2026 Active SWV WW Capacity Building Grant

PURPOSE

Active Southern West Virginia is providing funding for workplaces across West Virginia to increase access to healthy food, physical activity and other strategies to improve employee wellness. Worksites must have at least one employee who is Work@Health® certified. These limited, one time Capacity Building Grants are $1,500 per workplace.

GRANT APPLICATION GUIDELINES

Applications for the 2025-2026 grant cycle will be accepted between November 1, 2025 - December 10, 2025. Capacity Building Grants are competitive.

Each application will be objectively ranked by a selection committee using this Scoring Rubric. The total number of projects funded will be up to five. Projects may receive partial funding.

FUNDING GUIDELINES

  • Limit all incentives to $25 or less per item
  • No more than 50% of the budget can be for incentives
  • No more than 20% of the budget can be for purchasing food
  • You must have at least 1 employee who is Work@Health® certified

GRANT CANNOT BE USED TO FUND:

  • Activities taking place at school during the school day
  • One-time events that are not aligned with long-term programming
  • Clinical care
  • Furniture (this does not include office workout equipment)
  • Political purposes
  • Publicity or propaganda

APPLICATIONS MUST DEMONSTRATE THE FOLLOWING:

  • Policy, systems, and environment change strategies
  • Sustainability
  • Clear budget narrative

BEFORE YOU BEGIN:

  • Please download this paper application HERE to preview the questions.
  • This application is expected to take 20-30 minutes to complete.
  • You will need a copy of the current version of your organization's W-9 to upload.
  • You will need a copy of your latest CDC Worksite ScoreCard to upload.
  • Please contact Kelly Fox, Active SWV Workplace Wellness Director, at kelly@activeswv.com if you have any questions or need assistance.

Please click next to begin the application.

Fields marked with an * are required.

Please verify that you have checked the “I'm not a robot” checkbox.

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General Information
Project Information, Fiscal Agent Information, and W-9 Submission

The fiscal agent is to whom the grant check should be written and addressed. To whose attention should the envelope be made to? Example: ABC Company Attn: Mike Smith 123 Street. To whose attention would be Mike Smith who is expecting this grant check. 

A W9 is required for funding to be dispersed for this project.  Please use the folloiwng space to attach your W9.

20MB max

Describe your workplace.  How do you serve the community?

Which county or counties does your project serve?  Please list all that apply. 

It is required for your worksite to have at least one Work@Health certified employee.  Please provide the name and email of the employee below:

Please provide the name and email below for any other employee who wants to become Work@Health trained.

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CDC Worksite ScoreCard

You are required to submit your more recent CDC Worksite ScoreCard as part of this application process.  You'll be asked to complete the ScoreCard again at the end of the grant period.  For more information about this ScoreCard, click HERE.

Please use the space provided to upload a PDF copy of your CDC Worksite ScoreCard.

20MB max

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Work Plan
Policy, Systems, and Environment (PSE) Changes

What is a Policy Change?

Changing or implementing laws, regulations, rules, ordinances, or resolutions. Policy changes can be

classified as Big Policy Changes such as changing policies at the national, state, or local governmental level

or within healthcare settings, schools, communities or Little Policy Changes like internal changes to

organizations or groups.

Some Policy Change Examples:

We will implement a new policy in our workplace that allows for workers to take a 30-minute

exercise break per day by the end of the grant cycle.

  • We will implement a new policy in our workplace to improve access to physical activity or reduced sedentary behavior.
  • We will implement a new policy in our workplace no sugar sweetened beverage for meetings and/or workplace vending and cafeterias.
  • We will implement a new policy in our workplace to support flexible work scheduling.
  • We will implement a new policy in our workplace to ban tobacco use in all forms on all workplace property.

To help you know whether your activity is a policy, systems, or environment change, please refer to this flow

chart.

If you plan to implement policy changes, please provide a description of the activity and up to three action

steps that will need to happen to successfully implement the policies. Please include the target completion

dates for each activity and the individual or organization responsible. As a reminder you are required to

complete 3 PSE changes.

If you do not plan to implement policy changes, please move on to the next question.

Example:

POLICY CHANGE
ACTION STEPS
TARGET COMPLETION DATE
INDIVIDUAL/ORGANIZATION RESPONSIBLE
Policies for no sugar sweetened beverage for meeting and/or workplace vending and cafeterias.  1.  Develop a written policy for no sugar sweetened beverages to be served at any office meetings or events.
2.  Get approval for the new policy from (department chair, upper management, section leader, whomever must approve) for approval.
3.  Provide information to all individuals that will be impacted by the new policy.		01/025/2025




02/05/2025





03/31/2025



Jane Doe




John Doe





John Doe



Policy Action Steps Target Completion Date Individual/Organization Responsible

What is a Systems Change?

Changing processes or practices of an organization, institution, or system to address the healthy change

you are trying to make. Examples of organizations, institutions, or systems include communities,

workplaces, schools, or health care systems.

Some Systems Change Examples:

  • Implement educational programming (i.e. lunch and learns, Walk with Ease, National DPP, TOPS, etc.) to improve key chronic disease indicators and educate employees on health lifestyles.
  • Provide morning and afternoon physical activity breaks for employees.
  • Educate employees about any preventive services and benefits covered by their health insurance plan.
  • Make some or all company-specific health promotion programs available to family members.
  • Provide healthy snack and beverage options during meetings and trainings.

To help you know whether your activity is a policy, systems, or environment change, please refer to this flow

chart.

If you plan to implement systems changes, please provide a description of the activity and up to three action

steps that will need to happen to successfully implement the systems change. Please include the target

completion dates for each activity and the individual or organization responsible. As a reminder you are

required to complete 3 PSE changes.

If you do not plan to implement systems changes, please move on to the next question.

Example:

SYSTEMS CHANGE
ACTION STEPS
TARGET COMPLETION DATE
INDIVIDUAL/ORGANIZATION RESPONSIBLE
Implement educational programming (i.e. lunch and learns, Walk with Ease, National DPP, TOPS, etc.) to improve key chronic disease indicators and educate employees on healthy lifestyles.1.  Use employee feedback and CDC Health Scorecard to determine 3 wellness topics of need and interest.
2.  Schedule a series of lunch-n-learns for the topics.  Secure a presenter to share educational material and provide an interactive component at each lunch-n-learn.
3.  Collect employee participant feedback and attendance for each session to gage level of success and participation.		11/15/2025




01/30/2026






03/01/2026




Jane Doe




John Doe






Jane Doe




System Action Steps Target Completion Date Individual/Organization Responsible

What is an Environment Change?

Physical, observable changes to the built, economic, or social environment. These changes can take place in

stores, schools, workplaces, parks, rail trails, health clinics, offices, and communities.

Environment change examples:

  • We will install ADA accessible playground equipment in a local park.
  • Promote and provide access for increased water consumption (re-think your drink).
  • Carpeted room designated for onsite classes for physical activity, healthy food/weight, or tobacco cessation.
  • Offer or promote an onsite or nearby farmers market or other arrangement where fresh fruits and vegetables are sold.
  • Onsite exercise facilities or walking trails, bike racks, etc.
  • Lactation room, diabetes rest station, self-monitoring blood pressure stations, etc.

To help you know whether your activity is a policy, systems, or environment change, please refer to this flow

chart.

If you plan to implement environment changes, please provide a description of the activity and up to three

action steps that will need to happen to successfully implement the environment change. Please include the

target completion dates for each activity and the individual or organization responsible. As a reminder you

are required to complete 3 PSE changes.

If you do not plan to implement environment changes, please move on to the next question.

Example:

Environment Action Steps Target Completion Date Individual/Organization Responsible

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Key Partners

Do you have any key partners or stakeholders outside of your organization or workplace that will help you complete your project?

Yes
No

Which outside organizations are planning to help you carry out your workplan?

Some examples of potential partners:

  • American Lung Association
  • American Heart Association
  • Divisions at he Bureau for Public Health
  • Community-based organizations
  • WVU Extension, etc.


Add a row per Partner.

Representative Organization Role

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Evaluation
Assessing whether your project has been successful is an important part of any public health initiative. Evaluation is a tool that we use to examine how successful a project, program, or initiative is. It can also be used to find out what worked and that did not work so well in the process. For more information about evaluation, please click HERE.

Does the project evaluator differ than the project lead listed previously?

Yes
No

How will you know your project is successful? Consider both immediate and long term successes.

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Sustainability
Sustainability is achieved when a program is able to continue after the initial grant funding has ended. This includes having the human, informational, technical, organizational, or financial resources available to continue the intervention or program. For more information about sustainability, please click HERE.

What is Sustainability?

Sustainability is achieved when a program is able to continue after the initial grant funding has ended. This

includes having the human, informational, technical, organizational, or financial resources available to

continue the intervention or program. For more information about sustainability, please click HERE.

By checking this box, I pledge to plan for the long-term sustainability of my project.

Which of the following strategies will you use to ensure the sustainability of your project? Check all that apply.

Create long-term policy change(s) (example: create a policy that states that food served to participants is healthy, create a tobacco policy in a workplace, adapt already existing policies to reflect current needs)
Implement long-term environmental change(s) (example: provide a workout area to employees, making an enhancement to a trail, install a playground)
Enable existing staff or group(s) to continue activities
Integrate changes into organizational practices or strategic plan
Secure additional funding to continue activities after the grant cycle
Create reusable educational materials (examples: training videos, recordings of classes, toolkits, etc.)
Identify partners or collaborators to complete certain aspects of project (example: identify partner organization to help maintain trails and signage in the future)
Create tools to monitor and track project progress (evaluation)
Increase or sustain buy-in from workplace leadership

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Dissemination

As a requirement, please indicate how you will share your work with other groups across the state.  Please select 2.  You are requires to provide Active SWV with a copy of what you disseminated.  

Provide updates at funding organization meetings
Write a newsletter article about project efforts for Active Southern West Virginia
Present posters or presentations at state, regional, or national conferences, webinars, etc.
Share project progress on social media
Work with mass media to share information about the project.
Other (Describe below).

If you checked "OTHER" above, please describe.

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Budget & Justification

Please download and complete the following budget document HERE and upload it in the space provided below.

20MB max

In the space below, please provide a budget narrative.

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Sign & Submit

Affirmation of Validity of Application and Grantee Compliance

If our worksite receives funding through the Capacity Building Grant Program, we agree to complete the following:

Related Activities:

  • Our organization will participate in communication and promotion efforts related to the funded projects.
  • Funding organization team members may visit to learn about and visit funded projects. Your worksite will assist with facilitating these visit(s). You will be informed before any visit.


Financial Assurances:

  • Capacity Building Grant awardees will comply with best practices for financial management of funds.
  • All Capacity Building Grant expenditures will be documented.
  • All financial documentation related to the Capacity Building Grant will be available for audit and provided upon request.


Project Completion:

  • All project activities will be completed by November 30, 2026.
  • The project coordinator will be notified in writing if any circumstances change that may impact the ability to carry out the Capacity Building Grant project.
  • Final project reports and budget forms will be sent to the project coordinator by December 15, 2026.

By Checking THIS BOX, you agree that the information in this application is complete. * NAME * DATE *