||||||||
| [B.3.03] Number of worksites that adopt strategies to increase physical activity | ||||||||||||||
| [B.3.04] Number of employees who work in worksites that adopt strategies to increase physical activity | ||||||||||||||
| Strategy 4: Promote reporting of blood pressure and A1C measures; and, as able, initiate activities that promote clinical innovations, team-based care, and self-monitoring of blood pressure | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.4.01] Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0018 | ||||||||||||||
| [B.4.02] (OPTIONAL MEASURE) Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control | ||||||||||||||
| [B.4.03] (OPTIONAL MEASURE) Proportion of patients in health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control | ||||||||||||||
| [B.4.04] (OPTIONAL MEASURE) Proportion of health care systems with policies or systems to encourage self monitoring of high blood pressure | ||||||||||||||
| [B.4.05] (OPTIONAL MEASURE) Proportion of patients in health care systems with policies or systems to encourage self monitoring of high blood pressure | ||||||||||||||
| [B.4.06] (OPTIONAL MEASURE) Proportion of health care systems with electronic health records appropriate for treating patients with high blood pressure | ||||||||||||||
| [B.4.07] (OPTIONAL MEASURE) Proportion of patients in health care systems with electronic health records appropriate for treating patients with high blood pressure[ | ||||||||||||||
| [B.4.08] (OPTIONAL MEASURE) Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0059 | ||||||||||||||
| Strategy 5: Promote awareness of high blood pressure among patients | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.5.01] Proportion of adults in the state aware they have high blood pressure | ||||||||||||||
| Strategy 6: Promote awareness of prediabetes among people at high risk for type 2 diabetes | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
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| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.6.01] Prevalence (%) of people with self-reported prediabetes | ||||||||||||||
| Strategy 7: Promote participation in ADA-recognized, AADE-accredited, state-accredited/certified, and/or Stanford licensed diabetes self-management education (DSME) programs | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Activities | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [B.7.01] Proportion of people with diabetes in targeted settings who have at least one encounter at an ADA recognized, AADE accredited, state accredited/certified, and/or Stanford licensed DSME program | ||||||||||||||
Sheet 3: Domain 2 Work Plan
| Domain 2: Environmental Approaches that Promote Health | ||||||||||||||
| WORK PLAN FOR DOMAIN 2 | ||||||||||||||
| Strategy 1: Increase access to healthy foods and beverages | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Provide access to healthier food retail | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Provide access to farmer's markets | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.1.01] Number of small retail venues (e.g., corner stores, bodegas, gas stations, drug/dollar stores, etc.) that sell healthier food options in underserved areas | ||||||||||||||
| [2.1.02] Number of adults, youth, or families that access small retail venues (e.g., corner stores, bodegas, gas stations, drug/dollar stores, etc.) offering healthier food options | ||||||||||||||
| [2.1.03] Number of farmer’s markets that are accessible to designated underserved areas | ||||||||||||||
| [2.1.04] Number of farmer’s markets that accept federal or state nutrition assistance benefit programs (e.g., SNAP, WIC, FMNP) | ||||||||||||||
| [2.1.05] Number of adults or families that access farmer’s markets in underserved areas | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.1.06] Percent of adults or youth who increase consumption of nutritious food and beverages | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.1.07] Percentage of adults or youth who are overweight or obese | ||||||||||||||
| Strategy 2: Implement food service guidelines/nutrition standards where foods and beverages are available. Guidelines and standards should address sodium | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Implement food service guidelines in priority settings (ECEs, worksites, communities) | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.2.01] Number of ECEs that develop and/or adopt policies to implement food service guidelines, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [2.2.02] Number of worksites that develop and/or adopt policies to implement food service guidelines, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [2.2.03] Number of community settings that develop and/or adopt policies to implement food service guidelines, including sodium (cafeterias, vending, snack bars) | ||||||||||||||
| [2.2.04] Number of children who attend ECEs that have developed and/or adopted policies to implement food service guidelines, including sodium | ||||||||||||||
| [2.2.05] Number of employees who work in worksites that have developed and/or adopted policies to implement food service guidelines, including sodium | ||||||||||||||
| [2.2.06] Number of persons who access community settings that have developed and/or adopted policies to implement food service guidelines, including sodium | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.2.07] Percent of adults or youth who increase consumption of nutritious foods and beverages | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.2.08] Percentage of adults or youth who are overweight or obese | ||||||||||||||
| Strategy 3: Create supportive nutrition environments in schools | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Interventions and Activities | ||||||||||||||
| Implement policies and practices that create a supportive nutrition environment, including establish standards (including sodium) for all competitive foods; prohibit advertising of unhealthy foods; and promote healthy foods in schools, including those sold and served within school meal programs and other venues | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.3.01] Number of local education agencies that received professional development and technical assistance on strategies to create a healthy school nutrition environment | ||||||||||||||
| [2.3.02] Number of students in local education agencies where staff received professional development and technical assistance on strategies to create a healthy school nutrition environment | ||||||||||||||
| [2.3.03] Percent of local education agencies that have adopted and implemented policies that establish standards (including sodium) for all competitive foods available during the school day | ||||||||||||||
| [2.3.04] Percent of schools that do not sell less healthy foods and beverages (soda pop or fruit drinks, sport drinks, baked goods, salty snacks, candy) | ||||||||||||||
| [2.3.05] Percent of local education agencies that have adopted and implemented policies that prohibit all forms of advertising and promotion (e.g., contests and coupons) of less nutritious foods and beverages on school property | ||||||||||||||
| [2.3.06] Percent of schools that prohibit all forms of advertising and promotion for candy, fast food restaurants, or soft drinks | ||||||||||||||
| [2.3.07] Percent of schools that price nutritious foods and beverages at a lower cost while increasing the price of less nutritious foods and beverages | ||||||||||||||
| [2.3.08] Percent of schools that provide information to students or families on the nutrition, caloric, and sodium content of foods available | ||||||||||||||
| [2.3.09] Percent of schools that place fruits and vegetables near the cafeteria cashier, where they are easy to access | ||||||||||||||
| [2.3.10] Percent of schools that allow students to have access to drinking water | ||||||||||||||
| [2.3.11] Percent of schools that offer fruits or non-fried vegetables when foods or beverages are offered at school celebrations | ||||||||||||||
| [2.3.12] Percent of schools that allow students to purchase fruits and vegetables from vending machines or at the school store, canteen, snack bar, or as a la carte items | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.3.13] Percent of K-12 students who ate vegetables 3 or more times per day (in the local education agencies targeted by FOA funding) | ||||||||||||||
| [2.3.14] Percent of K-12 students who ate fruit or drank 100% fruit juices two or more times per day (in the local education agencies targeted by FOA funding) | ||||||||||||||
| [2.3.15] Percent of K-12 students who drank a can, bottle or glass of soda or pop at least one time per day (in the local education agencies targeted by FOA funding) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.3.16] Percent of K-12 students who are overweight or obese (in the local education agencies targeted by FOA funding) | ||||||||||||||
| Strategy 4: Increase physical activity access and outreach | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Create or enhance access to places for physical activity with focus on walking combined with informational outreach | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Design streets and communities for physical activity | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.4.01] Number of adults or youth who have access to places for physical activity, with a focus on walking | ||||||||||||||
| [2.4.02] Number of local or state policies that include language that supports environmental changes to enhance places for physical activity, emphasizing walking | ||||||||||||||
| [2.4.03] Number of communities that develop and/or adopt a pedestrian or transportation master plan | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.4.04] Percent of adults or youth who have increased physical activity through walking | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.4.05] Percentage of adults or youth who are overweight or obese | ||||||||||||||
| Strategy 5: Implement physical activity in early care and education | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Implement ECE standards for physical activity | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.5.01] Number of ECEs that develop and implement standards to increase physical activity | ||||||||||||||
| [2.5.02] Number of children who attend ECEs that adopt and implement guidelines to increase physical activity | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.5.03] Percent of children in ECEs who engage in levels of age-appropriate physical activity as recommended by Caring For Our Children (CFOC) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.5.04] Percent of children in ECEs who are overweight or obese | ||||||||||||||
| Strategy 6: Implement quality physical education and physical activity in K-12 schools | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Develop, implement, and evaluate comprehensive school physical activity programs (CSPAP). CSPAP includes quality physical education and physical activity programming before, during, and after school, such as recess, classroom activity breaks, walk/bicycle to school, physical activity clubs) | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.6.01] Number of local education agencies receiving professional development and technical assistance to establish, implement, evaluate CSPAP | ||||||||||||||
| [2.6.02] Number of students in local education agencies where staff received professional development and technical assistance on establishing, implementing, and evaluating CSPAP | ||||||||||||||
| [2.6.03] Percent of schools within local education agency that have established, implemented and/or evaluated CSPAP | ||||||||||||||
| [2.6.04] Percent of schools that provide or require daily physical education | ||||||||||||||
| [2.6.05] Number of state-level multi-component physical education policies for schools developed and adopted by the state | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.6.06] Percent of K-12 students who attend PE classes on one or more days in an average week when they were in school (in the local education agencies targeted by FOA funding) | ||||||||||||||
| [2.6.07] Percent of K-12 students participating in 60 minutes of daily physical activity (in the local education agencies targeted by FOA funding) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.6.08] Percent of K-12 students who are overweight or obese (in the local education agencies targeted by FOA funding) | ||||||||||||||
| Strategy 7: Increase access to breastfeeding friendly environments | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Implement practices supportive of breastfeeding in birthing facilities | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Provide access to professional and peer support for breastfeeding | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Ensure workplace compliance with federal lactation accommodation law | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.7.01] Number of birthing facilities with ideal practice on those specific practices that facilities are addressing | ||||||||||||||
| [2.7.02] Total composite quality score from CDC’s Maternity Practices in Infant Nutrition and Care Survey (mPINC) (biennial) | ||||||||||||||
| [2.7.03] Number of facilities designated as Baby-Friendly | ||||||||||||||
| [2.7.04] Number of community sites that provide professional and peer support for breastfeeding | ||||||||||||||
| [2.7.05] Number of employers that provide space and time for nursing mothers to express breast milk | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.7.06] Proportion of infants ever breastfed | ||||||||||||||
| [2.7.07] Proportion of infants breastfed at 6 months | ||||||||||||||
| [2.7.08] Proportion of infants exclusively breastfed at 6 months | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [2.7.09] Proportion of children who are overweight or obese | ||||||||||||||
Sheet 4: Domain 3 Work Plan
| Domain 3: Health System Interventions | ||||||||||||||
| WORK PLAN FOR DOMAIN 3 | ||||||||||||||
| Strategy 1: Increase implementation of quality improvement processes in health systems | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider and systems level | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.1.01] Proportion of health care systems with EHRs appropriate for treating patients with high blood pressure | ||||||||||||||
| [3.1.02] Proportion of health care systems with EHRs appropriate for treating patients with diabetes | ||||||||||||||
| [3.1.03] Proportion of patients that are in health care systems that have EHRs appropriate for treating patients with high blood pressure | ||||||||||||||
| [3.1.04] Proportion of patients that are in health care systems that have EHRs appropriate for treating patients with diabetes | ||||||||||||||
| [3.1.05] Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0018 | ||||||||||||||
| [3.1.06] Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0059 | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.1.07] Proportion of adults with high blood pressure in adherence to medication regimens | ||||||||||||||
| [3.1.08] Proportion of patients with diabetes in adherence to medication regimens | ||||||||||||||
| [3.1.09] Proportion of patients with high blood pressure that have a self-management plan (may include medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.1.10] Proportion of adults with known high blood pressure who have achieved blood pressure control | ||||||||||||||
| [3.1.11] Decreased proportion of PWD with A1C >9 | ||||||||||||||
| [3.1.12] Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes | ||||||||||||||
| Strategy 2: Increase use of team-based care in health systems | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase engagement of non-physician team members (i.e., nurses, pharmacists, and patient navigators) in hypertension (HTN) and diabetes management in health care systems | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Increase use of self-measured blood pressure monitoring tied with clinical support | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.2.01] Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control | ||||||||||||||
| [3.2.02] Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to A1C control | ||||||||||||||
| [3.2.03] Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary approach to blood pressure control | ||||||||||||||
| [3.2.04] Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary approach to A1C control | ||||||||||||||
| [3.2.05] Proportion of health care systems with policies or systems to encourage patient self-management of high blood pressure | ||||||||||||||
| [3.2.06] Proportion of patients that are in health care systems that have policies or systems to encourage patient self-management of high blood pressure | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.2.07] Proportion of adults with high blood pressure in adherence to medication regimens | ||||||||||||||
| [3.2.08] Proportion of patients with diabetes in adherence to medication regimens | ||||||||||||||
| [3.2.09] Proportion of patients with high blood pressure that have a self-management plan (may include medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [3.2.10] Proportion of adults with known high blood pressure who have achieved blood pressure control | ||||||||||||||
| [3.2.11] Decreased proportion of PWD with A1C >9 | ||||||||||||||
| [3.2.12] Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes | ||||||||||||||
Sheet 5: Domain 4 Work Plan
| Domain 4: Community-Clinical Linkages | ||||||||||||||
| WORK PLAN FOR DOMAIN 4 | ||||||||||||||
| Strategy 1: Increase use of diabetes self-management programs in community settings | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase access, referrals, and reimbursement for AADE-accredited, ADA-recognized, State-accredited/certified, or Stanford-licensed DSME programs* | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| *DSME program = ADA-recognized, AADE-accredited, state-accredited/certified, or licensed Stanford Diabetes Self-Management Education programs | ||||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.1.01] Number of ADA recognized, AADE accredited, or state accredited/certified DSME programs during the funding year | ||||||||||||||
| [4.1.02] Number of Stanford DSMP workshops offered during the funding year | ||||||||||||||
| [4.1.03] Proportion of counties with ADA recognized, AADE accredited, or state accredited/certified DSME programs | ||||||||||||||
| [4.1.04] Proportion of counties with Stanford DSMP workshops | ||||||||||||||
| [4.1.05] Number of Medicaid recipients with diabetes who have DSME as a covered Medicaid benefit | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.1.06] Proportion of people with diabetes in targeted settings who have at least one encounter at an ADA recognized, AADE accredited, state accredited/certified, and/or Stanford licensed DSME program during the funding year | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.1.07] Decreased proportion of people with diabetes with A1C >9 | ||||||||||||||
| [4.1.08] Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes | ||||||||||||||
| Strategy 2: Increase use of lifestyle intervention programs in community settings for the primary prevention of type 2 diabetes | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase referrals to, use of, and/or reimbursement for CDC recognized lifestyle change programs for the prevention of type 2 diabetes | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.2.01] Proportion of health care systems with policies or practices to refer persons with prediabetes or at high risk for type 2 diabetes to a CDC-recognized lifestyle change program | ||||||||||||||
| [4.2.02] Proportion of participants in CDC-recognized lifestyle change programs who were referred by a health care provider | ||||||||||||||
| [4.2.03] Number of Medicaid recipients or state/local public employees with prediabetes or at high risk for type 2 diabetes who have access to evidence-based lifestyle change programs as a covered benefit | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.2.04] Number of persons with prediabetes or at high risk for type 2 diabetes who enroll in a CDC-recognized lifestyle change program | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.2.05] Percent of participants in CDC-recognized lifestyle change programs achieving 5-7% weight loss (as reported by the CDC Diabetes Prevention Recognition Program) | ||||||||||||||
| Strategy 3: Increase use of health-care extenders in the community in support of self-management of high blood pressure and diabetes | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase engagement of community health workers (CHWs) in the provision of self-management programs and on-going support for adults with diabetes | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Increase engagement of CHWs to promote linkages between health systems and community resources for adults with high blood pressure | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Increase engagement of community pharmacists in the provision of medication/self-management for adults with high blood pressure and adults with diabetes | Is this intervention selected? | Select | ||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.3.01] Proportion of recognized/accredited DSME programs in targeted settings using CHWs in the delivery of education/services | ||||||||||||||
| [4.3.02] Proportion of health care systems that engage CHWs to link adult patients with high blood pressure to community resources that promote self-management | ||||||||||||||
| [4.3.03] Proportion of community pharmacists that promote medication-/self-management for adults with high blood pressure | ||||||||||||||
| [4.3.04] Proportion of community pharmacists that promote medication-/self-management for adults with diabetes | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.3.05] Proportion of patients with high blood pressure in adherence to medication regimens | ||||||||||||||
| [4.3.06] Proportion of patients with diabetes in adherence to medication regimens | ||||||||||||||
| [4.3.07] Number of participants in recognized/accredited DSME programs* using CHWs in the delivery of education/services | ||||||||||||||
| [4.3.08] Proportion of patients with high blood pressure that have a self-management plan (including medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.3.09] Decreased proportion of people with diabetes with A1C >9 | ||||||||||||||
| [4.3.10] Proportion of adults with known high blood pressure who have achieved high blood pressure control | ||||||||||||||
| Strategy 4: Increase use of chronic disease self-management programs in community settings | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Increase access to and use of Chronic Disease Self-Management (CDSM) programs (Note: States selecting this strategy must already be engaged in this work at a state level and/or be currently funded for by the CDC Arthritis Program to support work in CDSMP.) | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.4.01] Number of CDSM workshops offered during the funding year | ||||||||||||||
| [4.4.02] Proportion of counties with CDSM workshops | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.4.03] Number of CDSM program participants who self-report having diabetes and complete at least 4 out of 6 workshop sessions, as a proportion of the total number of people with diabetes in the state | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.4.04] Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes | ||||||||||||||
| Strategy 5: Implement policies, processes, and protocols in schools to meet the management and care needs of students with chronic conditions | ||||||||||||||
| Jurisdiction Scope Please select | ||||||||||||||
| Setting Select yes for all that apply | ||||||||||||||
| State Government | Community | Faith-based | Healthcare | School/ Early Care | Worksite | Other (please describe) | ||||||||
| Population of Focus Please select general or specific | ||||||||||||||
| Gender | Race | Age | ||||||||||||
| Male | African American or Black | Infants / Toddlers (0-1 yrs) | ||||||||||||
| Female | American Indian or Alaska Native | Infants / Toddlers (2-3 yrs) | ||||||||||||
| Transgender | Asian Indian | Children (4-11 yrs) | ||||||||||||
| Sexual Identity | Chinese | Adolescents (12-17 yrs) | ||||||||||||
| Bisexual | Filipino | Adolescents (18-19 yrs) | ||||||||||||
| Gay | Japanese | Adults (20-24 yrs) | ||||||||||||
| Heterosexual | Korean | Adults (25-39 yrs) | ||||||||||||
| Lesbian | Vietnamese | Adults (40-49 yrs) | ||||||||||||
| Questioning | Other Asian (specify) | Older Adults (50-64 yrs) | ||||||||||||
| Geography | Native Hawaiian or other Pacific Islander | Older Adults (65 yrs & older) | ||||||||||||
| Rural | Guamanian or Chamorro | Other Populations | ||||||||||||
| Urban | Samoan | Low Socioeconomic Status | ||||||||||||
| Frontier | White | Disability | ||||||||||||
| Ethnicity | Other (specify) | Other (specify) | ||||||||||||
| Hispanic or Latino | ||||||||||||||
| Not Hispanic or Latino | ||||||||||||||
| Intervention Activities | ||||||||||||||
| Identifying and tracking students with chronic conditions that may require daily or emergency management, e.g. asthma and food allergies | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Developing protocols that ensure students identified with a chronic condition that may require daily or emergency management are enrolled into private, state, or federally funded insurance programs if eligible | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Providing assessment, counseling, and referrals to community-based medical care providers for students on activity, diet, and weight-related chronic conditions | ||||||||||||||
| Activity Description | Lead Personnel Assigned | Contributing Partner(s) | Key Contracts & Consultants | Timeframe | ||||||||||
| Start Quarter | End Quarter | |||||||||||||
| Performance Measures | ||||||||||||||
| Short-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.5.01] Number of local education agencies that receive professional development and technical assistance on meeting the daily management and emergency care needs of students with chronic conditions | ||||||||||||||
| [4.5.02] Percent of schools that identify and track students with chronic conditions that may require daily or emergency management, e.g. asthma and food allergies | ||||||||||||||
| [4.5.03] Number of local education agencies that receive professional development and technical assistance on meeting the daily management and emergency care needs of students with chronic conditions | ||||||||||||||
| [4.5.04] Number of students identified with chronic conditions in local education agencies with staff that received professional development and technical assistance on meeting the daily management and emergency care needs of students with chronic conditions | ||||||||||||||
| [4.5.05] Percent of schools that have protocols that ensure students identified with a chronic condition that may require daily or emergency management are enrolled into private, state, or federally funded insurance programs if eligible | ||||||||||||||
| [4.5.06] Number of local education agencies that receive professional development and technical assistance on assessment, counseling, and referrals to community-based medical care providers for students on activity, diet, and weight-related chronic conditions | ||||||||||||||
| [4.5.07] Number of students identified with chronic conditions in local education agencies with staff that received professional development and technical assistance on assessment, counseling, and referrals to community-based medical care providers for students on activity, diet, and weight-related chronic conditions | ||||||||||||||
| [4.5.08] Percent of schools that provide students with referral to community-based medical care providers for students identified with chronic conditions or at risk for activity, diet, and weight-related chronic conditions | ||||||||||||||
| Intermediate Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
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| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.5.09] Reduced absences for students identified with chronic conditions (in the local education agencies targeted by FOA funding) | ||||||||||||||
| Long-Term Performance Measures | Data Source | Baseline | Year 2 Target | Year 5 Target | Measure Notes (Baseline to Year 5) |
|||||||||
| Date Data Collected | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | Numerator/ Count | Denominator | Rate/ Percent | |||||
| [4.5.10] Percentage of students identified with chronic conditions who have a medical home (i.e., a medical home with skilled and knowledgeable health care professionals who, acting as a team, continuously monitor the child’s health status over time and manage the medications (not merely episodic management of attacks) (in the local education agencies targeted by FOA funding) | ||||||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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