Form FNS 889 FNS 889 SNAP Ed Connection Sharing Form

Food Stamp Nutrition Connection Resource Sharing Form

Attachment 1 FNS 889

Resource Sharing Form (State, Local & Tribal Government)

OMB: 0584-0625

Document [pdf]
Download: pdf | pdf
Submit Educational Materials | SNAP-Ed Connection

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Nutrition Education

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Submit Educational Materials
Form Approved OMB No. 0584-0625
Expiration Date: xx/xx/xxxx
You must provide the full text document for review if you are submitting an Educational Material. You are not
required to submit the full text of Training or Other Materials. After the review process the documents that you
submit will only become publicly available if you make that choice below. Instructions for submitting materials are
also included below.
Title *

Quick Links
SNAP-Ed Library

Description of Material



Photo Gallery
Seasonal Produce Guide



Recipes & Menus
Eat Right When Money's
Tight
Nutrition Education
Materials
Spanish Materials
Meal Planning, Shopping,
and Budgeting
State SNAP-Ed Programs

Content limited to 2000 characters, remaining: 2000

Material Information
Developer/Author *
Separate multiple authors with commas.
Organization *
Funding Source *
For example, USDA, Private Organization, Company, etc.
Contact Email
Email address where people can send questions about this material

Publication/Revision Year *

Format: 2017

Is the material free? *
No
Yes
Material Cost
$
Numbers only, for example, "40" or "40.95".

Cost Notes
For example, "Bulk discounts are available" or "Cost varies depending on items chosen".

Evidence base / Evaluation *
A validated evaluation tool used to
create this resource
An impact evaluation conducted for
this resource
A pilot study conducted for this
resource
A process evaluation conducted for
this resource

Participant surveys / questionnaires
included in this resource
Peer-reviewed papers are associated
with this resource
Logic model / theoretical framework
used to develop resource
Toolkit Designation: Evidence-based

Toolkit Designation: Research-tested
Toolkit Designation: Emerging
Other evaluation activities conducted
for this resource
None
Unknown

Toolkit Designation: Practice-tested

Please choose all that apply

Evaluation Framework Indicators & Evaluation Activities



List the SNAP-Ed Evaluation Framework indicators that are associated with this tool or intervention. Also include
peer-reviewed literature citations, pilot study information, and other evaluation information. Be as specific as
possible.

https://snaped.fns.usda.gov/node/add/educational-materials

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Submit Educational Materials | SNAP-Ed Connection

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Target Audience
Adults

Organizational Partners

Older Adults

Policy, Systems, Environmental Leaders / Organizations

Pregnant / Breastfeeding Women

SNAP-Ed Paid Staff or Personnel

Parents / Mothers / Fathers

State Agencies (SA's) or Implementing Agencies (IA's)

Homeless / Food Pantry Clients

Volunteers / Community Peers

Native Hawaiian or Other Pacific Islander

Elementary School

Black or African American

Preschool (<5 years old)

Asian

Middle School

Hispanic or Latino

High School

American Indian or Alaska Native
SNAP-Ed Behavioral Objectives
Dietary Guidelines for Americans Food Groups
Decreasing Sugar, Sodium, and Saturated Fat
Physical Activity and Reducing Screen Time
Food Insecurity/Food Assistance
Obesity Prevention
Policy, Systems, and Environment, and Partnership Work Products
Coordinated Plans and Benchmarks
Assessment, Scoring, and Reporting Instruments
Communication Tools and Reports
Model Policies, Standards, Guidelines
Contract Language, Memorandums of Understanding, Partner Agreements
Other information about the material



Has this material been used by a SNAP-Ed program?
N/A
Yes
No
Unknown
How will full text be submitted to SNAP-Ed Connection for review? *
I will send my document(s) electronically to SNAP-Ed Connection (instructions below).
I will enter the website link below. The website has a link to the full text document.
I have already submitted the material.
I will mail the material.
Please mail your material to:
SNAP-Ed Connection
Food and Nutrition Service
Supplemental Nutrition Assistance Program
Program Administration and Accountability Division
3101 Park Center Drive, Room 8-20
Alexandria, VA 22302
Evaluation Framework Indicators
LT7
LT13
LT1
LT8
LT14
LT2

LT19

MT6

MT12

R5

R11

ST6

MT1

MT7

MT13

R6

ST1

ST7

LT3

LT9

LT15

MT2

MT8

R1

R7

ST2

ST8

LT4

LT10

LT16

MT3

MT9

R2

R8

ST3

LT5

LT11

LT17

MT4

MT10

R3

R9

ST4

LT6

LT12

LT18

MT5

MT11

R4

R10

ST5

SNAP-Ed Intervention Channels
Active Transportation/Complete Streets

Adult Education

After-School/Summer/Community Youth Organizations

Clinics/Health Care Systems

Community Organizations for Adults

Congregate Meal/Elder Service Centers

Early Childhood Education/Day Care/Head Start

Emergency Food Assistance/Food Banks/Food Pantries

Extension Offices

Faith Centers

Farmers’ Markets

Food Stores/Supermarkets

Gardens

Indian Tribal Organizations

Libraries

Mass media (Advertising, Promotion, Social Media, etc.)

Other Programs (Women, Infants, Children (WIC), Child
Nutrition, etc.)
Schools/K-12

https://snaped.fns.usda.gov/node/add/educational-materials

Parks and Recreation Centers/Districts
Restaurants/Fast Food
Shelters/Adult Rehabilitation Centers

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Submit Educational Materials | SNAP-Ed Connection

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Supplemental Nutrition Assistance Program (SNAP)
Offices/Systems

Worksites/Job Training sites/Temporary Assistance for Needy
Families (TANF)
Hide row weights

Web Site

Order
URL

Title

0



The link title is limited to 128 characters maximum.

Add another item

Additional Information about Material
Send Your Files

File Privacy *
Only SNAP-Ed Connection Staff can view the document(s) for review purposes.
The documents are for public use. I want SNAP-Ed Connection to host the files and put them online.
You can send your files and thumbnail image by securely emailing your files to [email protected]
Your Thumbnail Image
SNAP-Ed Connection will automatically generate a thumbnail for this resource. You may also email your own thumbnail
image. You can send an image file (such as jpg's, png's, etc.) to be the thumbnail for your material. The image will be
automatically resized to fit the available dimensions.
How to order this material
Is this material available to order? *
Yes
No
Contact Name or Organization for Ordering
Ordering Web Site Link

Email for Ordering
Phone
Address




Publication Number
Not ISBN. Examples: Item Number, Ordering Number, Identification Number.

Ordering Notes



Content limited to 700 characters, remaining: 700
About You
Submitter Name *
Submitter Email *

State

- None Alabama
Alaska
Arizona




According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless
it displays a valid OMB control number. The control number for this collection is OMB # 0584-0625. The time required to complete this information will vary based upon
one's relationship to the resource being submitted. It is estimated to take 10 minutes to complete the entire survey. This includes time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you need help with this
form, please contact us. Expiration date: xx/xx/xxxx
FNS-889

Submit

Cancel

https://snaped.fns.usda.gov/node/add/educational-materials

10/25/2017

Submit Educational Materials | SNAP-Ed Connection

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Last Modified: Oct-25-2017
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10/25/2017


File Typeapplication/pdf
File Titlehttps://snaped.fns.usda.gov/node/add/educational-materials
AuthorJennifer.M.Anderson
File Modified2017-10-25
File Created2017-10-25

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