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King County Food and Fitness Initiative

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PROPOSAL NARRATIVE

I.COMMUNITY CONTEXT

The Pacific Northwest is known for its livable communities and King County is home to anumber of initiatives that aim to make it easier to eat well and live actively. Efforts are underwayto promote local agriculture and provide fresh, healthy food to King County residents, especiallythose in underserved communities. Building environments that support physical activity isattracting increasing attention. A King County Food and Fitness Initiative (KCFFI) would be thecatalyst for integrating and expanding these existing efforts.

King County covers 2,134 square miles and is home to 1.8 million residents, 33% of whom livein Seattle, 60% in suburban cities, and 7% in rural areas. Despite a generally healthy economy,minorities and low-income communities are affected by significant economic disparities. Recentgrowth in Seattle has resulted in increasing concentrations of minority and low-incomepopulations in the suburban cities south of Seattle. Over one in five people live in householdsbelow 200% of the federal poverty level. See appendix 1 for demographic data.

Local health department data from the Behavioral Risk Factor Surveillance System (BRFSS)

show that while half of residents are overweight or obese, the likelihood of being obese is 1.3times more for those with low-incomes compared to those with high incomes, 1.6 times more forAfrican Americans relative to whites, and 1.6 times more for people living in suburban southKing County than for those in urban Seattle. Disparities in physical activity are even morepronounced. Overall, 44% of residents are not moderately physically active. Latinos reportlacking physical activity at a rate 1.9 times higher than whites, people with low-incomes at a rate2.9 times higher than those with higher incomes, and south King County residents at a rate fourtimes higher than Seattle residents. While 5.1 % of the total population has diabetes, 7.6% ofAfrican Americans, 8.8% of Native Americans and 8.5% of low-income people are affected.

Community Selection

The KCFFI will work at three distinct and nested geographic levels: 1) the food production

region (primarily Washington State), 2) King County, and 3) two local communities. In order toproduce measurable changes in behavioral and health outcomes, the Collaborative will focusmore intensively on two smaller communities affected by the disparities described above withpopulations less than 120,000. Eight communities are under consideration for inclusion(Appendix 2). Communities will be compared using the data described in appendix 3 and othervariables that may emerge through the planning process. Detailed demographic, health andbehavioral data for the eight communities are included in appendix 4.

The Leadership Council (see below) will review the data, identify gaps in information needed tomake the selection and prioritize selection criteria. Once the necessary information has beencollected, the Leadership Council will review the final data and select two communities. Thisselection process will coordinate with existing coalitions (Appendix 5) addressing food and

fitness issues in the area in order to create linkages and assure a critical mass of activities toproduce community change.

Local Food System

For this Initiative, the primary region of food production is defined as Washington State.However, emphasis will be placed on components of the food system (production, marketing,distribution, etc.) as close to King County as possible. Significant changes in this food system areunfolding. More families are seeking locally and sustainably produced foods, for the health of

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their children and the natural environment. The food system is beginning to respond to this shiftin consumer preferences with several innovative approaches, as described below.

Production

Farms: Demand for fresh produce has led to increased production of high value crops throughintensive row and greenhouse/nursery methods. The value of produce has more than doubled invalue since 1982. Public interest in preserving farmland, expressed through the CountysFarmland Preservation Program, has maintained farmland acreage at 41,759 acres since 19921.The average farm is 38 acres, and the average farmer is 56 years old. Attracting new farmers tosustain the farming industry in the area is a challenge for local agriculture.

Community Gardens: Seattle residents have increasingly participated in community gardens.There are now 70 gardens managed through the P-Patch Program, which encompasses 14 acresof land, 2,500 plots, and 5,000 urban gardeners, with a waiting list of 500. The aptly namedLettuce Link program provides 7-10 tons of fresh P-Patch produce to urban food banksannually. Community garden programs are lacking throughout the rest of King County.

Efforts have begun to extend the benefits of community gardens to low-income and immigrant

residents. Marra Farm, a four-acre inner city farm in a largely Latino low-income Seattleneighborhood, is an inspiring model for the Collaborative (Appendix 6). It integrates communitydevelopment, local food production, and opportunities for physical activity while increasingaccess to fresh, inexpensive food. The site offers a place for social gatherings and physicalactivity. Cultivating Communities, a program within P-Patch, has partnered with immigrant andlow-income residents to create urban market gardens, youth gardens, and nutrition educationprograms. Immigrant populations include Southeast Asian, East Africak and Latino. Marra Farmand P-Patch are KCFFI partners.

Interest in involving youth in gardening is increasing. School garden programs are beginning tointegrate gardening activities into curriculum. The Puget Sound School Gardens Collectiveconnects existing school garden programs and links them to other farm-to-table efforts.

Homeless and under-served youth engage in garden-based education and employment, farm atMarra Farm, and sell produce in Seattle farmers markets through Seattle Youth Garden Works.The demographics of these programs are representative of those of low-income communitiesacross the county.

Marketing and Distribution

Families in King County are now able to purchase locally produced food in a number of venues.Locally produced food is contributing a growing share to the $108 million in dairy products and$120 million in vegetable products sold each year in King County1.

Direct Markets: Families can shop at 28 farmers markets in King County, including ten inSeattle. Washington State farmers' market sales have increased 20% annually since 1997, withestimated total sales of $22 million in 2003. In 2005, Seattle farmers' markets alone totaled $3.5

million in sales, and all county markets combined totaled more than $7 million. Farmers travelfrom all over the state to sell at King County farmers markets2. The Puget Sound Freshmarketing program, a KCFFI partner, promotes local farm products in King and eleven othercounties in Western Washington (Appendix 7). Farmers within King County participate intwelve CSA programs, 59 market directly on the web through Puget Sound Fresh, and 51 farmsand farmers markets sell directly through the annual Puget Sound Fresh Farm Guide.

Retail: Families can find locally produced foods at many grocery retailers, including PCCNatural Markets, Whole Foods Markets, Safeway, Thriftway, QFC and Metropolitan Markets.

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PCC, a KCFFI partner, is the largest food cooperative in the country (40,000 members). Inaddition to buying from local farms, PCC supports the local food system by participating in theActing Food Policy Council, and by operating a Farmland Trust to purchase and protectWashington State farmland.

Families that eat out can find more locally produced foods on the menu. An increasing number

of restaurants purchase from local farms. For the last two years, a partnership between ChefsCollaborative, Ecotrust, Cascade Harvest Coalition, Washington State Department ofAgriculture, and others brought over 250 farmers, food buyers, and chefs together to increasemarkets for local farmers and provide procurement options.

Food Assistance: Food assistance programs help many residents meet basic food needs. Wellover 68,000 low-income families in Seattle depend on a network of 30 community food banks. Asubstantial proportion of food bank clients are families with children. Despite the important rolethat the food bank system plays in feeding children during their most critical developmentalyears, food banks receive little fresh, local produce and other healthy food products. Food banksin Seattle and King County are coordinated by the Seattle Food Committee and the King CountyFood Coalition, whose participation in KCFFI will help the Initiative engage low-income

families at increased risk for obesity and poor nutrition.

Schools: Youth eating at schools find more local produce in the cafeteria through efforts of theFarm-to-School-Connections Team. Parents, schools, food producers, and retailers connectschools to farms via the classroom and the cafeteria, or at the farm. The Cascade HarvestCoalition works with the University of Washington to increase locally grown food in campuscafeterias.

Wholesale Markets: In addition to direct sales to consumers, many larger farms sell wholesalethrough local buyer/distributors that in turn supply local restaurants, schools, and institutions.While some farmers have cultivated relationships with retailers and restaurants through directsales, there is significant opportunity for expanding wholesale networks.

Gaps in the Food SystemThe local food system has significantly increased its capacity to deliver local foods to KingCounty families over the last decade, but barriers to accessing to locally grown food remain.Farmers lack access to processing and storage facilities, transportation networks, andinfrastructure necessary to move food efficiently to local markets. Farmers selling to institutionssuch as hospitals or schools encounter liability issues related to food safety. The true cost of foodproduction makes local, healthy food less affordable for low-income communities.

Public Health and Health Care Institutions

Public Health - Seattle & King County (PHSKC) has made prevention of overweight throughbuilt environment and nutrition strategies one of its top three priorities since 2004. Its initiativesemphasize working with youth and families in low-income communities. PHSKC supports

several coalitions that address food and fitness issues (see Section IIIC below and Appendices 5and 8). Efforts addressing the built environment include piloting of health impact assessmenttools and checklists for planners. PHSKC recently hired an environmental health planner, whowill participate in KCFFI, to address issues of health and the built environment.

Childrens Hospital and Regional Medical Center, a recognized leader in pediatric health, theChildrens Obesity Action Team (COAT), and Odessa Brown Childrens Clinic, all KCFFIpartners, are dedicated to the prevention and management of pediatric overweight. These groupsprovide innovative community-based programs (e.g. Strong Kids Strong Teens program for

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overweight youth and families) and culturally responsive, age specific resources promotingnutrition and active living. They emphasize partnerships with parents and children, linkage withcommunity resources, and a cohesive system of care based on the socio-ecologic model tosupport children, youth, and families making healthy lifestyle choices. For details on these andother clinical services for children, see appendix 9.

Education SystemThe K-12 schools of the county can greatly influence food and fitness among children and youth.In King County, nearly 260,000 students are enrolled in public schools (Appendix 10). TheSeattle School District recently passed progressive School Nutrition (2004) and Physical Activity(2005) policies (Appendix 11). The framework is in place to balance the fiscal limitations ofschool meal programs with policies to support local procurement. The Robert Wood Johnson-funded Eat Better, Feel Better Project at TT Minor Elementary School is changing the schoolfood and activity environment (Appendix 12).

The University of Washington is a center for innovation in addressing the impact of the built andfood environments on health. The Center for Public Health Nutrition in the School of PublicHealth has extensive experience in community-based participatory research aimed at improvingcommunity health through environmental and policy change. The Urban Form Lab and the NWCenter for Livable Communities, both part of the College of Urban Design and Planning, usecommunity data to describe the built and food environments. Washington State University KingCounty Extension (WSU KCE) translates research knowledge into practice in nutrition,agriculture, and local food systems through individual and community education. WSU KCE hasbeen at the forefront in developing a local food policy council and the Farm-to-SchoolConnections Team. WSU KCE also helps Hmong farmers successfully produce and market theircrops. Both UW and WSU KCE are KCFFI partners.

Recreational Resources

Many community organizations provide opportunities for safe recreation, often in partnership

with city and county parks and recreation agencies. Examples of organizations providing free orlow-cost recreation opportunities for children, youth, and their families include: the AustinFoundation Youth and Fitness, The Service Board, Girls on the Run, Passages Northwest,YMCA, Bike Works, Bicycle Alliance, Cascade Bicycle Club, the School of Acrobatics andNew Circus Arts, and Skiforall. These organizations take advantage of the numerous publicrecreational facilities and parks that offer year round recreation including hiking, biking, skiing,boating, camping, and swimming. The Austin Foundation, Passages Northwest, and YMCA areKCFFI partners.

Transportation

Members of the KCFFI such as Feet First, Cascade Bicycle Club, and Transportation ChoicesCoalition promote policies to improve regional non-motorized transportation options. Such

organizations have been instrumental in legitimizing biking and walking through activities suchas enacting Complete the Streets legislation, creation of a Bicycle Master Plan this year(Walking Master Plan to be developed in 2007), and developing Safe Routes to Schools.

Planning Environment

Local and regional planning efforts shape the food and built environments in which families liveand play. The Puget Sound Regional Council (PSRC), a KCFFI partner, focuses on regionaltransportation, economic planning, and growth planning. Through collaboration with localplanners and public health officials, PSRC leaders are beginning to integrate health concerns

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(especially the impact of the built environment) into their planning vision3. Local public healthand planning officials are developing health policy language for inclusion in the PSRC Vision2040 plan. The King County Executive advocates for recognition of the impact of the builtenvironment (land use planning and transportation systems) and food systems on health inplanning efforts. He calls for incentives for high street connectivity and compact development.

The City of Seattle departments of utilities, sustainability and the environment, planning anddevelopment, neighborhoods and parks and recreation are all actively engaged in issues of localfood, land use and the built environment effects on physical activity, and communityengagement for community action, The relevant departments within government in thecities/communities of Kent, Burien, White Center, Federal Way, Tukwila will be activelyengaged as needed once the geographic areas of focus are clarified in the earliest stage of theplanning process. The Acting Food Policy Council (AFPC) advocates for regional food securityand sustainable food systems as necessary elements of regional planning. Recent updates to KingCountys Comprehensive Plan integrate planning with public health, climate change, andtransportation. While the Plan addresses agriculture in terms of land use, it does not mentionfood systems.

Policy and Regulatory EnvironmentsCity and county governments are increasingly developing policies and programs to supporthealthy eating and active living. Voters recently passed Bridging the Gap, a Seattle propositionthat funds street maintenance, sidewalk construction, and a Bicycling and Pedestrian MasterPlans (Appendix 13). Last year, the King County Board of Health adopted a resolution withspecific policy goals for promoting nutrition, increasing physical activity, and improving thebuilt environment and land use to reduce overweight and obesity prevalence in the population(Appendix 14).

The King County Agriculture Commission has advised local elected officials how to promotecommercial agriculture since 1995. Although King County has implemented strong farmlandpreservation policies and programs, city and county governments do not address the food systemin any formal capacity at this time. The Acting Food Policy Council, a KCFFI partner, conveneddiverse sectors of the food system in early 2006 to address policies and collaborate with otherfood system assessment efforts to improve the local food system. The AFPC seeks officialrecognition from the City of Seattle and King County. In Seattle, an informal cityinterdepartmental team has been examining food system enhancement from the municipalperspective for the last two years in conjunction with the University of Washington and theAFPC.

Economic Development

Economic development is a priority for both the City of Seattle and King County. A number ofinitiatives throughout the region are creating economic opportunities in potential KCFFI focus

communities. For example, in White Center, one of the lowest-income neighborhoods in KingCounty, a Community Development Association was formed in 2002 to revitalize economic,physical, and social environments. Black Dollar Days Task Force works to decrease socialservice dependency in central and southeast Seattle through community-based economicdevelopment. Their buy-local campaign includes a community urban farming project.Sustainable Seattle is assessing the multiplier factor for locally produced food to make anevidenced-based economic case for strengthening local food economy linkages. Its HealthyBusiness Districts program increases understanding of factors that make a place desirable,

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economically successful, and the center of a community. Local philanthropic organizations areinvesting in work that supports healthy communities. Several large corporate employers contractwith food service companies, such as Bon Appetit Management Company, that make local foodprocurement a priority.

Seattle and King County have the resources and relationships among government, non-profit,

grassroots, and business entities to create a strong KCFFI Collaborative and develop aninnovative Community Action Plan to integrate local food systems, the built environment, andhealth.

II.VISION AND PRINCIPAL OBJECTIVES

The Collaborative envisions healthy, vibrant communities where all residents have equalopportunities to reach their maximum health potential through access to healthy, locally grownfood; safe environments for physical activity and play; and economic development that supportsand sustains the natural environment. As one Collaborative member put it, We want anenvironment where the healthy choice is the easy choice, healthy for people, the environment,and the economy. The KCFFI approach to systems change will use a socio-ecological model thatconsiders interventions at the individual, social network, community, organizational,environmental, and policy levels. This approach is more effective than focusing solely onindividuals. Higher-level changes make it possible to reach more people at lower cost and createhealth-promoting social and physical environments for people of all races, ethnicities, andincomes. Changes that are incorporated into institutional policies, laws, or regulations are morelikely to be sustained than costly programmatic services.

Implementation Phase Goals and Objectives

The Collaborative anticipates the following five goals for the Implementation Phase (IP):

IP Goal 1: Foster social environments that encourage healthy eating and physical activity, andreduce socioeconomic disparities in overweight, poor nutrition, and physical inactivity.

IP Goal 2: Develop an integrated regional food system that supports local, sustainable

agriculture and provides healthy, affordable food - especially to marginalized communities.IP Goal 3: Create built environments and land use policies that promote physical activity andenvironmental sustainability - especially in marginalized communities.

IP Goal 4: Engage youth and others disproportionately impacted by health disparities inprogram planning, intervention, implementation, and policy development.

IP Goal 5: Continue the participatory, community-based process initiated during the PlanningPhase to realize KCFFI goals.

While the specific objectives and activities to reach these goals will be determined throughcollaborative decision-making during the Planning Phase, the Collaborative Partners havedeveloped a menu of potential objectives and strategies (Appendix 15). Each activity will beevaluated for its impact on reducing disparities, cultural competence, improving social and builtenvironments and health, cost-effectiveness in promoting healthy eating and active living,community acceptability, feasibility of implementation, local food system improvement,sustainability, and other measures of best practice. Benchmarks for the overall success of theKCFFI will be guided by national W.K. Kellogg Foundation FFI objectives, CDC HealthyPeople 2010 objectives, and other objectives determined by KCFFI.

The following strategies provide examples of what KCFFI will consider for inclusion in itsCommunity Action Plan.

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Individual

Promote awareness of links between sustainable food systems, nutrition, physical activity,and health through individual education and social marketing.

Family and social networks

Encourage families to share healthy mealtimes.Encourage families to participate in one hour of daily physical activity together.

Community

Promote creation of and participation in community gardens (including youth gardens) andsmall urban farms, especially in low-income and minority communities.

Institution/organization

In schools: Implement policies to increase availability of healthy, locally produced foods andopportunities for daily, vigorous physical activity; integrate nutrition education for studentsthrough curriculum development and school gardens; extend learning to families (e.g. funand informative family nights aligned with community culture and interests).

In large institutions (e.g. schools, hospitals and government agencies): Enhance access tolocally produced foods for employees through cafeterias, CSAs, and onsite farmersmarkets;stock vending machines with foods that meet rigorous nutrition standards; increase actions topromote physical activity and reduce stress at work; provide incentives that help employeesmake healthier choices at work and home.

In restaurants: increase menu labeling and healthy food choices and provide incentives forrestaurants to serve locally produced foods.

In architectural, engineering and urban planning agencies and organizations: Offer trainingin food and fitness issues and strategies; encourage the use of built environments andhealth checklists and Health Impact Assessments when designing and approving projects.

In the health system: Link patient care to community food and fitness resources; encourage

nutrition education that emphasizes consumption of locally produced foods.

In food banks: Increase availability of locally produced and other healthy food items;conduct cooking demonstrations and health awareness activities.

Environment

Increase the number of safe, quality parks, trails, and recreational facilities so that allneighborhoods have access to spaces that promote physical activity.

Improve access to farmers markets, grocery stores, or produce stands selling locallyproduced foods.

Complete missing sidewalk links so that children can bike or walk to schools, homes offriends and family, and parks.

Develop food distribution systems to link small-medium sized local farms to local markets.

Policy

Implement policies that increase access to local, healthy food for low-income populations(e.g. increased funding and use of the farmers market nutrition programs, EBT machines foreach farmer at farmers markets).

Increase use of Health Impact Assessments for land-use, zoning, and development decisions.

Secure official recognition of the food policy council by local governments.

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Encourage the federal government to reduce and eventually eliminate subsidies for farmcommodities, and to increase support for the production of food by sustainable local farms.

Decrease marketing of unhealthy food to children by voluntary agreements or regulation oflocal television broadcasting and food placement by retailers.

Promote preferential purchasing of local, sustainable food by public agencies and eliminatepolicies that limit geographic preference for purchasing.

Increase public/private funding for parks and trails.

Coordinate land use planning efforts across urban and rural communities, such as integratingaccess to locally grown food with planning for non-motorized transit, economicdevelopment, and physical activity in an urban environment.

Planning Phase Goals and Objectives

The goals of the Planning Phase (PP) focus on developing a diverse Collaborative and aCommunity Action Plan (CAP). Specific strategies for attaining these goals are found in sectionsIII and IV. Measures for each objective are described in Section V (Evaluation Plan).

PP Goal 1: Create a King County Food and Fitness Initiative Collaborative

Objectives:

Create a strong, representative Collaborative based on democratic and inclusive principles,and develop a participatory process for planning and implementing the KCFFI.

Create and build upon existing community networks to engage youth and communitymembers in assessment, program design, advocacy, and policy development.

Take early steps to assure sustainability of the Collaborative and/or its actions by developinga sustainability plan, developing communications strategies, and building a constituency.

PP Goal 2: Develop a Community Action Plan (CAP)

Objectives:

Assess the status of the food system and built and social environments to identify gaps andredundancies in current activities; identify opportunities to expand successful approaches.

Collect information on best and promising strategies for addressing concerns and gaps.

Assess each activity for its impact on reducing disparities, cultural competence, improvingsocial and built environments and health, cost-effectiveness in promoting healthy eating andactive living, community acceptability, feasibility of implementation, potential for improvingthe local food system, sustainability, and other measures of best practice.

Develop a comprehensive Community Action Plan that prioritizes strategies and definesroles and accountabilities for implementation.

Identify two communities for focused KCFFI activities and engage members from thesecommunities in leadership roles.

PP Goal 3: Implement pilot projects to develop effective local approaches for implementing

Community Action Plan strategies

Objectives:

Develop two culturally appropriate pilot projects in focus communities.

Develop two policy background and position papers.

PP Goal 4: Begin integration of current and future food, fitness, and health activities

Objectives:

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Facilitate networking, communication, and information sharing among Collaborativemembers and others interested in food and fitness.

Identify areas of common interest and activity among Collaborative members and others;discuss development of common approaches and tools.

Facilitate collaboration on shared projects or policy work.

Establish linkages among organizations and activities to promote coordination and synergies.

PP Goal 5: Implement a communications strategy

Objectives:

Develop credibility and recognition of the KCFFI among community members, media, anddecision makers though implementation of a communications strategy.

Assure smooth flow of information among Collaborative members.

III.COMMUNITY COLLABORATIVE

A. Collaborative Partners

The Collaborative Partners, their constituencies, and roles in the KCFFI are listed in attachment

B. The newly formed KCFFI Collaborative has strong representation from the regional foodsystem, with participation of local leaders representing rural and urban farms, youth andcommunity gardens, food distributors, restaurants, school nutrition services, farm-to-schoolconnections, food assistance programs, farmers markets, food policy council, retail sales,education, and government. The physical activity and built environment sectors are representedby partners from community based organizations, schools, employer wellness programs,universities, economic development, and government agencies (parks, community development,transportation, and urban planning). Community health partners work in hospitals, schools,community health centers, a foundation, the local health department, and community basedorganizations. The Collaborative will seek more direct participation from the businesscommunity, food distribution and processing entities, faith-based organizations, local funding

entities, and farmers. The Co-conveners have begun attending organizational meetings, usingsnowballing methods to identify interested organizations and leaders, and educating potentialfunders. The Collaborative will strive to create a welcoming and inclusive environment thatprioritizes trust-building and values the contributions of all participants. Through its governancestructures, decision-making processes and culture, the Collaborative will demonstrate that ithighly values diversity of cultures, sectors, and viewpoints.

The KCFFI is facilitating multicultural collaboration by uniting with networks and organizationsconnected to racial and ethnic communities through membership (e.g. Black Dollars Day TaskForce, Seattle Indian Health Board, International District Housing Alliance), affiliation (e.g.faith-based organizations, SeaMar), or mission (e.g. REACH Coalition, Austin Foundation).

Youth will participate in the KCFFII. The Collaborative already counts several youth-focused

organizations among it members (4H of King County, YMCA of Greater Seattle, the AustinFoundation, Childrens Hospital and Regional Medical Center, Cultivating Youth, Food $ense-CHANGE, Passages NW, Steps School Council, and Puget Sound School Gardens Collectiveand is engaging with others (Bike Works, Seattle Youth Garden Works, The Service Board, andGirls on the Run).Youth will participate in the Advisory and Working Groups (see below),collaborate with the Assessment Team through acquiring data on their local food system andbuilt environment, and contribute to development of the Community Action Plan by suggestingactivities and reviewing proposals. During the Implementation Phase, they will conduct food and

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built environment projects, participate in service-based learning, and join in advocacy work.KCFFI will inform its youth engagement strategies by referring to innovative model programssuch as AmeriCorps, BLASTs Youth Initiative, and Youth Infusion.

B. Infrastructure

The proposed structure is a flexible vehicle for encouraging all relevant sectors of the communityto work together towards the goals of the KCFFI. The Collaborative will seek to develop thecharacteristics of successful coalitions described in the literature (Appendix 16).

Structure

The Conveners and Proposal Planning Group developed a provisional structure (Appendix 17). Itreflects the Collaboratives core values of democratic decision-making, shared leadership, andinclusion of diverse constituencies. It offers multiple ways to be involved. The Collaborative willreview, revise, and adopt its structure within the first three months.

Collaborative: Membership in the Collaborative is open to any organization, agency, orcommunity member interested in the Initiative who will participate in regular meetings oractivities of at least one of the component groups described below. The Collaborative will meet

as a whole twice a year.Leadership Council: The Leadership Council (LC) will include representatives from theWorking and Advisory Groups, an at-large member (a member who is not otherwise involved ina Group), and the Conveners (as facilitators). The LC will assure that the mission and vision ofthe KCFFI are realized. It will be the primary decision-making and guiding body of theCollaborative and assure that planning and policy initiatives and evaluation are carried out. Itwill meet monthly. A Fiscal Oversight Committee (a sub-group of the LC) will assure thatresources and funding are used effectively.

Conveners: The Convenerswill facilitate the Collaborative by ensuring that KCFFI efforts stayfocused, that relationships are built and maintained, that additional funding is secured, and thatevaluation efforts are completed. The two Co-conveners will share responsibility for most of the

roles of the Co-convener, including managing day-to-day operations, including organizing andfacilitating meetings, developing meeting agendas with input from the LC, maintainingcommunication, and engaging partners, strategic planning, policy development, staffing of theLeadership Council, support the Working and Advisory Groups, coordinating the Youth Team,representing the Collaborative, fundraising and grant writing, reporting to the grantor andpreparing manuscripts. They will be accountable to the LC. The Conveners will represent theKCFFI to other organizations, coalitions, and media.

Advisory Groups: Advisory Groups will enable meaningful participation of community membersin the planning process. To ensure that diverse community voices are part of the core discussionsand decisions, a Community Member Group (including families and youth) will have threerepresentatives on the LC. Community members will also join Advisory Groups focused on

Initiative topic areas (Physical Activity, Community Health, Local Food Systems - onerepresentative from each to serve on the LC). Additional Advisory Groups or members may becreated once the focus communities are chosen and important constituent groups are identified.

Working Groups: Several Working Groupswill form to develop and participate inimplementation of specific aspects of the KCFFI (Assessment, Communication and Outreach,Policy, Strategic Planning, Evaluation, Youth, and Collaborative Development). These groupswill operate during different phases of the planning process as appropriate. To promote learningand leadership development, community members will be encouraged to take leadership roles in

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the Working Groups and be compensated by a stipend as appropriate. Each Working Group willidentify one member as representative to the LC. The proposed Working Groups include:

Assessment: Oversee year one assessment activities in conjunction with the AssessmentTeam (see below) and then fold into the Strategic Planning Group in year two.

Communication and Outreach: Initiate communication with the media and wider communityduring year one and develop and implement a communications strategy with thecommunication consultant during year two and the Implementation Phase. Promote a diversemembership by recruiting new members from missing groups and sectors.

Policy: Develop policies for the Implementation Phase and seek opportunities to work withother organizations in implementing food and fitness policies during both phases.

Strategic Planning: Develop the Community Action Plan. Form in year two from acombination of the Assessment, Policy and Youth Working Groups.

Evaluation: Oversee the evaluation. Includes the evaluators contracted by the KCFFI (seeSection V) and interested members of the Collaborative.

Youth: Assure youth involvement in the planning process by working directly with youth and

representatives of youth groups.

Ad hoc Collaborative Development: Propose bylaws, standard operating procedures andother governance policies.

The Conveners, with direction from the LC, will recruit Working Group members from currentCollaborative members and add additional members as needed throughout the Planning Phase toassure diverse participation. The Collaborative will select Advisory members based on planningneeds. It will develop criteria for selecting Advisory and Working Group members. The Groups,which will include professionals and laypersons, will be formed within the first four months. Tofacilitate youth and community member participation, the Collaborative will provide meals,childcare, easily accessible meeting locations and times, and incentives. Incentives may includeequipment for physical activity, gift certificates for healthy family activities or farmers marketsand healthy food stores, or cash. In addition, whenever possible, the Collaborative will meetyouth, families and community constituents in their community settings.

Process

Decision Making: The Collaborative will develop an egalitarian and transparent process thatrespects the interests and expertise of all participants and that delegates decision-makingauthority as appropriate. For example, Working Groups will have the autonomy to makedecisions that fall within their scope of responsibility as determined by the LC. Power will beequalized and conflicts resolved by having participants objectively define criteria for guidingdecision-making. Within the first three months, the LC will determine the dollar amount belowwhich Convener Staff will be permitted to make independent decisions.

The Collaborative will make decisions by consensus. If members do not reach consensus theywill attempt to address the concerns of the minority to achieve a decision that all can moveforward with. Appendix 18 contains a description of the proposed consensus process.

Communication: The Collaborative will develop an internal communication plan that identifieswhat information needs to be conveyed to Collaborative members, preferred communicationmethods (e.g. phone, email, website, list serves, newsletters, meetings, specialty publications,events, etc.), and a schedule of communication. When appropriate, meetings will include socialtime for networking, developing relationships, and building trust. Retreats for teambuilding and

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strategic planning will be held annually with additional retreats as needed. Meeting minutes willbe distributed by email and posted to a central web site.

Learning:Learning will be integral to the Collaboratives functioning. Members will learnthrough presentations, networking, study circles, newsletter items, retreats, workshops, and website content. Members will make brief presentations at meetings to share knowledge of their

organizations and communities. The Collaborative will model a culture of physical activity andhealthy eating by integrating both into meetings and events. The Conveners, with assistance froma Consultant, will host a workshop for development of leadership skills and for learning aboutmeeting facilitation, cultural competency, social justice, conflict resolution, and coalitionbuilding in year one.

Leadership/Governance:The Collaborative will adopt a model of shared leadership. The LC willhave overall responsibility for KCFFI. Sylvia Kantor (WSU KCE) and Erin MacDougall(PHSKC) will act as Conveners on behalf of their organizations to support the LC.

Administration:The Proposal Planning Group chose Public Health - Seattle & King County asthe named grantee and fiscal agent (See Section VII for further detail). With 2,000 employeesand an annual budget over $235 million, PHSKC has a proven track record as the administrativeand fiscal agent for complex, coalition-based community health projects funded by large federaland private grants. PHSKC has accounting staff and services in place to monitor budgets, issueand monitor subcontracts, and generate fiscal reports.

Conveners:The Proposal Planning Group selected PHSKC and WSU KCE as the Conveners.Between them, these organizations provide broad and deep access to the content areas andstakeholders relevant to this Initiative.

The mission of Public Health - Seattle and King County is: "To provide public health servicesthat promote health and prevent disease to King County residents in order to achieve and sustainhealthy people and healthy communities." PHSKC is recognized for its progressive public healthprogramming in many areas, including chronic disease prevention and addressing the linkage

between built environment and health. PHSKC has managed complex, coalition-basedcommunity health projects such as REACH 2010, King County Asthma Forum, Allies AgainstAsthma, King County Physical Activity Coalition, and Steps to Health (Appendix 5). To supportthese coalitions, PHSKC has established communication systems, organized regular and specialmeetings, developed strategic planning processes, identified routes to sustainability, providedstaff support to elected (non-PHSKC) leadership and committees, managed data systems, andoverseen evaluation activities. Central to this role, PHSKC has demonstrated its commitment toparticipatory community-based public health practice.

Washington State University King County Extension has served the local food and farmingcommunity for nearly 100 years, bringing Washington State University food and agricultureexpertise and resources to the community. It provides leadership in agriculture and the

stewardship of land; creates confident, public-service-oriented citizens through the 4-H programand adult leadership training; delivers evidenced-based nutrition programs that target low-income families with youth; and strengthens families and the viability of communities. It leadsefforts to develop the food policy council, build farm-to-school connections, and providesupport for and technical assistance to area farmers, including targeted outreach to immigrantcommunities. In addition, it has developed a $785,000 nutrition education program serving low-income youth called Food $ense CHANGE Cultivating Health and Nutrition throughGardening Education (Appendix 19). This program generates half its budget through community

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matching funds and in-kind work, and typifies the community-based approach of all WSU KCEprograms.

C. Collaborative History

Seattle/King County has an extensive history of cross-sectoral collaborations, communitybuilding, and participatory planning. Brief descriptions of several local coalitions are containedin appendix 5. In the area of food and fitness, strong coalitions exist in food systems (e.g. ActingFood Policy Council, Cascade Harvest Coalition, Sno-Valley Tilth), overweight and health(Steps to Health KC, Overweight Prevention Initiative, KC Physical Activity Coalition, FeetFirst), and the built environment (Transportation Choices Coalition), and all currently are, or areexpected to soon be, KCFFI participants.

For example, King County Steps to Health is a $9 million, CDC-funded, five year initiative thataims to reduce the impact of chronic diseases through preventing and controlling asthma,diabetes, and obesity; promoting a comprehensive approach that coordinates actions at theindividual, family, clinical, school, and community levels; integrating interventions addressingmultiple chronic conditions; and reducing health disparities. Steps has more than 75 members,including community-based organizations, health care providers, hospitals, health plans, clinics,universities, faith-based groups, government agencies, and school districts. Activities related tofood and fitness include teaching groups how to shop for healthy foods; successfully promotingschool policies that discourage sales of non-nutritious foods and encourage physical activity (seeAppendix 11); promoting housing and community development policies that support physicalactivity, nutrition and healthy environments; developing capacity to apply Health ImpactAssessment methods to land use decisions; and supporting programs that encourage physicalactivity (e.g. running groups for adolescent girls, walking groups, biking to school, mentors,personal trainers) and good nutrition (e.g. food preparation demonstrations, healthy snacks).Steps has successfully integrated built environment and community health efforts. The Stepscoalition is a member of the KCFFI and Steps members are also participating in the Initiative(e.g. Austin Foundation, Bike Alliance, Bike Works, Feet First, Girls on the Run, PHSKC,Strong Kids, Strong Teens).

The Overweight Prevention Initiative has likewise brought together community health and builtenvironment concerns. It has created a strong network of researchers, clinicians, urban planners,policymakers, educators, and public health professionals to address obesity through programs,policies, and systems change (Appendix 8).

While some coordination is occurring across these partnerships (e.g. REACH and Stepsparticipate in the Overweight Prevention Initiative, Steps used the OPI policy goals to guideselection of its policy priorities), much more is needed to develop an integrated, cross-sectoralapproach to food and fitness. This RFP provides an ideal opportunity to do so by building on afirm foundation and the strong interest among the coalitions for further collaboration.

D. Challenges and OpportuntiesThe joining of diverse individuals and organizations in the KCFFI has presented both challengesand opportunities. Members have encountered diverse communication styles and varieddisciplinary cultures, languages, and values. They have more to learn about building thesedifferences into strengths though improving communication skills and appreciating differences.The rapid pace of preparing the application did not permit as participatory a process as manymembers desired. Conveners have noted issues that need more discussion and the Collaborativewill address these in the coming months. Maintaining a balance between process and product

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that suits all members will be a challenge. The Collaborative recognizes the need to engageadditional stakeholders who are not participants. Bringing them to the table will be anopportunity to create connections between sectors working in isolation. This is perhaps thegreatest opportunity presented by the Initiative. Participants have been impressive in theircommitment to building systems and looking beyond narrow organizational interests. Yet the

Collaborative undoubtedly will run into conflicts between organizational and Collaborativegoals, and will need to support individual organizations while addressing systems-level issues.

IV.PLANNING APPROACH AND TIMETABLE

The goals of the Planning Phase are described in Section II. This section outlines how goalsrelated to the planning process (PP goals 2, 3 and 5) will be implemented.

PP Goal 2: Develop a Community Action Plan (CAP)

The CAP will include the goals, objectives, and strategies for the Implementation Phase, a logicmodel, a specification of the roles of Partners in implementing the activities, and a timeline. Thefollowing steps will lead to development of the CAP.

Community Assessment

The community assessment, completed in year 1, will describe the production, distribution, andaccess to locally grown food and features of the built environment that promote active living. Itwill guide the selection of the two focus communities, lay the groundwork for developing theCommunity Action Plan, and provide baseline measures for evaluation of the Initiative. Potentialassessment items, measures, and data sources are described in appendix 3. Using participatoryassessment methods, an expert Assessment Team will work closely with the Collaborative todesign the assessment process, select appropriate measures and activities, review and interpretdata, and present findings. Multiple qualitative and quantitative assessment methods will beemployed based on established approaches.4, 5, 6, 7, 8

Qualitative Assessment: Ethnographic methods will be used to collect qualitative assessmentinformation on food and fitness issues and strategies. The analyst will conduct key informant

interviews with 10-15 individuals knowledgeable about food systems, built environments, andaccess to food in King County, including members of the Leadership Council and individualsrecommended by the Collaborative. She will conduct five group interviews to understandbarriers and opportunities for physical activity and access to healthy food.9 Potential groupscould include: youth; parents; farmers, distributors and sellers; retail market managers; schoolstaff; community council members; city and county planners; planning council members; andcommunity center staff. Some of the interviews will be conducted in a language other thanEnglish, reflecting the ethnicities involved in this project. Youth will add data by conductingpeer interviews. A sample question guide and data collection plan are in appendix 20.

Discussions with community organizations and boards: The Collaborative will directly engageresidents and organizations from the focus communities to discuss food and fitness issues and

strategies through community forums and meetings with organization staff and boards.Community audits: Initiative staff will support youth and adult community members inconducting walking/biking audits and community food assessments of the focus communitiesusing standard tools (Appendix 21). Staff will support youth in using photo voice methods. 10This approach allows youth to visually document and communicate their experiences regardingcommunity assets and barriers related to food and fitness. Assessment staff will work withinterested residents and the Leadership Council to analyze these data (including GIS methods).

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Analysis of archival materials: Staff will collect, catalog, and analyze archival materialsdescribing local activities related to the built environment and health, food systems, growthmanagement and long range urban growth boundary planning, regulations and policies, programmaterials, and evaluations of local, community-based health/food/built environment initiatives.For example, the Sound Food Report2 is an assessment of the current food system. These

materials will provide the contextual background (e.g. historical and political factors) necessaryto build this Community Action Plan.

Quantitative Assessment: Staff will analyze data from several secondary data sets (and collectlimited primary data) to provide a quantitative description of food and fitness issues and assets.Data sets include public-access geospatial data on the built environment collected and organizedby the University of Washington Urban Form Lab (Appendix 22) and geocoded individual-levelpopulation-based socioeconomic, risk, and health outcome data from Behavioral Risk FactorSurveillance System (BRFSS), vital records, and other sources. See appendix 3 for a list ofpotential variables. For example, staff will produce maps at the regional level to display foodsystem and transportation assets and barriers. Detailed maps at the neighborhood level will showlocations of parks and playgrounds, gaps and hazards in walking and biking routes, locations of

local healthy food sources (e.g. retailers, schools, hospitals, community centers), and locations ofless healthy fast foods. BFRSS data will describe physical activity and nutrition behaviors andoverweight prevalence, and vital records/hospitalization data will show disease rates. Data willbe analyzed at the community and county levels.

Assessment Team: The Assessment Team will include faculty and staff from the University ofWashington, WSU KCE, and PHSKC. See appendix 23 for Assessment Team members,affiliations, and expertise.

Policy Assessment

An inventory of regional food and fitness policy activities (historical and current) will be createdthrough key informant and group interviews and a review of web sites and public documents.Policies will be entered into a database modeled after the ENACT Local Policy Database andposted on the KCFFI website for local and national use.

Identification of CAP Objectives

Beginning in year two, the Strategic Planning Working Group will use the assessment findings toidentify issues at the regional, county, and neighborhood level and review assets, resource gaps,and barriers to addressing those gaps. The Group will present this analysis to the LC at a formaltwo-day retreat (with external facilitation). Using a charette model and nominal group process,the LC will agree upon objectives for the CAP. Staff will then present these objectives to keyinformant and group interview participants and selected CBOs for further comments. The LCwill then finalize its choice of objectives.

Review of Best and Promising Practices

The next step will be to collect best and promising practices for attaining CAP objectives. Staffwill identify model policies and programs through website searching, literature reviews,discussion with other FFI sites and program staff, and expert consultation (Appendix 24). Theinformation will be summarized using a standard template that includes a description of thestrategy, evidence of effectiveness, estimated local feasibility of implementation (including aSWOT analysis of policy options), estimated costs, potential implementing organizations, likelyimpact on disparities, ease of sustainability, and fit with existing activities. Summaries will bereviewed and modified by the Advisory and Working Groups.

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Selection of CAP activities

At a second facilitated retreat, the LC will review potential interventions emanating from the bestand promising practices review and suggestions generated from key informants, groupinterviews, and community outreach meetings. Members will suggest additional interventions.Local experts in food systems, built environments, nutrition, and physical activity will be invited

to serve as information resources. Members will prioritize activities using standard groupdecision-making methods (e.g. nominal group process). The process will integrate organizations,activities, and advocacy using methods developed by local coalitions such as Steps and AlliesAgainst Asthma (Appendix 25). Another round of community consultation will occur, in whichkey informants, group interview participants, and CBOs will review and comment on theselected strategies. The LC will review this input, develop a final list of priorities, and determinehow resources will be allocated for strategy implementation.

PP Goal 3: Implement pilot projects to develop effective local approaches for implementing

Action Plan strategies

Some ideas could be to:

Develop background and position papers on policy initiatives.Develop small-scale projects such as community gardens in focus neighborhoods, a trial of

CSA in a public housing site, school-based garden programs, or food service changes.

PP Goal 5: Implement a communications strategy

The Collaborative will develop and implement a communication plan in the second year with theassistance of a communications consultant to engage and inform community residents andorganizations about the Initiative and leverage support for policies, funding, and implementationfrom local public and private sector leaders. Specific objectives include:

Develop a compelling presentation on food and fitness and the CAP (this might include aDVD or PowerPoint presentation, brochure, press kit, talking points, or website content).

Create a media outreach strategy; track and distribute news coverage and articles to Initiativeparticipants and other target audiences.

Develop updates on the Initiative, ways to be involved, exciting developments, and successstories in order to increase the visibility of the Collaborative.

Train Collaborative members in media techniques including: responding to unexpectedmedia opportunities, identifying key messages, interviewing skills, publishing op-eds andguest columns, pitching talk shows, and preparing letters to the editor and blog comments.

Assist staff with development of internal communication mechanisms.

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TimelineActivity Year 1 Year 2

Qtr 1 Qtr 2 Qtr 3 Qtr 4 Qtr 1 Qtr 2 Qtr 3 Qtr 4

Community Assessment

Qualitative data collection and analysis

Archival analysis

Community discussions

Community auditsQuantitative data analysis

Policy Assessment

Develop database of past and current policies

CAP Development

Determination of CAP objectives

Review of best and promising practices

Selection of CAP strategies/activities

Pilot projects

Identify topics for projects

Implement and evaluate projects

Collaborative Development

Finalize structure and governance

Outreach

Communications

Develop external communications strategy and resources

Develop internal communications methods

V.EVALUATION

The KCFFI is a complex, multi-level program and evaluating it will be a complex undertaking.Evaluators will look to the emerging systems thinking approach as a framework for theevaluation.11, 12 They will use methods for capturing systems change developed in previouswork.

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A. Outcome Measures

Planning Outcomes

Five goals are outlined above for the Planning Phase. With respect to the first goal, creating theKCFFI Collaborative (PP1), the outcome measures will include participant satisfaction withprocesses, diversity of members, number of youth participating, representation from key sectors,

satisfaction with leadership, diversity of leadership, number of collaborative actions initiated byyouth and residents and number of sustainability actions identified and initiated. Data will beanalyzed separately for youth in order to assess youth engagement.

Evaluators will assess attainment of goals PP2 and PP3, developing a CAP and implementing thepilot projects, by seeking evidence of task completion.

Outcome measures associated with integration (PP4) include density of communication linkages,number of tools and approaches developed jointly by KCFFI members, number and descriptionof joint projects and policy initiatives, density of coordination linkages among members, numberof cross-referral mechanisms established, and number of activities coordinated.

Finally, outcome measures for developing a communications strategy (PP5) include componentsof strategy implemented, number of contacts, number of media mentions, satisfaction withknowledge of initiative, and ease of communicating with other members.

Implementation Outcomes

Five overall implementation goals are outlined in this proposal, related to social environments,integrated food systems, built environments, engaged youth, and a participatory communityprocess.

Distal outcomes: The first three goals are ambitious, targeting overarching community systemsand norms, and it will be challenging to demonstrate a measurable change in distal outcome

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measures (e.g. overweight prevalence or physical activity levels) specifically attributable toKCFFI activities. As a result, the outcome measures will focus on outcomes that are moreproximal to the activities of KCFFI; for example, specific changes in the built environment thatthe partnership targets (e.g. a walking trail) or evidence of greater access to locally producedfoods for employees in cafeterias. It may be possible to measure population-level distal outcome

changes in the two local communities and attribute those changes to KCFFI. Examples of theseoutcomes are included in appendix 3 and might include prevalence of overweight, physicalinactivity, inadequate fruit/vegetable consumption among children and adults, number andlocation of farmers markets, or proportion of selected foods sold by community retailers.

Intermediate outcomes: Intermediate outcomes related to systems and policy changes will beprimarily qualitative; for example, descriptions of changes in community-level food systems,changes in the built environment, and changes in policy. For each community change, theevaluators will measure to the extent possible both the reach of the change (e.g. how manypeople are affected), and the intensity of the change (e.g. magnitude of effect on each affectedperson), to the extent possible. Most of the intensity information will come from previousstudies; for example, estimates of the effect of implementing a walking trail on physical activity.

Youth Engagement: Outcomes related to youth engagement (IP4) will include number of youthinvolved in KCFFI, a description of their roles, a self-rating of the impact they have had and thedegree to which they have been engaged.

Community Engagement: Assessment of the community process (IP5) will focus on theCollaborative itself, continuing to track measurements of effective collaborative functioning.Additional community process outcomes will include the degree to which potential communitypartners, outside the formal process, have been engaged.

B. Data

Planning Data:The evaluation of the planning process will rely primarily on qualitative data:participant observation at meetings, interviews with members and other community stakeholders,

reports, meeting notes, attendance lists, planning products, and activity logs of key staff.Qualitative data will be supplemented with a closed-ended partnership member survey, assessingsatisfaction with the partnership, based on the California Health Endowment Partnership Survey(Appendix 26).

Implementation Data:Implementation data on proximal policy and systems change outcomeswill come primarily from documents and interviews with representatives of sectors where thesystems/policy changes are occurring. Estimates of the reach and intensity of communitysystems and policy changes will come from documents, project logs, and literature on the impactthese changes have had in other settings. Outcome data related to youth engagement and thecommunity process will come from surveys, interviews, meeting minutes, and other documents.Data on project reach will be collected with an online database (Appendix 26).

Principal long-term outcome measures at the local community level such as population-levelchanges in diet, physical activity, and accessibility of healthy food options, will come fromsecondary data sources when available and primary data collection if necessary. Secondarysources for measuring individual-level behavior change include the Healthy Youth Survey(Washington State version of the Youth Risk Behavior Survey) and BRFSS.Primary sourcesmay include community walking audits and community food assessments, carried out byUniversity of Washington students, youth, and other community members (Appendix 3).

C. Design

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D. Collaborative Process

The Evaluation Team uses a collaborative approach in all of its evaluation work, involvingcommunity members and other stakeholders in the process. Following past practices, theevaluators will lead the Evaluation Working Group comprised of stakeholders who provideongoing feedback and input on key decisions. In addition, the evaluators will create opportunities

for feedback from all Leadership Council participants on key decisions (design, data collectionmethods and instruments, analysis, and interpretation) that minimize the time required but alloweveryone to be aware of evaluation status and to offer feedback. Often, feedback is elicitedthrough periodic evaluation presentations at Leadership Council meetings. This approach assuresbroader community representation. The Evaluation Working Group will work with theLeadership Council to identify the best approach to communicate evaluation results that may beuseful for refining and improving the planning process. This will include brief summary reportsof specific survey activities and presentations to partnership meetings.

E. Evaluation Leadership

The evaluation will be led by the Group Health Community Foundation Evaluation Team, whichhas conducted evaluations of several large-scale community-based initiatives (more fullydescribed in Appendix 26 and Attachment C) including the Kaiser Permanente (KP) CommunityHealth Initiative, which is using an approach similar to the W.K. Kellogg FFI to promote healthyeating and active living in 14 communities in 8 KP regions. Most of these initiatives included aplanning or start-up phase focusing on development of community action plans andforming/strengthening community coalitions. Allen Cheadle PhD, Research Professor atUniversity of Washington School of Public Health, will lead the Evaluation Team. He has ledmany of the Group Health evaluations (Appendix 26, Attachment C).

VI.OTHER FUNDING RESOURCES

The prospect of W.K. Kellogg Foundation funding and excitement with the vision of the KCFFI

have allowed the Collaborative to leverage significant additional resources. The Conveners havepledged resources valued at $217,477 for the two-year period. Funding sources for WSU KCEare state funds (through WSU) local funds (through King County, including general tax revenuesand water quality), and federal pass-through dollars. PHSKC resources are from state dollarsallocated to local health jurisdictions to support capacity development. In addition, severalCollaborative Partners have committed to leverage resources for a total of $337,349 in additionto 486 hours of staff time (dollar amount not specified) (Attachment B).

The Seattle Foundations Healthy Kids Fund has pledged $50,000 contingent upon receipt of thegrant. Funds will be used for a discrete project to augment assessment activities, with emphaseson improving access to healthy foods, and improvement of the regional food and farming system.The Collaborative has identified additional areas of interest and will continue to seek funding

during the planning years to enhance the proposed scope of work.

VII.DESCRIPTION OF THE APPLICATION PROCESS

This planning grant was prepared through a participatory process. On October 18, 2006 PHSKCconvened a facilitated meeting of those who were involved in preparing the Letter of Intent aswell as additional organizations interested in the proposal for the Planning Phase of the Initiative(Appendix 27). At this meeting, participants decided on a process for selecting a fiscal agent,selected the Conveners, and identified Collaborative Partners for the Planning Phase based on a

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set of mutually agreed upon criteria (Appendix 28). A Proposal Planning Group open to allinterested participants was formed (Appendix 29). Facilitated by the Conveners, this group metin person five times and exchanged numerous emails and phone calls to develop this proposal(Appendix 30). The Conveners prepared an initial draft of the proposal with assistance fromplanning group members. The evaluators prepared a draft of the evaluation section and PHSKC

and UW staff prepared a draft of the assessment section. The planning group reviewed eachsection and Conveners made revisions. The Conveners integrated these components into the finalfull proposal, which they sent out for email review. A draft budget was prepared by theConveners, and along with the final version of the narrative, was approved by the ProposalPlanning Group.

1 Ostrom, M, et al. 2005 King County Food System Atlas, WSU CSANR Technical Report 2005-05-10 (2005).

2 Garrett, S, et al. Sound Food Report: Enhancing Seattles Food System, (2006).

3 Whats Health Got to Do with Growth Management, Economic Development and Transportation? (2006).

4 Beebe, J. Rapid Assessment Process: An Introduction. Walnut Creek, CA: AltaMira Press (2001).

5 Mizoguchi, N, et al. A Handbook for Participatory Community Assessments: Experiences from Alameda County.Oakland, CA: Alameda County Public Health Department (2004).

6 Heaven, C. Developing a Plan for Identifying Local Needs and Resources. Ed. K. Nagy and J. Schultz. CommunityToolbox. 2003. University of Kansas. March 2004. http://ctb.lsi.ukans.edu - Accessed 12/4/06.

7 AssessNow: A Washington State CDC funded assessment clearinghouse. http://www.assessnow.info/ - Accessed12/4/06.

8 Israel, Barbara A, et al. eds. Methods in Community-Based Participatory Research for Health. John Wiley andSons: San Francisco, CA (2005).

9 Keiffer, E, et al. The Application of Focus Group Methodologies to Community-Based Participatory Research inMethods in Community-Based Participatory Research for Health. Israel, Barbara A., Eugenia Eng, Amy J. Schulz,Edith A. Parker, eds. John Wiley and Sons: San Francisco, CA (2005).

10 Lpez, E, et al. Photovoice as a Community-Based Participatory Research Method: A Case Study with AfricanAmerican Breast Cancer Survivors in Eastern North Carolina in Methods in Community-Based ParticipatoryResearch for Health. Israel, Barbara A., Eugenia Eng, Amy J. Schulz, Edith A. Parker, eds. John Wiley and Sons:San Francisco, CA (2005).

11 McLeroy K. Thinking of Systems. Am J Public Health 96:402 (2006).

12 Leischow S, Milstein B. Systems Thinking and Modeling for Public Health Practice. Am J Public Health 96:403-405 (2006).

13 Cheadle A, et al. The California Wellness Foundation's Health Improvement Initiative: Evaluation Findings andLessons Learned. Am J Health Prom;19(4):286-296 (2005).

14 Thyer BA. Promoting Research on Community Practice: Using Single System Designs. Research Strategies forCommunity Practice. J Community Practice. Supplement 1: 47-61 (1998).

15 Biglan A, et al. The value of interrupted time-series experiments for community intervention research. Prev Sci.Mar 1(1):31-49 (2000).

16 Yin RK. Case Study Research: Design and Methods. Applied Social Research Methods Series. Thousand Oaks:Sage Publications (1994).

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