HP 489 HEALTH PROMOTION INTERNSHIP
MANUAL
Updated 11/14/06
Applications for internships are due November 15 for spring internships
and April 1 for fall or summer internships.
Available on the Health Promotion web site
<http://www.bgsu.edu/colleges/edhd/FCS/HEALTHPROMOTION/healthpromotion.html>
Health Promotion
School of Family and Consumer Sciences
Bowling Green State University
1
TABLE OF CONTENTS
Introduction ............................................................................................................................................................... 3
Terminology .............................................................................................................................................................. 3
Objectives .................................................................................................................................................................. 3
Prerequisites .............................................................................................................................................................. 3
Length of Internship ................................................................................................................................................ 4
Placement Process ................................................................................................................................................... 4
Internship Sites ......................................................................................................................................................... 5
Internship Activities ................................................................................................................................................. 6
Intern Responsibilities ............................................................................................................................................... 6
Sponsoring Organization Responsibilities ................................................................................................................. 7
Health Promotion Program Responsibilities ............................................................................................................. 8
Evaluation Criteria .................................................................................................................................................... 8
Health Promotion Specialist Entry Level Performance Competencies ..................................................................... 8
Internship Major Project ........................................................................................................................................... 9
Internship Major Project Outline and Strategic Plan ............................................................................................. 10
Final Report/Binder ................................................................................................................................................ 11
Weekly Flow Chart .................................................................................................................................................. 12
Application Form .................................................................................................................................................... 13
Verification Form ................................................................................................................................................... 15
Orientation Report Form ......................................................................................................................................... 16
Weekly Progress Report Form................................................................................................................................. 18
Evaluation Form. ..................................................................................................................................................... 19
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professional field experience for a BGSU Health
Promotion Intern. May also be referred to as Sponsor.
BGSU Catalog Description:
489. Internship in Health Promotion (10-15). Fall,
Spring, Summer. Pre-professional field experience at
an approved site; 40 hours of fieldwork required per
credit hour. Prerequisites: Minimum GPA of 2.5
overall or > 2.75 in core courses, completion of HP
310 and HP 411 with a "C" or better, and approval of
academic adviser. Application deadlines: 11/15 for
Spring; 4/1 for Summer and Fall.
University: Bowling Green State University
(BGSU).
University Supervisor: The university faculty
member who supervises interns in close cooperation
with the site supervisor.
OBJECTIVES
INTRODUCTION
By the end of the internship, the intern will have:
The Health Promotion Internship is a concentrated
pre-professional experience that provides an
opportunity for health promotion majors to apply the
theories, knowledge and experiences gained from
their undergraduate coursework to real life situations.
The internship is the culminating event of a student’s
university experience. Thus, it is critical for the
internship to be carefully planned and implemented.
The Internship Manual contains a comprehensive set
of guidelines to help insure that the internship is a
valuable and positive experience. As you begin
planning your internship, please keep in mind that the
manual is designed to be used in conjunction with
counsel from your academic advisor.
1.
2.
3.
4.
an understanding of the structure and function
of the sponsoring organization,
the skills and knowledge deemed appropriate
for an entry-level health promotion specialist,
an understanding of how health promotion
professionals enhance their programs by
networking with individuals and agencies,
made a meaningful contribution to the
sponsoring organization.
PREREQUISITES
1.
2.
3.
TERMINOLOGY
Advisor: Intern's academic advisor at BGSU.
4.
Program Area: Health Promotion, School of Family
and Consumer Sciences.
Completion of HP 310 and HP 411
Senior standing,
Over-all GPA of 2.5, or a 2.75 grade point
average in professional core courses, *
Health Promotion faculty approval of
internship application. Applications for
internships are due November 15 for spring
internships and March 31 for fall or summer
internships.
Intern: BGSU student enrolled in HP 489
* A student not meeting this prerequisite is
encouraged to consult with his/her Academic
Advisor. Student options include: taking additional
courses to improve GPA, petitioning HP to waive the
GPA requirement (granted only in rare cases),
transferring to a planned program or a different
major.
HP 489 Health Promotion Internship: This course
was designed to provide a fulltime (40 field work hrs
per credit hr; 15 credit hrs = 600 fieldwork hrs; 10
credit hrs = 400 fieldwork hours) supervised
experience in a corporate, commercial, clinical or
nonprofit health-related facility, agency, or
institution. Health promotion majors are required to
complete a minimum of 10 credits of HP 489 (400
contact hrs).
LENGTH OF INTERNSHIP
The internship may be a paid or unpaid full-time
position in order for the intern to experience the
responsibilities and commitment required of health
professionals who are full-time employees of the
sponsoring organization. Thus, the intern is expected
to work 30-40 hours per week on internship related
activities for 10-15 weeks. All interns are required to
work a minimum of 400 hours (10 credit hours), but
they are allowed to work up 600 hours (15 credit
Site Supervisor: An experienced health promotion
specialist assigned by the sponsoring organization to
provide direct on-site supervision of the intern.
Sponsoring Organization: A corporation,
government agency, private agency, association,
society, or institution that has a health promotion
component and is willing to provide a pre-
3
hours). A total of 40 hours of fieldwork are required
per credit hour.
4)
LIABILITY INSURANCE
Most practicum sites will require students to carry
student medical professional liability insurance
during their internship assignments. The University
Office of Risk Management automatically provides
student interns with $1,000,000 of coverage per claim
with a $3,000,000 annual aggregate. Coverage is
provided for claims arising out of a real or alleged
incident when the injury being claimed is the result of
an act or omission while the student is performing
activities related to their educational curriculum.
Faculty members are responsible for notifying risk
management of the students to be covered. For
additional information and specific details, contact
your advisor or the BGSU Office of Risk
Management, 604 Administration Building, phone
419-372-2127.
OPTIONAL INSURANCE
Interns may obtain travel risk insurance through the
Office of Field Experience in the College of
Education and Human Development. The insurance
costs $.50 per day and provides up to $5,000 for
injuries sustained while traveling to and from the
internship site and while participating in any
activities arranged by the sponsoring organization.
Excess automobile liability insurance is provided to
interns driving their personal vehicles to their
assigned sites. This insurance is excess over any
other valid and collectible insurance that is carried by
the vehicle owner or operator. Students that wish to
secure coverage need to complete the excess
automobile liability insurance form found at
http://www.bgsu.edu/offices/riskmgmt/resources/auto
.pdf . Forms are also available from the Office of
Field Experiences; phone 419-372-7389.
3)
INTERNSHIP SITES
Organizations suitable for consideration include, but
are not limited to the following. Also, check with
your Academic Advisor for recommendations.
Addiction Counseling & Education Services
Akron General Lifestyles Wellness Center
American Cancer Society; Maumee
American Corporate Health Programs, Inc.
American Diabetes Association, Toledo
American Red Cross; Toledo
Athletic Club; Boca Raton, FL
Baylor Fitness Center
Bethesda Preventive Health Systems; Cincinnati
Bowling Green State University Student Recreation
Center
Bluffton Family Recreation Center
Bruce B. Siegel Center for Health Education;
Columbus
Canyon Ranch Resort, Tucson, AZ
Cascade Spa & Club; Vail, CO
Center for Sports Medicine; Tipp City
PLACEMENT PROCESS
Students are responsible for locating an internship
site and making all necessary arrangements for
placement. To insure a successful placement, the
following steps need to be followed.
1)
2)
for prospective internship sites. Identify 3-5
potential internship sites.
It is the responsibility of the intern to contact
potential sponsoring organizations. When
making contacts with potential sponsors,
inquire about their particular internship
application procedures. As part of the
application process you will be responsible
for providing the sponsoring organization
with:
a)
Write a letter of introduction
b)
Update your resume
d)
Write a letter of thanks to the
sponsoring organization for having
granted the interview
e)
When an internship is offered by a
sponsoring organization, respond to that
offer immediately with either a letter of
acceptance or a letter of regret.
f)
Meet with your advisor to confirm
placement or discuss alternative sites, if
necessary.
g)
Submit the internship application for
signatures.
Complete an HP 489 Health Promotion
Internship Application form, secure your
Academic Advisor’s signature and submit
the form to the University Supervisor. The
University Supervisor will review the
application and if it meets the requirements,
she will notify the FCS secretary to enroll
you in HP 489.
Attend the mandatory pre-internship
meeting the semester prior to applying for
the internship. These meetings are generally
held in October and February.
See Internship Sites listed below, consult the
HP internship binders in 201 Eppler North
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Chrysalis Women’s Fitness and Aerobic Center
Cleveland Clinic Foundation
Columbus Department of Health
DaimlerChrysler Corp, Toledo Jeep Plant,
HealthyLife Program
Doctor’s Fitness Center; Phoenix, AZ
Ethicon Endo-surgery; Cincinnati
Fisher-Titus Medical Center; Norwalk
Ford Motor Company; Lima
Fostoria Community Hospital Positive Lifestyles
Glaxo Wellcome
Grace Martin White House Athletic Center;
Washington, DC
Harris Health Trends; Toledo
Health Fitness Corp; Texas Instruments; Sherman TX
Health/Fitness Designs; Grove City
Henry L. Morse Health Research Center
Highmark Bluecross Blueshield; Erie, PA
Honda; Marysville, OH
Huron County General Health District; Norwalk
Jewish Community Center of Toledo
Johnson & Johnson Health Care Systems, Inc.,
Owens Corning; Toledo
Kent State University Wellness Program
Lifetime Fitness
Marathon Oil Company; Findlay OH
Medical College of Ohio Sports Care; Toledo
MedCentral Health System; Mansfield
Memorial Hospital; Fremont
MFit, University of Michigan Medical Center; Ann
Arbor, MI
Mount Carmel East Hospital; Columbus
NASA GRC Fitness Center; Cleveland
Northwestern University Fitness & Recreation
OCLC Online Computer Library Center, Inc.;
Dublin, OH
Ohio State University Medical Center for
Wellness and Prevention
Paramount Health Care; Maumee
Paramount Health Care; Toledo
Parma Community General Hospital
Perrysburg Area Substance Abuse Prevention
Partners
Planned Parenthood of Northwest Ohio, Toledo
Portland Adventist Medical Center, Health for Life;
Portland, OR
PowerLine Personal Fitness Trainers; Toledo
Progressive Insurance; Mayfield
St. Charles Center for Health and Rehabilitation;
Oregon
St. James Club; Toledo
Sarasota County Government Wellness Program;
Sarasota, FL
Saturn Corporation, Ford Motor Company; Michigan
Sears “Live For Life” Wellness Center;
Hoffman Estates, IL
SPARKPEOPLE; Cincinnati
Spectrum Rehabilitation; Cincinnati
Strongsville Recreation & Senior Complex
Techneglas, Inc.; Columbus
Timken Mercy Medical Center; Canton
University Hospitals of Cleveland
Wellness Connection, BGSU
Wellnes Works, Wood County Hospital, Bowling
Green, OH
Welltrack, The Toledo Hospital
Westfield Companies; Westfield Center
White House Athletic Center; Washington, DC
Wildwood Athletic Club; Toledo
Wood County Committee on Aging
Wood County Health Department
INTERNSHIP ACTIVITIES
Internship activities are mutually agreed upon by the
intern, advisor/university supervisor, and site
supervisor. Possible ideas include, but are not limited
to:
1.
Identification and diagnosis of a program need
or problem as determined by the sponsoring
organization,
2.
Fact finding as related to a program need or
problem, e.g., conducting literature searches,
writing reports, press releases, news articles,
etc.
3.
Developing, coordinating, and administering a
program activity,
4.
Attending professional meetings,
5.
Attending staff meetings,
6.
Assisting in the preparation of special reports,
grant applications, and curricula,
7.
Presenting health related information,
8.
Assisting with program evaluation,
9.
Working with the professional staff on an
interagency basis,
10. Visiting other health related agencies to
discuss networking or the types of services
they provide.
INTERN RESPONSIBILITIES
Interns will:
1.
Locate an appropriate internship site and make
all necessary arrangements for placement,
2.
Attend an internship orientation seminar
conducted by the university supervisor prior to
the beginning of the internship (contact
advisor for time, date, and location),
3.
Comply with all pertinent rules, regulations,
policies, and requirements of Bowling Green
State University and the sponsoring
organization,
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4.
5.
6.
7.
8.
9.
10.
11.
12.
Submit a copy of current American Red cross
First Aid and CPR certifications prior to the
beginning of the internship
Complete a minimum of 40 hours of internship
related activities per credit hour (e.g., 10 hrs of
academic credit = 400 hours of fieldwork),
Conduct yourself in a manner that will bring
credit to you, the university, and the
sponsoring organization,
Establish a professional rapport with
supervisors, co-workers, clients, and others to
whom the intern represents the sponsoring
organization,
Respect the confidentiality of the sponsoring
organization and its clients,
Maintain communication with the university
supervisor (frequency and methods will be
determined by the university supervisor and
the intern),
Submit to the university supervisor on agreed
upon dates
a.
Completed and approved Application
Form (Application deadlines: 11/15 for
Spring; 4/1 for Summer and Fall)
b.
Completed Verification Form (Due first
week of the internship)
c.
Weekly Progress Reports (Due within
5-7 days following the end of each work
week)
d.
Schedule & complete a phone call to the
University Supervisor by the end of
week 2. Discuss major project.
e.
Schedule & complete a second phone
call to the University Supervisor by the
end of week 3. Discuss major project.
f.
Detailed Major Project & Strategic Plan
(Due by the end of the 4th week)
g.
Mid-term Evaluation (Due at
approximately 300 hours)
h.
Final Evaluation (Due at approximately
600 hours)
i.
Final Report (Due during finals week of
the internship semester)
j.
Other documents as deemed appropriate
by the university supervisor,
Complete a significant project that
demonstrates competency as a health
promotion specialist; the nature of the project
will be determined collaboratively by the
Intern, Site Supervisor, and University
Supervisor (detailed outline due by the end of
the third week of the internship),
Successfully complete the internship
responsibilities and activities mutually agreed
upon by the Intern, the University Supervisor,
and the Site Supervisor,
13.
14.
15.
Host a site visit by the University Supervisor
(generally between weeks 7 and 12),
Attend a final meeting of all interns, 11AM2:30PM, Monday of finals week. Summer
intern final meeting will be scheduled at the
end of the summer. Each intern will give a
concise, 10-15 minute PowerPoint or Keynote
presentation (with handouts) to the group. The
presentation will highlight the following:
a.
Description of the internship site
(selection, appropriateness, features of
the site, etc.),
b.
Goals of the internship,
c.
Responsibilities and projects,
d.
Major project (theory applied to the
development of the project, project
description, strategic plan),
e.
Project implementation and outcomes,
f.
Challenges and accomplishments, and
g.
Knowledge and skills acquired
h.
Overall assessment of the experience
including recommendations that may be
of value to future interns
Interns should also be prepared to offer
feedback regarding how well their training
prepared them for an entry-level position in
health promotion (helpful parts of the
curriculum as well as suggested
improvements). This meeting will take place
Monday of exam week 11AM-2:30 PM as
indicated above.
SPONSORING ORGANIZATION
RESPONSIBILITIES
The sponsoring organization will:
1.
2.
3.
4.
5.
6
Together with the intern, complete the
Internship Verification Form (in the Sponsor
Packet) and return to the intern, who will
transmit it to the university supervisor,
Design and implement an experience that
provides the intern with an opportunity for
participation in a variety of tasks and
relationships common to the activities of
health professionals at the internship site,
Provide the intern with the physical facilities
and supplies necessary to accomplish his/her
on site responsibilities (desk space, computer
access, telephone, office supplies, and other
essential services),
Provide the student with an orientation to the
organization at the beginning of the internship
experience,
Provide an opportunity for the intern to
function as a full-time staff member,
6.
7.
8.
9.
10.
11.



Provide monetary compensation to the intern
when he/she is required to travel outside of the
immediate area, or to participate in such
activities that require the outlay of funds on
the intern's part. In this respect, the same
consideration should be given to the intern as
is given any professional staff member,
Provide the intern with regular and specific
feedback about his/her performance
throughout the internship period,
Provide mid-term and final evaluations of the
intern's performance, using the Internship
Evaluation Form in the Sponsor Packet,
Maintain communication with the university
supervisor; frequency and methods of
communication will be mutually agreed upon
by the sponsoring organization and the
university supervisor,
Discuss intern performance during the site
visit,
Submit to the University Supervisor (via the
Intern) on agreed upon dates
a.
Signed weekly progress reports
prepared by the Intern (forms in
Sponsor Packet),
b.
Mid-term evaluation (in Sponsor
Packet),
c.
Final evaluation (in Sponsor Packet),
d.
Other documents as deemed appropriate
by the University Supervisor.


1
Supervisor evaluations will be determined by
multiplying 20 times the average of the total scores
for the final intern evaluation. For example, if an
intern received an average score of 4.2 out of a
possible 5.0, the score given will be 84 for this
category.
2
All students are required to be in attendance at the
final internship meeting to submit binders and give
an oral presentation on their experiences. Students
who do not attend this meeting automatically receive
a deduction of 20% on their binder scores. Therefore,
if a student would normally receive a score of 93,
he/she would actually be given a grade of 73.
3
Professionalism is based on timeliness of weekly
reports, mid-term evaluations, etc., as well as the
academic internship supervisor's perception of the
overall quality of the intern's interactions with him or
her. Students who are consistently late with
submitting requirements receive a lower score.
HEALTH PROMOTION SPECIALIST
ENTRY LEVEL PERFORMANCE
COMPETENCIES
HEALTH PROMOTION PROGRAM
RESPONSIBILITIES
The Health Promotion Program of the School of
Family and Consumer Sciences at Bowling Green
State University will:
1.
2.
3.
4.
5.
Site Supervisor Evaluations1 = 35%
Weekly Reports = 20%
Final Report Binder2 and presentation at
final meeting = 10%
Major Project (includes theory &
strategic plan) = 25%
Professionalism = 10%
By the completion of the internship, the intern shall
be able to:

provide responsibility guidelines for the Intern
and the Sponsoring Organization,
meet with potential interns to plan an
appropriate internship experience based on the
student's qualifications and career
goals/objectives,
conduct (if geographically feasible) at least
one on-site visitation during the internship
(time and date to be arranged with the intern),
provide additional supervision via telephone
and other appropriate means,
determine a final grade for the intern based
upon the evaluation criteria.






EVALUATION CRITERIA

The final grade will be determined as follows:
7
Select and demonstrate personal health
practices consistent with comprehensive
health.
Describe current lifestyle diseases facing
society.
Select and apply health and risk evaluation
strategies for individuals and groups.
Identify factors that increase risk of selected
lifestyle diseases.
Identify and implement appropriate
interventions for reducing health risks.
Demonstrate an understanding of the
principles that impact health behavior
change.
Recognize social and personal stress factors
that affect individual health.
Select referral services within the
community.








Project Focus. The project should demonstrate your
competency as a health promotion specialist. The
nature of the project will be determined
collaboratively by the intern, intern supervisor, and
the university supervisor. Some examples of projects
conducted by previous interns include the following:
Design effective health promotion programs.
Select appropriate methodology for
delivering health information.
Demonstrate effective presentation skills.
Demonstrate skills in problem solving and
decision-making.
Demonstrate competency in written, verbal,
intrapersonal, and interpersonal skills.
Demonstrate knowledge of current trends in
health promotion.
Demonstrate a command of knowledge
relative to the field of health promotion.
Demonstrate knowledge and skills related to
assessing physiological components of
fitness (e. G., cardio-respiratory endurance;
muscular strength, endurance, flexibility and
composition).





INTERNSHIP MAJOR PROJECT
Interns may be involved in many projects during the
internship period; however, each intern will be
responsible for one major project during the
semester. A major project provides many benefits
and opportunities for personal growth and individual
skill development in your area of interest.

Internship Focus. Developing a major project will
enable you to work on a specific goal in the midst of
seeming confusion, chaos and the endless array of
activities that are (at least initially) so much a part of
the daily routine at various internship sites.
Implementing and evaluating a heart healthy
educational unit for employees of the
sponsoring organization.
Developing a marketing strategy for a
health-related program offered by the
sponsoring organization.
Developing and evaluating a new healthrelated program for the sponsoring agency.
Coordinating a community health fair to
highlight the services and programs offered
by the sponsoring organization.
Developing in-house promotional materials
to encourage employee participation in
existing wellness programs.
Planning and implementing special events
that enhance employee wellness (e.g., fun
runs, spirit days, nutrition demonstrations,
health screening test, fitness assessments,
body fat composition testing, walking
competition).
INTERNSHIP MAJOR PROJECT
DESCRIPTION & STRATEGIC PLAN (MPSP)

Portfolio Development. Identifying, designing and
completing projects provide evidence of your
effectiveness as a health promotion professional.
Additionally you may use the projects as a point of
discussion for future interviews that you may have
with prospective employers.

Internship Site Enhancement. You receive education,
training and an excellent experience. Your internship
should also serve to benefit the participating
organization. The projects you develop, especially
the Major Project) should help the sponsoring
organization attain its institutional goals.

Evaluation of Student Internship. Your performance
relative to working on projects provides the Health
Promotion faculty with a means of evaluating the
quality of the internship site and the intern's
professional skills. The evaluation of your project
will be determined by the Site Supervisor and the
University Supervisor.

By the end of the 1st week, interns should
have scheduled a telephone meeting with the
internship supervisor to be conducted during
the 2nd week. Interns should be ready to
discuss the feasibility of their major project
idea and specifically how a behavior change
theory or planning model will assist in
developing the project.
By the end of the 3rd week of the internship,
interns are expected to have improved their
proposals and scheduled and conducted a
2nd telephone meeting with the University
Supervisor to discuss it.
The first written draft of parts 1-3 of the
Major Project Strategic Plan (MPSP) is due
by the end of the 3rd week. Parts 4-7 by the
end of the 4th week, parts 8-11 by the end of
week 5, and part 12 by the final meeting.
All HP 489 applications and reports must be
typed on a computer.
1) Title Page – Author, Title, Date
2) Review of the Literature/Needs Assessment –
What is the nature of the problem you want to
8
address? Describe the problem and successful
interventions that have been reported in the
literature. Use APA citation style (this will be
reviewed carefully, so be accurate) and cite at
least 8 references. (e.g., Guide to Community
Prevention Services: Systematic Reviews and
Evidence Based Recommendations at
http://thecommunityguide.org/)
3) Goal Statement - Project goals are broad,
generalized statements about health outcomes. A
good place to start is Healthy People 2010.
4) Theory – Select a Health Promotion theory or
planning model you will use to develop the
project: {e.g., PRECEDE, Social Learning
Theory, Behaviorism (Stimulus Response;
Stimulus - Organism - Response), Social
Marketing, Diffusion Theory, Health Belief
Model, Attribution Theory, Theory of Planned
Behavior, Theory of Reasoned Action, Stages of
Change Theory (Transtheoretical Model)}.
a) Resources - In addition to your textbooks
(e.g., from HP310 & HP 411), the following
web sites offer concise summaries of
relevant health behavior theories:
i) National Cancer Institute’s Theory at a
Glance: A Guide for Health Promotion
Practice.
http://www.cancer.gov/theory/allpages
ii) Health Behavior Models by Redding,
Rossi, Rossi, Velicer, & Prochaska
(IEJHE, 2000; 3(Special)
http://www.kittle.siu.edu/iejhe/3special/
redding.htmhttp://wwwunix.oit.umass.e
du/~aizen/tpb.html
iii) Social marketing
http://www.cdc.gov/nccdphp/dnpa/socia
lmarketing/index.htm and
http://www.socialmarketing.com/whatis.html and
http://www.pubmedcentral.nih.gov/artic
lerender.fcgi?artid=1253475
b) Description - Describe the theory or
planning model in general terms.
i) Table - Create a table that summarizes
the key constructs of the theory or
planning model you have selected. Be
sure to cite applicable references
appropriately. The table should consist
of 3 columns:
(1) Constructs - list variables
(2) Definition - define the constructs
(3) Implications - How the construct
will be used to develop your
intervention.
5) Objectives - Set SMART objectives (specific,
measurable, achievable, realistic, with a time
frame)
a) Justify the specific targets listed in your
objective. Check the literature for the
success rates found using similar
interventions. Discuss objectives with other
site personnel. If this program is similar to
last year’s program, the success rate will
probably be similar.
b) Objectives are tools used to make sure you
are on target to meet your goal.
c) Make a table with 2 columns: Objectives,
Measurement. Number the objectives. There
should be approximately 3-5 objectives.
d) Sample objectives are listed below:
Sample Objectives
Objectives
1. By the end of the
program we will
have provided safe
on-site clinical
administration of flu
vaccine to at least
500 adults.
2. At the end of the
class session, 90%
of the students will
know the
recommended
amount of fruits &
vegetables per day.
Measurement
Program records
Program evaluation item
“What is the
recommended number of
fruits & vegetables each
day?”
SMART Guidelines for Writing Objectives 1) Set broad goals, but very Specific objectives,
detailing steps for reaching your goal.
2) Objectives should be quantifiable/Measurable,
i.e., 10 pounds weight loss, walking 3 miles in
15 minutes
3) The objectives you set should be challenging, yet
Achievable.
4) The objectives you set should be Realistic in
terms of health & safety factors, based on your
culture/ethnicity, personal & community
resources available, and should be able to be
accomplished within the designated time frame.
5) Each objective determined along the way to
achieving your overall goal should have a
specific Time frame, e.g., 8 weeks.
9
Components Of Good Objectives
1) Who or what is the target? (e.g., all buildings,
25% of overweight employees)
2) By when will the objective be accomplished?
(e.g., within one year, by the end of the seminar)
3) What will be measured? (e.g., participation,
cholesterol level, # of curl-ups)
4) How much change will occur? (e.g., 90% of
employees on the third shift will decrease blood
pressure by 10%)
5) How will the change be measured? (e.g., using a
skin-fold caliper, using a checklist, completing a
survey). This is not necessarily included in the
objective, but you must be sure to have a way to
measure changes.
6) Outcomes should be action verbs (e.g., list,
describe, analyze, perform).
9)
10)
11)
6) Intervention - Describe the intervention in detail
(the nature and size of the target audience, the
scope, intensity and duration of the intervention)
and then articulate, step-by-step, variable-byvariable, how the theory or planning process was
used to design the various components of the
intervention. Include a copy of the survey or
other instrument and a description of how you
plan to use it to evaluate the project.
7) Gantt Chart - Develop a Gantt chart in
Microsoft Word or Excel indicating steps and
timelines for developing, implementing and
evaluating the intervention. Gantt chart
guidelines may be fond at the following URL
http://www.me.umn.edu/courses/me4054/assign
ments/gantt.html
8) Budget - Develop a Budget for the intervention
using the Budget Excel form on Blackboard.
Then develop a Budget Narrative (in Microsoft
Word) in which you explain and justify each
expense. Be sure to include a description of all
of the resources and materials needed, including
staff & consultant time needed to develop,
market, implement & evaluate the intervention.
The budget must cover every aspect of the
intervention including planning time,
implementation and evaluation. A dollar value
must be attached to voluntary staff time.
The following URL is for a web site that
addresses the cost of volunteers. This will help
you assess the value of your time when
developing the budget for your major project. It
will also help you assess in kind contributions
if/when you write grants while working for
nonprofit agencies. The estimated dollar value of
volunteer time is $18.04 per hour for 2005, the
most recent data available. Here is the web
address:
12)
http://www.independentsector.org/programs/rese
arch/volunteer_time.html#state
Challenges & Solutions - Description of the
aspects of the project you think will be the most
challenging. How will these challenges be
addressed?
Learning - Description of what you hope to
learn from the project.
References – List all references on the last page.
Use APA style. The BGSU library provides a
summary of the APA Publication Manual (5th
Edition) at
http://www.bgsu.edu/colleges/library/infosrv/lue/
resources.html
According to the Academic Honesty Policy (p.
26) in the BGSU Student Handbook, plagiarism
is defined as "representing as one's own in any
academic exercise the words or ideas of another
including but not limited to quoting or
paraphrasing without proper citation."
Summary of the major project including an
assessment of the results
INTERNSHIP FINAL REPORT/BINDER
(All HP 489 reports and forms must be typed on a
computer.)
1) Binders - Final Reports must be submitted in
white 3-ring binders with drop in sleeves for
inserts on the front and side. Both the front and
side of the binder must contain the following
information: intern’s name, internship site and
city, semester, and year. All sections should be
clearly labeled. Samples are available in 201
Eppler North.
2) Due dates - Reports are due at or before the
Final Meeting (held 11AM-2:30 PM, Monday of
finals week). Summer intern final meetings will
be scheduled at the end of the summer.
3) Format - The Final Report consists of:
a) Cover Page
b) Index
c) The structure and function of the sponsoring
organization
d) Copies of the weekly reports with
appropriate signatures
e) Written summary of the intern's
responsibilities and experience
f) Copies of supporting documentation of
projects such as brochures, minutes, and
fliers
g) Copies of materials developed by the intern
h) Summary of the major project including a
copy of the strategic plan, implementation
issues, and an assessment of the results
i) Summary of intern challenges and
10
accomplishments
Assessment of the internship experience
including recommendations that may be of
value to future interns
k) Completed and signed final evaluation form
by the internship supervisor placed in the
inside pocket of the 3-ring binder. These
will be removed prior to placement in 201
Eppler North.
4) Timely Progress - Interns are encouraged to
assemble appropriate materials for the Final
Report on a daily or weekly basis rather than
waiting until the end of the semester.
5) Copies - Interns are encouraged to make two
copies of the Final Report Binder: one to be
submitted to the University Supervisor (and
stored in 201 Eppler North for future students to
review), and one to keep for personal use (e.g.,
for job interviews).
j)
11
Weekly Flow Chart
WEEK
1
ACTIVITIES






2
Arrive at internship site.
Complete verification report and submit it to the BGSU intern supervisor.
Complete orientation to organization and submit it to the BGSU intern supervisor.
Define internship roles and activities. Begin carrying out responsibilities.
Schedule telephone conference with BGSU supervisor to discuss your MPSP
Submit weekly report.




3



4
5
6-14
15
Plan a specific concentrated project (major project) to be completed during the internship.
Complete a telephone conference with the BGSU supervisor to discuss your major project
proposal. Present a plan as to how a behavior change theory or planning model will be used to
develop the project.
Schedule a 2nd telephone conference with your BGSU supervisor to refine your major project
concept.
Submit Weekly Report.
Complete a 2nd telephone conference with your BGSU supervisor to discuss your major project.
Revise your project accordingly.
Submit parts 1-3 of your MPSP to your BGSU supervisor
Submit weekly report.




Submit parts 4-7 of your MPSP to your BGSU internship supervisor
Revise parts 1-3 of your MPSP as indicated by your BGSU internship supervisor.
Continue carrying out internship responsibilities and projects.
Submit weekly reports.




Continue carrying out internship responsibilities and projects.
Submit parts 8-11 of your MPSP to your BGSU internship supervisor
Continue to revise Major Project and Strategic Plan as indicated by the BGSU supervisor
Submit weekly reports.




Continue carrying out internship responsibilities and projects.
Finalize projects and bring closure to responsibilities.
Submit Midterm site supervisor evaluation half way through the internship
Schedule a site visit for your BGSU internship supervisor site between weeks 10 and 14.

Submit Final Evaluation and Final Report/Binder, including parts 1-12 of your MPSP.
12

Attend Health Promotion symposium to process and give PowerPoint presentation about the
internship experience.
13
APPLICATION FORM
HP 489 (Health Promotion Internship)
School of Family and Consumer Sciences, Bowling Green State University
Due November 15 for spring internships and April 1 for fall or summer internships.)
(All HP 489 forms must be typed, preferably on a computer.)
Name
Semester internship is requested Fall
Credit hours (between 10 & 15)
Spring
Summer
Date ____/____/_____
BG ID Number
Residential or cell phone during internship
Residential address during internship
Permanent/Mailing Address
Permanent Telephone
Email during internship
Class Standing: Freshman
Sophomore
Junior
Grade point average (obtain from HP Secretary)
Senior
Other
Secretary signature
If Overall GPA is below 2.5, list GPA for the Professional Core (major)
During which semester did you/will you complete:
HP 215
HP 340
HP 489
KNS 313
HP 216
HP 308
BIOL 332
KNS 360
HP 310
HP 411
CS 100
HP 393
HP 338
HP 481
F&N 207
Expiration date of your CPR certification? (attach copy of card to application) _______________/___________
Expiration date of your First Aid certification? (attach copy of card to application) _____________/__________
Is the internship site located more than 50 miles from the BGSU campus?
Yes
No
Name of Company/Agency
Department/Area of Placement
Name and Title of Contact Person
Site/Agency Address
Site Supervisor Phone Number (include area code)
Fax
Number of hours a week you will spend at the internship site:
(continued on next page)
14
(continued from previous page)
What are your career goals?
List the objectives you have for your internship.
1.
2.
3.
A copy of your current CPR and First Aid cards must be attached to this application.
Do not write below this line.
Academic Advisor Signature
Date _____/_____/_____
BGSU Internship Supervisor Signature
Date _____/_____/_____
15
HP 489 (Health Promotion Internship) Verification Form
To be completed by the intern and site supervisor and returned to the BGSU supervisor by the end of the first week
of the internship, preferably prior to the beginning of the internship.
Intern's name
Intern’s local address during internship semester
Telephone (
)
Intern’s email address during internship semester
Organization name and department
Organization address
City
State
Internship Site Supervisor name
Zip
Telephone
(
)
Internship Site Supervisor’s email address
Internship Site Supervisor title:
Fax (
Dates of internship:
Ending _____ /_____ / ____ _
Beginning _____ /_____ / ____ _
)
Work schedule (no credit for transportation to and from the site and no credit for lunch/dinner breaks):
Day of the
week
Times
worked*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Total Hours
Number of
Hours
* Include time off for lunch or dinner.
Intern's job description (attach separate sheet of paper if necessary):
Site Supervisor’s Signature
Intern’s Signature
Date
Return to: Molly Laflin, Ph.D., Professor, Health Promotion, School of Family and Consumer Sciences, 215 Eppler
North, Bowling Green State University, Bowling Green, OH 43403, phone = 419-372-0301; fax = 419-372-8216.
16
ORIENTATION REPORT
(Submit to University Supervisor by the end of the first week of the Internship)
Intern’s Name
Date
Intern address during internship:
Address:
Home Phone:
E-mail:
Work Phone:
Work Fax:
Best way to receive messages:
Fax
E-mail
Phone
Name of Organization
Name of Immediate Supervisor
General Description of the Agency/Company: (Responses may be typed in spaces below or provided using attached
materials.)
1.
Mission, goals, objectives
2.
Populations served
3.
Programs/services offered
17
4.
Number and types of employees
5.
Organizational structure (departments/divisions, organizational flow chart)
6.
Revenue/income sources
7.
Facilities and special equipment utilized by the organization
18
This is a copy of the Excel form you should use. It is available on Blackboard.
Health Promotion Internship Weekly Progress Report
To be completed by the intern, mailed, faxed (419-372-8216) or emailed to the BGSU supervisor.
Due by Thursday of the following week.
Name:
Sponsoring Organization/Internship Site
Internship Site Supervisor
Reporting Dates:
Week Beginning (month/day/year)
Week ending (m/d/y)
Hours worked (no credit for transportation to and from the site or for lunch/dinner breaks):
Must use military time (e.g., for 2:30 pm, type 14:30) to complete the following table.
Sunday
Monday
Tuesday
Wednesday
Thursday
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
Subtotal
0:00:00
0:00:00
0:00:00
TOTAL
0:00:00
0:00:00
0:00:00
Friday
Saturday
Total
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
0:00:00
in
out
Subtotal
in
out
Subtotal
in
out
ACTIVITIES AND OBSERVATIONS
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
19
FRIDAY
SATURDAY
PERSONAL
COMMENTS
Intern signature
Date:
Site Supervisor signature
Date:
20
INTERNSHIP EVALUATION FORM
(Midterm evaluation due when approximately half of the required fieldwork hours have been completed. Final
evaluation due when the required fieldwork hours have been completed. Site Supervisors need not type this form.)
Intern:
Organization:
Internship Supervisor
Midterm Rating Date: ______/_____/________
Final Rating Date: ______/_____/________
Rating Scale:
1
= Major problem; special measures needed to deal with the situation.
2
= Below average; intern needs remedial help to achieve an acceptable level of performance.
3
= Acceptable; performance/skill will improve with additional practice/mentoring.
4
= Good performance/skill level; fine tuning will result in excellence.
5
= Excellent; no additional work needed.
NA = Not applicable
Midterm
Evaluation
I.
Interpersonal Skills
1.
Compatibility with co-workers
2.
Relationship with clients
3.
Respect and acceptance of others
4.
Receptivity to feedback/suggestions
5.
Acceptability and non-judgmental
6.
Ability to work in groups
II.
Intrapersonal Skills
1.
Self-confidence
2.
Ability to adjust to change
3.
Problem solving skills
4.
Positive attitude/optimistic
5.
Ability to manage stress
III.
Communication Skills
1.
Oral
2.
Written
3.
Listening and responding
IV.
Work Performance
1.
Promptness and dependability
2.
Enthusiasm
3.
Projects submitted on time
4.
Quality of work
5.
Willingness to assume responsibility
6.
Planning and organizational skills
7.
Creativity
8.
Ability to provide for client needs
9.
Time management skills
10. Self motivation (initiative)
11. Dress/appearance
12. Personal conduct
21
Final
Evaluation
Midterm
Evaluation
V.
Final
Evaluation
Presentation Skills
1.
Utilization of effective methodology
2.
Voice projection/modulation
3.
Questioning techniques
4.
Classroom/group management
5.
Checking for understanding
6.
Clarity in giving directions and delivering content
7.
Ability to focus participants at the beginning of the session
General overall rating
Would you hire this intern if there were an appropriate vacancy?
Yes
No
If no, please give reason.
Summary of strengths: (This feedback is important for the intern’s professional growth. Please do not omit this
section.)
Suggestions or recommendations for improvement: (This feedback is important for the intern’s professional growth.
Please do not omit this section.)
Recommended grade for the semester (A, B, C, D or F): ______________
Intern
Site Supervisor
22
Date
HEALTH PROMOTION INTERNSHIP CHECKLIST
Name
Date
Internship Semester and Year
 Internship Application form
 Orientation meeting with Internship instructor (meeting occurs prior to the internship)
 Verification Report
 Orientation Report
 Weekly Reports/logs submitted by Thursday of the following week
 Major Project & Strategic Plan (2 telephone meetings and a written proposal)
 Mid-term Evaluation
 University Supervisor site visit
 End of term presentation at BGSU
 Final Report (3 ring binder)
 Final Evaluation
23