Nutrition Education Program Proposal

7

Nutrition Education ProgramProposal

Step 6 Worksheets Planning the evaluation

InStep 6, you plan the evaluation for your program. The outcomes arethe personal mediators from your theory model, the program goalbehaviors, and the selected health issues. You will also evaluatechanges in food environment–policy supports.

Atthe conclusion of the Step 6 worksheets, you will have the followingproducts:

Step6A: Diagramof conceptual framework for program evaluation

Step6B: Indicatorsof, and measures for, evaluating individual level changes (mediators,behaviors, health outcomes)

Step6C: Indicatorsof, and measures for, evaluating environment-policy supports

Usethe provided worksheets as a guide to plan your evaluation.Electronic versions of these worksheets are available at http://nutrition.jbpub.com/education/2e/. If you are unable to access theworksheets electronically, you can write onto this blank worksheet orcreate a text document that uses the same flow of information.

Step 6A: Program evaluation conceptual framework

Diagramthe conceptual framework that will guide your program evaluation.

Step 6 Worksheets Planning the evaluation

Step 6B: Evaluation plan for individual level component

Identifyindicators of achievement for the selected goal behaviors, mediators,and health issues as well as potential measures/instruments to assessthe achievement of outcomes.

Behavioral outcome

Indicator of achievement

Measures/instruments

The child will register a decreased consumption of meals that are considered to be unhealthy and an increased consumption of healthy diet.

Short term and long term indicators: A reduction in intake of unhealthy snacks such as highly processes sugars.

An increase in consumption of vegetables and fruits and other healthy snacks.

Objective questionnaires

Mediator outcomes

General educational objective

Indicatorof achievement

Measures/instruments

Physical outcome expectations (personal risks)

The child should be able to evaluate the intake of a meal with the recommended meal as well as the consequences of unhealthy diet.

An improvement in the tools measuring perceived personal risks.

Objective questionnaires such as multiple choice or true/false questions.

Physical outcome expectations (personal benefits)

The child should demonstrate they understand and appreciate the personal benefits of a healthy diet or reducing intake of unhealthy diet.

Improvement in personal benefits score.

Objective questionnaires

Social outcome expectations

The child should demonstrate increased awareness that the peers consume healthy diet and unhealthy eating is undesirable.

Improved score on descriptive norms.

Objective questionnaires

Barriers

The child is able to list some of the major barriers to a healthy diet and work as a group in suggesting workable solutions.

Improvement and decline in perceived barriers and overcoming barriers scores respectively.

Objective questionnaires

Self evaluation outcome expectation

The child should demonstrate the ability to evaluate themselves relative to the set goals.

Improved score on self monitoring and evaluation.

Objective questionnaires

Self efficacy

The child should demonstrate self belief in their ability to make health decisions in relation to their eating habits.

Improved score on self efficacy.

Objective questionnaires

Step 6 Worksheets Planning the evaluation

Health outcome

Indicator of achievement

Measures/instruments

Reduction in the prevalence of obesity and diet related health outcomes.

A decrease or maintenance of BMI among the children compared to the baseline.

Calculating BMI using self reported data.

Step 6C: Evaluation plan for environmental/policy supports component

Identifyindicators of achievement for the selected environmental/policysupports targeted by your program.

Environmentsupport outcomes

Indicator of achievement(general support objectives)

Measures/instruments

Food environment. Programs that promote healthy cooking and eating such as displays around the school.

Programs that provide opportunities for the children to learn about healthy options.

Objective questionnaires and observation.

Food offering. Programs that ensure that the children have access to healthy eating options.

Programs that promotes easy access to healthy foods.

Analysis and review of food offering.

Peer education. Programs that promote positive peer influence for healthy eating habits.

Peer programs that promote healthy eating habits through fun.

Analysis and evaluation of enrollment in peer education programs.

Community support. Community based programs that support health eating habits.

Community motivators to creating a healthy food environment.

Surveys and community based programs enrolment data.

School administration support. Policies by the school administration that supports the program.

Policies by the school administration to promote health eating habits among the children.

Indication of support from administration for example, attending meetings.

Changes in curriculum and incorporation of health lifestyle learning materials.

Program evaluation plan

Evaluationof the program is very essential in ensuring that the program issuccessful in influencing behavioral changes that promotes healtheating habits among the children. Both formative and summativeevaluations will be used in the program evaluation. The formativeevaluation will be an ongoing evaluation in the course of theprogram. This will serve as a feedback and will enable modificationof the program to increase its efficiency. On the other hand,summative evaluation will evaluate the effectiveness of the programin meeting the objectives as well as how the program was implementedor installed. The evaluation will be administered by the projectimplementers or self administered. This will include objectivequestionnaires, surveys, observation as well as recording of bodyweight and height. The data and information collected will beanalyzed and evaluated relative to the objectives of the program.

References

Han J. &amp Lawlor D. (2010). &quotChildhood obesity&quot. Lancet375 (9727): 1737–1748.

McBride, D. (2010). “Childhood obesity”. Practice Nurse,39(11), 40-45

Bessesen D H (2008). &quotUpdate on obesity&quot. J. Clin.Endocrinol. Metab. 93 (6): 2027–34.

Nutrition Education Program Proposal

9

Nutrition Education ProgramProposal

Nutrition Education ProgramProposal

Step 5 Worksheets (Environment) Designing activities for mediators

InStep 5, use your theoretical model, philosophy of nutritioneducation, and nutrition education program objectives to create (1)educational plans for the individual-level components and (2)environmental supports plans for environmental/ policy components.

Thesepages of the Step 5 worksheets are devoted to designing theenvironmental supports plan for the environmental/policy components. Generally, the environmental/policy componentsconsist of activities directed at changes that impact one or morefacets of the environment or policy as these relate to your program’sbehavioral goals.

Youshould have onesupportplan for eachenvironmental/policy component you stated in Step 3.

Atthe end of the Step 5 worksheets for the environmental/policycomponents, you will have the following products:

Step5D: Generalsupport objectives for each environmental or policy component.

Step5E: Amatrix that links mediators, objectives, and activities to help youdesign your support plan.

Usethese worksheets as an organizational guide to help you design yourenvironmental support plan and translate theory mediators intoenvironmental and policy change activities. Electronic versions ofthese worksheets are available at http://nutrition.jbpub.com/education/2e/. If you are unable to access the worksheetselectronically, you can write onto this blank worksheet or create atext document that uses the same flow of information.

Step 5D: General support objectives

Supportplan title: Environmentalsupport plan

Programgoal behaviors: Environmentprograms to modify eating behaviors among children and adolescent.

Writethe general educational objectives.

Mediator (from Step 3)

General support objectives

Physical outcome expectations (personal risks)

Creating an environment that increased awareness of risks associated with bad eating habits, such as obesity and associated health and social problems.

Physical outcome expectations (personal benefits)

Creating an environment that creates awareness of benefits associated with a healthy diet, for example, body strength and reduced risk of diseases.

Social outcome expectations

Fostering positive environmental influences to good diet, for example, acceptance by the peers and friends.

Self evaluation outcome expectation

Providing environmental motivations to self evaluation.

Barriers

Increasing environmental reinforcement that increases awareness on what motivate children and adolescent to take bad diet and discourage them from taking healthy diets.

Self efficacy

Enhancing environmental factors that enhance the ability of children and adolescent to control their diets.

Step 5 Worksheets (Environment) Designing activities for mediators

Step 5E: Designing the support plan: matrix format

Designyour support plan in matrix format. Writespecific objectives for the mediators in your theory model (Step 3).Then, write the theory-based strategy you will employ to address themediator and create support activities that will be meaningful,interesting, and appropriate for your audience and willoperationalize strategy.

Mediator (from Step 3)

Specific support objectives*

Strategies to achieve environmental/policy support objectives

Physical outcome expectations (personal risks)

Creating awareness among parents, teachers, school administrators and other responsible adults.

Display of messages on dangers of unhealthy food.

Decrease access to unhealthy foods.

Change of school policies and traditions.

Educating parents and policy makers.

Physical outcome expectations (personal benefits)

Creating awareness among parents, teachers, school administrators and other responsible adults.

Increasing the accessibility of healthy food, for example, subsidizing the costs of fruits in the school canteens

Display of messages on benefits of healthy eating habits.

Change of school policies and traditions.

Educating parents and policy makers

Social outcome expectations

Pushing for changes in social norms that promote unhealthy eating habits.

Educational programs that target the whole society.

Self evaluation outcome expectation

Increasing availability of self evaluation materials and equipment.

Enhancing reinforcement from teachers and parents.

Change of school policies and traditions.

Educating parents and policy makers

Barriers

Display of information related to tastes and preferences.

Positive peer influence and education.

Peer education

School policies

Self efficacy

Display of health diet information.

Increasing availability of healthy food.

Educating parents and policy makers.

* Use your findings about the changes that could be made in your audience’s environment (Step 2D) for each category to guide your writing of the specific objectives

Thereare numerous nutrition related challenges that are facing the modernhealth care systems. Majority of the serious illnesses that arecommon in the modern world are associated with unhealthy lifestyle.This includes overindulgence in unhealthy eating habits as well aslack of adequate physical exercise. This has resulted into increasedprevalence of obesity in the modern population. Childhood obesity isone of the most important health issues in the modern world(Bessesen, 2008). It is estimated that the number of obese childrenin the world has increased four folds in the last three decades. Inthe United States, the number of obese children between the age of 6and 11 has increased from 7 percent to 18 percent in the last threedecades. Additionally, the number of obese adolescents has increasedfrom five percent to 21 percent over the same period of time. It isestimated that a third of children in the United States are obese oroverweight. Although obesity is more prevalent in the low incomefamilies, childhood obesity is a problem in all societies, affectingchildren from both genders, all racial and ethnic groups. Althoughthere are other factors that contribute to childhood obesity, forexample genetic make up or medical conditions, there is no doubt thatunhealthy eating habit is one of the major causes (McBride, 2010).

Thehealth and psychological impacts of obesity in both children andadult is well documented in scholarly literatures. Studies indicatethat childhood obesity has direct and indirect impacts on health ofthe individual. Most importantly, childhood obesity is associatedwith obesity in later stages of life. Majority of obese children willstruggle with obesity in adulthood. Some of the immediate effects ofobesity include increased risk chronic diseases such ascardiovascular diseases, diabetes and bone and joints problems.Childhood obesity is also associated with psychological problems suchas low self esteem and social stigma. Some of the long term effectsinclude increased health risks associated with obesity in adult whichis associated with a wide range of health complications. Studiedsuggests that obesity is one of the leading causes of preventabledeaths in the world (McBride, 2010).

Goals

Although childhood obesity is major health issue in the modernsociety, it is important to note that children are not directlyresponsible for their health. The actions or inaction by the parents,guardians, teachers, the society and the government can impact onchildhood obesity. Focusing on school and family based interventionswill have a huge impact on childhood obesity initiatives. Theinitiatives should be aimed at promoting health food choices andincreased physical activity among children. However, it is importantto note that some children may require personalized support to dealwith obesity. The main goal for the program would be promoting healtheating habits among children. This is because overindulgence inunhealthy food is the main cause of childhood obesity. The programwill also aim at promoting physical exercise, both in school and athome. The main goal of the program is behavior change to increase theintake of a health diet by ensuring that the children take at leasttwo servings of fruits and vegetables in every day. This willsignificantly reduce the likelihood of indulgence in unhealthy eatinghabits. The primary target of the program is children and adolescentaged between the age of 9 years and 15 years. At this age, the targetgroup is increasingly becoming independent and is experiencingnumerous changes in their lives. There are different learning stylesthat can be used to educate these children on good eating habits. Anappropriate learning style would a cognitive approach to the learningprocess. Some of the major aspects of this learning style would beparticipative, collaborative and independent learning.

The program, will aim at modifying specific behaviors practices aswell as the policy and environmental factors that have an impact onunhealthy eating habits. This includes individual behaviors andcommunity based practices, family, school and environment basedfactors as well as policies that have a direct impact on the targetedbehavior. The learning objectives and targeted modification will beguided by the motivational mediators identified by the targetedgroup. The philosophy adopted in the program is that children,especially adolescent have the ability to take responsibility fortheir health. Young people between the age of nine and fifteen yearshave the ability to set goals and adopt lifestyles that enables themto meet these goals.

Action plan

Research indicates that a healthy diet has many benefits on anindividual’s health and plays a critical role in prevention andmanagement of obesity. It is recommended that individuals shouldconsume food rich in fruits and vegetables, less added sugars, lowfats and live a less sedentary lifestyle. This will significantlyreduce the risk of childhood obesity. However, surveys suggest thatchildren and adolescents are more likely to over indulge in unhealthyeating habits. They are more likely to prefer foods rich inartificial sweetness and fats as opposed to healthy fruits andvegetables. Additionally, fast food stores mainly target children andadolescence which is major contributor to increased incidences ofchildhood obesity (Han &amp Lawlor, 2010). There is a need toincrease among of fruits and vegetables servings eaten by children ina day. This should be accompanied by a reduction in the amount offast foods, sweetened food and packaged food consumed in a day.

References

Han J. &amp Lawlor D. (2010). &quotChildhood obesity&quot. Lancet375 (9727): 1737–1748.

McBride, D. (2010). “Childhood obesity”. Practice Nurse,39(11), 40-45

Bessesen D H (2008). &quotUpdate on obesity&quot. J. Clin.Endocrinol. Metab. 93 (6): 2027–34.