Post 5: Lesson Plan

What college students need to know about children’s nutritional needs for future careers in healthcare: A service learning approach

Health Topic and Intended Audience

This lesson will be used to teach college students of Tarrant County College who are enrolled in a learning community between an Anatomy and Physiology II class and a Concepts of Physical Activity class, both prerequisites for the nursing and many allied health programs, about the basic nutritional needs of children in order to better prepare these future healthcare workers to serve this population. Learning communities and service learning are considered high impact teaching methods (Finley, 2011). Students in the course range from 18-64 years of age. Nearly 90% of the students are female and 30% are Hispanic. Throughout the semester, the students will be using integrative assignments between the two courses and a culminating service learning project to gain a deeper understanding of human health and disease. This lesson in particular is a mock trial for the service learning project in order to prepare the students to work with the children from Nash Elementary School, a low-income school with a minority-majority student population, in the Fort Worth Independent School District.

            Globally, the United States ranks at the highest levels for overweight, obesity and high body mass index- a status which very few other countries have “achieved” (WHO, 2008). The last two decades have seen an alarming increase in the number of obese persons in the United States. According to the Centers for Disease Control and Prevention (CDC), in 1990 no single state had obesity rates higher than 14% (2011a). Today, one generation later, every state in the United States has an obesity rate of 20% or more, with states such as Texas seeing average rates of 30% or more (CDC, 2011a). Children are no exception to the increase rates of obesity as an estimated 17% of children aged 2-19 years are obese (CDC, 2011b). Obesity in children ages 2-17 has tripled since 1980 (CDC, 2011b). There are disparities in obesity between socioeconomic groups and ethnic and racial minorities. The 2009 Pediatric Nutrition Surveillance System data reports that nearly one in three low-income preschoolers age 2-4 is overweight or obese (National Center for Chronic Disease Prevention and Health Promotion, 2009). Preschool children who are American Indian and Alaska Native and Hispanic children have the highest rates of obesity, 20.7% and 17.9% respectively (National Center for Chronic Disease Prevention and Health Promotion, 2009). With rates such as these in our youngest members of society, the future of chronic disease looks grim. In addition, research has found that significant weight gain occurs between 18 and 29 years of age (Mokdad, et al., 2003). According to the Centers for Disease Conrol & Prevention, only 37% of Hispanic college students reguluarly engage in moderate physical activity, while less than one-fourth eat the recommended daily amount of fruits and vegetables (2010).  Drastic measures must be taken by individuals, communities and the government to make significant changes in obesity rates especially for the most vulnerable populations. Although this lesson aims to prepare future healthcare workers to work with children, the course as a whole aims to give the college students the knowledge and motivation they need to make positive health-related changes in their own lives and in the lives of their families and communities.

Setting

The lesson will take place during class time, from 10:25am-11:45am on a Thursday on the Tarrant County College Trinity River Campus. This lesson will go outside of the normal classroom and into the area where the service learning project will take place. This is a large room that has a capacity of 200 people, giving plenty of room for everyone to circulate around the room easily. It will be set up to resemble a marketplace café with tables of various types of food around the periphery and small round tables in the middle. There will be 12 tables with 4 chairs each to accommodate 24 college students who will be working with 24 elementary students (each college student will be assigned one elementary student). A computer lab will be used at the end of the lesson to complete the blast off activity.

Estimated Time

Total time: 1 hour and 20 minutes

Introduction (10 minutes)

Hand out materials (5 minutes)

Activity 1- song (5 minutes)

Instruction (10 minutes)

Activity 2- food (20 minutes)

Instruction and moving (10 minutes)

Activity 3- interactive game (15 minutes)

Evaluation (10 minutes)

Materials Needed

Reservation of the Action room to be set up as a market place and café: set up with 10 rectangular tables around the periphery with white table cloths; 12 round tables in the middle of the room with 4 chairs at each table.

Reservation of computer lab with at least 24 computers

Audiovisual equipment (computer with projector, speakers for sound)

Die cuts of various foods from each of the 5 food groups

24 folders

24 copies of each handout for folders (song lyrics, MyPlate worksheet, and evaluation)

Masking tape

12 packages of non-toxic markers

24 paper plates and napkins

Guiding Health Education Theory

The guiding theory for this learning community as a whole is the Transtheoretical model.  Stages of change, processes of change, decisional balance and self-efficacy are the core constructs of the Transtheoretical model (Glanz, Rimer, Viswanath, 2008). Students who registered for the linked courses are most likely at least at the stage of contemplation because they have registered for a class in which they will be required to do physical activity and learn about nutrition. Once in the course, the processes of change most likely to apply include: consciousness raising, self-reevaluation, self-liberation, social liberation and healthy relationships. These processes of change will help the student gain self-efficacy through which they can progress into stages of action, maintenance and termination. Using college students, Werch, et al. demonstrated significant increases in physical activity and consumption of healthy fats after interventions using transtheoretical model as a basis (2007). Di Noia and Prochaska have evaluated 27 studies and found the transtheoretical model to be a useful method for understanding behavior change as it relates to dietary behavior (2010).

Goal

The goal of this lesson is for college students who plan to work in healthcare to know the nutritional recommendations for children. After the lesson, students should be able to name the five food groups and give examples of foods in each. Students should be able to demonstrate their knowledge of the MyPlate guidelines for children.

Process Objectives:                                              

1.      Evaluate the each of the 24 student’s readiness to work with the elementary students by administering a knowledge evaluation at the end of the lesson.

Outcome Objectives:

1.      After the lesson, 90% of students will be able to name the five food groups (cognitive).

2.      After the lesson, 75% of students will be able to list three examples of foods within each of the five food groups (cognitive).

3.      After the lesson, 80% of students will be able to draw and label the parts of MyPlate correctly (psychomotor).

Procedures

1.      Introduction (10 minutes)

Remind students that the service learning activity will be taking place soon and that today will be a mock run of the event. After taking attendance, walk students to the Action room where the event will take place. Once at the room, say:

 

The students from Nash Elementary school will be coming next week to learn about eating healthy. This is the room where we will meet the students. The students from Nash Elementary will be arriving at 10:30am and will leave at 12pm. Each one of you will be paired with an elementary student upon their arrival. Today we are going to do a mock run of our service learning project so that you will be prepared to work with the students next week. At the end of the lesson, you should be able to list the five food groups and give examples of foods within each of those groups. In addition, you should be able to draw and label the parts of MyPlate. Let’s begin by working in pairs. (Give students a minute to find a person to pair up with). Within each pair choose one person to be the “college student” and one person to be the “elementary student”. College students greet your elementary student and ask them their name. Smile and be friendly. (Pause) Our first activity will be done while standing. College students, tell your elementary student that we will be singing a song to learn about the five food groups. (Pause)

 

2.      Hand out materials (5 minutes)

Pass out the folders containing the handouts inside. Have each student write their name on the outside of the folder. Say:

 

Now, look inside your folder and take out the handout titled “Original Songs Lyrics”. We will be singing the “Alive with 5 Food Groups” song. First, I want you to listen to the song and follow along with the words on your handout so that you can get familiar with the rhythm. I will play the song again and we will all sing together. Ready? If you feel ready to join in the first go round, please feel free to do so. Here we go.

 

3.      Activity 1- song (5 minutes)

Play the song twice. If students seem apprehensive about singing, just tell them to sing the chorus only or to just say “Alive, with five” and the words in parenthesis on the lyrics sheet instead of singing the whole song. They can also clap with the song where appropriate. After you practice the song, have the students put the lyrics page back into their folders.

 

4.      Instruction (10 minutes)

Have the students take out the “Serving up MyPlate” handout. First, review the five food groups and their portion sizes on the MyPlate example at the top of the handout. Then, pass out two paper plates and a set of markers to each pair of students. Say to the students:

“College students”, use the markers to show your “elementary student” the correct portions of each of the five food groups on your paper plate. Label the word dairy on the napkin. Then, have your “elementary student” do the same on their plate and napkin acting as a guide when necessary. Remember to be encouraging and positive. Once your student has completed the activity, go over the examples of each of the five food groups listed in your “Serving up MyPlate” handout. Be sure to discuss “sometimes” foods and physical activity. Does anyone have any questions? If you find that you have questions as you work, please raise your hand and I will come by to help.

 

5.      Activity 2- food (20 minutes)

After answering any questions from students, give them about 7 minutes to complete the tasks. Once the students are finished say:

 

Now we are going to practice using the MyPlate guidelines. On the day of the actual event, we will have real food, but today we will be using paper food to practice. “College students” you will take your “elementary students” around the market. While you are looking for food to fill your plate, remember to be positive about every food and encourage your “elementary student” to try something new. As a role model, you should also try something new or something that you don’t normally eat. Be sure to talk to your “elementary student” about your decision to try something new or different. When you are done, sit at the small round tables with another group. Take time while “eating” to discuss exercise activities that you each enjoy. Help your “elementary student” think about where and when they can exercise. Also, take time to discuss “sometimes” foods. “Elementary students” come up with a few “sometimes” foods that you think a real elementary student might eat or drink too often and talk to your “college student” about when, where and how often you eat these foods. Together, discuss healthy alternatives to “sometimes” foods that you eat or drink too often. Go ahead and begin. Let me know if you have questions during this process.

 

6.      Instruction and moving (10 minutes)

After activity 2 is done, take the students to the computer lab for activity 3. Once you are in the computer lab, have each pair of students share one computer. Then say:

 

Our last activity is an online interactive game called “Blast off!” In this game, the elementary students will have to plan a day of healthy meals and snacks while ensuring they do at least 60 minutes of physical activity. If they meet the daily requirements of nutrition and exercise, they will be able to blast off into space. Write down this website on the back of your “Serving up MyPlate” handout so that you will have in next week for our real event. http://www.fns.usda.gov/multimedia/Games/Blastoff/BlastOff_Game.html (write it on the board for students to copy). Then, type the URL into your browser. Once you click Play Game, have your “elementary student” put in their name, gender, and age. Remember that our real elementary students will be between 6 and 8 years old, so be sure to use that age range. Click “enter” and begin playing the game. Let me know if you have any questions.

 

7.      Activity 3- interactive game (15 minutes)

Students should then work on the Blast Off game. Walk around to answer any questions. Once you notice students are coming near the end, say:

 

Once you finish the game, click “continue to your mission report” then click “view your certificate”. When the students come next week, you will print the certificate for them so that they can take it home. Today, you do not need to print the certificate.

 

8.      Evaluation (10 minutes)

Pass out the evaluation sheets to each student. The evaluation should ask the students to do the following:

a.       List the five food groups.

b.      Next to each food group, give three examples of healthy foods/drinks in the group.

c.       List two “sometimes” foods/drinks.

d.      Draw MyPlate and label each food group on your drawing.

Collect the evaluations and dismiss the class.

Anticipated Problems and Solutions

1.      Computer or projector may not work. A solution is to bring hard copies of the powerpoint presentation to pass out to students.

2.      Sound on AV equipment may not work. A solution is to bring a cd player or ipod player as a backup for listening to the Alive with Five song.

3.      Students may be embarrassed to sing in front of others. A solution is to have students chant only the catch phrases of the song such as “alive, with five” and the words “fruits”, “vegetables”, “dairy”, “grains” and “protein” instead of singing the whole song.

4.      Students may lose their folders with materials after the lesson. A solution is to make additional folders for students who lose the materials between the mock lesson and the real service learning program. Another solution is to provide each of the handouts electronically for students to print out as needed.

5.      Students may not have accomplished all three parts of the outcome objectives and therefore did not demonstrate readiness to teach the elementary students. A solution is to provide a list of resources for students to practice the material. Another solutions is to have two college students work with two elementary students so that the students who did not demonstrate proficiency in all three outcome objectives with working with another college student who did.

References

Centers for Disease Control and Prevention. (2010). Youth risk behavior surveillance: National college health risk behavior survey- United States, 2009. MMWR surveillance summary, 59, 1-142.

Centers for Disease Control and Prevention (2011a). Overweight and obesity: data and statistics. Retrieved from http://www.cdc.gov/obesity/data/trends.html

Centers for Disease Control and Prevention. (2011b). Overweight and obesity: childhood data and statistics. Retrieved from http://www.cdc.gov/obesity/childhood/data.html

Di Noia, J., & Prochaska, J. (2010). Dietary stages of change and decisional balance: a meta-analytic review. American Journal Of Health Behavior, 34(5), 618-632.

Finley, A. (2011). Assessment of High-Impact Practices: Using Findings to Drive Change in the Compass Project. Peer Review, 13(2), 29-33.

Mokdad, A., et al. (2003). Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Journal of American Medical Association, 289, 76-79.

National Center for Chronic Disease Prevention and Health Promotion. (2009). Facts sheet: Obesity among low-income preschool children. Retrieved from http://www.cdc.gov/obesity/downloads/PedNSSFactSheet.pdf

Werch, et al. (2004). Brief multiple behavior interventions in a college student health care clinic. Journal of Adolescent Health, 41, 577-585.

World Health Organization. (2008). Global health observatory: overweight and obesity. Retrieved from http://www.who.int/gho/ncd/risk_factors/overweight/en/index.html