Afterschool Program Needs Assessment

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1. How often does your after-school program promote healthy food choices to students through planned educational lessons or interactive activities?

How often does your after-school program promote healthy food choices to students through planned educational lessons or interactive activities?   One day per week Two days per week Three days per week Four days per week Everyday None, we do not provide this type of education

Other (please specify)

2. Would you be interested in learning how to promote healthy food choices to students by using any of the following fun, interactive activities in your after-school program? Check all that apply.

Would you be interested in learning how to promote healthy food choices to students by using any of the following fun, interactive activities in your after-school program? Check all that apply.   Gardening activities Hands-on food or cooking activities Peer or cross-age education (students teaching students) Take home activities for students to do with their families Service learning projects (students providing community service) Student advocacy projects (students advocating for changes that promote health in their community or school)

Other (please specify)

3. Would you be interested in learning how to promote healthy food choices to students using fun, interactive activities that help students meet the following academic goals/standards? Check all that apply.

Would you be interested in learning how to promote healthy food choices to students using fun, interactive activities that help students meet the following academic goals/standards? Check all that apply.   Math Science Social Studies Language Arts Technology

Other (please specify)

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4. Does your after-school program provide healthy snacks OR do the students in your program have access to healthy food or beverage choices at your site?

Does your after-school program provide healthy snacks OR do the students in your program have access to healthy food or beverage choices at your site?   Yes No Not sure if the snacks/beverages are healthy

5. Would you like information on federally-funded child nutrition programs that can support healthy snacks for your after-school program?

Would you like information on federally-funded child nutrition programs that can support healthy snacks for your after-school program?   Yes No

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6. How many days per week do the children that attend your after-school program engage in "structured physical activity" (activity led by a member of the staff or an outside provider - such as kickball, a running or walking club, or aerobics)?

How many days per week do the children that attend your after-school program engage in "structured physical activity" (activity led by a member of the staff or an outside provider - such as kickball, a running or walking club, or aerobics)?   None 1 day 2 days 3 days 4 days Everyday We do not have structured activity time, but we do have "free time" when children can choose to be physically active or not.

Other (please specify)

7. If your after-school program does not provide daily opportunities for structured physical activity, what are the biggest barriers to doing so? Check all that apply.

If your after-school program does not provide daily opportunities for structured physical activity, what are the biggest barriers to doing so? Check all that apply.   Lack of staff Lack of training or "know how" to provide structured physical activity Lack of space Lack of equipment

Other (please specify)

8. Does your after-school program partner with any organizations (park districts, YMCA, schools, local businesses, etc.) in the community to support student wellness?

Does your after-school program partner with any organizations (park districts, YMCA, schools, local businesses, etc.) in the community to support student wellness?   Yes No

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9. Would you be interested in participating in a webinar that provides information, strategies, and resources to help students make healthy food choices and be more physically active?

Would you be interested in participating in a webinar that provides information, strategies, and resources to help students make healthy food choices and be more physically active?   Yes No Not sure

10. What types of resources would be useful to you on a web page devoted to student wellness promotion in after-school programs? Check all that apply.

What types of resources would be useful to you on a web page devoted to student wellness promotion in after-school programs? Check all that apply.   Short and simple activities that encourage children to make healthy food choices Nutrition activities that can be used with a wide range of ages Free, downloadable nutrition activities or physical activity programs Physical activity ideas for small spaces, such as a classroom Training opportunities for staff development Funding opportunities for after-school programs Innovative ways to connect with community partners Best practice ideas for after-school programs Ideas for healthy snacks, recipes, or menus for your program Take-home activities Spanish resources

Other (please specify)