Project

Executive Summary

Get HAPPY! (Houston Activity and Play Promotion for Youth) is a physical activity

promotion program for inner-city children, ages 5-12, in the Houston Independent School

District. The initial program will be a pilot study consisting of 200 children in one elementary

school in Houston, Texas. There will be 30 local volunteers consisting of internship students

from nearby colleges, faculty staff from the school, a Registered Dietician, and a Sport Exercise

Science Specialist. Houston, Texas, consists of a diverse culture which Get HAPPY! will

incorporate into the daily activities and centered curriculum for the students enrolled in the

program. Get HAPPY! will run 3 days a week from 3:30-5:30 pm. The focus will be on ethnic

centered, fun physical activities, sports games run by professional sports players from local

teams like the Houston Texans, nutritional education, and healthy snacks.

The goal of this program is to increase physical activity in youth to 60 minutes of

vigorous activity most days of the week with the outcome of reducing the obesity epidemic that

is growing to devastating numbers worldwide The program will utilize the PRECEDE-

PROCEED model which incorporates evaluation of the process, the intervention itself, and the

final outcome and data collection. This model is supported with three underlining categories

predisposing, enabling, and reinforcing factors which influence behavior and environmental

factors that may be barriers to physical activity in children. Barriers will be evaluated in the

needs assessment and formative evaluation before and during the implementation of the

program. Summative evaluation data will be collected by an expert evaluation coordinator and

used to devise future programs that will be extended to more schools and more students in the

Houston Independent school District.

Rationale

Responsible for 60% of deaths worldwide (WHO, 2009a), noncommunicable diseases

(NCD) represent the biggest threat to present day public health. One major contributor to the

high prevalence of NCDs is physical inactivity (PI; WHO, 2009b). Although PI is responsible for

3.2 million deaths worldwide every year (WHO, n.d.), PI predominantly contributes to NCDs

and deaths through its’ main consequence overweight/obesity. Worldwide, overweight/obesity

has increased dramatically in the past 30 years, going from 857 million in 1980, to 2.1 billion in

2013. The United States significantly contributes to this prevalence, with 69% of adults and 35%

of children being overweight/obese (Preidt, 2014).

As overweight/obese children grow to become overweight/obese adults, so too will the

costs. Childhood overweight/obesity alone costs $14 billion annually (Thomson Medstat, 2006),

with the most costly medical expenditures being hospitalization, with a cost of $237.6 million a

year (Trasande, Liu, Fryer, &Weitzman, 2009). When compared to a normal-weight child,

overweight/obese children incur greater expenditures due to hospital outpatient visits,

prescription drugs, and emergency room visits (Trasande & Chatterjee, 2009), as well as a

greater number of office visits (Thomson Medstat, 2006). Aside from direct costs, indirect costs

of overweight/obesity are also extremely expensive. Not only does overweight/obesity increase

the rates of absenteeism, and decrease productivity, paid wages, and academic achievement

(Arons, 2011), it is also associated with significant stigma and lower quality of life (Crosnoe

&Muller, 2004).

Childhood overweight/obesity has been associated with lower socioeconomic status

(SES) as well as race/ethnicity. Children from low income households are more than twice are

likely to develop overweight/obesity than children from higher income homes (Singh et al.,

2010). Approximately 29% of Caucasian girls are overweight/obese compared to 36% of Black

and 37% of Hispanic girls, while 28% of Caucasian boys are overweight/obese compared to 34%

of Black and 28% of Hispanic boys (Ogden et al., 2014).

In a state like Texas, where many household incomes fall below the national average

(Healthy Kids, Healthy Communities, 2013), and the fastest growing populations are Hispanic

and Black (Texas Comptroller of Public Accounts, n.d.), it should come as no surprise that two-

thirds of Texas adults and one third of children are overweight/obese (Arons, 2011). In fact,

Texas has one of the fastest growing rates of obesity, as it increased 120% between 1990 and

2005 (Combs, 2007). A major contributor to this substantial increase comes from

overweight/obese children who will grow up to become overweight/obese adults (Arons, 2011).

Overweight is classified as a Body Mass Index (BMI) between 25-29.9 kg/m2, and

obesity is classified by a BMI greater than 30 kg/m2. Overweight/obesity is caused by an energy

inbalance where the amount of Calories consumed (energy intake) exceeds the amount of

Calories expended (energy output). The average child exceeds their recommended energy intake

by 110-165 Calories per day (Wang et al., 2006), which can result in a 11-17 pound weight gain

in one year and a 57-86 pound weight gain over five years.

One way to address this energy inbalance and prevent weight gain is to increase energy

output through increased physical activity (PA). School based PA programs, in particular,

provide a great opportunity to influence children’s health and well-being because almost all

children attend school. Such programs may enhance learning, provide social benefits, enhance

health during critical growth and development periods, decrease risk of certain chronic diseases

in adulthood, and may help establish healthy habits at an early age which may continue into

older ages (Veugelers & Fitzgerad, 2005). While the typical school day holds three opportunities

for physical activity (physical education class, recess, and outside of school) (Beighle et al.,

2006), after school programs have been found to be effective to not only improve PA levels, but

other physiological markers such as body composition and blood lipid levels (Bettes, Beighle,

Erwin, & Huberty, 2009)

Given that overweight/obese children are likely to grow into overweight/obese adults,

only 30% of Texas youth meet the PA recommendations (CDC, 2014), and that by 2040, an

estimated 43% of all Texas adults will be obese (Esbach & Fonseca, 2009), there has never been

a more critical time to address the problem of overweight/obesity in the great state of Texas.

The goal of “Get HAPPY!” (Houston Activity and Play Promotion for Youth) is to

reduce the incidence of overweight/obesity and improve QOL through increased PA in Houston

area children ages 5-11. While enrolled in Get HAPPY!, children will participate in successful,

fun, and interactive PA opportunities designed to build their self-efficacy, self-esteem, and

confidence. Common barriers to PA such as lack of transportation, knowledge, skills, and/or

equipment will be addressed and overcome. Recommendations and lessons learned from

previous successful PA programs will be utilized to ensure its success.

Program Planning Documentation

Team LLHE has selected physical activity (PA) promotion in inner-city children ages 5-12

for our topic. In order to create a program for this, we have chosen to use PRECEDE-PROCEED

as our planning model. PRECEDE-PROCEED can be considered a participatory model which

incorporates the ideas and help of the community. That means that its use will provide planners

with better quality and quantity of data, concerning the issues in question, and with a better

understanding of their history and context in the community. PRECEDE-PROCEED

incorporates evaluation of the process, the intervention itself, and the final outcome. That allows

the intervention to be monitored and adjusted to respond to community needs and changes in the

situation, and checks that its accomplishments actually lead to the projected goal. The model is

underpinned by three categories of correlates termed predisposing, enabling, and reinforcing

factors. The first two steps in designing a PA promotion program will involve an examination of

the recent data identifying the dramatic increases in obesity in children in Houston and how that

increase impacts quality of life. In Step 3 of the PRECEDE-PROCEED model, existing

behavioral and environmental factors of children will be identified. Predisposing, enabling, and

reinforcing factors that would influence the likelihood of behavioral and environmental change

will be identified in Step 4. After identifying the predisposing, enabling, and reinforcing factors

that influence behavioral and environmental change relating to children’s PA, Get HAPPY! will

be designed and implemented initially as an after-school program (Steps 5 and 6 of the

PRECEDE-PROCEED model). Steps 7-9 are the evaluation portions of the model. By following

PRECEDE-PROCEED, it will ensure process, impact, and outcome evaluation occur (Glanz,

Rimer, & Viswanath, 2008).

LLHE chose to use PRECEDE-PROCEED for several reasons: (1) It is one of the most

widely used planning models in health education (Glanz, Rimer, & Viswanath, 2008); (2)

Behavioral and environmental factors, filed into predisposing, reinforcing, and enabling factors,

in steps 4 and 5 align well with constructs from Health Belief Model (HBM) and Social

Cognitive Model (SCT); (3) A literature search revealed correlates to PA or lack of PA in

children – which can easily be categorized into predisposing, reinforcing, and enabling factors,

and then target them during the intervention in educational strategies; (4) Evaluation is built into

the model so it won’t be overlooked; and (5) members of LLHE have experience using

PRECEDE-PROCEED.

The behavior change theories Get HAPPY! employs will be aspects from Health Belief

Model (HBM) and Social Cognitive Theory (SCT). Constructs from HBM which apply to the

program include barriers, benefits, modifying variables, cues to action, and self-efficacy. In the

literature search, barriers were a main reason for lack of participation in PA in this population,

thus they must be targeted and they can be easily filed into predisposing, reinforcing, and/or

enabling factors. Modifying variables such as sex, SES, and education were also found to be

correlates associated with participation or lack of participation in PA. These will be considered

in educational strategies and the content of the activities offered. Cues to action will include

providing how-to information, promoting awareness, offering reminders to be active.

Opportunities to build self-efficacy will be included in each and every lesson offered in the

intervention. This will help with maintenance post intervention. SCT is made up of three main

constructs of the individual, the behavior, and the environment, and the idea of reciprocal

determinism – a change in one of the aforementioned constructs elicits a change in all three. As

applied to Get HAPPY! the behavior is PA, factors associated with the individual and the

environment can be sorted into predisposing, reinforcing, and enabling factors which will be

targeted during lessons of the intervention. Get HAPPY! will also use the following processes of

change from Trans-Theoretical Model: consciousness raising, environmental re-evaluation, self

re-evaluation, counter-conditioning, and helping relationships. These processes will be utilized

during the actual lessons of the intervention.

Other successful programs targeting PA promotion in children which have used

PRECEDE-PROCEED include Be a Fit Kid (Slawta & DeNeui, 2010) and CHANGE!

(Mackintosh, Knowles, Ridgers, Fairclough, 2011).

Teaching strategies will be developed with consideration to the developmental stages

of the 5-12 year old age group, with both cognitive and physical abilities considered. Typical

development characteristics for children aged 5-7 years are that they are competitive, self-

assured, eager learners with short attention spans and learn best with activities which are

organized, rule driven. For ages 8-10, team games are popular because cognitively they are able

to maintain interest for longer periods of time as well as makes plans and decisions. With those

ages 11-12, care should be given due to body consciousness as well as inclusion of friends in

activities (Big Brothers and Big Sisters, 1991). Specific strategies to be used include direct

instruction, role play, simulations, persuasive communication, active learning, tailoring, direct

experience, rehearsal, feedback, demonstrations, small group instruction, facilitation, modeling,

environmental and self re-evaluation, social comparison, goal setting, and skill development.

Intervention Outline

Mission Statement: The mission of the Get HAPPY! program is to promote and improve the

health, well-being, and quality of life of Houston Independent School District’s students through

increased physical activity and improved nutrition.

Goal(s): To increase physical activity rates in the students of Houston Independent School

District.

Objectives:

 Prior to the start of the Get HAPPY! program, teachers and/or program staff will deliver a

program advertisement to each eligible HISD student in the month preceding the start of

the program.

 By the end of the Get HAPPY! program, 50% of participants will report performing

activities learned in the program at their homes at least three times per week.

 Within three months of the start of Get HAPPY!, at least 50% of participants enrolled in

the program will report engaging in sedentary behaviors (watching TV, playing video

games, recreational computer use) three hours less per week.

 Within three months of the start of Get HAPPY! at least 50% of participants enrolled in

the program will increase their moderate to vigorous physical activity by at least two

hours per week.

 Within 6 months of the start of Get HAPPY!,50% of overweight/obese children enrolled

will decrease their age-adjusted Body Mass Index by two points.

Get HAPPY! will be implemented as an afterschool program which meets three times a

week from 3:30 to 5:30 p.m. for eight weeks. It will occur at the Houston Independent School

District school(s) which adopts it. Facilities needed include use of facilities (classrooms, gyms,

playgrounds), stereo equipment, projector and projector screen, and gym equipment for team

sports (e.g. bats, different types of balls, cones, etc.).

Prior to implementation, a marketing campaign will occur. Fliers will be sent home with

each eligible student to share with parents, posters will be placed all over the school, fliers and

posters will be posted at grocery stores, community centers, churches, YMCAs, children’s

clothing stores, etc., a facebook and webpage will be set up, and television and radio

commercials will be made. Marketing the program will begin approximately four to six weeks

prior to the start of the program.

Get HAPPY! sessions meet three times a week for 2 hours. The school can decide if it

wishes the meetings to occur on Monday/Wednesday/Friday, or Tuesday/Wednesday/Thursday.

Each meeting session will begin with a snack and educational segment which lasts 60 minutes.

Participants will be divided into their respective age groups so that age appropriate education can

be delivered to match the participant’s cognitive levels. During this time participants will be

served a snack consisting of fruit, a snack bar, and water, while different educational methods

will be administered. The first day Get HAPPY! meets the education and activity will based on a

cultural/ethnic theme. The themes will match the ethnicities of participants enrolled which

include Hispanic, African American, White, Asian, and Native American. Education

administered will include information regarding the specified culture’s healthy eating habits and

activity preferences. Once snack and education time is over, participants will then move to the

activity portion of the program where on day one they will perform traditional activities

associated with the culture being explored. First participants will be shown a video which

presents the cultural activity they will learn to perform during the activity segment of the

program. For example, during the Hispanic week(s), Mariachi music will be played and

participants will learn how to perform a Mexican hat dance; during African American week(s),

participants will learn how to perform traditional African dance moves; and so on.

As previously stated, day one of Get HAPPY! will be based around culture/ethnicity,

with education discussing nutrition for that culture/ethnicity. On day two, education and activity

will be based around the weeks’ culture/ethnicity, but during education time participants will

learn about games played by that culture/ethnicity and the American counterpart. Then during

activity time the games will be played. For example, during Hispanic week(s) Brincar la cuerda

(jump rope), Encantados (freeze tag), or Atrapadas (catch) will be played. Additionally, games

which have no counterpart may also be played such as Coleadas (children hold hands and one is

in charge of running and zigzagging around things until other fall off), or Chinche al agua (a

team game where players from one team jump on the backs of players from the other and try not

to fall off) (Donquijote.org, n.d.). On day three of Get HAPPY! a traditional American team

sport will be played or skills from a sport will be practiced such as soccer or kicking or dribbling

with the feet. Typically these games/sports/skills will be explained in a group setting. However

when participants break into smaller groups to practice games/sports/skills one-on-one

interaction may be necessary in order for participants to learn the movements, particularly with

the 5-6 age group.

The timeline for the Get HAPPY! program spans 30 weeks, and begins with program

rationale development during the first month. Three weeks are allotted for a needs assessment,

and two weeks for goal and objective development based on the needs assessment. The creation

of the intervention, along with assembly of resources and marketing of the program will occur in

weeks five through nine. The Get HAPPY! program will kick off in week 10 and last through

week 17. During this time data will be collected weekly, as well as every month following the

end of the program. Data will be analyzed upon completion of the program, and this information

will be shared with stakeholders. Because Get HAPPY! will be implemented again, data and

feedback from personnel will be used for program refinement and plans for the next session will

be made. The detailed timeline can be seen in Table 2.

Several resources will be needed to implement Get HAPPY!, including personnel,

educational materials, space, and equipment. The personnel needed are three physical education

(PE) teachers to oversee the participants, 15-30 PE students from local colleges/universities to

serve as volunteers and work with the participants, and three dietetics students or dieticians to

deliver the nutrition education portion of the program and serve the snacks. The educational

materials will be gathered by the PE teachers and dietetics professionals from free resources such

as eatright.org, myplate.org, teachervision.com, and activity village. These materials were

chosen because they are free, reliable, accurate, and can be easily translated or already come in

Spanish (which is important for our program because the vast majority of participants will be

English as a second language learners and parents may not speak English). The space necessary

will come from already existing facilities. For example Get HAPPY! will be implementing the

program at the elementary school which adopts it. Thus that space will be used. The space will

be available because the program occurs after school and the school has agreed to not schedule

any other programs within the space needed for use.There will be no cost to Get HAPPY! for use

of the facilities because it is being implemented at the school with no cost to the school or the

participants. All these details were negotiated when HISD administration adopted the program.

The equipment and supplies needed which will be required to purchase can be seen in Table 3.

The school will provide the gym and sound/stereo equipment needed for the program. Other

supplies include pedometers (to be donated by a Wal-Mart community grant), promotional

materials (T-shirts, water bottles, Frisbees, jump ropes), electronic tablets for planners to use for

field notes and log books for participants to track their activity, all of which will be purchased

with grant moneys.

Get Happy! is an eight week program focusing on promotion of physical activity and

healthy nutrition. The majority of the $15,000 grant will be centered on transportation, food,

supplies, and marketing materials for participants. Donations of food from Urban Harvest and

pedometers from the Wal-Mart Foundation will help offset some of these costs. Personnel will

include Physical Education teachers and physical education students who need to do volunteer

hours for their certifications and dietician students doing their internships. All activities will be

held at the school, so there are no line items for gym equipment or for space and the janitors are

already at the school for other school functions. LLHE has worked hard to ensure that the

majority of the grant money goes directly to Get HAPPY!. See Table 3 for the detailed budget.

Evaluation Plan

Evaluation is the process of determining a program’s value, worth, efficacy, or

effectiveness. By evaluating the Get HAPPY! program, program planners will determine if the

program is being implemented as it was intended, is meeting its’ objectives, and if any changes

need to be made for the next time it is implemented. To achieve this, process, impact, and

outcome evaluations will be performed by the Get HAPPY! planning team. This team is made up

of Dr. Amanda Divin, internal evaluator, and team members Angelia Hayes, Evetta La Pread-

Shoulders, Jessica Mead, and Sheri Pascal.

The Houston Activity Play Promotion for Youth program (Get HAPPY!) will be

implemented in the Houston Independent School District (HISD) as an after school program

which meets three days a week for two hours and provides physical activity (PA) and nutrition

education to youth ages 5-12. Get HAPPY! was created with the goal of increasing physical

activity rates in the students of HISD due to the rising epidemic of physical inactivity and

overweight/obesity which is running rampant in the United States. HISD was specifically chosen

as a setting for Get HAPPY! when a needs assessment revealed that one third of Texas youth are

overweight/obese (Arons, 2011), and the vast majority of HISD students have several risk factors

for overweight/obesity such as SES, race/ethnicity, and lack of PA. Get HAPPY! aspires to meet

its’ goal through the following objectives: (1) By the end of the Get HAPPY! program, 50% of

participants will report performing activities learned in the program at their homes; (2) Within

three months of the start of Get HAPPY!, at least 50% of children enrolled in the program will

report engaging in sedentary behaviors (watching TV, playing video games, recreational

computer use) three hours less per week; (3) Within three months of the start of Get HAPPY!, at

least 50% of children enrolled in the program will increase their moderate to vigorous physical

activity by at least two hours per week; (4) Within 6 months of the start of Get HAPPY!, 50% of

overweight/obese children enrolled will decrease their age-adjusted BMI by two or more points.

Resources necessary and available for Get HAPPY! include use of HISD facilities and

equipment, three physical education (PE) teachers, 50 PE student volunteers, and three dietetics

students or professors. Activities to be completed during Get HAPPY! sessions include a 60

minute snack and educational segment and a 60 minute PA segment where students will

participate in cultural games and dances, and team sports. It is the mission of Get HAPPY! to

improve PA and nutrition habits and BMI in the long-term, as well as improve quality of life

and well-being of participants.

Stakeholders for the Get HAPPY! program include: (1) HISD administration, (2) the

program planning committee, (3) the PE teachers and volunteers who work with the program ,

(4) parents of children enrolled in the program, (5) the grant awarding agency, and (6) the

businesses who donate items for the program. Due to their differing roles, each stakeholder or

stakeholder group will be involved in the evaluation in a different way. Get HAPPY! is

following the recommendations of the CIPP evaluation model (Stufflebeam, 2007).

HISD administration will be involved in (1) contractual agreements, where it tells the

program committee what they wish to see evaluated, how they wish it to be collected, analyzed,

and presented, ensure the reporting process is legal and ethical, and the evaluation plan is

consistent with its protocol(s); (2) context evaluation, where it can have input on the program’s

goals, and make sure it is using community and school assets responsibly; (3) input evaluation,

where planners will use HISD’s input to assure Get HAPPY!‘s strategy is feasible for meeting

the needs of participants and accountability purposes in reporting; (4) process evaluation,

(5) impact evaluation, where it will receive results regarding the program’s findings to judge if it

served the correct target audience and if participant’s and community’s needs were met; (5)

effectiveness evaluation, where they will receive a final report; (6) sustainability evaluation,

where they will be asked about their opinions regarding what program activities and successes

should be maintained, as well as receive a final report regarding the program. Since HISD

administration has a stake in the success of this program, as well as liability for the program, it

should be easy to get them on board with these types of evaluation. Meetings will be scheduled

to discuss each of the aforementioned evaluations. Program planning committee, or member(s)

of that committee, will be in charge of conducting the evaluation. Specific aspects they will be

responsible for include: (1) contractual agreements, where all the details of what, how, when

things are going to be done; (2) context evaluation, where a needs assessment is conducted; (3)

input evaluation, where members explore the literature for existing programs which can serve as

models for Get HAPPY!; create budget, work plan; (4) process evaluation, where members will

observe and maintain a record of events, problems, costs, activities, etc.; (5) impact evaluation,

where each member will be asked their opinions of what is going well, what should change; (6)

effectiveness evaluation, to gauge program’s effects on participants and community, to figure out

any possible side effects, whether activities of the program need to be changed, to prepare and

distribute reports, to compare/contrast Get HAPPY! with other programs; (7) sustainability

evaluation, where all members of the committee will be asked their judgment of the program, if

it should be sustained, what activities should stay and which should change, what changes should

be made for the next round of implementation. Committee members should be engaged in the

evaluation since it is their job. The PE teachers and volunteers will be mostly involved in process

and sustainability evaluation, as LLHE will solicit their input to strengthen the program

activities, keep track of events, problems, costs, and maintain a record of the program’s progress,

as well as gauge their opinions on what program activities should be continued, what their

contributions were, changes which should be made for continuation, respectively. To engage PE

teachers and volunteers LLHE will solicit this information during the three staff trainings as well

as in weekly progress reports they will complete. Upon completion of the program, this

information will be shared with this group. Parents of children enrolled in the program will get a

final report (effectiveness evaluation) of the program. The grant awarding agency will be

involved in (1) input evaluation, where findings will be used to support funding requests for Get

HAPPY!; (2) process evaluation, where they will receive results regarding the program’s

progress; (3) impact evaluation, where they will receive results regarding the program’s

progress; (4) effectiveness evaluation, where they will receive findings to make a final evaluation

of the program’s success and significance. The grant funding agency doesn’t really have a role in

the actual evaluation process other than to receive the results and decide whether or not to

continue funding. Additionally grant requirements stipulate that results be reported to them. Thus

there is no need to engage them, as they will already be engaged. The businesses who donate

items for the program will receive results from the process and impact evaluations, where they

will receive results regarding the program’s progress and impact on participants. To engage

business owners, solicitation letters will first be sent out asking for donations, then thank you

letters with the results of the evaluations will be sent.

Process evaluation, impact evaluation, and outcome evaluation will be performed. Each

of these types of evaluation were chosen because they (1) align with PRECED-PROCEED, the

planning model used for Get HAPPY!, (2) assist in measuring the objectives as well as the

immediate and long-term results of the program, and (3) offer information regarding making

changes for the next round of implementation. For example process evaluation will show if

fidelity and dose were delivered as designed and intended. If fidelity and dose were not followed,

this may have an influence on overall effectiveness of Get HAPPY!. Therefore this information

may help to conceptualize the results if they are not favorable. It will also assist in making

changes for the next round of Get HAPPY! implementation. Impact evaluation shows immediate

changes which occur due to the program (Sharma & Bartlett, 2012). This will be used to measure

any immediate changes in physical activity and/or nutrition which may have occurred due to Get

HAPPY! Outcome evaluation measures changes in morbidity, mortality, and quality of life, as

well as long-term changes in behavior (Sharma & Bartlett, 2012). This will be used to determine

if Get HAPPY! made a long-term impact on overweight/obesity, quality of life, and if changes in

physical activity and nutrition behavior(s) were sustained over time.

Get HAPPY! will use a conventional approach for impact and outcome evaluation, and a

participatory approach to process evaluation. The participatory approach will be used during

process evaluation because planners need input from volunteers, participants, and everyone

involved in the Get HAPPY! program in order to improve the program and work out any kinks

which may arise. Planners cannot gather this information alone. The conventional approach will

be used for impact and outcome evaluation because only program planners will have and need

access to the data, are already trained in research and data analysis, and the funding agency

requires conventional evaluation for final outcome analysis.

Get HAPPY! will be using a non-experimental pre-test/post-test design. This was chosen

because we do not have a control group. Because LLHE is unsure about potential future funding,

it cannot ethically assign a group to control because it is uncertain if Get HAPPY! will be able to

be repeated to allow these participants to complete it. However qualitative data will be collected

to attempt to exclude confounding variables.

Specific questions to be asked and answered during the evaluation(s) include those about

the process, impact, and outcome, and can be seen in Table 4. Data will be collected by both

qualitative and quantitative methods. Surveys will be administered to parents and children which

solicit information from both likert-scale and open ended questions. The staff trainings will serve

as focus groups where information can be collected from volunteers. Observation will be

performed by program planners who attend the Get HAPPY! sessions. Document review will be

performed on the activity logs the participants complete. Taking the participants height, weight,

age, and blood pressure via direct measurement, and quality of life, satisfaction with the

program, and exercise habits will be collected via survey from participants.

Data will be analyzed via ANOVA(s), correlation(s) and regression(s), and a Cochran–

Mantel–Haenszel (CMH) analysis. ANOVA(s) will look for differences between groups,

regression will be used to calculate odds ratios (ORs), as well was what factors contribute to

success in Get HAPPY!, and the CMH analysis will look at if measurements changes over time

and varied between sex. Members of the planning committee will perform the data analysis. If

assistance on the analysis is needed, members of the committee have several colleagues they can

consult with for help. Accuracy and quality of the data will be ensured by having two sets of

eyes on all the coding and analysis. Each time any data entry, coding, or analysis is performed, it

will be double checked by another committee member. Confidentiality will be maintained by

allowing only members of the committee to have contact with the data collection sheets. Names

will not be used, each participant will be assigned a unique identifier such that if sheets fell into

the wrong hands the data would mean nothing to them. The master sheet with names tied to

identifers will be kept in a locked office in a locked file cabinet. Additionally when data is

entered electronically, files will be password protected, as will the computer. Computer will be

kept in locked office as well. Any hard copy data will be stored in a locked file cabinet in a

locked office which only committee members have access to.

All members of the planning committee will be involved in the evaluation. Data will be

collected weekly and results will be discussed at weekly committee meetings. If data indicates

that changes should be made, the committee will decide by majority vote on if such changes (and

what changes) will occur. As previously described above, different results will be shared with

different stakeholders at different points during the evaluation processes. Results will be shared

via presentations during volunteer and committee meetings held every two weeks, a written

report will be sent home to parents upon completion of the evaluation, and HISD administration

and the grant funding agency will receive a presentation and final report. Any feedback received

from stakeholders will be considered by the committee for the next round of Get HAPPY!.

A work plan for Get HAPPY! can be seen in Table 5.

References

Arons, A. (2011). Childhood obesity in Texas: The costs, the policies, and a framework for the

future. Retrieved from www.Childhealthtx.org:

http://www.childhealthtx.org/pdfs/Childhood%20Obesity%20in%20Texas%20Report.pd

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Appendices

Table 1: Detailed Implementation Plan

Day 1 Day 2 Day 3

Week 1 & 5

Hispanic

1) Education and snack (60 min)

- Healthy Nutrition

& Activity

Preferences

2) Activity (60 min) - Mexican hat dance

1) Education and snack (60 min)

- Learn about traditional

Hispanic games and their

American counterparts

2) Activity (60 min) - Brincar la cuerda

- Encantados

- Atrapadas

- Chinche al agua

1) Education and snack (60 min)

- Learn about American

team sport

2) Activity (60 min) - Practice Soccer

Week 2 & 6

African

1) Education and snack (60 min)

- Healthy Nutrition

& Activity

Preferences

2) Activity (60 min) - Traditional African

dance

1) Education and snack (60 min)

- Learn about traditional

African games and their

American counterparts

2) Activity (60 min) - Ampe

- Stockings

1) Education and snack (60 min)

- Learn about American

team sport

2) Activity (60 min) - Practice basketball

Week 3 & 7

Asian

1) Education and snack (60 min)

- Healthy Nutrition

& Activity

Preferences

2) Activity (60 min) - Traditional Asian

dance

1) Education and snack (60 min)

- Learn about traditional

Asian games and their

American counterparts

2) Activity (60 min) - Catch the dragon’s tail

- Chinese ball

- Hawk catching young

chicks

1) Education and snack (60 min)

- Learn about American

team sport

2) Activity (60 min) - Practice T-ball, soft ball

Week 4 & 8

Native

American

1) Education and snack (60 min)

- Healthy Nutrition

& Activity

Preferences

2) Activity (60 min) - Traditional Native

American dance

1) Education and snack (60 min)

- Learn about traditional

Native American games

and their American

counterparts

2) Activity (60 min) - Stickball

- Lacrosse

- Running game

- Kick the stick

1) Education and snack (60 min)

- Learn about American

team sport

2) Activity (60 min) - Practice volleyball

Table 2: Timeline for Get HAPPY!

Tasks Week

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Develop program

rationale

X X X X

Conduct needs

assessment

X X X

Develop Goals &

Objectives

X X

Create

Interventions

X X X X

Formative

Evaluations

X X X X X X X X X X X X X

Assemble

necessary

resources

X X X X

Market program X X X X

Program Kickoff X

Pilot test Get

HAPPY!

X X X X X X X X

Collect data X X X X X X X X X X X

Summative

evaluation

X X X X X X X X X X X X X X

Data analysis X X X X X

Refine program X X X X

Share results with

stakeholders

X X X

Plan for next

session

X X X

Continue with

follow-up for

long-term

evaluation

X X X X X X X X X X

Table 3: Projected Budget for Get HAPPY!

Revenue and Support

Contributions from sponsors:

Pedometers 300 pedometers

Fruit

200 pounds of bananas

200 pounds of apples

Snacks 400 Granola bars

Grants $15000.00

Expenditures

Supplies:

Prizes $1000.00

Frisbees 300 x $2.00 $600.00

Jump Ropes 300 x $2.00 $600.00

Water Bottles 300 x $2.00 $600.00

T-shirts 300 x $5.00 $1500.00

Hand sanitizer 300 x $2.00 $600.00

HP tablets 5 x $115.00 $600.00

Snacks:

Kidz Zone Bars 30 packs ($120) x 8 weeks $1000.00

Fruit $1000.00

Bottled Water 10 packs ($40) x 8 weeks $350.00

Advertising $900.00

Printing

Log Book Printing 250 x $5.00 $1250.00

Brochures, Flyers, Posters $1500.00

Transportation: Busses $3,500.00

Total Expenses $15,000.00

Table 4: Examples of Specific Questions to be asked during Evaluation

How Collected

From Whom

Collected

Process Evaluation

Did every session meet for the allotted 60

minutes? Checklist, focus group

Volunteers, PE

teachers, program

planners

Were log books distributed and collected at

the correct times?

Count of log books,

checklist,

Volunteers, program

planners

Did each participant get a pedometer? Checklist, focus group

Volunteers, program

planners

Were three sessions a week actually held or

were there missed days/cancelations due to

weather or other circumstances? Checklist, focus group

Program planners, PE

teachers

Impact Evaluation

How many minutes of physical activity a

week did the participate engage in

following the cecessation of Get HAPPY!?

Log books, self-report

survey

Participants,

participant’s parents

Did the quality of the participant’s

nutrition/eating habits change during and/or

following the program?

Log books, self-report

survey

Participants,

participant’s parents

Did the participant’s weight change? BMI Participants

Outcome Evaluation

Did the participant’s physical activity

quantity increase, decrease, or maintain six

months following the program?

Log books, self-report

survey

Participants,

participant’s parents

Did changes in the participant’s

nutrition/eating habits remain elevated six

months following the program?

Log books, self-report

survey

Participants,

participant’s parents

Did the participant’s weight change? BMI

Did the participant’s quality of life improve

following the program? Self-report survey

Participants,

participant’s parents

Table 5: Work Plan for Get HAPPY! Evaluation

Staffing Person(s) Responsible Timeframe

Evaluation Coordinator Program Manager Week

Formative Evaluation/Context Evaluation

-Get HAPPY! is designed using Health Belief Model,

Social Cognitive Theory, and the Theory of Planned

Behavior. The team evaluator will evaluate some of

the obstacles that will be a barrier for children to

participate in physical activity. Providing

transportation through the bus system to the program

and home will be evaluated during the program.

Behavioral, environmental factors, filed into

predisposing, reinforcing, and enabling factors, will be

evaluated. Personal logs will be given to children and

their parents. Included in the log with be questions

related to knowledge, attitudes, and beliefs relating to

physical activity and dietary habits. Enabling factors

will include determining what children are eating at

home and their sedentary behavior also tracked and

logged throughout the program. The evaluator will

read these logs weakly and this will help determine

what are Registered Dieticians and Fitness Specialist

are teaching the children. Reinforcing factors will

include monitoring children’s steps with pedometers

and prizes given to children that are doing the best.

Healthy snacks will be provided and nutritional

curriculum included during the learning section of the

program.

BMI will be measured at the start of the program,

Evaluation coordinator that is

part of the program team an

internal evaluator and

program planning committee

will be responsible for

formative evaluation tasks

speaking with parents to

evaluate if transporting is

efficient for parents. Working

with Registered Dietitians to

review food logs and Fitness

specialist to review fitness

activity and sedentary

behavior at home and

evaluating what information

will be discussed each week

during the leaning segment.

BMI measurements will be

conducted from a school

nurse and logged into tablets

that will be purchased for

team evaluator.

Week 5-Week

17

Start of

program Week

10

Summative Evaluation

-BMI will be measured half way through the program

and 3 time post program to determine if the program

was effective and if children are maintain or losing

more weight.

-Post program surveys will be conducted to evaluate

participants (children and parents concerns, likes or

dislikes out the program)

School Nurse will administer

BMI Measurements. Team

evaluator will record

Team evaluator will review

surveys and communicate

findings with all team

members of HAPPY to

determine future decisions

and possibly changes in the

program

Half way

through

program week

14 end of

program at

week 17, post

measurements

at weeks 21

and 29.

Program

surveys will be

handed out

week 25

Engaging Stakeholders

Grant Awarding Agency

Program planning committee

Program manager and

committee

Week 3

Week 1-8

HISD Administration

PE teachers and volunteers who work with the

program

Evaluation Coordinator &

Program Manager Week 4

Businesses who donate items for the program Program Manager and team

committee Week 5-8

Parents of Children enrolled in the program Program Manager and team

committee Week 8-10

Focusing the Evaluation

Impact Evaluation Develop evaluation questions for

parents and get feedback from management parents

Evaluation Coordinator with

feedback from Executive

Director and Program

Manager

Week 6-8

Contractual agreement

Program Manager &

evaluation coordinator School

Administration

Week 5

Input evaluation Program Manager, team

evaluator and team committee Week 6

Context evaluation

Program committee,

volunteers, evaluation

coordinator

Week 4-5

Gathering Credible Evidence

Conduct Needs Assessment Program planning committee

School administration Week 1-4

Process evaluation Program planning committee

team evaluation coordinator Week 8-17

Impact Evaluation: administer and review surveys

Program committee,

volunteers, evaluation

coordinator

Week 10-13

BMI testing and log evaluations

School Nurse, evaluation

coordinator

Week 10 14,

17, 21,29

Log every

week

Justifying Conclusions Sustainability evaluation Program Manager solicits

staff and client interpretation on data. Evaluation

coordinator compares to local data and standards.

Decided what should stay what should go

Evaluation Coordinator with

Program Manager and

program committee,

volunteers

Week 20

Effectiveness evaluation comparing Team HAPPY to

existing programs and literature and see what effects it

had on children and community

Evaluation coordinator and

program committee

Week 19

PE Teachers and volunteers input Week 19

Obtain and examine plans, budgets, staff assignments,

and other relevant information to gauge the likelihood

that the program will be sustained.

Week 21

Using Evaluation Results

Plan activities to share results and solicit feedback

from clients. Prepare presentation and share results at

Committee meeting. Incorporate client and Board

feedback into evaluation report for grant committee.

Evaluation Coordinator Week 22

Implement necessary changes for future programs Week 23

Institutionalize the program to more than one pilot

school

Week 24