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7334251352550Health 4150: Needs Assessment & Planning Health Promotion ProgramsBy: Amber Ward, Megan Passey, & Melanie SpeechlyFor: Dr. Patricia Cost Fall 2010 AbstractWith the massive influx of illness and diseases occurring in our society the average age of death is decreasing. This in part due to unhealthy behaviors, such as: increased stress, poor nutrition and hygiene, lack of physical activity, and the absence of healthy conflict resolution skills. Not only are lives shorter, but also the quality of life is poorer. These unhealthy behaviors have started at even younger ages and the rate of childhood obesity is rapidly increasing in the United States. In order to break the cycle of unhealthy lifestyle behaviors we developed a program entitled Healthy Heroes to educate 63 2nd grade students at Club Heights Elementary in Ogden, Utah. It was our hope to empower these students with self-efficacy skills to live longer, healthier, and happier lives. We also thought it was important and hope these students will take this knowledge and skills to help their families break the cycle of unhealthy behaviors. This program consisted of four separate interventions that were an hour long and included the following topics: nutrition, friend-shipping/bullying, dental hygiene, and physical activity. Prior to and following the four separate interventions a survey was administered to the 63 2nd grade students and significant changes were shown by the results of these surveys. The students understand what healthy behaviors were and could recognize healthy foods and activities. These results show that in our efforts to empower these students with the knowledge and skills to live longer, healthier lives they can make a lifestyle change. We conclude that if these students continue to make healthy decisions they will be able to live longer, happier lives and will have a good quality of life. AcknowledgementsWe would like to thank all of those who have worked together to make this program a success! First, we would like to thank the 2nd grade teachers at Club Heights Elementary, Mr. Sianez, Mrs. Alsup, Mrs. Green, and Mrs. Martin, for their support and help throughout the whole program. We greatly appreciated everything you did to help us create a wonderful program. The students were so much fun to work with and you all made this project very enjoyable. It was a great learning experience to be able to work with these three different 2nd grade classes and to be able to work with the 63 2nd grade students. We will always cherish this experience. We also wanted to thank the staff at Club Heights Elementary who made it possible to come into the school and do these four interventions. Thank you for everything!Next, we would like to thank Dr. Patricia Cost for all of her hard work and efforts. We would never be able to create such a successful program if it weren’t for the Health 4150 class. You encouraged us along the way and we are grateful for your contributions to the success of our education at Weber State University. Finally, we would like to thank all of our family, friends, and fellow students that have supported us along the way. We are so grateful for your patience, love, and support throughout this whole project. Thank you for supporting us in our education and our desire to make a difference in the world! Table of ContentsTABLE OF CONTENTSAbstract……………………………………………………………………………...……..iAcknowledgements……………………………………………………….…………….…iiTable of Contents…………………………………………………………………………ivCHAPTER I INTRODUCTIONIntroduction/Background………………………………….……………………………...1Team Members………………………………………..…………………………………..2Brief Bio of Each………………………………………………………...………..2Roles and Responsibilities of Each………………………………………………..5Community Based Learning………………………………………………………………6 Defined………………………………………………………………………...….6Benefits…………………………………………………………………………....6Community Based Research………………………………………………………………7Defined……………………………………………………………………...…….7Benefits………………………………………………………………………..…..7Community Partners………………………………………………………………………7Defined……………………………………………………………………...…….7Advantages……………………………………………………………………..…8Disadvantages……………………………………………………………………..8Process of Building a Community Partner…………………………………..…….8Description of Our Community Partner……………………………………………..…….9Statement of the Problem…………………………………………………………….…..10Need for the Intervention……………………………………………………………...…10Mission Statement……………………………………………………………………11Program Philosophy ………………………………………………………………..……12Definition of Terms…………………………………………………………………..…..12Timeline……………………………………………………………………………….....13 Appendix ISummary………………………………………………………………………………....13CHAPTER IIREVIEW OF RELATED LITERATUREIntroduction...…………………………………………………………………………....16Healthy People 2010……………………………………………………………………..17Defined…………………………………………………………………………..17Objectives Specific to this Program……………………………………………...19Health Promotion Programs………………………………………………………..…….23Defined…………………………………………………………………………..23Planning………………………………………………………………………….24Implementation………………………………………………………………….25Evaluation……………………………………………………….………………26Our Project: Healthy Heroes, an Educational Intervention………………………….…..27Defined…………………………………………………………………………..27Benefits…………………………………………………………………………..27Challenges……………………………………………………………………..…28Health Promotion Planning Models……………………………………………………...28Types of Planning Models/Purposes………………………………………….….28Advantages………………………………………………………...…………….29Disadvantages………………………………………………………..…………..29Model Chosen for this Program………………………………………..………….30Defined…………………………………………………………………………..30Application……………………………………………………………………….30Qualitative Research……………………………………………………………………..31Defined…………………………………………………………………………..31Developing Qualitative Questions……………………………………………….32Analyzing Qualitative Research…………………………………………………32Quantitative Research…………………………………………………………….……...34Defined……………………………………………………………………….….34Analyzing Quantitative Research……………………………………………..…34Developing a Survey………………………………………………………………...…..34Reliability………………………………………………………………………..35Validity………………………………………………………………………….35SMOG………………………………………………………………………...…35 CHES Competencies…………………….………………………………………………37 Defined………………………………………………………………………….37How they relate to this project…………………………………………………..44Competencies developed by doing this project………………………………....44Types of Evaluation……………………………………………………………………..47Process…………………………………………………………………………..47Impact…………………………………………………………………………...47Outcome………………………………………………………………………....48Summary………………………………………………………………………………...48CHAPTER IIIGOALS & OBJECTIVES FOR THIS PROGRAMIntroduction...……………………………………………………………………………50Program Goals………………………………………………………………………..….51Importance of Goals……………………………………………………………...51Developing Goals………………………………………………………………...51Program Objectives……………………………………………………………………....52Defined………………………….……………………………………………….52Importance of Objectives………………………………………………………...52Goals and Objectives Specific to this Program………………………………………….53Program Goal……………………………………………………………...…….53 Program Objectives…………………………………………………………..…..53Learning Objectives……………………………………………………………...53Behavioral Objectives……………………………………………………………54Summary………………………………………………………………………………....54CHAPTER IVMETHODSIntroduction……………………………………………………………………..……….56Choosing Our Community Partner………...…………………………………….………58Initial Meeting with our Community Partner……………………………….……………58Program Plan……………………………………………………………………………..59Planning Model Used…………………………………………………………………….64Application……………………………………………………………………….64Marketing of Program Plan………………………………………………………………67Survey Development……………………………………………………………..67Question Development……………………………………………………..…….68Expert Panel Review……………………………………………………..………69SMOG Readability Results………………………………………………………69Population Surveyed……………………………………………………………..69Sampling Techniques Used……………………………………………………...70Data Collection…………………………………………………………….…….70Data Analysis…………………………………………………………………….70Evaluation……………………………………………………………………..…71Purpose of Evaluation…………………………………………………………....71Summary…………………………………………………………………………...…….71CHAPTER VRESULTSIntroduction…………………………………………………………………………………...….74Program Plan Overview……………………………………………………………………….…75Participant Demographics………………………………………………………………………..77Data Analysis of Surveys…………………………………………………………………….…..78Post Nutrition Survey………………………………………………………………...…..78Post Program Survey……………………………………………………………..………81Summary………………………………………………………………………………...……….85CHAPTER VISUMMARY, DISCUSSION, CONCLUSIONS, ANDRECOMMENDATIONSIntroduction……………………………………………………………………………………...87Summary of the Program………………………………………………………………………...88Conclusions……………………………………………………………………………………....90Recommendations….…………………………………………………………………………….90For Future Projects…………………………………………………………………….....90For Projects Using Surveys………………………………………………………………91Summary…………………………………………………………………………………………91REFERENCES………………………………………………………………………………….94APPENDICES Appendix A Pre and Post Surveys…………………………………………………………….97 Appendix BLesson Plans…………………………………………………………………….100 Appendix C Lesson Plan Pictures……………………………………………………………118 Appendix DPost Nutrition Survey…………………………………………………………...129Appendix EColoring Book…………………………………………………………………..131Appendix FHealthy Heroes Badge………………………………………………………….139Appendix GProgram Proposal……………………………………………………………….141Appendix HPictures………………………………………………………………………….143Appendix IProgram Timeline………………………………………………………………147Appendix JBullying Certificate…………………………………………………………….149Chapter IIntroductionIntroductionAlthough life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; for some members of the general population, preventable chronic diseases are on the rise and contribute to a majority of deaths in our society. The number of overweight children has risen from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). The increase in chronic disease is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially because of unhealthy lifestyles. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. Research has shown that you what you learn as a child stays with you throughout your entire life; therefore, it is necessary to instill healthy lifestyle habits at an early age. We chose to teach 63 second grade students at Club Heights Elementary school in Riverdale, Utah healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. In this chapter we will explore the different dimensions of community based learning, research, and partners. Team members will be introduced and responsibilities will be explained. We will also evaluate problems and the need for intervention. We will discuss our mission statement and our program philosophy. Lastly our timeline will be illustrated, and terms will be defined.Biography of Team MembersAs part of the Health Promotion Program at Weber State University students are given the opportunity to plan, implement, and evaluate a program. Students participate in the Health 4150 Needs Assessment and Planning Health Promotion Programs course; a hands-on community-based learning course, taught by Dr. Patricia Cost, aimed at developing interventions to improve the health of the community. It was early on in this class that our group collaborated together to come up with the idea of the Healthy Heroes program. Because of the shared passion for healthy lifestyle habits we all decided that it would be best to work with children to create a positive attitude towards these healthy habits at a young age. It was our hope to be able to instill that same passion for healthy lifestyles in the 63 students that we taught at Club Heights Elementary that we all shared as a group. The following are brief introductions of each team member in the Healthy Heroes program. Amber WardMy name is Amber C. Ward; I grew up in Layton Utah with two brothers and one sister. I love my family and have always been very close with them. My dad is a Registered Dietician; therefore, it was my dad’s interest in nutrition and exercise that got me into my same interests of nutrition, exercise, and wellbeing. I went to Northridge High School where I ran cross country and participated on the girls’ tennis team. It was also in high school that I grew to love aerobics classes, with kick-boxing being my favorite. I graduated from high school in 2007 and have been going to school ever since, including summers (four years). During that time I have attended both Utah State University and Weber State University (WSU). On March 14, 2009 I got married to my husband Spencer in the Salt Lake Latter Day Saint (LDS) Temple. Spencer is currently going to Brigham Young University majoring in Construction Management and works at America First Credit Union. We are both enjoying the ‘married life’ and taking every opportunity that we can to learn and grow. We are both serving in our church’s primary organization for children. I love to learn new things, run, spend time with family, exercise, make crafts, go hiking, shop, and spend time with my husband. I love helping people and hope to use knowledge obtained through the Health Promotion program at WSU to better people’s lifestyles in a positive way for the better. I am also pursuing a Nutrition Education minor and hope someday to work with a non-profit organization doing nutrition counseling/education. Health Promotion is a great major because it engages your talents, skills, and interests into something proactive that may potentially influence the people and community around you. Melanie SpeechlyAs a mother of five, acquiring knowledge and sharing it with those I love has always been an important aspect of my life. I have been attending Weber State University (WSU) off and on over the last eight years. It has been fun to be a college student at the same time many of my children have been in college. We can empathize with each other about school pressures during finals week! I take pleasure in cooking healthy meals for my family and adapting recipes to be more nutritious. Learning about the different dimensions of health and how to achieve optimal health is something I enjoy. I became interested in Health Promotion as a career a few years ago, while trying to pick a major. The advice I received most often was to do what you love. My passion lies in educating and supporting those around me move toward their goals and improve their lives. Through my own experiences, I have found that we can all improve our wellness and it is a worthwhile pursuit. The second half of my life will be spent enjoying all the things I love; my family, hiking, skiing, reading good books, working in a field I love, and working to become my best possible self. Megan PasseyMy name is Megan Passey. I grew up in a large family of?eight brothers and sisters, I'm number six. My father was in the Air Force so we moved around more than most families. I was born in Maryland, we then moved to?Alabama,?West Virginia, and then finally?Utah. My brothers and sisters are now scattered across America, one sister is even in?Germany, but we still get together every once in awhile which I look forward to very much!?My family loves music and I'm no exception. I've been singing longer than I've been talking! I love to sing and play the piano. Unfortunately, I don't have a piano so I don't get to practice much. I do get to sing?every Sunday?in my church's choir and I enjoy being part of a group that makes beautiful music.?I went to?Weber High School?where I ran?Track & Field?and?Cross Country. First, I became interested in how the body works in?high school. Because I was running so much, I wanted to know what I could do to make myself the best runner I could be.??I met my husband, Ben, October 14, 2005. We fell in love fairly quickly, but not by Utah standards! We dated for nine months before we got engaged in July of 2006. We were married in the?Salt Lake City temple?on September 14, 2006. We have now been married for four years and have two wonderful children, a boy and a girl. They are a lot of work but are also a lot of fun!?I've been attending?Weber State University?for six years. For the first few years I explored many different areas of study before deciding to pursue?a degree in Health Promotion. I enjoy Health Promotion because I've always been fascinated by how the?human body works?and what I can do to make it work its best. I also enjoy?helping others. Health Promotion is a perfect fit for me!Roles and Responsibilities of Team MembersEach member in our group was able to feel a sense of accomplishment and ownership because we all gave the same amount of effort and time into the Healthy Heroes program. Together we were able to do each step in the planning, implementing, and evaluating of this program. The great thing about this project is there is not one thing that only one of us did. As a team we worked together to make our program a success! In order to create a successful Health Promotion program each team member must be able to show initiative and dedication to their roles and responsibilities. Each member of the Healthy Heroes program showed these attributes and worked together on every aspect. We all worked on the lesson plans together. We would sit down and plan the assignments together or split them up each of us taking a portion, and then combining them. Not only was teamwork necessary for planning the lesson plans, activities, etc. but we each maintained the responsibility to teach a 2nd grade class. Specific roles that some of the team members volunteered to do included: Megan Passey as team leader, Amber Ward as the team organizer, and everyone helped plan, implement, and participate in the evaluation. We all have really enjoyed working together and have worked together to make our program a success!Community Based LearningDefinitionCommunity based learning (CBL) as defined by Weber State University is a learning opportunity gained through real life experiences and the application of knowledge in the community. Community-based learning courses connect meaningful community experience with intellectual development, personal growth, and active citizenship through a structured approach to learning and teaching. Community-based learning also “enriches coursework by encouraging students to apply the knowledge and analytic tools gained in the classroom to the pressing issues affecting local communities” (2010, weber.edu).BenefitsCommunity Based Learning (CBL) has many positive affects on students, faculty and the community alike. Community Based learning helps students develop personal efficacy and identity as well as social, leadership, and communication skills. Community Based Learning (CBL) builds better student-faculty relationships, and gives the community resources of the college or university it may have not had otherwise. Students engaged in CBL feel more engaged and connected with their community, have an increased satisfaction with college, and are more likely to graduate and get jobs (2010, clark.edu).Community Based ResearchDefined Community Based Research (CBR) is defined, “as a mutually beneficial collaborative effort between academic researchers and community partners who have a common goal of achieving social justice through research and actions that are mutually beneficial to the organization and community,” (2010, stmarys-ca.edu). In other words CBR involves students working with teachers and community partners to develop and conduct research as well as collect and analyze data. The students share the conclusions gathered from the research with their community partner, in hopes of fostering social justice, (2010, ).BenefitsCommunity Based Research has many benefits, but one of the biggest benefits is the research itself. With a collaborative effort the research itself includes: better questions, recruitment, data collection, and better analysis of the data. It is also found that there is better dissemination, as well as better action within the community. With CBR the community is better able to implement the research or outcomes into munity PartnersDefinedA community partnership is a group of people who are trying to change the community together. The purpose of a partnership is to bring people together by connecting them in mutually relationships which benefit all parties. Partnerships lend resources to create something worthwhile and allow groups to bring all their resources together, (Mutsambi, 2009).AdvantagesBy communities coming together they bring with them increased resources and efficiency. Due to the diverse populations who are part of a partnership more views and opinions about issues, needs, and resources are shared. Community partnerships also accrue a larger support system and help to maximize resources and reduce duplication. Most importantly “partnerships build communities,” (Mutsambi, 2009, p.18).DisadvantagesThe disadvantages of having a community partnership often stop individuals and communities from establishing a partnership. Large amounts of effort and time are used in the beginning stages of building a partnership. Not only are effort and time needed in the beginning stages, but also throughout partnership. There also has to be skilled members filling all positions. Finally, there has to be cooperation from all parties, (Mutsambi, 2009).Process of Building a Community PartnerThe process of building a community partner is very simple, but if done incorrectly can create confusion and a loss in time. John M. Mutsambi, Chiquia Coppage, and Brianna Wright outline perfectly how to build a community partnership while keeping simplicity to this crucial task. Create your idea and form your community plan. Next, share your ideas with others. Search for the right partnership. This may involve going to different meetings and getting to know different community members who may become key individuals in your program. Next choose the right person or organization. Let them know what your plan is and how you are going to achieve it. Make an outline of what is needed such as, funding or activities. Make sure to be open to others and their ideas. Establish the responsibilities each partnership will have. Be sure all agreements are clear, and that all members understand. Establish the goals that need to be accomplished. Make any adjustments to the goals or roles. Define deadlines. Progress and achieve different milestones. It is important to apply all rules and to remember they help to create organization. However, disregarding one may create chaos and waste time. Description of Community PartnerThe Healthy Heroes program community partner was Club Heights Elementary Title I school located in Ogden, Utah at 4150 South 100 East. The principal of Club Heights Elementary is Karen Neiswender, which was also our initial contact with the school. After contacting Mrs. Neiswender we were able to meet with the three 2nd grade teachers, which are: Mr. Sianez, Mrs. Martin, Mrs. Green and Mrs. Alsup. Our group thoroughly enjoyed working with these teachers. We were able to communicate with them effectively and they were a tremendous help to us throughout the whole program. The Healthy Heroes program would not have been a success if it had not been for the support and help of our community partner. We were able to utilize their skills, knowledge, and resources. Statement of the ProblemWhile life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006, there has been a massive influx of illnesses and diseases in our society are occurring more frequently and the quality of life is decreasing. Also, the number of overweight children rose from 11% to 18% from 1988 – 2006, (CDC, 2009, pg 28). The decrease in overall morbidity in part due to unhealthy behaviors, such as: poor nutrition and hygiene, lack of physical activity, and the absence of healthy conflict resolution skills. Lives may be longer overall, but the quality of life is poorer. We would like to educate second grade children at Whiteside’s Elementary School to empower them with self-efficacy skills to live longer, healthier, and happier lives. Also with the hope they will help their families to break the cycle of unhealthy behaviors.As a group, we wanted to focus on Title I schools where children are at higher risk for unhealthy behaviors due to their poverty level. Weber State tends to service communities in Weber County, but with both Loralee and Stefanie living in Davis County they wanted to service a community in which they lived. Stefanie’s children attend Whiteside’s Elementary school which happens to be a Title I school, so they felt it appropriate to make this school their community partner.Need for InterventionUnhealthy lifestyles contribute to many, if not all of illnesses and diseases. These harmful habits begin at a young age and continue throughout life. All unhealthy behaviors affect the quality of life and produce outcomes that shorten lives. There is a tremendous need for intervention in preventing these illnesses and diseases, and also improving longevity and quality of life. The following interventions were covered; nutrition, hygiene, conflict resolution, and physical activity. These particular interventions were chosen because, while discussing with the 2nd grade teachers at Club Heights Elementary how we could provide service through classroom interaction, these were the issues to be observed as the biggest problems. Also, it was our hope to help create awareness in the children’s lives at Club Heights Elementary of how important it is to be healthy. The outcome of these life lessons will successfully improve the children’s lives at Club Heights Elementary if implemented, and hopefully improve the lives of those the children live with. Program Mission StatementThe mission of the Healthy Heroes 4-week intervention program is to provide education and intervention services to 2nd grade students. It is our goal to empower students with self-efficacy skills to live longer, healthier, and happier lives. In an attempt to break the unhealthy lifestyles of the community we will provide information that these children can take back to their families. Club Heights Elementary Mission Statement: Club Heights Elementary Commitment-“We are committed to creating a safe school where every student, without exception and without excuse, will attain high levels of success in academics and citizenship."Weber School District Mission Statement“Weber School District?is committed to provide educational experiences which motivate each student to become a lifelong learner, attain academic and personal potential, and enter the work force with the necessary skills.”Program PhilosophyChildren who live without adequate information, resources, and skills to practice healthy lifestyle habits have increased rates of obesity. In order to prevent children from living unhealthy lifestyles including; low self-esteem, poor hygiene, inadequate nutrition, lack of physical activity, and other negative health conditions; it is essential to educate and inform children about healthy lifestyle choices. Our “Healthy Heroes” program will educate and empower 50% of the second grade students at Whiteside’s Elementary to make healthy lifestyle choices. Our program will help motivate them to make healthy decisions and lead healthy lives in relation to physical activity, nutrition, friend-shipping, and hygiene. We are dedicated to educating these students in ways they will understand; therefore increasing the probability of healthy lifestyle changes, which will positively affect their lifelong wellbeing and improve the health and wellbeing of their families. We believe:Children will make healthier lifestyle decisions if they are educated about such habits.Children should know how to develop healthy relationships.Children should participate in physical activity at least 5 days a week.Children should be taught how to take care of their bodies, including adequate hygiene practices.Children should be given healthy snack and meal options.Definition of TermsFriend-shipping: The act of building a positive relationship with an individual Bully: A person who is habitually cruel or overbearing, especially to smaller or weaker peopleIntervention: to come in or between by way of hindrance or modificationsHealthy: enjoying health and vigor of body, mind, or spiritTimelineThe timeline for the Healthy Heroes program can be found in Appendix I.SummaryIn conclusion, the need for intervention is overwhelming. In order to prevent the overall wellbeing of communities and the 63 students at Club Heights Elementary from continuing to decline, health educators must take the responsibility to help reinforce positive measures through effective health promotion programs, such as the Healthy Heroes program. Healthy Heroes has implemented different aspects of health which included; friend-shipping, hygiene, nutrition, and physical activity. The community has been examined on the different levels of learning, research, and the participating partners. The team members have been introduced and their responsibilities have been determined. The problems have been evaluated, and the need for intervention has been proven to be absolutely beneficial. Our mission statement and program philosophy have been discussed. Lastly our timeline was introduced and all terms have been defined. In order to prevent the overall wellbeing of communities from declining, it is a health educator’s responsibility to help reinforce positive measures through health promotion programs. For a health promotion program, such as educational interventions, to be carried out properly each individual and educator involved in the process must take a certain number of roles and responsibilities. An effective program clearly delineates its’ distinguishing features such as goals, objectives, mission statements, etc. The Healthy Heroes program is aimed to be productive in all of these aspects. Chapter IIReview of Related LiteratureIntroductionAlthough life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; for some members of the general population, preventable chronic diseases are on the rise and contribute to a majority of deaths in our society. The number of overweight children has risen from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). The increase in chronic disease is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially because of unhealthy lifestyles. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. Research has shown that you what you learn as a child stays with you throughout your entire life; therefore, it is necessary to instill healthy lifestyle habits at an early age. We chose to teach 63 second grade students at Club Heights Elementary school healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. In order to develop an efficient health promotion program it was necessary for our group to be familiar with literature pertaining to the development of such programs, such as Healthy People 2010. This chapter is focused on specific literature that relates to the planning, implementation, and evaluation of the Healthy Heroes program and to the group as health educators. Such information will be reviewed throughout this chapter and includes the following: Healthy People 2010 history and objectives, Health Promotion programs, planning models, qualitative research, quantitative research, developing a survey, types of evaluation, and competencies related to the CHES certification. Healthy People 2010DefinedIn 1979, The Surgeon General released a report entitled Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention. Within this report national goals were provided and outlined, that if reached, would lead the nation to reduce premature death rates and increase the elderly populations’ likelihood of independence (Healthy People 2010 (1), October 16, 2010). This report laid the foundation for a national disease prevention and health promotion agenda (What Is Its History? October 16, 2010).The following year, in 1980, another report was released. Its title was Promoting Health/Preventing Disease: Objectives for the Nation. In this report 226 health objectives were outlined for the nation to strive to achieve over the next decade. Then, in 1990, another report was released titled Healthy People 2000: National Health Promotion and Disease Prevention Objectives. This report consisted of health improvement goals and objectives to be reached by the year 2000; additionally it served as a starting point for the development of state and community health plans (What Is Its History? October 16, 2010). Building on the initiatives that were pursued over the past twenty years, the Department of Health and Human Services (HHS) with cooperation from the Office of Disease Prevention and Health Promotion (ODPHP) has launched Healthy People 2010, a comprehensive, nationwide health promotion and disease prevention agenda. It is intended to serve as a roadmap for improving the health of the people of the United States. Healthy People 2010, includes 467 objectives designed to serve as a framework for improving the health of all people in the United States during the first decade of the 21st Century. Individual states, communities, professional organizations, and any others interested in assisting in the development of programs to improve our Nations health have been encouraged to do so. The Healthy People 2010 program has been designed to achieve two overarching goals: Goal 1: Increase Quality and Years of Healthy LifeThe first goal of Healthy People 2010 is to help individuals of all ages increase life expectancy and improve their quality of life. Goal 2: Eliminate Health DisparitiesThe second goal of Healthy People 2010 is to eliminate health disparities among different segments of the population. There are ten leading health indicators and 28 focus areas indentified. They are listed below:Access to Quality Health ServicesArthritis, Osteoporosis and Chronic Back ConditionsCancerChronic Kidney DiseaseDiabetesDisability and Secondary ConditionsEducational and Community- Based ProgramsEnvironmental HealthFamily PlanningFood SafetyHealth CommunicationHeart Disease and StrokeHIVImmunizations and Infectious DiseasesInjury and Violence PreventionMaternal, Infant, and Child HealthMedical Product SafetyMental Health and Mental DisordersNutrition and OverweightOccupational Safety and HealthOral HealthPhysical Activity and FitnessPublic Health InfrastructureRespiratory DiseasesSexually Transmitted DiseasesSubstance AbuseTobacco Use Vision and HearingObjectives Specific to this Program:Educational and Community Based Programs: Increase the quality, availability, and effectiveness of educational and community-based programs designed to prevent disease and improve health and quality of life (#7).The importance of including health instruction in education curricula has been recognized since the early 1900’s. In 1997, the Institute of Medicine advised that students should receive the health-related education and services necessary for them to derive maximum benefit from their education and enable them to become healthy, productive adults.The school setting, ranging from preschool to university, is an important avenue to reach the entire population and specifically to educate children and youth. Schools have more influence on the lives of young people than any other social institution except the family and provide a setting in which friendship networks develop, socialization occurs, and norms that govern behavior are developed and reinforced. Each school day about 48 million youth in the United States attend almost 110,000 elementary and secondary schools for about six hours of classroom time. More than 95 percent of all youth aged five to 17 years are enrolled in school.The key elements of school health education are identified as: a documented, planned, and sequential program of health education for students in kindergarten through grade 12; a curriculum that addresses and integrates education about a range of categorical health problems and issues at developmentally appropriate ages; activities to help young people develop the skills they will need to avoid risky behaviors; and instruction provided for a prescribed amount of time at each grade level. Health promotion programs need to be sensitive to the diverse cultural norms and beliefs of the people for whom the programs are intended. Achieving such sensitivity is a continuing challenge as the Nation’s population becomes increasingly diverse. To ensure that interventions are culturally appropriate, linguistically competent, and appropriate for the needs of racial, ethnic, gender, sexual orientation, disability status, and age groups within the priority population. Educational and community-based programs must be supported by accurate, appropriate, and accessible information derived from a science base. Increasing evidence supports the efficacy and effectiveness of health education and health promotion in schools.Health Communication: Use communication strategically to improve health (#11).Health communication encompasses the study and use of communication strategies to inform and influence individual and community decisions that enhance health. For individuals, effective health communication can help raise awareness of health risks and solutions provide the motivation and skills needed to reduce these risks, help them find support from other people in similar situations, and affect or reinforce attitudes. The promotion of regular physical activity, healthy weight, good nutrition, oral health and hygiene behaviors, and sensitivity to the diverse cultures in our schools require a range of information, education, and advocacy efforts.Nutrition and Overweight: Promote health and reduce chronic disease associated with diet and weight (#19).Nutrition is essential for growth and development, health, and well-being. Behaviors to promote health should start early in life with breastfeeding and continue through life with the development of healthful eating habits. Nutritional, or dietary, factors contribute substantially to the burden of preventable illnesses and premature deaths in the United States. Many diseases are associated with overweight and obesity. Indeed, dietary factors are associated with four of the 10 leading causes of death: coronary heart disease (CHD), some types of cancer, stroke, and type 2 diabetes. Many dietary components, such as high fat consumption, are involved in the relationship between nutrition and health. A primary concern is consuming too much saturated fat and too few vegetables, fruits, and grain products that are high in vitamins and minerals, carbohydrates (starch and dietary fiber), and other substances that are important to good health.Establishing healthful dietary and physical activity behaviors needs to begin in childhood. Educating school-aged children about nutrition is important to help establish healthful eating habits early in life. A well-designed curriculum that effectively addresses essential nutrition education topics can increase students’ knowledge about nutrition, help shape appropriate attitudes, and help develop the behavioral skills students need to plan, prepare, and select healthful meals and snacks. Topics considered to be essential at the elementary, middle, junior high, and senior high school levels include using the Food Guide Pyramid; learning the benefits of healthful eating; making healthful food choices for meals and snacks; preparing healthy meals and snacks; using food labels; eating a variety of foods; eating more fruits, vegetables, and grains; eating foods low in saturated fat and total fat more often; eating more calcium-rich foods; balancing food intake and physical activity. Two essential goals of the Healthy Heroes program include: Improving accessibility of nutrition information and nutrition education for 2nd grade students.Focusing on preventing chronic disease associated with diet and weight, beginning in youth.Oral Health: Prevent and control oral and craniofacial diseases, conditions, and injuries and improve access to related services (#21).Oral health is an essential and integral component of health throughout life. No one can be truly healthy unless he or she is free from the burden of oral and craniofacial diseases and conditions. Dental caries is the single most common chronic disease of childhood, occurring five to eight times as frequently as asthma, the second most common chronic disease in children. Despite the reduction in cases of caries (cavities or decay) in recent years, more than half of all children have caries by the second grade, and, by the time students finish high school.Physical Fitness and Activity: Improve health, fitness, and quality of life through daily physical activity (#22).Physical activity among children and adolescents is important because of the documented related health benefits (cardio-respiratory function, blood pressure control, and weight management) and because a physically active lifestyle adopted early in life may continue into adulthood. Even among children aged three to four years, those who were less active tended to remain less active after age three years than most of their peers. These findings highlight the need for parents, educators, and health care providers to become positive role models and to be involved actively in the promotion of physical activity and fitness in children and adolescents.Many children are less physically active than recommended and physical activity declines during adolescence. One study found that one-quarter of U.S. children spends four hours or more watching television daily. Schools are an efficient vehicle for providing physical activity and fitness instruction because they reach most children and adolescents. Participation in school physical education ensures a minimum amount of physical activity and provides a forum to teach physical activity strategies and activities that can be continued into adulthood.Young people are at particular risk for becoming more sedentary as they grow older. Therefore, encouraging moderate and vigorous physical activity among youth is important. Because children spend most of their time in school, the type and amount of physical activity encouraged in schools are important components of a fitness program and a healthy lifestyle. Each person should recognize that starting out slowly with an activity that is enjoyable and gradually increasing the frequency and duration of the activity are central to the adoption and maintenance of physical activity behavior.Health Promotion ProgramsDefinedIn response to the rapidly increasing numbers of negative health behaviors, health promotion programs and health education is needed more now than ever. Known as, “any planned combination of educational, political, environmental, regulatory, and organizational mechanisms that support actions and conditions of living conducive to the health of individuals, groups, and communities” CITATION McK09 \p 4 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 4), health promotion goes hand-in-hand with health education. The two concepts together form a basis for health promotion programs. Health promotion programs are designed to enhance an individual’s health and wellbeing and to change attitudes and beliefs towards healthy lifestyles. It is said that a health promotion program:“Is the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health. Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice” CITATION ODo09 \p 1 \l 1033 (O'Donnell, 2009, p. 1).In order to make an effective behavior change among individuals, groups, and communities there are several key processes that must take place. These three parts of a successful health promotion program include: planning, implementing, and evaluating.Planning“Planning, implementing, and evaluating programs are all interrelated, but good planning skills are prerequisite to programs worth of evaluation” CITATION McK09 \p 11 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 11). Planning is the first step in developing a health promotion program. Planning is a multi-step process that takes into consideration many variables and circumstances. Many factors such as the setting, resources, funding, and other factors of a program will determine where to begin the planning process. Although determining when to begin planning a program varies there are several aspects that are part of every planning process; most specifically, support of the decision makers, forming a planning committee, and identifying the planning parameters. Once the planning committee is structured the next step in the planning process is determining the needs of the priority population. This is conducted through a needs assessment, which may be the most critical step in the planning process CITATION McK09 \p 80 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 80). There are several ways of conducting a needs assessment. The needs assessment is important because it leads to the program focus, which is the primary reason for having a health promotion program. Through a process of measuring, gathering, and analyzing data; assessing needs through the ecological perspective; and identifying factors that contribute to health behaviors the health educator can then start planning what type of program would be beneficial to the target population. The next step in planning a health promotion program is identifying goals and objectives. “To plan, implement, and evaluate effective health promotion programs, planners must have a solid foundation in place to guide them through their work. The mission statement, goals, and objectives of a program can provide such a foundation. If prepared properly, a mission statement, and objectives should not only give the necessary direction to a program but also provide the groundwork for the eventual program evaluation.” CITATION McK09 \p 138-139 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, pp. 138-139). By developing a mission statement, goals, and objectives that are specific to a program gives a solid direction to where you want to go with the health promotion program. ImplementationAfter planning the intervention and considering several different factors such as funding, resources, community needs, etc. the action phase sets in; this is known as implementation. Implementation means to carry out CITATION McK09 \p 316 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 316). It is defined as, “the act of converting planning, goals, and objectives into action through administrative structure, management activities, policies, procedures, regulations, and organizational actions of new programs.” It also has been described as the setting up, managing, and executing of a project CITATION McK09 \p 316 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 316). All of these definitions and descriptions give good insight to what the implementation stage is. Similar to other stages of the program planning process there are many factors that should be considered in this step of implementing the program. To name a few: safety and medical concerns, ethical issues, legal concerns, registration and fee collection, procedures for recordkeeping, dealing with problems, training for facilitators, and many more CITATION McK09 \p 324-331 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, pp. 324-331). Also associated with implementing a health promotion program is five phases that planners go through to provide a successful program. These include: 1) adoption of the program, 2) identifying and prioritizing the tasks to be completed, 3) establishing a system of management, 4) putting the plans into action, and 5) ending or sustaining a program. All of these steps are necessary in order to implement an effective program. EvaluationThe final stage of program planning is evaluation. Performing adequate and appropriate evaluation is necessary for any program regardless of size, nature, or duration CITATION McK09 \p 336 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 336). Evaluation is a major component of a program, for it determines the effectiveness and quality of a program. Evaluation is defined as, “a process of reflection whereby the value of certain actions in relation to projects, programs, or policies are assessed; and, the comparison of an object of interest against a standard of acceptability” CITATION McK09 \p 337 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 337). Several types of evaluations are used including: process, impact, and outcome evaluations. All different types are used within the program to make it more effective and to change any components that are weak. If the evaluation is designed well and conducted, the findings can be extremely beneficial to the program stakeholders CITATION McK09 \p 347 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 347).Any health promotion program involves three different aspects: planning, implementing, and evaluating. All of these components are necessary to create an effective health promotion program and to have success with that particular program. Health educators that are experienced in all three areas of evaluation can benefit the community and its’ priority populations significantly by making sure the goals and objectives are met and the program may be implemented in the future. Our Project: Healthy Heroes, an Educational InterventionDefinedFor our program, Healthy Heroes, we decided to do a series of four-week educational interventions; going once a week we taught second grade students at Club Heights Elementary in Ogden, Utah healthy lifestyle behaviors including bullying, nutrition, physical activity, and dental hygiene . Our program would fall under the ‘Health Communication Strategies’ category of types of interventions. These four interventions were designed to inform and influence individual decisions to enhance health. By going into these second grade classrooms we were communicating the importance of healthy lifestyles. There were several benefits and challenges that were incorporated in our program. BenefitsThe benefits of our program are: Higher understanding of engaging in healthy habits for the students.These second grade students will understand the benefits of healthy living.Increased wellbeing from integrating behaviors into daily life. Decreased sedentary lifestyles.Students gain knowledge and self-efficacy of what ‘healthy’ and ‘unhealthy’ habits include.Educating students at a young age that will help influence the decisions made at a later date concerning healthy lifestyle habits.ChallengesThe challenges of our program include:Lack of family role models that can influence the decisions of these students to make healthy choices.Lack of school resources. Different levels of understanding.Cultural diversity (i.e. language barriers).Lack of reinforcement of behaviors at home. Health Promotion Planning ModelsTypes of Planning Models/ PurposesOne of the major roles and responsibilities of a health educator is to plan, implement, and evaluate health promotion programs. Good health promotion programs are not created by chance; they are the product of coordinated effort and are usually based on a systematic planning model. Models are the means by which structure and organization are given to the planning process CITATION McK091 \p 17 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 17). Planning models are important because they give the planner a sense of direction and a foundation to build their program out of. There are several different types of planning models; however, there are several steps that are conducted in each planning model. The generalized model for program planning outlines these common steps: assessing needs, setting goals and objectives, developing an intervention, implementing the intervention, and evaluating the results CITATION McK091 \p 17 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, p. 17). By understanding this general model the educator will be able to better plan their own health promotion program. As mentioned above, there are several different types of planning models. There are three important criteria that should be considered before determining which planning model will be used; these criterions are entitled ‘The Three Fs of Program Planning’. These three important factors include: fluidity, flexibility, and functionality. Once the health educator/planner has determined which planning model fits all three areas of program planning, they can then decide which planning model would best fit their needs. In addition to the three Fs, planners also need to ensure that the model is conducive to planning a population-based approach and that is uses an ecological framework CITATION McK091 \p 18-19 \l 1033 (McKenzie, Neiger, & Thackeray, 2009, pp. 18-19). Advantages/ DisadvantagesThe most common types of planning models used in Healthy Promotion are: PRECEDE-PROCEED, CDCynergy, SMART, PATCH, Social Marketing, MATCH, etc. Each planning model has its’ advantages and disadvantages and the program planner needs to weigh those factors to determine which one will be used. According to Mckenzie, Neiger, & Thackeray, 2009; each model has a wide range of planning approaches even though they share similar elements mentioned in the generalized model. Some of those advantages and disadvantages, to name a few, include: Type of Planning ModelAdvantagesDisadvantagesPRECEDE-PROCEEDWorks well for health interventions and community interventionsProvides more accurate informationProvides more structureWell-known; has been used a lot in the pastVery broadTime constraintMATCHHas also been used in professional practice; well-knownEmphasizes implementation phase of program planningMostly used for implementationTime sensitivePATCHLed to the inspiration of PROCEEDEasy to useInvolves communityNeed support from community leaders; can be a problem when there is lack of supportModel Chosen for this Program: PATCHApplicationAfter reviewing all of the different Health Promotion planning models we chose to use the Planned Approach to Community Health (PATCH) model. There were several factors that appealed to the use of this model for our program. These included: 260032540005The Five Elements of Patch: Community members participate in the processExamples: School Teachers, Administration, WSU Dental Hygiene Students, Students, Parents, and other such community leadersData Guide the Development of ProgramsExamples: Conduct a series of student/parent and faculty surveys to obtain the data that is required to decipher what knowledge is neededChoosing Health PrioritiesExamples: Determining goals and objectivesCourse Goal: To help 63 second grade students at Club Heights Elementary in Ogden, Utah learn preventative health behaviors including; friend shipping, nutrition, physical activity, and dental hygiene.Course Objectives: By the end of the period, students will understand the benefits of practicing preventative health behaviors.By the end of the course, students will be able to differentiate between healthy and unhealthy habits.By the end, students will exercise preventative health behaviors.Conducting a Comprehensive Intervention PlanExamples: Four interventions including lesson plans and activities regarding the following four topics- Nutrition, Dental Hygiene, Friend-shipping and Bullying; and Physical Activity.EvaluatingExamples: Conducting surveys and ongoing observations; develop an after-action report.Are the goals/objectives being met? With these five elements of the PATCH model the Healthy Heroes program was able to be successfully organized and implemented. Qualitative ResearchDefinedQualitative research is research done to provide depth of understanding, study motivation, allow discovery, are probing and interpretive, and permit insights into behavior and trends. CITATION Jam09 \l 1033 (James F. McKenzie, 2009) This type of research produces data in a narrative format, such as descriptions. Qualitative data may be gathered from case studies, focus groups, and in-depth interviews. Qualitative research strives to answer the question “why?” and does this through interpreting explanations and observations of participants.Developing Qualitative QuestionsIn writing qualitative questions, the questions usually begin broad. Through refining the questions, the study gets more focused on a specific topic. The process of focusing the questions is a reflective process that leads to data that can add knowledge to a larger field of study. CITATION Jan09 \l 1033 (Agee, 2009)Another important, if not obvious, factor of writing qualitative questions is to be sure the questions are answerable. To ensure that the questions are answerable it is important to phrase the questions at the correct reading level using a readability test such as The Simple Measure of Gobbledygook (SMOG).A further factor to consider in writing qualitative questions is the researcher’s time frame and resources. The researcher needs to take into account the cost of travel, copying, time, and materials required to obtain the answers to their questions. CITATION Jan09 \l 1033 (Agee, 2009)Another issue in writing a qualitative research question is to phrase the question in such a way that it doesn’t “lead” to any prescribed answer. “Leading” questions can bias a study and therefore prevent the researcher from obtaining quality data. CITATION Jan09 \l 1033 (Agee, 2009)Finally, in writing qualitative research questions, the words that construct the question are important. “Substituting one word for another or adding one word can clarify or obscure the meaning of a question.” CITATION Jan09 \l 1033 (Agee, 2009) It’s also important not to have multiple sub-questions within a question. It’s easier for a participant to answer questions completely and accurately if multi-part questions are broken up into their own distinct questions.Analyzing Qualitative ResearchIn an article written by Greenhalgh and Taylor, a set of questions was developed to assess the quality of qualitative research. CITATION Tri97 \l 1033 (Trisha Greenhalgh, 1997) First, did the article describe an important health problem through a clearly formulated question? The article should state that there is need for research to be done on the subject and the questions should be based on that need.Second, was a qualitative approach suitable for the study? If the researcher is interested in why something happens, rather than how much something happens, than a qualitative approach is suitable.Third, how was the setting and the subjects selected? A random sample of subjects is not fitting for qualitative research; rather, specific populations are sought out for qualitative research. Fourth, what was the researcher’s perspective and was it taken into account? The researcher needs to understand any potential bias they may have so the data is interpreted accurately. CITATION Ran10 \l 1033 (Randall R. Cottrell, 2010) Fifth, were the data collection methods sufficiently explained? Some questions to ask include, “Are these methods adequate to answer the research question?” and “Have I been given enough information to feel confident in the data collected?” CITATION Ran10 \l 1033 (Randall R. Cottrell, 2010)The sixth question is about the “methods used in analyzing the data and what quality control measures were taken.” CITATION Ran10 \l 1033 (Randall R. Cottrell, 2010) Seventh, are the results credible? One way to determine this is if the authors cite other studies or quotes that support their results. The eighth question is whether the conclusions can be justified by the results. The final question to ask when analyzing qualitative research is, “are the study’s findings transferrable?” If the findings are transferrable then it can applied to other populations. CITATION Ran10 \l 1033 (Randall R. Cottrell, 2010)Quantitative ResearchDefinedQuantitative research refers to consistent data collection and methods, using predetermined questions with a set number of pre-established responses. Quantitative data can be transformed into numerical data which makes it easier to see trends and groupings. Quantitative data may be gathered from surveys, telephone interviews, and tests. This type of research usually includes large sample groups—anything from 50 to any number of participants. CITATION Jam09 \l 1033 (James F. McKenzie, 2009)Analyzing Quantitative ResearchThe goal of analyzing any collected data is to identify and prioritize any health problems. The data can be analyzed by inputting the results into a spreadsheet program and comparing both the significant and insignificant results. Researchers and program planners then can analyze the data collected to categorize and prioritize the information and therefore accurately identify trends within the surveyed population. CITATION Jam09 \l 1033 (James F. McKenzie, 2009)Developing a SurveyThe most important part of developing a survey, and also the most difficult, is ensuring that the questions being asked are simple enough for the participant to understand and to provide accurate answers. ReliabilityThe reliability of a measurement instrument is the degree to which it produces consistent results. In other words, if the instrument produces the same result time after time, then it is deemed reliable. Researchers can increase the reliability of an instrument in many ways. First, the instrument should be administered in the same way each time. In other words, the use of the instrument needs to be standardized. Second, anyone using the instrument should be well trained to avoid human error. CITATION Pau10 \l 1033 (Paul D. Leedy, 2010)ValidityValidity helps ensure that researchers are measuring what they initially set out to measure. When using valid methods and instruments the likelihood that researchers are measuring what they intended to measure is greatly increased. CITATION Jam09 \l 1033 (James F. McKenzie, 2009)SMOGWhen distributing material it is important to ensure that everyone who will be receiving it will be able to read and understand it. A way to check the reading level of written materials is through a readability formula such as, The Simple Measure of Gobbledygook (SMOG). Smog was developed by G. Harry McLaughlin in 1969 CITATION Wik102 \l 1033 (Wikipedia, 2010). Guidelines for properly executing a SMOG test are as follows: For materials containing > 30 sentencesCount off 10 consecutive sentences at the beginning, middle, and end of the text.Count the number of words with 3 more syllables in the 30-sentence sample.Use the answer to step 2 to look up the reading grade level in the chart.For materials containing < 30 sentencesCount the number of sentences:Count the number of words with 3 or more syllables in the sample:Divide the number of sentences in the sample into 30 (i.e. 30/25) and multiply this number by the number of words from step 2.Use the answer to step 3 to look up the reading grade level in the chart.“SMOG Conversion Chart”Number of words with 3 or more syllables in a 30 sentence sample:Approximate Reading Grade Level0-243-657-12613-20721-3831-42943-561057-721173-901291-11013111-13214133-15615157-18216Reading level of this materialth grade (plus or minus 1.5 grades)A Few Notes:A sentence is defined as a string of words punctuated with a period, exclamation point, or question mark.Hyphenated words are considered one word.Numbers should be considered as if they were written out (i.e. both “25” and “twenty-five” should be considered to have 3 or more syllables).Proper nouns should be consideredAbbreviations should be considered in their unabbreviated form.These SMOG Guidelines were obtained from the University of South Carolina Prevention Research Center (USC Prevention Research Center Reports and Tools, 2008).CHES CompetenciesDefinedCertified Health Education Specialists (CHES) are professionals who design, conduct and evaluate activities that help improve the health of all people. These activities can take place in a variety of settings: schools, communities, health care facilities, businesses and colleges. Health educators are employed under a range of job titles such as patient educators, health education teachers, trainers, community organizers and health program managers. A Certified Health Education Specialist (CHES) are those who have met the standards of quality established by NCHEC by successfully passing the CHES examination. The CHES designation after a health educator's name is one indication of professional competency. Under the CHES qualifications are certain roles and responsibilities that health educators follow. The following are those specific roles and responsibilities of health educators.RESPONSIBILITY I: Assess Individual and Community Needs for Health EducationCompetency A: Access existing health-related data Sub-competencies:Identify diverse health-related databases.Use computerized sources of health-related information.Determine the compatibility of data from different data sources.Select valid sources of information about health needs and petency B: Collect health-related data Sub-competencies:Use appropriate data-gathering instruments. Apply survey techniques to acquire health data. Conduct health-related needs assessments. Implement appropriate measures to assess capacity for improving health petency C: Distinguish between behaviors that foster and hinder well-being Sub-competencies:Identify diverse factors that influence health behaviors.Identify behaviors that tend to promote or comprise petency D: Determine factors that influence learningThis Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of petency E: Identify factors that foster or hinder the process of health education Sub-competencies:Determine the extent of available health education services.Identify gaps and overlaps in the provision of collaborative health petency F: Infer needs for health education from obtained data Sub-competencies: Analyze needs assessment data.RESPONSIBILITY II: Plan Health Education Strategies, Interventions, and ProgramsCompetency A: Involve people and organizations in program planning Sub-competencies:Identify populations for health education programs.Elicit input from those who will affect or be affected by the program.Obtain commitments from individuals who will be involved.Develop plans for promoting collaborative efforts among health agencies and organizations with mutual petency B: Incorporate data analysis and principles of community organization Sub-competencies:Use research results when planning programs.Apply principles of community organization when planning programs.Suggest approaches for integrating health education within existing health municate need for the program to those who will be petency C: Formulate appropriate and measurable program objectives Sub-competencies:Design developmentally appropriate petency D: Develop a logical scope and sequence plan for health education practice Sub-competencies:Determine the range of health information necessary for a given program of instruction.Select references relevant to health education issues or petency E: Design strategies, interventions, and programs consistent with specified objectives This Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of petency F: Select appropriate strategies to meet objectives Sub-competencies:Analyze technologies, methods and media for their acceptability to diverse groups.Match health education services to proposed program petency G: Assess factors that affect implementation Sub-competencies:Determine the availability of information and resources needed to implement health education programs for a given audience. Identify barriers to the implementation of health education programs.RESPONSIBILITY III: Implement Health Education Strategies, Interventions, and ProgramsCompetency A: Initiate a plan of action Sub-competencies:Use community organization principles to facilitate change conducive to health. Pretest learners to determine baseline data relative to proposed program objectives.Deliver educational technology effectively.Facilitate petency B: Demonstrate a variety of skills in delivering strategies, interventions, and programs Sub-competencies:Use instructional technology effectively.Apply implementation petency C: Use a variety of methods to implement strategies, interventions, and programs Sub-competencies:Use the Code of Ethics in professional practice.Apply theoretical and conceptual models from health education and related disciplines to improve program delivery.Demonstrate skills needed to develop capacity for improving health status.Incorporate demographically and culturally sensitive techniques when promoting programs.Implement intervention strategies to facilitate health-related petency D: Conduct training programs This Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of practice.RESPONSIBILITY IV: Conduct Evaluation and Research Related to Health EducationCompetency A: Develop plans for evaluation and research Sub-competencies:Synthesize information presented in the literature.Evaluate research designs, methods and findings presented in the petency B: Review research and evaluation procedures Sub-competencies:Evaluate data-gathering instruments and processes.Develop methods to evaluate factors that influence shifts in health petency C: Design data collection instruments Sub-competencies:Develop valid and reliable evaluation instruments.Develop appropriate data-gathering petency D: Carry out evaluation and research plans Sub-competencies:Use appropriate research methods and designs in health education practice.Use data collection methods appropriate for measuring stated objectives.Implement appropriate qualitative and quantitative evaluation techniques.Implement methods to evaluate factors that influence shifts in health petency E: Interpret results from evaluation and research Sub-competencies:Analyze evaluation data.Analyze research pare evaluation results to other findings.Report effectiveness of programs in achieving proposed petency F: Infer implications from findings for future health-related activities This Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of practice.RESPONSIBILITY V: Administer Health Education Strategies, Interventions, and ProgramsCompetency A: Exercise organizational leadership Sub-competencies:Conduct strategic planning. Analyze the organization’s culture in relationship to program goals.Promote cooperation and feedback among personnel related to the petency B: Secure fiscal resources This Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of petency C: Manage human resources Sub-competencies:Develop volunteer petency D: Obtain acceptance and support for programs This Competency is not addressed in the study guide, because the Sub-competencies are related to an advanced level of practice.RESPONSIBILITY VI: Serve as a Health Education Resource PersonCompetency A: Use health-related information resources Sub-competencies:Match information needs with the appropriate retrieval systems.Select a data system commensurate with program needs.Determine the relevance of various computerized health information resources.Access health information resources.Employ electronic technology for retrieving petency B: Respond to requests for health information Sub-competencies:Identify information sources needed to satisfy a request.Refer requesters to valid sources of health petency C: Select resource materials for dissemination Sub-competencies:Evaluate applicability of resource materials for given audience.Apply various processes to acquire resource materials.Assemble educational material of value to the health of individuals and community petency D: Establish Consultative Relationships Sub-competencies:Analyze parameters of effective consultative relationships.Analyze the role of the health educator as a liaison between program staff and outside groups and organizations.Act as a liaison among consumer groups, individuals and health care providers.Apply networking skills to develop and maintain consultative relationships.Facilitate collaborative training efforts among health agencies and organization.RESPONSIBILITY VII: Communicate and Advocate for Health and Health EducationCompetency A: Analyze and respond to current and future needs in health education Sub-competencies:Analyze factors (e.g., social, cultural, demographic, political) that influence decision-petency B: Apply a variety of communication methods and techniques Sub-competencies:Assess the appropriateness of language in health education pare different methods of distributing educational materials.Respond to public input regarding health education information.Use culturally sensitive communication methods and techniques.Use appropriate techniques for communicating health education information.Use oral, electronic and written techniques for communicating health education information. Demonstrate proficiency in communicating health information and health education petency C: Promote the health education profession individually and collectively Sub-competencies:Develop a personal plan for professional petency D: Influence health policy to promote health Sub-competencies:Identify the significance and implications of health care providers’ messages to consumers.(National Commission for Health Education Credentialing, 2008)How they relate to this projectThe CHES competencies relate to this project thoroughly and we followed their guidelines so that our program would be organized and delivered efficiently to the 63 second grade students at Club Heights Elementary in Riverdale, Utah. We believe it is because we followed the competencies that our program was a success and the objectives of the program were petencies developed by doing this project When planning the Healthy Hero’s intervention for the second grade students, we made sure to include most of the CHES responsibilities and competencies. Here is an outline of how we applied each responsibility and competency:Responsibility I: Assess Individual and Community Needs for Health EducationBefore we implemented our four-week program once each week for one hour for the 63 second-grade students at Club Heights Elementary, we met with Principal Neiswender and the three second-grade teachers. In this meeting we gathered information that the students needed from our program. We also administered a pre-survey (Appendix A) to collect information on what the students already knew about nutrition, physical activity, hygiene, and, bullying, identifying behaviors that could compromise health.Responsibility II: Plan Health Education Strategies, Interventions, and ProgramsWe spent many, many hours planning the four one-hour interventions; there was a lot of information to sift through to find the concepts we believed would best suit second graders and facilitate the learning process. We also wanted to make sure the information we shared with students met the requirements required by Title I schools. We had one hour for each of our four interventions and wanted to use the time wisely for the benefit of the students. We decided we wanted the students to learn experientially as much as possible, rather than giving a lecture type lesson. Finally, we always e-mailed our lessons to the principal and teachers a few days before the intervention, so that they could approve them prior to implementation. We also examined our lesson plans with our Health 4150 Planning and Evaluation class, as well as the instructor Professor Patti Cost. Responsibility III: Implement Health Education Strategies, Interventions, and ProgramsWe implemented our Healthy Hero’s program based on a four-week, one hour per week intervention plan set up in the introductory meeting. We demonstrated a variety of skills in delivering our material to the students during the interventions. We were aware of the many different cultures in our population, for example low-income families of different nationalities, and were always sensitive to those differences while developing our lesson plans and working in the classrooms.Responsibility IV: Conduct Evaluation and Research Related to Health EducationWe wanted to evaluate the second grade students’ knowledge of nutrition, physical exercise, hygiene, and bullying/friend-shipping after the program had been implemented to see if there was an increase in knowledge and behavior from the pre-test survey. To do this, we conducted a post-test survey (Appendix A) with the same questions. We also conducted a process evaluation at the end of each intervention to review what worked and what could be improved. Through evaluation we were able to report on the effectiveness of programs in achieving the proposed objectives.Responsibility V: Administer Health Education Strategies, Interventions, and ProgramsWe exercised leadership when implementing our interventions by conducting strategic planning with the major stakeholders (i.e. teachers, school, principal, office staff), analyzing the priority population at Club Heights Elementary in relationship to program goals, and promoting cooperation and feedback among the second grade teachers and Principal Neiswender. We also worked closely with all of the second grade teachers to secure their support of our program and also their assistance in the classroom as needed.Responsibility VI: Serve as a Health Education Resource PersonWe served as Health Educators by answering questions that students had concerning nutrition, physical activity, hygiene, and bullying. When they requested more understanding of certain concepts, we would answer their questions to the best or our ability.Responsibility VII: Communicate and Advocate for Health and Health EducationWe fulfilled this responsibility by responding to the current and future needs in health education that was discussed in our introductory meeting with the second grade teachers. We communicated on a regular basis with the three teachers in order to make our program a success. We promoted health education by making learning fun so that the students would want to learn and share what they learned with their families at home.Types of EvaluationProcessProcess evaluation is “any combination of measurements obtained during the implementation of program activities to control, assure, or improve the quality of performance or delivery. Together with preprogram studies, makes up formative evaluation (Green & Lewis, 1986, p. 364).We used this type of evaluation by observation and feedback from the 2nd grade teachers. This occurred while we were instructing the students on the health topics; bullying, nutrition, dental hygiene, and physical activities. While instructing, we could observe the students to see what strategies were working and what needed to be fixed. After each class was finished, we talked to the second grade teachers and asked for feedback and used that feedback to improve each subsequent lesson.ImpactImpact evaluation is the “immediate observable effects of a program, leading to the intended outcomes of a program; intermediate outcomes” (Green & Lewis, 1986, p. 364). Measures of awareness, knowledge, attitudes, skills, and behaviors all yield impact evaluation data (McKenzie, Neiger, & Thackeray, 2009, p.339).For example, being able to re-visit these same first grade students as they grow older would be a great opportunity to conduct an impact evaluation. If we were able to annually visit these students and provide a questionnaire about the different health topics; bullying, nutrition, dental hygiene, and physical activity for the students; we would then be able to evaluate the long term results of the program.OutcomeOutcome evaluation is “an ultimate goal or product of a program or treatment, generally measured in the health field by mortality or morbidity data in a population, vital measures, symptoms, signs, or physiological indicators on individuals” (Green & Lewis, 1986, p. 364). Outcome evaluation is long-term in nature and takes more time and resources to conduct than impact evaluation (McKenzie, Neiger, & Thackeray, 2009, p. 339).The outcome evaluation was conducted through a post-program survey, immediately following the four week program. We did this to find out immediate knowledge, effectiveness, and behavior changes according to bullying, nutrition, dental hygiene, and physical activity. SummaryLiterature review provides groundwork to see what has already been discovered as well as supplemental information to help health promotion program planners stay on a path to success. Healthy People 2010 provide nationwide goals and objectives designed to help people stay on that path to success. Understanding the foundation and groundwork for health promotion programs provides the planner with skills and knowledge to plan, implement, and evaluate successful programs and interventions. Chapter IIIGoals & Objectives Introduction Although life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; for some members of the general population, preventable chronic diseases are on the rise and contribute to a majority of deaths in our society. The number of overweight children has risen from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). The increase in chronic disease is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially because of unhealthy lifestyles. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. Research has shown that you what you learn as a child stays with you throughout your entire life; therefore, it is necessary to instill healthy lifestyle habits at an early age. We chose to teach 63 second grade students at Club Heights Elementary school healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. As we planned, implemented, and evaluated the Healthy Heroes program we developed goals and objectives to meet the requirements of the state of Utah’s Education curriculum. Such goals and objectives helped determine the purpose and direction our program took. Also, as we evaluated our program we were able to go back through and see if the goals and objectives created at the beginning were successful. Program GoalsA goal is defined as a “future event toward which a committed endeavor is directed.” It is also a statement with no limit of time for futuristic program rational (McKenzie, Neiger, &Thackeray, 2005). The goal of the Healthy Heroes intervention is to educate and promote healthy behaviors and increase the quality of life of the 53 second grade students at Club Heights Elementary school.Importance of GoalsIn order for a program to be developed and function correctly it needs to have specific goals and objectives. Goals and objectives give a program a foundation and direction in which it needs to go. We found this to be true for the Healthy Heroes program; without the development of effective goals and objectives there was no direction. Therefore, to build the foundation of our program and the direction we wanted to go we found that goals and objectives are essential to the planning, implementing, and evaluating of a successful Health Promotion program. Developing GoalsGoals are an essential part of any Health Promotion program. When developing goals, it is crucial to remember there are general guidelines to be followed. Key concepts when developing goals include simplicity and concision. When creating a goal, two components must exist: who will this program impact and what will be changed because of the program (McKenzie, Neiger, & Thackeray, 2005). This was a primary focus when developing the goals for the Healthy Heroes program. Program ObjectivesDefinedAlong with the development of goals, objectives are equally important in the planning, implementing, and evaluating a successful Health Promotion program, such as Healthy Heroes. Objectives are steps used to accomplish a goal; they are the detailed steps that lead to the successful completion of a goal. They are ways to follow your progress while incorporating a program. Specific objectives state the different degrees of which a goal will be met (McKenzie, Neiger, & Thackeray, 2005). Importance of ObjectivesAs stated above, goals and objectives are equally important in the implementation of any Health Promotion program. According to McKenzie, Neiger, and Thackeray, “objectives are crucial. They form a fulcrum, converting diagnostic data into program direction and resource allocation over time.” Therefore, objectives form the base to the foundation of a Health Promotion program and give a sense of direction in which the program should follow. An effective objective answers the questions of who will be affected, what behavior is targeted, what will take place, when, where, and how much. The following goals and objectives are an essential component of the Healthy Heroes program.Goals and Objectives Specific to this ProgramProgram GoalThe goal of the Healthy Heroes intervention is to educate and promote healthy behaviors and increase the quality of life of the 53 second grade students at Club Heights Elementary school.Program/Process ObjectivesIn accordance with Utah’s Second Grade Health Education Objectives, by the end of the four week Healthy Heroes program at Club Heights Elementary second grade students will:Participate in a lesson about bullying.Have a lesson about the benefits of physical activity and participate in exercise activities.Learn about hygiene and taking care of their bodies.Learn about dental hygiene and taking care of their teeth.Be introduced to information about making nutritious food choices and will participate in several learning games.Learning Objectives Upon completion of the Healthy Heroes four week course, the second graders at Club Heights Elementary school will be able to recognize and understand what a healthy choice is in regards to nutrition, exercise, oral hygiene, and being a friend. By the end of the Healthy Heroes four week course, second graders at Club Heights Elementary school will:Understand ways of properly taking care of their teeth by experiential learning.Understand the benefits of healthy eating choices by participating in classroom activities.Understand the benefits of physical activity by hands-on experience. Recognize when someone is being a bully and will understand how to handle such situations through activities and lecture completed in the classroom.Behavioral ObjectivesBy the end of the four week Healthy Heroes program at Whitesides and Club Heights Elementary second grade students will:Increase the amount of healthy foods they consume.Increase the time they spend doing physical activities.Decrease the amount of nutrient empty foods they consume.Decrease the time they spend doing sedentary activities; i.e. TV, video games, computer usage.Apply friend shipping skills and will stand up to bullying.Brush their teeth twice daily and floss daily.SummaryIn conclusion, this chapter looked at the different goals and objectives specific to the Healthy Heroes program. It also explored the importance of goals and objectives. Goals and objectives of this program have helped our group plan, implement, and evaluate a successful program. We hope that individuals and groups may be able to use these goals and objectives to create a similar profitable Health Promotion program in the future. Chapter IVMethodsIntroductionAlthough life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; for some members of the general population, preventable chronic diseases are on the rise and contribute to a majority of deaths in our society. The number of overweight children has risen from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). The increase in chronic disease is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially because of unhealthy lifestyles. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. Research has shown that you what you learn as a child stays with you throughout your entire life; therefore, it is necessary to instill healthy lifestyle habits at an early age. We chose to teach 63 second grade students at Club Heights Elementary school healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. In previous chapters we have discussed the importance of surveys and evaluation of a Health Promotion program. This specific chapter will review the analysis and results of those surveys. Participant demographics and the Healthy Heroes program plan overview will also be examined. Program Plan OverviewWe created the Healthy Heroes program specifically for the 63 second grade students at Club Heights Elementary in Riverdale, Utah. After the initial meeting with all of the second grade teachers (Mr. Sianez, Mrs. Green/Alsup, and Mrs. Martin) we saw a need to create a program that would motivate these children to engage in healthy lifestyle behaviors. Following this meeting we created a pre-survey (Appendix A) that was distributed to the three second grade classes by their teachers. They went through the survey in class and the students would circle the best answer that applied to their life. Once all of the surveys were completed and returned to the group we compiled, tallied, and analyzed the surveys. This became the development of our mission statement, goals, and objectives. We decided what we wanted to focus on and where the students needed improvement. It was also after these surveys that we narrowed our topics down to four areas of focus, including: bullying/friend-shipping, nutrition, dental hygiene, and physical activity. The Healthy Heroes program consisted of four separate interventions. Each intervention took place on a Tuesday afternoon from two o’clock to three o’clock (except one that was rescheduled to be from noon to one o’clock) for one hour. The first intervention took place on October 12, 2010 and was focused primarily on bullying and how to be a good friend. This intervention was created to show children that they can be like their superhero idols and can be a friend to everyone. The first section focused on bullying and how to handle such situations. The second section focused on being a good friend to others and standing up to bullies. The second intervention was on October 19, 2010 and was on nutrition. The nutrition lesson plan was designed to introduce the My Pyramid to students and each food group was examined. The students participated in several activities that allowed them to retain their knowledge about different food groups and why they are important. We taught the students which foods belonged to each food group and created activities that were fun and interactive.The third intervention took place on October 26, 2010 and was about dental hygiene. This lesson plan focused on the ways to keep our teeth healthy such as brushing, flossing, and using fluoride. The students participated in several activities that taught them about dental hygiene. Also, several models of teeth (both healthy and unhealthy) were shown to the children to show them the difference between healthy teeth and unhealthy teeth. With the help of the teachers and local dentists we were able to provide the students with a tooth kit which included: a toothbrush, toothpaste, and floss. They loved the kit and were excited to use it at home. The fourth and final intervention took place on November 2, 2010. The final intervention was focused on physical activity and all of the second grade classes were combined to complete the lesson plan. Together we participated in activities that demonstrated flexibility, strength, and endurance. The children really enjoyed all of the activities and it turned out to be a true success. After the final intervention we ended with a final meeting with the teachers and discussed the strengths, setbacks, and challenges of the Healthy Heroes program. This was very effective and we were able to get substantial feedback from the teachers. We also had the teachers distribute the post-survey of the program. After collecting the surveys, we were then able to organize and analyze the information. This helped us determine whether our program was successful in our goals and objectives and outlined recommendations we would have for a similar program to be implemented in the future. Participant DemographicsThe demographics that were used to analyze our target population consisted of the zip code 84405. This zip code included the following areas of Utah: Riverdale, Uintah, South Weber, Washington Terrace, and South Ogden. The average household income for this population was $46, 911. These figures are an average for the above stated areas of Utah; therefore, the statistics may be different. Club Heights Elementary is a title one school and the income ratio varies tremendously. Club Heights Elementary, our community partner, has a total of 20 teachers and over 392 students (numbers may have changed due to high frequency of move-in/out rates). Table 1.1 shows the distribution of teacher to student ratios. This table also shows the average percentages of students at Club Heights Elementary that qualify for and obtain free lunches. By using the participant demographics we were able to successfully analyze the surveys that were distributed to the 63 second grade students. Table SEQ Table \* ARABIC 1.1- Teacher/ Student RatioClub Heights Utah Average Teachers 1:19 1:21 % White 49% 77% % Hispanic 44% 16% % Black 4% 2% % Asian 3% 3% % Free Lunch 51% 25% Data Analysis of SurveysPost Nutrition SurveyThe Healthy Food Choices survey (Appendix D) was administered after teaching the 63 second grade students about nutrition and making smart food choices. Our aim was to discover if the students felt positive about eating foods from the five food groups; grains, vegetables, fruit, milk, protein, and oils; after the lesson.Figure 1 shows the breakdown of the feelings the second graders have towards grains. The majority feel positive when they eat grains. Only two of the students reported they feel negative when they eat grains.Figure SEQ Figure \* ARABIC 1Figure 2Sixty nine percent of the second grade students feel good about vegetables with only 10 percent feeling bad when they eat vegetables.Figure 3Figure 4When asked how they feel when they eat fruit the second graders overwhelmingly answered that they feel positive (96%). The second graders felt less positive towards milk products with 75 percent answering that they felt positive about milk products. Figure 5Figure 6When asked how they feel when they eat protein nearly three quarters of the second graders answered that they feel positive with 21 percent answering that they feel have neutral feelings toward protein and six percent answering negative.The second graders responses were split somewhat evenly when asked how they feel when they eat sugary or fatty foods. According to the results, a majority of the 63 surveyed second grade students felt positive (44%) about eating sugary and fatty foods. Thirty one percent of the second graders replied that they have neutral feelings and a quarter of the students answered that they feel negative to consuming sugary and fatty foods.Based on these results we conclude that the 63 second graders at Club Heights Elementary feel positive when eating foods from the various food groups. For future projects we would recommend surveying the students before as well as after the nutrition lesson to see if the lesson made a direct impact of the students’ attitudes towards eating healthy foods. Post Program SurveyAt the conclusion of the program we provided the teachers with a post-program survey (Appendix A) to administer to the 63 2nd grade students in class. Similar to the pre-program survey the teachers went through the survey with the students in class by explaining each question to the 2nd grade students. The post-program survey was identical to the first survey provided (Appendix A). Our intention was to determine if the student’s attitudes, behavior, and knowledge had positively changed due to our interventions.The first question posed was on fruit and vegetable consumption. When asked whether or not they ate fruits or vegetables the students answered almost unanimously yes with only two percent of students answering no (see Figure 1). Figure SEQ Figure \* ARABIC 2The second question asked whether or not the students had friends in their class. Again the majority of students answered yes they have friends (see figure 2). Following the same topic, the third question asked if kids picked on them at school. Slightly more than a third answered yes at 35 percent.-57150199390 Figure 2Figure 3 The next question quizzed their nutrition knowledge by asking them what they thought was a healthy snack and gave them the following options to choose from; cookies and milk, apples and peanut butter, cheese and crackers, or soda and chips. Most answered apples and peanut butter (70%). The next question asked what they drink the most of from the following options; soda, water, milk, and juice. Half of the students answered water, with the second most frequent answer being milk.3009900171450 Figure 4Figure 5The next questions focused on physical activity. First, we asked about their rate of television viewing, next their rate of playing video or computer games, and last we asked what they liked to do after school. First, how much T.V. do you watch each day? The largest section of students (50%) answered three or more hours each day (see Figure 6). The next major group answered one to two hours a day (40%). A note of interest, the smallest group answered three to four hours but then there was a huge jump with students answering they watch five or more hours each day! Next, we asked ‘how long do you play video or computer games each day?’ The student’s answers were varied. The greater part of the students answered none to one to two hours (60%). Last, the final question asked: after school do you; play with friends, watch TV, play video or computer games, play sports, or sleep? The large majority plays with friends. Watching TV, playing video/computer games, and sports tied for second (see Figure 8). Figure 6Figure 7 Figure 8The last question was about their dental care. We asked, how many times do you brush your teeth in one day? The largest portion answered three or more times a day. With the next portion answering twice a day (see Figure 9). Sadly, one student doesn’t brush their teeth at all.Figure 9From these results we conclude that the students recognized the topics that were taught them in our intervention. Students were more aware of bullying, nutrition habits, dental hygiene, and physical activity habits. They had a more positive attitude towards these healthy behaviors after our program was completed. This energy and self-efficacy that the students gained will, hopefully, help them in their healthful choices in the future. SummaryIt is important to know the overview of the program plan, to assist in any necessities that may be missing and to ensure cooperation from all members. It is crucial to know the demographics of the community you are serving. While implementing the Healthy Heroes program we found it helpful to recognize the needs of Club Heights Elementary as a Title One school. We were able to incorporate many of these needs into the intervention and the pre and post program surveys describe the fulfillment of our goals and objectives. Many of the 63 2nd grade students (more than 35% of the students) come from low income households. Surveys were distributed to the 2nd grade students and the data emphasized the need for the four interventions which included nutrition, personal hygiene, friend-shipping, and physical activity. In the end, we were happy with the results demonstrated from the pre and post surveys and were excited from the improvement healthy lifestyle habits the 63 2nd grade students at Club Heights Elementary made. Chapter VResultsIntroductionAlthough life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; for some members of the general population, preventable chronic diseases are on the rise and contribute to a majority of deaths in our society. The number of overweight children has risen from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). The increase in chronic disease is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially because of unhealthy lifestyles. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. Research has shown that you what you learn as a child stays with you throughout your entire life; therefore, it is necessary to instill healthy lifestyle habits at an early age. We chose to teach 63 second grade students at Club Heights Elementary school healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. In previous chapters we have discussed the importance of surveys and evaluation of a Health Promotion program. This specific chapter will review the analysis and results of those surveys. Participant demographics and the Healthy Heroes program plan overview will also be examined. Program Plan OverviewWe created the Healthy Heroes program specifically for the 63 second grade students at Club Heights Elementary in Riverdale, Utah. After the initial meeting with all of the second grade teachers (Mr. Sianez, Mrs. Green/Alsup, and Mrs. Martin) we saw a need to create a program that would motivate these children to engage in healthy lifestyle behaviors. Following this meeting we created a pre-survey (Appendix A) that was distributed to the three second grade classes by their teachers. They went through the survey in class and the students would circle the best answer that applied to their life. Once all of the surveys were completed and returned to the group we compiled, tallied, and analyzed the surveys. This became the development of our mission statement, goals, and objectives. We decided what we wanted to focus on and where the students needed improvement. It was also after these surveys that we narrowed our topics down to four areas of focus, including: bullying/friend-shipping, nutrition, dental hygiene, and physical activity. The Healthy Heroes program consisted of four separate interventions. Each intervention took place on a Tuesday afternoon from two o’clock to three o’clock (except one that was rescheduled to be from noon to one o’clock) for one hour. The first intervention took place on October 12, 2010 and was focused primarily on bullying and how to be a good friend. This intervention was created to show children that they can be like their superhero idols and can be a friend to everyone. The first section focused on bullying and how to handle such situations. The second section focused on being a good friend to others and standing up to bullies. The second intervention was on October 19, 2010 and was on nutrition. The nutrition lesson plan was designed to introduce the My Pyramid to students and each food group was examined. The students participated in several activities that allowed them to retain their knowledge about different food groups and why they are important. We taught the students which foods belonged to each food group and created activities that were fun and interactive.The third intervention took place on October 26, 2010 and was about dental hygiene. This lesson plan focused on the ways to keep our teeth healthy such as brushing, flossing, and using fluoride. The students participated in several activities that taught them about dental hygiene. Also, several models of teeth (both healthy and unhealthy) were shown to the children to show them the difference between healthy teeth and unhealthy teeth. With the help of the teachers and local dentists we were able to provide the students with a tooth kit which included: a toothbrush, toothpaste, and floss. They loved the kit and were excited to use it at home. The fourth and final intervention took place on November 2, 2010. The final intervention was focused on physical activity and all of the second grade classes were combined to complete the lesson plan. Together we participated in activities that demonstrated flexibility, strength, and endurance. The children really enjoyed all of the activities and it turned out to be a true success. After the final intervention we ended with a final meeting with the teachers and discussed the strengths, setbacks, and challenges of the Healthy Heroes program. This was very effective and we were able to get substantial feedback from the teachers. We also had the teachers distribute the post-survey of the program. After collecting the surveys, we were then able to organize and analyze the information. This helped us determine whether our program was successful in our goals and objectives and outlined recommendations we would have for a similar program to be implemented in the future. Participant DemographicsThe demographics that were used to analyze our target population consisted of the zip code 84405. This zip code included the following areas of Utah: Riverdale, Uintah, South Weber, Washington Terrace, and South Ogden. The average household income for this population was $46, 911. These figures are an average for the above stated areas of Utah; therefore, the statistics may be different. Club Heights Elementary is a title one school and the income ratio varies tremendously. Club Heights Elementary, our community partner, has a total of 20 teachers and over 392 students (numbers may have changed due to high frequency of move-in/out rates). Table 1.1 shows the distribution of teacher to student ratios. This table also shows the average percentages of students at Club Heights Elementary that qualify for and obtain free lunches. By using the participant demographics we were able to successfully analyze the surveys that were distributed to the 63 second grade students. Table SEQ Table \* ARABIC 1.1- Teacher/ Student RatioClub Heights Utah Average Teachers 1:19 1:21 % White 49% 77% % Hispanic 44% 16% % Black 4% 2% % Asian 3% 3% % Free Lunch 51% 25% Data Analysis of SurveysPost Nutrition SurveyThe Healthy Food Choices survey (Appendix D) was administered after teaching the 63 second grade students about nutrition and making smart food choices. Our aim was to discover if the students felt positive about eating foods from the five food groups; grains, vegetables, fruit, milk, protein, and oils; after the lesson.Figure 1 shows the breakdown of the feelings the second graders have towards grains. The majority feel positive when they eat grains. Only two of the students reported they feel negative when they eat grains.Figure SEQ Figure \* ARABIC 1Figure 2Sixty nine percent of the second grade students feel good about vegetables with only 10 percent feeling bad when they eat vegetables.Figure 3Figure 4When asked how they feel when they eat fruit the second graders overwhelmingly answered that they feel positive (96%). The second graders felt less positive towards milk products with 75 percent answering that they felt positive about milk products. Figure 5Figure 6When asked how they feel when they eat protein nearly three quarters of the second graders answered that they feel positive with 21 percent answering that they feel have neutral feelings toward protein and six percent answering negative.The second graders responses were split somewhat evenly when asked how they feel when they eat sugary or fatty foods. According to the results, a majority of the 63 surveyed second grade students felt positive (44%) about eating sugary and fatty foods. Thirty one percent of the second graders replied that they have neutral feelings and a quarter of the students answered that they feel negative to consuming sugary and fatty foods.Based on these results we conclude that the 63 second graders at Club Heights Elementary feel positive when eating foods from the various food groups. For future projects we would recommend surveying the students before as well as after the nutrition lesson to see if the lesson made a direct impact of the students’ attitudes towards eating healthy foods. Post Program SurveyAt the conclusion of the program we provided the teachers with a post-program survey (Appendix A) to administer to the 63 2nd grade students in class. Similar to the pre-program survey the teachers went through the survey with the students in class by explaining each question to the 2nd grade students. The post-program survey was identical to the first survey provided (Appendix A). Our intention was to determine if the student’s attitudes, behavior, and knowledge had positively changed due to our interventions.The first question posed was on fruit and vegetable consumption. When asked whether or not they ate fruits or vegetables the students answered almost unanimously yes with only two percent of students answering no (see Figure 1). Figure SEQ Figure \* ARABIC 2The second question asked whether or not the students had friends in their class. Again the majority of students answered yes they have friends (see figure 2). Following the same topic, the third question asked if kids picked on them at school. Slightly more than a third answered yes at 35 percent.-57150199390 Figure 2Figure 3 The next question quizzed their nutrition knowledge by asking them what they thought was a healthy snack and gave them the following options to choose from; cookies and milk, apples and peanut butter, cheese and crackers, or soda and chips. Most answered apples and peanut butter (70%). The next question asked what they drink the most of from the following options; soda, water, milk, and juice. Half of the students answered water, with the second most frequent answer being milk.3009900171450 Figure 4Figure 5The next questions focused on physical activity. First, we asked about their rate of television viewing, next their rate of playing video or computer games, and last we asked what they liked to do after school. First, how much T.V. do you watch each day? The largest section of students (50%) answered three or more hours each day (see Figure 6). The next major group answered one to two hours a day (40%). A note of interest, the smallest group answered three to four hours but then there was a huge jump with students answering they watch five or more hours each day! Next, we asked ‘how long do you play video or computer games each day?’ The student’s answers were varied. The greater part of the students answered none to one to two hours (60%). Last, the final question asked: after school do you; play with friends, watch TV, play video or computer games, play sports, or sleep? The large majority plays with friends. Watching TV, playing video/computer games, and sports tied for second (see Figure 8). Figure 6Figure 7 Figure 8The last question was about their dental care. We asked, how many times do you brush your teeth in one day? The largest portion answered three or more times a day. With the next portion answering twice a day (see Figure 9). Sadly, one student doesn’t brush their teeth at all.Figure 9From these results we conclude that the students recognized the topics that were taught them in our intervention. Students were more aware of bullying, nutrition habits, dental hygiene, and physical activity habits. They had a more positive attitude towards these healthy behaviors after our program was completed. This energy and self-efficacy that the students gained will, hopefully, help them in their healthful choices in the future. SummaryIt is important to know the overview of the program plan, to assist in any necessities that may be missing and to ensure cooperation from all members. It is crucial to know the demographics of the community you are serving. While implementing the Healthy Heroes program we found it helpful to recognize the needs of Club Heights Elementary as a Title One school. We were able to incorporate many of these needs into the intervention and the pre and post program surveys describe the fulfillment of our goals and objectives. Many of the 63 2nd grade students (more than 35% of the students) come from low income households. Surveys were distributed to the 2nd grade students and the data emphasized the need for the four interventions which included nutrition, personal hygiene, friend-shipping, and physical activity. In the end, we were happy with the results demonstrated from the pre and post surveys and were excited from the improvement healthy lifestyle habits the 63 2nd grade students at Club Heights Elementary made. Chapter VISummary, Discussion, Conclusions, and RecommendationsIntroduction Life expectancy has increased from 75.4 years in 1990 to 78.1 years in 2006; with the massive influx of illness and diseases occurring in our society the quality of lives are decreasing. The number of overweight children rose from 11% to 18% from 1988 – 2006 (CDC, 2009, pg 28). This decrease in overall morbidity is in part due to unhealthy behaviors, such as: increased stress, poor nutrition, lack of adequate hygiene skills, lack of physical activity, and the absence of healthy conflict resolution skills. The quality of life for the future generations is declining substantially. In order to prevent severe chronic illnesses and the rate of quality of life to decline further we found it necessary to plan, implement, and evaluate an educational intervention to develop healthy lifestyle habits at a young age. The things that you learn as a child stick with you throughout your whole life; therefore, it is necessary to instill healthy lifestyle habits at an earlier age. We chose to teach 63 second grade students at Club Heights Elementary school healthy lifestyle habits including: nutrition, dental hygiene, bullying/friend-shipping skills, and physical activity to empower them with self-efficacy skills to live longer, healthier, and happier lives. It is our hope that with the knowledge and skills that these students learned through the Healthy Heroes program that they will be able to help their families break the cycle of unhealthy behaviors. As we planned, implemented, and evaluated the Healthy Heroes program we found many things that we would recommend for future interventions. Such recommendations, as well as the summary of the whole program, and conclusions of the Healthy Heroes program are discussed throughout this chapter. We hope others may be able to take this book and develop successful Health Promotion programs in the future. Summary of the Whole ProgramEstablishing healthful nutrition and physical activity choices, learning about oral health, and encouraging positive social behaviors should begin in childhood. We felt that creating a healthy lifestyle intervention at a Title I elementary school would be ideal for reaching those children most at risk. Healthy lifestyle topics are often overlooked due to the time required for teachers to teach the core basics of reading, writing, and arithmetic. We carefully planned a series of four interventions using the PATCH planning method that would effectively cover education topics to increase students’ knowledge, help shape appropriate attitudes, and help the student develop behavioral skills early in life.Both pre and post-surveys were handed out to the 63 boys and girls in the 2nd grade at Club Heights Elementary School. The initial survey was an attempt to discover the level of knowledge and level of healthy lifestyle behaviors of the second graders. This step was part of the planning stage of our program. The follow-up survey was to evaluate the success of the interventions.A well-designed curriculum that effectively addresses nutrition education topics can increase students’ knowledge about nutrition, help shape appropriate attitudes, and help develop the behavioral skills students need to plan, prepare, and select healthful meals and snacks. We taught the 2nd grade students about appropriate food choices using the Food Guide Pyramid; the children fished for foods in a swimming pool and as they “caught” a food, we discussed the benefits of healthful eating and the student placed the food item in the appropriate column of the Food Guide Pyramid. We also had the children prepare a healthy meal of their own in an art activity. They cut out healthy foods from the grocery advertisements and glued them on a paper plate.Physical activity among children and adolescents is important because of the related health benefits and weight management and because a physically active lifestyle adopted early in life may continue into adulthood. Many children are less physically active than recommended and physical activity seems to decline during adolescence. We had the 2nd grade students at Club Heights participate in a group exercise plan that reinforced the basic components of physical activity: endurance, flexibility, and strength. Oral health is also an essential and integral component of health throughout life. Tooth decay is the single most common chronic disease of childhood, occurring five to eight times as frequently as asthma, the second most common chronic disease in children. More than half of all children have cavities by the second grade. Because of this statistic and the lack of proper dental care for those children who live in poverty, we planned an additional intervention on dental hygiene. We provided toothbrushes, floss, and toothpaste for each of the students. We displayed a large tooth and brush and taught the children how to properly brush their teeth. We read the students a Berenstein Bear book about visiting the dentist. Then we had the children use a special mouthwash that turned their teeth blue when it came in contact with plaque that forms on teeth. After the mouthwash, they used their new toothbrushes and brushed their teeth. We also provided a coloring book for them to take home with their new tooth care kits. By using experiential learning techniques, we believe we made an impact on the children and that they will in turn share their enthusiasm and knowledge with their families. This will help achieve the mission, goals, and objectives of the Healthy Heroes program.ConclusionsBased on this experience we conclude the following:The students had fun with the activities and asked when we would be returning to teach them more about health related issues. Most importantly we witnessed kids develop self-efficacy skills and more positive attitudes towards healthy living including friend-shipping, nutrition, hygiene, and physical activity.Based on the results of our surveys (Appendix), we conclude that the students did make improvements on the healthy lifestyle habits that were taught to them in the Healthy Heroes four-week intervention.RecommendationsFor Future ProjectsRecommendations for future projects include: splitting the students into smaller groups for better classroom management and better able to maintain their attention. Had we had more people in our group we could have done this to improve the quality and effectiveness of our lesson plans. Also, it is evident that students have less distraction(s) in smaller groups, which would have made the learning process easier to track.It is also recommended that more time be allowed for the evaluation process at the end of each intervention. This would have made our data analysis easier to collect, and evaluate. We were given 45 minutes per intervention, which didn’t leave adequate time to do an evaluation and effectively teach the planned material. Another recommendation would be more time to better prepare for the different interventions and lesson plans. We, as a group, felt there was not adequate time in the semester to sufficiently prepare and feel prepared for the interventions themselves. We often felt uncomfortable with the length of time we had to prepare our interventions. More time between interventions would have proven to help us feel more comfortable with the information we were teaching.Another recommendation is that there is good communication between the instructors of the interventions and the community partner. We had several scheduling conflicts, which made preparing and presenting our interventions more difficult.For Projects Using SurveysWhen doing surveys, it is really important that those taking the surveys understand all the questions that are being asked as well as how to answer, such as, circling only one answer. In our case we left the surveys with the teacher to have them fill them out with their students. We had many children circle more than one answer when only one answer was required to be able to evaluate the data. Creating a survey that 2nd graders can understand is difficult. As a result we recommend using a readability test such as the Simple Measure of Gobbledygook (SMOG) to ensure that the intended audience will understand the survey.SummaryThis chapter gave a summary of the whole program, conclusions, and recommendations for future projects. A well designed program can be seen in the summary of a program and is reflected in the details of the whole program. The students loved the Healthy Heroes program, and wanted us to come back and teach more. The program was a huge success and created awareness in the second grade students to be able to live healthier lives. It is also important to include recommendations in an evaluation. Knowing what can be improved can increase the effectiveness of a program. With further recommendations and conclusions we feel that this program and programs like it may be implemented successfully in the future. ReferencesReferencesAgee, J. (2009). Developing qualitative research questions: a reflective process. International Journal of Qualitative Studies in Education , 431-447.Building Effective Community Partners. (n.d.). Retrieved October 21, 2010, from , C., & Wright, B. (2008). School and Community Partnership Building. Retrieved October 21, 2010, from “Healthy People 2010 (1).” Welcome to Health Net Federal Services (TRICARE North Region & VA Programs). N.p., n.d. Web. 16 Oct. 2010.“Healthy People 2010 (2).” . N.p., 2008. Web. 16 Oct. 2010. hpcomments.“How Was Healthy People 2010 Developed?” Healthy People 2010 Home Page. U.S. Department of Health and Human Services, n.d. Web. 16 Oct. 2010.James F. McKenzie, B. L. (2009). Planning, Implementing, & Evaluating Health Promotion Programs. San Francisco: Benjamin Cummings.Mutsambi, J. M. (2009). Forming and Sustaining Successful Partnerships. Retrieved October, 2010National Commission for Health Education Credentialing. (2008) Responsibilities and Competencies of Health Educators. Retrieved October 2010, from National Commission for Health Education Credentialing: Credentialing Excellence in Health Education: D. Leedy, J. E. (2010). Practical Research Planning and Design. Saddle River: Pearson.Randall R. Cottrell, J. F. (2010). Health Promotion & Education Research Methods Using the Five-Chapter Thesis/Dissertation Model. Sudbury: Jones & Bartlett Publishers.Trisha Greenhalgh, R. T. (1997). How to read a paper: Papers that go beyond numbers (qualitative research). British Medical Journal , 740.“What Is Its History?” Healthy People 2010 Home Page. U.S. Department of Health and Human Services, n.d. Web. 16 Oct. 2010. . (2010, August 1). SMOG. Retrieved October 13, 2010, from Wikipedia, the free encyclopedia: A Pre and Post SurveysHealthy HeroesThank you for your willingness to participate in our program! We are seniors at Weber State University enrolled in our capstone class, Health 4150: Program Planning and Evaluation, taught by Dr. Patti Cost. We are collecting data from your 2nd graders at Club Heights Elementary in hopes of being able to plan, implement, and evaluate four different health-related interventions for your students. Directions: Please read the following questions to your students and instruct them to circle their ONE BEST response. After we analyze the data we will develop a program based on their needs and we are also more than happy to share our data results with you. Thank you again for your help and support.1. Are you a boy or a girl? BoyGirl2. Do you eat fruits and vegetables?YesNo3. Do you have friends in your class? YesNo4. Do kids pick on you at school? YesNo5. What do you think is a healthy snack?Cookies and milkCrackers and cheese Soda and chipsApples and peanut butter6. What do you drink the most of? Soda Water MilkJuice7. How much T.V. do you watch each day? None 1-2 hours 3-4 hours5 or more8. How long do you play Video or computer games a day? None 1-2 hours 3-4 hours 5 or more hours9. After school do you:Play with friends Play Video or computer games Watch TV Play sportsSleep10. How many times do you brush your teeth in one day? None 1 23 or moreThank you!Healthy HeroesThank you for your willingness to participate in our program! We are seniors at Weber State University enrolled in our capstone class, Health 4150: Program Planning and Evaluation, taught by Dr. Patti Cost. We are collecting data from your 2nd graders at Club Heights Elementary in hopes of being able to plan, implement, and evaluate four different health-related interventions for your students. Directions: Please read the following questions to your students and instruct them to circle their ONE BEST response. After we analyze the data we will develop a program based on their needs and we are also more than happy to share our data results with you. Thank you again for your help and support.1. Are you a boy or a girl? BoyGirl2. Do you eat fruits and vegetables?YesNo3. Do you have friends in your class? YesNo4. Do kids pick on you at school? YesNo5. What do you think is a healthy snack?Cookies and milkCrackers and cheese Soda and chipsApples and peanut butter6. What do you drink the most of? Soda Water MilkJuice7. How much T.V. do you watch each day? None 1-2 hours 3-4 hours5 or more8. How long do you play Video or computer games a day? None 1-2 hours 3-4 hours 5 or more hours9. After school do you:Play with friends Play Video or computer games Watch TV Play sportsSleep10. How many times do you brush your teeth in one day? None 1 23 or moreThank you!Appendix BLesson PlansBe a Friend, Be a HeroElementary Anti-Bullying LessonOctober 12, 2010Goal: Create awareness in the 63 2nd grade students what bullying, teasing, and friendship is in an effort to create an environment where students will treat each other with respect and learn how to stand up to bullying.Objectives: By the end of the class, the 63 2nd grade students will:be able to identify kindness behaviors;be able to identify bullying behaviors; be able to appreciate other students’ differences and talents, and we all have different talents;demonstrate giving compliments to each other; and,feel confident in themselves to stand up to bullying.Materials:Attached story sheetBall(s) of yarnCrayons, markers, colored pencils, pencilsPictures of the Super Heroes: Superman, Batman, Wonder Woman, Flash, Green Lantern, Aquaman, Martian Hunter, and Hawkgirl. Pictures of the Villains: Doomsday, Ares, Volcana, Chronos, and Bizarro.Bullying Certificate (Appendix J)Procedure:Anticipatory Set: (10-15 minutes)Ground Rules:No one has to talk unless they want to.Respect what others have to say; no laughing.One person talks at a time.Define: Ask the students the following questions.Show the pictures of each super hero and ask the students what some of their super powers are. Write their answers on the white board. When all of the super heroes have been covered point out that they all have different strengths and talents, just like how all of the students have different strengths and talents. All of the super heroes are still really cool and special even though they are different, and they use their powers together to fight crime.Are superheroes kind to each other? (Yes, they treat each other with respect, and help each other out.When you are in class, on the bus or walking to school, at lunch, or recess do you see classmates being kind to others? What did you see them do?What is a friend?Show the students the pictures of the super villains and ask them what makes them the ‘bad guys”? What kinds of things do they do? What are some traits and attributes they have?What is a bully? (Someone who is mean; picks on or teases other kids, someone who hits, or steals lunches, just like the super villains.)Have you seen classmates be mean to other classmates?Do you think that made the classmate feel bad?What do you do when you see someone being mean to someone else?What should you do when you see someone being mean to someone else? (Explain to the students that there are three aspects of bullying, the bully, the victim, and the person who stands there and watches, and it’s important for anyone who sees someone being bullied to take action by reporting it to an adult you trust like a teacher, or parent that is present, we can stand up for the person by saying something to the bully.) Do superheroes help their friends when someone is being mean to them? (Yes they do. Just like the superhero friends we need to help someone who is being bullied.)Activities: Scenarios: (10-15 minutes)Review with the students what a bully and a friend are. Next explain to the students we are going to play a game. We are going to give them a scenario; if the heroes or villains are kind they are to put their thumbs up. If the hero/villain is being a bully have them put their thumbs down. At recess Superman Showed Batman how to jump rope.Doomsday told Hawkgirl that she was not his friend because she was smaller than him.Volcana called Bizarro “stupid” because Bizarro got less right on his math test.Aquaman helped Marian Manhunter when he fell down at recess, even though they do not have the same skin color.Chronos called Green Lantern a baby because he did not know how to tie his shoes.Flash showed Hawkgirl how to play shoot the ball.Ares took cuts in the lunch line and tried to take Wonder Woman’s lunch, because Wonder Woman was smaller.Writing/Drawing Activity (10 min)Students draw, color, and either write or dictate a time when they were kind at school. Use story sheet attached. Yarn Game: (15-20 min)Have the students get into groups of about 20, (each class will be a group). Have the students form a circle. Once the circle has been made the teacher/instructor will start the game by saying something kind about a student and pass the ball of yarn to that student. The teacher will hold onto the end of the yarn. The student will then say something nice about a student and pass the yarn, but still hold on to the end of it. This will continue until all the students have a piece of the yarn, forming a web. No student can be repeated and all comments have to be something they did or something about who they are, not visible characteristics. Conclusion: (2-3 min)Talk to the students and emphasize how important it is to be a friend and that everyone is different, but have great things about them. If you have time hand out the Bullying Certificate (Appendix J) or give to teachers to hand out. Works Cited:Faine. (n.d.). Group Cooperation: Lesson Plan, Activity, or Teaching Idea from A to Z Teacher. Retrieved October 1, 2010, from A to Z Teacher Stuff: HYPERLINK "" 1 (yarn game)San Francison Unified School District School Health Programs Department. (2004, April 7). Day of Kindness. Retrieved September 25, 2010, from . (n.d.). multiple pages. Retrieved October 1, 2010, from (pictures of superheroes and villians)Name _____________________At school I am kind when I______________ ______________________________________________________________________________________________________Super Food for SuperheroesElementary Nutrition LessonOctober 19, 2010Goal: To motivate 63 2nd grade students to make healthful and nutritious food choices by creating awareness and learning about nutrition.Objectives: By the end of the class, the 63 2nd grade students at Club Heights Elementary will:be able to recognize the difference between healthy and unhealthy foods;be able to classify foods to the different food groups; demonstrate making a nutritious snack;feel good about making healthy food choices.Time: One HourMaterials:Butcher Paper (4x4 square & six smaller pieces)MarkersScissorsPictures of food from the six different food groupsConstruction paper or other heavy paperLaminatorPaper clipsWooden dowel or rulerStringMagnetBaby swimming pool (cost: free to $10)Paper platesGrocery adsGlue sticksProcedure:Preparation:MyPyramid:Materials Needed:Butcher Paper (4x4 square and six smaller pieces)MarkersScissorsUsing the large piece of butcher paper, draw the MyPyramid figure; one large triangle with six segments within the triangle. Using the six smaller pieces of butcher paper, cut the paper to fit the sections within the MyPyramid figure. On each segment write the name of a different food group (Grains, Vegetables, Fruits, Oils, Milk, and Meat & Beans). Tape the large piece of butcher paper to the board.Fishing for Food:Materials Needed:Pictures of food from the six different food groupsConstruction paper or other heavy paperScissorsLaminator (or access to one)Paper clipWooden dowel or rulerStringMagnetPrint pictures of food from the six different food groups onto colored construction paper. Cut the pictures out and laminate for extra sturdiness. Attach a paper clip to each picture of food.Attach string to dowel or ruler and tie a magnet to the string to make a fishing pole.Anticipatory Set: (5-10 minutes)Introduction: Introduce the topic by talking to the students about food. Ask the students to raise their hands and name their favorite foods. Then ask the students what superheroes eat to stay strong. Make sure to emphasize the healthier foods; fruits, vegetables, grains, etc. Inform the students that they’ll be learning about the food pyramid which is a guide to help us make healthy food choices each day.Activities: My Pyramid (10 minutes)Materials: My Pyramid PosterTapeTell the students that there are six different parts to the food pyramid. Ask the students if they know of any. As each food group is introduced, have a student tape the food group segment to the appropriate section of the pyramid. Discuss how many servings from each food group are needed each day.Fishing for Foods (25-30 minutes)Materials:Laminated food pictures with paper clip attachedBaby swimming poolFishing polesTapePlace the pictures in the baby pool. One at a time each student will fish for a food item. Once a picture is caught, have the student name the food and the food group. Once the student has identified the food item and which group according to the My Pyramid food group it goes in, have the student attach (with tape or magnets) the food to the appropriate group on the My Pyramid model displayed on the board. Continue fishing until each student has had a turn or until all pictures on displayed.Paper-Plate Meals (10-15 minutes)Materials:Paper plate for each studentGrocery store adsScissors for each studentGlue stick for each studentHand out materials to each student. Have the students go through the ads and cut out pictures of food from each of the six different food groups to include in their “meals.” Have the students glue the food onto their plates to create a meal. Discuss how it is important to have a variety of foods from each of the six food groups.Grocery Bag Relay: (5-10 minutes) optional, if time allowsMaterials:Two grocery bagsSix legal size envelopesIndex cards (two sets, each set a different color)Black markersPreparation:Write the names of the following foods on index cards, using one card per food. Write the name of each food twice—once on one color index card, and once on the other color card. You will have four index cards for the grain group, three index cards for the vegetable group as well as the fruit group, two index cards for the dairy and meat groups, and one index card for oils. Procedure:Place each set of index cards into a grocery bag. The two grocery bags will be in the front of the room. Divide the class into two teams. Team 1 and Team 2 will line up in single file. When you say “go,” the race will begin. The first student in each team will run to the bag in front of his or her line. The student will pull a card from the bag, read it, and place it in the correct envelope. For example, a student who pulls banana will place this card in the envelope that is attached to the Fruit Group. When the student completes this task, she or he will run back to the line and tag the next student in line. This continues until one team finishes.Check the envelopes to make sure the foods were placed in the correct food groups. The team that finished first will get 15 points and the team that finished second will get 10 points. In addition each food placed in the correct envelope will earn 2 points for that team. For each card placed incorrectly in the envelope, you will subtract 2 points from the team’s total points. As you check each envelope, review the foods and the correct food groups.Conclusion: (2-3 min)Go over the food groups asking students for examples from each group. Ask the students how they feel, or how they might feel, when they eat foods from the different groups. Emphasize to the students how important it is to make healthy food choices so we can be strong like the superheroes.Works Cited:Family Education. (n.d.). Paper Plate Meals and other activities - . Retrieved 10 7, 2010, from Family Education: Diary Council. (2010, October). Food Model Activities:Fishing for Foods Game:Nutrition Explorations. Retrieved 10 6, 2010, from Nutrition Explorations: States Department of Agriculture. (n.d.). - Inside the Pyramid. Retrieved 10 7, 2010, from : Hill Companies, Inc. Pyramid Relay. McGraw Hill.YOU have the Power!Dental Hygiene Lesson PlanOctober 26, 2010Course Goal: to instruct 63 2nd grade students about the importance of good oral hygiene and to practice healthy habits. Objectives: By the end of the class, the 2nd grade students at Club Heights Elementary will:Demonstrate correct ways of brushing and flossing teeth through modeling. Understand the benefits of keeping your teeth healthy and clean.Recognize healthy and unhealthy oral hygiene patterns.Time: 1 hourWhere: Classroom (with a sink provided, preferably)Materials: 12” piece of floss12 “ piece of string/yarnOne dozen egg carton(s)55 soft bristle toothbrushes (one for each child)55 packets of mint wax floss (one for each child)55 travel size packets of Colgate toothpaste (one for each child)19 Ziploc quart-size baggies (one for each child)‘The Berenstain Bears Visit the Dentist’ book by: Stan & Jan BerenstainWordsearch Glue KnifeSpray Paint (white)Construction PaperFluoride/Mouthwash ‘Plaque Detector’Mini cups (55- one for each child)One roll of paper towelsWatercolor marker, black (1)Sink (found in classroom or school bathroom)Tooth model and toothbrush (found at Weber County library or dentist office)Coloring book (Appendix E)Preparation:Organize oral hygiene kits for each child by filling a Ziploc baggie with one toothbrush, floss, and toothpaste in each (you may want to include any pamphlets or handouts regarding oral health that the students can take back to their families). Anticipatory Set (5-10 minutes):Begin the lesson by reviewing with the children the reasons why teeth are important and what teeth help us do (smile, talk, chew, etc.). A. Ask the children the following questions:"When do you wash your hands?""Why do you wash your hands?" (Elicit from children responses such as "to clean off dirt" and "to remove germs.")"Can you see dirt on your hands?" (Yes)"Can you see germs on your hands?" (No)"How do you clean your hands to get the dirt and germs off?" (Wash with soap and water.)"Show me how you clean your hands." (Have children show motion of rubbing hands.)"What would happen if you didn't wash your hands?" (Encourage responses such as you might get dirt in your food; you might get sick; a scratch or cut might not get better.)Explain to the children that they should wash their hands to clean off dirt and remove germs even though they don't see the germs.Another place where there are germs that they cannot see is in their mouth. These germs need to be cleaned off too.?B. Ask children the following questions."How do you clean your mouth to get rid of the germs?" (Brush my teeth.)"What do you use when you clean your teeth?" (Toothbrush and toothpaste.)"What would happen if you didn't clean your teeth?" (Explain that just as we can get sores on our hands or get sick when we don't keep our hands clean, our teeth get sick and hurt if we don't keep them clean.)?Activities:1. Story Time (5-10 minutes) Materials Needed:‘The Berenstain Bears Visit the Dentist’ book by Stan and Jan BerenstainRead the above story to the students with the students sitting quietly in their seats. Emphasize certain parts of the book and discuss questions they might have at the end. At the end, discuss the importance of visiting the dentist on a regular basis. 2. Egg Carton Flossing (10 minutes)Materials Needed: Egg cartonSpray Paint (white, preferably)Floss (a thread per child)Construction PaperKnifeGlueSteps: Cut several white egg cartons into strips (cut carton in half so you have one row of bumps).Glue each strip to a sheet of construction paper and tape it to a table.Use a knife to carefully cut half-inch slits between each egg cup.Give each student a length of dental floss. Then have the students practice flossing between each tooth.Students will have a great time doing this in the class! Ask the students what they learned by completing this activity. Discuss the importance of flossing.3. Brushing Tooth Model (5 minutes) Materials Needed: Tooth model and toothbrush (found at Weber County library or dentist office)Steps:After showing the students how to floss with the egg carton show them the tooth model and demonstrate the correct way of brushing their teeth. Explain the importance of brushing and how we can protect our teeth and gums if we floss and brush regularly.4. Power Plaque Mouthwash (15-20 minutes)After going over the importance of brushing and flossing their teeth, explain to the children that using mouthwash and fluoride can also help protect their teeth from bad bacteria. Preparation:Prepare the mouthwash into small or mini cups by pouring a small amount into the cup ready for the children to try (may want to measure the recommended amount found on the mouthwash bottle). Materials Needed:Mouthwash ‘Plaque Detector’Sink with mirror (found in classroom or bathroom)WaterPaper towelsToothbrushToothpasteSmall/mini cupsSteps:Explain to the children the importance of using mouthwash and fluoride (protects from bad germs that might get in their mouth and cause cavities). Show the kids the mouthwash that they will be using and explain that this special mouthwash will turn all of the plaque and extra germs in their mouth blue so that they can see where it is and clean it off. Instruct the students not to swallow the mouthwash.Have each of the children, one table at a time, take turns using the mouthwash (use the sink in the classroom if one is located; otherwise, have them all line up to go to the bathroom to use the sink).Time the students for 30 seconds. After the 30 are up have them spit the mouthwash out and look in the mirror to see if their teeth turned blue. Once the children have used the mouthwash and have seen the effects of not brushing, have them each use a toothbrush and toothpaste to wash off the excess mouthwash. Hand out the oral hygiene packets to the students so they may use the toothbrush and toothpaste to brush their teeth. If you are having the children take turns, provide a word search or coloring book page that they may do while they are waiting for their turn. Ask the children if they enjoyed seeing what was in their teeth. Explain that if they do not take care of their teeth by brushing, flossing, and using mouthwash that their teeth will wear down and they will get more diseases, such as cavities, in their mouth. 5. How a Cavity Grows (5 minutes): Materials:Paper towel1 crayon (to draw on paper towel)1 watercolor marker (black, preferably)WaterSpray bottleSteps:Draw a large tooth on a paper towel with a crayon or permanent marker. Using a black watercolor marker, make a heavy dot on the tooth to represent a cavity.Add a drop of water or spray water onto the cavity to represent an acid attack. After a few seconds look at the tooth and see how the “cavity” has spread.Reemphasize the importance of brushing and flossing to prevent cavities from spreading. Discuss how much they should brush and the benefits of brushing their teeth morning and night before bedtime. Explain to the children that they should visit the dentist often to prevent cavities and other oral diseases.Conclusion (5 minutes): Explain to the children that in order to keep their bodies healthy they also need to take care of their teeth and mouth. Mention the daily habits that they should be participating in such as brushing, flossing, and rinsing with mouthwash. Explain to the children that all of those things are important to keep their teeth healthy and that they should be visiting the dentist regularly for healthy gums and teeth. Give the children the coloring book (Appendix E).References:American Dental Association. (2005). Module 2: Plaque Attack! Retrieved October 2010, from : of Health and Human Services. (n.d.). Lesson: The Importance of Keeping Teeth and Gums Healthy. Retrieved October 2010, from bmcc.edu: Web. (2005). Egg Flossing Lesson Plan. Retrieved October 2010, from : Superhero TrainingElementary Physical Fitness LessonNovember 2, 2010Goal: to instruct 63 2nd grade students at Club Heights Elementary on the components of physical fitness; strength, endurance, and flexibility; and to motivate the students to participate in physical activity each day.Objectives: By the end of the class, these 63 2nd grade students at Club Heights Elementary will:Be able to identify the different components of physical fitness; strength, endurance, and flexibility. Experience fun physical activities that can be used outside of school and P.E. time.Perform fundamental locomotor (i.e. skip, gallop, run) and nonlocomotor (i.e. twist, stretch, balance) skills.Time: One HourMaterials:4 cones6 hula hoops30+ bean bagsAccess to large area (gymnasium or outdoor recreation area)Music (Theme from Mission Impossible)Plastic Bowls (60 bowls)Six different Healthy Hero’s in six colors (10 of each)60 index cardsA sticker for each team member in the color of their team HeroHole Punch55 Superhero Training Badge (one for each student)55 pieces of yarn (long enough to go around child’s neck)Preparation:Print off superhero badge (one for each student), laminate, and cut out; see Appendix. Use a hole punch to make two holes at the top of the badge. Tie string/yarn through hole punches to make a necklace that the student can wear around their neck. Procedure:Anticipatory Set: (5-10 minutes)Introduction: Introduce the topic by talking to the students about fitness. Ask the students if they like to play at recess. Then ask the students if they like to exercise. Explain to the students that when they play they are using their muscles. This is exercising. Ask the students if they think Superheroes exercise. Explain that superheroes need to exercise and stay physically fit to fight the villains. Activities:Teach them about the components of physical fitness. Strength, Endurance, Flexibility.Hungry Crabs (15 minutes)Materials:4 cones6 hula hoops30+ bean bagsAccess to large area (gymnasium or outdoor recreation area)Preparation:Prior to the activity, set up a large area (depending on the number of students) with boundaries marked by cones. Scatter the bean bags through the designated area. Place the hula hoops on the outside of the boundaries.Procedure:Divide the students into six groups and place each group at one of the hula hoops. Explain to the students that the area inside the cones is the “ocean” and the bean bags are “crab food.” Explain that the hula hoop is their team hula hoop and is where they are going to place the bean bags they collect.Tell the students they are going to crab walk inside the boundaries and collect the bean bags. Explain or demonstrate a “crab walk.” They are only allowed to get one bean bag at a time.Once they get a bean bag, tell the students they need to place it on their stomach and crab walk to their team’s hula hoop.Once the student has placed his/her bean bag in the hula hoop, the next team member leaves to get another bean bag.Each team is trying to collect the most bean bags either before time runs out or all the bean bags are gone.Evaluation:At the end of the activity, ask the students what muscles they used during the activity. Explain the muscles of the upper body that were used and how this activity helps improve strength and endurance.Healthy Heroes Training Mission (20 minutes)Materials:Music (Theme from Mission Impossible)Plastic Bowls (60 bowls)Six different Healthy Hero’s in six colors (10 of each)60 index cardsA sticker for each team member in the color of their team Hero (6 stickers of each color)Preparation:Using different colored Healthy Heroes, glue a hero on top of each plastic bowl.Write the following missions on index cards and tape on index card on the bottom of each of the plastic bowls.Hop on your right foot 10 timesDo 15 jumping jacksLock arms and walk in a circle for 30 secondsHop on your left foot 10 timesCount to 20 while using a Hula Hoop the whole timeDo 5 + 3 pushupsUsing the jump rope, jump 10 timesCrawl from cone to cone like a bearHop from cone to cone like a frogKick a soccer ball into the goalHide each of the bowls, turned upside down (colored Hero visible) around the room/gymnasium.Have the “Mission Impossible” theme playing as students are “training.”Procedure: Divide the class into six even teams. Assign each team a Healthy hero that coincides with one of the colors of the upside down bowls. In order to keep track of the students and which team they are on give the students a sticker to put on their hand or shirt that matches the Healthy Hero bowl color (i.e. if they decide to be the blue team, give each student on the team a blue sticker). On your signal, direct the team players to interlock arms and move together as a team to find the hidden bowls with their team color.Each time a colored bowl is found, a member of the team reads the mission (taped to the inside of the bowl) and the team begins completing the mission.Have the team sit down as soon as they finish the entire training.You will know when everyone has completed their training mission because the students will all be sitting down.Evaluation:Observe the students as they are working as a group to complete all of the missions. Watch to see if they are all participating and whether each team member is completing the task. Examine to see if the students are having a hard time participating in physical activity. Once all of the students are seated ask them how they felt while completing each mission and have them explain whether it was hard or easy to complete each task. Explain to the students that in order to keep their bodies healthy they need to engage in physical activity every day (emphasize that superheroes also have to work at their strength/muscles by exercising every day).Conclusion: Hand out Superhero Training badges to each student (Appendix F). Discuss the importance of physical activity and the results of physical activity. Thank the students and teachers for letting us come teach them healthy lifestyle habits. Dismiss the students to their classrooms. Appendix CLesson Plan Pictures4216400379095Nutrition Lesson Plan PicturesNote: Cut out and LaminateFruit--175895196215-34925368303345815171450768352190753474720262255Grains-2869565496951029665312889115190504454741Meat & Beans-Milk & Dairy-Vegetables- 30607004123690Junk Food- 2898775252730Appendix DPost Nutrition SurveyHealthy Food ChoicesRead the following and circle the face that shows how you feel.When I eat grains; bread, pasta, rice, tortillas; I feel:When I eat vegetables; broccoli, carrots, mushrooms; I feel:When I eat fruit; apples, grapes, bananas; I feel:When I eat milk products; milk, yogurt, cheese; I feel:When I eat protein; chicken, beef, pork, beans; I feel:When I eat sugar and fatty foods; candy, chocolate, soda, chips; I feel:Appendix EColoring Bookcenter-709295Kids Coloring BookKids Coloring BookAppendix FHealthy Heroes Badge19050-390525-53530503134360Appendix GProgram Proposal19050114300HEALTHY HEROES ProposalMegan Passey, Amber Ward, & Melanie SpeechlyOverviewTo teach the importance of healthy behaviors including; bullying, nutrition, physical activity, and dental hygiene. We plan to do this through a series of 4 classes using hands-on methods that will engage the students and will help them feel confident in their ability to practice the behaviors at home and school. Who: 2nd Graders at Club Heights Elementaryright2943225When: Fridays during the last hour of the day [alternate days: Tuesday or Thursday]Where: In the classrooms or as a whole grade in the cafeteria spaceTimeline9/24: Pre-process survey to teachers9/29: Collect pre-process surveys from teachers10/15: First Class: Bullying10/22: Second Class: Nutrition10/29: Third Class: Exercise11/5: Fourth Class: Dental HygieneQuestions-What types of interventions would you like to see us create?203205986145- What topics of interest do you think are most valuable or would like us to touch on?- What type of support would we be getting from the staff (i.e. teachers)??- Which day(s) and time would work better for you to have us come teach the students?- Would you like us to come on four different occasions or have just one big health fair/assembly?- Are there other times that you would be able to meet with us besides Wednesdays?- Do you have any resources that you have readily available to assist in our interventions (i.e. pictures, posters, etc)?-What is your funding source?Appendix HPictures504825390525790575971551085850422275-5905501784354857754857752190754953000Appendix IProgram TimelineHealthy Heroes Program Timeline Club Heights ElementaryFinalize Goals & Objectives. Start Lesson Plans.Oct. 4 – Oct. 8Finalize lesson plans, resources, & supplies.Oct. 12First Intervention: Friend-shipping.Process Evaluation.Oct. 19Second Intervention: Nutrition.Process Evaluation.Oct. 26Third Intervention: Dental Hygiene.Process Evaluation.Nov. 2Fourth Intervention: Physical Activity.Drop off exit surveys.Process Evaluation.Nov. 11 – Nov. 17Collect exit pile program data.Finish book.Present at symposium.Nov. 25 – Dec. 1Sept. 27- Oct. 1 Sept. 29Sept. 22Sept. 22Collect Surveys.Identify Needs.Drop off pre-program survey.Meet with community partner. Appendix JBullying Certificate ................
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