Health 4150: Needs Assessment & Planning Health Promotion Programs
By: Amber Ward, Megan Passey, & Melanie Speechly
For: Dr. Patricia Cost
Fall 2010
1
Abstract
With 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.
2
Acknowledgements
We 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!
3
Table of
Contents
4
TABLE OF CONTENTS
Abstract……………………………………………………………………………...……..i
Acknowledgements……………………………………………………….…………….…ii
Table of Contents…………………………………………………………………………iv
CHAPTER I
INTRODUCTION
Introduction/Background………………………………….……………………………...1
Team Members………………………………………..…………………………………..2
Brief Bio of Each………………………………………………………...………..2
Roles and Responsibilities of Each………………………………………………..5
Community Based Learning………………………………………………………………6
Defined………………………………………………………………………...….6
Benefits…………………………………………………………………………....6
Community Based Research………………………………………………………………7
Defined……………………………………………………………………...…….7
Benefits………………………………………………………………………..…..7
Community Partners………………………………………………………………………7
Defined……………………………………………………………………...…….7
Advantages……………………………………………………………………..…8
Disadvantages……………………………………………………………………..8
Process of Building a Community Partner…………………………………..…….8
Description of Our Community Partner……………………………………………..…….9
Statement of the Problem…………………………………………………………….…..10
Need for the Intervention……………………………………………………………...…10
Mission Statement
……………………………………………………………………11
Program Philosophy ………………………………………………………………..……12
Definition of Terms…………………………………………………………………..…..12
Timeline……………………………………………………………………………….....13
Appendix I
Summary………………………………………………………………………………....13
CHAPTER II
REVIEW OF RELATED LITERATURE
Introduction...…………………………………………………………………………....16
Healthy People 2010……………………………………………………………………..17
Defined…………………………………………………………………………..17
Objectives Specific to this Program……………………………………………...19
5
Health Promotion Programs………………………………………………………..…….23
Defined…………………………………………………………………………..23
Planning………………………………………………………………………….24
Implementation………………………………………………………………….25
Evaluation……………………………………………………….………………26
Our Project: Healthy Heroes, an Educational Intervention………………………….…..27
Defined…………………………………………………………………………..27
Benefits…………………………………………………………………………..27
Challenges……………………………………………………………………..…28
Health Promotion Planning Models……………………………………………………...28
Types of Planning Models/Purposes………………………………………….….28
Advantages………………………………………………………...…………….29
Disadvantages………………………………………………………..…………..29
Model Chosen for this Program
………………………………………..………….30
Defined…………………………………………………………………………..30
Application……………………………………………………………………….30
Qualitative Research……………………………………………………………………..31
Defined…………………………………………………………………………..31
Developing Qualitative Questions……………………………………………….32
Analyzing Qualitative Research…………………………………………………32
Quantitative Research…………………………………………………………….……...34
Defined……………………………………………………………………….….34
Analyzing Quantitative Research……………………………………………..…34
Developing a Survey………………………………………………………………...…..34
Reliability………………………………………………………………………..35
Validity………………………………………………………………………….35
SMOG………………………………………………………………………...…35
CHES Competencies…………………….………………………………………………37
Defined………………………………………………………………………….37
How they relate to this project…………………………………………………..44
Competencies developed by doing this project………………………………....44
Types of Evaluation……………………………………………………………………..47
Process…………………………………………………………………………..47
Impact…………………………………………………………………………...47
Outcome………………………………………………………………………....48
Summary………………………………………………………………………………...48
CHAPTER III
GOALS & OBJECTIVES FOR THIS PROGRAM
Introduction...……………………………………………………………………………50
Program Goals………………………………………………………………………..….51
Importance of Goals……………………………………………………………...51
Developing Goals………………………………………………………………...51
Program Objectives……………………………………………………………………....52
Defined………………………….……………………………………………….52
6
Importance of Objectives………………………………………………………...52
Goals and Objectives Specific to this Program………………………………………….53
Program Goal……………………………………………………………...…….53
Program Objectives…………………………………………………………..…..53
Learning Objectives……………………………………………………………...53
Behavioral Objectives……………………………………………………………54
Summary………………………………………………………………………………....54
CHAPTER IV
METHODS
Introduction……………………………………………………………………..……….56
Choosing Our Community Partner………...…………………………………….………58
Initial Meeting with our Community Partner……………………………….……………58
Program Plan……………………………………………………………………………..59
Planning Model Used…………………………………………………………………….64
Application……………………………………………………………………….64
Marketing of Program Plan………………………………………………………………67
Survey Development……………………………………………………………..67
Question Development……………………………………………………..…….68
Expert Panel Review……………………………………………………..………69
SMOG Readability Results………………………………………………………69
Population Surveyed……………………………………………………………..69
Sampling Techniques Used……………………………………………………...70
Data Collection…………………………………………………………….…….70
Data Analysis…………………………………………………………………….70
Evaluation……………………………………………………………………..…71
Purpose of Evaluation…………………………………………………………....71
Summary…………………………………………………………………………...…….71
CHAPTER V
RESULTS
Introduction…………………………………………………………………………………...….74
Program Plan Overview……………………………………………………………………….…75
Participant Demographics………………………………………………………………………..77
Data Analysis of Surveys…………………………………………………………………….…..78
Post Nutrition Survey………………………………………………………………...…..78
Post Program Survey……………………………………………………………..………81
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Summary………………………………………………………………………………...……….85
CHAPTER VI
SUMMARY, DISCUSSION, CONCLUSIONS, AND
RECOMMENDATIONS
Introduction……………………………………………………………………………………...87
Summary of the Program………………………………………………………………………...88
Conclusions……………………………………………………………………………………....90
Recommendations….…………………………………………………………………………….90
For Future Projects…………………………………………………………………….....90
For Projects Using Surveys………………………………………………………………91
Summary…………………………………………………………………………………………91
REFERENCES………………………………………………………………………………….94
APPENDICES
Appendix A
Pre and Post Surveys…………………………………………………………….97
Appendix B
Lesson Plans…………………………………………………………………….100
Appendix C
Lesson Plan Pictures……………………………………………………………118
Appendix D
Post Nutrition Survey…………………………………………………………...129
Appendix E
Coloring Book…………………………………………………………………..131
Appendix F
Healthy Heroes Badge………………………………………………………….139
Appendix G
Program Proposal……………………………………………………………….141
Appendix H
Pictures………………………………………………………………………….143
Appendix I
Program Timeline………………………………………………………………147
Appendix J
Bullying Certificate…………………………………………………………….149
8
Chapter I
Introduction
9
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 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.
10
Biography of Team Members
As 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 Ward
My 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).
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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 Speechly
As 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.
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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 Passey
My 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!
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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 Members
Each 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!
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Community Based Learning
Definition
Community 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, www.weber.edu).
Benefits
Community 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, www.clark.edu).
Community Based Research
Defined
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
15
organization and community,” (2010, www.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,
http://documents.weber.edu/catalog/0910/~CBL.htm).
Benefits
Community 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 action.
Community Partners
Defined
A 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).
Advantages
By 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).
16
Disadvantages
The 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 Partner
The 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.
1. Create your idea and form your community plan. Next, share your ideas with others.
2. 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.
3. Next choose the right person or organization. Let them know what your plan is and how
you are going to achieve it.
4. Make an outline of what is needed such as, funding or activities. Make sure to be open to
others and their ideas.
5. Establish the responsibilities each partnership will have. Be sure all agreements are clear,
and that all members understand.
6. Establish the goals that need to be accomplished.
7. Make any adjustments to the goals or roles.
8. Define deadlines.
9. Progress and achieve different milestones.
17
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 Partner
The 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 Problem
While 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.
18
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 Intervention
Unhealthy 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 Statement
The 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 selfefficacy skills to live longer, healthier, and happier lives. In an attempt to break the unhealthy
19
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 Philosophy
Children 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.
20
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 Terms
1. Friend-shipping: The act of building a positive relationship with an individual
2. Bully: A person who is habitually cruel or overbearing, especially to smaller or weaker
people
3. Intervention: to come in or between by way of hindrance or modifications
4. Healthy: enjoying health and vigor of body, mind, or spirit
Timeline
The timeline for the Healthy Heroes program can be found in Appendix I.
Summary
In 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.
21
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.
22
Chapter II
Review of Related
Literature
23
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.
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
24
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 2010
Defined
In 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
25
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 Life
The 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 Disparities
The 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
Services
Arthritis, Osteoporosis and
Chronic Back Conditions
Cancer
Chronic Kidney Disease
Diabetes
Disability and Secondary Conditions
Educational and CommunityBased Programs
Environmental Health
Family Planning
Food Safety
Health Communication
Heart Disease and Stroke
HIV
Immunizations and Infectious
Diseases
Injury and Violence Prevention
Maternal, Infant, and Child Health
Medical Product Safety
Mental Health and Mental Disorders
Nutrition and Overweight
Occupational Safety and Health
26
Oral Health
Physical Activity and Fitness
Public Health Infrastructure
Respiratory Diseases
Sexually Transmitted Diseases
Substance Abuse
Tobacco Use
Vision and Hearing
Objectives 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
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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.
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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.
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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.
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Health Promotion Programs
Defined
In 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” (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” (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” (McKenzie, Neiger, & Thackeray, 2009,
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p. 11). Planning is the first step in developing a health promotion program. Planning is a multistep 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 (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.” (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.
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Implementation
After 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 (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 (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 (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.
Evaluation
The final stage of program planning is evaluation. Performing adequate and appropriate
evaluation is necessary for any program regardless of size, nature, or duration (McKenzie,
Neiger, & Thackeray, 2009, p. 336). Evaluation is a major component of a program, for it
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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”
(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 (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 Intervention
Defined
For 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
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communicating the importance of healthy lifestyles. There were several benefits and challenges
that were incorporated in our program.
Benefits
The 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.
Challenges
The 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 Models
Types of Planning Models/ Purposes
One 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 (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.
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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 (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 (McKenzie, Neiger, & Thackeray, 2009, pp. 18-19).
Advantages/ Disadvantages
The most common types of planning models used in Healthy Promotion are: PRECEDEPROCEED, 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 Model
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Advantages
Disadvantages
PRECEDE-PROCEED





MATCH


PATCH


Works well for health
interventions and
community
interventions
Provides more accurate
information
Provides more
structure
Well-known; has been
used a lot in the past
Has also been used in
professional practice;
well-known
Emphasizes
implementation phase
of program planning
Led to the inspiration
of PROCEED
Easy to use
Involves community


Very broad
Time constraint

Mostly used for
implementation
Time sensitive


Need support from
community leaders;
can be a problem when
there is lack of support
Model Chosen for this Program: PATCH
Application
After 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:
 The Five Elements of Patch:
a) Community members participate
in the process
i) Examples: School Teachers,
Administration, WSU
Dental Hygiene Students,
Students, Parents, and other
such community leaders
b) Data Guide the Development of
Programs
i) Examples: Conduct a series
of student/parent and faculty
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surveys to obtain the data that is required to decipher what knowledge is needed
c) Choosing Health Priorities
i) Examples: Determining goals and objectives
ii) Course 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.
iii) Course Objectives:
(1) By the end of the period, students will understand the benefits of practicing
preventative health behaviors.
(2) By the end of the course, students will be able to differentiate between healthy
and unhealthy habits.
(3) By the end, students will exercise preventative health behaviors.
d) Conducting a Comprehensive Intervention Plan
i) Examples: Four interventions including lesson plans and activities regarding the
following four topics- Nutrition, Dental Hygiene, Friend-shipping and Bullying; and
Physical Activity.
e) Evaluating
i) Examples: Conducting surveys and ongoing observations; develop an after-action
report.
ii) 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 Research
Defined
Qualitative research is research done to provide depth of understanding, study
motivation, allow discovery, are probing and interpretive, and permit insights into behavior and
trends. (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 indepth interviews. Qualitative research strives to answer the question “why?” and does this
through interpreting explanations and observations of participants.
Developing Qualitative Questions
In 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
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is a reflective process that leads to data that can add knowledge to a larger field of study. (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. (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. (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.” (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 Research
In an article written by Greenhalgh and Taylor, a set of questions was developed to assess
the quality of qualitative research. (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.
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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. (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?”
(Randall R. Cottrell, 2010)
The sixth question is about the “methods used in analyzing the data and what quality
control measures were taken.” (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. (Randall R. Cottrell, 2010)
Quantitative Research
Defined
Quantitative 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
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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. (James F.
McKenzie, 2009)
Analyzing Quantitative Research
The 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. (James F. McKenzie, 2009)
Developing a Survey
The 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.
Reliability
The 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. (Paul D. Leedy, 2010)
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Validity
Validity 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. (James F. McKenzie, 2009)
SMOG
When 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 (Wikipedia, 2010).
Guidelines for properly executing a SMOG test are as follows:
For materials containing > 30 sentences
1. Count off 10 consecutive sentences at the beginning, middle, and end of the text.
2. Count the number of words with 3 more syllables in the 30-sentence sample.
3. Use the answer to step 2 to look up the reading grade level in the chart.
For materials containing < 30 sentences
1. Count the number of sentences:
2. Count the number of words with 3 or more syllables in the sample:
3. 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.
4. 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:
0-2
3-6
7-12
13-20
21-3
31-42
43-56
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Approximate
Reading Grade Level
4
5
6
7
8
9
10
57-72
73-90
91-110
111-132
133-156
157-182
11
12
13
14
15
16
Reading level of this material
th 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 considered

Abbreviations 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 Competencies
Defined
Certified 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
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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 Education
Competency A: Access existing health-related data
Sub-competencies:
1)
2)
3)
4)
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 interests.
Competency B: Collect health-related data
Sub-competencies:
1)
2)
3)
4)
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 status.
Competency C: Distinguish between behaviors that foster and hinder well-being
Sub-competencies:
1) Identify diverse factors that influence health behaviors.
2) Identify behaviors that tend to promote or comprise health.
Competency D: Determine factors that influence learning
This Competency is not addressed in the study guide, because the Sub-competencies are related
to an advanced level of practice.
Competency E: Identify factors that foster or hinder the process of health education
Sub-competencies:
1) Determine the extent of available health education services.
2) Identify gaps and overlaps in the provision of collaborative health services.
Competency F: Infer needs for health education from obtained data
Sub-competencies:
1) Analyze needs assessment data.
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RESPONSIBILITY II: Plan Health Education Strategies, Interventions, and Programs
Competency A: Involve people and organizations in program planning
Sub-competencies:
1)
2)
3)
4)
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 interests.
Competency B: Incorporate data analysis and principles of community organization
Sub-competencies:
1)
2)
3)
4)
Use research results when planning programs.
Apply principles of community organization when planning programs.
Suggest approaches for integrating health education within existing health programs.
Communicate need for the program to those who will be involved.
Competency C: Formulate appropriate and measurable program objectives
Sub-competencies:
1) Design developmentally appropriate interventions.
Competency D: Develop a logical scope and sequence plan for health education practice
Sub-competencies:
1) Determine the range of health information necessary for a given program of instruction.
2) Select references relevant to health education issues or programs.
Competency 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 practice.
Competency F: Select appropriate strategies to meet objectives
Sub-competencies:
1) Analyze technologies, methods and media for their acceptability to diverse groups.
2) Match health education services to proposed program activities.
Competency G: Assess factors that affect implementation
Sub-competencies:
1) Determine the availability of information and resources needed to implement health
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education programs for a given audience.
2) Identify barriers to the implementation of health education programs.
RESPONSIBILITY III: Implement Health Education Strategies, Interventions, and
Programs
Competency A: Initiate a plan of action
Sub-competencies:
1)
2)
3)
4)
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 groups.
Competency B: Demonstrate a variety of skills in delivering strategies, interventions, and
programs
Sub-competencies:
1) Use instructional technology effectively.
2) Apply implementation strategies.
Competency C: Use a variety of methods to implement strategies, interventions, and programs
Sub-competencies:
1) Use the Code of Ethics in professional practice.
2) Apply theoretical and conceptual models from health education and related disciplines to
improve program delivery.
3) Demonstrate skills needed to develop capacity for improving health status.
4) Incorporate demographically and culturally sensitive techniques when promoting programs.
5) Implement intervention strategies to facilitate health-related change.
Competency 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 Education
Competency A: Develop plans for evaluation and research
Sub-competencies:
1) Synthesize information presented in the literature.
2) Evaluate research designs, methods and findings presented in the literature.
Competency B: Review research and evaluation procedures
Sub-competencies:
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1) Evaluate data-gathering instruments and processes.
2) Develop methods to evaluate factors that influence shifts in health status.
Competency C: Design data collection instruments
Sub-competencies:
1) Develop valid and reliable evaluation instruments.
2) Develop appropriate data-gathering instruments.
Competency D: Carry out evaluation and research plans
Sub-competencies:
1)
2)
3)
4)
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 status.
Competency E: Interpret results from evaluation and research
Sub-competencies:
1)
2)
3)
4)
Analyze evaluation data.
Analyze research data.
Compare evaluation results to other findings.
Report effectiveness of programs in achieving proposed objectives.
Competency 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
Programs
Competency A: Exercise organizational leadership
Sub-competencies:
1) Conduct strategic planning.
2) Analyze the organization’s culture in relationship to program goals.
3) Promote cooperation and feedback among personnel related to the program.
Competency B: Secure fiscal resources
This Competency is not addressed in the study guide, because the Sub-competencies are related
to an advanced level of practice.
Competency C: Manage human resources
Sub-competencies:
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1) Develop volunteer opportunities.
Competency 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 Person
Competency A: Use health-related information resources
Sub-competencies:
1)
2)
3)
4)
5)
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 references.
Competency B: Respond to requests for health information
Sub-competencies:
1) Identify information sources needed to satisfy a request.
2) Refer requesters to valid sources of health information.
Competency C: Select resource materials for dissemination
Sub-competencies:
1) Evaluate applicability of resource materials for given audience.
2) Apply various processes to acquire resource materials.
3) Assemble educational material of value to the health of individuals and community groups.
Competency D: Establish Consultative Relationships
Sub-competencies:
1) Analyze parameters of effective consultative relationships.
2) Analyze the role of the health educator as a liaison between program staff and outside groups
and organizations.
3) Act as a liaison among consumer groups, individuals and health care providers.
4) Apply networking skills to develop and maintain consultative relationships.
5) Facilitate collaborative training efforts among health agencies and organization.
RESPONSIBILITY VII: Communicate and Advocate for Health and Health Education
Competency A: Analyze and respond to current and future needs in health education
Sub-competencies:
1) Analyze factors (e.g., social, cultural, demographic, political) that influence decision-makers.
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Competency B: Apply a variety of communication methods and techniques
Sub-competencies:
1)
2)
3)
4)
5)
6)
7)
Assess the appropriateness of language in health education messages.
Compare 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 needs.
Competency C: Promote the health education profession individually and collectively
Sub-competencies:
1) Develop a personal plan for professional development.
Competency D: Influence health policy to promote health
Sub-competencies:
1) Identify the significance and implications of health care providers’ messages to consumers.
(National Commission for Health Education Credentialing, 2008)
How they relate to this project
The 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 met.
Competencies 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 Education
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Before 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 Programs
We 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 Programs
We 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
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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 Education
We 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 Programs
We 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 Person
We served as Health Educators by answering questions that students had concerning
nutrition, physical activity, hygiene, and bullying. When they requested more
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understanding of certain concepts, we would answer their questions to the best or our
ability.

Responsibility VII: Communicate and Advocate for Health and Health Education
We 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 Evaluation
Process
Process 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.
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Impact
Impact 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.
Outcome
Outcome 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.
Summary
Literature 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
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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.
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Chapter III
Goals & Objectives
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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.
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Program Goals
A 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 Goals
In 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 Goals
Goals 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.
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Program Objectives
Defined
Along 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 Objectives
As 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 Program
Program Goal
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.
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Program/Process Objectives
In 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:
A. Participate in a lesson about bullying.
B. Have a lesson about the benefits of physical activity and participate in exercise
activities.
C. Learn about hygiene and taking care of their bodies.
D. Learn about dental hygiene and taking care of their teeth.
E. Be introduced to information about making nutritious food choices and will
participate in several learning games.
Learning Objectives
1. 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.
2. By the end of the Healthy Heroes four week course, second graders at Club Heights
Elementary school will:
A. Understand ways of properly taking care of their teeth by experiential learning.
B. Understand the benefits of healthy eating choices by participating in classroom
activities.
C. Understand the benefits of physical activity by hands-on experience.
D. Recognize when someone is being a bully and will understand how to handle such
situations through activities and lecture completed in the classroom.
Behavioral Objectives
By the end of the four week Healthy Heroes program at Whitesides and Club Heights
Elementary second grade students will:
A.
B.
C.
D.
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.
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E. Apply friend shipping skills and will stand up to bullying.
F. Brush their teeth twice daily and floss daily.
Summary
In 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.
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Chapter IV
Methods
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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.
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.
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Program Plan Overview
We 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
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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 Demographics
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The 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 1.1- Teacher/ Student Ratio
Club Heights
Utah Average
Teachers
1:19
1:21
% White
49%
77%
% Hispanic
44%
16%
% Black
4%
2%
% Asian
3%
3%
% Free Lunch
51%
25%
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Data Analysis of Surveys
Post Nutrition Survey
The 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.
Grains
Vegetables
2%
8%
10%
Negative
Negative
21%
Neutral
Positive
69%
Neutral
Postive
90%
Figure 1
Figure 2
Sixty nine percent of the second grade students feel good about vegetables with only 10
percent feeling bad when they eat vegetables.
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Fruit
Milk
2%
2%
6%
Negative
19%
Neutral
Negative
Nuetral
Positive
Positive
75%
96%
Figure 3
Figure 4
When 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.
Protein
Oils
8%
21%
71%
Negative
25%
44%
Negative
Neutral
Neutral
Positive
Positive
Figure 5
31%
Figure 6
When 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.
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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 Survey
At 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).
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Fruit and Vegetable
Consumption
2%
Yes
No
98%
Figure 2
The 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.
Friends
Bullied
6%
35%
Yes
Yes
No
No
65%
94%
Figure 2
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Figure 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.
Drinks
Healthy Snack
Cookies and
milk
12%
Cheese and
crackers
10%
6%
72%
10%
47%
25%
Milk
Juice
Soda and
chips
18%
Apples and
peanut butter
Figure 4
Soda
Water
Figure 5
The 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,
143 | P a g e
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).
TV Viewing
Video/Computer
Games
None
30%
20%
1-2 Hours
22%
29%
1-2 Hours
3-4 Hours
11%
39%
None
3-4 Hours
18%
5 or more
Hours
31%
Figure 6
5 or more
Figure 7
After School Activities
6%
Play with Friends
16%
Watch TV
45%
Video/Computer Games
Sports
16%
Sleep
17%
Figure 8
The 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.
144 | P a g e
Teeth Brushing
2%
8%
None
Once
47%
Twice
43%
Three or More
Figure 9
From 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.
Summary
It 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
145 | P a g e
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.
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Chapter V
Results
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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.
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
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surveys. Participant demographics and the Healthy Heroes program plan overview will also be
examined.
Program Plan Overview
We 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.
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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.
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Participant Demographics
The 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 2.1- Teacher/ Student Ratio
Club Heights
Utah Average
Teachers
1:19
1:21
% White
49%
77%
% Hispanic
44%
16%
% Black
4%
2%
% Asian
3%
3%
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% Free Lunch
51%
25%
Data Analysis of Surveys
Post Nutrition Survey
The 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.
Grains
Vegetables
2%
8%
10%
Negative
Negative
21%
Neutral
Positive
69%
Neutral
Postive
90%
Figure 3
Figure 2
Sixty nine percent of the second grade students feel good about vegetables with only 10
percent feeling bad when they eat vegetables.
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Fruit
Milk
2%
2%
6%
Negative
19%
Neutral
Negative
Nuetral
Positive
Positive
75%
96%
Figure 3
Figure 4
When 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.
Protein
Oils
8%
21%
71%
Negative
25%
44%
Negative
Neutral
Neutral
Positive
Positive
Figure 5
31%
Figure 6
When 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.
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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 Survey
At 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).
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Fruit and Vegetable
Consumption
2%
Yes
No
98%
Figure 4
The 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.
Friends
Bullied
6%
35%
Yes
Yes
No
No
65%
94%
Figure 2
155 | P a g e
Figure 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.
Drinks
Healthy Snack
Cookies and
milk
12%
Cheese and
crackers
10%
6%
72%
10%
47%
25%
Milk
Juice
Soda and
chips
18%
Apples and
peanut butter
Figure 4
Soda
Water
Figure 5
The 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,
156 | P a g e
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).
TV Viewing
Video/Computer
Games
None
30%
20%
1-2 Hours
22%
29%
1-2 Hours
3-4 Hours
11%
39%
None
3-4 Hours
18%
5 or more
Hours
31%
Figure 6
5 or more
Figure 7
After School Activities
6%
Play with Friends
16%
Watch TV
45%
Video/Computer Games
Sports
16%
Sleep
17%
Figure 8
The 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.
157 | P a g e
Teeth Brushing
2%
8%
None
Once
47%
Twice
43%
Three or More
Figure 9
From 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.
Summary
It 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
158 | P a g e
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.
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Chapter VI
Summary, Discussion,
Conclusions, and
Recommendations
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Introduction
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 Program
Establishing 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
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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
162 | P a g e
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.
Conclusions
Based 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 fourweek intervention.
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Recommendations
For Future Projects
Recommendations 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 Surveys
When 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.
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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.
Summary
This 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.
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References
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References
Agee, 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
http://www.iel.org/pubs/sittap/toolkit_01.pdf
Coppage, C., & Wright, B. (2008). School and Community Partnership Building. Retrieved
October 21, 2010, from
http://www.healthyfoodshealthymoves.org/conference/HFHM_CoppageWright.pdf
“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).” www.health.gov. N.p., 2008. Web. 16 Oct. 2010.
www.health.gov/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,
2010
National Commission for Health Education Credentialing. (2008) Responsibilities and
Competencies of Health Educators. Retrieved October 2010, from National Commission
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for Health Education Credentialing: Credentialing Excellence in Health Education:
http://www.nchec.org/credentialing/responsibilities/
Paul 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. http://www.healthypeople.gov/About/history.htm.
Wikipedia. (2010, August 1). SMOG. Retrieved October 13, 2010, from Wikipedia, the free
encyclopedia: http://en.wikipedia.org/wiki/SMOG
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Appendices
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Appendix A
Pre and Post Surveys
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Healthy Heroes
Thank 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?
Boy
Girl
2. Do you eat fruits and vegetables?
Yes
No
3. Do you have friends in your class?
Yes
No
4. Do kids pick on you at school?
Yes
No
5. What do you think is a healthy snack?
Cookies and milk
Crackers and cheese
Soda and chips Apples and peanut butter
6. What do you drink the most of?
Soda
Water
Milk
Juice
7. How much T.V. do you watch each day?
None
1-2 hours
3-4 hours
5 or more
8. How long do you play Video or computer games a day?
None
1-2 hours
3-4 hours
9. After school do you: Play with friends
Watch TV
Play Video or computer games
Play sports
Sleep
10. How many times do you brush your teeth in one day?
Thank you!
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5 or more hours
None
1
2
3 or more
Healthy Heroes
Thank 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?
Boy
Girl
2. Do you eat fruits and vegetables?
Yes
No
3. Do you have friends in your class?
Yes
No
4. Do kids pick on you at school?
Yes
No
5. What do you think is a healthy snack?
Cookies and milk
Crackers and cheese
Soda and chips Apples and peanut butter
6. What do you drink the most of?
Soda
Water
Milk
Juice
7. How much T.V. do you watch each day?
None
1-2 hours
3-4 hours
5 or more
8. How long do you play Video or computer games a day?
None
1-2 hours
3-4 hours
9. After school do you: Play with friends
Watch TV
Play Video or computer games
Play sports
10. How many times do you brush your teeth in one day?
Thank you!
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5 or more hours
Sleep
None
1
2
3 or more
Appendix B
Lesson Plans
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Be a Friend, Be a Hero
Elementary Anti-Bullying Lesson
October 12, 2010
Goal: 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 sheet
 Ball(s) of yarn
 Crayons, markers, colored pencils, pencils
 Pictures 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)
1. 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.
2. 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
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










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:
3. 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.
o At recess Superman Showed Batman how to jump rope.
o Doomsday told Hawkgirl that she was not his friend because she was
smaller than him.
o Volcana called Bizarro “stupid” because Bizarro got less right on his math
test.
o Aquaman helped Marian Manhunter when he fell down at recess, even
though they do not have the same skin color.
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o Chronos called Green Lantern a baby because he did not know how to tie
his shoes.
o Flash showed Hawkgirl how to play shoot the ball.
o Ares took cuts in the lunch line and tried to take Wonder Woman’s lunch,
because Wonder Woman was smaller.
4. 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.
5. 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.
6. 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:
1. 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: 1 (yarn game)
2. San Francison Unified School District School Health Programs Department. (2004, April
7). Day of Kindness. Retrieved September 25, 2010, from
http://portal.sfusd.edu/data/school_health/ES_Lesson_Plan.pdf
3. Wikipedia. (n.d.). multiple pages. Retrieved October 1, 2010, from www.wikipedia.com
(pictures of superheroes and villians)
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Name _____________________
At school I am kind when I______________
__________________________________
__________________________________
__________________________________
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Super Food for Superheroes
Elementary Nutrition Lesson
October 19, 2010
Goal: 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 Hour
Materials:
 Butcher Paper (4x4 square & six
smaller pieces)
 Markers
 Scissors
 Pictures of food from the six
different food groups
 Construction paper or other heavy
paper
 Laminator
 Paper clips







Wooden dowel or ruler
String
Magnet
Baby swimming pool (cost: free to
$10)
Paper plates
Grocery ads
Glue sticks
Procedure:
Preparation:
MyPyramid:
Materials Needed:
o Butcher Paper (4x4 square and six smaller pieces)
o Markers
o Scissors
Using 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.
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Fishing for Food:
Materials Needed:
o Pictures of food from the six
different food groups
o Construction paper or other
heavy paper
o Scissors
o
o
o
o
o
Laminator (or access to one)
Paper clip
Wooden dowel or ruler
String
Magnet
Print 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)
7. 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:
1. My Pyramid (10 minutes)
Materials:
o My Pyramid Poster
o Tape
Tell 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.
2. Fishing for Foods (25-30 minutes)
Materials:
 Laminated food pictures with
paper clip attached
 Baby swimming pool
Place the pictures in the baby pool.


Fishing poles
Tape
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
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Pyramid model displayed on the board. Continue fishing until each student has had a turn
or until all pictures on displayed.
3. Paper-Plate Meals (10-15 minutes)
Materials:
 Paper plate for each student
 Grocery store ads


Scissors for each student
Glue stick for each student
Hand 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.
4. Grocery Bag Relay: (5-10 minutes) optional, if time allows
Materials:
 Two grocery bags
 Six legal size envelopes
 Index cards (two sets, each set a different color)
 Black markers
Preparation:
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.
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5. 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 - FamilyEducation.com. Retrieved
10 7, 2010, from Family Education: http://fun.familyeducation.com/imaginativeplay/nutrition/54994.html
National Diary Council. (2010, October). Food Model Activities:Fishing for Foods Game:Nutrition
Explorations. Retrieved 10 6, 2010, from Nutrition Explorations:
http://www.nutritionexplorations.org/educators/lessons/foodmodels/foodmodels-actfishingforfood.asp
United States Department of Agriculture. (n.d.). MyPyramid.gov - Inside the Pyramid. Retrieved 10
7, 2010, from MyPyramid.gov: http://www.mypyramid.gov/pyramid/index.html
McGraw Hill Companies, Inc. Pyramid Relay. McGraw Hill.
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YOU have the Power!
Dental Hygiene Lesson Plan
October 26, 2010
Course 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 hour
Where: Classroom (with a sink provided, preferably)
Materials:














12” piece of floss
12 “ piece of string/yarn
One 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
Berenstain
Wordsearch
Glue
Knife
Spray Paint (white)
Construction Paper
Fluoride/Mouthwash ‘Plaque
Detector’
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





Mini cups (55- one for each child)
One roll of paper towels
Watercolor 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:
o "When do you wash your hands?"
o "Why do you wash your hands?" (Elicit from children responses such as "to clean
off dirt" and "to remove germs.")
o "Can you see dirt on your hands?" (Yes)
o "Can you see germs on your hands?" (No)
o "How do you clean your hands to get the dirt and germs off?" (Wash with soap
and water.)
o "Show me how you clean your hands." (Have children show motion of rubbing
hands.)
o "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.)
o 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.
o 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.
o "How do you clean your mouth to get rid of the germs?" (Brush my teeth.)
o "What do you use when you clean your teeth?" (Toothbrush and toothpaste.)
o "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 Berenstain
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Read 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 carton
Spray Paint (white, preferably)
Floss (a thread per child)
Construction Paper
Knife
Glue
Steps:
1. Cut several white egg cartons into strips (cut carton in half so you have one row of
bumps).
2. Glue each strip to a sheet of construction paper and tape it to a table.
3. Use a knife to carefully cut half-inch slits between each egg cup.
4. 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:
1. 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.
2. 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.
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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)
Water
Paper towels
Toothbrush
Toothpaste
Small/mini cups
Steps:
1. Explain to the children the importance of using mouthwash and fluoride (protects from
bad germs that might get in their mouth and cause cavities).
2. 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.
3. 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).
4. 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.
5. Hand out the oral hygiene packets to the students so they may use the toothbrush and
toothpaste to brush their teeth.
6. 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.
7. 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 towel
1 crayon (to draw on paper towel)
1 watercolor marker (black, preferably)
Water
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
Spray bottle
Steps:
1.
2.
3.
4.
5.
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.
6. 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
www.ada.org:
http://www.ada.org/sections/publicResources/pdfs/lifetime_module02_plaque.pdf
Department of Health and Human Services. (n.d.). Lesson: The Importance of Keeping Teeth and
Gums Healthy. Retrieved October 2010, from www.bmcc.edu:
http://www.bmcc.edu/Headstart/Dental/teethandgums.htm
Instructor Web. (2005). Egg Flossing Lesson Plan. Retrieved October 2010, from
www.instructorweb.com: http://www.instructorweb.com/lesson/eggfloss.asp
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Superhero Training
Elementary Physical Fitness Lesson
November 2, 2010
Goal: 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 Hour
Materials:







4 cones
6 hula hoops
30+ bean bags
Access 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 cards
A sticker for each team
member in the color of their
team Hero
Hole Punch
55 Superhero Training Badge
(one for each student)
55 pieces of yarn (long
enough to go around child’s
neck)
Preparation:
1. 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)
1. 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.
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Activities:
1. Teach them about the components of physical fitness. Strength, Endurance, Flexibility.
2. Hungry Crabs (15 minutes)
Materials:



4 cones
6 hula hoops
30+ bean bags

Access to large area
(gymnasium or outdoor
recreation area)
Preparation:
o Prior to the activity, set up a large area (depending on the number of students)
with boundaries marked by cones.
o Scatter the bean bags through the designated area.
o Place the hula hoops on the outside of the boundaries.
Procedure:
1. Divide the students into six groups and place each group at one of the hula hoops.
2. Explain to the students that the area inside the cones is the “ocean” and the bean
bags are “crab food.”
3. Explain that the hula hoop is their team hula hoop and is where they are going to
place the bean bags they collect.
4. 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.
5. 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.
6. Once the student has placed his/her bean bag in the hula hoop, the next team
member leaves to get another bean bag.
7. 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.
3. Healthy Heroes Training Mission (20 minutes)
Materials:
 Music (Theme from Mission
Impossible)
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
Plastic Bowls (60 bowls)


Six different Healthy Hero’s
in six colors (10 of each)
60 index cards

A sticker for each team
member in the color of their
team Hero (6 stickers of
each color)
Preparation:
o Using different colored Healthy Heroes, glue a hero on top of each plastic bowl.
o 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 times
- Do 15 jumping jacks
- Lock arms and walk in a circle for 30 seconds
- Hop on your left foot 10 times
- Count to 20 while using a Hula Hoop the whole time
- Do 5 + 3 pushups
- Using the jump rope, jump 10 times
- Crawl from cone to cone like a bear
- Hop from cone to cone like a frog
- Kick a soccer ball into the goal
o Hide each of the bowls, turned upside down (colored Hero visible) around the
room/gymnasium.
o Have the “Mission Impossible” theme playing as students are “training.”
Procedure:
1. 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).
2. 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.
3. 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.
4. Have the team sit down as soon as they finish the entire training.
5. 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.
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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.
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Appendix C
Lesson Plan Pictures
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Nutrition Lesson Plan Pictures
Note: Cut out and Laminate
Fruit-
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Grains-
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Meat & Beans-
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Milk & Dairy-
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Vegetables-
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Junk Food-
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Appendix D
Post Nutrition Survey
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Healthy Food Choices
Read the following and circle the face that shows how you feel.
1. When I eat grains; bread, pasta, rice, tortillas; I feel:
2. When I eat vegetables; broccoli, carrots, mushrooms; I feel:
3. When I eat fruit; apples, grapes, bananas; I feel:
4. When I eat milk products; milk, yogurt, cheese; I feel:
5. When I eat protein; chicken, beef, pork, beans; I feel:
6. When I eat sugar and fatty foods; candy, chocolate, soda, chips; I feel:
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Appendix E
Coloring Book
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Coloring
KidsKids
Coloring
Book
Book
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Appendix F
Healthy Heroes Badge
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Appendix G
Program Proposal
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HEALTHY HEROES Proposal
Megan Passey, Amber Ward, & Melanie Speechly
Overview
To 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 Elementary
When: 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 space
Timeline
9/24: Pre-process survey to teachers
9/29: Collect pre-process surveys from teachers
10/15: First Class: Bullying
10/22: Second Class: Nutrition
10/29: Third Class: Exercise
11/5: Fourth Class: Dental Hygiene
Questions
-What types of interventions would you like to see us create?
- 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?
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Appendix H
Pictures
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Appendix I
Program Timeline
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Healthy Heroes Program
Timeline Club Heights
Elementary
Sept
. 22
Sept.
22

Meet with
communit
y partner.
Sept.
29

Drop off
preprogram
survey.
Collect
Surveys.
Identify
Needs.
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Sept.
27Oct. 1
Oct. 4
–
Oct. 8


Finalize
Goals &
Objectives.
Start Lesson
Plans.
Finalize
lesson plans,
resources, &
supplies.
Oct.
12

First
Intervention:
Friendshipping.
Process
Evaluation.
Oct.
19

Second
Intervention:
Nutrition.
Process
Evaluation.
Oct.
26
Nov. 11
–
Nov. 17
Nov.
2

Third
Intervention:
Dental
Hygiene.
Process
Evaluation.

Fourth
Intervention:
Physical
Activity.
Drop off exit
surveys.
Process
Evaluation.

Nov. 25
–
Dec. 1

Collect
exit
surveys.
Compile
program
data.

Finish book.
Present at
symposium.
Appendix J
Bullying Certificate
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