Fit Kids 360 Grant Proposal - Chris Miller - PA 535

Wayne Children’s Healthcare Access Program

Fit Kids 360 Grant Proposal

Children’s Obesity Fund

June, 2015

June 9, 2015

Dr. Julian Omidi Children’s Obesity Fund Dear Dr. Omidi, Thank you for the opportunity to submit the enclosed proposal for “Fit Kids 360”, a programmatic proposal through Wayne Children’s Healthcare Access Program (WCHAP) that aims to reduce child obesity for low-income children who do not have the adequate access to care in the Detroit metropolitan area. WCHAP has developed a plan to expand Fit Kids 360 programming from two to three classes per week (each class is a different group of children) over the next calendar year to better serve our community that is in need of dire help. Adding an additional class to the programming will help us serve our waitlist in a much more timely fashion – transiency is one of the largest barriers to care in the community, and many times, when we get to contacting some on the waitlist, they have changed addresses/phone numbers and are lost to follow up; getting to these children and families in a shorter timeframe ensures their spot in a Fit Kids 360 class, and improves their access to care exponentially. Aside from the direct service portion of this plan, there is also a public relations/marketing component to it as well; as a smaller non-profit in Detroit, greater visibility and recognition of our programming will have a direct increase in the number of children and families we serve. As of this grant proposal, we have completed 10 Fit Kids class sessions since November of 2012 with a decent amount of success. Fit Kids 360’s primary goal is to address and reduce the obesity issues children of Detroit face, but it also addresses behavioral/mental health issues, health literacy issues, and encourages the importance of family togetherness when it comes to setting goals and tackling them. To date, we have seen how integral Fit Kids 360 is for families that are trying to make changes they have had immense difficulty with on their own – as a whole, our programming has kept a steady 85% retention rate, and many families are eager for continued programming and supplemental activities and classes. We have recently partnered with the Wayne State University School of Medicine – we have an ongoing agreement to have Fit Kids 360 programming be a required piece of volunteer service for the medical students, and they have been doing a wonderful job.

WCHAP and Fit Kids 360 respectfully request a Children’s Obesity Fund gift of $98,000 toward the expansion of our programming for the next year. Please contact me if you have any inquiries pertaining to this project. Thank you for your interest. Sincerely, Chris Miller Program Manager, Fit Kids 360/WCHAP

APPLICATION COVER SHEET

Date of Application: June 8, 2015 Legal Name of organization applying: Wayne Children’s Healthcare Access Program Year Founded: 2010 Current Operating Budget Executive Director: Melissa Freel E-Mail Address: [email protected] Contact Person: Melissa Freel, Executive Director Phone Number: 313.863.2427 Address: 17567 Hubbell - WCHAP Suites Westminster Church of City/State/Zip: Detroit, MI 48235 Phone: 313.863.2427 Web address: www.wchap.org List any previous support from this funder in the last 5 years: N/A Project Name: Fit Kids 360 Purpose of Grant: To directly serve more children by expanding Fit Kids programming by offering an additional class, as well as creating a public relations campaign to increase program visibility. Dates of the Project: July 1, 2015 – June 30, 2016 Amount Requested : $98,000 Total Project Cost Geographic Area Served: _____________________________________ ______________________________________ Signature, Program Manager Signature, Executive Director ______________________________________ _______________________________________ Printed Name and Title Printed Name and Title ______________________________________ ________________________________________ Date Date

Executive Summary

Fit Kids 360 is a comprehensive program that helps overweight children lead healthier lives and improve their health. The program gives children and their parents the support they need to make real, lasting behavior change. Our goal is to provide tools that promote a healthy weight to children and their families by teaching nutritional, physical activity, and behavioral change through education, exercise and goal setting. Fit Kids 360 programming is a major piece of Wayne Children’s Healthcare Access Program’s (WCHAP) mission to improve access to care and establish a medical home for Medicaid enrolled families in Wayne County, Michigan, specifically within the city of Detroit.

On behalf of WCHAP, the Fit Kids 360 program is seeking a gift of $98,000 to expand programming by offering three classes per week to serve the needs of at least 300 children within the coming twelve months, as well as vastly improving community visibility of the program through public relations and media campaigns. As of this proposal submission, Fit Kids 360 has completed 10 classes since the Fall of 2012, and classes 9 and 10 were running co-currently (this is first time we have experimented with running two classes per week) – with expanded funding for the program, by the time the twelve months for the grant pass, we will have completed an additional 17 classes, bringing the total to 27 classes.

Classes are eight weeks in length, and run for two hours each schedule night. As mentioned, curriculum includes one hour of physical activity per week (i.e. zumba, yoga, karate, and dance) and the following behavioral/nutritional topics: family goals, emotions, health literacy, bullying, MyPlate, role modeling, self-esteem, meal planning, screen time, general communication, eating out, and discipline.

Performance outcomes for Fit Kids 360 will include a comprehensive evaluation of each class – the evaluation will consist of report cards for children and parents, parent/volunteer/mentor satisfaction surveys, and a longitudinal study on how accurate/appropriate the measure of BMI is over the course of the class sessions.

Organizational History

Wayne Children’s Healthcare Access Program (WCHAP) was founded in 2010. WCHAP is a community based medical home model designed to improve child health outcomes, reduce emergency room and hospitalization costs and cause systems change. Our organization is built upon the Children’s Healthcare Access Program (CHAP) model that is part of the national movement to assure that all children have a medical home that is accessible, family centered, continuous, compassionate, comprehensive, culturally effective and coordinated with all other health and social services. This definition by the American Academy of Pediatrics is the impetus for the Children’s Healthcare Access Program that, in Colorado, has grown from a demonstration pilot to statewide implementation. Fit Kids 360 is originally a product of west Michigan, specifically in Grand Rapids as a program

offered by First Steps Kent. WCHAP adapted Fit Kids 360 programming in 2012

Mission and Goals

Together with our partners, WCHAP’s mission is to improve health outcomes, access, and quality of care for children, as well as decreasing costs by lowering emergency room use and unnecessary hospitalization via providing a medical home for our patients.

Families o WCHAP will, through a multi-disciplinary team of community health

workers, specialists, social workers, a nurse, and a practice engagement specialist, provide coordination for prevention services (immunizations), early hearing detection/intervention services, asthma education, and childhood obesity intervention through Fit Kids 360 to 2,000 Detroit children in 2015 through 2016

Practices o WCHAP will, through its Chief Medical Officer (CMO), Executive

Director, and a practice engagement specialist strengthen WCHAP’s efforts to connect with the daily needs of physicians practicing in Detroit to provide quality care to their patients. Currently 12 clinics refer to WCHAP. WCHAP will strengthen the referrals from these sites through the practice engagement specialist and regular visits of the CMO. Further, WCHAP will add two clinic sites in 2015. WCHAP’s CMO will also convene all of the WCHAP practices four times a year to discuss services and needs

Strategic Partners o WCHAP will, through its Board of Directors and its Executive Director

operationalize contracts with two Medicaid Health Plans serving 1,000 of the proposed 2,000 children. WCHAP secured commitment from two Medicaid Health Plans in late 2014/early 2015. WCHAP is proposing an initial investment model to these plans that is mutually palatable and allows time for the WCHAP service experience to demonstrate the value of this service. With these contracts in place, WCHAP and the health plans will be able to share data and measure change associated with the intervention of WCHAP

Current Programs, Activities, and Accomplishments

Fit Kids 360 o As of this proposal, WCHAP has completed 10 Fit Kids 360 class

sessions and will be beginning the eleventh class session on July 8 o WCHAP has experimented with running overlapping classes (two per

week) and it has had moderate success

o We currently have a waitlist of 110 children waiting to be placed for class sessions – we are receiving referrals for Fit Kids every day

o We are continuing to try and increase program recognition throughout Detroit and Wayne County and are exploring partnerships specifically pertinent to Fit Kids 360 programming

Statement of Need

As you are aware, urban centers are associated with a number of health disparities for adults and children alike. Many disparities are linked with one another due to socioeconomic factors and race; we know that these issues more adversely affect low-income, African American children in Detroit than any other group and/or location in the state of Michigan. Data from the Center for Disease Control and Prevention show that one in three children in Michigan is obese, and further data shows that 23 percent of high school students in Detroit were obese. The main factors of obesity are physical inactivity and unhealthy dietary behaviors. Inactivity and behavioral related obesity problems work in a vicious cycle between school and home life.

The 2013 Detroit Youth Risk Behavior Survey illustrated a number of the most pertinent obesity-related issues:

Unhealthy Dietary Behaviors

• 11% did not eat fruit or drink 100% fruit juices during the 7 days before the survey.

• 8% did not eat vegetables during the 7 days before the survey. (1)

• 10% drank a can, bottle, or glass of soda or pop three or more times per day during the 7 days before the

survey. (2)

• 30% did not drink milk during the 7 days before the survey.

• 17% did not eat breakfast during the 7 days before the survey.

Physical Inactivity • 21% did not participate in at least 60 minutes of physical activity on at least 1 day. (3)

• 51% did not attend physical education classes on 1 or more days in an average week when they were in

school.

• 38% watched television 3 or more hours per day on an average school day.

• 33% used computers 3 or more hours per day on an average school day. (4)

Access to basic needs and other socioeconomic factors certainly have a relationship with the aforementioned data – the topics that are most salient to the issues of obesity are as follows: poverty, community disparities (i.e. Detroit’s status as a food desert), education, health insurance, access to a vehicle, and enrollment in food assistance programs. Poverty According to KidsCount 2013 data, 81 percent of all children in Detroit (150,000) are living in concentrated poverty, while 64% of children in Detroit (89,000) are living in low-income housing that is financially burdensome for their parents (more than 30% of income is spent on rent). Families that are cycled through low-income

housing are often transient, which translates to missed appointments, missed days of school, and lack of communication/follow-up from providers to patients. Community Disparities According to the Child Policy Research Center and the National Initiative for Children’s Healthcare Quality, in Wayne County, there are only 2.8 grocery stores per 10,000 people, while there are 6.2 fast-food restaurants per 10,000 people. Education KidsCount 2013 data shows that 35.6 percent of students in Detroit are not graduating on time – many factors influence educational attainment, and health and health outcomes are two of the most integral. Health Insurance KidsCount 2013 data shows 90.5 percent of children in Detroit (171,928) are enrolled in a Medicaid health plan. Access to Vehicle According to KidsCount 2013 data, 20 percent of parents are without access to a vehicle, which exponentially increases access to care issues. Food Assistance Programs KidsCount 2013 data shows that 61 percent of Detroit children ages 0-18 (116,795) are enrolled in some type of food assistance program. Childhood obesity can produce a number of negative outcomes as children grow and get older, specifically in terms of social and emotional growth and physical health ailments. Depression, poor self-esteem, bullying, behavior/learning problems, and stress/anxiety are all social and emotional by-products of childhood obesity. Type 2 Diabetes, high blood pressure, high cholesterol, sleep apnea, bone/joint problems, metabolic syndrome, and asthma are some of the physical by-products of childhood obesity. If not properly addressed, the cyclical nature of poor health in Detroit will continue to ravage its communities and neighborhoods. The solutions are somewhat clear– we know that better health education, more physical education and activity programs, and healthier school environments are they keys to better outcomes, but the implementation and resources available are the difficult part of getting things done. Fit Kids 360 can change the landscape of childhood obesity - we are growing,

but still relatively small; to date, we have had wonderful success with our programming and have an extensive wait list, but we still need to build capacity by offering more classes and increasing our presence in the community. Building that capacity will allow us to empower the families we serve to make the changes that they have had a hard time trying to make themselves. The “360” of Fit Kids is reflective in the curriculum, as we touch on physical activity, nutrition, behavioral health, health literacy, and the family unit – though the child enrolled is the focal point, the parents are just as important to the programming, as they are required to stay for the two hour classes each week, and by that we cultivate a culture of positive reinforcement throughout the family unit. Program Goals and Objectives

Goals/Objectives:

1. Expand Fit Kids 360 programming by increasing the number of co-occurring classes (increase from two to three per week)

a. Reach 300-500 children between July of 2015 and June of 2016 2. Expand our community visibility and presence

Objectives:

Expand Fit Kids 360 Programming o Expand programming by offering an increased number of co-

occurring classes via hiring more mentors (10-15 per class), volunteers (5-10 per class), an additional dietician (1), and an additional exercise physiologist

Expand our community visibility and presence o Hire a public relations consultant to construct a media campaign o Hold Fit Kids 360 open house prior to starting new set of classes o Reach out to Detroit Free Press, Channel 7, Channel 4, and Channel 2

for media inquiries and human interest pieces o Explore additional partnerships with Detroit based corporations and

sports franchises for expanded recognition within the community o Expand social media presence by creating Instagram and Twitter

account Timeline

Date Task/Activity Responsibility

Upon Award Write job description for Public Relations Consultant and post opening

WCHAP Executive Director/Admin. Staff

Upon Award Write job description for additional Dietitian and Exercise Physiologist and post opening


Upon Award Write job description for additional Program Coordinator, Mentors and Volunteers and post openings

Begin recruitment process


July 1, 2015 Draft Fit Kids 360 media campaign

Public Relations Coordinator

July 6, 2015 Contact Detroit Free Press, MLive, Channel 2/4/7 for inquiries


July 13, 2015 Finalize Fit Kids 360 Media Campaign


July 15, 2015 Send out Press Release regarding new campaign and expanded class sessions to Detroit Free Press, MLive, and Channels 2/4/7


July 15, 2015 Send out Press Release regarding Fit Kids 360 open house taking place at Children’s Hospital Specialty Center on July 22, 2015 – Detroit Free Press, MLive, Channels 2/4/7


July 15, 2015 Begin to look for ad space within the city


July 22nd, 2015 Hold Fit Kids 360 open house at Children’s Hospital Specialty Center

All WCHAP staff

July 24, 2015 Secure ad space (billboards, busstops, children’s hospital)


Last week of July, 2015

Create and launch Fit Kids 360 Instagram and Twitter accounts


July-August Fit Kids 360 Classes 11 & 12 (final of the two per week set programming)

Fit Kids 360 Program Manager, Dietitian, Exercise Physiologist, Volunteers, and Mentors

Week of August 3, 2015

Set up appointments with Detroit based corporations and sports franchises in regards to partnerships

Public Relations Coordinator, Executive Director


Secure and schedule at least two media pieces for a printed/online circulation and a television news story prior to start of new classes



Secure partnership/sponsorship with at least one corporation or professional sports team

Public Relations Coordinator /WCHAP Executive Director

Week of September 1, 2015

Crunch data and create report cards for classes 11/12 and send them to students and funder

Fit Kids 360 Program Manager

Week of September 8th, 2015

Begin classes 13, 14, and 15

Fit Kids 360 Program Staff

Week of October 26th, 2015

Publish/air human interest story on new funding and achievement of Fit Kids program after first set 3 per/week classes

Public Relations Coordinator, WCHAP Executive Director, Detroit Free Press, Selected local television station

Week of October 26th Crunch data and create report cards for classes 13, 14, and 15, and send them to students and funder

Fit Kids 360 Program Manager

Week of November 9th, 2015


Fit Kids 360 Program Manager & staff

January 5, 2016 Meet with Funder for mid-year update

WCHAP Executive Director, Fit Kids 360 Program Manager, Public Relations

Coordinator Week of January 4, 2016

Crunch data and create report cards for classes 16, 17, and 18 and send them to students and funder

Fit Kids 360 Program Manager & staff

Week of January 11, 2016


Fit Kids 360 Program Manager & Staff

Week of March 1, 2016

Crunch data and create report cards for classes 19, 20, and 21, and send them to students and funder

Fit Kids 360 Program Manager and Staff

Week of March 7, 2016



Week of April 25, 2016

Crunch data and create report cards for classes 22, 23, and 24, and send them to students and funder


Week of April 25, 2016

Run human interest story on local news

Public Relations Coordinator, Executive Director, Fit Kids 360 Program Manager and Staff, and news station

Week of May 2, 2016 Begin classes 25, 26, and 27


Week of June 20, 2016

Crunch data and create report cards for classes 25, 26, 27 and send them to students and funder



Run human interest story on local news, specifically on the effectiveness of the grant a year later

Public Relations Coordinator, Executive Director, Fit Kids 360 Program Manager and Staff, and news station


Meet with Children’s Obesity Fund to discuss program success at the end of grant and explore funding extension opportunities

WCHAP Executive Director, Fit Kids 360 Program Manager, Public Relations Consultant

Grant Budget

A: Organizational fiscal year: 2015-2016 B: Time period this budget covers: July 1, 2015 – July 1, 2016 C: Expenses (Specifically for Fit Kids 360 programming): (New Fit Kids 360 Funding Request) (General WCHAP Budget)

Salaries $60,000 $427,402

Payroll Taxes $0 $36,833 Fringe Benefits $0 $10,000 Consultants/Professional Fees $16,000 $86,428

Chief Medical Officer - $38,880 Maternal Child Health Consultant -$24,360 Fit Kids Contract Staff - $16,704 Parent Engagement - $6,484

Specific Program Expenses $ - $31,885 Fit Kids 360/Obesity Programming - $15,000 Maternal Child Health Programming - $3,700 Parent Empowerment - $1,000 Asthma Programming - $2,145 PCP Quarterly Meetings - $1,240 Board of Directors/Advisory Meetings-$1,800 Training - $7,000

Insurance $0 $ - (rolled into rent figure)

Travel $0 $0 Equipment $1,500 $0 Supplies $4,500 $5,200 Printing and Copying $4,000 $6,000 Telephone and Fax $0 $9,800 Computer/Internet $0 $3,000 Postage and Delivery $0 $900 Rent $0 $32,000 Utilities $0 $ - Maintenance $0 $0 Evaluation $0 $7,500 Marketing $12,000 $0 Other (specify) $0 $330 (Bank Service Charges) $1,000 (Dues, Memberships) $350 (Meals) $5,100 (Legal services)

$13,300 (Accounting services) $10,000 (Audit) $25,000 (Ingham Co. Fiduciary Fee)

$474 (Alarm)

$18,000 (Electronic Medical Record)

$800 (Other)

Total Amount Requested: $98, 000 Total Project Expenses: $731,303

D. Revenue (for WCHAP as a whole)

1. Grants/Contracts/Contributions

Committed Pending Local Government $0 $25,234 State Government $25,000 $0 Federal Government $0 $0 Foundations $280,957 $63,117 Corporations $0 $0 Individuals $0 $0 Other $280,957 $188,117 (Health Plans/Medicaid Match)

2. Earned Income

Events $0 $0 Publications and Products $0 $0

3. Membership Income $0 $0 4. In-Kind Support $0 $0 5. Other (specify) $0 $0

6. Total Revenue $586,914 $276,468

Budget Narrative

Personnel/Salaries: Fit Kids 360 and WCHAP are requesting salaries for 1 FTE Public Relations Consultant at $45,000 annually for12 months, and a .5 FTE Fit Kids 360 Program Coordinator at $15,000 annually for 12 months. Total line item requested of Children’s Obesity Fund grant funds is $60,000. Consultants/Contractual/Professional Fees: Fit Kids 360 and WCHAP are estimating these costs to be a total of $16,000 as seen on the line item.

Requesting funds for compensation for an additional Dietitian for the added class per week at $4,000 over the 12 month period ($100 per class session)

Requesting funds for compensation for an additional Exercise Physiologist for the added class per week at $4,000 over the 12 month period ($100 per class session) every for the Public Relations Coordinator’s R

Requesting funds for stipends for Fit Kids 360 mentors at $8,000 over the 12 month period (8 mentors for each class grouping – 3 classes for every 2 months)

Supplies/Materials: Estimated costs of $4,500 for new supplies (for in-class activities, food/snacks, end of class prizes for Fit Kids) Equipment: Estimated costs of $1,500 for new equipment (for each specific lesson plan) Printing/Copying/Media: This line item includes $3,500 for the use of print media in pertinence to the Public Relations Coordinator – with program expansion; there is an increased cost of print materials to advertise for programming Marketing: This line item includes $12,000 for billboard space, open houses/networking events, and potential newspaper ad space. Evaluation

Fit Kids 360 and WCHAP will be collecting data on the efficacy of the Fit Kids 360 program through an extensive evaluation system we have used in the past that consists of pre and post measurements of children enrolled in the program (physical measurements like BMI and height), as well as FNPA (family nutrition and physical activity) metrics (television screen time, hours of physical activity per day, and fruit intake to name a few), as well individual report cards sent to parents and children involved in the program, and overall class report cards to distribute to our strategic partners, funders, and community stakeholders. We also conduct volunteer, mentor, and parent satisfaction surveys. Collecting all of this data will allow us to:

Provide our partners, funders, and community stakeholders data that can be used to make curriculum and programmatic adjustments

o Over the course of the 12 month funding cycle, Fit Kids 360 and WCHAP will host a data update meeting that will include time for troubleshooting and strategic planning to further programming goals

Currently, we send out each of those data pieces separately, but going forward with potential funding, our Fit Kids 360 program staff will design a comprehensive evaluation plan that includes all aforementioned elements to be distributed in one package that measures:

The general effect of and sentiments on Fit Kids 360 programming on enrolled children, their parents, volunteers, and mentors

Longitudinal study pertaining to BMI rates in Fit Kids, and whether or not that is truly the best metric to go by (the popular argument that BMI is an antiquated measure)

Sample Report Card: Fit Kids 360 – WCHAP Children’s Hospital Specialty Center

9/11/2014 - 10/30/2014

Table 1. Physical measures. Mean (standard deviation) values pre- and post-treatment: 6 week

follow-up, FitKids360.

Pre Post

Height (cm) 136.4 (19.6) 139.1 (16.9)

Weight (kg) 55.7 (16.4) 54.8 (15.9)

BMI (kg/m2) 29.6 (4.9) 28.2 (6.4)

Percent body fat (%) 43.8 (8.1)

41.0 (11.1)

Table 2. Health behaviors including nutrition, physical activity, sedentary behavior (screen time),

and FNPA. Mean (standard deviation) values pre- and post-treatment: 6 week follow-up,

FitKids360.

Nutrition

Pre Post

Fruit Intake (servings/d) 1.9 (0.9) 3.2 (1.2)

Vegetable intake (servings/d) 1.6 (1.2) 3.0 (0.9)

Dairy intake (servings/d) 1.6 (1.8) 3.0 (1.3)

Soda/Pop intake (servings/d) 0.3 (0.4) 0.1 (0.2)

Physical Activity

Physical activity (min/d) 1.2 (0.6)

1.3 (0.9)

Screen Time

TV weekday (hours/d) 1.7 (1.0)

1.1 (0.4)

TV weekend (hours/d) 2.9 (2.5)

1.8 (1.4)

Total TV (hr/d) 2.1 (1.3)

1.3 (0.7)

Computer weekday (hr/d) 0.8 (0.9) 0.5 (0.7)

Computer weekend (hr/d) 0.7 (1.0) 0.7 (1.3)

Total Computer (hr/d) 0.8 (0.9) 0.6 (0.8)

Video games weekday (hr/d) 0.7 (0.9) 0.6 (0.8)

Video games weekend (hr/d) 1.0 (1.1) 0.7 (0.9)

Total video games (h/d) 0.8 (0.9) 0.6 (0.8)

Weekly screen time (hr/d) 3.6 (2.0) 2.5 (1.2)

Family Nutrition and Physical Activity (FNPA) Screening Tool

FNPA score 56.6 (10.2) 64.7 (6.2)

Documents

Fit Kids 360 Grant Proposal - Chris Miller - PA 535