PLEASE NOTE THAT THIS IS NOT A GRANT APPLICATION Grant Application Questions/Worksheet for Planning and Implementation Grants

Call for Proposals opens November 1, 2012submissions due January 31, 2013 Grant applications will be accepted online only http://www.aap.org/catch/grantapplications.htm For assistance with proposal development contact your Chapter CATCH Facilitator Visit the AAP grants database for descriptions of previously awarded CATCH grants. Division of Community-based Initiatives CATCH staff: 800/433-9016, ext 4916 or 847/434-4916 E-mail: catch@aap.org Review the Call for Proposals/Grant application Guidelines before beginning your application. Planning Grant guidelines Implementation grant guidelines 1. CATCH project title (MUST be 6 words or less) STEPS, fighting obesity step by step 2. Is this an existing program? Yes X No 3. Proposal abstract (Maximum 250 words) Summarize the project. Obesity has reached epidemic proportions in NY City and across the nation. Like the AAP, we seek to improve the health and wellbeing of children by reducing the prevalence of childhood obesity. This goal can only be accomplished by collaborating with local organizations to target the program to the needs of the community. Specifically, the goal of the project is to create a new culture of physical activity and smart nutrition choices as a routine way of life. This goal will be achieved through a comprehensive 8 week program in the underserved immigrant communities of Harlem, Northern Manhattan, and South Bronx. It will have 4 major components: medical, exercise, nutrition, and psychological. The medical component will include a thorough initial evaluation by any community pediatrician who will assess BMI, set realistic goals, and screen for complications of childhood obesity such as hypertension, diabetes, fatty liver, and dyslipidemia. The exercise component will consist of a biweekly group walking program using pedometers and yoga. Walking was specifically chosen because cost and accessibility are major barriers in this lower income immigrant community and yoga can continue at home for free. The certified nutritionist will meet weekly with the child and parent to increase knowledge about portion size, calories, and food groups so that families are empowered to make better food choices. The behavioral component includes an initial assessment by a licensed social worker to address ongoing issues that may have contributed to their weight gain such as depression, anxiety, or difficult family circumstances.

4. What makes you a community pediatrician? (Describe in 2 sentences) I am a community pediatrician because I not only seek to help my individual patients, but I have a priority to address the prevalent health care needs of the entire community, seeking to implement solutions to common problems. In addition, I partner with parents, schools, and local community programs to advocate for my patients who face unique obstacles as children of immigrants with language barriers who often live in poverty.

5. Narrative biographical sketch of the applicant; rsums and CVs will not be accepted. Maximum 300 words My interest in the obesity epidemic stems from an inherently healthy childhood and a subsequent realization of the sedentary lifestyles of urban children. Of Chinese American descent, my childhood diet was well balanced and sports were fun and available. I attended college at UPenn in West Philadelphia, a city with one of the highest obesity rates. In college, I had work study jobs in the public school system and daycares, and the lack of playgrounds and sports was shocking to me. I later attended NYU school of medicine and completed my pediatric internship there at Bellevue, one the largest public hospitals in the U.S. I completed my pediatric residency at Harvard Massachusetts General Hospital. During residency, I contributed to several medical missions in Bolivia, Honduras, and Central Mongolia. Although I treasured my time abroad, I realized that my skills could be well utilized in underserved areas in my own country. After residency, I was very excited to start my pediatric career at Pediatrics 2000, a busy urban practice in Inwood and Harlem that serves a predominantly immigrant Spanish speaking population and a significant African American community. As a general pediatrician for 5 years, I am constantly amazed about the lack of nutrition knowledge and sedentary lifestyles. However, I also understand that many sports programs are too expensive to someone making minimum wage or less, and that many schools simply dont have gym class or any afterschool sports. Recently, my practice opened a new office that has ample space to hold free classes, and I began organizing a free teen yoga class. We added a nutritionist and social worker to our team and I have been collaborating with local exercise programs. Now that I have all the components at my fingertips, I have realized the potential to create something special.

6. Have you been awarded a CATCH grant as a primary applicant in the past? Note: Former grantees are encouraged to apply, although current CATCH grant projects must be completed prior to submitting another application. Yes, I have received a resident grant Yes, I have received a planning grant Yes, I have received an implementation grant X No, I have never applied

7. Did you receive technical assistance (recommended) with the preparation of your grant application from any of the following sources? Check all that apply. X AAP CATCH staff assistance coordinator Chapter CATCH Facilitator District CATCH Facilitator Resident CATCH Liaison (specify name Dana Bennett-Tejes MA technical (specify name (specify name (specify name Robert Perello MD MPH

Former CATCH grantee X Other pediatrician/physician X Other No, I did not receive any assistance.

(specify Nutritionist Enerolisa

8. What type of technical assistance with the preparation of your grant application did you receive? Check all that apply. X Grant writing/proposal preparation Information/Materials X Networking/Referrals X Online application logistics Sample grant documents Information from AAP grants database or assistance with how to search the database Other (specify ________________________________) I did not receive any assistance. 9. Please indicate the primary employment setting of the pediatrician applicant, that is, the setting where he or she spends the most time. Please check only ONE response. Solo or two-physician practice X Pediatric group practice, 3-10 pediatricians Pediatric group practice, >10 pediatricians Multispecialty group practice Health Maintenance Organization (staff model) Medical school or parent university Non-profit community health center Non-government hospital or clinic City/county/state government hospital or clinic US government hospital or clinic Other (please specify __________________________________) 10. What is the present employment status of the pediatrician applicant? Check ONE response. Full X Part-time Retired Semi-retired Temporarily not in practice Not active for other reasons (please specify____________________) 11. Approximately what percentage of the pediatrician applicant's time is spent in the following areas? General Pediatrics 100 ___% Other specialty/subspecialty area: specify ___________________ ___% 100% 12. Select ONE topic from the tables below as the project's primary topic area. Primary topic: Overweight and obesity 13. In your own words tell us what personal experience led you to want to address this particular child health need in your community.

After practicing general pediatrics for several years, I began to notice repeated misconceptions in the population about weight, nutrition and general health. At every visit I review body image, BMI and diet, and in general, most normal weight people think they are too skinny, most overweight people think they are normal, and most obese people think they are only slightly overweight. It seems that the prevalence of obesity in this poor underserved immigrant community has subconsciously changed the perception of normal weight. Many people think walking up a flight of stairs daily or a few blocks to school is enough exercise. Countless people have mistakenly assured me that they dont drink soda, but only drink juice, or that they only eat fast food a few times a week. These patients truly believed they were making smart choices. I hear comment after comment of commonly believed misconceptions. I believe knowledge is power and this community cannot improve without imparting health knowledge and changing the culture of healthy living. In my years as a pediatrician, I have also seen a sense of desperation in some children who want to be active in sports or dance but never get the opportunity due to cost and the logistics of parents working long inflexible hours. On the other hand, I see many kids that want to lose weight but have no athletic interest or talent and therefore feel scared to try traditional sports programs. It seems like the athletic kids at least get some exercise, and the others are left to watch tv and play video games. Working in this neighborhood has made me realize that every kid deserves an opportunity to exercise and change their lives for the better but ideally it has to be close, free, and easy to continue on their own.

14. From the three lists below, select FIVE additional topics to serve as key words for your project. You do not need to select a topic from each list. Include topics specific to the grant period onlynot long term. Health Topics ADHD Asthma Autism spectrum disorders Behavioral health Breastfeeding Child development/developmental delay Child abuse and neglect Diabetes ER/urgent care Environmental quality Famil y violence Hearing HIV/AIDS Immunization Infectious disease Injury and violence Learning disabilities Mental Health X Nutrition XOverweight and obesity Oral/dental health Pregnancy outcomes Responsible sexual behavior School health

School violence SIDS STDs Substance abuse Teenage pregnancy and parenting Tobacco use Vision Health Well-child/well-baby care

Special Population Groups X Adolescent health Border health Children of incarcerated parents Children with special health care needs/disabilities Foster care Homeless care Immigrant/migrant /undocumented health Native American child health Refugee health Rural health X Urban health Strategies Access/barriers to health care Advocacy Care coordination/case management Child care Crisis intervention Culturally effective care Disaster preparedness Family centered care General pediatrics Health disparities X Health education and prevention Home visitation Literacy Medical home Medical-Legal partnership Mobile care Palliative care/hospice Parenting/parent education X Physical activity Primary care SCHIP/Medicaid enrollment/outreach/retention Screening/detection/surveillance School readiness/Head Start Sex education Transitions

15. Please identify the activities that will be a part of your CATCH project. Check up to ten boxes. Coalition development Community assessment/ needs assessment X Community awareness promotion Community meeting support X Focus groups Grant writing/proposal development Interviews X Mentorship Outreach X Program development/program planning X Program evaluation X Program implementation (does not apply to Planning Grant applicants) Resident/medical student community experiences Resource/tool development Survey development Task force development 16. Describe your target population (Include children's health statistics and number of children potentially affected by the project.) Maximum 300 words The target population is overweight and obese boys and girls ages 13-18 years old living in West Harlem, Northern Manhattan (Washington Heights/Inwood) and South Bronx, the main areas from which we draw our patient population. Our practice has over 17,000 patients with 73% of Latino Descent. Of those patients ages 13-18 years old, 48% are either overweight (31%) or obese(17%). In 2007, the NYC Department of Health published obesity reports for specific neighborhoods in our target area. Data on adolescent obesity was obtained from the Youth Risk Behavior Survey, a self-administered anonymous questionnaire by a representative sample of students. For high school students in Harlem, 32% report heights and weights that indicate obesity(14%) or overweight(18%). In the same neighborhood report for South Bronx, similar trends appeared for high school students with 38% being obese (17%) or overweight (21%). Of note, these values for high school students may be underrepresented since it was a self- survey, whereas data from Head Start and elementary schools using physical forms showed almost 50% overweight and obese. In Harlem and the South Bronx 38-43% of high school students report not exercising at least 20 minutes per day or 3 days per week and 57-59%% watch TV at least 3 hours/day. 80- 83% of adolescents report eating fewer than 5 servings of fruits and vegetables per day. Obese teens are more likely to have prediabetes, bone and joint problems, sleep apnea, and social and psychological problems. They are at greater risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis. This age group was specifically chosen as a time when adolescents are asserting their independence and taking responsibility for their own bodies and life choices. This project will enroll 2 groups of 15 teenagers every 2 months. 17. Do children with any of these types of health care coverage comprise 50% or more of the project's target population? Check all that apply to the 6-month grant project only not long term. .Indian Health Service Medicaid/SCHIP recipients .Private Insurance .Uninsured children

.Other (specify _____________________ 18. What is the race/ethnicity of the project's primary target population? Check all that apply to the 6-month grant project only not long term. Asian/Pacific Islander Black Hispanic Native American White, non-Hispanic Other (specify ___________________________)

X X

19a. Implementation Grant applicants only: What is the developmental stage of the primary target population AND the projected number of children who will be served by the project? Check all that apply to the 6-month grant project only not long term. Infant and toddler (birth-2 years) Preschool age (3-5 years) School age (6-10 years) X Adolescent (11-21 years) Other (specify) 19b. Planning Grant applicants only: What is the developmental stage of the primary target population? Check all that apply to the 6-month grant project only not long term. Infant and toddler (birth-2 years) Preschool age (3-5 years) School age (6-10 years) Adolescent (11-21 years) Other (specify) 20. Does the project target any of these special populations? Check up to ten boxes. Check all that apply to the 6-month grant project only not long term. X Children living in poverty Children with special needs Families in crisis Families in transition Foster children Gay, Lesbian, Bisexual, Transgender or Questioning Youth Families in crisis Families in transition Homeless families X Immigrant/Migrant/Undocumented families X Minority populations Native Americans Pregnant women/New mothers Refugee families

Enter #________ Enter #________ Enter #________ Enter #________ Enter #________

X Underserved children & families Uninsured/underinsured children & families Youth with special needs

21. Describe the community (eg, agricultural, industrial, number of pediatricians and other health care professionals in the area, employment data, socioeconomic data).

Our Level 3 medical home is physically located in the neighborhood of West Harlem in New York City. New York City is the most populous city in the US with over 8 million people and the most densely populated city in the nation. Approximately 35% are foreign born and the neighborhoods are ethnically and socioeconomically diverse. Specifically, this project is targeting the immigrant Latin communities where most of the patients from our medical home live: Harlem, Northern Manhattan (Washington Heights and Inwood) and the South Bronx (Highbridge and Morrisania). According to the American Public Health Association, three community districts in Manhattan have been designated medically underserved areas by the Centers for Medicare and Medicaid Services: Central Harlem, East Harlem, and Washington Heights/Inwood. These districts have larger populations with greater proportions of children and minorities than other districts. According the NYC Department of Health Community Profiles in 2006, Central Harlem is 19% Hispanic and 67% Black, Washington Heights/ Inwood is 71% Hispanic and 14 % Black, and the South Bronx is 57% Hispanic and 39% Black. In these areas, only about one quarter of the residents have a high school diploma and approximately one third of the residents live below the poverty line. For adults, the percentage of obese residents in Central Harlem, Washington Heights/Inwood and South Bronx respectively is 27%, 21% and 27% compared to the percentage in Manhattan of 15%. For children, data from NYC Department of Education Fitnessgram , a criterion based personal health assessment given to public school students, showed about 40% of kindergarten-8th graders being overweight but less affluent areas such as our target community of Harlem and Washington Heights had almost 50% of overweight and affluent areas such as Tribecca and Soho had only 15%.

22. Please characterize the target community for the project. Check all that apply to the 6-month grant project only not long term. X Urban, inner-city Urban, not inner-city Suburban Rural Other (specify ___________________________)

23. Is the primary setting of your project academic or non-academic? Academic X Non-academic 24. Please identify the primary setting of your project. Clinic - FQHC X Clinic - not FQHC Community-based organization Hospital Multispecialty clinic Preschool/day care center/Head Start Private practice Public Health Department School (elementary or secondary) Other (specify ___________________________) 25. Describe the barriers in your community that impact access to medical homes and other needed health care services for your target population (eg, geographic, cultural, physical, socioeconomic, communicative). Maximum 300 words
The major barriers in my community that impact access to medical homes, physical activity, and health education are cultural and socioeconomic. Culturally, there are major language barriers. With about half of parents being immigrants and predominantly Spanish speaking, it can be difficult for teachers, community leaders, and doctors to increase awareness of the problem of obesity and counsel on ways to deal with it. Culturally, many Hispanics have a view that it is healthier to be heavier, requesting nutrition supplements for overweight children that they feel do not eat enough. It

would take significant time beyond a 30 minute well child visit to change the mentality of a healthy body and healthy way of life. Additionally, with low education levels in parents, there is little knowledge about many aspects of nutrition. If nutrition education is implemented, it must be culture specific as well, with healthier versions of the specific diet eaten by each ethnic group. When parents have low paying jobs below the poverty line and long hours, they may have a tendency to seek healthcare less often and not have the time or money to participate in physical activities such as organized soccer, karate, or dance. Often children in my office express an interest in a physical activity, but parents say that it is financially and logistically impossible. Another barrier to physical activity in NYC is physical space, compared to suburban or rural areas, there is less open outdoor space and less large indoor spaces for teens to congregate and have classes, especially in certain neighborhoods.

26. How will the proposed project address these access barriers? Max 300
This program addresses the major access barriers which are mainly cultural and socioeconomic. The program is completely free, eliminating cost as a factor. For those children who always had an interest in exercise, but whose parents could not afford it, this would be an excellent option. Additionally, the specific exercises chosen, walking and yoga, can be continued after the program at no cost with limited outdoor space and limited apartment space. These activities were chosen specifically over other activities that require gathering groups of kids or purchasing expensive equipment like baseball, soccer, biking, or karate. We address the cultural barrier by having our nutritionist meetings held in Spanish if needed. Our nutritionist was born and raised in the Dominican Republic, fluent in Spanish and English, and familiar with the diet, traditions, and health misconceptions of the culture. She can deliver a culturally appropriate message. Our social worker and many of our providers are Hispanic or fluent Spanish speakers. For the teens who have never been interested in healthy living, we hope to promote a culture of physical activity and good nutrition by connecting them with motivated, inspirational, and caring team leaders who are more than willing to spend quality time with kids, walking, talking, and learning. The facility has a very convenient and visible location in the neighborhood, a few blocks from subway access, many schools and the boys and girls club. In addition we have an extremely large space for NYC, 10,000 square feet, and are therefore able to accommodate classes and workshops. Additionally, we are 1 block from Hudson river park, a beautiful public waterfront bike and pedestrian walkway that extends the length of Manhattan which we will use for the walking program.

27. Describe your project and explain why CATCH should fund it (ie, summarize and justify the need for funding). Maximum 300 words This project is an 8 week healthy lifestyle program with the goal to inspire a love of physical activity as a way of life. We can empower teens with the tools to lead healthy lives in the future through a nutrition curriculum. Children will be grouped by age and gender, addressing the problem from four angles: medical, exercise, nutrition, and psychological. The medical component will include a thorough initial evaluation by a pediatrician and follow up at our medical home or their own. Patients do not need to be patients at our clinic to participate in the program, but if they do not have a medical home, they will have gained access. The exercise component will consist of a biweekly group walking program with pedometers led by a pediatrician, social worker, or nutritionist. Yoga classes will also be offered weekly. The certified nutritionist will meet weekly with the participant and in group workshops to educate. The behavioral component includes an initial assessment by a social worker who will also lead a peer group discussing emotional issues and challenges surrounding weight. There are few comprehensive and multidisciplinary programs that educate from every angle including exercise, nutrition, behavioral and medical. With the program held at a medical home, there is greater participant accountability. Funding is needed for promotion, basic equipment, incentives, and salaries. CATCH should fund this project because it reaches out to an underserved community, poor immigrants of Harlem, Northern Manhattan and South Bronx that lack access to a medical home and provides a long needed health service not available, a comprehensive healthy lifestyle program. By partnering with local agencies and schools, we will be connecting various underinsured populations with a medical home. These partnerships with existing local programs are essential to meeting our goals of serving the entire community.

28. Identify your present and future community collaborative partners and describe their role in this project. For example, grassroots associations, parents, faith-based groups, local businesses, local public health service agencies, nongovernmental health agencies, hospitals List your current community collaborative partners and describe their role in this project. Please do not use acronyms. 1. CHALK Choosing Healthy Active lifestyles for Kids : a collaboration between NewYorkPresbyterian Hospital Ambulatory Care Network and Columbia University Medical Center's Department of Child & Adolescent Health. The goals of CHALK are to reduce over time the prevalence of childhood obesity. I have attended meetings and collaborated ideas with several local pediatricians and community leaders who have an interest in obesity to refine the project logistics. 2. Boys and Girls Club : Manhattanville Community Center Clubhouse. Tel: 212 491 3377. Address: 530 W 133st (Amsterdam) M-F 2:30-8pm Community coordinator Doreen Davis is involved in the planning of the project, coordinating ideas for a successful project, and networking. We discussed the need for the program in this community and what exercise activities already exist at their center. Teens will be referred from their afterschool program to our program who are overweight and in need of nutrition education and a medical home. We will refer patients to the boys and girls club for continued or supplementary exercise classes, cooking classes, dance classes, and recreational gym use that they provide. It is located only 3 blocks from our facility and it has complimentary services but not overlapping. We will also be using their seminar room space for workshops. 3. Roberto Clemente Middle school/ Kipp Infinity Charter Tel: 212 690 5848 625 West 133 street. School Nurse Kra, NYC Dept of Heath office of school health. lkra@health.nyc.gov She is involved in the planning of the program, collaboration of ideas to create the most targeted and effective project, and referral of students in need of a healthy lifestyle changes in their life. She runs HOP: healthy options in physical activity for 5 schools. She feels that this program would compliment her program and the community has a need. 4. A Philip Randoplph High School Tel: 212 926 0113 School Nurse She is involved in the planning of the program, collaboration of ideas to create a successful project and referral of students in need of a healthy lifestyle changes in their life. 5. Catholic Guardian Society: Foster agency in the neighborhood that works with ACS. We discussed the need for this type of program in the community and the best partners in the area. They will be making referrals.

List any additional individuals, groups or organizations you plan on partnering with during this project and describe their potential role. Please do not use acronyms. 29. What are the pediatrician applicants responsibilities in carrying out the project? Maximum 300 words The pediatrician applicants responsibilities are both organizational as well as hands on. I will be the major force organizing and launching the program. I will work with my team of pediatricians, social worker and nutritionist to come up with the educational program and formalize assessments. I have and will be collaborating with several public schools and local boys and girls clubs to assess the need for such a program, obtain ideas to improve the program to suit community needs, and learn what programs already exist, so that we can compliment existing community programs. Other community agencies will provide referrals to at risk children who could benefit from our program and thus link the uninsured to a medical home. After completion of the program, we will refer kids back to these agencies for ongoing exercise activities such as zumba, cooking

classes, and the gym so that they can maintain the lifestyle with fun and variety. I have also attended CHALK meetings, a local hospital based organization trying to reduce obesity in order to meet other community members with similar goals and refine the program. I will continue to partner with all of these groups. I will hold an introductory information session reviewing our initial goals, the plan, and medical reasons to stay fit and participate in the program. All promotional items will be created by the pediatrician applicant. When the program starts, I will be one of the many pediatricians making the initial medical assessment. I am very excited about serving as an inspiring, caring, and dedicated mentor by leading a group of teens in the weekly walking program. We will be walking, talking, laughing, and learning together. I will periodically review long term results using our e clinical system data and our pre and post health IQ exams. 30. Describe project-related activities completed to date. For example: prior involvement with local community; conducted informal or formal community, health, or needs assessment; attended community meetings focused on child health issues; read literature suggesting a need in the community or established community need; informally or formally documented child health trend in own practice. Maximum 300 words As a general pediatrician for several years, I have been informally making needs assessment in the office, always discussing body image, reviewing BMI and asking about exercise and diet. I have repeatedly heard misconceptions about exercise such as considering walking 5 blocks to school or up a few flights of stairs to their apartment enough exercise. Many parents complain of low weight when their child is actually overweight. Children have often explained to me that their school doesnt have after school sports or gym class. Parents have explained that children expressed interest in swimming, baseball or dance but that it is simply too expensive to pay for the class or equipment or logistically too far. To assess the need for such program in the community, I have reached out to several school nurses at local middle and high schools, the boys and girls club community coordinator, and a foster agency about existing programs and needs. All agencies were extremely interested and ready to provide ideas, referrals and facilities. I have also worked with CHALK, an anti- obesity campaign at Columbia Presbyterian, our local childrens hospital, attended meetings and collaborated with other local community leaders with similar goals. There is general agreement that the Harlem community would benefit from such a comprehensive program, and that it would compliment other afterschool exercises classes well by bridging the knowledge gap and addressing the medical and psychological component. We have formed partnerships agreeing to collaborate throughout the planning and implementation and refer. I have also discussed the project with our medical director with a masters in public health who believes the program could be replicated elsewhere if it shows good results. In addition, I helped launch a free teen Yoga class at our clinic, and the huge interest shows a clear community need. 31. Project goals: Note: list goals for the project period only. You will be asked an additional question later about the long-term goals of the project beyond the grant period. LIST GOALS, NOT ACTIVITIES 1. Promote exercise and walking as a routine part of life with a new awareness or knowledge of what activity qualifies as physical activity and how much time should be spent to burn a given number of calories. 2. Increase education on nutrition so that teens are aware of what constitutes a healthy food choice, knowledge about calories, portion size, food groups etc. 3. Increase emotional strength, confidence, and self image through mentoring, peer social interaction and self awareness.

32. Describe major project activities, with timeline incorporated, based on a 6-month project period. From: Month Month #1 Month #1 Week 2,4, 6,8 Week 1,3,5,7 Week 1 or 2 Through: Month Month #2 Month #2

Project Activity 1. 1 hour of group walking 2 X/week 2. Yoga 1 X/week 3. Individual meeting with nutritionist 4. Nutrition group workshop 5. Initial psych evaluation with Social Worker and 1 hour peer group counseling

6. Initial evaluation by physician and follow up 7. Weekly healthy snack and discussion of progress

Week 1 &8 Month #1 Month 2

8. Completion ceremony and healthy dinner The program will be repeated every 2 months with a new group of kids.

Week 8

33. Identify the long-range goals for this project beyond the grant period. Maximum 300 words
The long term goals of the project are to show continued improvement in BMI in the months and years following each individuals 8 week participation in the program. With each yearly physical exam we can track the patients who belong to our medical home or another. I hope to prove that if this community is given the proper tools and knowledge about nutrition, exercise, and mental and physical health, that they can not only achieve goals during the program, but continue to trend towards a healthier weight on their own well after the program ends. In the long term, when the program is running successfully, I would like to expand to enroll a larger number of children. There are 2 major universities several blocks from the facility, Columbia University and City College, from which we can recruit volunteer leaders for the walking component of the program. We can select highly motivated energetic and inspirational college students with medical, nutrition, physical fitness, or social work interests to lead more groups, or lead groups of children that completed the program but wish to continue group walking. I want to provide this community with a well respected and effective program that continues to change families lives for years. If strong data is produced from the efficacy of the program, I predict we will obtain continued funding. I predict the model will be replicated in other pediatric clinics. In addition, convincing data will increase the likelihood that insurance programs will pay for more parts of the program paving the way for other pediatric offices to offer similar programs. If we fail to obtain additional funding immediately , the program can be continued by our providers in a less intense scale with less nutrition and behavioral workshops and less incentives.

34. How do you plan to sustain and implement the project beyond the grant period? Maximum 300 words
To continue the program exactly as it has been carefully planned for the 6 month period funded by CATCH, we would need to apply for further funding through grants. After speaking with several community members at Boys and Girls Club, local schools and the CHALK program (hospital based obesity campaign), I have learned of many organizations that will fund ongoing programs that have proven to be beneficial, especially programs that target obesity. These knowledgeable and well connected partners have assured me that this is exactly the type of project that can easily get

continued funding. In the worst case scenario, the unique aspect of this project is that it is possible to sustain the program using the resources from our office and the equipment provided by the CATCH grant in a less intense skeleton program, without weekly nutritionist meetings or incentives or yoga. However, this situation would not be ideal, and my goal is to get a new round of larger funding for several years once we prove efficacy. The basic equipment funded by CATCH such as yoga mats and pedometers will continue to be used for years. With the exception of the yoga instructor, we have the entire team of professionals involved in this program on staff already, doctors, nutritionist and social worker. Each member is basically doing the job they are paid and trained to do, with additional hours provided by the nutritionist to intensify the program. Each member who chooses to work in the program and serve as a walking leader is the type of person that truly enjoys mentoring and physical activity so they will continue because it is a fulfilling experience. As mentioned earlier, college volunteers could also serve as leaders for the walking part of the program if needed. Premed, nursing, nutrition, and psychology students would be ideal.

35. How will you assess the achievement of your project goals listed at the beginning of this section (outcomes must be measurable)? Check all that apply. X Number of children served: Implementation Grant applicants only (Specify number 90 in 6 months) Coalition formed Community forum held Completion of community assessment Number of children/families enrolled Number of grant applications written Number grant applications submitted Number grants submitted Funding obtained Number of meetings of planning committee/task force Number provider contacts Number of referrals made or completed Number of surveys/focus groups/interviews Partnerships developed Other (specify ___________________________) 36. Please describe how you will assess achievement of your project goals. Maximum 200 words The achievement of the project goals can be assessed by a pre and post program questionnaire or exam. Before the program, we can have each participant answer questions about health, nutrition, and exercise. We can ask knowledge based questions about calories, cholesterol, BMI, and exercise to assess their Health IQ. I suspect a substantial increase in their Health IQ after their 8 week participation in the program. We can also ask participants to rate their confidence and body image before and after the program. We can mail questioners to see if participants are continuing walking and diet. In addition, using E clinical, we can track the BMI, weight, BP and cholesterol in the months and years following the program to show long term results. 37. BUDGET DETAIL AND JUSTIFICATION OF LINE ITEMS To avoid the possibility of personal tax liability, after receipt of award notification and budget approval, applicants are required to appoint a tax-exempt fiscal agent to deposit the grant funds. For example: Your AAP chapter, a nonprofit community organization, your tax-exempt organization or institution. The institution or organization that acts as fiscal agent is not the grantee or cograntee. 1. 2. 3. 4. Budget must clearly support the goals and timeline outlined in your application. Budget must include a complete description of each activity. All budget line items must include a formula. Do not group multiple activities in one line item. Description of Activity Description of Expense and Formula

$ Amount

1. Walking Program supplies 2. Yoga supplies

1.

Podometer $10.00 per piece X 33 participants ( 30 people and 3 extra) 1. Yoga mats bulk pack of 36 mats 2. Yoga blocks $4.00 X 30 people

$330 $300 $120

3.

Nutrition lesson supplies

1. Fat caliper $5.00 X 2 2. Food diary Meade notebooks $1 X90 participants for 6 months

$10 $90 $90

3.Calculators $3 X 30 4. Promotion and Advertising $720 1. Custom Ink T shirts $8.00 X90 (30 kids per 2 month session, 6 month period) $280 2. Brochures ($0.40 X 700)

5.

Incentives 1. Gift Certificate for free fruit smoothie at nearby store for 2 participants with highest miles walked per week in each group $3.00 X4 people per week X 24 weeks 2. Prize Yoga mat for top 4 people who attended the most extra yoga sessions. $11/mat X 4 people X3 session ( over 6 month period) 3. Prize podometers for 4 people who walked the most miles mid program and 4 people that walked the most miles by the end of the program. $10 X 8 people per session X 3 sessions (over 6 months) 4. Celebratory End of Program Healthy Dinner Party. $5.00 per plate X 30 participants X2 for parent X 3 sessions (over 6 month period) $288

$132

$240

$900

6. Food Healthy Snack 1X/week at meet up, $2.00 per person X 30 people X 8 weeks X3 sessions $2.50 per subway ride X 4 rides per week ( back and forth for biweekly walking) X 8 weeks X8 people ( majority will live in walking distance) X 3 sessions ( over 6 month period) $75 per session, once per week for 24 weeks ( over 6 months, each group has 8 week session )

$1440

7. Subsidized Transportation

$1920 $1800

8. Yoga instructor salary

9. Nutritionist Salary

$18/hour, 30 minute group info sessions X4( 1 X/week for 4 weeks)

$36

Individual nutrition sessions $18/hour long session X 2 sessions and 30 participants X3 ( over 6 $3240 months there are 3 separate groups enrolling) Note: nutritionist protocol for her current part time employment financed by our clinic is to see a patient only once per month, in other words 2 sessions over the 2 months is routine practice. In this intense 8 week comprehensive program, the patient meets weekly with nutritionist, specifically 4 X are in a group and 4 X are individual. Therefore I am asking for 2X to be funded by CATCH grant because these are extra individual sessions above her normal role as a nutritionist ) Maximum Allowance $12,000 $11,936 If your budget includes salaries, please justify by relating each staff position to a specific outcome. 38. Identify sources of past, current, and possible future funding. Past: none Current: (for the proposed project only) AAP CATCH Possible future: Pediatrics 2000, All City, Healthy Tomorrow RFP grant, CHALK (Choosing Healthy Active Lifestyle for Kids), NIH obesity grants, Aetna and other health insurance obesity grants, ConAgra Foods Foundation, Finishline, The Obesity Society, New Balance Foundation, Heinz, The Clorox company. OPTIONAL ATTACHMENTS: The online application allows a maximum of 4 one-page attachments. Attachments may not be used to respond to questions contained within the application.

PEDIATRICIAN SURVEY: The applicant must respond to the questions below in order to submit the completed application. This survey is not scored or considered in funding decisions. This is an anonymous data collection for CATCH Program evaluation purposes. 1. How did you learn about CATCH grants? Check all that apply. AAP News X AAP Website AAP Mailing AAP Chapter Meeting CQ Newsletter Email list serve (specify _______________________) Colleague Other (specify_______________________________) 2. Please indicate your current involvement with AAP. Check all that apply for both state and national. State AAP Chapter Attend meeting Serve on committee Other (specify ________________________) X None National AAP X Attend meeting Serve on committee Other (specify ________________________) None 3. Have you participated in any of the following AAP child health initiatives? Check all that apply. Bright Futures CATCH Community Pediatrics Training Initiative (CPTI/Dyson Initiative) Healthy Child Care America Healthy Tomorrows X Medical Home Initiative Mentorship and Technical Assistance Program (MTAP) None of the above 4. Please identify other community child health activities in which you have been involved in the past 12 months: Check all that apply. X Health and Fitness Related includes camp, health fair, public health clinic, recreational sports team physician Please specify activity: _____Yoga Class______________________________ School/Education Related includes child care center, school consultant, school health clinic provider, special education program consultant, school board member, school sports team physician Please specify activity: _____________________________________ Other Government/Public Health Program Related includes child protection services/agencies, children with special health care needs/Title V, Courts, Child-specific advisory committees (eg, IDEA (Individuals with Disabilities Education Improvement Act), newborn screening, Head Start, MCH, Immunization) Please specify activity: _____________________________________

Non Profit Organization Related includes child advocacy (eg, Voices for Children, Children's Defense Fund), shelters for homeless, mobile health services, volunteer organizations (eg, AAP chapter or national activities, March of Dimes, Rotary, Kiwanis) Please specify activity: _____________________________________ Other Please specify:_Red Cross Disaster Relief, Pediatric Team: Hurrican Sandy, John Jay Shelter None of the above 5. What benefits do you receive as a result of your participation in community child health activities? Check all that apply. Benefits to practice (referrals, agency relationships, etc) Money/compensation Professional recognition X Opportunity to spend time with like-minded peers X Gain valuable skills and/or knowledge Mentorship Meet professional requirement/obligations X Personal satisfaction Visibility and/or credibility in the community X Opportunity to improve child health in your community No benefits Other (please specify ____________________________) 6. Do you have contact with a person who provides guidance or advice to you about involvement in community child health activities? X Yes No 6a. Please indicate from whom you receive guidance or advice. Check all that apply X Pediatrician practicing in the community , Dr Perello MD MPH, medical director at Pediatrics 2000 Pediatrician in an academic setting X Non-clinician from a community-based organization , social worker and nutritionist Family member X Community member , Doreen Davis: Boys and Girls Club community coordinator Other (specify____NYC DOH School Nurse for Kipp Charter Infinity and Roberto Clemente middle school___________) 7. Do you provide guidance or advice to colleagues or trainees about community child health activities? X Yes No 8. About how many days have you participated in community-based child health activities during the past 12 months? No days 1-10 days X 11-20 days 21-30 days More than 30 days

9. Would you say your current level of involvement in community-based child health activities is: Too little X About right Too much 10. In the next 5 years, do you expect your level of involvement in community-based child health activities will: X Increase Stay the same Decrease 11. Which, if any, of the following strategies do you use to influence child health in your home or practice community? (Check all that apply.) Volunteer at a community clinic Serve on a community organization board X Participate on a child health committee or project Work as a coalition member Educate legislators (e.g. send letters, email, provide testimony) Communicate with the media (e.g. letter to editor, op ed, provide interviews) X Address parent, teacher, or other community groups Mentor other professionals Work with local AAP Chapter or other professional organizations Vote in local or state elections Other (specify _______________________) None of the above For assistance with proposal development contact your Chapter CATCH Facilitator and/or staff. See below for budget development guidelines.

Division of Community-based Initiatives American Academy of Pediatrics CATCH staff: 800/433-9016, ext 4916 or 847/434-4916 E-mail: catch@aap.org