Public Health Goal: What is the public health goal that the intervention is addressing? Resources List all resources available for the program and ensure that the activities are implemented Program activities Describe activity #1 Describe activity #2 Describe activity #3 Outputs Number of products of intervention #1 Number products of intervention #2 Outcomes Short term What is the short- term outcome of these activities? Mid-term Mid-term outcome Long term Long-term outcome What are the external factors identified by the literature or the stakeholders that affect program implementation? Public Health Goal: Reduce the rates of disease and disability associated with obesity Resources The policy that requires 30 minutes of physical activity Space Teachers Curriculum Equipment Allocated funds for salary supplements Program Activities Training camps for teachers Exercise Curriculum administered in classrooms Intramural sports activities Outputs Number of teachers across the district trained in the policy and curriculum Number of schools in the district who have adopted the policy Outcomes Short term Increased percent of K-12 children who are physically active Mid-term Reduced rates of obesity Long term Reduced rates of obesity related disease and disability External Factors: Resistance to physical activity in schools from law makers; lack of equipment for physical activity; insufficient trained staff; few options for physical activity in school; poor funding of schools