Wellness Program Implementation: School & Student Toolkits
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 14 - 20 |
| Updated: | 12/6/2018 |
| Start Date: | July 2013 |
| End Date: | June 30, 2018 |
The project is designed to evaluate a participatory implementation model in HealthCorps (HC)
high schools and to assess outcomes within and across school settings . The behavioral
objectives from the 2010 Dietary Guidelines to address obesity in youth include: 1)
decreasing sugary beverage intake; 2) increasing frequency of breakfast; 3) increasing
vegetable and fruit intake to 2½ cups per day;4) decreasing frequency of fast food meals;5)
becoming physically active (goal of 1 hour per day); and 6) reducing sedentary behavior time
(<2 hour day). The study is employing system dynamics modeling (SDM) to assess wellness
programming options and to evaluate the program implementation within the context of diverse
school ecologies. The RE-AIM evaluation metric (Reach, Effectiveness, Adoption,
Implementation, and Maintenance) is used to guide SDM development and validation.
The Specific Aims are:
1. To use PAR (Participatory Action Research) methods to refine the school wellness program
model and toolkit components that address institutional/community level program
implementation barriers and individual level barriers to achieving healthy lifestyle
recommendations.
2. To assess the effectiveness of program components using process evaluation techniques
guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance)
model.
3. To evaluate implementation with system dynamics modeling to facilitate dissemination.
The simulation analysis will apply the RE-AIM framework to address: Reach (participation
rates), effectiveness (outcomes), adoption (acceptability), implementation (intervention
fidelity), and maintenance (sustainability of lifestyle changes by students and programs
by schools), in order to facilitate refining the toolkits and training program for
dissemination to other school setting and diverse educational venues.
high schools and to assess outcomes within and across school settings . The behavioral
objectives from the 2010 Dietary Guidelines to address obesity in youth include: 1)
decreasing sugary beverage intake; 2) increasing frequency of breakfast; 3) increasing
vegetable and fruit intake to 2½ cups per day;4) decreasing frequency of fast food meals;5)
becoming physically active (goal of 1 hour per day); and 6) reducing sedentary behavior time
(<2 hour day). The study is employing system dynamics modeling (SDM) to assess wellness
programming options and to evaluate the program implementation within the context of diverse
school ecologies. The RE-AIM evaluation metric (Reach, Effectiveness, Adoption,
Implementation, and Maintenance) is used to guide SDM development and validation.
The Specific Aims are:
1. To use PAR (Participatory Action Research) methods to refine the school wellness program
model and toolkit components that address institutional/community level program
implementation barriers and individual level barriers to achieving healthy lifestyle
recommendations.
2. To assess the effectiveness of program components using process evaluation techniques
guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance)
model.
3. To evaluate implementation with system dynamics modeling to facilitate dissemination.
The simulation analysis will apply the RE-AIM framework to address: Reach (participation
rates), effectiveness (outcomes), adoption (acceptability), implementation (intervention
fidelity), and maintenance (sustainability of lifestyle changes by students and programs
by schools), in order to facilitate refining the toolkits and training program for
dissemination to other school setting and diverse educational venues.
This research project focuses on enhancing implementation of school wellness activities with
the goal of achieving federal lifestyle recommendations to reduce obesity. The study will
evaluate whether using a toolkit approach with problem-solving and other strategies helps
schools and students develop healthier lifestyle choices.
At the school level, we will focus on implementation barriers identified by (or brought to)
the school Wellness Champion Network (e.g., crowded gym, lack of equipment, food service
issues) using a toolkit approach that builds on the Alliance for a Healthier Generation
school toolkits.
At the student level, the toolkit will focus on a self-assessed health-behavior feedback
mechanism to personalize behavioral goal setting when addressing obesity related lifestyle
recommendations.
An iterative intervention dissemination will be used to achieve sequential roll out to all
HealthCorps-affiliated Living Lab schools over time. This design allows for an increasingly
larger selection of schools to receive the enhanced support through participation research
principles to determine how to address obesity-related school mandates. Consistent with
participatory research principles, all HealthCorps coordinators have received training to
function as Wellness Council facilitators. This study will evaluate a participatory
implementation model designed to extend wellness and stakeholder collaborations towards
achieving policy standards and goals focusing on the school wellness network. By the end of
the study, all HealthCorps Living Labs schools will be implementing this participatory
implementation for wellness programming.
This implementation approach increases the potential for learning lessons that can be
generalized more widely as in pragmatic trials. In keeping with participatory research
principles, school Wellness Councils will use data obtained during the trial as feedback for
potential refinement of their toolkit components.
The research team will work with school Wellness Councils and key stakeholders to develop
additional school toolkit items utilizing problem-solving strategies and low-cost methods to
address implementation barriers. The elements of participatory action research focus on
forming a school Wellness Council partnership to build trust, shared vision, and mutual
capacity, and includes engagement at multiple levels as well as active participation of
stakeholders to create more salient and effective programs. The HealthCorps coordinator will
guide stakeholders via the Wellness Council network and by specific program area to engage in
a 6-step iterative process listed below:
1. Examine local indicator data e.g., FitnessGram, Health Behavior Survey with Youth
Behavioral Risk Factor Surveillance System (YBRFSS) items, food service data, school
environment/climate data, community data
2. Consider how current programs/curricula and alternatives relate to behavioral indicators
(using a social ecological framework) to student, family, school, and community
consideration of media and other spheres of influence,
3. Develop program/curriculum S.M.A.R.T. (specific, measurable, attainable, realistic and
time limited (considering semester/school year)) goals focusing on Dietary Guidelines,
mental resilience, and FitnessGram indicators
4. Identify barriers and develop strategies for the school and student toolkit
5. Implement school program elements with ongoing monitoring by stakeholders and the
Wellness Council
6. Use an iterative process to adapt to new needs and sustain program
Basic simulation models will be used to demonstrate the potential effects of implementing a
given toolkit option. The school and student toolkits developed during the formative
evaluation will serve as a template to be used with the intervention schools. The initial
training and guide/toolkit formatting will be based on those used by the Alliance for a
Healthier Generation in their school wellness programming. Initial feedback from HealthCorps
coordinators indicates that the Alliance Wellness Council guide/toolkit can be readily
implemented in HealthCorps high schools. The HealthCorps coordinators will build on the
Alliance's collaborative guidelines and training to enhance collaboration as an active
Wellness Council. In addition, to build youth leadership thereby obtaining student support,
the toolkit will include demonstration exercises to be lead by HealthCorps coordinators in
collaboration with student leaders and school wellness stakeholders. These demonstration
activities, linked to the intervention's behavioral objectives, provide share-able knowledge
and skills to promote positive health behavior change.
The outcomes simulation will expand the types of data used to include the survey's
psychosocial variables and extensive administrative data such as attendance, demographics,
and reduced/free lunch and student, teacher and parent school evaluations.
the goal of achieving federal lifestyle recommendations to reduce obesity. The study will
evaluate whether using a toolkit approach with problem-solving and other strategies helps
schools and students develop healthier lifestyle choices.
At the school level, we will focus on implementation barriers identified by (or brought to)
the school Wellness Champion Network (e.g., crowded gym, lack of equipment, food service
issues) using a toolkit approach that builds on the Alliance for a Healthier Generation
school toolkits.
At the student level, the toolkit will focus on a self-assessed health-behavior feedback
mechanism to personalize behavioral goal setting when addressing obesity related lifestyle
recommendations.
An iterative intervention dissemination will be used to achieve sequential roll out to all
HealthCorps-affiliated Living Lab schools over time. This design allows for an increasingly
larger selection of schools to receive the enhanced support through participation research
principles to determine how to address obesity-related school mandates. Consistent with
participatory research principles, all HealthCorps coordinators have received training to
function as Wellness Council facilitators. This study will evaluate a participatory
implementation model designed to extend wellness and stakeholder collaborations towards
achieving policy standards and goals focusing on the school wellness network. By the end of
the study, all HealthCorps Living Labs schools will be implementing this participatory
implementation for wellness programming.
This implementation approach increases the potential for learning lessons that can be
generalized more widely as in pragmatic trials. In keeping with participatory research
principles, school Wellness Councils will use data obtained during the trial as feedback for
potential refinement of their toolkit components.
The research team will work with school Wellness Councils and key stakeholders to develop
additional school toolkit items utilizing problem-solving strategies and low-cost methods to
address implementation barriers. The elements of participatory action research focus on
forming a school Wellness Council partnership to build trust, shared vision, and mutual
capacity, and includes engagement at multiple levels as well as active participation of
stakeholders to create more salient and effective programs. The HealthCorps coordinator will
guide stakeholders via the Wellness Council network and by specific program area to engage in
a 6-step iterative process listed below:
1. Examine local indicator data e.g., FitnessGram, Health Behavior Survey with Youth
Behavioral Risk Factor Surveillance System (YBRFSS) items, food service data, school
environment/climate data, community data
2. Consider how current programs/curricula and alternatives relate to behavioral indicators
(using a social ecological framework) to student, family, school, and community
consideration of media and other spheres of influence,
3. Develop program/curriculum S.M.A.R.T. (specific, measurable, attainable, realistic and
time limited (considering semester/school year)) goals focusing on Dietary Guidelines,
mental resilience, and FitnessGram indicators
4. Identify barriers and develop strategies for the school and student toolkit
5. Implement school program elements with ongoing monitoring by stakeholders and the
Wellness Council
6. Use an iterative process to adapt to new needs and sustain program
Basic simulation models will be used to demonstrate the potential effects of implementing a
given toolkit option. The school and student toolkits developed during the formative
evaluation will serve as a template to be used with the intervention schools. The initial
training and guide/toolkit formatting will be based on those used by the Alliance for a
Healthier Generation in their school wellness programming. Initial feedback from HealthCorps
coordinators indicates that the Alliance Wellness Council guide/toolkit can be readily
implemented in HealthCorps high schools. The HealthCorps coordinators will build on the
Alliance's collaborative guidelines and training to enhance collaboration as an active
Wellness Council. In addition, to build youth leadership thereby obtaining student support,
the toolkit will include demonstration exercises to be lead by HealthCorps coordinators in
collaboration with student leaders and school wellness stakeholders. These demonstration
activities, linked to the intervention's behavioral objectives, provide share-able knowledge
and skills to promote positive health behavior change.
The outcomes simulation will expand the types of data used to include the survey's
psychosocial variables and extensive administrative data such as attendance, demographics,
and reduced/free lunch and student, teacher and parent school evaluations.
Inclusion Criteria:
- Students (grades 9-12).
Exclusion Criteria:
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