Shape Up SF Collective Impact Reporting: Opportunities for Physical Activity PSE Strategies

Please enter the following information for any policies, systems, or environmental strategies your organization has implemented to increase opportunities for physical activity from July 1,2016

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* 1. What organization are you with?

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* 2. What is your name?

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* 3. What is your email address?

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* 4. Briefly describe any policy, systems, or environmental strategies your organization is working on to increase opportunities for physical activity.

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* 5. Which statement best describes how far along your organization is in implementing the above strategies? Please choose one.

Discussion and/or interest from leadership.

Actively gathering input and/or drafting a policy.

Policy has been approved but not yet implemented.

Policy has been approved and we have begun implementation - not complete roll out and/or compliance.

Policy has been approved and is fully implemented.

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* 6. Estimate the annual impact of this PSE strategy (Ex. 20 staff, 100 community members).

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* 7. Will members of the following groups be impacted? Select all that apply.

Black, Latino, Asian, and/or API youth 11 and under

Black, Latino, Asian, and/or API youth 12-17 years old

Black, Latino, Asian, and/or API adults

Providers (health care, teachers, childcare, etc.) who work primarily with youth or adults who are Black, Latino, Asian, and API

None of the above

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* 8. We want to understand if or how Shape Up SF contributed to making it happen. Please let us know if you agree or disagree with the following statements:

	Agree	Disagree
This activity would not have happened if SUSF hadn't prioritized increasing access to healthy foods.	This activity would not have happened if SUSF hadn't prioritized increasing access to healthy foods. Agree	This activity would not have happened if SUSF hadn't prioritized increasing access to healthy foods. Disagree
This activity would not have happened without funding, TA, or other support/encouragement from SUSF.	This activity would not have happened without funding, TA, or other support/encouragement from SUSF. Agree	This activity would not have happened without funding, TA, or other support/encouragement from SUSF. Disagree

Any comments about how Shape Up SF supported this activity?

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* 9. What advice do you have for other organizations considering PSE strategies to increase opportunities for physical activity? What leads to success?