This sample is brief and incomplete and is intended to demonstrate the relationship between elements.
Ctrl+Click on instructions and measurement of performance(below) for more information.
Title V / Maternal and Child Health (MCH) subgrant – FY 2013
Report on Work Plan
☒1st Quarter / ☐2nd Quarter / ☐3rd Quarter / ☐4th Quarter10/01/12 -12/31/12 / 01/01/13 – 03/31/13 / 04/01/13 – 06/30/13 / 07/01/13 – 09/30/13
Subrecipient: / ABC Organization
Street Address: / 12345 East South Street
City, State, Zip: / Anytown, NE 68989
Primary Contact: / Sally Brown
Phone: / (308)356-2345
Email: /
Seeinstructions.
See measurement of performance.
ABC OrganizationFY 2013 - 1st QuarterPage 1
Use the space below for more general narrative about the Work Plan. For example, share success stories, unanticipated challenges, and/or to describe any change in the Work Plan based on your formative evaluation.
There was a slight delay in the October 1 start-up due to an unanticipated staff change in August in a partner organization. The position was filled in late October. We vigorously worked to get the partner’snew hire oriented to the project. The other partner organizations pitched in to help with recruitment of participants and to compensate for a change in the timing of the first meeting of the working group. As of December 31st, the project is nearly back on the 1st Quarter ending timeline, and is expected will be completely on track by February 1st.
Goal1 / Reduce percent of school-age children who are overweight and obese in Community XYZ.Outcome1 / School Districts in XYZ provide nutritious and appealing school meals that comply with the “Dietary Guidelines for Americans”.
Objective 1 / By September 30, 2013, 90% of schools in XYZ will use healthy food preparation methods and purchasing techniques.
Activities:
1.1 A working group has initially formed with relatively good representation of school administration and food service management after two meetings. The first meeting was held November 8 with an agenda of open dialogue and initial next steps; five administrators and three food service managers participated. Each participant committed to personally invite one additional person, at a minimum, and promote their attendance at the December 10 meeting. There were nine administrators and seven food service managers at the 2nd meeting December 10. The completed agenda expanded on the dialogue of the prior meeting, established a working group charter to guide the group towards its mission of full compliance with the “Dietary Guidelines for Americans”, and scheduled the 3rdmeeting and agenda which should help recruit/promote additional participation.
1.2 Guidelines and standards were reviewed at the 2nd meeting. Input from the nine administrators and several food service managers was documented and sent out to invitees requesting additional input,along with the notice of 3rd meeting notice and agenda scheduled for January 15.
1.3 – 1.6 Not applicable this period.
Performance Measures: In the first row, state the measure for each: a) quantity; b) quality; c) result. Report on the measure in the row immediately below it.
a) / 90% of schools in district participate in work group. (quantity; effort)
Initial report on this measure is 50% at the 2ndmeeting mark. Nine administrators and seven food service managers represent 10 schools of the 20 schools in the district. We expect these numbers to rise and with wider district representation at the 3rdmeeting.
b) / Two (2) schools complete pilot of consensus work plan. (quality; effort)
Not reportable this period.
c) / 90% of schools are implementing piloted and updated work plan. (result; effect)
Not reportable this period.
Goal 1 / Reduce percent of school-age children who are overweight and obese in Community XYZ.
Outcome 2 / Parents/guardians of school-age children model and/orsupport physical activity and nutrition at home.
Objective 1 / By September 30, 2013, 50% of respondents representing households in the school district report an increase in physical activity and nutrition for their school-age children within the past 12 months.
Activities:
1.1 Results of a written survey of parents/guardians administered in print and online in the previous school year were used to identify the areas of strengths and challenges experienced in households within the school district, leading to the design and content of the school assemblies.
1.2 Five school assemblies were broadly announced and the content promoted through traditional methods and social media for wide appeal among parents/guardians:
October 25 - 46 parents/guardians representing 33 of 89 households (37%) @ Sandoz Elementary
November 5 - 83 parents/guardians representing 51 of 122 households (42%) @ Cather Elementary
November 7 - 37 parents/guardians representing 21 of 73 households (29%) @ Prairie Elementary
November 8 - 62 parents/guardians representing 45 of 98 households (46%) @ Abbott Elementary
November 14 - 51 parents/guardians representing 35 of 102 households (34%) @ Norris Elementary
1.3 Schools regularly posted messageson their Face Book page headed "Tip of the Week" to offer suggestions to parents/guardians on practical ways to enhance physical activity and nutrition at home, as both model and coach with their school-age children. The posts have received numerous hits with many likes and a number of comments (see Attachment 1).
1.4 - 1.5 Not applicable this period.
Performance Measures: In the first row, state the measure for each: a) quantity; b) quality; c) result. Report on the measure in the row immediately below it.
a) / 30% of district households attend school assembly regarding family's role in physical activity and nutrition. (quantity; effort)
To-date, 279 parents/guardians representing 38% of households (185/484) have attended an assembly held in 5 of the 20 schools.
b) / 70% of parents/guardians are favorable to suggestions to support physical activity and nutrition at home. (quality; effort)
Very early indications are positive that parents/guardians are receptive to suggestions about their role as parents and how they can help to achieve this goal. Qualitative data is being collected which is based on the number of hits, likes, and comments on the "Tip of the Day" posts on Face Book and comments at the school assemblies held to-date.
c) / 40% of parents who acknowledged their own personal ‘room for improvement’ are practicing increased physical activity and improved nutrition at home to model to their school-aged children. (result; effect)
Not reportable this period.
ABC OrganizationFY 2013 - 1st QuarterPage 1
INSTRUCTIONS: A fillable form is intended to simplify the report process. If you have problems using the form, you may type your report in your own document, however, use the same format.
Click on the box to insert an ‘x’ next to the relevant Quarter. Enter information in the shaded areas of the fillable form; it will expand as text is entered. Enter demographic information. Double click at the bottom of the page to toggle to the footer. Enter Subrecipient name and reporting period (e.g. FY 2013 - 1st Quarter). Double click to return to the document.
Report on the Work Plan using these steps: Step 1. Copy / paste or type the Goal, Outcome(s) and Objectives for each goal from your DHHS-approved Work Plan. Helpful hint: Click inside the shaded area and begin typing, or copy/paste from your Work Plan. Step 2. Create additional table(s) for each goal and outcome. A goal may have more than one outcome and typically has multiple objectives. Helpful hint: Rest the cursor on the table until the table move handle appears. Copy the entire table, or only parts of the table. Paste into the shaded areas. Check that the Goal, Outcome, and Objectives are numbered correctly. Step 3. Use a separate report for each quarter. Do not add text to previous reports for a cumulative report as this practice unnecessarily creates lengthy reports. Helpful hint: Duplicate the MS Word file for each of the four reporting periods. Determine if, for your specific Work Plan, it is more efficient to duplicate before, or after, the next step. Step 4. Using the numbering system in the approved Work Plan (1.1, 1.2, 1.3; 2.1, 2.2; 3.1, 3.2, etc)., report on each planned activity, including as relevant ‘not applicable this quarter’ . Be sure to adjust activities, if needed, based on your formative evaluation. Step 5. Report on performance measures when appropriate to do so. Because the performance measures assess different aspects of an objective, they will not necessarily be measured at the same time or with the same data/methods. Measures of quantity may be reportable for 1st or 2nd Quarters, measures of quality for 2nd or 3rd Quarters, and measures of results for 3rd or 4th Quarters. Helpful hint: If your performance measures were incorrectly stated as activities in the Work Plan, it’s not too late to modify the measures to more accurately identify an expected level of achievement towards the objective. Step 6. Submit the report electronically to , or mail to Rayma Delaney, Lifespan Health Services, Nebraska.
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The measurement of performance is meant to improve program delivery and effectiveness. The objectives in your Work Plan must be monitored and measured for progress towards the outcome(s) and goal. This is done through performance measures. Each objective should have three corresponding performance measures that address 1) quantity, 2) quality, and 3) result. It may be necessary to set baselines of current performance and targets for improvement based on new activities.
Be careful when developing performance measures. Measures are not statements of activity, rather a statement how a culmination of Work Plan activities can simply be identified as having reached an expected level of achievement. Correct performance measures are dependent on the goal, outcomes(s), and objectives as well as the resources that can be committed to achieving the desired results. Below is a brief description of the three types of measures:
- Measures of Quantity: This is a measurement of effort and is the most common type of data collected by a program or project. This answers questions about what is being produced and how much was provided. Examples are the number served and demographics, or the number of activities.
- Measures of Quality: This is a measurement of effort that answers questions about how well the program/activity did in meeting an objective. Examples of measures of quality are motivation, satisfaction, knowledge, and awareness of participants or the target population as well as the accuracy, accessibility, and timeliness of the intervention/activity.
- Measures of Result: This is a measurement of effect that answers questions about how well your effort worked for those you are targeting and whether the expected change occurred. Some examples are the number and percent who perform as expected (now and across time) or number and percent reporting a change in behavior.
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Instructions - Title V / MCH Subgrant - Report on Work Plan