FAITH IN PREVENTION PROGRAM Faithful Families Eating Smart and Moving More

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FAITH IN PREVENTION PROGRAM REQUEST FOR APPLICATIONS Faith-Based Organization Mini-Grants I. OVERVIEW: With support from the New Jersey Department of Health (NJ DOH), Public Health Services, and Division of Family Health Services, the Camden Coalition of Healthcare Providers is pleased to present Faith in Prevention, a cross-cutting public health initiative. Faith in Prevention is designed to fortify ties among faith-based organizations (FBOs), hospitals, and community based health services to improve the quality of care for vulnerable populations, mitigate the chronic disease burden, and reduce health care costs. The Faith in Prevention program is intended to build partnerships with the faithcommunity to increase knowledge regarding healthy lifestyles, increase the number of congregants who adopt healthy eating and active living practices, and improve health outcomes for the city of Camden. The program aligns with goals and objectives in the national Healthy People 2020 plan and the State of New Jersey s Healthy NJ 2020 plan. The Camden Coalition s Faith in Prevention project involves a two-part strategy: Part I involves promoting health education, meal planning, and cooking activities among Camden s faith-community by implementing Faithful Families Eating Smart and Moving More (FFESMM), and evidence-based curriculum, and awarding mini-grants to implement policy and environmental changes. Part II entails integrating the faith-based community into the Camden Coalition s care coordination activities utilizing the Health Information Exchange, a web-based platform that offers faith-based organizations the opportunity to increase the level of support to members who have been recently admitted to the hospital. Rolling applications will be accepted starting February 2, 2016. Early submissions will receive priority. Submissions will be closed when all positions are filled.

FAITH IN PREVENTION PROGRAM II. REQUIREMENTS / ELIGIBILITY: 1. Applicant must be a faith-based organizations located within Camden City. 2. Applicant must have three (3) individuals who will become the group leaders and participate in all required trainings for the Faithful Families program. 3. Applicant must submit responses to all of the questions asked in Section V. 4. Applicant must secure the involvement of their congregants or community members for participation in the Faithful Families program, with a focus (but not exclusively) on individuals with chronic diseases. The Faith in Prevention program is also great to run within youth groups. III. TECHNICAL ASSISTANCE: 1. All interested faith-based agencies are highly encouraged to attend a Technical Assistance Meeting on January 26, 2016 at 9:30 AM 800 Cooper Street, 7th Floor (large conference room) Camden, NJ 08102 2. Site visits may be scheduled before final approval of application. 3. All questions must be emailed to statum@camdenhealth.org. Rolling applications will be accepted starting February 2, 2016. Early submissions will receive priority. Submissions will be closed when all positions are filled.

FAITH IN PREVENTION PROGRAM III. FUNDS AVAILABLE: The has set aside $92,720 in Faith in Prevention grant funds to award mini-grants to eligible applicants. Mini-grants will be awarded based upon the proposed activities, with a maximum grant amount of $4,600. For a faith-based organization to be eligible, the organization must have met Level 1 requirements of the FFESMM curriculum, as follows: 1. Selection through this Request for Proposal and successful completion of the Faithful Families leaders training is a pre-requisite to submit proposals for policy and environmental implementation mini-grants. 2. Demonstrated commitment from congregation leadership to support the program. This may include personally participating in the program and serving as a role model; quoting stories or scriptures from the faith tradition about healthy eating, physical activity, or healthy lifestyles in sermons and talks; making announcements about the program and promoting healthy eating, physical activity, and healthy living in bulletins, newsletters, and other organization communications; etc. i. Identification of Faith in Prevention program coordinator for the faith-based organization (may be staff member or lay person). ii. Establishment of a health committee (2-3 ppl) to conduct assessment and planning and oversee implementation. iii. Assessment of the faith community to ascertain areas of need and interest, using FFESMM survey tools for the community as a whole and for individual members. iv. Development of a program plan for the faith community. This plan should guide your response to the RFP. IV. COMPENSATION: FBO will receive compensation for successful completion of the above services and shall not exceed $1,000. The compensation schedule is set forth in the schedule below: (a) Completion of lay leader training (minimum 3 lay leaders): $1,000. a. The $1,000 should be used as program start-up funds and will be deducted from the total amount available per faith-based organization.

FAITH IN PREVENTION PROGRAM V. APPLICATION: The Applicant must respond to all questions asked and provide the following: 1. Letter of commitment on organization letterhead, signed by authorized individual (e.g., church pastor, leader of faith-based CDC, etc.). The letter should include ways that leadership plans to support and promote the adoption of FFESMM guidelines and activities. 2. Written proposal explaining why the Faithful Families program would be beneficial to your congregants (2-3 paragraphs). 3. Each faith-based agency must identify three staff and /or congregants participate and complete the Faithful Families Eating Smart and Moving Forward curriculum and will be responsible in implementing the program within your agency. Please describe the qualifications of the three individuals who may participate in the training and clearly identify the project coordinator. 4. On Attachment A, please estimate the demographics of your congregation. 5. On Attachment B, please provide a description of the facilities to be used in implementing the Faithful Families program. 6. Faith Community Assessment a. The Faith Community Assessment should be used by faith-based organizations to draft mini-grant proposals. The mini-grant proposal should outline policy and environmental changes that will mitigate the impact of health issues that afflict individual participants and entire congregations. Please see the Faith in Prevention program schedule for mini-grant submission dates. 7. Provide a Certificate of Insurance showing the current business insurance policies your agency has in place. *Note: If an organization wishes to establish a community garden to grow fresh produce as one of its FFESMM activities, the Camden Coalition has an agreement with Parkside Roots to Market to provide education and technical assistance. Rolling applications will be accepted starting February 2, 2016. Early submissions will receive priority. Submissions will be closed when all positions are filled.

FAITH IN PREVENTION PROGRAM VI. REVIEW, AWARD, & TRAINING SCHEDULE: October 1, 2015 Release of Request For Proposals January 26, 2016 Technical Assistance Meeting 9:30 am 11:00 am 800 Cooper St., 7th flr Large Conference Room, Camden, NJ 08102 Rolling applications will be accepted starting February 2, 2016. Early submissions will receive priority. Submissions will be closed when all positions are filled. VII. SUBMISSION: 1. One (1) original and three (3) copies of the complete must be submitted 2. Applications are to be submitted online (camdenhealth.org) - or delivered to: Summer Tatum 800 Cooper Street, 7th Floor Camden, NJ 08102 3. It is recommended that all applications be hand delivered. No faxed application packets will be accepted. All packets must be received by the required due date and time. 4. Application packets can also be delivered electronically to the following: Summer Tatum statum@camdenhealth.org

FAITH IN PREVENTION PROGRAM ATTACHMENT A DEMOGRAPHICS In the chart below, estimate the demographic make-up of your congregation. Place a number in each box. The minimum number of participants will be 15 with a maximum number of participants being 30. Faith-Based Organization: Project Leader: Address: City: Total Population: ZIP: AGE Race Residency # to Participate African American Hispanic Caucasian Other Camden City Other Camden City Other ** 10 20 21 40 41 60 61 80 Over 80 ** - No more than 20% of the participants can reside outside of Camden City. This information is provided as a snapshot look at my faith-based agency. Changes may need to be made as we move forward. Faith-Based Leader s Name (Print) Faith-Based Leader s Signature

FAITH IN PREVENTION PROGRAM ATTACHMENT B FACILITIES For each of the activities listed, identify where the group activities will take place. Faith-Based Agency: Project Leader: Address: City: ZIP: Activity Faithful Families classes Location Maximum Number of People Recreation Space Cooking classes One on One Activities (biometric data collection) Office facilities Green/Growing Space (on-site community garden) This information is provided as a snapshot look at my faith-based agency. Facility changes may need to be made as we move forward. Faith-Based Leader s Name (Print) Faith-Based Leader s Signature

FAITH IN PREVENTION PROGRAM FAITHFUL FAMILIES NUTRITION TRAINING (Mandatory for all Faith in Prevention Leaders) WHEN FEBRUARY 15 TH 17 TH TIME 5:30 PM NIGHTLY WHERE Camden Coalition of Healthcare Providers Bridgeview Building, 8 th FL 800 Cooper Street Camden, NJ 08102 CLASS SCHEDULE: February 15 th : Faith in Prevention Overview Faithful Families Overview Role of the Lay Leader February 16 th : Faithful Families Sessions 1 4 Cooking Demonstration February 17 th : Faithful Families Sessions 5 9 Program Expectations Program Recruitment CONTACT INFORMATION: Summer Tatum x. 2074 Deborah Riddick x. 2088

Faith Community Assessment NJDOH Faith in Prevention Initiative General Information Date: / / Name of Faith Organization: Address of Faith Organization: Phone Number of Faith Organization: County: Person conducting survey: Name and title of interviewee: Phone number of interviewee: Email address of interviewee: PROFILE OF THE FAITH COMMUNITY 1. Faith Tradition: A.M.E. Zion Baptist (not specified) Baptist (Southern) Baptist GBSC Episcopal Disciples of Christ Greek Orthodox Jewish (Reform) Latter Day Saints Jewish (Conservative) Jewish (Orthodox) Presbyterian Church of Am. Lutheran Methodist United Church of Christ Pentecostal Presbyterian (USA) Hindu Roman Catholic Seventh Day Adventist Muslim Non-denominational Christian Inter-denominational Christian Buddhist Other Tradition: 2. What is interviewee s role in the organization? Pastor/Priest/Rabbi/Imam Deacon Member Other: 3. About what percent of the faith community is made up of: Hispanics White Black or African American American Indian or Alaska Native Native Hawaiian Vietnamese Asian Indian Guamanian or Chamorro Korean Chinese Samoan Japanese Filipino Other Pacific Islander Other Asian

4. Number of members of faith community: 5. About what percentage of the faith community is: Male Female Transgender 6. Percentage of the faith community aged: 0 12 Years 13 24 Years 25 35 Years 36 54 Years 55 66 Years 67 and older 7. What are the languages spoken/written by your congregants other than English and Spanish? HEALTH/WELLNESS INFRASTRUCTURE 8. Does the faith community have health as part of its creed or mission statement 9. Does the faith community have an active health team or committee? 10. Does the faith community have a person appointed to be responsible for health related activities? 11. Does the faith community have a lay health advisor program? 12. Has the faith community surveyed members on health issues in the past 12 months? (choose all that apply) yes, a survey was conducted to help community leaders understand the health issues of the membership (e.g. needs assessment) yes, surveys or forms were used to help community members identify their own personal lifestyle risk profile (e.g. health risk appraisals) no surveys were used don t know 13. Does the faith community have a budget for health promotion or health related activities? 14. Has the faith community ever established health or wellness goals for the organization/membership? Score: (# of Yes answers) out of 7 PARTNERSHIPS AND PROGRAMS 15. Has the faith community sponsored a health fair during the past 12 months? In the past 12 months, has the faith community offered: blood pressure screening? cholesterol screening?

blood sugar/diabetes screening? healthy body weight screening? 16. Has the faith community participated in a parish nursing program within the past 12 months? 17. Do any members currently represent the faith community by serving on a community health coalition or committee (e.g. fitness/nutrition council)? 18. Has the faith community had a relationship with another health, health promotion, or human services agency to provide services to members in the past 12 months? If so, what are those agencies? Agency 1: Agency 3: Agency 2: Agency 4: Score: (# of Yes answers) out of 8 PEOPLE 19. How many of the following people are members of this faith community? Physicians/doctors Other health professionals Dentists Type of health professionals counted above: Nurses/CNAs Health educators PHYSICAL ACTIVITY ENVIRONMENT 20. Does the faith community have an exercise room? 21. Does the faith community have any exercise equipment on-site? 22. Does the faith community have a walking trail? 23. Does the faith community have any outdoor courts or ball fields? 24. Does the faith community have a playground? Score: (# of Yes answers) out of 5 PHYSICAL ACTIVITY POLICIES AND LEADERSHIP 25. Does the faith community have a policy supporting physical activity opportunities at meetings or functions (e.g. walks, exercise breaks)?

26. Has the faith community provided physical activity opportunities at meetings or functions in past 12 months (e.g. walks, exercise breaks)? 27. Has leadership promoted physical activity in a public speech or sermon in the past 12 months? Score: (# of Yes answers) out of 4 PHYSICAL ACTIVITY GROUP SUPPORT/CLASSES 27. Has the faith community conducted any aerobics classes in the past 12 months? 28. Has the faith community promoted walking clubs in the past 12 months? 29. Has the faith community sponsored or supported sports team for members in the past 12 months? Score: (# of Yes answers) out of 3 PHYSICAL ACTIVITY INDIVIDUAL EDUCATION/INFORMATION 31. Has the faith community provided any individual fitness counseling in the past 12 months? 32. Has the faith community distributed any fitness guides to members in the past 12 months? 33. Has the faith community specifically promoted physical activity through posted information in the past 12 months (e.g. bulletin board, posters, flyers, leaflets)? 34. Has the faith community specifically promoted physical activity in the bulletin, program or newsletter in the past 12 months? 35. Has the faith community specifically promoted physical activity on the faith community website in the past 12 months? 36. Does the faith community have a relationship with a fitness club to offer discounted rates for faith community members? 37. Does the faith community support physical activity in any other way? (e.g. provide physical activity in faith community day care program or through religious education classes) If yes, please describe: Score: (# of Yes answers) out of 7

Nutrition Environments 38. Does the faith community have a cooking, kitchen, or hospitality committee? 39. Does the faith community have a kitchen or place to prepare meals? 40. Does the faith community have a garden maintained by faith community members? 41. Does your faith community have any vending machines? yes no (if no, go to Question 46) don t know (If yes) 42. Do vending machines have bottled water? yes no no drinks in vending machines don t know 43. Do vending machines have 100% juice? yes no no drinks in vending machines don t know 44. Do vending machines have low fat items (e.g. pretzels, light popcorn)? yes no no food in vending machines don t know 45. Do vending machines label low fat or healthy items? yes no no food in vending machines don t know Score: Score: out of 3 (if no vending machines) out of 7 (if the faith community has vending machines) Nutrition Policies and Leadership 46. Does the faith community have guidelines for faith community meals requiring that: fruits and vegetables be offered? 100% fruit juice be offered? water be offered? low-fat items be offered? low/no sugar items be offered? low-sodium items be offered? 47. Has leadership promoted nutrition in a public speech or sermon in the past 12 months? 48. Number of food events in the past 12 months: 49. Were healthy foods typically served at these food events? Score: out of 8

Nutrition Group Support/Classes 50. Has the faith community had any healthy cooking classes in past 12 months? 51. Has the faith community offered or organized any weight loss support groups in past 12 months? 52. Has the faith community provided any other nutrition-related classes or groups in the past 12 months? Score: out of 3 Nutrition Individual Education/Information 53. Has the faith community provided any individual weight control or nutrition counseling in past 12 months? 54. Has the faith community distributed any nutrition guides or healthy recipes (including cookbooks) to faith community members in the past 12 months? 55. Has the faith community promoted nutrition through posted information (e.g. posters, flyers, leaflets) in the past 12 months? 56. Has the faith community promoted nutrition in the bulletin, program or newsletter in the past 12 months? 57. Has the faith community promoted nutrition on the faith community website in the past 12 months? 58. Does the faith community support nutrition in any other way? (e.g. healthy food guidelines for faith community day care program, for meals for seniors or needy families) If yes, please describe: Score: out of 6 Relationship Between Religion and Health In Faith Community 58. What are some key teachings about health in the faith community? 59. What are some key scriptures, inspirational passages or religious teachings about health from this community s faith tradition?

60. Why is it important to participate in the Faith in Prevention program? Scoring: Health/Wellness Nutrition Health/Wellness Infrastructure: of 7 Nutrition Environments: of 3 or 7 (dependent on vending machine) Health/Wellness Percentage: Nutrition Environments Percentage: Partnerships and Programs: of 8 Nutrition Policies and Leadership: of 8 Partnerships and Programs Percentage: Nutrition Policies and Leadership Percentage: _ Physical Activity Nutrition Group Support/Classes: of 3 Physical Activity Environments: of 5 Nutrition Group Support/Classes Percentage: Physical Activity Environments Percentage: Nutrition Individual Education/Information: of 6 Physical Activity Policies and Leadership: of 4 Physical Activity Policies and Leadership Percentage: Nutrition Individual Education/ Information Percentage: Physical Activity _ Physical Activity Group Support/Classes: of 3 Area with highest percentage (e.g. environment, group, individual, etc.): Physical Activity Group Support/Classes Percentage: Area with lowest percentage (e.g. environment, group, individual, etc.): Physical Activity Individual Education/ Information: of 7 Physical Activity Individual Education/Information Percentage: Nutrition Area with highest percentage (e.g. environment, group, individual, etc.): Area with lowest percentage (e.g. environment, group, individual, etc.): *This survey is adapted from North Carolina s Program