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Home My WebLink About991704.tiff RESOLUTION RE: APPROVE GRANT APPLICATION FOR NUTRITION AND FITNESS PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Grant Application for the Nutrition and Fitness Program from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Action for Healthy People, Inc., commencing October 15, 1999, and ending October 14, 2000, with further terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Grant Application for the Nutrition and Fitness Program from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Action for Healthy People, Inc., be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 26th day of July, A.D., 1999. BOARD OF COUNTY COMMISSIONERS W COUNTY, COLORA 0 ATTEST: Lill ; ,' ; . \Z riall, Chair Weld County Clerk to the ar, t.or4t,te,lath �, �c_rbar J. Kirkmeyer, 'ro-Tem &' BY: �o i// C , 'a Deputy Clerk to the Boa a' � � _ George E. axer _APPROVEQ'AS TO FORM: //e pz6/ ( M. J Gei e �/J County Attorney .�C�TC,<INU Glenn Vaad 991704 . /� HL0025 I!/ (, DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17T"AVENUE \ GREELEY,COLORADO 80631 J ADMINISTRATION(970)304-6410 PUBLIC HEALTH EDUCATION AND NURSING(970)304-6420 C FAX(970)304-6416 ENVIRONMENTALHEALTH SERVICES(970)304-6415 FAX(970)304-6411 COLORADO MEMORANDUM To: Dale K. Hall, Chairman, Board of County Commissioners From: John S. Pickle, Director % ,artment of Public Health and Environment Date: July 23, 1999 Subject: Nutrition and Exercise for Adults Grant Application to Colorado Action for Healthy People Enclosed for Board review and approval is a grant application to Colorado Action for Healthy People. This grant will help continue the collaborative work begun by the Weld County Diabetes Coalition, which is no longer eligible for funding from the Colorado Department of Public Health and Environment. This grant would provide funding for nutrition classes at Senior Nutrition Sites and other venues in the county, designed to reduce the risk for chronic diseases, such as heart disease, the leading cause of death in Weld County. It would supplement the Senior Walking Program and other physical fitness activities for adults in Weld County. The Weld County Area Agency on Aging, Wellness Services at North Colorado Medical Center, CSU Extension Services, and Aims Community College are cooperating agencies. The term of the grant, assuming it is received, would be from October 15, 1999 to October 14, 2000, with the possibility of renewal for two additional years. I recommend your approval. Enc. GRANT APPLICATION FORM COMMUNITY ACTION FOR HEALTH PROMOTION INITIATIVE HEALTHY HABITS Colorado Action for Healthy People,Inc, 1999 Project Title A Nutrition and Fitness Program for Weld County Adults Applicant Name Weld County Department of Public Health and Environment Address 1555 N. 17th Avenue Greeley, CO 80631 Contact Person Gaye Akin, RD, MPH Health Education Specialist _ (Name &Title) Phone (9 a.m. - 5 p.m.) 970-304-6420 x2385 Secondary contact person and phone (if applicable) Marian Ruge, MS, RD 970-304-6420 x2384 (Name & Title) Phone (9 a.m. - 5 p.m.) Amount Requested $ 10,000 from October 15, 1999 to October 14, 2000 ($10,000 maximum) month/day/year month/day/year LIMIT THE NARRATIVE TO THE SPACE PROVIDED IN THIS APPLICATION, UNLESS INDICATED. PROPOSALS LACKING ANY OF THE REQUESTED INFORMATION AND/OR EXCEEDING THE PAGE LIMITS WILL NOT BE CONSIDERED FOR FUNDING.* SUPPORTIVE MATERIALS ARE ALLOWED BUT PLEASE BE SELECTIVE. ORIGINAL PROPOSAL PLUS NINE (9) COPIES MUST BE RECEIVED BY CAHP BY 12:00 NOON,FRIDAY,JULY 30, 1999. *Please use at least 11 point type throughout the application 5 Project Title: Nutrition and Exercise Program Applicant's Name: Weld County Department of Public Health and Environment Address: 1555 N. 17th Avenue Greeley, CO 80631 Phone Number: (970) 304-6420 Director: John. S. Pickle, M.S.E.H. Contact Persons: Gaye Akin, R.D., M.P.H. & Marian Ruge, M.S., R.D. Amount Requested: $10,000.00 WELD COUNTY DEPARTMENT WELD COUNTY BOARD OF COMMISSIONERS OF PUBLIC HEALTH AND ENVIRONMENT %JD Dale Hall, Chair ohn S. Pickle, M.S.E.H., Director Date © -a6 - 7 wsk,1'LE' TO THE BOARD �. . / • etrAr At e0 Project Summary This project is intended to increase the number of adults ages 20 and older participating in regular exercise and nutrition programs in Weld County. We target two segments of the population: older adults through senior nutrition programs and other adults through recreation/fitness centers. We reduce the risks for developing heart disease,diabetes and other chronic diseases and their complications through increased exercise and improved nutrition. We can build capacity to promote a healthier lifestyle in our population by utilizing existing programs Organized nutrition and exercise programs exist in many communities in Weld County. By coordinating with these existing programs and other local agencies, we can support and enhance these efforts. The Area Agency on Aging(AAA), Wellness Services at North Colorado Medical Center, and Aims Community College are currently piloting a walking program with three Senior Nutrition Sites in Weld County. Many seniors participate in the congregate meals but do not engage in regular exercise programs. We can expand the pilot walking program to more sites in Weld County and offer nutrition education classes to provide a complete community based chronic disease prevention program. Many adults in Weld County, ages 20-64 years old are engaged in regular exercise programs through local fitness/recreation centers. We can develop new nutrition education programs and add to existing ones at these facilities by collaborating with their staff and nutrition consultants. T he Colorado State University La Cocina Saludable nutrition classes will be offered at the Jesus Rodarte Center and other appropriate sites. Once developed, these classes will be available on an on-going basis at low or no cost. The funding from this grant combined with the resources and commitments of the project partners can help establish a more comprehensive exercise and nutrition program for adults in Weld County. PROJECT PLAN ELEMENTS . 1. Problem Statement The goal of this project is to reduce the risks for developing chronic disease and their complications is It is well documented that heart disease, diabetes, high blood pressure, cerebral vascular disease, chronic obstructive pulmonary disease("COPD"),arthritis and their complications can be delayed and/or prevented through increased physical activity and better nutrition By targeting the adult population in Weld County through organized senior nutrition programs, recreation center/fitness clubs, we can enhance their program by adding either the exercise or the nutrition component. The behaviors that contribute to developing chronic disease and its complications can then be modified. According to the 1997 Colorado Vital Statistics, 63.7%of Weld County residents are ages 20 and older, (36.9%20-44 years old, 16.6%45 - 64 and 10.2% 64 and older). The age adjusted death rate from heart disease, cerebrovascular disease, diabetes and COPD are listed below for Weld County, Larimer County(an adjacent front range county)and Colorado. The age distribution for Larimer County populations statistics is similar to Weld County with 71.96% adults ages 20 and over(42% ages 20 - 44,20.10%45-64,and 9.83%over 65). Table 1: Adjusted Death Rates for Specific Causes County/State _ Heart Disease Cerebrovascular COPD Diabetes _ Colorado 97.2 23.1 26.7 9.1 Weld County 104.4 25.9 41.1 12.79 Larimer County 84.8 20.6 23.3 3.35 The population of Weld County is 25%Hispanic origin compared to 13%for the state of Colorado and as a result,the incidence of Type 2 diabetes in Weld County is higher. It is estimated by the Colorado Department of Public Health& Environment that over 8,000 people in Weld County have diabetes and only 4000 have been diagnosed. 25%of these are of Hispanic origin compared 19% for Colorado. The age adjusted death rates from these causes are statically higher in Weld County than for Larimer County and Colorado. In 1998, the Area Agency on Aging conducted a needs survey of adults ages 60 and over in Weld County. The types of health conditions that affect this population the most are arthritis 60%,high blood pressure,41.4%, problems with breathing, 19.7%, heart disease, 17.8 % and diabetes, 8.7%. Breathing, heart disease,diabetes and osteoarthritis conditions interfere with 18-20%of their daily activities. This indicates a clear need for more chronic disease prevention activities in Weld County for adults of all ages. Transportation was identified as a significant problem in Weld County for seniors. Transportation problems are reduced by using any program where seniors already assemble in conjunction with other activities. The service with which the seniors are the most familiar is the senior center. Most(91%)have heard of the service and 31.4% have used the service. There are senior nutrition programs in 21 different locations in Weld County, rural and urban. The Weld County Diabetes Coalition worked with the senior nutrition site coordinators to offer free blood sugar screening at 11 sites in 1998-1999. National statistics indicate that 10%of a community participates in regular organized exercise programs. Participation at the two facilities, the Evans recreation Center and Better Bodies for Women is over 750 adult members. This is a large number of people who are already pursuing regular physical activity and will serve as a model for timely nutrition and chronic disease intervention. 2. Rational. The goal of this project is to reduce risks for developing chronic disease such as heart disease, diabetes, arthritis, and chronic obstructive pulmonary disease through increased exercise and better nutrition in the adult population in Weld County. This promotes the proposed Healthy People 2010 objectives to: 1) improve the health, fitness and quality of life of all Americans through the adoption and maintenance of regular,daily physical activity; and 2)promote health and reduce chronic disease risk, disease progression, debilitation and premature death associated with dietary factors; and 3) increase the quality, availability and effectiveness of educational and community based programs designed to prevent disease and improve the health and quality of life of the American people. This is a collaborative effort catalyzed by the Weld County Diabetes Coalition to further efforts for prevention of diabetes, heart disease and other chronic diseases in our community. This project blends an exercise component and a nutrition education component for adults participating in organized programs at senior nutrition sites and health club/recreation facilities. This project can expand to other senior nutrition sites, recreation centers and fitness clubs through the continuing support of the coalition members and the Weld County Department of Public Health and Environment(WCDPHE). This project aims to improve the health of the citizens of Weld County by impacting people's behavior to prevent chronic disease. The established senior nutrition programs provide opportunity for education and increased socialization. The recreation//fitness programs offer regular exercise programs. By building on existing programs to offer the "missing"component, adults in Weld County will have both the information and the opportunity to reduce their risks for chronic disease. The Weld County Department of Public Health &Environment will both develop and utilize existing nutrition programs,teach classes, train volunteers from each site as assistants, serve as liaison with other collaborators through the Weld County Diabetes Coalition. Teaching modules will be developed or adopted from currently available programs concerning four different topics. The topics and times will be decided after a brief survey is conducted at the senior nutrition sites and the recreation/fitness centers. Volunteers from each site will act as leaders to continue the programs. Incentives will be provided for participants in the nutrition/cooking classes, cooking utensils and cookbooks. For those participants signing up for 3 classes,the health risk appraisal and 6 month health data monitoring will be provided for free. These classes will be offered at times convenient for the facility and the participants. The CSU Extension Program,La Cocina Saludable, will be utilized for classes at the Jesus Rodarte Center and others as needed. A Spanish speaking member of the health promotion team will co-teach the class. The participating agencies will furnish the cooking facilities and help recruit members for classes. The Area Agency on Aging, Wellness Services at North Colorado Medical Center, and Aims Community College are preparing to pilot a walking program for seniors with volunteer Senior site coordinators. The Evans Recreation Center Senior Nutrition Site has already implemented a walking program. This program will begin in conjunction with the annual Senior Health Fair sponsored by Area Agency on Aging, Aims Community College and North Colorado Medical Center in September, 1999. Following the 6 month pilot, the program will be initiated through out Weld County. Volunteer "leaders" from each site will recruit participants and help promote the program. This grant will help provide support in the form of incentives for the participants such as certificates, shoestrings, water bottles, etc. and for the senior health risk assessment. Monthly educational programs are planned on one aspect of health and wellness(physical,mental, social, emotional, spiritual and occupational)as support and motivation. Printed materials about many aspects of health&wellness will be available including a newsletter provided by the CSU Extension Service. The health related data will be measured through pre and post tests such as blood pressure, cholesterol, resting heart rate and strength and flexibility. This will help measure change in overall health, with specific emphasis on diet,exercise and mobility. This project is a collaboration by eight different agencies with a commitment to sustain and expand the project to other communities in Weld County. The project will be successful because it builds on existing programs and successful relationships utilizing various strategies to establish participation. 3. Target Population. The target population for this project are Weld County adults ages 20 and over particiipating in organized community programs such as senior nutrition programs, recreation centers and fitness/exercise clubs. The geographic area includes all of Weld County. The Senior Nutrition sites through the Area Agency on Aging, are located in 21 different towns/cities in Weld County, rural and urban The locations represent all areas of Weld County including sites in Grover, Wagons,Briggsdale, Windsor, Mead, Johnstown,Milliken; Eric, Firestone, Ft. Lupton, Lockbuie,and Evans. Most nutrition sites are located at senior centers and/or recreation centers and some in other city/community buildings. These sites provide congregate meals at least once weekly and serve as a local gathering place for seniors in the community for many other activities. Senior Site Coordinators arrange the activities and recruit participants. We will use the Diabetes Coalition blood sugar screening as a model for setting up the nutrition classes. Through the coordinators and volunteers at each site,we can implement the walking program and nutrition classes. We will offer a choice of 4 different nutrition classes and will provide one or more at the sites requesting the classes. The volunteers will schedule the classes with the health department. We will provide a total of 24 classes during the grant period, 6 per quarter at as many different sites as possible representing the different areas of Weld County. We will offer the Spanish speaking module at the Greeley Jesus Rodarte Center and at other locations as requested. The program can be used again for other classes by the consultant dietitian with Area Agency on Aging. After completion of the pilot walking program, it will be implemented throughout Weld County again using the senior centers and congregate meals as regional sites. Targeted pilot sites for the walking program are Milliken, Evans,Ft. Lupton and Greeley. The county wide walking program will be adapted after completion of the pilot programs making any recommended changes before going county wide. Aims Community College Senior Exercise program has classes in some of these locations and hopes to expand their classes to others along with the walking program. The nutrition classes will be implemented at the Evans Recreation and Senior Center located in Evans, Colorado. Evans has a senior nutrition site and they have agreed to sponsor the nutrition classes at their facility in the Evans Recreation Center. In cooperation with the nutrition consultant at the recreation center,we can offer the nutrition classes to the adult exercise participants as well. The recreation center will help recruit participants for the programs and provide the facility. The curriculum can be used again for seniors and adult exercise participants and adapted as needed by the nutritionist and/or teaching assistants. Better Bodies for Women fitness center has 250 members and is located at 2501 West 10 th St., Greeley, CO. They do not have a nutrition consultant on staff and want to offer nutrition classes to their members. They will recruit participants and provide the facility. In the future,the center can use the materials developed for other classes and/or contract with a nutrition consultant to teach the classes at a reasonable cost to their members. We will make this material available to other recreation and fitness centers in Weld County after the grant period. The senior nutrition sites can offer the nutrition classes to other adults in the community to increase utilization of their facilities and promote intergenerational activities. The classes will be appropriate for anyone but will be adapted for the participants who sign up. Suggested classes are: cooking for one or two using modified recipes from participants own favorites; quick meals for families, herbs and supplements, and sports nutrition. Each class will focus on chronic disease prevention and include cooking demonstrations and samples. Actual topics will be based on results of surveys conducted at each facility. 4. Project Plan. Goal: To reduce the risks for developing a chronic disease such heart disease,diabetes., COPD, arthritis,cerebral vascular disease or hypertension,and preventing their complications through increased regular exercise and better nutrition in adults. Objective 1: To increase the fitness level of participants in the walking program at senior nutrition sites in one year in Weld County. Steps: Step 1: Increase the miles walked per week in one year(by a percentage to be decided upon by participant, physician and exercise specialist) Step 2: Increase total physical activity in two other ways over one year. Responsibility: The volunteers are responsible to: • gather monthly walking and activity logs kept by participants • send logs to Walking Program Coordinator monthly • completes charts of total miles, individual achievement with other activities • reports results to participants at monthly support meetings. The Walking Program Coordinator from the Wellness Center • works with participants to identify walking goal and two other physical activities at the beginning of the program and at reviews at six months. • coordinates pre and post testing on health data- blood pressure,cholesterol, resting heart rate and strength& flexibility at 6 months and one year. • administering the Health Age Profile to all participants at the beginning at one year. Measures: • trained volunteers for on site programs. • walking logs for number of miles walked and activity logs will show an increase in miles and activities from the beginning of the program by the percent indicated. • pre and post test data will measure improvement in the health risk data. Objective 2. Increase awareness and knowledge about fitness&walking in participants of the walking program at senior nutrition site in Weld County in one year. Steps: Step 1: Present quarterly walking clinics on various topics. Step 2: Provide handouts on tips and various topics at monthly support/motivational meetings. Step 3: Provide referral to wellness specialist for individual assistance as needed: Responsibilities The Walking Coordinator will: • Administer the Health Age Personal Wellness Profie (PWP)to all participants. • Work with on site coordinators for the monthly support meetings. • Deliver quarterly clinics to program participants on topics of-. Obtaining proper shoes Race walking techniques Weight training Measures: • Pre and post tests for quarterly clinics. • Referrals to the Walking Coordinator for individual assistance. • Utilization of proper shoes for walking. Objective 3: Increase the knowledge and awareness of better nutrition and how it relates to the prevention of chronic disease in adults participating in organized exercise and walking programs at senior nutrition sites and recreation/fitness clubs in Weld County in one year. Steps: Step 1: Develop and implement a brief survey for participants on practical ways to improve nutrition practices for themselves and their families. Step 2: Develop four different nutrition classes that address these needs and demonstrate methods for changing behaviors. Step 3: Implement nutrition classes at senior nutrition sites by request, Evans Recreation Center and Better Bodies for Women Fitness Club providing at 24 1 hour classes on a these topics by the end of one year. Responsibility: The dietitians from the WCDPHE will: • develop the surveys • develop nutrition classes • prepare pre and post tests and evaluations • purchase supplies and materials needed for classes and incentives for participants (Cookbooks, hot pads,measuring cups, etc.) • train the Spanish speaking staff member as a co-teacher of the La Cocina Saludable • provide the classes in the future as requested, including the La Cocina Saludable program. The dietitians at Area Agency on Aging and Evans Recreation Center will: • assist with recruiting participants to the classes • review the curriculum for content • provide the classes to members of their facilities in the future at low cost. The volunteers from the senior nutrition sites and fitness clubs will: • distribute and collect the surveys at each participating site. • assist with recruiting the participants for the classes. • assist with teaching the nutrition classes: Measures: • Change in pre and post test scores. • Evaluation scores for the nutrition classes of effectiveness of the classes. • Improvement in health related data collected for the walking program • Improvement in health related data for those adults participating in 3 of the nutrition classes at recreation/fitness center. 5. Collaboration. This project brings together various community agencies as collaborators. Although the strategies are fairly basic, including a walking program, health risk assessment, nutrition education and assessment,the strength of this project lies in the wide variety of locations where the program will be offered. The plan builds on the current successful collaboration between agencies and adds a complementary piece to help improve the health of Weld County residents. The foundation of the project established by the Weld County Diabetes Coalition will support the efforts of these agencies in our community. The project collaborators are: Wellness Services at North Colorado Medical Center- provide leadership and coordination for the walking programs,administer the Senior Assessment Plus, monitor the health data and develop a recognition and incentive program for participants in the walking program. Aims Community College-has on-going exercise classes at some senior nutrition sites and will promote the walking program and the nutrition classes to these participants. Area Agency on Aging- Senior Nutrition Site coordinators will assist with raising awareness of and soliciting participation in both the walking program and the nutrition classes. They will help recruit the volunteers for"team leaders". CSU Extension - Provided curriculum, materials and incentives for the La Cocina Saludable program and will provide a monthly newsletter for participants of the walking and nutrition classes. Evans Recreation Center and Better Bodies for Women - help promote nutrition classes to their participants and provide the facility for the classes. The nutritionist will use the nutrition program materials for Jesus Rodarte Center- collaborate with agencies to recruit participants for the nutrition classes and walking program and provide the facilities for the nutrition classes. Weld County Department of Public Health & Environment- develop nutrition education curriculum, develop incentives and recognition for adult fitness,recruit volunteers for teaching assistants,teach nutrition classes and serve as the program liaison. The collaborators(coalition)will continue to meet on a regular basis, monthly or bi-monthly, to coordinate the walking program,motivational classes, fitness classes and the nutrition classes. We will include the nutritionists and volunteers from the senior nutrition sites, recreation and fitness center. The coalition will monitor the project plan,review nutrition topics and classes, and provide recogniition to participants. They will guide project implementation and make recommendations for enhancements during the project based on the results of the evaluations and pre and post test scores and input from the participants. During this project,the guidelines for continuing the walking and nutrition programs will be developed and implemented. 6. Community Resources. To our knowledge,the partners in this collaboration are the agencies in the community doing a walking and nutrition program. At the coalition meetings as we developed ideas, we looked for other groups doing similar things and invited them to discuss their ideas and projects. The Wellness Center expanded their participation to include the senior wellness coordinator and business/industry program coordinator. CSU Extension, a new member of the coalition, is very involved in nutrition education in our community and has a wealth of resources available. They also have the Food Stamp Nutrition Education Program series of classes "Eat Well for Less" available to any of the low income sites. We will offer this on a referral basis as need is identified. We know the larger fitness clubs in Greeley provide nutrition classes for their members as well as fitness testing. The Conditioning Spa in Greeley has expressed an interest in the classes if we can offer them in coordination with their nutritionist after the grant period. We will invite members of other facilities in each community to attend the classes through the media publications of the recreation center, fitness club and senior nutrition sites. There are other community nutrition sites that are not affiliated with the Area Agency on Aging and we have done blood sugar screening at some. We will contact and offer the nutrition classes and walking program to any of these sites interested in participating. Catholic Charities Northern provides services at senior complexes in Ft. Lupton and Greeley/Evans and may also participate in these programs as well. Aims Community College will advertise the classes and the walking program to their senior exercise participants. We may offer these to the adult fitness participants at Aims in the future for low or no cost.. The walking program and the nutrition classes will be offered to anyone in the communities wanting to participate, using the senior nutrition sites as a springboard and meeting center. We hope to identify new programs and partners to expand the program to all sites in Weld County. As the project begins we will make every effort to identify and coordinate with other similar projects to extend resources and sustain the programs. 7. Barriers and Obstacles. Communication between the partners is a very important part of this project. Because of the number of partners, it:is an obstacle to maintain close communication on all parts of the project. Continuing the coalition meetings on a monthly basis, we have established a regular meeting expectation. We need to engage the new members of the group from the beginning of the project to ensure they have a good understanding of the project. By involving the volunteers for the nutrition classes and walking program as well as the site coordinators, we can augment the communication between the sites, facilities and the project partners. Another obstacle we need to address is how to make the nutrition classes exciting and relevant. People talk about wanting to know about good nutrition but often don't take the time to go to classes when they are offered. Letting then have input on class subjects and times should help. Involving "locals"as volunteer teaching assistants should increase interest. Using recipes submitted by participants for discussion and preparation will help point out the different nutrients and their benefits. Information on healthy eating needs to be illustrated. Each class is a hands on demonstration that will provide information on current topics such as sports nutrition, stress/depression, healthy fats in our diets, health and healing properties of herbs and spices we commonly use, etc. Cooking at home is one of the most inexpensive and healthy behaviors we can promote. We can demonstrate the easiest ways of preparing food at home and stress the true value in terms of quality family time, food cost savings and good health. Developing a schedule for the nutrition programs at each of the facilities and sites will be challenging. The facilities are in high demand at certain times. Finding times that do not conflict with other activities and busy schedules is difficult. We can include questions on scheduling in the surveys. We need to set the class times and dates as early as possible. A barrier may exist in recruiting Spanish speaking participants at the Jesus Rodarte Center in Greeley. It will be important to determine their particular needs and accommodate these as much as possible with the La Cocina Saludable. We can use the set senior meal time to prepare their meal for that day utilizing some of their favorite recipes and their help with cooking. The volunteer and health promotion staff member can help develop a menu of local cuisine and identify concerns we should address. The same stral:egy can be utilized at other senior sites to promote the classes. Using their usual meeting day and time and preparing one part of the meal with their assistance and input can stimulate interest in other classes. It is a comfortable way to bring out concerns and questions among the participants. Transportation is a barrier for many seniors, especially low income elders. Using established meal times may help. Using volunteers,public transportation, or facility vans to provide rides to and from classes are possible solutions. Project Future. This project is part of a community capacity building project underway through the Area Agency on Aging, Wellness Center at North Colorado Medical Center and Aims Community College. We all have a an interest in promoting prevention of chronic disease and disability in our communities. The project partners offer different services to this population and bring a variety of resources together. The strength of this project is the number of agencies and facilities represented,the number of services offered, and the, commitment of these partners to the community. Although a variety of services are offered,the piece that is missing in many facilities/programs is the nutrition education piece. The Weld County Department of Public Health and Environment can provide quality comprehensive nutrition programs in cooperation with the project partners. This involves not only the agencies who provide services to the communities, but staff, consultants and volunteers from the facilities. By working with the nutrition site coordinators, nutrition consultants and participant volunteers we add another dimension of durability. Linking this project with the existing on-going programs in the community means we are not creating something new but enhancing existing programs. The nutrition consultants with the Area Agency on Aging, Evans Recreation Center and CSU Extension Service are excellent resources for developing sustainable programs with their audiences. The curriculum developed for the nutrition classes can also be implemented at the Weld County Department of Public Health& Environment for Spanish speaking and low income clients in the future. The health department serves many younger adults with families who will benefit from this service. In addition, we can use this venue to promote regular physical exercise through education and referral. Clients who quality for the CSU Food Stamp Nutrition Education Program will be refereed to this program to increase educational opportunities for this population. By partnering with the extension office and the senior nutrition sites,the lower income and Spanish speaking populations can be better served in the future. The development of the senior walking program through Area Agency on Aging, Wellness Center, and Aims Community College to augment Aims senior exercise classes and other senior activities is really a dream come true for each of these agencies. By coming together with their ideas and resources,they are able to make this a reality. The addition of health data monitoring dimension to promoting health and fitness. The benefits of increased regular exercise will be measurable. By adding the nutrition education component, we can demonstrate the relationship between more exercise and better nutrition. This partnership has been successful and will be even more so with the addition of new constituents. This project represents a county wide effort and commitment to address preventable health problems by building community capacity in Weld County. BUDGET Applicant:WELD COUNTY DEPARTMENT OF Pnsr.TC TIEALTB Funding Period: ort 15, 1999 Oct 14, 2000 AND ENVIRONMENT CAHP LOCAL LOCAL TOTAL Line Item REQUEST CASH IN KIND BUDGET EXPENSES Personnel Project Director (attach resume) $ 4957.50 $ 436.42 $ 4957.50 $ 10,351.42 (salary=$3966; fringe=$793.20; indirect=$198.30) Other Staff time from collaborating $ $ $ moon no $ in-OOn nn agencies SuppliesMaterials for $ 1300.00 $ $ $ 1,300.00 Nutrition Classes Printing/Copying $ 300.00 $ $ 200.00 $__500.00 Telephone $ $ $ 350.00 $__350.00 Postage $ $ $ 350.00 $__350.00 Info./Ed. Materials $ 1992.50 $ $ $_L992.50 Travel $ 300.00 $ $ 300.00 600.00 Meeting Costs $ 150.00 $ $ 150.00 $—_300.00 Consultant Costs $ $ $ 450.00 $__450.00 (Spanish language .presenter) Other (specifyyersonal Wellness $ 1 non no $ $ 1 nnn on $_a,.o00_p0__ Profiles/Senior Assessment Plus Equipment $ $ $ 500.00 $__500.00 Space Rental (in-kind only) $ X)OCX $ $ 1100.00 $ 1 1 on on TOTAL EXPENSES $ 10,000.00 $ 436.42 $ 19.357.50 $29.793.92 15 Budget Narrative. Please explain how the funds requested for each budget item will be used. Be as specific as possible. Provide detail for local cash and in-kind. Personnel: This project will be directed by a team of two registered dietitians currently employed at the Weld County Department of Public Health and Environment. Five hours per week of Gaye Akin's time will be directed toward this project,the funding provided as local in-kind. The request for five(5) hours of time per week for Marian Ruge will increase her FTE (currently at 18 hours per week). Local cash equal to$436.42 will come from WCDPHE funds to make up the difference between the 5%of personnel limit for indirect and the 9.52% of total grant funds assessed by Weld County to administer the grant. Collaborating agencies will provide local in-kind funding through the salaries that are paid to their staff members who are involved in coordinating the various parts of the program. This includes North Colorado Medical Center Wellness Services, Aims Community College, Weld County Area Agency on Aging, Senior Nutrition Site Coordinators, and Colorado State Cooperative Extension FSNEP staff. Supplies: Materials will be needed to present cooking demonstrations and provide samples of the foods prepared. Printing& Copying CSU Extension has agreed to donate 200 copies of six newsletters about nutrition and exercise to program participants. This is included in the local in-kind. Some printing will be necessary for promotion of classes and handouts for class participants. Telephone&Postage: This will be provided as local in-kind by the WCDPHE. Infor./Ed. Materials: Incentives for nutrition class participation will include the materials that are available through La Cocina Saludable, (measuring cups and spoons, apron, cloth bag)when that curriculum is used. For other class participants, incentives such as a quick recipe flipchart, certificates of completion, hot pads, etc. will be provided. The senior walking program that is partnering with this grant does not include any money for incentives for participation. Part of this grant funding would be used to purchase incentives for the walkers, such as shoestrings, water bottles, certificates for miles or time walked, etc. Travel will cover expenses for travel around the county related to this project. Meeting Costs Bi-monthly meetings will be held to coordinate the nutrition classes and walking program. In the past,the Weld County Diabetes Coalition,of which this grant request is an outgorwth, met at noon or early morning,with simple refreshments provided to those attending. Consultant Costs The cost of the Spanish language presenter for La Cocina Saludable is local in-kind equivalent to 50 hours of time for training and presentation of one series of classes. Other Personal Wellness Profiles/Seniors Assessment Plus cost is about$10 each for processing. This would provide funding for 100 seniors to complete the Health Risk Appraisal which will give valuable baseline data about current nutrition and exercise habits. Plans are to repeat the profiles every year or two to note changes. NCMC Wellness Services will also provide funding for these health risk assessments. Equipment: Stoves,refrigerators, cooking equipment, etc will be provided by the Senior Nutrition Sites where the classes are presented. Space Rental (in-kind only)The WCDPHE is fortunate to have an attractive new building with meeting space available. The Senior Nutrition Sites and small fitness centers also have adequate space for the nutrition classes. The total is calculated at$50 per class/meeting. Gaye Akin 5349 Arrowhead Drive Greeley,CO 80634 EDUCATION Masters of Public Health - University of Northern Colorado, Greeley, Colorado, 199E B.A. Dietetics - University of Northern Colorado, Greeley, Colorado. May 1976. Registered Dietitian - 1977 -present PROFESSIONAL EXPERIENCE Health Education Specialist/Health Education Standards Coordinator at Weld County Dept Public Health& Environment, Greeley, CO., 1996 -present. Coordinator of the Health Education Standards: Guidelines for Practice in Colorado. This project provided assessment/ training to local public health entities to increase capacity for providing quality health education programs in their communities. Co-coordinator of the Weld County Diabetes Coalition. Coordinator of the CCNA, CPHA, CEHA Public Health Leadership Series. Provide health and nutrition education for clients and community groups, facilitator for nursing/Board of Health work groups. Clinical Dietitian at PVH/Mountain Crest Behavioral Health Care System, Ft. Collins, Colorado 1996 - Present. Provide nutrition assessment, evaluation, care and education for the senior, adult and adolescent clients for psychiatric disorders and addiction recovery. Develop clinical care procedures and client educational materials. Provide consultation for food service policies and procedures; maintain JCAHO nutrition care policies; member of the Patient Care Committee. A LA PREM Catering- Owner/operator, Greeley, Colorado. 1995-Present Personalized catering for luncheons, dinner parties, receptions and other special events. Customized menus for all occasions with complete professional service. Assistant Manager, Chief Clinical Dietitian - Food and Nutrition Services, North Colorado Medical Center. Greeley, Colorado 1978 -1995. Coordinator for clinical nutrition care for patients and Continuous Quality Improvement Program; chairperson for the Nutrition Support Service and liaison with the medical staff and other clinical services. Preceptor for the internship (AP4)programs for CSU and UNC graduate students in food and nutrition; provided nutrition care for psychiatric and recovery clients,pediatrics, ICCU, and medical patients; provided nutrition classes for clients in recovery and for the adolescent treatment program. Developed the outpatient nutrition component of the Lifetime Wellness Center and provided classes on. nutrition, creative cuisine cooking, and eating disorders. MARIAN CAST RUGE 1734 34th Avenue Greeley, CO 80634 (970) 353-5661 EDUCATION Registered Dietitian - 1983 to present M.S. Nutrition and B.S. with High Distinction, University of Nebraska - Lincoln PROFESSIONAL EXPERIENCE Health Education Specialist at Weld County Health Department, Greeley, CO. 1987 to present. Provide nutrition counseling for high risk pregnant women. Helped create WeldSTAR, a sanitation and safety workshop for food workers. Work with community groups involved with traffic safety, injury prevention, diabetes, and chronic disease prevention. Quality Control Supervisor for Aspen Mulling Spices, Aspen, CO. 1987 to present. Seasonal work supervising the packaging of over 1 million units each year. Maintain accurate records of production and inventory. Prepare regular reports. Instructor at the University of Northern Colorado. Taught general nutrition and community health classes, 1991, 1998 and 1999. WIC Nutritionist at Grand Island-Hall County Health Department, Nebraska. 1981- 86. Assessed nutritional adequacy of diets for pregnant or breast- feeding women, infants and children. Provided health and nutrition education to 600 participants. Developed teaching materials. Administrative/Clinical Dietitian at Memorial Hospital, Grand Island, NE. Supervised and scheduled 25 dietary staff. Ordered food supplies for 100 bed hospital. Provided dietary instruction for patients and orientation for new staff. Public Health Nutritionist in Lae, Papua New Guinea. Nutrition Research Assistant at the University of Nebraska-Lincoln. Teacher at the American College Institute, Izmir, Turkey. Cooperative Extension Agent for Boone and Nance counties in Nebraska. Peace Corps Volunteer, Community Development in Morocco. LcIej July 16, 1999 Wellness Services A service of Western Plains Health Network Colorado Action for Healthy People, Inc. 4300 Cherry Creek Dr. South, 2nd Floor Denver, CO 80246-1530 Dear Sir/Madam: I am writing to express our support for a Wellness Services grant being submitted by Marian Ruge and Gaye Akin, Health Education Specialists at the Weld County Department of Public Health on "Nutrition and Exercise Programs for Adults." Marian and Gaye have formed a community coalition, of which I and my agency . (Wellness Services at North Colorado Medical Center) are a part. This coalition has worked together on this grant proposal to reduce risks for developing heart disease and diabetes through increased exercise and better nutrition. Wellness Services' commitment to this proposal is to provide leadership and coordination for a walking program, to administer a Senior Assessment Plus, to develop a recognition and incentive program for participants in the walking program, and to support and assist the Department of Public Health in any other way possible to fulfill activities described in the grant proposal. (See attachment describing the walking program component for more details on administering and coordinating this aspect of the grant proposal activities). I am pleased to be part of this community coalition working to improve health and well-being through specific interventions in nutrition and exercise for Weld County citizens. I have been extremely impressed with how well agencies and professionals work together in Weld County on a variety of community issues, and hope this will be another such community venture, with your support and assistance. If you need any further information, or wish to contact me, please feel free; my phone number is 970-350-6911, and my e-mail is "fspring@Ihsnet.com". Thank you for your consideration of this grant proposal. Sincerely, Felicity Spring, Gerontologist Wellness Specialist Wellness Services FACILITIES East Morgan County Hospital • Brush,CO• (970)842-5151 North Colorado Medical Center•Greeley, CC) (970)350-6633 McKee Medical Center• Loveland,CO • (970)635-4053 Sterling Regional MedCenter•Sterling,CO(970)521-3260 Walking Program for Older Adults In light of the overwhelming evidence linking increased physical activity with improved health, wellness and well-being in older adults, it behooves all those who work with older adults to encourage and plan for activities that will promote fitness and physical activity. Planning for specific activities needs to address a variety of physical fitness levels, some restrictions, and special concerns for older populations. Walking is often recommended as an "ideal" physical activity because duration and intensity can be individually customized, because no specialized equipment is needed, because walking can take place both indoors and outdoors (eliminating weather factors),and because it is an activity that can be begun at minimal levels and expanded to more extensive levels. Walking also does not put as much stress on joints as more vigorous activities, and can be adapted for populations with special needs (those with limiting conditions such as arthritis, Parkinson's Disease, etc.). It is a simple activity to promote, to carry out, and to monitor. Even small increases in walking can reap rewards, which reduces dropout due to discouragement or failure. Walking can also be done individually, or can be a group activity; thus is more amenable to scheduling flexibility. Any program or activity which capitalizes on sites where seniors already assemble, and which is carried out in conjunction with already established senior programs and activities achieves the added benefits of 1) reducing transportation problems (which in Weld County can be significant), and 2) minimizing conflicts with other activities and programs. The walking program described below is recommended as an extension of senior center services, which already provide at least one congregate meal per week, and is a current gathering place of area seniors. Collaborating and consulting agencies working with senior centers include: Area Agency on Aging, Aims Community College, and North Colorado Medical Center. 6 Month Pilot Walking Project Four senior centers throughout Weld County, representing different geographic and population/concentration areas, will be invited to participate in promoting a senior walking program. Individual participants will be solicited at senior congregate meals for the month preceding the inauguration of the walking program. Initially, participants will be given a pretest, and several screenings will be provided: blood pressure, cholesterol, a senior health risk assessment. Participants will also be given a packet of information about the benefits of walking, some long forms and hints on getting started. Throughout the month, participants will log their walking, and at the end of each month will turn in their logs to senior center personnel. Opportunities for both group walking and individual walking will be provided. Monthly educational programs will be presented by the Wellness Staff from NCMC, each month focusing on promoting one of the following aspects of health & wellness: physical, mental, emotional, social, spiritual and occupational/contributory. Incentives and feedback will be provided in the form of charts depicting total miles, average mile per participant, per senior site, and in individual achievement awards. At the end of the six months, post-tests will be administered (using the same measures as in the pre-tests) and winners in the categories described above will be announced at the county Senior Health Fair. Simultaneously, a kick-off campaign for a county-wide walking program at all senior centers will be presented. County Senior Walking Program Upon completion of the pilot walking program, a walking program for older adults throughout Weld County will be initiated, again using senior centers and congregate meals as a springboard and as regional sites. Many of the same features of the pilot program will be incorporated into the county-wide walking program, with adaptations and changes made as necessitated and recommended by the pilot program. Because it will coincide with the annual Senior Health Fair, much more clinical data will be available (via the chern 24 panel), and the Sr. HRA will also be administered at the Health Fair. Monthly educational programming may utilize teleconferencing technology as well as on- site presentations. It is planned that the walking program will be a part of a larger senior wellness program that will incorporate regularly scheduled goal- setting and follow-ups based on the HRA and clinical data, and that a Health Journal will be given to each participant, which will include walking log sheets, along with other health data. Yearly follow-up data (blood pressure, cholesterol, etc.) will again coincide with the annual Senior Health Fair, but will be used to evaluate individual and group progress in the walking component as well. Incentives for each site will include charts for total miles accumulated, average miles per participant, and individual achievement awards. ‘01.4%. DEPARTMENT OF HUMAN SERVICES WELD COUNTY AREA AGENCY ON AGING 1551 NORTH 17TH AVENUE PO BOX 1805 C GREELEY, 1805 (970) 353-3800 FAX (970) 356-3975 COLORADO� July 22, 1999 Colorado Action for Healthy People 4300 Cherry Creek Drive Denver, Colorado 80246-1530 To Whom It May Concern: I am pleased to support the Weld County Diabetes Coalition application for funds to provide nutrition and exercise programs in conjunction with senior nutrition meal sites throughout Weld County. The Weld County Area Agency on Aging has funded 22 senior nutrition meals sites in weld County for over twenty years. These sites are much more than a meal for the approximately 1,300 seniors who participate annually. The opportunity for socialization and for participation in other supportive activities are all part of the holistic approach to services that make these sites successful. The opportunity to partner with the Weld County Diabetes Coalition through this grant is timely. We are currently developing wellness initiatives that include the introduction of pilot waling programs at several of our senior nutrition sites. This proposal will greatly enhance our ability to offer incentives for walking and to include nutrition counseling as an adjunct to the walking program. It is our goal to expand the walking program to the majority of our nutrition program participants and this will be more easily achieved with the help of the Diabetes Coalition support if this application is funded. I would also like to note that there is a long and positive history of cooperation and coordination between the Area Agency on Aging programs and the agencies and individuals represented in this proposal. I expect that we have laid the groundwork for collaboration for which can lead to success with this proposed application. Sincerely yours, r �1 1 G a,.l t-s✓ Linda E. Piper, Director Weld County Area Agency on Aging Better bodies fOOID) VOMEhl •Cordio *Strength •Fitness July 14, 1999 To: Colorado Action for Healthy People, Inc 4300 Cherry Creek Drive South, 2nd floor Denver, CO 80246-1530 Re: Nutrition classes To Whom it May Concern: The Weld County Department of Public Health has recently contacted us regarding the possibility of offering nutrition classes to our members. We are very excited about this prospect as our members struggle to understand nutrition. We have offered nutrition classes in the past to our members and they have been very successful. However, this is a costly endeavor as we cover the cost of the class and don't charge our members for the classes. Being a small club, we are not able to offer these classes as often as our members would like. We would like very much to offer nutrition classes on a regular basis to our members. It is surprising how little our clients know about good nutrition which is essential especially when beginning an exercise program. Thank you in advance, Dorothy and Gaye Becker Partners, BBFW (970) 356-9477 3487-D W10th St, Greeley Color o thiversity July 15, 1999 Cooperative Extension Colorado State University Weld County Extension Office 425 North 15th Avenue Exhibition Building.Island Grove Park Colorado Action for Healthy People, Inc. Greeley,Colorado 80631 (970)356-4000 Ext.4465 4300 Cherry Creek Drive South, 2nd Floor FAX: (970)351-0415 Denver, CO 80246 This letter is to indicate support for the concept put forth by the Weld County Health Department in it's request for CAHP funding. The plan outlined by the Health Department addresses the needs of older adults by utilizing the strengths and expertise of many community agencies, and the participants in the projected programming would clearly benefit from a coordinated effort that promotes healthy habits as a means of disease prevention. The most effective preventative behaviors do not occur in isolation, such with a dietary change made as a result of nutrition education, but need to be understood as part of a constellation of healthy habits that include awareness, education, diet and physical activity. The wellness profiles, nutrition education and exercise programs included in the Weld County plan will help the participants to make those logical connections that produce true lifestyle changes. The Food Stamp Nutrition Education Program in Weld County, which is coordinated through Colorado State University Cooperative Extension, can contribute the conduction of nutrition education classes at 1:he sites serving low-income seniors. Our curriculum has been developed specifically for the low-income audience and covers food resource management and food safety in addition to basic nutrition. In-kind donation of teaching time, materials, lesson enhancements and food normally given to our class participants during the lesson series, will be made. Evaluation includes pre and post testing regarding knowledge, selected food behaviors and dietary intake. We will include 200 copies each of six issues of"Nutrition News", a newsletter developed for senior citizens by Colorado State University Cooperative Extension. The issues include articles on nutrition topics, exercise, food safety and consumer issues. The plan developed by the Weld County Health Department encompasses many different community agencies as well as a thorough approach to disease prevention and health promotion for the older adult population. It has the potential not only to make resources more accessible to the older adults, but to promote the agency collaboration necessary to a healthy community. Sincerely, t Jc Debra A. Scholfield, CHES Extension Agent, FSNEP Colorado State University,U.S.Department of Agriculture and%Veld County cooperating. Cooperative Extension programs are available to all without discrimination. PARKS & RECREATION DEPARTMENT City of GREELEY RECREATION CENTER, 651-10TH AVENUE, GREELEY, COLORACO 80631 •(970)350-9400� Greeley July 15, 1999 Colorado Action for Healthy People, Inc. 4200 Cherry Creek Drive, 2nd Floor Denver, Colorado 80246-1530 Colorado Action for Healthy People, Inc.: We are very excited to offer the Nutrition and Exercise Program for Adults at the Jesus Rodarte Cultural Center. We look forward to collaborating with the Weld County Department of Public Health and Environment to implement this much needed program for the 69 members of Los Alegres Ancianos Mexicanos (LAAM)who gather at the Rodarte Center once a week for a meal and social time. The Rodarte Center has a kitchen, conference room and exercise room that can be utilized for this program. Also seniors can walk around Rodarte Park. We will gladly recruit the seniors for the program. We can begin classed immediately pending the funding for this wonderful program. Sincerely, n `��t�� c (i Ruben Flores, Recreation Program Manager Jesus Rodarte Cultural Center SERVING OUR COMMUNITY • I T S A TRADITION ifde promise to preseroe anc(improoe Ifie 9aal•y offfe for 9reefey lkrou94 timely, courteous arrfcosl effective seroice. / July 21, 1999 ims Community College 2 Colorado Action for Healthy People, Inc. 4300 Cherry Creek Drive South, 2nd Floor Denver, Colorado 80246-1530 To Whom It May Concern: As Director of the Senior Adult Education Program at Aims Community College in Greeley, Colorado, I am honored to be asked to write a letter in support of a grant proposal that the Weld County Department of Public Health and Environment is submitting to you for funding. This funding is based on the need for rural area adults to become more aware of the health benefits they can directly experience from an exercise program and better daily' nutritional eating habits. For many years, Aims exercise classes for mature adults have been offered twice a week at numerous rural senior sites in Weld County, often in conjunction with the senior lunches that are served at these same senior sites, These opportunities for exercising and eating are taken very seriously by these rural groups; there is great enthusiasm and camaraderie that takes place not only within the groups, but also with the exercise instructors and the senior site coordinators. However, only a limited number of participants can take part in these Aims classes because of the tuition costs. A few people can qualify for financial aid through the college but are too proud to fill out the form required. Also, even though nutrition classes are offered through the college, rural adults do not sign up to take them; hence, they do not have the latest information on healthy food choices and continue to eat the same foods that they have cooked for years in their kitchens. With the grant, new exercise programs and nutritional classes could begin, and many participants could have the opportunity to reap the benefits of a healthier life style. I have had the opportunity to be a member of the Weld County Diabetes Coalition for the past two years, and know how important exercise and nutrition are to the health of all ages of people as well as to the health of the entire county. Far less money is spent on hospital costs when people are motivated to take charge of their own health and are pro actively working toward this goal. I would be willing to promote nutritional and exercise opportunities through this grant funding by speaking to groups, by working with the site coordinators, by inviting groups to our Aims campus, and by publicizing the grant efforts through letters and phone calls. Inn support of good health, Marilyn Gerbrandt Senior Adult Education Program sl FitD1 20th Street • PO Box 69 ■ C,re0ey Colorado 80632 ■ (97( ,3 i0-B y-P,, ■ i Y a'i l Website, Nmv.airos.eau Colorado State I'niversin1 Cooperative ENtClIS1( 11 "The Healthy Kitchen" oNvzni�- 0 �`�� Nutrition Education Research Project In 1993, the United States Department of Agriculture(USDA) asked for help in Alf jt meeting the nutrition education needs of"high risk"populations around the �� • we country. Low income Hispanic and migrant farm worker families living in — .. \ Colorado represent one of these populations due to their socio-economic status � and inherent predisposition to certain nutrition-related diseases. In the past, C1 I ' nutrition education programs targeting this population have been ineffective and C ' inappropriate by not taking into consideration cultural food preferences, language, and low-literacy levels. As a result,La Cocina Saludable (The at Healthy Kitchen) was developed to provide accurate, effective, and culturally sensitive nutrition education to these groups. There were four prongs to this 411 n. project. Cl �� 1) Professionals and Paraprofessionals: Area professionals and Lj paraprofessionals including WIC, EFNEP, HeadStart, day care educators, and nurses participated in a series of four 4-hour workshops using a combination Illir of interactive video, videotape(both documentary style and lecture style), correspondence study and hands-on workshop formats. Evaluation of this component supported distance learning as a viable method for this population using one-way videotapes with two-way audio facilitated by a moderator. Further, the program is economically feasible and easily transferable. '' tilitildl 2) Abuelas: Abuelas(Hispanic grandmothers) were trained as nutrition educators, using educational material developed for this program. These two- day trainings were conducted by project team members. The content and format of the educational materials were based on focus groups and Prochaska's Stages of Change Theory. Overall, abuelas acted as liaisons between Colorado State University Cooperative Extension and the target population by being"recruitment vehicles." The training covered six content areas: Make It Healthy/Hagala Saludable (The Food Guide Pyramid); Make It Fun/Hagala Divertida(Introducing food to children in fun, colorful and diverse ways); Make A Change/Haga Cambios (Modifying recipes and food preparation for a healthy diet);Make It Safe/Hagala Confiable (Safe food handling and storage); Make A Plan/Haga Un Plan (Getting the most out of food dollars); and Make A Great Start (Planning a healthy breakfast and integrating concepts from other sections). Training tools included: A bilingual resource guide, which.contains both a script for teaching classes and background information on relevant nutritional messages in the script; a bilingual 35-page flip chart(1 l"x17") of color photography using simple phrases in both Spanish and English with a color 01° key to the Food Guide Pyramid; and a 10" high color model of the Spanish/English Food Guide Pyramid, which coordinates with the flip chart and brochures for use as a table top model for instruction. Results indicated that knowledge and skills scores increased significantly in four of five content areas from the pre- to post-test periods, with highly significant increases in total scores. Similar results were seen when including data from six-month follow-up questionnaires, with significant differences shown between pre- and follow-up scores. Issued in furtherance of Cooperative Extension work, acts i)I May 'i z.ud June A 1, 1914, in cooperation with the U.S. Department of Agriculture, Milan A. Icewerts,interim director of Cooperative Extension, Colorado State University, Fort Collins, C• loratio, Cooperative Extension programs are open to all without discrimination Higher knowledge and skills scores were also seen among abuelas who were teaching at the time of the evaluation compared to abuelas who were no longer teaching and abuelas who never taught. Follow-up telephone interviews with abuelas indicated that abuelas perceived the trainings as effective in providing them with the necessary knowledge and skills, confidence, and educational materials to conduct nutrition classes. Behavior change questionnaire results indicated the need for further research in the development of appropriate behavior change evaluation tools, as well as the appropriateness of these questionnaires in relation to Hispanic populations. 3) Low Income Hispanics and Migrant Farm Workers with Preschool Children: Trained abuelas educated low income Hispanics and migrant farm workers using the same curriculum and training tools as for the abuelas' training (resource guide, flip chart,table top Food Guide Pyramid). A total of six incentives geared specifically to this population were used as encouragement and motivation to complete all classes, one incentive corresponding to each section/content area. The incentives in this project included handy kitchen utensils with the La Cocina Saludable logo imprinted on them as well as the name of the specific session(e.g., Make It Healthy/Hagala Saludable)each incentive represents, as a reminder of the nutrition education message. Limited paper handouts served to underscore the six content messages. Migrant families were vocal in their need for useful products, rather than paper handouts, which they would not carry with them as they moved to new agricultural areas. It should also be noted that this is a low-literacy population. In total, 836 low income Hispanics and migrant farm workers participated in the program. Data analysis indicates that participants' knowledge and skills scores increased significantly. In comparison to a control group (n=52), participants had significantly higher knowledge and skills scores,behavior scores, and total scores. Participants also showed a progression through the Stages of Change, indicating a positive behavior change. Qualitative confirmation analysis through a series of nine focus group discussions was conducted with 46 low income Hispanic and 26 migrant farm project worker graduates to determine participants responses to La Cocina Saludable. Information from focus groups suggested that, overall,the project and materials were well received. In the words of one client, "They were fun, we learned a lot, it was very informative, it gave you ideas about how to get your kids to eat nutritionally when they are picky eaters like mine." Another said, "I didn't find anything that wasn't satisfying; it was just the way it should be." The participants' perceptions of the motivators, facilitators, and bathers experienced as they attempted to make changes, revealed some useful insights into the processes of behavior change among low income Hispanics and migrant farm workers in southern Colorado. 4) Multi-media: A pictorial WIC allowable foods list for use in WIC offices and grocery stores was developed to meet the needs of low-literacy and Hispanic populations. Evaluation supported the use of pictorial guides with WIC clients,WIC educators, and even grocery store clerks. As a result, 77,000 were printed for state WIC use in 1997. Two modules of a bilingual interactive multimedia program, "Make it Healthy"and"Make A Change,"based on La Cocina Saludable have been developed and evaluated. Touch screen computer kiosks at food assistance programs and clinics provide nutrition information to varying low-income populations. This method was well received by food assistance participants and was effective in increasing nutrition knowledge and reported healthful behaviors. A cost analysis revealed further effectiveness of this approach, especially when potential impact was assessed. Currently, revisions are being made on these modules based on the evaluation. Development of the "Make it Safe"module has begun. Other Integrating key concepts from the existing six content areas (for the abuelas and participant components), a new content area covering breakfast topics has been developed. The content area, Make A Great StartiHaga Un Gran Comienzo, has been added to the Resource Guide and the flip chart with a Food Guide Pyramid magnet as its incentive. By including a breakfast component,the La Cocina Saludable curriculum can now be used within EFNEP programs. Persona Wel 'Iness Profile = IOR ASSESSMENT E PLUS • a fir • w... a 4 •. - ;40. - BONN • r, .RIrk w J Y fi R A, ft 5- 11.1111116911111 • - Ieb _ _ IMM _ _ _ - ie..: - \\ SENIOR ASSESSMENT PLUS 1, Iell Personal Wellness Profile MB — im ♦ Use a Number 2 pencil only. < , a - • Print clearly in the boxes, and make heavy Proper Mark • Improper Marks izi ce black marks, filling the ovals completely. a ADDRESS AND PHONE - PRINT CLEARLY a - - -% - • Erase changes cleanly, and do not make a any stray marks. — NAME • Do not fold or wrinkle the questionnaire. a — STREET a ♦ To fill in your name, social security or a ID number, group ID, etc., start from the ▪ CITY STATE left and use only as many spaces and ovals as yot need. Do not use dashes. — ZIP CODE.: RHONE.. NUMBER i a LAST NAME SPACE FIRST NAME PERSONAL ID OR GROUP ID • a f imilii ,®, uiuu®,®m®,®, SOCIAL SECURITY NUMBER Tr T � Tr r ®'�®_ a ©o,4�tu'c) ociov� o(aa� rro (:► ar'ot�t:�o'W'c�.ce.t3 I i_L L a ' 0420I444C10 (3 f1000400000.0 xO 004* 0 0 000`Ira 0 0000000 04 a 00 (3.4).0000303400140-- .0c) O CO ().() (N () (a 0'0 iS$0000.000'000 0...0 O 490.04) a '0 CO 0 0 0 CO 40 0 0 0 0 03 0 0 40 CI 0 44 40) O (•) 4) 40 0 2 0 0 0 0 0 00 0 0 0 0 0 0 0 0 00 0 2 7 — 0 44 44 44 0 44 4* 4) 44 40 444401044 44 44 44 4440 444310 C°004000'000 40 00 0044)00 a '004J ty4J43044.0 to 44 /0 (J (:) tJ (J 44 44 to 0 4404I0 '000000-.00© 00 0.00-.'0000 .10 a 'G 0.0 CO 00000 (130 CO CO I) 000 CO 0- t3 00,0s4400440 t0 5 0 0:till 4) 0140 fit '9, — 490 co 4;D IJ C) CI CI ID /:1 /:1 Ail ID /:) 0 1i) 1:1 1.'1 1:/ a;D IJ l:l IH /:) Q C Q 00 0 0':0.0 0 [J` r) 0 0 04 0 Fl 4 0 •:'i a 00 CD 000'000000 CS 04) 0000000 (® 0 Cfy O:U?OFIFQ0F107 '0 (e (v0OSQO 1— �.J. 00000000000.00 el 00000 (4) 0 N) 0 a`0043 000000430 O000 U00 ed — K 141313 C41404S 137443144300 043 0 /3 C( 43 CI CI 44 C}00,0000r 000. 00 0.000.000 • a 4*494443000 0.0O0 0119101400001000 Q 49 /4 a .00o0C00Ci) la JCA0CI00'0041) Rl430CI00 HEIGHT WEIGH. AGE FENDER I� — 000 00 0 0 0 0�CV© 00 a 4J ID 0 W CI 43 el 0 GI 0 Ft Ins Pounds ,Year'. i • 0.4rfs0to4liaaeo � oc) ool.� � moov) mmc•�c) ' , ' ' I a p-:© tirOOQ.f31i Q1 O144i 4] ('J - -r 7 I:1 /:1 tJ U IJ C? I )MALE 1344r+ a. 0)0)c ett4o•el o o Qiea ee e 001CO04 l 00elCO00 0oc)4 oo ai a • 0000 41)0.00004404J 000(a 0.00-.4JO 49 I 00 000 tOO. I a 049 01J 1900000000000000490000 i0 144444 04 a 00000000000.0000004I04. 00044 I ' I L 3 tit I. m0019m1U0um ©/IJoml4Qm�1� (1>, mo IUOm iC)FEMALEI, �a OCD eal i oOUn: U0So0000000O oOOUe► ; 44 . Cl0 CO ki IrtiA .4441400100000000C30004400000114. ' . :0 '"")I 0 0 0 6... 6 a •— .090043 Q O Et 00 O 000CS Et 010 00 Et 430 O. I .® I '[ 00 00 a OO UU OOO 0U 0 CO CO 404/ Ct 00'000_O U O 0 1 0 00 0a — 0114*0S0,13.004000040. 040t4000t4t400130: i ______--- ---_ I_1 .,9_ _ 00 er 9 —��i w~_��_� PLEASE DO NOT WRITE IN THIS AREA ,_ ;ILD•O•C (DOtC OCUOCO OU U•0 8004885 ,i a _.. I- _ . 1 1.1 NM NM 1 . Health In general, would you say your 6. Emotional problems During the past four — health is: weeks, to what extent have you accom- — 0 excellent 0 fair plished less than you would like in your Ma very good 0 poor work or other daily activities as a result of —, O good emotional problems, such as feeling de- - pressed or anxious? MIN Cr not at all — O slightly — 0 moderately - 2. General health Compared to one year 0 quite a bit — ago, how would you rate your health in 0 extremely — general now? — O much better now than one year ago — p somewhat better now than one year ago 7. Social activity During the past four weeks, — O about the same to what extent has your physical health or —. ® somewhat worse now than one year ago emotional problems interfered with your — p much worse now than one year ago normal social activities with family, friends, neighbors, or groups? — 0 not at all - • slightly - O moderately - 3. Bodily pain How much bodily pain have 0 quite a bit you had during the past four weeks? err extremely — er none — 0 very mild O mild 8. Telephone contact Do you have a p moderate telephone so you can be contacted or O severe use in case of an emergency? O very severe 0 yes 0 no 9. Transportation Do you have reliable IIIND transportation when you need it? — 0 yes cp no - 4. Health view Mark all of the following that apply to you: I'm as healthy as anybody I know. O. Feelings The next questions are about how — I seem to get sick a little easier you feel things have been with you during — than other people. the past four weeks. For each question, — I expect my health to get worse. please give the one answer that comes - 0 I have a serious health problem. the closest to the way you have been — feeling. How much of the time during the —, past four weeks... — r _ all the time - 2 - most of the time 3 - a good bit of the time - 5. Health limitations During the past four 4 some of the time -- weeks, how much difficulty did you have 5 - a little of the time — doing your work or other regular daily activi- 6 - none of the time; — ties as a result of your physical health? 1. a s n e ® • Have you felt calm — none at all and peaceful? - 0 a little bit 2. 3. w Did you have a lot some of energy? — 0 quite a bit 3. -00,,1000 Have you felt — could not do daily work downhearted and blue? — 4. 000000 Have you been a - happy person? - - • 2 MI • - _ - 11 . Eating habits The following items relate 13. Exercise How many days per week do you - to your eating habits. Mark any item engage in aerobic exercise of at least - that is true for you or describes your 20 to 30 minutes duration (brisk walking, - current situation. golf (walking, no cart), dancing, active - 1. 0 I have an illness or condition that has gardening, cycling, swimming, etc.)? - made me change the kind or amount 0 none 0 three to four - of food I eat. 0 one to two OP five or more - 2. 0 I eat fewer than two meals per day. - 3. 0 I eat few fruits or vegetables, or - milk products. - 4. 0 I have three or more drinks of beer, - liquor. or wine almost every day. 14. Fruits and vegetables How many servings - 5. 0 I have tooth or mouth problems that of fruits and vegetables do - make it hard for me to eat. you usually eat per day? p - 6. 0 I don't always have enough money to 0 one or less o� - buy the food I need. 0 two t «'°,' •+ - 7. 0 I eat alone most of the time. O three t � "- 8. 0 Without wantingto, I have lost 0 four � - or gained 10 pounds in the last s. five or more a .,..,,, �� - six months. 9. 0 I am not always physically able to , N .1, mg shop, cook, and/or feed myself. � - - 122. Health practices The following questions 15. Personal health history Has a doctor - refer to common health practices. Please informed you that you currently have any of - answer yes or no. Do you... the following health problems? If yes, mark - 1 - yes either yes, but not taking or yes, and - 2 - no taking medication; otherwise mark no. - 1. ©O currently smoke? 1 - yes, not taking "naedtcatbon - 2. 0 2 often use medicines that affect 2 - yes takinc ieatior - your mood, help you relax or sleep? 3 - no, don't h'1;re this .:trndirfon - 3. Ho often have more than one to two 1. u oo arthritis - alcoholic drinks in a day? 2. ,u no bladder or bowel control problems - 4. CXD usually get seven to eight hours 3. o or© blind/trouble seeing, sleep daily (including naps)? even with glasses - 5. r 2 ever drive after drinking? 4. 040 3 cancer, other than skin cancer - 6. f0 consider yourself more than 20 (within past five years) - pounds overweight? 5. oon congestive heart failure - 7. 00 always wear your seat belt when 6. a7 3 heart attack angina, by-pass surgery, - driving or riding in a car? or angioplasty - 8. 00 usually eat breakfast? 7. C chronic back problem or sciatica - 9. a 0 eat primarily whole-grain breads 8. 0 2 a deafness or trouble hearing - and cereals? 9. g 2 0 diabetes (in last 12 months) - io. , 2. make a serious attempt to eat 10. o 0 0. high blood pressure (140/90 or higher) - primarily low fat foods? 11. o a or lung disease, emphysema, - 11. O 2 regularly snack on junk foods bronchitis, or asthma - (chips, doughnuts, cookies, candy)? 12. as 3' memory problems - 12. 00 have a working smoke alarm (more than typical) - at home? 13. o 0-3' kidney disease - 13. 00 always do heavy lifting with legs, 14. oas• 2 stroke - not back? 15. 0 ,33 ulcer or gastrointestinal bleeding - 14. 00 cope well with stress in your life? - - - _ a 3 • SI IS 16. Social health Answer the following ques- 23. Nonprescription drugs How many tions with a yes or no. different types (pain killers, antacids, — I - yes decongestants) do you take daily? — 2 _ no 0 none f three to five — 1. i0 Do you participate in religious 0 one to two CO six or more — (church, synagogue, etc.) or community activities regularly — with your friends? 24. Medicines Do you have trouble paying for 2. a a Do you have a plan for getting your medicines? -- emergency help if you need it? 0 yes — 3. as Do you feel overwhelmed by a 0 only sometimes — recent crisis or loss? 0 no or not applicable — 4. it n Have you recently considered — ending your life? — 5. o.© Is there anyone capable and/or — available to care for you if you were 25. Falling Have you fallen in the last year to become sick or injured? (how often)? O no — 17. Living arrangements I live with... O yes, one to two times — O my spouse 0 family/relatives 0 yes, three or more O by myself O a friend times — O a paid caregiver 0 other — 18. Hospital How many times were you hospi- 26. Medical equipment Are you currently — talized in the past 12 months? using medical equipment, for example: — O none O three or more oxygen, hospital bed, wheelchair, walker? — O one to two 0 yes — no — 19. Emergency room How many times did you — seek care in the emergency room in the — past 12 months? — _O none O three or more 27. Home health services Are you currently — 0 one to two receiving home health services, such as: — visiting nurse, physical therapy, home- — 20. Doctor visits How many times did you visit maker/aide, adult day care, etc? a doctor in the past 12 months? O yes O none 0 three to four O no -• O one to two O five or more — 21. Nursing home In the past year, have 28. Physical health Think about your physical — you been admitted to a nursing or health, including illness and injury. How a convalescent home? many days during the past 30 days was — O yes 0 no your physical health not good? 0 none 0 three to five s O one to two 0 six or more 22. Prescription drugs How many different prescribed drugs do you take daily? O none 0 three to five — O one to two O six or more 29. Mental health Think about your mental — health, including stress, depression, and — IIMII problems with emotions. How many days a' during the past 30 days was your mental iiiii,( iii,,,I ... a health not good? — G? three to fiveO none# 0 one to two six or more — mar a • 4 III MI - MN N MI 11 MIMI _ _ 30. Blood pressure Is your blood 34. Preventive exams Mark the preventive pressure 140/90 or higher? exams you have had during the time frame 0 yes listed (leave blank if you are not sure). - 0 no 1. 0 cholesterol check, within the past 0 don't know 2-5 years 2. C3 blood pressure check, every 1-2 years 3. 0 check for blood in stool yearly. or 31 . Cholesterol Do you have a cholesterol bowel exam with flexible level of 200 or higher? sigmoidoscopy every 3-10 years - 0 yes 4. 0 dental exam, yearly no 5. 0 vision, every 2 years 0 don't know 6. 0 hearing, periodically as needed MS 7. 0 health-lifestyle assessment, every 1-2 years - 8. 0 tetanus shot, every 10 years 32. Daily activities The following items are 9. 0 pneumonia immunization, once about activities you might do during a io. a flu shot, yearly typical day. Does your health now limit you ii. 0 PAP smear, every 1-3 years in these activities? If so how much? 12. a mammogram with breast exam, every I - yes, limited a lot 1-2 years up to age 69 2 - yes, limited a little 13. 1,--) breast self-exam, monthly 3 - nos not limited at all 14. < PSA and rectal exam every 1-2 years 1. a a o lifting or carrying groceries 2. a 0 a climbing several flights of stairs 3. one walking several blocks 4. ea © bathing 5. aa,a, dressing 35. Race Mark one. (optional) N MI 6. sew getting out of bed 0 American Indian - 7. to ?: getting out of a chair 0 Asian 8. a as eating 0 African-American, black - 9. one using the toilet Caucasian, white MIN 10. CeO walking around in the house 0 Hispanic PM 11. c a s shopping and running errands 0 Other - 12. aaa housekeeping m. 13. 1 ©n preparing meals 14. aae doing laundry >_ 15. aso using the telephone - 16. i a; taking medications 17. 1 a a driving or taking other transportation - 18. a a,a managing your money ▪ 33. Physical exam When was your last physi 36. Living win Have you completed a living will cal examination? Within the past... or an advance directive. (A statement pre- pared when a person is well and competent 0 yeartwo years concerning end of life issues.) - 0 three years 0 yes 0 no 0 four years five or more years <IMO NM � MM 5 NM MII 37. Readiness to change Indicate how ready . Scientific Basis for PWP - 1 you are to make changes or improvements in your health in the following areas: The Personal Wellness Profile was developed - 1 - haven't thought about changing by a team of health promotion specialists, - 2 - plan a change in next 6 months including doctors, health educators, - 3 -plan to change this month nutritionists, and exercise physiologists. - 4 - recently started doing this - 5 - do this regularly(last 6 mos.; Recommendations for risk reduction and - 1. se tit-a0 be physically active health enhancements are drawn from currently - 2. ea- soar practice good eating habits established guidelines of leading health - 3 enema not smoke or use tobacco - 4 r sr 4 lose weight, or organizations in America, including: _ maintain healthy weight American Cancer Society - 5. as 0 o et handle stress well - 6. -no no live an overall healthy lifestyle American College of Sports Medicine - American-Heart Association - Health Outcomes Institute - Johns Hopkins Medical Institutions - 38. Health interest survey Mark any of the National Center for Health Statistics following health improvement opportunities National Committee for Quality Assurance - that you would like to be notified about if National Institutes of Health - available. - 1. Help quitting smoking National Mental Health Association - 2. 0 Weight management National Research Council - 3. 0 Aerobic exercise to music US Department of Agriculture - 4. 0 A walking group US Department of Health and Human Services - 5. 0 A jogging group US Preventive Services Task Force - 6. C A fitness evaluation - 7. p Nutrition improvement University of California at.Berkeley - 8. C Cholesterol reduction University of Michigan - 9. 0 Blood pressure control World Health Organization MIN 10. 0 Coronary risk reduction University of Minnesota - 11. C; Cancer risk reduction - 12. C Alcohol/drug awareness - 13. 0 Healthy back program - 14. 0 Medical self-care OPTIONAL SECTION - 15. C Stress management - 16. C CPR training For additional questions use the area below - n. 0 First aid to mark your answers. Complete only if - 18. C Comprehensive health evaluation -instructed to do so. 19. Women's health programs - 20. C Diabetes education ,,. N '1 N 'v N !mu 21 C Retirement planning 1. Cr* , 8.1 i a -DO 15. en ; 4 - 22. C Living wills/advance directives 2. Ce.;,ts"m 3 9. a 3 -D0 16. OC 0 - 3. ct'1 asss 10. ,1 on DC 17, eaoers - C Do not notify me about health 4 C:.m aaa 11. m n e DO 18. 0 00 o o - improvement opportunities 5. C: as a•S.5 12. o n o Do 19. ®44 et 0® - 6. CDC0.0 ,: 13. • maD0 20. sa0ese - 7 OC aft 7,, 14. i On'nO 21. "1 2 0 00 a ©1987, revised 1998, Wellsource®Inc.,Clackamas OR - 39. When is the best time to contact you? HSQ-12 v2.0©1993, 1995 Health Outcomes Institute ii C) morning 0 afternoon 0 evening Product#APS-324 - SC■C■CCC•C111COUCCC.C■11111.0 8004885 - -- - 'Gans-Outi'6 b9 NC5 MM20894834 654321 Pr,nind In U-S A III 3 M MI a • 11•1•11•1111•0111alleiale War Congratulations you have finished filling out the p °p Senior Assessment a ▪ STOP CLINI • DATA Staff use only Blood Tests C nonfasting O 3 hr.fast 0 12 hr.fast C mmoles use decimals,oPnenvi r nwe decimaIs (k ) Imo HERE Blood Pressure Heie Weight Waist Hip Systolic Diastolic Ins f Ibs j Girth Girth • t C C®LCo `Co U_'I Li-)ts))1 !Cr a)aI � ;a:� — r.D a)CCP T. 1Li)n:i C :;col l CD CLThia.1111 — Cmr)Oz )'_ C col co c=? CDC,L:Cz L- (D).®CC OC:CO ON a a C WCCCe (1)Ce a) 6-3 ( )nU isme C,,OC)(T'C C6 61i Wm, C- )r C INS 000(171C1 O1 Oi CSC (..D 01 C',. This CLINICAL DATA ®rip,20, ©(a q (.1 ni a: ponce 3:� ° 1� 91QlJri.:J C_�I 1 a)apk C7' )C v.02_ L portion is to be filled _.______ • out by Clinical Staff rCholesterol — Total I HDL LDL y'y(.e'rdesi Glucose PSA� - personnel ONLY. oJO®OO ( (:(Ur®C,co-)a) os,cop: R r:.C: i Q"1uC0(*.`(1)C.)W(i)if';C?<''IC:;C1)ri_i OI ( Ctl i1 :'i'. ( 1CD 3)a corn ))(z)z)cocot co,s ay; a' .=)C ?lC ao C2 CI � (73 -TO nOO c. (rn r) r3)l3) > 11 L i C J(13-)(��C� � Thank you ::Ca C`(a_;T®C) Ur?j Ctj(a ro,'i)ta i C iCT ^ 1) a.0 sim ®a)Go 5O CS)J(s)C� sfp CZ.( _ a)(LT D(=) Djr C-.r. i C1 (e, (6)CJC Ti)'] k '(( I S i (7)GOO (-i 0(7)O (3)cp.(-7(7 ) ''Or _i(:'=)laic r22.._9..CiT.. P.•D)T'(I)JC),k r re)©(A e?C (a i a Cw)C ii,1,(3)Ca)CrOI(a a;CI s,i D;",� [a)CJl SCLSCC ' , 1r1 O,D (9'<-.. J 11 MIN PWPTM is published and copyrighted, 1987, 1997 by Wellsource® Inc. Hello