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2023 Application Form

GHC Recognition Level Application

This is the application for your community to receive a Growing Healthy Community Recognition Level.

Communities like yours have set out to get healthier—economically, policy-wise, nutritionally and physically. In each Growing Healthy Community, there is an organized, multidisciplinary team working actively to drive health forward.

Applications are awarded on a monthly basis to communities (neighborhoods, schools, businesses), cities, and counties. Awards will state the year and recognition level of award. In order to retain Growing Healthy Community recognition status, communities must complete and submit the application by November of each calendar year.

 

GHC Recognition Level

Emerging Communities

Communities who receive the “Emerging” designation, are laying a strong foundation with a team of at least five individuals. GHC teams are made up of diverse stakeholders who are interested in creating healthier communities: elected officials, fundraisers, community volunteers and professionals in education, health-care, civic government and more.

Blossoming Communities

Communities that receive the “Blossoming” designation build upon the requirements of Emerging Communities and also provide a checklist community highlights, strategize plans for change, document successes and lessons learned, develop a strategic action plan that will help your community address concerns related to increasing access to healthy foods & physical activity. Strategic plans guide the direction community members take towards a clear, unified vision forward. Even better: ArCOP provides tools & guidance to assist communities with such planning! Documenting and publicizing success stories can rally community members and help them see that positive change is within reach! Publicizing projects helps increase success through maximized community use and/or participation. Discussing and tracking lessons learned can help community teams make improvements even faster by identifying what went well and what can be improved.

Thriving Communities

Communities that receive the “Thriving” designation build upon the requirements of Blossoming Communities and also demonstrate change through data and demonstrate environment, system and policy level change. ArCOP’s goal of a healthier Arkansas starts with individual communities. Providing data and demonstrating how your community’s efforts make positive change helps Arkansas measure statewide improvement. A community’s ability to make lasting change to both the environment and public policies is a sign of success and sustainability.

About Your Community

How would you like your community name in print?
County
Provide a 2-3 sentences, that we can publicize, telling us about your great community.
Upload any community images you would like publicized.
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General Information

Are you answering this survey to apply for Growing Healthy Community recognition with the Arkansas Coalition for Obesity Prevention?
If there is not a Mayor in your city, please list a City Elected Official.

Local Contact Information

Name of the main local contact person
Agency Affiliation of main local contact person
Phone Number of the main local contact person
Email address of the main local contact person
Growing Healthy Community (GHC) or Coalition/project Name
Name of Coalition Chairperson(s)
Agency Affiliation of Coalition Chairperson
Phone Number of the Coalition Chairperson
Email address of Coalition Chairperson
Add additional GHCs or projects working together in this county.
Name of Arkansas Department of Health (ADH) Local Health Unit Administrator
Name of Mayors involved in the project. Please indicate the city/town affiliation.
List names of other elected officials involved in the project. Please indicate the city/town affiliation.
Name(s) of person(s) completing this application
Email contact(s) for person(s) completing this application.
Name(s) of HHI staff member(s) assisting with completing this application.
List any other team members involved in the project that have not already been named.

GHC Team Member Contact Information

To receive Growing Healthy Community recognition, a community must have a team of at least five members.  Please provide the following information for five team members. 

Main Contact - Member #1
Member #2
Member #3
Member #4
Member #5

List Any Additional Members

Community Highlights

Activities
Select all activities that apply.
List any other activities that are not listed:

Healthy Active Arkansas (HAA)

HAA Priorities
In the past 12 months, which of the following priority areas from the HAA plan have you addressed? Select all that apply.

Stakeholders

Stakeholders
Who were key stakeholders implementing your plan? Select all that apply.
Other

Share Your Communities Success

Share one or more success stories from your team's efforts this year.
Marketing
Please share how you publicized the success. Select all that apply.
Other
Which of the following social media or electronic communications tools does your coalition/project use? (Check all that apply.)
Share one or more lessons learned from your team's efforts this year.

Policy Change

Share one or more examples of policy changes your community has made i.e. worksite wellness policy, complete streets policy, nutrition policy. If you have not made any changes yet please state "Not at this time."

Environment Change

Share one or more examples of changes your community has made to the physical environment i.e. sidewalks, bike lanes, signs and/or places encouraging active living or healthy eating, etc. If you have not made any changes yet please state "Not at this time."

System Change

Share one or more examples of system changes your community has made i.e. city ordinance, worksite functions/work flow, nutritional standards, etc. If you have not made any changes yet please state "Not at this time."

Previous Recognition

Please tell us if you have been recognized as a "Growing Healthy Community" before.
In what year(s) did you receive recognition? Check all that apply
What level(s) of recognition did you receive?

Coalition/Project Organization and Infrastructure

How do you best classify the organization of your coalition/project? (Choose the best one.)
Please indicate the items below that your coalition/project currently has in place. (Check all that apply.)
Upload meeting agendas or notes that reflect your project's priority areas of work (Up to 5 points)
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Upload mission and/or vision statements. (Up to 5 points)
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Upload overview of strategic plan (Up to 10 points)
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Upload brief written work plan. (Up to 5 points)
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Which of the following are currently represented on your coalition/project? (Check all that apply).
Which of the following high-level positions (or his designee) does your coalition/project have engagement or buy-in from? (Check all that apply.) "Engagement" would include ACTIVE coalition/project participation in some form. (Additional 1 point for each)
In 2022 (Jan 2022-present) which of the following did your coalition/project try to align or collaborate with when selecting its own priorities, strategies, and/or activities?
Does your coalition/project partner with any other local coalitions or groups to work on strategies and activities that also affect the program areas or health outcomes listed below?
If you answered Yes above, identify areas of partnership with any other local coalitions or groups (Check all that apply).
What percent of a full-time employee (FTE) is dedicated to coalition/project activities? This person could be funded by a grant or a partnering organization to work on coalition/project activities.
In 2022 (Jan 2022-present), which of the following funding sources helped support your coalition/project? (Include in-kind contributions of gifts, materials, printing, meeting locations, etc.) (Check all that apply.)
In 2022 (Jan 2022-present), which one of the following ranges includes the approximate dollar amount of your coalition's/project's total annual budget? Choose the most appropriate dollar range.
In 2022 (Jan 2022-present), at what level(s) was your coalition working to improve health? (Check all that apply.)
Upload any documents that verify your answer from above, i.e. event notice, policy, photo, organizational document, etc.) (up to 10 points)
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In 2022 (Jan 2022-present) , which of the following populations or areas did your coalition/project specifically target with any projects or activities in your community? (Check all that apply.)
For the target population group(s) checked, please briefly describe how you engaged with these groups during the planning and implementation of your efforts.

Settings and Strategies: The following questions ask about the settings where your coalition is working and your use of specific strategies that have been identified as Scientifically Supported or Some Evidence from relevant research. These strategies are likely to make a difference or tested favorable overall.

In 2022 (Jan 2022-present) , in which of the following settings did your coalition implement a strategy to promote healthy behavior? (Check all that apply) (Up to 3 points for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved to improve active living and healthy eating where people LIVE and PLAY? (Check all that apply) (Up to 2 points for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved to improve active living and healthy eating where people LEARN? (Check all that apply) (Up to 2 points for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved to improve active living and healthy eating where people WORK? (Check all that apply) (Up to 2 points for each)
In FY 2021 (Jan 2021-present), in which following strategies was your coalition involved to improve active living and healthy eating where people PRAY? (Check all that apply) (Up to 2 points for each)
In FY 2022 (Jan 2022-present), in which following overall strategies was your coalition involved to improve healthy families? (Check all that apply) (Up to 2 points for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved for injury and violence prevention? (Check all that apply) (Up to 1 point for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved for reproductive and sexual health? (Check all that apply) (Up to 1 point for each)
In FY 2022 (Jan 2022-present), in which following strategies was your coalition involved for mental and emotional well-being? (Check all that apply) (Up to 1 point for each)
In FY 2022 (June 2021-July 2022) , which of the following evaluation activities did your coalition participate? (Check all that apply) (Up to 3 points for each)
Please upload any additional documents that verify the work you are reporting. You will need to save them in one file.
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