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FIT FOR FAMILY PROGRAM EVALUATION 1
Implementation and Evaluation of Fit for Family:
A Family-based Community Education Program
Joseph Kalscheur
University of Wisconsin – Stout
December 18th, 2013
FIT FOR FAMILY PROGRAM EVALUATION 2
Abstract
In November, 2013, a family-based community education program titled Fit for Family
joined the growling battle against obesity in America. In Dunn County Wisconsin, obesity rates
and low income levels both exceed the state averages. With an above average obesity rate and
low income level, Dunn County Wisconsin was seen as a prime location for Fit for Family to
administer curricula focused on increasing the acceptance of and knowledge about the health
benefits of a healthful diet and physically active lifestyle. The goal of the implementation of Fit
for Family was to bring families together in a fun and interactive environment that fosters
healthy lifestyle choices in wake of an obesity epidemic. Fit for Family involved three 90-minute
sessions that meet once a week. Each session was broken up into three main components: healthy
snack, nutrition education, and physical activity, where community volunteers from all around
the county came and lent a hand. Evaluation of this program was administered via pre-and-post
surveys. Results from these surveys indicate that this program was in deed effective in improving
participant’s knowledge and acceptance towards making healthy lifestyle choices. Due to
relatively small sample size, and many lurking variable with this kind of study, further research
is needed to generate more conclusive evidence on the effectively of this program.
FIT FOR FAMILY PROGRAM EVALUATION 3
Introduction
There is a great need for the programs that are centered on healthy eating and physical
activity throughout the state of Wisconsin, particularly in Dunn County. According to the
Wisconsin Nutrition Education Program (WNEP), in 2011, 53% of all deaths in Wisconsin were
due to heart disease, cancer, and diseases clearly linked to diet (An Investment in Wisconsin,
2013). WNEP data from 2009 show that only 23% of Wisconsin adults eat the recommended
serving of fruit and vegetables. (An Investment In Wisconsin, 2013). According to the Wisconsin
Diabetes and Prevention Control Program, Division of Public Health, and Department of Health
Services, the burden of food and nutrition-related diseases in the area is substantial and reflects
the rates of overweight and obese people around the nation, with 63% of adults being classified
as either overweight or obese and roughly 26% being classified as obese. In Dunn County,
approximately 24% of the adult population is identified as having high blood pressure, a disease
linked to excess consumption of high sodium processed foods and low consumption of fruits and
vegetables (Wisconsin Diabetes and Prevention Control Program, Division of Public Health, and
Department of Health Services, 2011). The fact of the matter is that poor eating habits are highly
associated to poor health.
Low-income families are particularly susceptible, with inadequate diets and less
knowledge about nutrition recommendations than families with more financial resources
(Wisconsin Nutrition Education Program: An Investment in Wisconsin, 2013). The poverty level
in Dunn County is higher than the average in the state of Wisconsin, with 15.5% of the
population in Dunn County below the poverty level, compared to the state rate of 12% (U.S.
Census Bureau, 2011). This trend in having higher than average poverty rates in Dunn County
transcends to having a significant percentage of students enrolled in the Menomonie School
FIT FOR FAMILY PROGRAM EVALUATION 4
District who participate in the free and reduced lunch program. In Dunn County, the percentage
of students participating in the free and reduced lunch program ranges from 25.9% in Oaklawn
Elementary School to 65.8% in River Heights Elementary School. Fit for Family aims to address
this population by forming a strong partnership with River Heights Elementary school coinciding
with it being designated as the host site for which Fit for Family will be instituted.
Purpose & Objectives
The goal of the implementation of Fit for Family was to bring families together in a fun
and interactive environment that fosters healthy lifestyle choices in wake of an obesity epidemic.
The intended outcomes for this program were to engage, educate, and empower families to make
healthier lifestyle choices that can eventually turn into habits. As a pilot study, this project was
not designed with the intent to uncover any earth-shattering findings that; nevertheless, this
project was developed to act as a firm stepping stone for future community health education
projects to learn from and expand upon our efforts. Specifically, the evaluation of Fit for Family
aimed to accomplish the following objectives:
1. Assess the effectiveness of the Fit for Family program on increasing the knowledge about
the health benefits of eating nutritiously (e.g. building a healthier plate, or balancing
sugar, fat, and salt within diet).
2. Assess the effectiveness of the Fit for Family on empowering families to make a healthy
lifestyle change in their personal lives (e.g. cook more home-cooked meals, be more
physically active, etc.).
3. Identify particular instructional methods that prove to be more effective than others.
FIT FOR FAMILY PROGRAM EVALUATION 5
The purpose of this research project was to evaluate the effectiveness of the Fit for Family
program in Menomonie, Wisconsin. Fit for Family focused on increasing the acceptance of and
knowledge about the health benefits of a healthful diet and physically active lifestyle. Initial
hypothesis for this project is as follows: if families actively participate in three 90-minute
community education sessions centered on nutrition and physical activity, then they will increase
their acceptance of and knowledge about making healthy life-style choices.
Review of Literature
One of the first seminal studies related to health and fitness in America was coauthored
by Dr. Hans Kraus and Bonnie Prudden in December 1953. The article “Muscular Fitness and
Health” sounded an alarm about the poor state of youth fitness in America (President’s Council
on Fitness, Sports and Nutrition, 2013). In the years that followed, growing concerns reached the
national level as President Eisenhower created the President’s Council on Youth Fitness in June
1956. From that point on, the Presidents Council has continued to grow and adapt as the needs of
the American people also grow and change over time. As the Council stands today, with
President Obama as their leader, the mission of the Presidents Council is to “engage, educate,
and empower all Americans to adopt a healthy lifestyle that includes regular physical activity
and good nutrition” (President’s Council on Fitness, Sports & Nutrition). Thereby, the program
outcomes and objective of Fit for Family augments the efforts supported by the current President
of the United States of America, Barrack Obama, and his affiliates.
Methodologies
A mixed methods research approach was used to assess the effectiveness of Fit for
Family. A quantitative evaluation measuring the effectiveness of Fit for Family was conducted
FIT FOR FAMILY PROGRAM EVALUATION 6
using pre-and post-surveys, modeled after pre-and-post surveys developed by the Department of
Agriculture, Trade and Consumer Protection (DATCP) (see appendix for sample surveys). The
time efficient surveys allowed us to collect the data we were interested in, while also exploiting
the limited amount of time we had to cover all the content and activities of each session. We
used the DATCP surveys as a model for the development of our own pre-and post-surveys
because; we knew they had been successfully used by other community outreach program
planners.
The qualitative assessment was collected from the post survey, where respondents were
asked to answer five open-ended questions. A benefit of including this qualitative component
into our data collection was that it allowed us to develop a more clear understanding of what the
participant’s thoughts and feelings were of this program by hearing it directly from the source.
The use of mixed methods research in this study was supported by Susan Foxwell, Director of
Research Services at the University of Wisconsin – Stout. During an in-person interview with
Foxwell, she explained that the mixed methods approach is always the most preferred method
because it provides an assessment of treatment from more than one perspective (S. Foxwell.
2013).
The program outline for Fit for Family did not follow any one particular community
health outreach program, but it was the product of collaborate brainstorming and strategic
planning between invested students, school administrators, community partners, school
educators, campus leaders, and local businessman.
Program Implementation
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Fit for Family meet once a week for three weeks on Thursdays from 6:00 pm to 7:30 pm
at the River Heights Elementary School between the dates of November 7th, 2013 and November
21st, 2013. The Fit for Family program was featured in the Fall 2013 Community Education
Guidebook for the School District of Menomonie. This Guidebook is disseminated to each family
enrolled in the School District of the Menomonie Area on a quarterly basis by Kale Proksch,
District Facilities Community Education Coordinator for the Menomonie Area School District.
Registration forms, along with the promotional fliers (see appendix for both) were original
documents made specifically for Fit for Family and were disseminated to each of the five
elementary schools within the Menomonie Area School District, separate to the Fall 2013
Community Education Guidebooks. These registration forms, along with a five dollar registration
fee were mandatory for each family to fill out and turn in before they could be accepted into the
Fit for Family program. The deadline to which families had to turn this form in was November
5th, 2013 (two days before the program started). Completed registration forms and fees were
either turned into Kale Proksch, Sarah Place (Grant Coordinator for the River Heights
Elementary School), or myself. Once registered, families (no matter the size) could expect to
participate in the programs three 90-minute sessions that were centered on nutrition and physical
activity. Each session was broken up into three main components: healthy eating, nutrition
education, and physical activity.
Healthy eating. This segment was offered during the first 15-20 minutes of the program.
This timeframe was chosen to allow families enough time to check-in at the registration table
upon arrival, grab a bite to eat, and then find a place to sit and eat comfortably together as a
family without being pressed for time. We were also informed by Sarah Place, who lead similar
community education events in the past, that it is common to have families arrive 10-15 minutes
FIT FOR FAMILY PROGRAM EVALUATION 8
late (which turned out to be absolutely true). Ultimately, offering the snacks at that time seemed
effective in insuring families had enough time to cozy-in before the actual didactic learning
began. The snacks were funded in part by the five dollar registration fee each family was
required to pay before participating. The vast majority of the snacks, however, were supplied by
community supporters such as UW-Extension, the Menomonie Area School District Food
Service Department, and the Menomonie Food Market Co-op.
Nutrition education. Immediately following the healthy eating time, families were taken
through a series of nutrition-focused presentations, demonstrations, games, and group
discussions. Each session was focused on a specific area of nutrition as shown below in Table 1.
The nutrition education sessions were led by Kara Helget, an AmeriCorps Farm to School
Nutrition Educator in the Menomonie Area School District. We also partnered with UW-
Extension, Mayo – Menomonie’s Education Center, and the Menomonie Food Market Co-op.
UW-Stout student volunteers also helped with the planning and delivery of the nutrition
education lessons. The goal of these lessons was not to lecture the families via PowerPoint.
Instead, we aimed to cover the material in a more informal, fun, and interactive way. This
presentation style allowed us to be more appealing for participants of any age. To help make
these lessons more kid friendly, we approved our plan with two UW-Stout students enrolled in
the Early Childhood Education program. While we still used PowerPoints at each of the three
sessions, we designed them to serve a secondary supportive roll to that of visual demonstrations,
group discussions, and games. Handouts were also created to highlight the main teaching or take-
a-way points that Kara covered at each session so that the families would have the information
on-hand for future reference. The SmartBoard technology was also used to deliver nutrition
education lessons to the youth population.
FIT FOR FAMILY PROGRAM EVALUATION 9
Physical activity. Following the nutrition education lessons, the remainder of each
session was devoted to bring families closer together through play and physical activity. Again,
each session focused on a separate avenue of movement-driven activities such as (1) Football
Training Camps with the UW-Stout Football team, (2) team building with University Recreation
– Stout Adventures, (3) Laughter Yoga with Sue Halama and Medic ball (Dodge ball) with help
from Mrs. Munoz, who is the physical education teacher at River Heights. Below you will find
the basic program outline for each of the three Fit for Family sessions, including the key
stakeholders who were held responsible for each particular activity.
Table 1: This table shows the major themes and activities for each of the three Fit for Family sessions.
Data Collection Procedures
There were two different methods of data collection used to assess the effectiveness of Fit
for Family: (1) registration forms and attendance records and (2) surveys.
FIT FOR FAMILY PROGRAM EVALUATION 10
Registration forms and attendance record. By the November 5th deadline, we received
18 completed family registration forms (Note: we did accept one unregistered family of five who
showed up the day of the event). The information included on these documents allowed us to
gain great perspective on the demographic of people who plan to participate during Fit for
Family. Such information included the name, age, grade level in school (if child), and special
needs of each family member planning to attend. Once all the forms were collected, information
from each form was compiled using Excel Software and then reviewed to identify any particular
patterns, trends, or special needs that should to be accounted for in program planning. From this
listing of participants, an attendance roster was generated that was later used to check-in each
participant before each session.
Pre-and-post surveys. The pre-and-post surveys used in this study served as the primary
data source in the assessment of Fit for Family. The pre-survey was disseminated at the
beginning of the 1st session while the families ate their healthy snack and before any nutrition
education content was covered. The post-survey was disseminated just before the families were
dismissed on the 3rd and final session. We neglected to survey the youth participants due to the
fact that we only had a limited amount of time to collect survey data without taking time away
from the programs scheduled activities. For our purposes, we classified any participant in 7th
grade or below as being a “youth”. The sample sizes for the pre-and-post surveys were 14 adults
and 11 adults, respectively. After all the anonymous surveys were collected, data from these
surveys was plotted using Microsoft Excel software. For objective I, we compared the difference
between the pre-and-post mean response values of two different survey questions: (Q1) “Rate
your level of knowledge on building a healthy plate.” and (Q2) “Rate you level of knowledge on
balancing sugar, fat, and salt in your diet.” Responses for these questions were based on a 1 to 5
FIT FOR FAMILY PROGRAM EVALUATION 11
scale with one being “none” and five being “extensive”. The mean value of the pre-and-post
survey responses for each question was then plotted and compared, as shown in Figure 4. For
objective II, this same process was repeated except for two different survey questions were
assessed: (Q3) “Rate your level of comfort on preparing healthy meals with your family.” (Q4)
“How motivated are you to make healthy lifestyle changes in your life?” These four scale-rated
questions served to provide quantitative data used in the assessment of objectives I and II. For
objective III, we looked at the variation in responses to the following open-ended questions as
they appeared on the post-survey: (1) “What was your favorite part of this program?” (2) “What
recommendations would you make to help us improve future programing? Additional questions
were added to the pre-and-post surveys for the purposes of uncovering useful information that
could also help guild future programs.
Results
The data collected from our attendance record showed that of the 67 registered
participants (19 registered families), 61 participants (17 families) attended session one, 45
participants (12 families) attended session two, and 32 participants (11 families) attended session
three. Thereby, the attendance rate of participants decreased in a somewhat linear fashion with
each offered session. The number of families also decreased, though at lesser rate. See figure 2
for a visual representation of this data.
FIT FOR FAMILY PROGRAM EVALUATION 12
Session 1 Session 2 Session 30
20
40
60
Participant vs. Family Attendance
FamiliesParticipants
Duration of Program Re
cod
of A
tten
danc
e
Figure 2: This graph shows attendance pattern of families and participants throughout Fit for Family.
Surveys
The pre-and-post mean response ratings to the four scale-rated questions used to test
objectives I and II are shown in Figure 4. As the results show, the mean scale-rated response
increased went up in value at the time of increased from pre-to-post, suggesting that Fit for
Family was effective on improving participant’s knowledge about eating nutritiously, while also
empowering them to make a healthy lifestyle change. Given that there are many lingering
variables that are likely to be at play with these results, more extensive evaluations need to be
conducted before these results can have merit.
01.5
34.5
3.867 3.625 3.4674.334 3.909 4.273 4.364
Pre-and-Post Survey Scale-Rated Responces
Pre-SurveyPost-Survey
Responce Categories
Ratin
g Sc
ale¹
FIT FOR FAMILY PROGRAM EVALUATION 13
Figure 4: This graph shows relationship between the pre-and-post mean response ratings to each of the
four featured researches questions.
To identify what instructional methods participants liked the best we asked the post-
survey sample subjects to provide narrative feedback responses to the following focus areas:
(1)“What was your favorite part of this program?” and (2)”Please list at least one
recommendation or suggestion to help us improve future programming.” Each response was
recorded as they were written. If sample subjects provided more than one answer (e.g. favorite
part was physical activity and meal suggestions) then each part would be counted individually at
the same weight. Duplicate responses were added together. The data sets from these two
response narratives can be seen below in Figure 5 and 6.
Physical
activit
yies
Games
Healthy e
ating
Food
Medic B
all
Kids acti
vities
Meal Su
ggesti
ons
Laugh
ter Yo
ga All 0
1
2
3
4
5
Favorite part of the program?
Program Favorits
Num
ber o
f Res
onde
nts
Figure 5: This graph shows the program “favorites” as seen by the post-survey sample subjects.
As shown in Figure 5, nine of the 14 responses are linked to the physical activity
component of Fit for Family (e.g. physical activities, games, Medic-ball, Laughter Yoga), while
FIT FOR FAMILY PROGRAM EVALUATION 14
the other five responses were shared between the food and nutrition education components. This
sufficient trend strongly suggests that the physical activity component of Fit for Family was
among, if not the “favorite part of the program”. Although the lack of an adequate sampling size
is apparent in Figure 6, an interesting relation between “more games” and “less lecture” can be
drawn out from this data. Furthermore, because the vast majority of the lecturing was
administered during the nutrition education lessons, one could speculate that even though we
tried reducing the “lecture” time given throughout this program, there is still room for
improvement in this area and should consider more creative content delivery methods in the
future.
Don't turn fami-lies away at the
door.
Less lecture More sessions More games 0
1
2
3
Recommendations/Suggestions for improvement?
Recieved Recommendations/Suggestions
Num
ber o
f Res
pond
ents
Figure 6: This chart shows that recommendations for improvement, provided by the five of the 11 post-
survey subjects.
In a different section of the post-survey, participants were asked to circle the number on
the rating scale that best describes them with 1 being “not at all” and 5 being “extremely”. After
reviewing all the responses to the question: “How well were your expectations met?”, four out of
the 11 respondents said their expectations were “very” met and the remaining respondents said
FIT FOR FAMILY PROGRAM EVALUATION 15
their expectations were “extremely” met. In a similar manner, the participants were asked the
question: “Would you attend another event with this focus?”. To our surprise, all the respondents
claimed that they would.
Limitations
The limitations of this project are extensive. First, the sample size for this study was
small and potentially skewed (14 pre-survey responses and 11 post-survey responses). With such
a small sample size it is harder to prove that our results did not persist through chance.
Generalizability is also a great limitation for this project being that all the participating families
lived within the Menomonie, Wisconsin area. Additionally, the data this study will generate is
likely to have some inclusion of lurking bias due to the fact that voluntary response sampling
(i.e. sampled participants choose to get involved) had to be used rather than random sampling.
As a result, the data collection for the study is susceptible to being biased because people are
motivated to respond or not. The validity of this research also depended on the clients’ honesty
in reporting.
Discussion
The results of this study gives inconclusive but supportive data in favor of the initial
hypothesis of this study, which claimed: if families actively participate in three 90-minute
community education sessions centered on nutrition and physical activity, then they will increase
their acceptance of and knowledge about making healthy life-style choices. Partial to the success
of this program, we can pay tribute to the challenges, moreover, the lessons learned from those
challenges. As a first-time program, the majority of the challenges we faced took place in the
pre-event and planning stage. To help minimize these particular challenges in the future the
FIT FOR FAMILY PROGRAM EVALUATION 16
registration deadline will be set one to two weeks before the start of the program, instead of just
two days before, leaving more time to properly plan for the exact number of participants.
Given the need for community education programs, such as Fit for Family, will remain
high for quite some time, our future plans for this winter will include making a plan for
developing a model that will help make community education programs more sustainable in the
long run. Although program development is challenging, it also is a lot of fun and satisfying
seeing people enjoy themselves and their family while participating in one of your events. Seeing
moments such as those unfold and hearing side comments such as: “that was awesome!”, “we
looked forward to this all week”, “do we have to leave already?”, reminded us (volunteers) that
even thought this was a short-term “pilot study” program, our efforts in this program have a real
and lasting effect on the life’s of the families we serve in their pursuit to a healthier lifestyle. My
hope is that through this program and the objectives we assessed more extensive family-based
community education programs can unfold in furthering obesity prevention and research in
America.
FIT FOR FAMILY PROGRAM EVALUATION 17
References
President’s Council on Fitness, Sports & Nutrition.
http://www.fitness.gov/about-pcfsn/
School District of Menomonie. (2013). Fall 2013 Community Education Guidebook.
S. Foxwell, personal communication, October 10th, 2013
Wisconsin Department of Agriculture, Trade and Consumer Protection. (2013). Buy local, buy
Wisconsin. Retrieved from
http://datcp.wi.gov/Business/Buy_Local_Buy_Wisconsin/Farm_to_School_Program
/index.aspx?AspxAutoDetectCookieSupport=1
Wisconsin Department of Public Instruction. (website)
http://fns.dpi.wi.gov/fns_progstat
Wisconsin Diabetes and Prevention Control Program (DPCP), Division of Public Health, and
Department of Health Services. (2011). The 2011 burden of diabetes in Wisconsin.
Retrieved from http://www.dhs.wisconsin.gov/publications/P0/P00284.pdf
Wisconsin Nutrition Education Program. (2013). An Investment in Wisconsin.
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Appendix
App. 1: Promotional Flier - Drafted by Joe Kalscheur
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App. 2: Registration Form – Drafted by Joe Kalscheur
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App. 3: Pre-survey (page 1 of 2)
FIT FOR FAMILY PROGRAM EVALUATION 21
App. 4: Pre-Survey (page 2 of 2)
FIT FOR FAMILY PROGRAM EVALUATION 22
App.5: Post-survey (page 1 of 2)
FIT FOR FAMILY PROGRAM EVALUATION 23
App. 5: Post-survey (page 2 of 2)