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Community Health and Wellness Program with Emphasis on Youth

Christina Estes
HW425-Health and Wellness Programming
Kaplan University

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Community Health and Wellness Program with Emphasis on Youth

The goal of a community health program is the prevention of disease. In a community,
there are many places where groups of youth gather such as schools, sports complexes, churches,
youth centers, parks, and private homes. Youth are the leaders of the future and how they learn to
handle stress, cope with lifes demands, balance personal relationships, and live productively
determines the Nations future. Many youth are struggling in many areas of their lives and
therefore making choices that are detrimental to their health physically, emotionally, and
spiritually. Due to these choices chronic disease becomes a real threat and even a reality for
many as they mature into adulthood. Chronic disease affects around 50% of Americans and is
part of the leading causes of death (CDC, 2013a). A successful health program needs to address
the preventable risk factors that predetermine chronic illness such as the use of tobacco, drugs,
risky sex; insufficient physical activity; and poor nutrition that contribute to poor health. The
psychological factors that affect youths ability to make good choices should also be addressed.
Family dynamics greatly influence a youths choices in wellness and need to be addressed as part
of the program. Each community has its own mix of population culturally and economically so
the program would need to be tailored according to those dynamics. The Precede-Proceed model
could be very useful in community health involving long term change. It is formed on the
understanding that changes in health habits are voluntary and require the participation of those
needing the change. It is a very logical model that would promote a well-planned program.
Success of the health program is promoted by participation of the community and supportive
people. Precede is the diagnostic part of the model which focuses on the fact that change will
come when concentration is on the desired outcome. Proceed is the treatment part of the model
and includes the implementation and evaluation (University of Kansas, 2013).

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Data collection to determine needs of the community can be done using the Community
Health Assessment and Group Evaluation (CHANGE) Tool and Action Guide (CDC, 2013b).
Coalition teams can assess, define, and prioritize areas for the program. It can also be used to
yearly assess the program policy, system and strategy to ensure success. In this case, the needs
assessment showed that a comprehensive health program that would be long term and in phases
that address each of the holistic needs of youth following Maslows Hierarchy of Needs. If a
youth has poor nutrition, poor shelter, and poor clothing the ability to learn new skills is
impeded. Encouraging youth to find health and wellness is a complex process.
The coalition would be comprised of health care workers, YWCA/YMCA, target
population representatives, school district faculty and staff, local health department employees,
business owners and managers. The lead agency being the local health department whose duties
include clerical work and managing the logistics of meetings. Stakeholders would include
members of the target population, those that are directly involved in the care of the target
population, and professional staff, and community leaders.
Phase one, would be to address basic needs of nutrition, health care, and shelter, while
addressing the need for safety in body, mind, and spirit. Tools in acquiring these needs would
include training in healthy boundaries. The Health Belief Model would be helpful in
understanding a persons willingness to participate in a healthy behavior is based on their
perceptions. Perceptions are based into four different categories: perceived susceptibility;
perceived severity; perceived benefits; and perceived barriers. The HBM would be useful for
helping the target population to focus on the health problem and then developing clear messages
to encourage healthy practices. One of the strategies recommended by HBM is conducting health
risk appraisals. It is important to clearly communicating the risks associated with an unhealthy

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behavior and all the actions required to change that behavior. It is also important to identify and
reduce barriers and provide incentives, reduce anxiety, and increasing self-efficacy by various
methods (Hodges & Videto, 2005).
Phase Two would address the social needs of friendship, family, and sexual responsibility
while looking at the areas of self-esteem, confidence, achievement, respect of others, and respect
by others. Phase Three would be reaching self-actualization of morality, creativity, spontaneity,
problem solving, lack of prejudice, and acceptance of facts (Huitt, 2007). The Stages of Change
Model would address the process people go through during change. Helping youth to understand
that it is a process would empower them to change. It is important to remember that there are
five stages, they are pre-contemplation, contemplation, decision/determination, action and
maintenance. This can be used during the needs assessment to explain why the target group is
participating in the dysfunctional behavior or to figure out what stage the population is in
(Hodges & Videto, 2005). Phases one, two and three could be simultaneous depending on target
populations response to each phase. Monthly tally sheets could be used to keep track of
counseling, including the number and characteristics of the youth (Adamchak, 2000).
A resource assessment of the program would include time, money, and people. Time
would include determining whether the program will be short term or long term. In this case, the
program will be over the course of a year and then reevaluated. A Gantt chart could be used to
determine a time frame of goals of objectives and their activities and when they are to be
accomplished. People resources will consist of personnel that will be used to run each phase.
Professional counselors, Youth Leaders, school staff, and other community leaders will need to
be accessed. Volunteer services will help with the budget that will be calculated as well as paid
positions of health staff. The budget will include paid personnel, supplies needed for brochures

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and forms, travel expenses, facility use, etc. Cost will need to be estimated and adjustments made
according to available finances.
Funding would be sought through grants, fundraising, and individual donors to support
the programs needs. The Community Transformation Grant (CTG) is awarded to communities
that design a program that addresses the prevention of chronic disease through prevention and
intervention. 70 million dollars was awarded to communities with populations of fewer than
500,000 in neighborhoods, school districts, villages, cities, towns, and counties (CDC, 2014).
Funding is also available through another CDC health initiative called REACH.
REACH, Racial and Ethnic Approaches to Community Health, is a national initiative
through the CDC to eliminate ethnic and racial disparities in health care. Programs that address
equal health opportunities for African American, American Indian, Hispanics/Latinos, Asian
Americans, Alaska Natives, and Pacific Islanders are awarded grant money. Racial and ethnic
minorities have the highest percentages in heart disease, obesity, and diabetes. REACH partners
with community based programs to identify, develop, and distribute effective strategies.
Addressing the causes of racial and ethnic inequalities is complicated and involves many factors.
REACH can help with a number of evidence and practice based interventions that assist in
programming a health program that will incorporate the needs of an ethnically diverse youth
population (CDC, 2013c).
Evaluation of the program is important to assess the activities and services and how well
the target population is being reached. Data received will allow for refinement of the program
including sites, training, supervisory needs, and feedback (Adamchak, et al. 2000). The results
can help stakeholders and the community understand how the program is doing. It is a way of
engaging the support of funding, government officials and community support. Using an outside

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source to perform the evaluation would allow for an objective view and analysis of data. Tools
and instruments that would be used are surveys, focus groups, community questionnaire, assess
coalition effectiveness, and a questionnaire for parents of the youth.
Obesity Health Program for Albia Community School District
The driving force for healthy initiatives in a workplace is that medical costs are
skyrocketing for companies. It is amazing that almost half, or 50 %, of health care costs are due
to a choice in lifestyle, and because it is a choice there is hope it can be changed. Statistics show
that poor diet and lack of exercise are the major contributing factors, many times resulting in a
huge spike in obesity. Along with obesity various diseases become a risk, such as diabetes, high
blood pressure, cardiac issues, and more. Obesity has doubled since the 1970s and the trend is
not stopping. Obesity is not only effecting the workplace but is trickling down into the family
unit. According to the CDC, 1 in 8 preschoolers are obese, this early obesity increases the
chances of adult obesity by 5 times (CDC: Vital Signs). Encouraging wellness at the adult level
will have an effect on the students by way of example. Medical expenses are estimated to be
42% higher for obese employees than those with a healthy weight (CDC, 2011).
In order to boost success for a school health program, support from senior management
must be obtained. It is important to present a strong case outlining benefits for the district,
including profits of a healthy lifestyle, financial savings due to less sick days and lowered
medical costs. A coalition made up of school staff, teachers, cafeteria personnel, student
leadership and leading members of the community would support the program and make it a
community effort. After a needs assessment of the target population, which is the staff of the
school district, it was revealed that weight loss and stress management were the number one
concern.

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The program would be long term, three to five years, due to the behavior changes that are
required. The stages of change model could be incorporated into the training material to address
the psychological path of gaining health through a change in lifestyle. A variety of activities
would be offered to cater to different likes and styles. Employees would be empowered to
encourage others and lead focus groups once goals have been achieved. Reward incentives
would be offered as goals are accomplished. The workplace environment would be encouraged
to support healthy choices, such as vending machines, pictures of those who have met their
goals, and healthy low-fat foods offered from foodservice.
Using a Planning Worksheet to organizing the program will aid in determining time
frames, activities, cost and budget, who will be responsible for each activity and the tools they
will use (CDC, 2010). Resources can include the local public health department, and state and
government agencies which may supply free materials. Volunteer trainers and speakers may be
available through the local hospital, college, and private physicians. A timeline could be in
conjunction with seasonal key dates such New Years Resolutions, slow times of the yearly
schedule, and National Health Observances. It would be very important to schedule the activities
at times that are convenient for school employees. Funding would be acquired through local and
state grants, private corporations, the school district, and individuals.
Activities could include opportunities to combine physical activities with health
education. Exercise prescriptions for an individual or group could be offered that would have
recommended frequency, intensity, and specific exercises. Wellness classes would be offered at
a very low rate or for free which would encourage participation. Behavioral activities could be
used such as weight-loss competitions with reward incentives, stress management training with
breathing techniques, Tai Chi, and meditation.

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A success story by Bell Helicopter stated that, My observation is that fit people are
always at work and more enthusiastic about what people are doing (Building Healthy Texans,
2004). Investing in a strategic Wellness campaign is worth the effort. It not only brings return
financially but fills the workplace with happier people that are more productive and living better
lives personally. The really great thing is that the program will not only benefit the adults but the
children who are our future. The generation that will be leading our countrys path to health.

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Reference:
Adamchak, S., Bond, K., MacLaren, L., Magnani, R., Nelson, K. & Seltzer, J. (2000). A Guide
to Monitoring and Evaluating Adolescent Reproductive Health Programs. FOCUS on
Young Adults: Tool Series 5. Fhi360. Retrieved August 9, 2014 from
http://www.fhi360.org/sites/default/files/media/documents/A%20Guide%20to%20Monit
oring%20and%20Evaluating%20Adolescent%20Reproductive%20Health%20Programs
%20-%20Part%201.pdf
Building Healthy Texans: A Guide to lower health care costs and more productive employees
(2004). CDC Resource Guide. Retrieved March 9, 2014 from
http://www.cdc.gov/leanworks/resources/stateresources.html
Centers for Disease Control and Prevention (2010). Create an Activity Action Plan. Appendix G
Planning Worksheet. Retrieved August 11, 2014 from
http://www.dhs.wisconsin.gov/physical-activity/activecommunities/pdfs/ACEsAppxGPlanning.pdf
Centers for Disease Control and Prevention (2013a). CDCs Healthy Communities Program.
Retrieved August 8, 2014 from
http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/overview/index.
htm
Centers for Disease Control and Prevention (2013b). Community Health Assessment and Group
Evaluation (CHANGE): Building a Foundation of Knowledge to Prioritize Community
Needs. CDCs Healthy Communities Program. Retrieved August 9, 2014 from
http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/change.ht
m
Centers for Disease Control and Prevention (2014). Community Transformation Grants (CTG).
Retrieved August 9, 2014 from
http://www.cdc.gov/nccdphp/dch/programs/communitytransformation/index.htm
Centers for Disease Control and Prevention (2011). CDCs Lean Works! A Workplace Obesity
Prevention Program. Retrieved August 11, 2014 from http://www.cdc.gov/leanworks/
Centers for Disease Control and Prevention (2013c). Racial and Ethnic Approaches to
Community Health (REACH). Investments in Community Heath. Retrieved August 9,
2014 http://www.cdc.gov/nccdphp/dch/programs/reach/index.htm
CDC-Vital Signs-childhood obesity. Retrieved March 10, 2014 from
http://www.cdc.gov/VitalSigns/ChildhoodObesity/
Hodges, B. C., & Videto, D. M. (2005). Assessment and Planning in Health Programs. Sudbury,
MA: Jones and Bartlett.

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10

Huitt, W. (2007). Maslow's hierarchy of needs. Educational Psychology Interactive. Valdosta,

GA: Valdosta State University. Retrieved [date]
from, http://www.edpsycinteractive.org/topics/regsys/maslow.html
University of Kansas (2013). Chapter 2: Precede/Proceed. Community Tool Box. Retrieved July
20, 2014 from http://ctb.ku.edu/en/table-contents/overview/chapter-2-other-modelspromoting-community-health-and-development/section-2