Assignment #2: Introduction to Target Community & Program Intervention Sample and Program

INTRODUCTION TO TARGET COMMUNITY AND PROGRAM INTERVENTION

SAMPLE AND PROGRAM

2

INTRODUCTION TO THE TARGETED COMMUNITY

Targeted Objective

Specific HP 2020 objective: Obesity/Physical Activity and Nutrition.

Targeted Behavior: Improve health, fitness, and quality of life through daily physical activity and

nutrition. Specific target population and age and geographical area: Middle school students/ages

10-14/ Lauderhill, Florida in Boward County.

Description of Targeted Community

The researcher’s targeted location was built in 1957, it was part of the flourishing suburbs

of a southeastern Florida city, but, now, it has become part of a lower income urban

neighborhood. Currently, the school’s population stands at 1,391. The school’s demographics

include 88% African American, 6% Hispanic, 4% White, and 1% multicultural students. Indian

and Asian students account for less than 1%. Many of the students at the school seriously lack

knowledge about health issues that may affect their lives due to obesity and the impact it has on

the world today. Therefore, the need for integrating physical education and health education into

this middle school’s curriculum is very relevant.

The psychological and social consequences of being overweight in a society preoccupied

with thinness can be severe and enduring. Core aspects of psychological functioning such as self-

esteem and body image can be affected; mood problems such as depression can occur; social

discrimination is common; and long-term negative associations of being overweight with college

admissions, employment opportunities, and income have been documented (Bar-Or et al., 1998).

Children spend a large portion of their day in school. Because many of the lifestyles and

behaviors choices associated with obesity develop during school-age years, a child’s food intake

3

and physical activity at school are important determinants of body weight. By providing meals,

physical activity, and health education, school policies can help prevent childhood obesity

(Carter, 2002). Garn (2002) stated, “Obesity is a relative term used to describe the condition

where the ratio of body fat, which is measurable, to total body mass is higher than accepted

norm” (p. 1). The terms obesity and overweight are often used interchangeably, but their

technical definitions are different. According to Garn, “Overweight refers to an excess of body

weight that includes all tissues--fat, bone, and muscle. Obesity refers specifically to an excess of

body fat” (p. 1).

Schools are learning environments for developing and practicing lifelong

behaviors. The entire school environment must be aligned with healthy goals before the

school can positively impact a student’s knowledge base, beliefs, and habits as they relate

to good nutrition and physical activity. These common goals bring the school cafeteria

and the classroom together in improving the health of all students.

Socioeconomic Factors

Research showed that socioeconomic factors are related to childhood obesity.

According to Hasty (2003), when income, education, and the number of parents in the

household were controlled in multivariate analyses, excess television viewing was

associated with a higher likelihood of being obese in young African American females but not in

young White females. Hasty reported that, among children ages 6-11 years, African American

and Hispanic students were more than twice as likely as other racial or ethnic groups to be

overweight. Granberry (2005) stated that, in the state of Florida, nearly one quarter of school-

aged children live in poverty and 8% live in extreme poverty (i.e., a family income that is below

4

50% of the poverty level).

In 2005, Granberry reported that 15% of high school and middle school Hispanic

students were at risk for being overweight and the Hispanic population is expected to be

the fastest growing minority in Florida by 2025. The Henry Kaiser Family Foundation

(2002) reported that African Americans top the list in the percentage of obese or

overweight persons in Florida and the nation; however, the foundation reported no data

for Asians, Pacific Islanders, Native Americans, and Alaskan natives. Other ethnic and cultural

issues related to obesity involve the shape and size of the body. Dalton (2004) wrote,

Ethnicity and culture shapes a child’s body image and influences young people’s

behavior in dealing with body size. While obesity weight rates are higher among

Black girls and adolescents, unhealthy dieting behavior such as vomiting and

using pills are more common among White adolescents. An overall culture

tolerance for large sizes in Black women and a stringent culture standard for

thinness in White women are often cited for this discrepancy. (p. 24)

DISCRIPTION OF HEALTH PROMOTION/INTERVENTION PROGRAM

Participants

The proposed intervention program will take 4 weeks to implement. The program will be

implemented during the first month of the school year and last until the end of the month. A

sample of no more than 50 students between the ages of 11-14 years in a public middle school in

southeastern Florida will be selected. Participants will be randomly assigned by the toss of a coin

into two even groups that will participate (intervention group) or will not participate (control

group) in the intervention, thus, reducing the chance that systematic differences between the

intervention group and the control group will occur (Bailey, 1997; Ledbetter, 2001). The

participants of the intervention program will receive health education lessons twice a week and

5

daily physical fitness activities, whereas, the control group will only receive the pre- and

postsurvey and attend regular physical education and science classes(5 times a week).

All students who participate will be required to take a pretest on nutrition and physical

activity. Then, the students will be divided into the experimental and control groups. The control

group will not participate in the intervention component of this study; they will only participate

in the pre- and posttesting.

Health Education Sessions and Duration

In this study, for the health education sessions, the EFNEP will be used with

modifications (U.S. Department of Agriculture, 2005a).The nutrition education intervention will

consist of six lessons conducted by a certified science teacher. All participants who return their

consent forms on a first come, first serve basis will participate in the assigned groups. The

nutrition lessons will begin in the first semester of the school year. The components of this

intervention will be conducted twice a week with each lesson being taught for approximately 60

minutes, and hands-on activities will also be implemented.

Each participant will receive a written manual consisting of three lessons. The materials

will consist of overhead visuals and food models for demonstrations, reproducible handouts and

recipes, leader script with lesson plans (science teachers), and demonstration of equipment and

food for preparation.

The researcher will encourage parents to attend meetings in order to inform them of the

nutritional and fitness program being implemented in school. The researcher will also encourage

parents to become part of a nutritional committee made up of school staff, teachers, parents, and

members of the community. This committee collaboration will serve as a vehicle to assist

6

students and parents on becoming healthy and leading lives of health and fitness.

Nutrition Curriculum

The nutrition curriculum was designed by the EFNEP from the My Pyramid Food Guide

and the Dietary Guidelines for Americans.

(Week 1 ) Lesson 1. This lesson will consist of educating the participants on three key

points: the timing of meals and snacks, the combination of food groups at each eating event, and

the importance of meal planning. The sections of the food pyramid will be discussed in detail,

describing the foods contained in each group and examples of portion sizes for each group.

Participants will be taught calorie levels (1,400-1,600 calories or 1,600-1,800 calories).

(Week 2) Lesson 2. In this lesson, participants will take the information they have learned

from Lesson 1 and apply it to sizes. Each participant will be asked to fill in a plate diagram with

actual food and portion sizes that they would eat during breakfast, lunch, dinner, and a snack.

The sample diagrams will be demonstrated by their science teachers.

(Week 3) Lesson 3. This lesson will teach the participants to utilize the information

learned from Lessons 1 and 2 on calorie level and plate recognition and use it to develop a meal

plan for the week and a shopping list based on their week’s worth of meals.

(Week 4) Lessons 4-6. Participants will learn about proper dining with low calorie dessert

choices. Lesson 5. Participants will learn about proper dining with main dishes. Lesson 6.

Participants will learn about proper dining with side dishes.

Also, during week 4, lessons 4 to 6 will be food demonstrations that will allow the

participants to observe the ease in food preparation of selected dishes, including desserts, side

dishes, and main dishes. They will be able to see how the food is prepared from the shopping list

7

and how it fits into their plate recognition forms. This week will also allow the instructors to

reinforce nutrition components.

All components of the health education lessons will be addressed from the previous

weeks as the students move along to the next lesson so that students will retain nutrition concepts

by the end of the intervention and the posttest. At the beginning of each lesson instructors will

review health objectives. At the end of each week of the health education sessions, students will

write down concepts they have learned, and concepts that they do not understand. The instructors

are required to collect the information from the students and make sure that those concepts are

addressed in the next session.

Physical Education Sessions

The physical education sessions will be implemented three times a week for 4 weeks. Students

will be required to participate in a daily warm-up routine that will be designed by their physical

education teacher to increase muscular strength and endurance. This daily exercise routine will

consist of (a) push-ups, (b) sit-ups, (c) laps, and (d) a variety of stretching exercises. This routine

will be performed Monday to Friday for approximately 30 minutes. As the intervention program

progresses, each participant will be encouraged to do more repetitions of push-ups and sit-ups

and run faster.

Conclusion

Parents can reinforce the message about health and physical activity their children learn

in school by involving their children in family activities that include physical activity such as

family hikes or bicycling (Johnson & Deshpande, 2000). According to Johnson and Deshpande

(2000), “Many opportunities exist for school, community, and family involvement in helping

8

children adopt the healthy habits that will lead them to a life of wellness, and each has its own

unique way of reaching students” (p. 67).

9

REFRENCES

Bailey, D. M. (1997). Research for the health professional (2nd ed.). Philadelphia: F. A. Davis.

Carter, R. (2002). The impact of public schools on childhood obesity. Medical Students Journal

of the American Medical Association, 288, 2176-2182.

Garn, S. A. (2002). The Gale encyclopedia of childhood and adolescence: Obesity. Retrieved

December 18, 2007, from Find Articles database.

Dalton, S. (2004). Our overweight children: What parents, schools, and communities can

do to control the fatness epidemic. San Francisco: University of California Press.

Granberry, M. (2005). Surgeon general asks communities to address obesity. Healthlink,

24(3), 198-204.

Hasty, S. (2003, May 26). Survey: Parents believe physical activity key to preventing

childhood obesity. Diabetes Week, 2, 1-2.

Henry Kaiser Family Foundation. (2002). Georgia: Overweight and obesity rate by gender,

2002. Retrieved January 21, 2008, from http://www.statehealthfacts

.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Georgia.htm

Health Education Services. (2007). Broward County Public Schools. Retrieved October

7, 2007, from http://www.broward.k12.fl.us/studentsupport/healthedservices/ index.htm

Johnson, J., & Deshpande, C. (2000). Health education and physical education: Disciplines

preparing students as productive, healthy citizens for the challenges of the 21st century.

The Journal of School Health, 70(2), 66-68

Ledbetter, C. E. (2001). Summary: Research design and methodology types. Retrieved May

10, 2008, from http://www.cplusr.com/RDM/rdm_intro.htm

U.S. Department of Agriculture. (2005a). My pyramid for kids. Retrieved January 12, 2009, from

http://www.mypyramid.gov/kids/index.html