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2015-2016 Project Diabetes Grant

Worksite Wellness

Mini-Grant Application

This project is funded under an agreement with

the State of Tennessee.

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2015-2016 Project Diabetes Worksite Wellness Mini-Grants

What is the purpose of the worksite wellness mini-grants?

The Knox County Health Department (KCHD), in partnership with the Tennessee Department of Health through funding from the Project Diabetes grant, is glad to announce grant funding available to worksites in Knox County. The mini-grant funding will assist worksites in developing and implementing nutrition and physical activity related programming and initiatives. The goal of these grants is to provide resources to worksites whose employees are facing disparities that put them at higher risk for developing diabetes and other chronic diseases. Employers will work with KCHD staff to make changes that will result in long-term programs, environmental changes or shifts in worksite culture. As we strive to make Knox County a healthier place to live, we encourage you to apply for one of eight (8) $2,500 reimbursement grants to promote wellness at your workplace.

Why should you apply?

Employers with successful wellness programs have lower rates of sick leave and absenteeism, lower health care costs and less employee turnover.

Employees participating in a wellness program typically experience increased energy, confidence and self-esteem.

Grant recipients will consult with professional and experienced staff.

Grant recipients will receive up to $2,500 to provide worksite wellness initiatives to promote healthy behaviors related to nutrition, physical activity and weight management.

Who can apply?

For profit and non-profit worksites with a Knox County address.

When are the grant applications available and when does funding start?

Project Diabetes Mini Grant Timeline

Date Activity

Monday, August 24, 2015 Applications open

Thursday, September 24, 2015 Applications due

Monday, November 2, 2015 Grant recipients announced

Mid November, 2015 – Friday, April 29, 2016

Project implementation (beginning after subcontract finalization)

Friday, February 12, 2016 Mid-project report and success stories due

Friday, May 6, 2016 Final project report and success stories due

May 2016 (Exact Date TBA) Recipients may be asked to present at the East Tennessee Wellness Roundtable (ETWR).

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How may grant funds be spent?

Guidelines o A total of $2500 will be reimbursed. All funds can be spent on sustainable purchases;

only $1000 can be spent on non-sustainable purchases. See below for more guidance. o Funds cannot be spent on resources that will go to branches outside Knox County. o You will not be reimbursed for gift cards, gift certificates, cash prizes or similar

monetary awards. o Funds cannot be spent on office equipment, computer hardware, staff time or salaries,

travel, professional development, mileage or commercial wellness packages. o Employees cannot be asked to pay a fee, co-pay or in any other way be charged to

participate in or utilize equipment, programs or other items funded by the mini-grant. o KCHD staff must approve budget items prior to purchase – no exceptions. o An example budget has been provided as Appendix B.

Sustainable items (Up to $2500 total) o A sustainable item is an item that will remain with the workplace beyond the grant

timeline and can be used towards ongoing wellness efforts.

Examples: exercise equipment, employee kitchen supplies (to encourage bringing lunch from home), refrigerated vending machines, lactation room supplies or signage for healthy programs.

o To extend grant funds, exercise equipment purchases are limited to:

Treadmills and ellipticals (Up to $750 each)

Stationary bicycles and televisions for exercise DVDs (Up to $500 each)

If more expensive equipment is desired, worksites may pay the remainder of the cost.

Non-sustainable items (Up to $1000 total) o A non-sustainable item is any item consumed, given to employees to keep or a service

not permanently available.

Examples: incentives, group fitness instructor or registered dietitian fees, food, equipment given to employees (that will not be returned) and biometrics.

o Food (Up to $500)

No vending subscriptions.

Food purchased with grant funds must be consistent with the recommendations from the Dietary Guidelines for Americans. Menu items must be reviewed by Khrysta Baig, a registered dietitian, prior to purchase.

Food purchases must strategically incentivize employee involvement. o Rewards/Incentives (Up to $250)

Items given to employees to keep.

Example: Pedometers given to employees (unless a sign-out sheet is utilized and equipment is considered worksite property).

Budget Changes o If awarded a mini-grant, all budget changes must be approved prior to making the new

purchases. o You will be asked to revise your budget if items are not in compliance with guidelines.

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How will the application be scored?

Please use only the space provided to respond to the application. Supplemental materials may be attached, but applications will be scored using the answers given in the space provided. Applications will also be evaluated for how clearly and consistently the goals, intervention, evaluation and timeline of the program are articulated and the likelihood that the intervention will meet the goals described. The uniqueness and fit of the intervention to your site will be evaluated. Goals should be measurable and achievable within the timeframe (ex: 30 employees will use exercise flex time at least once each week after implementation of policy; NOT: Staff will have a lower diabetes incidence rate following the intervention). Goals focused on sustainable interventions which address healthy lifestyle behaviors are preferred. Promoting healthy lifestyle behaviors, chronic disease prevention and weight management may take non-traditional forms such as making a lactation room, programing to promote adequate sleep, management training on the importance of work-life balance for employee health and implementation of policies to promote stress reduction. It is important that budget items are consistent with the guidelines from the section “How may grant funds be spent?” Applications with budgets which do not comply may be dismissed from review. During the review of applications, sustainable programing and culture changing interventions will be scored more favorably than one-time events and programs (such as weight loss challenges). One-time events, annual programs and other non-sustainable interventions will be considered, but the site may be asked to modify their plans to add a sustainable component prior to contract award. Additional points will be given to sites which sign (or have signed) the “Breastfeeding Welcomed Here” pledge prior to submission of their application. For more information or to sign the pledge, please visit: tn.gov/health/article/breastfeeding-welcomedHere

Are there resources about sustainable worksite wellness?

The East Tennessee Wellness Roundtable o An organization of worksite wellness professionals which meets every other month to

learn about current topics and trends in the field of wellness o Membership is free. Join here: etwellness.org/join-etwr/

The CDC Worksite Health ScoreCard o Contains guiding materials for assessing your current worksite culture and may provide

insights into areas for potential change. o The scorecard can be found here: www.cdc.gov/dhdsp/pubs/docs/hsc_manual.pdf

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How can our business apply?

Complete and submit the grant application including Appendix A.

Application MUST BE RECEIVED on Thursday, September 24, 2015 o Application may be submitted via email to Khrysta Baig at

Khrysta.Baig@knoxcounty.org o Other methods of submission must receive prior approval.

Questions?

Please contact Khrysta Baig at 865-215-5304 or by email at khrysta.baig@knoxcounty.org

__________ (KCHD use only)

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2015-2016 Project Diabetes Worksite Wellness Mini-Grant

Application

Contact Person’s Name and Title (Will receive all mini-grant communications)

Organization

Address of Organization

City, State, Zip

Phone

Email

Secondary Contact (Someone who should also receive all mini-grant communications)

Email

Name and Title of Legally Binding Agent (Someone who can legally sign agreements for your organization)

The Legally Binding Agent has been informed of this application. (Required)

__________

(Typed Initials of Contact Person)

__________ (KCHD use only)

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Description of Proposed Project

1. Please tell us your overall plan for promoting wellness at your facility. If awarded the mini-grant funds, what programs, policies or environmental changes would you make at your worksite?

__________ (KCHD use only)

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Timeline

2. Referring to the proposal outlined in Question 1, please provide a projected time frame for

mini-grant activities. Briefly include planning, major purchases, promotion to employees, initiative implementation and evaluation activities. Appendix C is a three month example timeline. Boxes may be left blank if no activities are proposed for that category during the month.

Mid-November

December

January

__________ (KCHD use only)

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February

March

April

__________ (KCHD use only)

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Supporting Questions

3. Referring to your proposal outlined in Questions 1 and 2, in what ways will your proposed

project or initiatives promote nutrition and/or physical activity in your workplace?

4. What is the goal(s) your workplace seeks to achieve with the wellness program outlined in Question 1? Please provide up to three goals below. Goal #1:

Goal #2: Goal #3:

5. Please describe staff and administrative support for wellness efforts at your workplace. Is there a wellness committee? Wellness champions? A dedicated staff member? Applicants will not receive fewer points during scoring if there is currently not a wellness committee or permanent staff member in place.

__________ (KCHD use only)

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6. Program Setting: Within Knox County, where will your program be delivered?

Sole location of business

Off site/branch/satellite location

Corporate headquarters

7. Who will the wellness programming primarily be offered too? Please provide an estimated

number range of those who will have access to all or any elements proposed in Question 1. Employees

Employees spouse

Employees dependents

8. Anticipated secondary beneficiaries. Please provide an estimated number range of those who will have access to all or any elements proposed in Question 1. Community members

Clients or customers

Partners

9. How will employees and other target audiences be encouraged to participate in your wellness program? List specific ways you will encourage participation for each of the major components of your proposal in Questions 1 and 2. Common methods include using buddy systems, point reward systems, email, flyers, posters, staff meeting time, breakroom reminders and the strategic use of incentives to encourage participation. Be creative.

__________ (KCHD use only)

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Budget Justification

10. How will these budget items contribute to recurring efforts and overall commitment to

worksite wellness, such as policies or environment changes? How will you continue worksite wellness and mini-grant activities after grant funding ends?

Conclusion

11. Referring to Questions 1 and 4, how will you measure the outcomes of the program and achievement of goals?

12. Why is this program worthy of a Project Diabetes worksite wellness mini-grant? What makes it unique?

__________ (KCHD use only)

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Worksite Demographics

13. Provide your best estimate of the following demographics of those who will have access to all or any elements proposed in Questions 1 and 2. Please do not leave responses blank.

a. Number of employees

b. Employee Age Age range:

Average age:

c. Employee Gender Male:

(Percentage) Female:

d. Employee Race/Ethnicity White/non-Hispanic: Asian:

(Percentage) African American: American Indian:

Hispanic/Latino: Other:

e. Employee Pay

(Percentage)

Hourly:

Salary:

Income: Less than 25,000/year

25,001 – 35,000

35,001 – 45,000

45,000+

14. Please describe a brief description of your employees’ daily habits and discuss the wellness

culture of your business.

Breastfeeding Welcomed Here

15. Would your business be willing to sign the “Breastfeeding Welcomed Here” pledge, stating that you will welcome breastfeeding mothers at your place of business and will educate staff regarding the Tennessee law which ensures a woman’s right to breastfeed in public? During application review, additional points will be given to businesses which have signed the pledge prior to application submission. For more information or to sign the pledge, please visit: tn.gov/health/article/breastfeeding-welcomedHere

Already signed Have not signed

Appendix A (Attachment 3): Project Diabetes Worksite Wellness Mini-Grant Budget __________ (KCHD use only)

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Anticipated Month of Purchase

Equipment/Supplies Category* Quantity Cost ($) Total Cost

Grand Total *Please indicate which category of spending you believe each purchase reflects. See the section “How may grant funds be spent?” for more information. S = Sustainable (Up to $2500 minus NS); NS = Non-sustainable (Up to $1000 including I&P); I&P = Incentives and Prizes (Up to $250)

Appendix B: Example Budget __________ (KCHD use only)

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Anticipated Month of Purchase

Equipment/Supplies Category* Quantity Cost ($) Total Cost

November Pedometers (to be signed out) S 50 5 250

December Exercise bike S 1 250 250

December Treadmill S 1 600 600

December Yoga mats S 15 15 225

December Exercise DVDs (including yoga and power walking) S 20 5 100

December Water bottle, hand weight set, exercise bag prize for pedometer challenge

I&P 2 35 70

December Flyers and posters printed NS 1 30 30

December Walking route mile markers S 8 10 80

December Blender, cutting board, knife, knife sharpener, can opener, colander & misc. kitchen items

S 1 150 150

December Large fridge magnet about benefits of bringing food from home

S 1 35 35

January Fruit, low-fat yogurt and granola for challenge launch breakfast

NS 1 150 150

January Packing a healthy lunch & snacks - dietitian fee NS 1 200 200

March Pedometer/Accelerometer/Watch prize for person who attends most walking groups

I&P 1 160 160

April Grocery store tour NS 1 200 200

Grand Total 2500 *Please indicate which category of spending you believe each purchase reflects. See the section “How may grant funds be spent?” for more information. S = Sustainable (Up to $2500 minus NS); NS = Non-sustainable (Up to $1000 including I&P); I&P = Incentives and Prizes (Up to $250)

Appendix C: Example Timeline __________ (KCHD use only)

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Mid-November

Planning: Create system for checking out pedometers. Information for fridge magnet. How we will measure walking routes. Ask: What exercise DVDs will our employees use?

Purchases: Pedometers

Promotion:

Implementation:

Evaluation:

December

Planning: Finalize fridge magnet, posters and flyers. Have them printed. Determine locations for mile markers. Plan January launch of walking groups, identify leaders.

Purchases: Buy exercise equipment, DVDs, small prizes for pedometer challenge, flyers, posters, fridge magnet and healthy kitchen materials.

Promotion: Hang posters, send emails and encourage employees to find a buddy before the January launch of the walking groups.

Implementation:

Evaluation:

January

Planning: Finalize prep for walking group launch. Schedule dietitian presentation. Step tracking method.

Purchases: Food for launch, dietitian fee

Promotion: Continue with December promotion. Promote dietitian with flyer invitations.

Implementation: Walking groups started. Pedometers distributed and step tracking method launched.

Evaluation: How many people attended the launch? Dietitian presentation? Are employees reaching their step goals regularly? How many walk each day at lunch?