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Work Statement <br />o)Complete the Work Statement Chart to describe the work to be performed. <br />This chart is used to document program activities, program goals, performance measures, <br />and actual results. (Add more rows as needed) If this is a new program, you will only <br />document the projected information. Every program is required to have AT LEAST 1 Program <br />Activity, which should be SMART (Specific, Measurable, Achievable, Relevant, and Time- <br />bound. Click on SMART Goals to learn more. <br />●Program Activities should outline major activities the agency implements to accomplish its <br />program goals. (i.e. Deliver meals to elderly/disabled residents.) <br />●Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br />statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br />Monday-Friday.) <br />●Performance Measures describe how you will evaluate the degree in which you achieved <br />the stated goals. (i.e. Will track the number of meals delivered each day.) <br />●Actual Program Results use program results to indicate the actual measurable <br />achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br />105 meals per day.) <br />Work Statement Chart for Program Sexual Health Education and Outreach <br />1.Program Activity Name Multi-session programs <br />Program Goal Provide at least 15 high school and 10 middle school teens with <br />evidence-based, multi-session sexuality education programs. <br />Performance Measures PPSAT will measure the competency levels of participants through <br />pre-and post-program tests. The pre-test will be administered at <br />the beginning of the first session, and the post-test will be <br />administered immediately following the conclusion of the program. <br />Measurable outcomes include a change in knowledge, attitudes, <br />and behaviors. <br />Previous Year Program Results We graduated 15 high school students and 13 middle school <br />students. Through pre-and post-testing, high school participants <br />demonstrated a 10% increase in knowledge, middle school <br />students demonstrated a 12% increase in knowledge. <br />Current Year Estimated Results Through pre-and post-testing, participants will demonstrate at least <br />a 10% increase in knowledge about preventing pregnancy and <br />STIs. <br />Next Year Projected Results Through pre-and post-testing, participants will demonstrate at least <br />a 10% increase in knowledge about preventing pregnancy and <br />STIs. <br />2.Program Activity Name Peer to Peer education <br />Program Goal Each high school student will work within their schools and <br />communities to disseminate to others the information they have <br />learned to at least 20 peers each. <br />Performance Measures Peer-educators maintain contact logs so that the community <br />educator can review them for accuracy and completeness. <br />Previous Year Program Results Each peer educator made 20 contacts for a total of 300 contacts. <br />Current Year Estimated Results Each peer educator will make 20 contacts. <br />Next Year Projected Results Each peer educator will make 20 contacts. <br />3.Program Activity Name Parent Workshops <br />Program Goal Provide family engagement for at least 15 parents. <br />Performance Measures Participants will provide feedback on the quality of the program by <br />Exhibit A: Provider's Outside Agency Application <br />DocuSign Envelope ID: ED368FB6-6FB1-45A7-A8CA-9AB3EAEB624E