Attachment 6.04 WIC Logic Model Form - FY 14
Breastfeeding Peer Counseling
Logic Model Instructions
1) Background
The Alaska Department of Health and Social Services (DHSS) is moving towards outcome based
performances that can measure how our efforts impact Alaska citizens. The Logic Model is a tool to
help with the development and evaluation of an outcome based Nutrition Services and Education Plan.
Please contact the Alaska WIC Program at 465-3100 for questions on how to complete a logic model
and the availability of training materials.
2) Instructions
a) Refer to the 3 logic model forms below
b) Update all sections of the Alaska BFPC goal areas:
Goal 1. Provide support to WIC eligible pregnant and breastfeeding women as an important
adjunct to the usual WIC program services.
Goal 2. To increase breastfeeding rates with an emphasis on exclusive breastfeeding and
ultimately reaching or exceeding the Healthy People 2020 Breastfeeding Goals.
Goal 3. Develop and implement partnerships for BFPC services to increase awareness of WIC
as a breastfeeding promotion and support program and aid in reaching Healthy People 2020
breastfeeding goals.
c) Complete and submit with BFPC FY 14-18 Proposal.
Attachment 6.04 BFPC RFP Rev. 1/18/13
Page i
LOGIC MODEL INSTRUCTIONS
This is a streamlined approach to creating a WIC BFPC logic model. Below is an example of how to
complete a Logic Model:
A. Choose an Alaska BFPC Goal Area: Goals are the ultimate impacts your program expects to
make, and are consistent with the larger mission and vision of your program.
Example: Goal Area— Develop and implement partnerships for BFPC services to increase
awareness of WIC as a breastfeeding promotion and support program and aid in reaching Healthy
People 2020 breastfeeding goals.
B. Choose a Long-Term Outcome: A long-term goal narrows the focus of the larger goal area.
Outcomes are the changes or benefits that result from program activities. The long-term goal will
probably not change from year to year, but may change every three to five years.
Example: Long Term Outcome—Increase breastfeeding duration at 12 months by 2%.
Determine the way(s) this outcome can be measured.
Outputs/measurements:
Example: Report 346 shows an increase in breastfeeding duration at 12 months.
C. Intermediate Term Outcomes: These are changes in beliefs, attitudes, knowledge, and
behaviors that the activity produces.
Example—Hospital OB staff will receive training on benefits of BFPC support at the hospital.
Determine the way(s) this outcome can be measured.
Outputs/measurements:
Example: Track number of BFPC referrals from hospital staff.
D. Short Term Outcomes: These are the activities, processes or events that you undertake using
the resources available to achieve the desired goal. List your major programmatic activities.
Examples: Meet with hospital administrative staff to discuss providing on-site BFPC services.
Determine the way(s) this outcome (activities, processes or events) can be measured.
Outputs/Measurements:
Example: Work with local hospital to provide BFPC services on-site to WIC clients.
Track the number of hospital based BFPC visits completed during the fiscal year.
Attachment 6.04 BFPC RFP Rev. 1/18/13
Page ii
Logic Model Form
Local Agency: ____Example_______________________________________
[SAMPLE] Alaska BFPC Goal Area 3:
o Develop and implement partnerships for BFPC services to increase awareness of WIC as a breastfeeding promotion and support
program and aid in reaching Healthy People 2020 breastfeeding goals.
1. Long Term Outcome:
Increase breastfeeding duration at 12 months by 2 %
Outputs/Measurements: (how results will be measured)
Report 346 will reflect an increase in Breastfeeding duration at 12 months.
2. Intermediate Outcome: (Learning/Knowledge)
Hospital OB staff will receive training on benefits of BFPC support at the hospital.
Outputs/Measurements: (how results will be measured)
Track the number of BFPC referrals from hospital staff.
3. Short-Term Outcome: (Activities/Behavior)
Meet with hospital administrative staff to discuss providing on-site BFPC services.
Outputs/Measurements: (how results will be measured)
Track the number of hospital based BFPC visits completed during the fiscal year.
Attachment 6.04 BFPC RFP Rev. 1/18/13
Page iii
Logic Model Form
Local Agency: ___________________________________________
Alaska BFPC Goal Area 1:
o
Provide support to WIC eligible pregnant and breastfeeding women as an important adjunct to the usual WIC program services.
1. Long Term Outcome: (Changes or benefits that result from program activities)
Outputs/ Measures (how results will be measured):
2. Short-Term Outcome: (Learning/Knowledge)
Outputs/ Measures (how results will be measured):
3. Intermediate Term Outcome: (Activities/Behavior)
Outputs/ Measures (how results will be measured):
Attachment 6.04 BFPC RFP Rev. 1/18/13
Applicant Logic Model Page 1
Logic Model Form
Local Agency: ___________________________________________
Alaska BFPC Goal Area 2:
o To increase breastfeeding rates with an emphasis on exclusive breastfeeding and ultimately reaching or exceeding the Healthy People
2020 Breastfeeding Goals.
1. Long Term Outcome: (Changes or benefits that result from program activities)
Outputs/ Measures (how results will be measured):
2. Short-Term Outcome: (Learning/Knowledge)
Outputs/ Measures (how results will be measured):
3. Intermediate Term Outcome: (Activities/Behavior)
Outputs/ Measures (how results will be measured):
Attachment 6.04 BFPC RFP Rev. 1/18/13
Applicant Logic Model Page 2
Logic Model Form
Local Agency: ____________________________________________
Alaska BFPC Goal Area 3:
o Develop and implement partnerships for BFPC services to increase awareness of WIC as a breastfeeding promotion and support program
and aid in reaching Healthy People 2020 breastfeeding goals
11. Long Term Outcome: (Changes or benefits that result from program activities)
Outputs/ Measures (how results will be measured):
2. Short-Term Outcome: (Learning/Knowledge)
Outputs/ Measures (how results will be measured):
3. Intermediate Term Outcome: (Activities/Behavior)
Outputs/ Measures (how results will be measured):
Attachment 6.04 BFPC RFP Rev. 1/18/13
Applicant Logic Model Page 3
Attachment 6.04 BFPC RFP Rev. 1/18/13
Applicant Logic Model Page 4