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GRANT PROPOSAL
for
GIFT OF HEALTH & WELLNESS
MOBILE KITCHEN PROGRAM
On the Road to A Healthy Lifestyle
-2nd
DRAFT-
1/15/2009
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 2
TABLE OF CONTENTS
Page
I. INTRODUCTION
Gift of Health & Wellness Organization 3
II. NEED IDENTIFICATION
A. The Problem Under Study: Obesity in the U.S 3 - 5
B. Need Statement 5 - 6
III. GIFT OF HEALTH & WELLNESS MOBILE KITCHEN PROGRAM
A. Program Overview, Target Populations and Selection Criteria 6 - 8
B. Purpose and Goals 9
C. Program Objectives 9 - 10
IV. METHODOLOGY
A. "Gift of Health & Wellness" Lunch Box Program 10 - 11
B. Meal Preparation via Mobile "Teaching" Kitchen 11 - 12
C. Organic Gardening 12 - 13
D. "Measure Up" Physical Activity 13
E. Key Metrics 13 - 14
V. ASSESSMENT
A. Reaction Assessment 14
B. Learning Assessment 15
C. Behavioral Assessment 15
D. Impact Assessment 15 - 16
VI. EVALUATION PLAN 16 - 17
VII. SUMMARY 18
APPENDIX
REFERENCES 20
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 3
I. INTRODUCTION
Gift of Health & Wellness Organization
In 2001, the former Elmhurst, IL-based health food store Good Eats! was established. Over
time, its owners began organizing a number of community outreach programs, such as Health
Fair Day, with medical facilities and churches located in Elmhurst and the surrounding area.
By 2005, they transformed their business into a 501c-3 community-based not-for-profit
organization called Gift of Health & Wellness, an organization which today works with
communities and local physicians to deliver health and wellness programs. Among its other
charters, Gift of Health & Wellness primarily seeks to provide instruction and after-school
activities to families with health disparities (obesity, diabetes, hypertension, etc.) and to youths
with special needs.
In this particular project, called the "Gift of Health & Wellness Mobile Kitchen Program, On
the Road to a Healthy Lifestyle", Gift of Health & Wellness will team with other partners to
provide nutritional and lifestyle solutions to youths aged 6 through 14 years in order to reduce
obesity-related problems, including diseases attributed to obesity, poor academic performance,
low self-esteem, lack of exercise, and a sedentary lifestyle. The overriding goal of this program
is to achieve an outcome of weight reduction among all its participants.
II. NEED IDENTIFICATION
A. The Problem Under Study: Obesity in the U.S.
In recent generations in the United States, health problems have increased as new technologies
and lifestyles have affected the way in which Americans select, prepare, and consume foods. The
practice of preparing home-cooked meals, eating locally-grown food, exercising regularly, and
choosing a balanced diet has long been a goal but rarely the norm for most families, particularly
for those living in urban and suburban areas. Locally grown fresh fruits and vegetables are often
either not readily available in urban areas, such as Chicago (often referred to as "food deserts"),
too expensive for these families to afford or sometimes simply not valued. In turn, the healthiest
foods are often the first ones stricken from a family’s grocery list. Given these circumstances, in
addition to unprecedented demands from work, and consequent time away from home, parents
are opting to buy fast foods instead of preparing healthy meals at home. This behavioral reality
not only threatens the health of the family, but also provides a much more diminished social and
familial environment for everyone to enjoy.
Fast food consumption is not only eroding the family unit, in part, on a social and communal
level, but it is also clearly having deleterious effects on the physical health and well-being of all
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 4
members. With fast food eating comes an inordinately high number of calories, fat, and sodium
consumed in the American diet, all detrimental to the health of every age group because of their
low metabolism value, and the corresponding decrease in immunity associated with increasing
obesity (Tanaka, et al., 1993; Zalevskai & Blagosklonnaia, 1981). The U.S. food supply
contains a great number of foods that are high in energy with an appealing taste, but which are
low in nutritional value. As a result of such a diet, consumers are predisposed to various health
risks, which the U.S. Surgeon General (2007) lists as premature death, heart disease, diabetes,
cancer, breathing problems, arthritis, and reproductive complications, to name a few. And, the
number one problem resulting from a poor diet is obesity. In children and in adolescents, the risk
of suffering from heart disease and Type 2 Diabetes (formerly considered to be only an adult-
onset disease) increases with being overweight and obese. In addition to suffering from
increased risks of these physical diseases, overweight and obese children also suffer from
psychosocial consequences. Obese children and adolescents are targets of early and systematic
social discrimination. The psychological stress of social stigmatization can lead to low self-
esteem, which can many times lead to poor academic performance and social functioning as a
child, and can continue into adulthood. (Centers for Disease Control and Prevention. "Tips for
Parents - Ideas to Help Children Maintain a Healthy Weight." 4/26/10).
Obesity - Definition and Statistics
Obesity has been traditionally defined as being more than 20% over one's ideal weight, and this
ideal weight must take into account that person's height, age, sex, and build. It has also been
defined more formally by the National Institutes of Health (the NIH) as one's having a BMI
(Body Mass Index) of 30 and above. Defined either way, obesity is a significant contributor to
many health problems, increasing the risk of developing a number of diseases including, but not
limited to:
 Type 2 (adult-onset) diabetes
 High blood pressure
 Stroke
 Heart attack
 Heart failure
 Cancer (certain forms, including that of prostate, colon, and rectum)
 Low metabolism, which leads to further weight gain
 Low immune system, decreasing the body's ability to fight diseases
 In the U.S., in 2003, 31.6% of children ages 10-17 years were overweight or obese
(NICH, National Initiative for Children’s Healthcare Quality, Child Policy Research Center,
2003)
 Obesity in youth - Illinois ranks 10th among the most obese states for youth ages 10-17
(Trust for America's Health, 2010)
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 5
 Obesity for Chicago's youth aged 3-7 is 22%, which is twice the national average
(Consortium to Lower Obesity in Chicago Children, CLOCC - 2010)
 Obesity is suspected to be a cause that predisposes affected individuals at higher risk of
infection by pandemic flu strains, such as the H1N1 virus (CDC, 2009)
Over the years, these realities have prompted the development of numerous initiatives by federal,
state, and not-for-profit organizations in Illinois and the entire nation to address the rising rate of
obesity among adults and children alike. These efforts have resulted in some improvement,
whereby obesity among children entering school fell from 24% in 2007 to 22% in 2008, although
the youth overweight score of children entering 6th grade is still 1.5 times that of the national
average (CLOCC, 2010). In 2009, the Obama administration (led by Michelle Obama) initiated
a nationwide program to combat obesity in children (http://www.letsmove.gov).
However, despite numerous efforts by many agencies, including the federal government, to
combat obesity, little headway has been made nationally (Illinois AgriNews, March 12, 2010).
In one study, Whitmore (2004) examined the role of school lunches in contributing to childhood
obesity. Whitmore observed that federally funded school lunch programs provide 40 to 120
calories more than do those lunches that are brown-bagged, resulting in a 2 - 4% higher obesity
rate among school lunch eaters. It was found that after a couple of years, school lunch eaters
experienced higher obesity rates than brown baggers. Therefore, if school lunches were made
"healthier", a significant decline in childhood obesity would occur.
It is now recognized that obesity at an early onset has long-term implications. Obese youth have
a high probability of remaining obese even as adults, and more so if either one or both parents
are also obese. A correlation has been established between obesity in parents and subsequent
development of obesity in their children (Review by Foy, 2000).
B. Need Statement
Given the steady increase in the number of school-aged children who are either overweight or
obese, as well as the number and variety of health risks associated with obesity as described in
the previous section, both physical and psychological, greater community involvement to combat
childhood obesity is sorely needed. Due to the number of households in which both parents are
working outside the home, as well as their increasing demands from their jobs, most families
often resort to eating fast food and other forms of quickly made, processed meals in an effort to
save time. Unfortunately, as outlined in the previous section, such choices continually made
over a long period of time can have detrimental effects on a child’s health and the health of
his/her entire family. However, by introducing the three key target groups of school-aged
children, their parents and, ideally and whenever possible, their grandparents, to a more
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 6
structured and sensible approach to healthier eating and healthier living, all three generations
within the family can learn how to shop for and prepare more nutritional meals, exercise safely,
and reap both the short-term and long-term benefits from following a healthy and active lifestyle.
To this end, the Gift of Health & Wellness Mobile Kitchen Program was designed in an effort
to combat the rising rate of childhood obesity, and teach all key stakeholders (e.g., school-
aged children (including special needs children), their parents, and their grandparent) how to
prepare home-cooked meals, become more active and lead a healthier lifestyle overall. This
proposal outlines the need for the development and implementation of the Gift of Health &
Wellness Mobile Kitchen Program, a four-pronged initiative which will serve as a model to be
replicated nationwide, and which includes the Gift of Health & Wellness Lunch Box Program.
It is also proposed that this model be implemented initially in Chicago and in the surrounding
metropolitan area.
III. GIFT OF HEALTH & WELLNESS MOBILE KITCHEN PROGRAM
A. Program Overview, Target Populations and Selection Criteria
Program Overview
The Gift of Health & Wellness Mobile Kitchen Program, On the Road to a Healthy Lifestyle
is an educational program designed to reverse the increasing rate of obesity within families and
communities nationwide, beginning, as proposed, in Chicago and the surrounding areas.
This program is designed to motivate and encourage school-aged youths (ages 6 to 14,
inclusive), their parents, and their grandparents, to lose weight (thereby reducing their risk of
encountering diseases), prepare healthier meals, become more physically active and strive to
develop a more sustainable healthy lifestyle. Specifically, the Gift of Health & Wellness
Organization will team with other partners to provide nutritional and lifestyle solutions to youths
aged 6 through 14 years in order to reduce their weight and obesity-related problems, including
diseases attributed to obesity, poor academic performance, low self- esteem, lack of exercise and
a sedentary lifestyle.
The Gift of Health & Wellness Mobile Kitchen Program will use a four-pronged approach to
combating obesity, including:
1. Offering the Gift of Health & Wellness Lunch Box Program
2. Introducing Healthy Meal Preparation via the Mobile Kitchen Unit
3. Introducing Organic Gardening
4. Introducing Physical Activity
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 7
In addition to providing the Gift of Health & Wellness Lunch Box Program and three areas of
instruction to their target audience, Gift of Health & Wellness will be researching their subjects
and measuring the overall performance of this study, examining the effects of both the Lunch
Box Program and various areas of instruction on the health of their subjects over time. In
particular, three years of project implementation, observation, and analysis are proposed, to be
detailed in sections IV-VI (Methodology, Assessment, and Evaluation Plan).
Target Populations
The Gift of Health & Wellness Mobile Kitchen Program targets three distinct segments:
1. At risk school-aged youth, between the ages of 6 and 14, inclusive (pending parent
approval).
2. Parents of those at-risk school-aged youth selected and approved for participation into the
program.
3. Grandparents of the same at-risk youth selected and approved for participation into the
program.
Selection Criteria
At-risk children will be the first group of subjects selected for this study, numbering 50 - 55
students per school (4 schools per year), based on the results of their free physical examinations
taken at the beginning of the school year, and associated assessed need and benefits to be gained
from participation in the Program. These students cannot participate in the study without the
approval and participation of their parents.
Ideally, should any parent-child pairing selected for observation also include a grandparent living
in the same household, the researchers of this study would encourage that grandparent to
participate in the same study, so as to have the opportunity to observe and measure the effects of
this program on three generations of one family, and promote all the benefits being taught
(preparing and eating healthy foods, achieving sustainable living, and exercising).
1st Year - 4 Schools Selected, with 50 - 55 students per school selected for the study
. 2nd Year - 4 New Schools Selected, with 50 - 55 different students (e.g., 2 classrooms) per
school selected for the study.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 8
Measurement During Year 2
In addition, during the 2nd Year, those students and other subjects (possible parent and/or
grandparent) pulled for the study conducted during Year One will be followed up with and
their results (particularly weight reduction) will be evaluated.
3rd Year - Measurement of 2nd Year Subjects Takes Place.
Participants from the second year of the study will be evaluated beginning in Year 3, after they
have completed their first year of participation in the study. Once again, weight reduction and
other key indicators of success will be evaluated.
Based on the designated segments for observation, households selected for this study can include
up to three subjects (a child/student, his/her parent, and his/her grandparent, if all three family
members are living in the same household). The child will be the first member selected for this
study, based on his/her physical characteristics and the level of need and benefit to be gained
from participation in the program, as deemed by the researchers. His/her parent will also be
required to participate. Finally, if a grandparent is living within the same household as the
youth, s/he can also potentially be selected for participation in the study. In some cases, a
student selected for the program may only have a grandparent caring for him or her. If such is
the case with any potential subjects, this grandparent will need to approve the child's
participation in the study, and participate in it him/herself.
The groups selected for participation in the Gift of Health & Wellness Mobile Kitchen
Program are vulnerable and should be examined because of their significantly increased risk of
developing a number of diseases which can stem from obesity. As health declines due to poor
nutrition and eating habits, children are much more likely to not only do worse in school but also
become less or not at all involved in extracurricular and community activities. As a result of
their lack of involvement in their community or extracurricular activities, they are more prone to
become agitated or simply get into trouble.
Community Problems to be Addressed - This project will attempt to tackle the rising rate of
obesity and its associated health risks among at-risk youth and their families by promoting the
preparation and consumption of nutritional foods, promoting exercise, and encouraging
sustainable living.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 9
B. Purpose and Goals of the Gift of Health & Wellness Mobile Kitchen Program
Overall, the goal of the Program is to instill the capability to prevent and control obesity and
other chronic diseases through healthful eating habits (choices), physical activity, and the
"right mindset", regarding sustainable living. The project will promote “Going Green” activities
for the environment, such as turning dormant backyards and empty window sills into organic
gardens, growing gardens in containers, and even developing gardens on rooftops and in vacant
city lots. This program will conduct studies to establish how inter- generational feeding habits
influence obesity in today's youth.
Specifically, the goals that test participants should achieve by the end of their first year on the
program are:
1. 10% reduction in BMI and/or a 20% reduction in weight
2. High self-esteem
3. Sustainable and cost-effective living through preparing healthy meals and growing any
of a variety of organic gardens (container, roof-top, window sill, etc.)
4. Greater physical mobility
5. Cultivation of living a healthy lifestyle among all generations living in one household
C. Program Objectives
In order to achieve the above-mentioned goals of the Gift of Health & Wellness Mobile Kitchen
Program, the following objectives have been set:
1. To teach youths and their parents the importance of living a healthy lifestyle, including
preparing healthy meals, exercising, and growing an organic garden, thereby striving to
achieve a modicum of sustainable living.
2. To teach youths and their parents how to prepare healthy meals, incorporating the
information and methods offered by Gift of Health & Wellness Mobile Kitchen
Program.
3. To teach youths how to grow various types of organic gardens, including container
gardening, transforming dormant backyards and empty window sills into organic
gardens, and growing gardens on rooftops and in vacant city lots.
4. To introduce exercise therapy and weight reduction to the target audience.
5. To conduct research by:
A) Analyzing data collected periodically through surveys administered to subjects by
researchers
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 10
B) Analyzing data collected through subjects' journal-keeping; and in particular, the
changes they experience as a result of participating in all aspects of the Gift of
Health & Wellness Mobile Kitchen Program.
C) Assessing subjects’ attitudes toward and overall experience with documenting the
physical, psychological, and behavioral changes they undergo and thoughts about
the program in general with their peers through various social media sites such as
Facebook and Twitter.
6. To document food-eating habits in the home and record any disorders associated with
overweight conditions.
7. To allow this initial installation of the Gift of Health & Wellness Mobile Kitchen
Program to serve as a model for subsequent programs to be rolled out nationwide.
IV. METHODOLOGY
The proposed duration of the Gift of Health & Wellness Mobile Kitchen Program, On the
Road to a Healthy Lifestyle is three years. Four schools and 50 - 55 students per school will be
selected to participate in this program in each of the first two years, for a total of 400 - 440
children subjects to be observed. The first year's subjects will be evaluated during the second
year of the study, when the second group of students will undergo the study. During the third
year, the second group of subjects will be evaluated, after their year of participation is
completed.
(For selection process, see the sub-heading "Selection Criteria" on pages 7-8).
Test subjects (children/students) will receive a lunch prepared by Gift of Health & Wellness
every day at school for one year. Additionally, this study group, along with their parents and, in
many cases, grandparents, will learn how to prepare well-balanced meals for their children
(through Saturday classes taught by the Gift of Health & Wellness Mobile Teaching Kitchen),
participate in physical exercises, and learn how to grow various types of organic gardens. A
detailed description of each of the four initiatives which comprise this program and its
methodology follows.
A. Gift of Health & Wellness Lunch Box Program
Whether prepared in the school or in the home, lunches have been cited as one of the leading
causes of overweight conditions in children. In different studies, it was shown that school-
based interventions resulted in reduced weight in school-aged children. By mainly altering food
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 11
quality and behavioral changes (watching less television, getting more physical exercise, etc.),
Gortmaker et al. (1999) showed that school-based interventions can reduce overweight
conditions in 6- to 8-year-olds. In another food-based study, Whitmore (2004) reported that
school-provided lunches were more likely to increase youth obesity than "brown-bagged"
lunches. It is quite apparent that a school-based intervention in the diet and behavior of youth
can lead to better body conditions.
Many obesity reduction interventions have tended to target only youths and ignore the role of
the parent. In cooking classes conducted every spring from 2008 through 2010, during Black
History Month in Saint Sabina Church in the south side of Chicago, participants reported the
following (Emma Theuri, pers. comm.):
1. Some parents/subjects never learned how to cook, and remarked how much better food
tastes when cooked at home, with added ingredients
2. Some parents never considered fresh vegetables as having nutritional value
3. Some parents were not aware of the great variety of food choices available to them
4. Children liked the flavor of home-cooked meals
As a result of participating in this class, participants were enthused to cook their own food at
least once a week, especially during the weekend.
Based on results from this and other childhood obesity-related studies, Gift of Health &Wellness
proposes to provide prepared boxed lunches to four schools during the first year, and four
schools during the second year of the program. Specifically, approximately 50 - 55 students per
school will receive boxed lunches every day, Monday through Friday, each year, based in large
part on their BMI. Specifically, at the start of the program, each student's body mass index
(BMI) will be documented at the beginning of the school year (this information will be made
readily available from the records of physical examinations that are administered to all students
at the beginning of the school year, free of charge). Those students selected for participation in
this study will be so chosen based on their need, and the amount of benefit they are expected to
receive from participation in the program, as determined by the researchers. Their BMIs
will be compared to the BMIs of students from control groups pulled from another school
that would be providing its own lunch throughout the year. At the end of the test year, the
BMIs of the test students from all four test schools will be compared once again to the BMIs of
the control group.
B. Meal Preparation via Mobile "Teaching" Kitchen
Another way in which Gift of Health & Wellness aims to address obesity is through providing a
well-balanced diet through the use of a mobile kitchen unit, and teaching both at-risk students
and their parents, as well as, potentially, their grandparents, how to prepare healthy and
nutritionally balanced meals.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 12
During selected Saturdays, students, parents and ideally grandparents as well will attend
cooking classes. Proposed venues include schools, churches, or community centers. The
nutritional benefits and tastiness of cooking a diverse cuisine (Hispanic, African, Oriental or
European dishes) will be discussed.
The Meal Preparation via Mobile "Teaching" Kitchen program initiative is expected to have
a multiplier effect: of the 20 or so families who participate in each cooking class, they will be
expected to reach another 20 families, allowing the outreach to grow exponentially. The goal of
this sub-program, among others, is to promote a broadened cultural awareness for children and
their families by bringing diverse ethnic meals to the table at least once per week, in the home.
Genetic predisposition, meal portion size, timing of eating, and physical activity play a key
role in combating obesity. Lifestyle mentors made available in a support group setting will
discuss how making various lifestyle choices and implementing certain techniques can improve
one's health.
The information that families will gain from participating in the Mobile "Teaching" Kitchen
activity will include learning about the benefits of eating fresh produce and non-processed foods.
These Saturday seminars will give children, parents, and grandparents...all generations... the
incentive to actively think about the food they consume and the types of benefits their bodies will
derive from it.
In the end, the success of these Mobile "Teaching" Kitchen seminars will be determined by
analyzing the change in parents' behavior during the course of the program ( e.g., a) how often
they are now cooking at home compared to how often they were cooking at the start of the
program, and b) what types of meals they are now preparing).
C. Organic Gardening
Another key initiative that comprises the Gift of Health & Wellness Mobile Kitchen Program
is teaching organic gardening. Gift of Health & Wellness proposes to teach youths, and their
families, how to grow various types of organic gardens, including container gardening;
transform dormant backyards and empty window sills into organic gardens, and grow gardens
on rooftops and in vacant city lots. Participants will also learn about some of the fundamentals
and benefits of composting and recycling. Finally, through participating in organic gardening
activities, families will realize the economic benefits that they can enjoy, saving them both time
(in preparing meals using locally-grown ("in the backyard") foods) and money (by not eating fast
food, going to restaurants, or taking carry out - all of which can cut very deeply into a family's
budget if done even a few days every week). But perhaps most important are the nutritional
and health benefits that children, parents, and grandparents alike will reap by eating natural,
home-grown fruits and vegetables. The benefits of organic gardening are endless. For instance,
it has been shown that organically grown food is significantly higher in the essential vitamins
and nutrients that the body uses in its defense against cancer. ("Benefits of Organic
Gardening", www.OrganicGardeningGuru.com). Since organic foods don't use pesticides,
organic gardeners are not polluting the environment. And, the simple act of organic gardening is
great for the spirit...participants should find it quite relaxing to feel the sun on their backs as they
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 13
plant, weed, or water. Researchers propose that it will allow participants to reconnect with the
earth, their health, and with each other, as a family.
Extending Reach
In addition to teaching children and families how to grow various types of organic gardens, Gift
of Health& Wellness will implement a "Tell-A-Friend" philosophy in their teachings, whereby
families will be encouraged to spread the word about the benefits of eating locally grown food.
Youths will learn how to identify plants and herbs as well as maintain a garden. Participating
families will make a pledge to donate an organic basketful of food to a person who is either
shut-in or vision-impaired, or even to any of the vulnerable groups who have worked with Gift of
Health& Wellness in the past.
D. "Measure Up" Physical Activity
The "Measure Up" component will introduce exercise therapy and weight reduction to study
participants. The youth and senior citizen participants alike will be shown various types of
physical activities and breathing techniques, and subsequently chart their progress.
1. Nature Path Walk - Study subjects will participate in Nature Path Walks, which will
provide the dual benefit of getting participants to exercise through walking as well as
teaching them how to identify plants.
2. Visual Big Projector Screen - Using interactive exercise and game technologies has become
a popular method among children and adolescents for partaking in physical activity (e.g., Wii
machines). Some technologies capitalize on kids' interest in computer or video interaction
while delivering a cardiovascular workout in a game format. GOHW proposes to incorporate
some form of interactive exercise in the GOHW Mobile Kitchen Program.
Once again, to measure the success of this particular component of the total Gift of Health &
Wellness Mobile Kitchen Program, researchers will use BMI and weight as two key metrics
for observation during the course of the study.
E. Key Metrics
As previously mentioned, the success of each of these four key components of the Gift of Health
& Wellness Mobile Kitchen Program will be measured. Measurement tools to be used include
pre- and post-program documentation of key physical attributes among study participants (e.g.,
BMI and weight); content of daily log journals to be completed individually by each program
participant, whether or not some form of organic gardening was maintained throughout the
course of the program, and whether or not participants remain physically active every day, or at
least, have developed a more physically active lifestyle by the end of the program compared to
their status at the beginning of the program.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 14
Some of the key indicators of success which will be measured, depending on the individual
initiative, are:
1. Improved body mass index (BMI) and weight reduction
2. Improved class performance
3. Improved physical mobility
4. Heightened self-esteem
5. Healthy food choices to prevent health discrepancies
6. Increased awareness of one's connectedness to the earth and all living things as well as
their increased commitment to maintain a measure of sustainable living
V. ASSESSMENT
Gift of Health & Wellness will measure the success of the Mobile Teaching Kitchen program
periodically, throughout the life of the program, using four basic types of assessments. Each
type of assessment will measure a different aspect of the program's effectiveness, and is done at a
different time in the life of the program.
A. Reaction (Attitudes) Assessment
The first type of assessment that Gift of Health & Wellness will utilize is the Reaction
Assessment, which involves asking subjects how they felt about participating in the program,
whether they enjoyed it, etc. This type of assessment is the easiest to obtain, but provides the
least information about the effectiveness of the program. It merely provides an indication of the
degree to which our audience will have found the program to their liking. For the Mobile
Teaching Kitchen program, we will be asking participants to use a daily journal to record not
only their physical progress from participating in the various initiatives of the program, but also
their general thoughts on the program.
Use of Social Media
In addition to their own daily journals, student subjects will be asked to communicate their
thoughts and feelings, sharing their likes and dislikes, about the program as well as some of their
outcomes with their peers on social media, including Facebook and Twitter. It is surmised by
our marketing team that incorporating social media channels in the overall program as a tool
through which students can communicate with each other should foster their greater program
adherence, positive behavior change and overall high satisfaction with the program. The
students participating in the control group, however, will not be utilizing any social media tools
in their journey to better health.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 15
B. Learning (Cognition) Assessment
The second type of assessment that Gift of Health & Wellness will utilize is the Learning
Assessment, which attempts to determine the degree to which participants have acquired some
knowledge as a result of the experience. Written or oral content matter tests can be used to
perform this type of assessment. Though acquiring knowledge does not always result in
behavioral change, it is still a good assessment to use in conjunction with behavioral assessment,
because participants should become at least aware of the many benefits of practicing healthy
cooking and eating, organic gardening, and exercise. Since "knowledge is power", they will at
least be equipped with the information needed to make better and healthier choices in their lives,
with the final choice being for them to act upon them, and make those choices.
C. Behavioral (Behavior) Assessment
The third type of assessment that Gift of Health & Wellness will incorporate is the Behavioral
Assessment, which seeks to determine the extent to which the program will be able to bring
about some actual change in the participant's behavior (e.g., are the participants doing anything
differently as a result of participation in the program?) This kind of assessment can be done by
self-report or reports from significant others, such as parents, teachers, neighbors, etc.
In this study, participants will be asked to "self-report", or to keep a log of their activity, as well
as their thoughts about the program. In addition, researchers will be evaluating their physical
progress periodically throughout the life of the program (e.g., evaluating various key metrics and
outcomes, such as BMI and weight, as well as assessing participants' adherence to the
program....maintaining their organic gardens, continuing their food preparations at home, and
maintaining some sort of exercise program on their own, etc.).
D. Impact (Outcomes) Assessment
The fourth type of assessment that Gift of Health & Wellness will utilize is the Impact
Assessment, which asks what type of real difference the program has made in terms of the extent
of the problem or issue in question (e.g., Did overweight subjects lose enough weight to no
longer be deemed overweight? Did obese subjects lose some weight? Did test subjects
participate in regular exercise, and in regular organic gardening/sustainable living? Did they
prepare meals at home more frequently by the end of the program than they did at the beginning
of the program?). Moreover, an impact assessment should be made in part to ascertain the
feasibility of extrapolating this program nationwide.
Through utilizing all four types of assessments, Gift of Health & Wellness will be able to
conduct the most comprehensive type of evaluation as possible. In order to conduct each type of
assessment accurately, the appropriate individuals will need to be selected. Moreover, one other
selection criterion which should be considered in selecting participants (youths between the ages
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 16
of 6 and 14, inclusive) is whether or not they are deemed by researchers to be able to effectively
track their own progress through self-reporting and logging their activity in their diaries. Given
the younger age of these test participants, the results of their self-reports may not always be the
most accurate. However, for this reason, it is important to obtain cooperation from their parents
and grandparents that they will work with their children (and supervise) the consistent and
accurate tracking of their various results and progress.
VI. EVALUATION PLAN
Gift of Health & Wellness research team will create five test groups among all participants, plus
five control groups, among all control participants. For this reason, it is ideal that 50 students
(and their parents and, in some cases, grandparents) are selected from each school. In this way,
50 can be evenly divisible by 5, to create the five test groups. A corresponding control group
will also be created for each test group, numbering 5 in total as well.
Test Group #1
In this group, the effects of participating only in the Mobile Kitchen Teaching Unit lessons and
Organic Gardening will be studied. Therefore, this test group of students will be participating
in only these two aspects of the study.
Test Group #2
In this group, the effects of participating only in the Mobile Kitchen Teaching Unit lessons and
Physical Activity will be studied. Therefore, this test group of students will be participating in
only these two aspects of the study.
Test Group #3
In this group, the effects of participating only in the School Lunchbox Program and Organic
Gardening will be studied. Therefore, this test group of students will be participating in only
these two aspects of the study.
Test Group #4
In this group, the effects of participating only in the School Lunchbox Program and Physical
Activity will be studied. Therefore, this test group of students will be participating in only these
two aspects of the study.
Test Group #5 – Full Treatment
In this group, all students will benefit from participating in all components of this study,
including physical activity, organic gardening, cooking at home, using techniques they learn
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 17
from the Mobile Teaching Kitchen Unit (though the parent and/or grandparent will be doing
most of the cooking at home), and the lunchbox program.
The diagram below illustrates the five test groups that will be created, in terms of the activities in
which members will be participating. One control group, who will not receive any treatment
throughout the course of the year-long testing period, each year, will also be created. As
previously addressed, a variety of factors will be evaluated and measurements made throughout
the course of the yearlong study, each year, across all test participants.
Activity
Participation Organic Gardening Physical Activity
Mobile Kitchen
Teaching Unit Test Cell #1 Test Cell #2
School
Lunchbox
Program
Test Cell #3 Test Cell #4
Test Cell #5
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 18
VII. SUMMARY
The Gift of Health & Wellness Mobile Kitchen Program provides several tangible benefits. First, it
responds to the urgent need to develop effective and practical solutions and resources for attempting to
combat obesity and its associated health risks. Second, it helps build family bonds by implementing
classroom and at-home activities in which all generations can participate and learn how to lead a much
healthier lifestyle together. Third, it can serve as a model that can be disseminated to large numbers
of children and their families both locally, in our test markets, and eventually, nationwide.
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 19
APPENDIX
USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 20
REFERENCES
1. Benefits of Organic Gardening.
Visit http://www.organicgardeningguru.com/unique-benefits.html
2. Centers for Disease Control and Prevention. 2009. H1N1 Flu in The News.
Visit http://www.cdc.gov/h1n1flu/in_the_news/obesity_qa.htm
3. Centers for Disease Control and Prevention. 2010. Tips for Parents- Ideas to Help Children
Maintain a Healthy Weight. Visit http://www.cdc.gov/healthyweight/children/index.html
4. Foy, M. 2000. Ph.D. Thesis, "Family Systems Variables as Predictors of Eating Styles And
Body Mass Index". Virginia Tech, VA.
5. Gortmaker, S.L., Petersen, K., Wiecha, J. , Sobol, A.M., Dixit, S., Fox, M. K., and Laird, N.
1999. Arch. Pediatr. Adolesc. Med. 153: 409-418.
6. Health Topics: Childhood Obesity, 2010. Report by Centers for Disease Control and Prevention.
Accessed in http://www.cdc.gov/HealthyYouth/obesity/
7. Nie, H.H., Bent & Hull, C.H. 1970. Statistical Package for the Social Sciences (SPSS).
8. Office of the Surgeon General. Overweight and Obesity: Health Consequences.
Accessed in: http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm
9. Rates of Obesity for Chicago Children. Consortium to Lower Obesity in Chicago Children
(CLOCC) report, 2010: Visit: http://www.clocc.net/news/CLOCC_Data_R_FINAL.pdf
10. State Data, Illinois. Trust for America's Health, 2010.
Visit: http://healthyamericans.org/states/?stateid=IL
11. Tanaka, S., Inoue, S., Isoda, F., Waseda, M., Ishihara, M., Yamakawa, T., Sugiyama, A.,
Takamura, Y., and Okuda, K. International Journal of Obesity-Related Metabolic Disorders
1995: 19 (3): 209.
12. Whitmore, D. 2004. Do School Lunches Contribute to Childhood Obesity? Harris School
Working Paper #05.13. Visit: http://www.uncg.edu/bae/econ/seminars/whitmore.pdf
13. Zalevskaia, A.G. & Blagosklonnaia, laV. 1981. Various indicators of cellular immunity in
obesity. Effect of low-calorie diet. Prbl Endokrinol (Mosk). 27 (5): 35-38.

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GRANT PROPOSAL (2nd DRAFT) for GOHW Mobile Kitchen Program

  • 1. GRANT PROPOSAL for GIFT OF HEALTH & WELLNESS MOBILE KITCHEN PROGRAM On the Road to A Healthy Lifestyle -2nd DRAFT- 1/15/2009
  • 2. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 2 TABLE OF CONTENTS Page I. INTRODUCTION Gift of Health & Wellness Organization 3 II. NEED IDENTIFICATION A. The Problem Under Study: Obesity in the U.S 3 - 5 B. Need Statement 5 - 6 III. GIFT OF HEALTH & WELLNESS MOBILE KITCHEN PROGRAM A. Program Overview, Target Populations and Selection Criteria 6 - 8 B. Purpose and Goals 9 C. Program Objectives 9 - 10 IV. METHODOLOGY A. "Gift of Health & Wellness" Lunch Box Program 10 - 11 B. Meal Preparation via Mobile "Teaching" Kitchen 11 - 12 C. Organic Gardening 12 - 13 D. "Measure Up" Physical Activity 13 E. Key Metrics 13 - 14 V. ASSESSMENT A. Reaction Assessment 14 B. Learning Assessment 15 C. Behavioral Assessment 15 D. Impact Assessment 15 - 16 VI. EVALUATION PLAN 16 - 17 VII. SUMMARY 18 APPENDIX REFERENCES 20
  • 3. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 3 I. INTRODUCTION Gift of Health & Wellness Organization In 2001, the former Elmhurst, IL-based health food store Good Eats! was established. Over time, its owners began organizing a number of community outreach programs, such as Health Fair Day, with medical facilities and churches located in Elmhurst and the surrounding area. By 2005, they transformed their business into a 501c-3 community-based not-for-profit organization called Gift of Health & Wellness, an organization which today works with communities and local physicians to deliver health and wellness programs. Among its other charters, Gift of Health & Wellness primarily seeks to provide instruction and after-school activities to families with health disparities (obesity, diabetes, hypertension, etc.) and to youths with special needs. In this particular project, called the "Gift of Health & Wellness Mobile Kitchen Program, On the Road to a Healthy Lifestyle", Gift of Health & Wellness will team with other partners to provide nutritional and lifestyle solutions to youths aged 6 through 14 years in order to reduce obesity-related problems, including diseases attributed to obesity, poor academic performance, low self-esteem, lack of exercise, and a sedentary lifestyle. The overriding goal of this program is to achieve an outcome of weight reduction among all its participants. II. NEED IDENTIFICATION A. The Problem Under Study: Obesity in the U.S. In recent generations in the United States, health problems have increased as new technologies and lifestyles have affected the way in which Americans select, prepare, and consume foods. The practice of preparing home-cooked meals, eating locally-grown food, exercising regularly, and choosing a balanced diet has long been a goal but rarely the norm for most families, particularly for those living in urban and suburban areas. Locally grown fresh fruits and vegetables are often either not readily available in urban areas, such as Chicago (often referred to as "food deserts"), too expensive for these families to afford or sometimes simply not valued. In turn, the healthiest foods are often the first ones stricken from a family’s grocery list. Given these circumstances, in addition to unprecedented demands from work, and consequent time away from home, parents are opting to buy fast foods instead of preparing healthy meals at home. This behavioral reality not only threatens the health of the family, but also provides a much more diminished social and familial environment for everyone to enjoy. Fast food consumption is not only eroding the family unit, in part, on a social and communal level, but it is also clearly having deleterious effects on the physical health and well-being of all
  • 4. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 4 members. With fast food eating comes an inordinately high number of calories, fat, and sodium consumed in the American diet, all detrimental to the health of every age group because of their low metabolism value, and the corresponding decrease in immunity associated with increasing obesity (Tanaka, et al., 1993; Zalevskai & Blagosklonnaia, 1981). The U.S. food supply contains a great number of foods that are high in energy with an appealing taste, but which are low in nutritional value. As a result of such a diet, consumers are predisposed to various health risks, which the U.S. Surgeon General (2007) lists as premature death, heart disease, diabetes, cancer, breathing problems, arthritis, and reproductive complications, to name a few. And, the number one problem resulting from a poor diet is obesity. In children and in adolescents, the risk of suffering from heart disease and Type 2 Diabetes (formerly considered to be only an adult- onset disease) increases with being overweight and obese. In addition to suffering from increased risks of these physical diseases, overweight and obese children also suffer from psychosocial consequences. Obese children and adolescents are targets of early and systematic social discrimination. The psychological stress of social stigmatization can lead to low self- esteem, which can many times lead to poor academic performance and social functioning as a child, and can continue into adulthood. (Centers for Disease Control and Prevention. "Tips for Parents - Ideas to Help Children Maintain a Healthy Weight." 4/26/10). Obesity - Definition and Statistics Obesity has been traditionally defined as being more than 20% over one's ideal weight, and this ideal weight must take into account that person's height, age, sex, and build. It has also been defined more formally by the National Institutes of Health (the NIH) as one's having a BMI (Body Mass Index) of 30 and above. Defined either way, obesity is a significant contributor to many health problems, increasing the risk of developing a number of diseases including, but not limited to:  Type 2 (adult-onset) diabetes  High blood pressure  Stroke  Heart attack  Heart failure  Cancer (certain forms, including that of prostate, colon, and rectum)  Low metabolism, which leads to further weight gain  Low immune system, decreasing the body's ability to fight diseases  In the U.S., in 2003, 31.6% of children ages 10-17 years were overweight or obese (NICH, National Initiative for Children’s Healthcare Quality, Child Policy Research Center, 2003)  Obesity in youth - Illinois ranks 10th among the most obese states for youth ages 10-17 (Trust for America's Health, 2010)
  • 5. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 5  Obesity for Chicago's youth aged 3-7 is 22%, which is twice the national average (Consortium to Lower Obesity in Chicago Children, CLOCC - 2010)  Obesity is suspected to be a cause that predisposes affected individuals at higher risk of infection by pandemic flu strains, such as the H1N1 virus (CDC, 2009) Over the years, these realities have prompted the development of numerous initiatives by federal, state, and not-for-profit organizations in Illinois and the entire nation to address the rising rate of obesity among adults and children alike. These efforts have resulted in some improvement, whereby obesity among children entering school fell from 24% in 2007 to 22% in 2008, although the youth overweight score of children entering 6th grade is still 1.5 times that of the national average (CLOCC, 2010). In 2009, the Obama administration (led by Michelle Obama) initiated a nationwide program to combat obesity in children (http://www.letsmove.gov). However, despite numerous efforts by many agencies, including the federal government, to combat obesity, little headway has been made nationally (Illinois AgriNews, March 12, 2010). In one study, Whitmore (2004) examined the role of school lunches in contributing to childhood obesity. Whitmore observed that federally funded school lunch programs provide 40 to 120 calories more than do those lunches that are brown-bagged, resulting in a 2 - 4% higher obesity rate among school lunch eaters. It was found that after a couple of years, school lunch eaters experienced higher obesity rates than brown baggers. Therefore, if school lunches were made "healthier", a significant decline in childhood obesity would occur. It is now recognized that obesity at an early onset has long-term implications. Obese youth have a high probability of remaining obese even as adults, and more so if either one or both parents are also obese. A correlation has been established between obesity in parents and subsequent development of obesity in their children (Review by Foy, 2000). B. Need Statement Given the steady increase in the number of school-aged children who are either overweight or obese, as well as the number and variety of health risks associated with obesity as described in the previous section, both physical and psychological, greater community involvement to combat childhood obesity is sorely needed. Due to the number of households in which both parents are working outside the home, as well as their increasing demands from their jobs, most families often resort to eating fast food and other forms of quickly made, processed meals in an effort to save time. Unfortunately, as outlined in the previous section, such choices continually made over a long period of time can have detrimental effects on a child’s health and the health of his/her entire family. However, by introducing the three key target groups of school-aged children, their parents and, ideally and whenever possible, their grandparents, to a more
  • 6. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 6 structured and sensible approach to healthier eating and healthier living, all three generations within the family can learn how to shop for and prepare more nutritional meals, exercise safely, and reap both the short-term and long-term benefits from following a healthy and active lifestyle. To this end, the Gift of Health & Wellness Mobile Kitchen Program was designed in an effort to combat the rising rate of childhood obesity, and teach all key stakeholders (e.g., school- aged children (including special needs children), their parents, and their grandparent) how to prepare home-cooked meals, become more active and lead a healthier lifestyle overall. This proposal outlines the need for the development and implementation of the Gift of Health & Wellness Mobile Kitchen Program, a four-pronged initiative which will serve as a model to be replicated nationwide, and which includes the Gift of Health & Wellness Lunch Box Program. It is also proposed that this model be implemented initially in Chicago and in the surrounding metropolitan area. III. GIFT OF HEALTH & WELLNESS MOBILE KITCHEN PROGRAM A. Program Overview, Target Populations and Selection Criteria Program Overview The Gift of Health & Wellness Mobile Kitchen Program, On the Road to a Healthy Lifestyle is an educational program designed to reverse the increasing rate of obesity within families and communities nationwide, beginning, as proposed, in Chicago and the surrounding areas. This program is designed to motivate and encourage school-aged youths (ages 6 to 14, inclusive), their parents, and their grandparents, to lose weight (thereby reducing their risk of encountering diseases), prepare healthier meals, become more physically active and strive to develop a more sustainable healthy lifestyle. Specifically, the Gift of Health & Wellness Organization will team with other partners to provide nutritional and lifestyle solutions to youths aged 6 through 14 years in order to reduce their weight and obesity-related problems, including diseases attributed to obesity, poor academic performance, low self- esteem, lack of exercise and a sedentary lifestyle. The Gift of Health & Wellness Mobile Kitchen Program will use a four-pronged approach to combating obesity, including: 1. Offering the Gift of Health & Wellness Lunch Box Program 2. Introducing Healthy Meal Preparation via the Mobile Kitchen Unit 3. Introducing Organic Gardening 4. Introducing Physical Activity
  • 7. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 7 In addition to providing the Gift of Health & Wellness Lunch Box Program and three areas of instruction to their target audience, Gift of Health & Wellness will be researching their subjects and measuring the overall performance of this study, examining the effects of both the Lunch Box Program and various areas of instruction on the health of their subjects over time. In particular, three years of project implementation, observation, and analysis are proposed, to be detailed in sections IV-VI (Methodology, Assessment, and Evaluation Plan). Target Populations The Gift of Health & Wellness Mobile Kitchen Program targets three distinct segments: 1. At risk school-aged youth, between the ages of 6 and 14, inclusive (pending parent approval). 2. Parents of those at-risk school-aged youth selected and approved for participation into the program. 3. Grandparents of the same at-risk youth selected and approved for participation into the program. Selection Criteria At-risk children will be the first group of subjects selected for this study, numbering 50 - 55 students per school (4 schools per year), based on the results of their free physical examinations taken at the beginning of the school year, and associated assessed need and benefits to be gained from participation in the Program. These students cannot participate in the study without the approval and participation of their parents. Ideally, should any parent-child pairing selected for observation also include a grandparent living in the same household, the researchers of this study would encourage that grandparent to participate in the same study, so as to have the opportunity to observe and measure the effects of this program on three generations of one family, and promote all the benefits being taught (preparing and eating healthy foods, achieving sustainable living, and exercising). 1st Year - 4 Schools Selected, with 50 - 55 students per school selected for the study . 2nd Year - 4 New Schools Selected, with 50 - 55 different students (e.g., 2 classrooms) per school selected for the study.
  • 8. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 8 Measurement During Year 2 In addition, during the 2nd Year, those students and other subjects (possible parent and/or grandparent) pulled for the study conducted during Year One will be followed up with and their results (particularly weight reduction) will be evaluated. 3rd Year - Measurement of 2nd Year Subjects Takes Place. Participants from the second year of the study will be evaluated beginning in Year 3, after they have completed their first year of participation in the study. Once again, weight reduction and other key indicators of success will be evaluated. Based on the designated segments for observation, households selected for this study can include up to three subjects (a child/student, his/her parent, and his/her grandparent, if all three family members are living in the same household). The child will be the first member selected for this study, based on his/her physical characteristics and the level of need and benefit to be gained from participation in the program, as deemed by the researchers. His/her parent will also be required to participate. Finally, if a grandparent is living within the same household as the youth, s/he can also potentially be selected for participation in the study. In some cases, a student selected for the program may only have a grandparent caring for him or her. If such is the case with any potential subjects, this grandparent will need to approve the child's participation in the study, and participate in it him/herself. The groups selected for participation in the Gift of Health & Wellness Mobile Kitchen Program are vulnerable and should be examined because of their significantly increased risk of developing a number of diseases which can stem from obesity. As health declines due to poor nutrition and eating habits, children are much more likely to not only do worse in school but also become less or not at all involved in extracurricular and community activities. As a result of their lack of involvement in their community or extracurricular activities, they are more prone to become agitated or simply get into trouble. Community Problems to be Addressed - This project will attempt to tackle the rising rate of obesity and its associated health risks among at-risk youth and their families by promoting the preparation and consumption of nutritional foods, promoting exercise, and encouraging sustainable living.
  • 9. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 9 B. Purpose and Goals of the Gift of Health & Wellness Mobile Kitchen Program Overall, the goal of the Program is to instill the capability to prevent and control obesity and other chronic diseases through healthful eating habits (choices), physical activity, and the "right mindset", regarding sustainable living. The project will promote “Going Green” activities for the environment, such as turning dormant backyards and empty window sills into organic gardens, growing gardens in containers, and even developing gardens on rooftops and in vacant city lots. This program will conduct studies to establish how inter- generational feeding habits influence obesity in today's youth. Specifically, the goals that test participants should achieve by the end of their first year on the program are: 1. 10% reduction in BMI and/or a 20% reduction in weight 2. High self-esteem 3. Sustainable and cost-effective living through preparing healthy meals and growing any of a variety of organic gardens (container, roof-top, window sill, etc.) 4. Greater physical mobility 5. Cultivation of living a healthy lifestyle among all generations living in one household C. Program Objectives In order to achieve the above-mentioned goals of the Gift of Health & Wellness Mobile Kitchen Program, the following objectives have been set: 1. To teach youths and their parents the importance of living a healthy lifestyle, including preparing healthy meals, exercising, and growing an organic garden, thereby striving to achieve a modicum of sustainable living. 2. To teach youths and their parents how to prepare healthy meals, incorporating the information and methods offered by Gift of Health & Wellness Mobile Kitchen Program. 3. To teach youths how to grow various types of organic gardens, including container gardening, transforming dormant backyards and empty window sills into organic gardens, and growing gardens on rooftops and in vacant city lots. 4. To introduce exercise therapy and weight reduction to the target audience. 5. To conduct research by: A) Analyzing data collected periodically through surveys administered to subjects by researchers
  • 10. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 10 B) Analyzing data collected through subjects' journal-keeping; and in particular, the changes they experience as a result of participating in all aspects of the Gift of Health & Wellness Mobile Kitchen Program. C) Assessing subjects’ attitudes toward and overall experience with documenting the physical, psychological, and behavioral changes they undergo and thoughts about the program in general with their peers through various social media sites such as Facebook and Twitter. 6. To document food-eating habits in the home and record any disorders associated with overweight conditions. 7. To allow this initial installation of the Gift of Health & Wellness Mobile Kitchen Program to serve as a model for subsequent programs to be rolled out nationwide. IV. METHODOLOGY The proposed duration of the Gift of Health & Wellness Mobile Kitchen Program, On the Road to a Healthy Lifestyle is three years. Four schools and 50 - 55 students per school will be selected to participate in this program in each of the first two years, for a total of 400 - 440 children subjects to be observed. The first year's subjects will be evaluated during the second year of the study, when the second group of students will undergo the study. During the third year, the second group of subjects will be evaluated, after their year of participation is completed. (For selection process, see the sub-heading "Selection Criteria" on pages 7-8). Test subjects (children/students) will receive a lunch prepared by Gift of Health & Wellness every day at school for one year. Additionally, this study group, along with their parents and, in many cases, grandparents, will learn how to prepare well-balanced meals for their children (through Saturday classes taught by the Gift of Health & Wellness Mobile Teaching Kitchen), participate in physical exercises, and learn how to grow various types of organic gardens. A detailed description of each of the four initiatives which comprise this program and its methodology follows. A. Gift of Health & Wellness Lunch Box Program Whether prepared in the school or in the home, lunches have been cited as one of the leading causes of overweight conditions in children. In different studies, it was shown that school- based interventions resulted in reduced weight in school-aged children. By mainly altering food
  • 11. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 11 quality and behavioral changes (watching less television, getting more physical exercise, etc.), Gortmaker et al. (1999) showed that school-based interventions can reduce overweight conditions in 6- to 8-year-olds. In another food-based study, Whitmore (2004) reported that school-provided lunches were more likely to increase youth obesity than "brown-bagged" lunches. It is quite apparent that a school-based intervention in the diet and behavior of youth can lead to better body conditions. Many obesity reduction interventions have tended to target only youths and ignore the role of the parent. In cooking classes conducted every spring from 2008 through 2010, during Black History Month in Saint Sabina Church in the south side of Chicago, participants reported the following (Emma Theuri, pers. comm.): 1. Some parents/subjects never learned how to cook, and remarked how much better food tastes when cooked at home, with added ingredients 2. Some parents never considered fresh vegetables as having nutritional value 3. Some parents were not aware of the great variety of food choices available to them 4. Children liked the flavor of home-cooked meals As a result of participating in this class, participants were enthused to cook their own food at least once a week, especially during the weekend. Based on results from this and other childhood obesity-related studies, Gift of Health &Wellness proposes to provide prepared boxed lunches to four schools during the first year, and four schools during the second year of the program. Specifically, approximately 50 - 55 students per school will receive boxed lunches every day, Monday through Friday, each year, based in large part on their BMI. Specifically, at the start of the program, each student's body mass index (BMI) will be documented at the beginning of the school year (this information will be made readily available from the records of physical examinations that are administered to all students at the beginning of the school year, free of charge). Those students selected for participation in this study will be so chosen based on their need, and the amount of benefit they are expected to receive from participation in the program, as determined by the researchers. Their BMIs will be compared to the BMIs of students from control groups pulled from another school that would be providing its own lunch throughout the year. At the end of the test year, the BMIs of the test students from all four test schools will be compared once again to the BMIs of the control group. B. Meal Preparation via Mobile "Teaching" Kitchen Another way in which Gift of Health & Wellness aims to address obesity is through providing a well-balanced diet through the use of a mobile kitchen unit, and teaching both at-risk students and their parents, as well as, potentially, their grandparents, how to prepare healthy and nutritionally balanced meals.
  • 12. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 12 During selected Saturdays, students, parents and ideally grandparents as well will attend cooking classes. Proposed venues include schools, churches, or community centers. The nutritional benefits and tastiness of cooking a diverse cuisine (Hispanic, African, Oriental or European dishes) will be discussed. The Meal Preparation via Mobile "Teaching" Kitchen program initiative is expected to have a multiplier effect: of the 20 or so families who participate in each cooking class, they will be expected to reach another 20 families, allowing the outreach to grow exponentially. The goal of this sub-program, among others, is to promote a broadened cultural awareness for children and their families by bringing diverse ethnic meals to the table at least once per week, in the home. Genetic predisposition, meal portion size, timing of eating, and physical activity play a key role in combating obesity. Lifestyle mentors made available in a support group setting will discuss how making various lifestyle choices and implementing certain techniques can improve one's health. The information that families will gain from participating in the Mobile "Teaching" Kitchen activity will include learning about the benefits of eating fresh produce and non-processed foods. These Saturday seminars will give children, parents, and grandparents...all generations... the incentive to actively think about the food they consume and the types of benefits their bodies will derive from it. In the end, the success of these Mobile "Teaching" Kitchen seminars will be determined by analyzing the change in parents' behavior during the course of the program ( e.g., a) how often they are now cooking at home compared to how often they were cooking at the start of the program, and b) what types of meals they are now preparing). C. Organic Gardening Another key initiative that comprises the Gift of Health & Wellness Mobile Kitchen Program is teaching organic gardening. Gift of Health & Wellness proposes to teach youths, and their families, how to grow various types of organic gardens, including container gardening; transform dormant backyards and empty window sills into organic gardens, and grow gardens on rooftops and in vacant city lots. Participants will also learn about some of the fundamentals and benefits of composting and recycling. Finally, through participating in organic gardening activities, families will realize the economic benefits that they can enjoy, saving them both time (in preparing meals using locally-grown ("in the backyard") foods) and money (by not eating fast food, going to restaurants, or taking carry out - all of which can cut very deeply into a family's budget if done even a few days every week). But perhaps most important are the nutritional and health benefits that children, parents, and grandparents alike will reap by eating natural, home-grown fruits and vegetables. The benefits of organic gardening are endless. For instance, it has been shown that organically grown food is significantly higher in the essential vitamins and nutrients that the body uses in its defense against cancer. ("Benefits of Organic Gardening", www.OrganicGardeningGuru.com). Since organic foods don't use pesticides, organic gardeners are not polluting the environment. And, the simple act of organic gardening is great for the spirit...participants should find it quite relaxing to feel the sun on their backs as they
  • 13. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 13 plant, weed, or water. Researchers propose that it will allow participants to reconnect with the earth, their health, and with each other, as a family. Extending Reach In addition to teaching children and families how to grow various types of organic gardens, Gift of Health& Wellness will implement a "Tell-A-Friend" philosophy in their teachings, whereby families will be encouraged to spread the word about the benefits of eating locally grown food. Youths will learn how to identify plants and herbs as well as maintain a garden. Participating families will make a pledge to donate an organic basketful of food to a person who is either shut-in or vision-impaired, or even to any of the vulnerable groups who have worked with Gift of Health& Wellness in the past. D. "Measure Up" Physical Activity The "Measure Up" component will introduce exercise therapy and weight reduction to study participants. The youth and senior citizen participants alike will be shown various types of physical activities and breathing techniques, and subsequently chart their progress. 1. Nature Path Walk - Study subjects will participate in Nature Path Walks, which will provide the dual benefit of getting participants to exercise through walking as well as teaching them how to identify plants. 2. Visual Big Projector Screen - Using interactive exercise and game technologies has become a popular method among children and adolescents for partaking in physical activity (e.g., Wii machines). Some technologies capitalize on kids' interest in computer or video interaction while delivering a cardiovascular workout in a game format. GOHW proposes to incorporate some form of interactive exercise in the GOHW Mobile Kitchen Program. Once again, to measure the success of this particular component of the total Gift of Health & Wellness Mobile Kitchen Program, researchers will use BMI and weight as two key metrics for observation during the course of the study. E. Key Metrics As previously mentioned, the success of each of these four key components of the Gift of Health & Wellness Mobile Kitchen Program will be measured. Measurement tools to be used include pre- and post-program documentation of key physical attributes among study participants (e.g., BMI and weight); content of daily log journals to be completed individually by each program participant, whether or not some form of organic gardening was maintained throughout the course of the program, and whether or not participants remain physically active every day, or at least, have developed a more physically active lifestyle by the end of the program compared to their status at the beginning of the program.
  • 14. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 14 Some of the key indicators of success which will be measured, depending on the individual initiative, are: 1. Improved body mass index (BMI) and weight reduction 2. Improved class performance 3. Improved physical mobility 4. Heightened self-esteem 5. Healthy food choices to prevent health discrepancies 6. Increased awareness of one's connectedness to the earth and all living things as well as their increased commitment to maintain a measure of sustainable living V. ASSESSMENT Gift of Health & Wellness will measure the success of the Mobile Teaching Kitchen program periodically, throughout the life of the program, using four basic types of assessments. Each type of assessment will measure a different aspect of the program's effectiveness, and is done at a different time in the life of the program. A. Reaction (Attitudes) Assessment The first type of assessment that Gift of Health & Wellness will utilize is the Reaction Assessment, which involves asking subjects how they felt about participating in the program, whether they enjoyed it, etc. This type of assessment is the easiest to obtain, but provides the least information about the effectiveness of the program. It merely provides an indication of the degree to which our audience will have found the program to their liking. For the Mobile Teaching Kitchen program, we will be asking participants to use a daily journal to record not only their physical progress from participating in the various initiatives of the program, but also their general thoughts on the program. Use of Social Media In addition to their own daily journals, student subjects will be asked to communicate their thoughts and feelings, sharing their likes and dislikes, about the program as well as some of their outcomes with their peers on social media, including Facebook and Twitter. It is surmised by our marketing team that incorporating social media channels in the overall program as a tool through which students can communicate with each other should foster their greater program adherence, positive behavior change and overall high satisfaction with the program. The students participating in the control group, however, will not be utilizing any social media tools in their journey to better health.
  • 15. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 15 B. Learning (Cognition) Assessment The second type of assessment that Gift of Health & Wellness will utilize is the Learning Assessment, which attempts to determine the degree to which participants have acquired some knowledge as a result of the experience. Written or oral content matter tests can be used to perform this type of assessment. Though acquiring knowledge does not always result in behavioral change, it is still a good assessment to use in conjunction with behavioral assessment, because participants should become at least aware of the many benefits of practicing healthy cooking and eating, organic gardening, and exercise. Since "knowledge is power", they will at least be equipped with the information needed to make better and healthier choices in their lives, with the final choice being for them to act upon them, and make those choices. C. Behavioral (Behavior) Assessment The third type of assessment that Gift of Health & Wellness will incorporate is the Behavioral Assessment, which seeks to determine the extent to which the program will be able to bring about some actual change in the participant's behavior (e.g., are the participants doing anything differently as a result of participation in the program?) This kind of assessment can be done by self-report or reports from significant others, such as parents, teachers, neighbors, etc. In this study, participants will be asked to "self-report", or to keep a log of their activity, as well as their thoughts about the program. In addition, researchers will be evaluating their physical progress periodically throughout the life of the program (e.g., evaluating various key metrics and outcomes, such as BMI and weight, as well as assessing participants' adherence to the program....maintaining their organic gardens, continuing their food preparations at home, and maintaining some sort of exercise program on their own, etc.). D. Impact (Outcomes) Assessment The fourth type of assessment that Gift of Health & Wellness will utilize is the Impact Assessment, which asks what type of real difference the program has made in terms of the extent of the problem or issue in question (e.g., Did overweight subjects lose enough weight to no longer be deemed overweight? Did obese subjects lose some weight? Did test subjects participate in regular exercise, and in regular organic gardening/sustainable living? Did they prepare meals at home more frequently by the end of the program than they did at the beginning of the program?). Moreover, an impact assessment should be made in part to ascertain the feasibility of extrapolating this program nationwide. Through utilizing all four types of assessments, Gift of Health & Wellness will be able to conduct the most comprehensive type of evaluation as possible. In order to conduct each type of assessment accurately, the appropriate individuals will need to be selected. Moreover, one other selection criterion which should be considered in selecting participants (youths between the ages
  • 16. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 16 of 6 and 14, inclusive) is whether or not they are deemed by researchers to be able to effectively track their own progress through self-reporting and logging their activity in their diaries. Given the younger age of these test participants, the results of their self-reports may not always be the most accurate. However, for this reason, it is important to obtain cooperation from their parents and grandparents that they will work with their children (and supervise) the consistent and accurate tracking of their various results and progress. VI. EVALUATION PLAN Gift of Health & Wellness research team will create five test groups among all participants, plus five control groups, among all control participants. For this reason, it is ideal that 50 students (and their parents and, in some cases, grandparents) are selected from each school. In this way, 50 can be evenly divisible by 5, to create the five test groups. A corresponding control group will also be created for each test group, numbering 5 in total as well. Test Group #1 In this group, the effects of participating only in the Mobile Kitchen Teaching Unit lessons and Organic Gardening will be studied. Therefore, this test group of students will be participating in only these two aspects of the study. Test Group #2 In this group, the effects of participating only in the Mobile Kitchen Teaching Unit lessons and Physical Activity will be studied. Therefore, this test group of students will be participating in only these two aspects of the study. Test Group #3 In this group, the effects of participating only in the School Lunchbox Program and Organic Gardening will be studied. Therefore, this test group of students will be participating in only these two aspects of the study. Test Group #4 In this group, the effects of participating only in the School Lunchbox Program and Physical Activity will be studied. Therefore, this test group of students will be participating in only these two aspects of the study. Test Group #5 – Full Treatment In this group, all students will benefit from participating in all components of this study, including physical activity, organic gardening, cooking at home, using techniques they learn
  • 17. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 17 from the Mobile Teaching Kitchen Unit (though the parent and/or grandparent will be doing most of the cooking at home), and the lunchbox program. The diagram below illustrates the five test groups that will be created, in terms of the activities in which members will be participating. One control group, who will not receive any treatment throughout the course of the year-long testing period, each year, will also be created. As previously addressed, a variety of factors will be evaluated and measurements made throughout the course of the yearlong study, each year, across all test participants. Activity Participation Organic Gardening Physical Activity Mobile Kitchen Teaching Unit Test Cell #1 Test Cell #2 School Lunchbox Program Test Cell #3 Test Cell #4 Test Cell #5
  • 18. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 18 VII. SUMMARY The Gift of Health & Wellness Mobile Kitchen Program provides several tangible benefits. First, it responds to the urgent need to develop effective and practical solutions and resources for attempting to combat obesity and its associated health risks. Second, it helps build family bonds by implementing classroom and at-home activities in which all generations can participate and learn how to lead a much healthier lifestyle together. Third, it can serve as a model that can be disseminated to large numbers of children and their families both locally, in our test markets, and eventually, nationwide.
  • 19. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 19 APPENDIX
  • 20. USDA Grant Proposal for Gift of Health & Wellness Mobile Kitchen Program Page 20 REFERENCES 1. Benefits of Organic Gardening. Visit http://www.organicgardeningguru.com/unique-benefits.html 2. Centers for Disease Control and Prevention. 2009. H1N1 Flu in The News. Visit http://www.cdc.gov/h1n1flu/in_the_news/obesity_qa.htm 3. Centers for Disease Control and Prevention. 2010. Tips for Parents- Ideas to Help Children Maintain a Healthy Weight. Visit http://www.cdc.gov/healthyweight/children/index.html 4. Foy, M. 2000. Ph.D. Thesis, "Family Systems Variables as Predictors of Eating Styles And Body Mass Index". Virginia Tech, VA. 5. Gortmaker, S.L., Petersen, K., Wiecha, J. , Sobol, A.M., Dixit, S., Fox, M. K., and Laird, N. 1999. Arch. Pediatr. Adolesc. Med. 153: 409-418. 6. Health Topics: Childhood Obesity, 2010. Report by Centers for Disease Control and Prevention. Accessed in http://www.cdc.gov/HealthyYouth/obesity/ 7. Nie, H.H., Bent & Hull, C.H. 1970. Statistical Package for the Social Sciences (SPSS). 8. Office of the Surgeon General. Overweight and Obesity: Health Consequences. Accessed in: http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm 9. Rates of Obesity for Chicago Children. Consortium to Lower Obesity in Chicago Children (CLOCC) report, 2010: Visit: http://www.clocc.net/news/CLOCC_Data_R_FINAL.pdf 10. State Data, Illinois. Trust for America's Health, 2010. Visit: http://healthyamericans.org/states/?stateid=IL 11. Tanaka, S., Inoue, S., Isoda, F., Waseda, M., Ishihara, M., Yamakawa, T., Sugiyama, A., Takamura, Y., and Okuda, K. International Journal of Obesity-Related Metabolic Disorders 1995: 19 (3): 209. 12. Whitmore, D. 2004. Do School Lunches Contribute to Childhood Obesity? Harris School Working Paper #05.13. Visit: http://www.uncg.edu/bae/econ/seminars/whitmore.pdf 13. Zalevskaia, A.G. & Blagosklonnaia, laV. 1981. Various indicators of cellular immunity in obesity. Effect of low-calorie diet. Prbl Endokrinol (Mosk). 27 (5): 35-38.