SAMPLE Logic Model Worksheet.docx
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- Opportunity number
- MP-CPI-24-001
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This document contains a logic model worksheet template and description of a federal grant opportunity through the Department of Health and Human Services to support community-level innovations for improving health outcomes among racial and ethnic minority groups. The logic model template provides boxes for applicants to outline contextual factors and assumptions, list activities and inputs, and describe short-term, intermediate, and long-term outcomes culminating in overall impact. The federal grant opportunity is designed to fund partnerships between public health, community-based organizations, and healthcare providers to demonstrate effective models for increasing utilization of preventative services. Projects should address one to two Healthy People 2030 Leading Health Indicators and target disadvantaged communities. This funding opportunity is assigned to the Community Programs to Improve Minority Health Grant Program under CFDA number 93.137, which supports evidence-based interventions and innovative models to enhance health equity.
SAMPLE Logic Model Worksheet.docx
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Module 2 – Logic Model Development Worksheet Logic models help ensure each part of the project serves a clear purpose by connecting it to the end goal. This worksheet can serve as a template for developing a logic model for your project.
Example Logic Model
Causal/ Contributing Factors OMH grant Partnership with the school district Activities Inputs Outputs Short-term Outcomes Number of sessions held Number of students taught Number of classes held Number of families taught Intermediate Outcomes Long-term Outcomes Impact Increased consumption of fruits and vegetables Decreased disparities based on race in obesity and chronic disease among youth Decreased HbA1c among overweight youth participants Increased number of healthy meals cooked each week
Limited knowledge of nutrition Increased knowledge about nutrition Nutrition education sessions during afterschool program
Limited knowledge / skill to cook healthy meals on a budget
Increased confidence in cooking healthy meals Cooking classes for children and parents once per week
Program director, health educators, chef
Limited access to healthy food choices
Assumptions: students already enrolled in afterschool programming; community centers will be willing to provide space for cooking classes Contextual factors: limited access to fresh produce, history of environmental racism
Logic Model Template Fill in the boxes beneath each component of the logic model below, using the guiding questions listed for each. Note that this is just a template and every project’s logic model will look different. Please delete or add boxes and arrows as necessary.Activities Causal/ Contributing Factors Impact Long-term Outcomes Intermediate Outcomes
Short-term Outcomes Inputs Outputs
What are the long-term goals of the project?
What are the desired results at the end of the program?
What is needed to conduct the activities?
What factors contribute to the need for the program?
What outcomes will result from each immediate achievement?
What does project aim to achieve immediately?
How will you know activities were conducted?
What will you need to do to achieve the outcomes?
Assumptions:
Contextual factors:
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