Introduction/Background€¦ · Web viewWomen’s Educational Workshops. Health 4150: Needs...

Women’s Educational Workshops

Health 4150: Needs Assessment and Planning Health

Promotion ProgramsBy: Candice Carlson, Nina Saadati, Rosa, Portillo, and Sarah

Bauch

For: Dr. Patti CostFall Semester 2011

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Abstract

The HEALTH Ladies are a group of Weber State University Health Promotion Seniors whose task it was to create a community program plan. They decided to help low-income women by educating them in preventative health measures. They developed a survey to assess the needs of these women, learning that they wanted to learn more about stress management, cooking on a budget and healthy relationships. Each member of the group designed one workshop of the intervention series. Four one-hour interventions were created based on the topics the women noted they wanted to learn more about and were taught in fun and interactive ways, engaging while educating the women. The interventions were conducted at Head Start’s main agency to best access the population that was targeted. Evaluation was conducted at these interventions through survey and exit interviews. Those who attended the workshops found great benefits that they could take home and use. Preventative health is oftentimes overlooked in this population. Low-income people have access to Medicaid, but they are not taught actions to take before they get sick. The HEALTH Ladies set out to provide this to their community and they succeeded.

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Acknowledgements

We would like to thank Head Start for being so welcoming and willing to have us educate their clients. Dr. Donald Carpenter and Laura Traum have been so helpful in organizing, marketing and providing resources. We would have struggled without their aid. We would like to thank Your Community Connection for their desire to also be a partner and have their clients participate in our workshops. Raquel Lee was very helpful in gathering data about the women as well as marketing in the facility. We would like to thank our friends and family who helped and encouraged us through this process. Finally, we would like to thank Dr. Patti Cost for her guidance and insight. She showed us how to make our program successful.

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Contents

CHAPTER ONE........................................................................................................................................ 1

INTRODUCTION AND BACKGROUND...................................................................................................................2

TEAM MEMBERS...........................................................................................................................................3

Biographies...........................................................................................................................................3

COMMUNITY BASED LEARNING........................................................................................................................6

Defined.................................................................................................................................................6

COMMUNITY BASED RESEARCH........................................................................................................................6

Defined.................................................................................................................................................6

Benefits.................................................................................................................................................6

COMMUNITY PARTNERS..................................................................................................................................7

Defined.................................................................................................................................................7

Advantages...........................................................................................................................................7

Disadvantages......................................................................................................................................8

Process of Building a Community Partner.............................................................................................8

DESCRIPTION OF OUR COMMUNITY PARTNER.....................................................................................................9

STATEMENT OF THE PROBLEM........................................................................................................................10

NEED FOR THE INTERVENTION........................................................................................................................11

MISSION STATEMENTS..................................................................................................................................11

PROGRAM PHILOSOPHY................................................................................................................................12

TIME LINE..................................................................................................................................................12

DEFINITION OF TERMS..................................................................................................................................14

SUMMARY..................................................................................................................................................14

CHAPTER TWO................................................................................................................................... 15

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INTRODUCTION............................................................................................................................................16

HEALTHY PEOPLE 2010................................................................................................................................17

Defined...............................................................................................................................................17

Objectives Specific to this Program.....................................................................................................18

HEALTH PROMOTION PROGRAMS...................................................................................................................18

Defined...............................................................................................................................................18

Planning.............................................................................................................................................19

Implementation..................................................................................................................................19

Evaluation...........................................................................................................................................20

OUR PROJECT.............................................................................................................................................20

Defined...............................................................................................................................................20

Benefits...............................................................................................................................................20

Challenges..........................................................................................................................................21

HEALTH PROMOTION PLANNING MODELS........................................................................................................21

Types of Planning Models...................................................................................................................21

Purpose...............................................................................................................................................22

Value..................................................................................................................................................22

Advantages.........................................................................................................................................22

Disadvantages....................................................................................................................................22

MODEL CHOSEN FOR THIS PROGRAM..............................................................................................................23

Defined...............................................................................................................................................23

Application.........................................................................................................................................24

QUALITATIVE RESEARCH................................................................................................................................24

Defined...............................................................................................................................................24

Developing Qualitative Questions......................................................................................................25

Analyzing Qualitative Research..........................................................................................................25

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QUANTITATIVE RESEARCH..............................................................................................................................25

Defined...............................................................................................................................................25

Developing Qualitative Questions......................................................................................................26

Analyzing Qualitative Research..........................................................................................................27

DEVELOPING A SURVEY.................................................................................................................................28

Reliability............................................................................................................................................28

Validity...............................................................................................................................................28

SMOG.................................................................................................................................................28

CHES COMPETENCIES...................................................................................................................................29

Defined...............................................................................................................................................29

How They Relate to This Project.........................................................................................................29

Competencies Developed by Doing This Project.................................................................................29

TYPES OF EVALUATION..................................................................................................................................30

Process...............................................................................................................................................30

Impact................................................................................................................................................30

Outcome.............................................................................................................................................31

SUMMARY..................................................................................................................................................31

CHAPTER THREE................................................................................................................................ 32

INTRODUCTION............................................................................................................................................33

PROGRAM GOALS.........................................................................................................................................34

Importance of Goals...........................................................................................................................34

Development of Goals........................................................................................................................35

PROGRAM OBJECTIVES..................................................................................................................................35

Importance of Program Objectives.....................................................................................................35

Developing Objectives........................................................................................................................36

GOALS AND OBJECTIVES SPECIFIC TO THIS PROGRAM...........................................................................................37

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Program Goal.....................................................................................................................................37

Program objectives.............................................................................................................................37

Learning objective..............................................................................................................................37

Behavioral objective...........................................................................................................................38

SUMMARY..................................................................................................................................................38

CHAPTER FOUR.................................................................................................................................. 39

INTRODUCTION............................................................................................................................................40

CHOOSING OUR COMMUNITY PARTNER............................................................................................................41

INITIAL MEETING WITH OUR COMMUNITY PARTNER.............................................................................................42

PLANNING MODEL USED................................................................................................................................42

Application.........................................................................................................................................43

PROGRAM PLAN..........................................................................................................................................44

MARKETING OF THE PROGRAM PLAN..............................................................................................................44

Advertising.........................................................................................................................................44

Survey development...........................................................................................................................44

Question Development.......................................................................................................................45

SMOG.................................................................................................................................................45

Preliminary review..............................................................................................................................45

Population surveyed...........................................................................................................................46

Data collection....................................................................................................................................47

Data analysis......................................................................................................................................47

Evaluation...........................................................................................................................................48

Purpose...............................................................................................................................................48

SUMMARY..................................................................................................................................................48

CHAPTER FIVE...................................................................................................................................... 49

INTRODUCTION............................................................................................................................................50

PARTICIPANT DEMOGRAPHICS........................................................................................................................51

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DATA ANALYSIS OF SURVEYS..........................................................................................................................52

SUMMARY..................................................................................................................................................52

CHAPTER SIX........................................................................................................................................ 53

INTRODUCTION............................................................................................................................................54

SUMMARY OF THE WHOLE PROGRAM..............................................................................................................55

CONCLUSIONS.............................................................................................................................................57

RECOMMENDATIONS....................................................................................................................................58

SUMMARY..................................................................................................................................................58

APPENDIX A......................................................................................................................................... 60

APPENDIX B......................................................................................................................................... 63

APPENDIX C......................................................................................................................................... 70

APPENDIX C......................................................................................................................................... 75

APPENDIX E......................................................................................................................................... 82

Appendix F...................................................................................................................................................89

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Chapter OneIntroduction

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Introduction and Background

The HEALTH Ladies are Weber State University Seniors studying Health Promotion and

are currently taking Health 4150: Needs Assessment and Planning Health Promotion Programs

taught by Dr. Patti Cost. As Health Promotion students, we want to educate and increase

awareness about health. By doing so, we hope to help others improve their overall health and

quality of life. This class has given us the opportunity to develop a purposeful community service

program based on the needs of the community. A partnership was established with Head Start

and Your Community Connection (YCC); developing interventions related to the needs of low-

income women in the community. Four interventions were planned, implemented and

evaluated to help educate low-income women about a variety of health topics.

Head Start began in 1965 by President Lyndon B. Johnson to help low-income children

be school ready and reach their fullest potential (aspe.hhs.gov). It is a preschool devoted to

help those in poverty give their children a head start in school by providing them with education

and resources to which they would not normally have access. Head Start is a part of a larger

organization called Ogden-Weber Community Action Partnership (OWCAP). This program is a

community based program designed to help those in need. The women of Head Start are in

poverty and have access to reactive care such as Medicaid and Medicare, but the HEALTH Ladies

recognized a need for proactive health care through education. Reports ran at Head Start tell us

that these women come from households that make less than $15,000 per year, most of them

making less than $3,000. These women mainly live in the down-town region of the city, low 2

income housing or homeless shelters. After conducting surveys (Appendix A), we know that

low-income women often face difficulties with nutrition (Appendix C), relationships (Appendix

D), and stress (Appendix B and E). They are often times not given the resources to make healthy

foods or don’t know what to make. They may be in relationships that are unhealthy or looking

to improve their current relationships. Finally, because of their current status, they are stressed

about money, children, work and life.

The HEALTH Ladies are determined and excited to have been given the opportunity to

educate these women on these topics to better the quality of their lives. They conducted a

needs assessment survey (Appendix A) to gather information on the perceived and actual needs

of these women. Based on the survey results, four workshops were created to address the

needs identified. From the workshops, it is the hope that lifestyle changes will be made from

knowledge gained in those areas of health.

The success of our community program was dependent on what was learned about a

variety of components relating to planning, implementing, and evaluating health promotion

programs. These components include: community based learning, community based research,

and community partnership. Information about each of these components can be found in this

chapter along with a brief biography of each team member, our timeline, mission statement,

philosophy, need for the intervention and description of the community partner.

Team MembersBiographies

Candice Carlson is 20 years old. She is a senior attending Weber State University and

will be graduating in April of 2012. Her major is in Health Promotion with a minor in Nutrition

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Education. She chose this major because she believes it is essential to help educate the

community about wellness and prevention relating to health behaviors. She believes it is

important to educate others about the importance of adopting healthy habits early in life to

prevent illness and disease.

Roles and Responsibilities

Helped create and distribute surveys at the Ogden Rescue Mission. Created lesson plan three. Helped to fulfill and implement four one-hour interventions. Assisted and provided supplies for each intervention. Assisted with the planning, preparation, organization, and implementing of each

intervention. Assisted in the evaluation of each intervention. Helped to write and create the program plan.

Nina Saadati was born and raised in Ogden, Utah. She is 21 years old and a Senior

attending Weber State University. Nina is majoring in Health Promotion with a minor in

Nutrition Education. She is looking forward to helping others with nutrition, exercise, and overall

achieving a healthy lifestyle in all aspects of health.


Helped create and distribute surveys at the Ogden Rescue Mission. Created lesson plan one. Helped to fulfill and implement four one-hour interventions. Assisted and provided supplies for each intervention. Assisted with the planning, preparation, organization, and implementation of each


Rosa Portillo was raised in Clearfield, Utah. She graduated from Clearfield High School in

2008, and then began her college education at Weber State University. Determined to graduate

from the nursing program, she immediately began taking some of the required classes to apply

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to the program. However, she discovered she did not want to work on treating or curing

illnesses, she wanted to help prevent them. Intrigued by the idea of education, during her

sophomore year, she changed her major to early childhood education. However, she still had a

passion for the health field. The summer before her junior year, she determined that teaching

young children was not her true calling. After earning her Associate of Science Degree in 2010,

she discovered that there was a middle ground, which is Health Promotion. She plans to

graduate in May of 2012 with a Bachelors of Science in Health Promotion.


Helped create and distribute surveys at Head Start. Created lesson plan four. Helped to fulfill and implement four one-hour interventions. Assisted and provide supplies for each intervention. Assisted with the planning, preparation, organization, and implementing of each


Sarah Bauch is a Health Promotion Major and a Nutrition Education Minor. She loves

the health promotion field and enjoys the freedom it gives her to be creative and teach health in

innovative ways. With every class and project completed, she has gained a better

understanding and love for the field.


Helped create and distribute surveys at Head Start. Created lesson plan two. Helped to fulfill and implement four one-hour interventions. Assisted and provide supplies for each intervention. Assisted with the planning, preparation, organization, and implementation of each


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Designated team leader Main communicator with partner

Community Based LearningDefined

Community Based Learning (CBL) helps students expand their learning possibilities.

Through CBL courses, students are able to apply the skills and knowledge gained within the

classroom to problems and issues within the community. The advantage of CBL is the

application and experience opportunities provided for students throughout each course. These

courses help students connect and grow through community services and projects.

Community Based ResearchDefined

Community-Based Research enables students to work with faculty members and

community leaders. In doing so, students are able to have learning opportunities through

their own communities. Students are able to develop research projects, collect data, and

analyze data; applying their knowledge from school to their community. At the

conclusion of the project, students are able to share their knowledge with their

community partners in hopes to create a positive impact. “Community-based research is a

partnership of students, faculty and community members who collaboratively engage in

research with the purpose of solving a pressing community problem or effecting social

change” (Strand, et al, 2003).

Benefits

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There are many benefits of this style of learning and research. For instance,

students are able to work with professors and community partners and gain support and

experience for their future. Community based research also provides students with a

sense of self-efficacy as they learn so they have a positive impact on real life challenges,

problems, and needs of their community. Students have enhanced problem-solving skills,

they have the ability to work in teams, and they learn to combine their abilities to make

great programs.

Community PartnersDefined

A community is defined as “a group of people who have common characteristics”

(McKenzie, Neiger, & Thackeray, 2009). According to Dictionary.com a partner is “a person who

shares or is associated with another in some action or endeavor (Dictionary.com, 2011).

Therefore, a community partner is an association with a group of people who have common

characteristics in some action or endeavor.

Advantages

Advantages of community partners are that they may provide funding, materials, and

other resources to implement a program. They have personnel on hand to help implement and

continue a program. Also, community partners may have already identified a need for a

program to be developed.

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Disadvantages

A disadvantage of community partners is they may have limited resources. It may also

be difficult to coordinate the different needs of the partners. These disadvantages may not be

too difficult to overcome, but it’s important to recognize that they do exist.

Process of Building a Community Partner

The first step of the community organizing and building process occurs when an issue

existing in the community is recognized and something needs to be done about it. The second

step is gaining entry into the community. Sometimes this step is not necessary if the issue is

identified by someone in the community. However, someone within the community may not

have lived in the community long enough, lacks political power, or does not know enough about

the interactions of the community to proceed with the process. The third step is organizing the

people. This means obtaining the support of the community members to deal with the issue.

The fourth step is assessing the community. This involves community building, which is an

orientation to the community that is strength based rather than need based and stresses the

identification, nurturing and celebration of community assets. The fifth step is determining

priorities and setting goals. There are two phases in the goal setting process. The first phase

involves identifying the priorities of the group, or what the group wants to accomplish. The

second phase uses the priority list to write goals. The sixth step entails arriving at a solution and

selecting intervention strategies. To accomplish the goals that were set, the group will need to

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identify alternative solutions and choose their course of action. The final steps in the community

organizing and building processes consist of implementation of the plan, evaluation of the

outcomes, maintaining the outcomes in the community, and, if necessary, looping back to the

appropriate point in the process to adjust the steps and restructure the plan (McKenzie, Neiger,

& Thackeray, 2009).

Description of Our Community Partner

Our main community partner is the Ogden-Weber Community Action Partnership

(OWCAP) with a focus on the mothers of Head Start children. The goal of OWCAP is not only to

help families’ immediate needs, but to help families become self- sufficient. Head Start was

founded in 1965 by Lyndon Johnson and aims to serve the poorest of the poor. Attention is

focused towards children ages 3-5 from low-income families.

The Head Start program is in almost every county in the country. Head Start in Ogden is

part of a Community Action Partnership (CAP) program. CAP programs help low-income families

achieve economic security. Ogden’s chapter of this program began the same year as the

national Head Start program as a result of concern of the community’s youth. The full budget

request for Head Start in fiscal year 2011 is about $8.2 billion which serves over 900,000

children.

The Ogden Head Start program is funded for 703 children; 584 children come from

households that make under $2,999, 4 from $3000-5999, 8 from $6000-8999, 7 from $9000-

11999, 7 from $12000-14000, and 93 from over $15000. They allow 10 children to enter the

program who are over the income; however, these spots are reserved for children who need

assistance with disabilities.

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Statement of the Problem

The women being served with this program often times do not have insurance or are

under insured. The percentage of those who are insured has steadily increased since 2005. In

fact, in 2008, 95% of the population was insured (www.usa.com). Many times, those who are

insured cannot afford their medical bills. Medicaid is a program that is available for low-income

women; however, it is completely reactive meaning it does not concentrate any of their efforts

on preventative health matters.

Poverty is something that greatly affects the Ogden area. 20.85% of the population is

currently living in poverty (www.usa.com). Information gathered from Head Start reports

indicate that over 83% of their clients make less than $3,000. This is obviously not the entire

Ogden population; however, it is a significant statistic to keep in mind when working with this

demographic. It will determine facets of their transportation, childcare, availability and other

factors.

Not only are there poverty issues in the city of Ogden, but there are also several health

issues that are more predominate than in the rest of the state of Utah. It is reported that 19%

are physically inactive (www.countyhealthrankings.org). This is interesting because inactivity is

the root of so many other health disparities. The birth rate of Downtown Ogden is around 110

per 1,000. This is over three times that of the state of Utah (www.usa.com). Other health

issues that Ogden struggles with more than the rest of the state include but aren’t limited to:

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heart disease, cancer, stroke, accidents, chronic respiratory diseases, influenza, pneumonia,

diabetes and suicide (www.usa.com).

The basic nature of the demographic, the combination of being low-income and not

having access to quality health care, can cause more distress than that of a different group of

people. It can be seen that there is a need for health education and preventative measures to

be incorporated into these women’s lives. If basic health education is done and preventative

measures are taken, there can be dramatic increase in health status in this group.

Need for the Intervention

Many low-income and under-privileged women may not recognize that they are able to

be healthy even though they do not have access to quality health care. Medicaid, Medicare,

cater to this demographic, but these organizations rarely focus on preventive health. With their

interventions, the HEALTH Ladies plan to help these women understand that they are able to

take control of their health, both physical and emotional. These women have been surveyed to

better understand their perceived and actual needs.

Mission Statements

The mission of Head Start is:

“Head Start is a national program that promotes school readiness by enhancing the

social and cognitive development of children through the provision of educational, health,

nutritional, social and other services to enrolled children and families”

(http://www.acf.hhs.gov).

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The Ogden-Weber Community Action Partnership houses and partners with the Head

Start program. Their mission in the following:

“Ogden-Weber Community Action Partnership inspires those in poverty to become self-

sufficient through innovative services and collaborative efforts” (http://www.owcap.org).

We, the HEALTH Ladies, feel it is our mission and responsibility, to instill through

education the importance of up keeping health and wellness in the under-privileged and low-

income women in our community in order to better the quality of their lives. It is our duty to

make preventative health easy, fun and exciting, inspiring those we teach to eagerly incorporate

our lessons into their lives.

Program Philosophy

Gandhi said “It is health that is real wealth and not pieces of gold and silver”. The

HEALTH ladies understand the difficulties that low-income and under-privileged women can

face. We recognize their plight of raising a healthy and happy family in the midst of poverty.

The HEALTH Ladies believe:

Education is the road for the journey of good health. We can better the quality of life for the under-privileged women in our community and

their children through empowering and educating. We can define the way to health and lead the way to wellness.

Time Line

Program Model: GMPP

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1) Step One – Needs Assessment

a. Determine the purpose and scope

i. Survey written and ready to go out week of 10/3

b. Gather data

i. Done week of 10/3

c. Analyze data

i. Done 10/3 and 10/13

d. Identify factors linked to the health problems

i. Done 10/3-10/18

e. Identify the program focus

i. Done10/3-10/18

f. Validate the prioritized needs

i. Done 10/18

2) Step Two – Set goals and objectives

a. Done 10/13

3) Step Three – Develop an intervention

a. Done 10/15-11/1

4) Step Four – Implement the intervention

a. First done 11/1

b. Second done 11/9

c. Third done 11/16

d. Fourth done 11/22

5) Step Five – Evaluate the intervention

a. Plan the evaluation

b. Collect the data

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c. Analyze the data

d. Report the results

e. Analyze the results

*All evaluation was done directly after each intervention

Definition of Terms

Low-income - The term "low-income individual" means an individual whose family's

taxable income for the preceding year did not exceed 150 percent of the poverty level

amount. Effective January 20, 2011, a family of 4 that makes less than $33,525 is

considered low-income (www2.ed.gov).

Stakeholder – a partner who has invested into the program. A stakeholder may have say

in what happens in the program as they have contributed to it.

Summary

The HEALTH Ladies, in summation, desire to help low-income and under-privileged

women take control of their health by educating them on preventative measures. The program

will help women realize their health potential through a series of 4 workshops which will teach

them through hands-on learning and demonstration; providing a comfortable and fun

environment in which to discover new and exciting things about health.

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Chapter TwoReview of Related Literature

15

Introduction



















making less than $3,000. These women mainly live in the down-town region of the city, low


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and community partnership. This chapter contains a literature review and models of successful

programs.

Healthy People 2010Defined

“Healthy People 2010 is a comprehensive set of disease prevention and health

promotion objectives for the Nation to achieve over the first decade of the new century.

Created by scientists both inside and outside of Government, it identifies a wide range of public

health priorities and specific, measurable objectives” (Healthy People, 2010).

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Objectives Specific to this Program

For the purpose of this program, the following Healthy People 2010 objectives have

been identified:

1-3 Increase the proportion of persons appropriately counseled about health behaviors.

1-4 Increase the proportion of persons who have a specific source of ongoing care. 7-12 Increase the proportion of older adults who have participated during the

preceding year in at least one organized health promotion activity. 10-5 Increase the proportion of consumers who follow key food safety practices. 11-2 Increase the health literacy of persons with inadequate or marginal literacy

skills. 15-34 Reduce the rate of physical assault by current or former intimate partners. 19-5 Increase the proportion of persons aged 2 years and older who consume at

least two daily servings of fruit. 19-6 Increase the proportion of persons aged 2 years and older who consume at

least three daily servings of vegetables, with at least one-third being dark green or orange vegetables.

19-7 Increase the proportion of persons aged 2 years and older who consume at least six daily servings of grain products, with at least three being whole grains.

19-8 Increase the proportion of persons aged 2 years and older who consume less than 10 percent of calories from saturated fat.

19-9 Increase the proportion of persons aged 2 years and older who consume no more than 30 percent of calories from total fat.

19-10 Increase the proportion of persons aged 2 years and older who consume 2,400 mg or less of sodium daily

Health Promotion ProgramsDefined

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Health promotion program are action-oriented. They are the process of enabling others

to have control of their own health. Health promotion programs are designed to help people

change their lifestyle to move toward a state of optimal health. They improve overall health,

reduce health risks, and encourage healthy behaviors of specific populations. The steps of health

promotion program consist of planning, implementing, and evaluating.

Planning

The first step of health promotion programs is planning. This is a multi-step process that

consists of selecting a program planning model, creating a rationale to gain support of decision

makers, creating a planning committee, determining the planning parameters, conducting

assessment of needs and gathering data, creating priorities and program focuses, measuring,

sampling, testing data, creating a mission statement, program goals, and objectives, reviewing

theories, models, and intervention strategies, and designing interventions. (McKenzie, 2009)

“To plan is to engage in a process or procedure to develop a method of achieving an end”

(Breckon, Harvey, & Lancaster, 1998, P.145).

Implementation

The next step in health promotion programs is implementation. Implementation is the

carrying out and putting into practice the activities that make up the intervention. At this point,

the planners will set into motion their intervention to meet the needs of the population and

fulfill the objectives that were set.

Implementation of a health promotion program consists of identifying personnel,

creating a budget and organizing finances, marketing, executing the health promotion program:

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adoption of the program, identifying and prioritizing the tasks to be completed, establishing a

system of management, putting the plans into action, ending or sustaining a program, and

working through any problems. (McKenzie, 2009)

Evaluation

Evaluation is the final step in health promotion programs. It is the process of assessing

the program’s effectiveness and achievement of objectives. Evaluation of a health promotion

program consists of deciding who will conduct the evaluation, considering ethical concerns,

pretesting and pilot testing, choosing a design for the evaluation, collecting and analyzing data,

interpreting data, creating reports, and understanding and utilizing data in future projects

(McKenzie, 2009).

Our ProjectDefined

The Health Ladies workshop series was designed to reach the low-income and under

privileged women of Ogden Utah. They learned the needs of these women through surveys

(Appendix A) given at strategic community partners around the city. The workshops were

designed to teach and empower these women so that they may take control of their health

through preventative measures. Because of the nature of the demographic, there was a

required prerequisite to make the workshops activities no-cost or low-cost so the women can

incorporate the lessons into their daily lives.

Benefits

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There are many benefits that can come from these workshops including but not limited

to: better nutrition, knowing low cost meals (Appendix C), stress management and relaxation

techniques (Appendix B and E), and healthy relationships(Appendix D). For these women, most

of the healthcare they have access to only involves reactive care. Our workshops want to focus

on preventative care. The HEALTH Ladies believe that through the education they are giving

these women, preventative care can be a reality.

Challenges

There are some challenges that come with this demographic. Transportation can be

difficult for these women, which would affect attendance. Another challenge is child care.

Because of strict standards set by Head Start, the HEALTH Ladies had issues figuring out the

logistics for this aspect of the workshops. To overcome this obstacle, they had activities for the

children in the back of the room. This way, the mothers could focus on the workshops, but not

be separated from their children.

Health Promotion Planning Models

Types of Planning Models

There are several different types of planning models that can be used when creating a

program. Most follow the general outline of assess, plan, implement and evaluate. Although

the models are similar, they may vary in their focus, resources used, stakeholder preferences

and sequence. The first created, and perhaps the most well know model, is precede-proceed.

This model follows the general outline of assess, plan, implement and evaluate, but it takes into

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account several different types of assessments and evaluations. Most program models are

simpler, but include the four main steps for a successful program. Other types of models

include PATCH, MATCH, MAPP, GMPP and SMART.

Purpose

The purpose of models is to guide the program and ensure all necessary steps are being

taken. The model acts as a road map in the journey of the program. Models are not meant to

limit a program into what they can or cannot do, but they are a guideline to follow and build

upon such that the program doesn’t get ahead of itself. The can be used to great effect to lead

planners in the right direction.

Value

If used correctly program models help to eliminate any unnecessary work for the

planner. Models are valuable in that their purpose is to guide and direct. They act as an

advisor to the planner in the program process without saying a word. They are there to consult

and give guidance.

Advantages

There are several advantages of planning models. First, they help to keep the program

on track and going in the right direction. They also aid in keeping the pace of the program and

ensuring that the facilitators don’t get ahead of themselves. Models are used as references and

guides for the planner to turn to when moving forward in the planning process.

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Disadvantages

A disadvantage of planning models is that they may not be what really happens in the

program. They act as guides, but reality may not always be as forgiving in its circumstances.

Stakeholders may also have different ideas as to what should happen. In this instance, you

have to forgo parts of the model and give into the stakeholders’ requests.

Model Chosen for this ProgramDefined

The model chosen for the HEALTH Ladies program is the Generalized Model for Program

Planning (GMPP). The GMPP is a representation of the foundation for health promotion

planning models. The steps included within the GMPP form a basic summary for planning

models. Instead of a formally tested model, the GMPP is a summary of multiple planning

models with no known historical perspective. It was created to summarize and provide a basic

foundation of the steps to implement in health education and health promotion practices.

The first step of the GMPP is performing a needs assessment of the target population.

This helps program planners identify the purpose of the program through gathering and

analyzing data in relation to the needs of the target population. The second step is setting goals

and objectives specific to the program. The goals of the program should be simple, general

statements. The objectives of the program should be precise and measureable. The third step

is creating an intervention. This includes planning different activities to help the program reach

its goal and objectives. The fourth step is implementing the intervention. This includes putting

into practice the planned activities. The last and final step is evaluating the results of the

23

program. This helps program planners know if the goals and objectives of the program were

met. It determines how effective the program was.

Application

To apply this model to the HEALTH Ladies program, a survey (Appendix A) was created

to perform the first step of the GMPP, assessing the needs of the target population. Surveys

were distributed at Head Start and Your Community Connection (YCC). The results of the

surveys showed a great need for stress management, relaxation techniques, healthy

relationships, and cooking on a budget. After finding out the results, goals and objectives were

established relating to the needs of the women. The overall goal for the HEALTH Ladies is to

educate low-income women in Ogden, Utah about the importance of preventative health

measures. The third step was creating the interventions. The interventions created for the

HEALTH Ladies program was based off of the needs assessment survey. Two interventions on

stress management (Appendix B and E), one intervention on healthy relationships (Appendix D),

and one intervention on cooking on a budget (Appendix C) were created. After developing the

interventions, they were presented to the low-income women in Ogden, Utah from Head Start

and YCC in November of 2011. Evaluations followed the interventions to measure the

program’s goals and objectives to determine the effectiveness of the program.

Qualitative ResearchDefined

24

Qualitative research, “focuses on phenomena that occur in natural settings, and involves

studying those phenomena in all their complexity” (Leedy & Ormrod, 2010). This helps to find

information that is descriptive. Qualitative research helps researchers understand and interpret

various behaviors. Some techniques used to get qualitative results include: focus group

interviews, case studies, and in-depth interviews (McKenzie, Neiger, & Thackeray, 2009).

Developing Qualitative Questions

Qualitative questions are usually open-ended and relate to “facts, beliefs, perspectives,

feelings, motives, present and past behaviors, standards for behavior, and conscious reasons for

actions or feelings” (Leedy & Ormrod, 2010). It is important to note that experiences are based

upon memory. Memory may be inaccurate because it can lead to what may have happened,

instead of what actually happened. This can make qualitative research difficult.

Analyzing Qualitative Research

Analyzing qualitative data is especially difficult. The data can be organized by using a

database on the computer. Some examples include: Excel, word processing, HyperRESEARCH,

and DataEase (Leedy & Ormrod, 2010). After entering the data into a database it is important to

try to get a feel for the data by determining possible interpretations. Next, it is important to

determine the major themes, subthemes, categories, and subcategories within the data. This

can help researchers decide what the results mean. Lastly, it is important to summarize the

conclusions. This can be done through the formation of hypotheses or through different charts

and diagrams.

25

Quantitative ResearchDefined

Quantitative research produces numerical data. According to A Dictionary of Nursing

(2008), quantitative research is “research based on traditional scientific methods, which

generates numerical data and usually seeks to establish causal relationships between two or

more variables, using statistical methods to test the strength and significance of the

relationships.” Quantitative data is often expressed as statistics, tables, and graphs.

Quantitative measures rely on “standardized data collection and reduction techniques, using

predetermined questions or observational indicators and established response items”

(McKenzie, Neiger, & Thackeray, 2009, p. 112).

Developing Qualitative Questions

As described by Burke Johnson and Larry Christensen from the University of South

Alabama (2010), there are three types of questions that can be used in developing quantitative

questions. There are descriptive, predictive, and casual questions.

Descriptive questions seek to find how much, how often, or what changes over time or

over different situations. When developing a quantitative question, they suggest using the

following “script”: “Do(es) (participants) (variable being studied) at (research site)?” Descriptive

questions also seek to identify a relationship between two or more variables. According to

Johnson and Christensen, the “script” to develop a descriptive relationship question is: “What is

the relationship between (variable 1) and (variable 2) for (participants)?”

26

Predictive questions seek to find if one or more variables can be used to predict a

potential result. They suggest using the following “script” to develop a predictive question:

“Does (predictor variable) predict (outcome variable) in (setting)?”

Casual questions seek to identify if different variations of one thing are a cause for

something else. These questions often involve manipulating the independent variable and

comparing the outcome. The “script” Johnson and Christensen suggest using to develop casual

questions is: “Does variation (or change) in the (independent variable) produce changes (e.g.,

increase, decrease) in (a dependent variable)” (Johnson & Christensen, 2010)?

Analyzing Qualitative Research

The authors of Practical Research (2010) note that in order to statistically analyze the

information (numbers) gathered through research, the scale of measurement that will be used

needs to be determined. The scale being used will dictate how the numbers gathered are

relative to one another. There are four scales of measurement are nominal, ordinal, interval,

and ratio data.

Nominal data are “numbers used only to identify different categories of people, objects,

or other entities. Nominal data do not reflect a particular quantity or degree of something.”

Ordinal data are “the assigned numbers that reflect an order or sequence.” Ordinal data

indicates the degree to which a variable has a certain feature of relevance. Interval data indicate

standard and equal units of measurement. Interval data can be used to determine “how much

difference exists in the characteristic being measured.” Ratio data are like interval data, but

have a true zero point. With ratio data, a zero value indicates a total absence of a particular

feature (Leedy & Ormrod, 2010, p. 262).

27

According to toolkit.pellinstitute.org (2011), once a scale a measurement has been

determined, results should be tabulated for different variables. This process will help identify

patterns within the data. Next, descriptive statistics are used to “describe” the data. Commonly

used descriptive are mean, median, mode, and maximum and minimum values. A mean

represents a “numerical average.” A median reflects a “numerical middle point.” A mode is “the

most common number score.” Maximum and minimum values are “the highest and lowest

value for a particular variable.” After that data has been described, it can be disaggregated

“across different variables and subcategories of variables.” Lastly, advanced analytical methods

are used to interpret the results of the data. Some examples of these methods are correlation,

regression, analysis of variance. “This type of analysis generally requires computer software and

a solid understanding of statistics to interpret the results” (The Pell Institute, 2011).

Developing a surveyReliability

Reliability “is an empirical estimate of the extent to which an instrument produces the

same result (measure or score), applied once or two or more times” (Windsor, Clark, Boyd, &

Goodman, 2004, p. 93). Reliability refers to consistency. It is when the same results are

produced numerous times, but nothing will be able to provide perfect accuracy. Reliability is the

repeatability of your measurement. It is not always measured, but more so estimated

(McKenzie, 2009).

Validity

28

Validity refers to what is being measured is correctly measuring the concepts it is

intended to measure. In other words, validity is measuring the “concepts under investigation.”

“Using a valid instrument increases the chance that planners/evaluators are measuring what

they want to measure, thus ruling out other possible explanations for the results” (McKenzie,

2009).

SMOG

Simple Measure of Gobbledygook (SMOG) is a test to check the reading level of the

written materials. SMOG consists of several steps to analyze printed materials. First all of the

words that are polysyllabic words are counted. Second, the total number of total sentences is

counted. Next, the total number of polysyllabic words is divided by the total number of

sentences in the sample. This number is used to look up the approximate grade level. The SMOG

test is a quick and easy way to design printed materials to the reading level of the targeted

population (McKenzie¸ 2009).

CHES competenciesDefined

Certified Health Education Specialist (CHES) competencies are qualities that all Health

Educators should strive to achieve to the highest degree. There are seven competencies total.

They are the following: assess needs, assists and capacity for Health Education; plan health

education; implement health education; conduct evaluation and research related to health

education; administer and manage health education; serve as a health resource person;

communicate and advocate for health and health education.

29

How They Relate to This Project

CHES competencies relate to this project because they are required to successfully carry

out any program. The competencies are in place because they are proven to be effective. The

CHES competencies are what all health promoters need to do to be successful in their field.

Competencies Developed by Doing This Project

All seven competencies were developed during this project to some extent. The

HEALTH Ladies have assessed, planned, implemented, and evaluated their program. They acted

as a resource as much as possible, administered health education and advocated for health to

the participants of the program.

Types of EvaluationProcess

Process evaluation takes place during the implementation of the program. It is defined

as “any combination of measurements obtained during the implementation of program

activities to control, assure, or improve the quality of performance or delivery” (McKenzie,

Neiger, & Thackeray, 2009, p. 339). This is usually done by asking participants questions about

their experience. This includes gathering “reactions from program participants about the times

programs were offered, or about program speakers” (McKenzie, Neiger, & Thackeray, 2009, p.

339). This information could be collected using short surveys or focus groups.

Impact

30

Impact evaluation is defined as an evaluation that “focuses on the immediate

observable effects of a program (e.g., awareness, knowledge, attitudes, skills, environment, and

behaviors) leading to the intended outcomes of a program” (McKenzie, Neiger, & Thackeray,

2009, p. 414). This type of evaluation helps to determine whether or not your program is

effective. If results from this evaluation indicate that your program needs to be more

interactive, you have the opportunity to change that for the next activity or intervention.

Outcome

Outcome evaluation “focuses on the end result of a program generally measured by

improvements in mortality, morbidity, or vital measures of symptoms, signs, or physiological

indicators” (McKenzie, Neiger, & Thackeray, 2009, p. 414). This type of evaluation is usually

“long-term and takes more time and resources to conduct” (McKenzie, Neiger, & Thackeray,

2009, p. 339). It is the final evaluation of all the hard work you put into the program.

Summary

In summary, the HEALTH Ladies have decided to use the MAPP program model to act as

the back bone to their program plan. They are incorporating all 7 of the CHES competencies in

order to be efficient Health Educators. The preliminary data collected from the surveys was

quantitative whereas the information gathered at the workshops was qualitative. Gathering

this data will be used as a process and impact evaluations to better future workshops.

31

Chapter ThreeGoals and Objectives for This Program

32

Introduction

















33



















and community partnership. The goals and objectives that the HEALTH Ladies want to

accomplish with their program are covered in this chapter.

Program goalsImportance of Goals

34

Program goals are of great importance within a health promotion program. A goal is

defined as, “a broad timeless statement of a long-range program purpose” (Mckenzie, Neiger, &

Thackeray, 2009). Goals provide the expectations and accomplishments the program planners

seek. They provide a structure that helps assist with the planning, implementing, and evaluating

process of each intervention. The foundation of the program is created with each program goal.

Development of Goals

Program goals should be developed as simple, clear, general statements. Each program

goal needs to include two important components. The first component should include who will

be impacted by the program, your target population. The second component should include the

changes that will occur from the implementation of the program. When writing program goals it

is important to remember the following guidelines. Goals are:

Global and encompassing. Include each portion of the program. Provide direction for the program. More general in nature. Take longer to accomplish. Do not include a deadline. Must be inferred. Not measurable in exact terms.

(Mckenzie, Neiger, & Thackeray, 2009)

Program Objectives

Importance of Program Objectives

35

Program objectives are also of great importance in health promotion programs.

Objectives outline the stages to help reach the overarching goal of the program. Objectives

state the exact changes that the program is hoping to accomplish within the targeted

population. It is essential that program planners develop specific objectives for each program.

Objectives help determine how effective the overall program was. “Objectives are crucial. They

form a fulcrum, converting diagnostic data into program direction and resource allocation over

time” (McKenzie, Neiger,& Thackeray, 2009).

Developing Objectives

Developing program objectives is an important skill for program planners to possess.

Program objectives are developed according to different levels. The different levels include

process or administrative, learning, action or behavioral, environmental, and outcome or

program objectives. Process or administrative objectives should be developed by showing

“activities were presented and tasks were completed” (McKenzie, Neiger,& Thackeray, 2009).

Learning objectives should include a “change in awareness, knowledge, attitude, behavior or

skill” (McKenzie, Neiger, & Thackeray, 2009). Action or behavioral objectives should include a

behavior change. Environmental objectives should include an environmental change, and

outcome or program objectives should include changes in the health of participants. Each

program does not need to include each level of objective.

When developing objectives these criteria need to be addressed.

Can the objective be achieved? Does the program have the resources they need available to them? Do the objectives violate rights of participants? Are the objectives aligned with the company’s policies are procedures?

36

Can the objective be realized during the program?

(McKenzie, Neiger, & Thackeray, 2009)

Goals and objectives specific to this program

The HEALTH Ladies defined their goals and objectives based on their populations needs

and survey results. The following are the primary goal and several objectives they wish to

accomplish with their program.

Program Goal

The overarching goal of the HEALTH Ladies is to educate the low-income women in

Ogden about preventative health measures.

Program objectives

At the education series workshops, the HEALTH Ladies will educate participants

on a variety of health issues through demonstration and interactive learning.

At the education series workshops, the HEALTH Ladies will teach participants

about resources in the community for additional educational and participation

opportunities.

Learning objective

37

After the workshops, participants of the HEALTH Ladies health education series

will know how make easy, but impactful, health choices in their daily lives.

After the workshops, participants of the HEALTH Ladies workshop series will

recognize resources in their community from which they can gain further help and

understand on a variety of issues.

Behavioral objective

At workshops presented by the HEALTH Ladies, attendees will participate and

understand through demonstration how preventative health measures can benefit their

lives.

At the education series by the HEALTH Ladies, attendees will participate in

several activities to better understand the concepts taught at the workshops.

Summary

Setting goals and objectives for a program should be a top priority for and planner.

Goals and objectives give of the focus of the program and allow planners to have something

measurable to gauge their progress. The HEALTH Ladies chose their goals and objectives based

on the survey results they attained during the assessment stage of the GMPP planning model.

38

Chapter FourMethods

39

Introduction

















40



















and community partnership. Information about our community partner and the methods used

to assess, plan and implement out program are contained in this chapter.

Choosing our community partner

41

Choosing the community partner was based on perceived need and access to resources.

The HEALTH Ladies are well aware that there are needs in the community. Head Start was

chosen as a partner because of the access to the community and the resources that it provided.

YCC is a partner of Head Start and was another great choice for being able to reach a high

number of the target demographic.

Initial meeting with our community partner

Because of the personal connection members of the HEALTH Ladies have with their

partners, the initial meeting went smoothly. It was, of course, necessary to discuss the details

and nature of the program and allow the partners to give their input. The initial meeting was a

great time to get a feel for what has worked for the partner in the past in regards to attendance

and anticipated participation. It was also a good time to see what resources were available for

them to use for the workshops. The overall sentiment given to the HEALTH Ladies program was

excitement and high hopes that it would work out well. Both Head Start and the YCC were

grateful that they were approached about the workshops and were fully onboard with the

program.

Planning model used

The model chosen for the program is the Generalized Model for Program Planning

(GMPP). The GMPP is a representation of the foundation for health promotion planning models.

The steps included within the GMPP form a basic summary for planning models. Instead of a

42

formally tested model, the GMPP is a summary of multiple planning models with no known

historical perspective. It was created to summarize and provide a basic foundation of the steps

to implement in health education and health promotion practices.

The first step of the GMPP is performing a needs assessment of the target population.

This helps program planners identify the purpose of the program, and can help them gather and

analyze data in relation to the needs of the target population. The second step is setting goals

and objectives specific to the program. The goals of the program should be simple, general

statements. The objectives of the program should be precise and measureable. The third step

is creating an intervention. This includes planning different activities to help the program reach

its goal and objectives. The fourth step is implementing the intervention. This includes actually

putting into practice the planned activities. The last and final step is evaluating the results of the

program. This helps program planners know if the goals and objectives of the program were

met. It also helps to determine the effectiveness of the program.

Application

To apply this model to the HEALTH Ladies program, a survey (Appendix A) was created

to perform the first step of the GMPP, assessing the needs of the target population. Surveys

were distributed and completed at Head Start and Your Community Connection (YCC). The

results of the surveys showed a great need for stress management, relaxation techniques,

healthy relationships, and cooking on a budget. After finding out the results, goals and

objectives were established relating to the program. The overall goal for the HEALTH Ladies is to

educate low-income women in Ogden, Utah about the importance of preventative health

measures. The third step was creating the interventions. The interventions created for the

43

HEALTH Ladies program was based off of the needs assessment survey. Two interventions on

stress management, one intervention on healthy relationships, and one intervention on cooking

on a budget were created. After developing the interventions, they were presented to low-

income women in Ogden, Utah from Head Start and YCC in November of 2011. Following the

interventions, an evaluation was done to measure the program’s goals and objectives. This

helped determine the effectiveness of the program.

Program Plan

The Health Ladies program plan is to provide low-income women of the Ogden, Utah

community an opportunity to participate in workshops which will educate them in preventative

health measures. Through survey (Appendix A), it was better understood what the women of

this demographic recognized as their real or perceived health needs. Stress management and

relaxation was the highest rated result in the survey. This was followed by cooking on a budget

and healthy relationships. The HEALTH Ladies put together workshops that would help the

women learn about these topics and incorporate the lessons into a lifestyle. They workshops

were designed to be very interactive and personal. Learning comes from doing and interacting,

not just listening.

Marketing of the Program PlanAdvertising

To advertise for the workshops, the HEALTH Ladies sent out flyers to each family at

Head Start and gave flyers to the YCC to post where they thought appropriate. Small posters 44

were also made to remind the Head Start mothers of the upcoming events. Fortunately, the

teachers and family advocated of Head Start were willing to encourage their families to attend

events held at the agency.

Survey development

In order to better understand the needs of our target population a Women’s Health

survey (Appendix A) was developed. We used the survey to gather information about the

individuals’ employment status, age, level of education and the number of children each

individual had. In addition, the survey asked for input on the type of workshops the participants

would be willing to attend. Exit interviews were conducted to determine if participants found

our workshops useful. Also, because the majority of the population is Hispanic, the surveys were

translated into Spanish by one of the team members who speaks Spanish fluently.

Question Development

The HEALTH Ladies created their survey to better understand the women that they were

going to serve. The questions on the survey asked demographic and socioeconomic questions

along with questions about what they would like to learn. Age, employment, highest level of

education completed, number of children, if they would attend the workshops and if they

needed childcare to attend (Appendix A).

SMOG

A survey was developed to determine the needs of the target population, low-income and

under-privileged women. Before conducting this survey a SMOG readability test was preformed.

45

After assessing the number of polysyllabic words in the survey, it was found that there were 12

of them. Next, the number 12 was rated on the SMOG readability test to determine the

approximate reading level. The grade level was sixth grade, which was an adequate reading level

for the target population.

Preliminary review

In Health 4150: Needs Assessment and Planning Health Promotion Programs, a

preliminary review was accomplished by Dr. Patti Cost and classmates. The surveys, flyers,

lesson plans, and emails were all examined and corrected. Suggestions and recommendations

were also given for each aspect of the program within each preliminary review. Each

preliminary review helped make each piece of the program clear and concise.

Population surveyed

The survey results allowed the HEALTH Ladies to better understand their demographic.

The following are the outcomes of the survey analysis from both Head Start and YCC:

Ages: 15-18 19-25 26-34 35-45 46 and up 2 18 32 25 12

Education: Some High School =22 High school graduate =25Some college =25 College graduate = 8

Employment Yes = 17 No = 71Children Yes = 83 No = 6

Number of children: Women who have that many children:1 15

46

2 21

3 21

4 14

5 3

6 1

7 2

8 2

11 1

Would they attend Yes = 70 No = 11Do they need child care Yes = 55 No = 29

Topics with most interest rated 1st to last

1) Stress and relaxation=522) Money management=383) Cooking on a budget = 374) Healthy relationships = 365) Healthy eating = 336) Exercise = 327) Self-esteem = 228) Personal health = 99) Sexual health = 910) Birth control = 2

Data collection

Data collection was done through survey (Appendix A) at both Head Start and YCC. The

survey conducted asked a variety of questions to better gage the population served. Staff at

47

YCC handed out the surveys while members of the HEALTH Ladies targeted Head Start for a few

hours to get a sample.

Data analysis

Analyzing the data was done through counting the survey results. There were about

100 surveys total from both YCC and Head Start, so analysis didn’t take too long. A results log

was started in which tic marks accounted for each answer on the surveys. SPSS and Excel would

also be acceptable mean of data analysis.

Evaluation

The Women’s Health survey and the exit interviews allowed us to evaluate the

effectiveness of the HEALTH Ladies program. The type of evaluation we used was a process

evaluation. As we concluded each workshop, we asked participants for their reactions in regards

to the workshop. With the results of the women’s health survey, we strived to provide effective

workshops, serve as a resource, and increase the knowledge of our participants.

Purpose

The program was evaluated to determine the strengths and limitations of each

intervention. This helped determine what changes could be made in the future to increase the

effectiveness of the program. It also helped to determine what aspects of the program were

successful and should be continued in the future. Evaluation of the program let participants

share thoughts, suggestions, and recommendations for the program.

48

Summary

The HEALTH Ladies assessed, planned, implemented and evaluated their health

program; catering it to the specific needs of their target population. They created a survey,

used SMOG to ensure the readability of their written materials, and analyzed the information

they collected to create the most effective program for their population.

Chapter FiveResults

49

Introduction
















50




















and community partnership. The results of the workshops and the demographics of the

participants are contained within this chapter.

Participant Demographics

51

We had five participants for our workshops. Three were unemployed and two were

employees of Head Start. The participants had heard about the workshops from word of mouth

or the flyers sent home. Their ages ranged from 26-36. Most were Hispanic, but two were

white. This was our target demographic, so we were excited to be able to reach this group.

Data Analysis of surveys

Because the number of participants was so small, the data analysis of the surveys was

quite simple. We counted and recorded the answer on each survey question to get our results.

Each participant was also interviewed after as an exit interview for the workshop.

Summary

Most of the women who attended the workshops were within the target demographic.

Because a participant survey was done and exit interviews were done, the HEALTH Ladies could

properly evaluate their program. Process and program evaluations were done to ensure the

effectiveness of the program and to make any changes needed along the way.

52

Chapter SixSummary, Discussion, Conclusions and

Recommendations

53

Introduction














54






















and community partnership. This chapter is a summary of the whole program and includes

recommendations and discussion.

55

Summary of the whole program

Low income individuals have very few resources available to them. Many of these

individuals do not know how or where to look for resources when they wish to take

preventative measures or improve their health. No program had been developed to serve as a

resource for preventative measures for the mothers of the children at Head Start. This being the

case, the HEALTH Ladies developed a program with a four workshop series to serve as a

resource, and educate the women.

The HEALTH Ladies program was developed based on our initial survey results. The

respondents identified key areas they would be interested in learning more about. These areas

included stress and relaxation, cooking on a budget, and healthy relationships. Each workshop

was approximately forty-five minutes long. The first workshop was on stress and relaxation

(Appendix B). The workshop began with participants making stress balls while learning what

stress is. In addition, they were educated on the negative effects of stress. Participants were

taught simple self-assessment techniques to help identify if they were feeling stressed. Next,

participants engaged in a gratitude activity, where the discussed what they were thankful for.

Lastly they participated in a relaxation technique called Guided Imagery.

Unfortunately, due to lack of attendance, our second workshop of cooking on a budget

(Appendix C) was not implemented. However, a lesson plan was developed to demonstrate how

to make the most out of cheap food and stick to a budget when preparing healthy meals. The

lesson plan also included information about how to use different spices to add more variety to

meals. In addition, an activity was planned that allowed participants to smell an unidentified

seasoning and guess what seasoning it was.

56

Our third lesson plan was on healthy relationships (Appendix D). During this workshop,

participants engaged in an activity where they were to imagine a funeral scenario. The purpose

of this activity was for participants to identify their values and to help determine what is truly

important to them. Participants were also allowed to brainstorm ideas of what characteristics of

a health relationship are. They then developed a recipe for a healthy relationship based on

those characteristics. We also educated participants on what the characteristics of an unhealthy

relationship are. Next we asked participants to identify and list what signs of healthy and

unhealthy relationships are between romantic, parent to child, teacher to student, and friend to

friend relationships. We concluded the activity with a quiz to determine what each participant’s

love language was and discussed each of the five love languages.

Our final workshop was another on stress and relaxation (Appendix E). During this

workshop, participants were informed of the benefits of using relaxation techniques. They then

engaged in an activity where they identified what made them happy, feel calm, feel relaxed,

have fun, what they enjoyed, and what they used their free time for. In addition, participants

learned a simple self-massage technique to help them relax. Participants also practiced

visualization where they were asked to imagine a setting that was most relaxing. In order to

recall that relaxing setting, participants were asked to describe that setting with as much detail

as possible. Lastly, participants practiced mantra meditation which allowed them to calm down

and relax.

The main goal of the HEALTH Ladies program was to educate the women on how to use

preventative measures to live and stay healthy. The program was implemented once a week, for

four weeks, during the month of November 2011. Each participant was able to actively engage

in the activities during our workshops and learn how to effectively use the information.

57

Conclusions

It could be said that those who attended the workshops benefited from the materials

with which they were presented. The materials taught targeted the population’s needs and

those who attended enjoyed the information presented to them. The presentations were also

given with their specific demographic in mind. They contained easy to do activities that

participant do in their own home with no cost. The HEALTH Ladies understand the difficulties

that low-income women can face and they presented the women with solutions they could

easily access and take part. Overall the HEALTH Ladies provided a great service to those who

attended the workshops by imparting preventative health measures to them to better the

quality of their lives.

Recommendations

If child-care is provided, make sure to have child-care volunteers get a background

check in advance. Head Start requires that volunteers watching children have a

background check.

Make a question on the survey about availability. Make sure the times at which the

workshops are going to the given are good time for the potential participants.

Make sure to advertise each intervention as much as possible. Send notes home with

the parents at Head Start, hang flyers on the doors, bulletin boards, and classrooms of

Head Start and YCC. Be sure to make posters to advertise each intervention at both

buildings and have teachers at Head Start encourage the women to attend.

Make sure enough notice is given for each intervention.

58

Summary

Overall, the HEALTH Ladies had wonderful workshops for the low-income women they

wanted to serve. Attendance could have been better, but measures were taken to improve

participant numbers. Recommendations for continuing the program have been listed, although,

each program following this one will be different. The program workshops that were given

targeted the real and perceived needs of the demographic and engaged them in learning about

preventative health matters that would directly affect their lives.

Appendix A

59

HEALTH LadiesWomen’s Health Survey

Instructions: Please read each question and circle the answer that best applies to you. The results are confidential, so please don’t put your name on this form.

1. How old are you?

15-18 19-25 26-34 35-45 46 or older

2. How much schooling have you completed?

Some high school High school graduate

Some college College graduate

60

3. Are you currently employed? Yes No

If you circled yes, What kind of work to you do? ____________________________

4. Do you have children? Yes No

If you circled yes, how many?___________________

Head Start would like to offer you four workshops. Circle the four topics you are most interested in.

Birth ControlCooking on a budgetEating HealthyExercise

Healthy RelationshipsMoney ManagementPersonal Care Sexual Health

Self-esteemStress and Relaxation

Other: ___________________________________________________________

If Head Start offered health workshops, would you attend? Yes No

Would you need child care to attend these workshops? Yes NoThank you for completing this survey!

Encuesta de la Salud de la Mujer

Instrucciones: Por favor, haga un círculo la respuesta que mejor se aplica a usted.

1. ¿Cuántos años tiene?

15-18 19-25 26-34 35-45 46 ó Mas

2. ¿Cuántos años escolarios ha completado?

Algunos años de la Secundaria Graduado de la Secundaria

Algunos años de la Universidad Graduado de la Universidad

3. ¿Está usted en le momento empleado?

61

Si No

4. ¿Tiene hijos?

Si No

Instrucciones: Por favor, haga un círculo en los cuatro mejores temas sobre salud de la mujer que le gustaría aprender más acerca de.

Cocinando con un presupuesto Ejercicio Salud Sexual

Estrés y Relajación Autodefensa Alimentación Saludable

Autoestima Administración de Dinero Control de Peso

Métodos Anticonceptivos Cuidado Personal Ayuda para Dejar de Fumar

Otros:___________________________________________________________________

Si Head Start ofrece talleres de salud, le asisten? Si No

Se necesita cuidado de niños para asistir a estos talleres? Si No

Gracias por completar esta encuesta!

Appendix B

62

63

64

Stress ReliefWomen’s Health Workshop 1

Nina Saadati, Candice Carlson, Sarah Bauch, Rosa Portillo

Activity 1: Background Information

Time: 10 minutes

Supplies: funnels, flour, balloons, and buckets

Purpose: For participants to gain knowledge about stress and have a way to release their stress through the stress balls.

Directions:

Talk to participants about what stress is, the top stressors, symptoms of stress, and health problems due to stress.

What is Stress: “Stress is a normal physical response to events that make you feel threatened or upset your balance in some way. When you sense danger – whether it’s real or imagined – the body's defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction, or the stress response.The stress response is the body’s way of protecting you. When working properly, it helps you stay focused, energetic, and alert. In emergency situations, stress can save your life – giving you extra strength to defend yourself, for example, or spurring you to slam on the brakes to avoid an accident.” (Understanding Stress)

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Top Stressors:

External:

Major life changes Work Relationship difficulties Financial problems Being too busy Children and family

Internal: Inability to accept uncertainty Pessimism Negative self-talk Unrealistic expectations Perfectionism Lack of assertiveness

(Understanding Stress)

Symptoms of Stress:

Cognitive Symptoms:

Memory problems Inability to concentrate Poor judgment Seeing only the negative Anxious or racing thoughts Constant worrying Emotional Symptoms: Moodiness Irritability or short temper Agitation, inability to relax Feeling overwhelmed Sense of loneliness and isolation Depression or general unhappiness Physical Symptoms:

Aches and pains Diarrhea or constipation Nausea, dizziness Chest pain, rapid heartbeat Loss of sex drive Frequent colds

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Behavioral Symptoms Eating more or less Sleeping too much or too little Isolating yourself from others Procrastinating or neglecting responsibilities Using alcohol, cigarettes, or drugs to relax Nervous habits (e.g. nail biting, pacing)

(Understanding Stress)

Health Problems: Acid Peptic Disease Alcoholism Asthma Fatigue Tension Headache Hypertension Insomnia Irritable Bowel Syndrome Ischemic Heart Disease Psychoneuroses Sexual Dysfunction Pain of any kind Heart disease Digestive problems Sleep problems Depression Obesity Autoimmune diseases Skin conditions, such as eczema

(Understanding Stress), (Less Stress)

During the discussion about stress, participants will be making stress balls using balloons and sand.

Have participants sit at a table with balloons, flour, buckets, and funnels. Using the funnels, the participants can pour the flour into the balloons while having the buckets underneath it, creating a stress ball.

Activity 2: Self-Assessment

Supplies:

chair, 67

watch or clock with second hand, paper pencil

Purpose: For participants to be able to asses their own stress levels.

Directions:

First, have participants sit and relax in a chair for at least 30 seconds. Participants need to find their pulse on wrist or neck for 60 seconds. Then they need to write down the number of beats they feel on the piece of paper.

Next, have participants place one hand on their stomach and the other on their chest above their heart. Have them take breaths for another 30 seconds, being aware of what hand moves more. Then have participants write either abdomen chest or both on their paper based on which one moved more.

Third, have participants count how many natural breaths they take within a minute (respiration rate) and write it down.

Finally, participants are ready to assess their stress.

Average heart rate: 70-80

Average respiration rate: 12-16

Faster rates could be an indicator of higher-than-desired stress levels.

Chest breathing: chronic activation of stress response, shallower, quicker breaths

Abdominal breathing: slows nervous system, deeper breathing creates more oxygen

(Olpin, 2010)

Activity 3: Gratitude

Time: 10 minutes

Supplies:

Paper Markers

Purpose: For participants to be able to realize what they are thankful and the positive things in their lives.

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Directions:

Paper will be out in the tables the participants are sitting at. There will also be an assortment of different colored markers. Each participant will take turns in writing five things that they are thankful for. They may also include other things such as the people in their lives they love or things that make them laugh.

Activity 4: Guided Imagery

Time: 15 minutes

Supplies:

Stress Relief CD CD player

Purpose: For participants to practice guided imagery as a relaxation technique and be able to relax.

Directions:

Talk with the participants about what guided imagery is and the benefits of it.

Guided Imagery:

Guided imagery, sometimes known as "visualization," is a technique in which a person imagines pictures, sounds, smells, and other sensations associated with reaching a goal. Imagining being in a certain environment or situation can activate the senses, producing a physical or psychological effect. (Olpin, 2010)

Benefits:

Improve performance skills Improve confidence and positive thinking Problem solving Control anxiety Reduce depression Increase number of immune system cells

(Less Stress)

Have participants sit comfortably in a chair or lie down on the floor and close their eyes. The lights should be turned off to help with relaxation. Jewelry can be taken off and tight clothing

69

should be loosened. Next, the Mountain Lake guided imagery from Michael Olpin’s Stress Relief CD is played.

Work Cited

Olpin, M. (2010). Stress management for life. (2 ed.). Belmont, CA: Wadsworth

Cengage Learning.

Diseases cause by stress. (n.d.). Retrieved from http://www.lesstress.net/diseases-

caused-by-stress.htm

Understanding stress symptoms, signs, sauses, and effects. (n.d.). Retrieved from

http://helpguide.org/mental/stress_signs.htm

Appendix C70

71

http://www.lesstress.net/diseases-

Cooking on a Budget

Women’s Health Workshop 2

Nina Saadati, Candice Carlson, Sarah Bauch, Rosa Portillo

Goal: The HEALTH Ladies will teach participants how to cook on a budget.

Learning Objective: After the workshop, participants will know how to get the most out of their grocery budget.

Behavioral Objective: At the workshop, 50% of the women will participate in making a meal plan.

Program Objective: At the workshop, the HEALTH Ladies will demonstrate and explain how to make money go farther when making food.

1. Ice breaker – demonstrate cheap and tasty food while we discuss current issues with making meals – Candice to start discussion; Sarah to make the food

a. Time - 10 minutes

b. Supplies:

i. Recipe

ii. Ingredients

iii. Cookware

c. Instructions

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i. Cooking demo and WIC discussion

ii. Make food and talk about cooking at home instead of going out

d. Questions to ask to start conversation

i. How often do you eat out instead of make dinner? Why?

ii. Does anyone think making dinner is difficult with kids? Why?

iii. What are some difficulties that you run into when trying to plan meals?

2. Meal Planning - How can you make your groceries go their farthest

a. Time

i. 15 minutes

b. Supplies

i. Pens

ii. Food lists

iii. Calendar

c. Instructions

i. Have participants make a meal calendar to use their groceries to their greatest potential

1. Start with a meat or protein

2. Add veggies

3. Add grain

ii. Have participants start with Monday

iii. Fill out the calendar with recipes that will use ingredients through out the week

iv. Learn meals that will be effective as starters of other meals in other meals during the week.

73

v. Explain that planning meals will make dinner prep and creation easier, cheaper, and faster

3. Seasonings – spicing up foods to get rid of boredom

a. Time – 15 minutes

b. Supplies

i. Seasonings

ii. Types of cuisines

c. Directions:

i. Smell and guess what the seasoning is

ii. Associate the seasoning cultural meal

iii. Explain how small changes in you foods can take bland to bold in the kitchen.

d. Questions to ask to start conversation

i. Do you like the way it smells?

ii. What does it remind you of?

iii. What foods do you think it would taste good with?

4. Make it cheaper…make it healthier

a. Time – 5 minutes

b. Supplies

i. none

c. Directions

i. Ask participants to list one of their favorite meals to make

ii. Ask if they want to make it cheaper or healthier

iii. Provide solutions to their request74

5. Tables in the back

a. WIC

b. Recipes

c. Cheap ways to pinch pennies on groceries

d. Easy kids meals

Works cited:

http://legacy.co.mohave.az.us/wic/CookingWithWICFoods.htm

http://www.food.com/cookbook/wic-friendly-recipes-231797

http://www.health.state.mn.us/divs/fh/wic/newwicfoods/ppt/foodfunfacts/recipes/index.html

75

Appendix C

76

Healthy RelationshipsWomen’s Health Workshop 3

Candice Carlson, Nina Saadati, Rosa Portillo, Sarah Bauch

Icebreaker: Funeral Scenario

Time: 5 minutes

Supplies: Paper, pencils, pens

Purpose: For participants to realize their values and determine what is important to them.

Directions: Have participants close their eyes while you read the following scenario. Have them imagine the scenario.

Imagine yourself going to the funeral of a loved one. Picture yourself driving to the funeral parlor or chapel, parking the car, and getting out. As you walk inside the building, you notice the flowers and the soft organ music. You see the faces of friends and family you pass along the way. You feel the sense of sorrow that permeates the room for losing this special person. You also sense the shared joy of having known this person that radiates from the hearts of all the people there.

As you walk down to the front of the room and look inside the casket, you suddenly come face to face with yourself. This is your funeral and all these people have come to honor you. They are here to express their feelings of love and appreciation for your life.

As you take a seat and wait for the services to begin, you look at the program in your hand. There are to be four speakers. The first speaker in someone from your immediate family – perhaps your mom or dad, brother or sister, or an aunt or uncle. The second speaker is one of your best friends, someone who is going to tell about the kind of person you were. The third speaker is from your work or an instructor in your school. The fourth is someone from your

77

church or community organization where you have been involved in service.Now think deeply. What would you like each of these speakers to say about you and

your life? What kind of son or daughter would you like their words to reflect? What kind of friend would you like to have others say you were? Were you there for others when they needed you? Did you care for them, trust them, and have a deep respect for them? What would your best friend say about you at your own funeral? What about someone who is a neighbor, but doesn’t know you very well? What contributions would you like them to have said you made to other people’s lives? What achievements would you want them to remember?

Have participants write down their thoughts and values after imagining the scenario. Discuss and share.

Activity 1: Healthy Relationships

Time: 10 minutes

Supplies: Markers, Whiteboard

Purpose: To have participants discuss and share what is important to them in a relationship. Participants will learn signs of a healthy relationship.

Directions: Ask participants what is important to them in a relationship and why. Discuss and write on whiteboard.

Examples include:

Acceptance Communication Compromise Maturity

Admiration Love Sex Trust

Appreciation Patience Passion Honesty

Balance Gratitude Forgiveness Family

Caring Friendship Warmth Stability

Commitment Responsibility Fun Liveliness

Discuss signs of a healthy relationship:

78

Feeling secure when alone or when you are together. You do not feel angry, deprived, sad, or suspicious.

Help and inspire one another to achieve goals and dreams. Show generosity and give all you can in your relationship. This inspires you to

help and give to others all around you.

Discuss how to have a successful relationship.

Communicate with one another. Learn and grow from each other. Be supportive and kind towards each other. Laugh and have fun. Be honest and loyal. Admit when you have made a mistake. Forgive. Don’t bring up previous relationships Be willing to negotiate and compromise. Share with each other what your needs are. Understand that a partner cannot fulfill every need. Don’t expect a partner to change to fulfill your expectations, accept that your

ideal partner is different from the person you are dating. See other point of views. Get professional help sooner rather than later.

Activity 2: Recipe for a Healthy Relationship

Time: 15 minutes

Supplies: paper, pencils, pens

Purpose: Have participants create a recipe based upon their needs in a relationship.

Directions:

Have each participant come up with a healthy relationship recipe. Have participants think about the “ingredients” they would include and how much they need. Decorate and share.

Example includes: 5 cups of honesty, a pinch of trust, a teaspoon of laughter.

Activity 3: Unhealthy Relationships

79

Time: 5 minutes

Supplies: None

Purpose: Help participants recognize the signs of an unhealthy and abusive relationship.

Directions:

Discuss signs of an unhealthy relationship

Feeling insecure around each other. Have low self-esteem Dishonesty Lack of trust. Complaining to others about your relationship. Unable to resolve differences. Feel hurt about how you treat each other. Can’t talk about problems with one another. Can’t solve problems together. Conflicts interfere with other aspects of life. Broken trust.

Signs of an Abusive Relationship:

1) Jealousy2) Controlling behaviors3) Isolation4) Threats of violence5) Verbal abuse6) Blaming others for mistakes or problems7) Unrealistic expectations8) Past battering9) Hypersensitivity10) Cruelty to children or animals

Activity 4: Group Activity

Time: 10 minutes

Supplies: Paper, markers

Purpose: Have participants recognize healthy and unhealthy relationships between friends, partners, children, and teachers.

Directions:

80

Split participants into four groups. Have each group list signs of a healthy and unhealthy relationship between each relationship.

Group 1: Romantic

Group 2: Parent-child

Group 3: Teacher-student

Group 4: Friend-Friend

Share and discuss answers.

Activity 4: 5 Love Languages

Time: 15 minutes

Supplies: Quizzes, pencils, pens

Purpose: Have participants about the different ways to show love relating to the 5 love languages.

Directions: Discuss the 5 love languages and have participants take a quiz.

1) Words of Affirmation: Compliments mean so much to you. Hearing “I love you” has great meaning to you and hearing the reasons for their love makes you happy. Insults may not easily be forgotten.

2) Quality Time: Spending time together, with undivided attention, shows “I love you.” It is important to have them there for you, with no distractions. It may hurt when they don’t listen, dates are postpones, or they become distracted.

3) Receiving Gifts: Focuses on the thoughts and love shown behind receiving a gift. By receiving gifts you feel cared for, recognized, and prized for your sacrifices. Missing a birthday or anniversary would be disastrous.

4) Acts of Service: Easing the burdens of others by volunteering “to do that for you.” Cleaning and performing service speaks wonders. Laziness hurts a person with this love language.

5) Physical touch: Likes hugs, holding hands, pats on the back, or a touch of the arm, shoulder, or face show love, care, and excitement. Neglect or abuse can be destructive to this love language.

Have participants take the 5 love languages quiz and discuss results.

Work Cited:

81

5 love language quiz and info

http://helpingmarriageswork.com/docs/resources/the-5-love-languages-quiz.pdf

Signs of abusive relationship

http://date.lifetips.com/tip41669/warning-signs/warning-signs/15-signs-of-an-abusive-relationship.html

How to have a successful, healthy relationship, unhealthy relationship

http://us.penguingroup.com/static/html/cig/pdf/0028642066.pdf

82

Appendix E

83

http://us.penguingroup.com/static/html/cig/pdf/0028642066.pdf



http://helpingmarriageswork.com/docs/resources/the-5-love-languages-quiz.pdf

Stress and RelaxationWomen’s Health Workshop 4

Rosa Portillo, Sarah Bauch, Candice Carlson, Nina Saadati

Icebreaker: Benefits of Relaxation Techniques (5 minutes)

Purpose: To get participants to understand the many benefits of relaxation techniques.

Materials: (Optional)

Pens, markers, pencils, dry erase markers, chalk Notepad, or Whiteboard/Chalkboard

Directions:

1. Have participants brainstorm ideas of what some benefits are. You may want participants to write their ideas down on a notepad, or on a whiteboard/chalkboard.

2. Discuss the following information with participants:The benefits of relaxation techniques -

When faced with numerous responsibilities and tasks or the demands of an illness, relaxation techniques may take a back seat in your life. But that means you might miss out on the health benefits of relaxation.

84

Practicing relaxation techniques can reduce stress symptoms by:

Slowing your heart rate Lowering blood pressure Slowing your breathing rate Increasing blood flow to major muscles Reducing muscle tension and chronic pain Improving concentration Reducing anger and frustration Boosting confidence to handle problems

To get the most benefit, use relaxation techniques along with other positive coping methods, such as exercising, getting enough sleep, and reaching out to supportive family and friends (Mayo Clinic, 2011).

Activity 1: Your Best Self (10 minutes)

Purpose: Discuss how you feel when you are not stressed. When people are not stressed, they are more likely to be at their best in all aspects of life.

Materials:

1 ball with phrases written on it.

Directions:

1. Write the following phrases all over a ball: - I feel happiest when…- I have fun by…- I feel calm when…- I relax by…- I enjoy…- I use my free time to…

2. For safety purposes, have participants stand for this activity.

85

3. Throw the ball to one individual to catch.4. Have the person who caught the ball finish the phrase that is closest to her right

thumb.5. Continue doing this for about 7 minutes.6. Finish the activity with a discussion about:

-Why we do all of these things:-How we feel when we are not stressed -How we feel when we take time to relax

Activity 2: Self-Massage (5-10 minutes)

Purpose: To use massage as a personal relaxation method. With this activity, participants will learn a simple technique they can use to relax when they do not have a lot a free time.

Materials:

No materials are necessary for this activity.

Directions:

1. Instruct participants to do the following: Place both hands on your shoulders and neck. Squeeze with your fingers and palms. Rub vigorously, keeping shoulders relaxed. Wrap one hand around the other forearm. Squeeze the muscles with thumb and fingers. Move up and down from your elbow to fingertips and back again. Repeat with other arm.

(Stamos Kovacs, 2011)2. While participants practice self-massage, emphasize how a simple technique like

this can help relieve stress.

Activity 3: Visualization (10 minutes)86

Purpose: To form mental images for the purpose of relaxation. Participants will use their imagination to create a mental image of a setting they perceive as relaxing.

Materials:

Paper Pens, pencils, crayons, colored pencils, markers

Directions:

1. Ensure that the room is quiet, and conducive to relaxation.2. Explain that in this technique, participants will “form mental images to take a

visual journey to peaceful, calming place or situation” (Mayo Clinic, 2011).3. Instruct participants to get into the most comfortable position possible and to

close their eyes.4. Tell participants to begin imagining their personal paradise. Whatever it may be

– a mountain scene, a sandy beach, an open field – allow them to begin imagining their paradise.

5. Ask the participants to use as many senses as possible – sight, smell, touch, sound.“If you imagine relaxing at the ocean, for instance, think about such things as the smell of salt water, the sound of crashing waves and the warmth of the sun on your body” (Mayo Clinic, 2011).

6. After 5 minutes of visualization, ask participants to draw, or descriptively write what their paradise looks light.

7. Conclude this activity by explaining that these pictures/descriptions can help reflect back to their personal paradise.

Activity 4: Mantra Meditation (10-15 minutes)

Purpose: To practice mantra meditation for the purpose of relaxation.

87

Materials:

No materials are necessary for this activity.

Directions:

1. Take about 2-3 minutes to explain the purpose and benefits of meditation. This includes:

2. Instruct participants to choose any word they would like as their mantra. A mantra is a sound, word, or phrase that you repeat over and over, as a focus point, to help you relax. Examples include, but are not limited to: peaceful, calm, serene, relax, still, soothe, or I am peaceful, I am calm, I am serene, etc.

3. Ensure the room is quiet, and conducive to relaxation. It is encouraged that the lights are turned off for this activity.

4. Tell participants to get into the most comfortable position as possible, allow them to sit in a chair, or lay on a floor. They may also want to loosen any tight clothing and remove jewelry and/or glasses.

5. Instruct participants to close their eyes and take a couple of slow, deep breaths. 6. After about 30 seconds, instruct participants to slowly begin repeating their

mantra. Repetition should slightly mirror the participants’ slow, deep breaths. 7. Explain to participants that if their mind begins to wander, simply acknowledge

the thoughts, and passively return their focus to repeating their mantra.8. Allow participants to continue this process for about 10 minutes.9. After 10 minutes, instruct participants to slowly return their minds to full

consciousness allow about 2-3 minutes to do so, do not hurry to end meditation.

Works CitedMayo Clinic. (2011, May 19). Stress Management. Retrieved October 26, 2011, from

Mayo Clinic: http://www.mayoclinic.com/health/relaxation-technique/SR00007/NSECTIONGR

88

OUP=2

Stamos Kovacs, J. (2011, October 21). Blissing Out: 10 Relaxation Techniques to Reduce Stress On-the-Spot. Retrieved October 26, 2011, from WebMD: http://www.webmd.com/balance/stress-management/features/blissing-out-10-relaxation-techniques-reduce-stress-spot?page=2

89

Appendix F

90

http://www.webmd.com/balance/stress-management/features/blissing-out-10-relaxation-techniques-reduce-stress-spot?page=2

http://www.webmd.com/balance/stress-management/features/blissing-out-10-relaxation-techniques-reduce-stress-spot?page=2

ReferencesA Dictionary of Nursing. (2008). quantitative research. Retrieved October 28, 2011, from

Encyclopedia.com: http://www.encyclopedia.com/doc/1O62-quantitativeresearch.html

Healthy People. (2010). Healthy People 2010. Retrieved October 20, 2011, from Healthy People 2010: http://www.healthypeople.gov/2010/About/hpfact.htm

Johnson, R. B., & Christensen, L. (2010). Writing Quantitative Research Questions. Retrieved October 23, 2011, from Educational Research Quantitative, Qualitative, and Mixed Approaches: http://www.southalabama.edu/coe/bset/johnson/oh_master/Ch3/Tab03-07.pdf

Leedy, P. D., & Ormrod, J. E. Practical researchplanning and design. (9 ed., pp. 135, 148,153-154). Upper Saddle River, NJ: Pearson Education, Inc.

McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2009). Planning, implementing, and evaluating health promotion programs. (5 ed., p. 362). San Francisco, CA: Pearson Benjamin Cummings.

The Pell Institute. (2011). Analyze Quantitative Data. Retrieved October 23, 2011, from Evaluation Toolkit: http://toolkit.pellinstitute.org/evaluation-guide/analyze/analyze-quantitative-data/

http://www.acf.hhs.gov/programs/ohs/index.html

http://www.countyhealthrankings.org/utah/weber

http://www2.ed.gov/about/offices/list/ope/trio/incomelevels.html

http://www.owcap.org/

http://www.usa.com/ogden-ut-income-and-careers.htm

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