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PROGRAM PLAN

The Standards for Health Related Quality of Life and Well

Being for the 21st Century

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PROGRAM PLAN

The Standards for Health Related Quality of Life and Well Being
for the 21st Century for Women in Menopausal Transition
Linda Allen
Need for Exercise Participation and Caloric Restrictions in Menopausal Transition
Measuring Health Related Quality of Life and Well Being (HRQOLWB) can help determine the burden of
preventable disease, injuries, and disabilities. The intervention will segment women in menopausal
transition. Research has indicated, women have a 39.5% greater risk of obesity between the ages 4059. . In 2005-2006, approximately 53% of African American women were obese. Consequently,
African American women 45-55 years old whose BMI >30 are primarily the cause of for the burden of
preventable disease, injuries, and disabilities. In addition to this segment of the populations obesity
epidemic women are experiencing a change in Health Related Quality of Life (HRQOL) across all domains
including vasomotor symptoms, urine leakage, poor sleep, arthritis, depressed mood, perceived stress,
and stressful life events.
Midlife women increase in total body fat and abdominal fat during this menopausal transition. The
excess abdominal fat accumulation is associated with an increased risk of cardiovascular and metabolic
disease, in addition impacts adversely on health-related quality of life and sexual function. According to
the CDC, obesity is determined by using weight and height to calculate the body mass index (BMI); an
individual is considered obese having a BMI 30 or higher. The potential health risks associated with
being overweight or obese include heart disease, high blood pressure, type 2 diabetes, gallstones,
breathing problems, and certain cancers. In addition, according to the National heart, Lung, and Blood
Institute, having two or more risks factors increases the risk of developing obesity-related diseases. Risk
factors include high blood pressure, high LDL cholesterol, low HDL cholesterol, high triglycerides, high
blood glucose, family history of premature heart disease, physical inactivity and cigarette smoking. A
small weight loss between 5 and 10 percent at baseline weight will help lower the risk of developing
those diseases.
In a previous study, author Thurston, et al evaluated the hypothesis thermoregulatory models
postulated that increased adipose tissue would be associated with a greater likelihood of vasomotor
symptoms. Thurston, et al investigation further indicates that it is the adiposity component that places
heavier women at risk for vasomotor symptoms. Thus, weight loss during menopausal transition is

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PROGRAM PLAN
relevant in reducing the risk factors of vasomotor symptoms. Research has shown women who engage
in physical activity have higher basal levels of endorphins which help to stabilize the thermoregulatory
centre and diminish the risk of hot flushes. Further findings indicated higher levels of sports/exercise
and daily routine activity were independently associated with lower weight and waist circumference.
In addition, any decrease in activity level in midlife women is associated with higher weight over time,
while increases in activity are associated with lower weight.
Therefore, a need for intervention is necessary to reduce the epidemic proportions of obesity, reduce
obesity-related diseases thus, simultaneously improving the HRQOL for women in the menopausal
transition through increased exercise and caloric restriction.

Goals and ObjectiveWeight Loss Program for Menopausal Transitioning Women

The following are the goals and the objectives for the weight loss and healthy eating program in the
Atlanta, Georgia area. All the goals and objectives involve collaborations with community organizations,
local county government, fitness and nutrition instructors and key sponsors to the program to make it a
success.

Reduce Total Body Weight by Physical Activity and Caloric Restriction

Goal:
To reduce the incidence of obesity in menopausal transitioning African American women.

Objective
1. Six weeks after program completion, based on expert opinion, 75% of the participants will have
increased physical activity 150 minutes per week and reduced body weight by 10%, consistent
with national strategy.

Increase Fruit and Vegetable Consumption Decrease Fats and Sugars

Goal:
To reduce the proportion of African American women 45-55 years old with a BMI >30 by increasing the
intake of fruits and vegetables and reducing caloric intake of fatty and sugary foods.

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PROGRAM PLAN

Objective:
1. Total coverage of participants will be able to identify five foods high in saturated fat and sugar
and will also learn the Maximum Recommended Amount of Daily Dietary Fat Intake and the
classification of carbohydrates.
2. Six months after the program, based on expert opinion, 50% of the intended primary target
audience who completed the program continued eating more fruits and vegetables and reduced
BMI by 10%, consistent with national strategy.

Reduce Vasomotor Symptoms

Goal:
To reduce vasomotor symptoms in menopausal transitioning African American women.

Outcome Objective
1. Six months after the program, based on expert opinion, 50% of the intended primary target
audience who have adopted lifestyle change will have improved their Health Related Quality of
life and reduced vasomotor symptoms

Sponsoring agency/Contact person

The intervention program will form a partnership with the CDC. The agency will provide access to the
target audience, more credibility, additional resources and expertise. In addition, collaboration with the
county Parks and Recreation will be established. The contact person is Linda Allen whose organization
Project Basic Needs, Inc will be developing and facilitating the program.

Primary target audience

Lower SES African American women 45-55 years old in menopausal transition experiencing Health
Related Quality of Life (HRQOL).
1. BehavioralApplying the Stages of Change Model, intended primary target audience have been
identified as being in the preparation stage and intends to take action within the next 30 days.
ITPA intention to change is a process of self-reevaluation.
2. CulturalIntended primary target audience will have the command of the English language.
ITPA cooking style involves the use of animal fats for a broth base, frying meats, and process
foods.

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PROGRAM PLAN
3. DemographicAlthough all demographics can participate, the projects primary demographic
comprises the lower socioeconomic status earning at the 125 percent or 185 percent of the
Federal Poverty Guidelines. Participants have low literacyeducational gradient in health
indicates a lower education is associated with a higher likelihood of obesity.
4. PhysicalWomen 45-55 years old. In 2005-2006, approximately 53% of African American
women were obese. ITPA may or may not attribute to 44% of the diabetes burden, 23% of the
ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are
attributable to overweight and obesity. Participants are at risk of potential health risks
associated with being overweight or obese include heart disease, high blood pressure, type 2
diabetes, gallstones, breathing problems, and certain cancers.
5. Psychographic Intended primary target audience excess abdominal fat impacts adversely on
health-related quality of life and sexual function. Participants self-efficacy is between low to
moderate. While their outlook on life and health remains positive it will improve through
intervention. IPTA are in the midlife stage of life.
Primary Target Key Strategies
The intended audience will take action upon realizing society is turning their attention on combating
obesity-related preventable diseases. The intended audiences overweight and obesity-conditions are
the second leading cause of preventable death. The intended audience will understand the change in
HRQOL is a result of the change in hormone levels and not the empty-nest syndrome to explain a
depressed mood, for example. The primary intended audience will further understand the HRQOL
domains will be lowered, or reversed upon exercise participation. Barriers to physical activity are
common when beginning a new program plan. Barriers may include lack of time, family obligation, lack
of energy and low self-efficacy. Participants will benefit from the program by reducing the HRQOL
domains and excess body and abdominal fat. In addition, participants will reduce the risk of obesityrelated conditions such as Type 2 Diabetes, hypertension and coronary heart disease. The intervention
is credible; according to the CDC reducing weight by 10% at baseline will reduce your risk of obesityrelated conditions. In order for participants to adopt behavior change, multiple message delivery
channels will be put into action. Key channels include interpersonal, group, organizational and
community, mass media and digital media channels.

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PROGRAM PLAN

Secondary target audience

Based on formative research the intended secondary audience is the IPTAs children. Program activities
will be directed at the IPTA to encourage their influence on their children.

1. BehavioralApplying the Stages of Change Model, secondary target audience have been
identified as being in the preparation stage and intends to take action within the next 30 days
encouraging and participating in the lifestyle changes the intended audience is beginning.
2. CulturalSecondary target audience will have the command of the English language. The
secondary audience are subjected to foods containing the use of animal fats for a broth base,
frying meats, and process foods.
3. DemographicAlthough all demographics can participate, the projects primary demographic
comprises the children of the primary target audience living among the lower socioeconomic
status household at the 125 percent or 185 percent of the Federal Poverty Guidelines.
Participants have at level literacyeducational gradient in health indicates a lower education is
associated with a higher likelihood of obesity.
4. PhysicalChildren 2-19 years old. According to the CDC, approximately 17% (or 12.7 million) of
children and adolescents aged 219 years had obesity. In 2011-2012, obesity prevalence was
higher among Hispanics (22.4%) and non-Hispanic black youth (20.2%) than non-Hispanic white
youth (14.1%). Over time, the prevalence of obesity among girls whose adult head of
household had not finished high school increased from 17% (19992002) to 23% (20072010).
5. Psychographic Secondary target audience excess abdominal fat impacts adversely on peer
interactions and physical activity participation.

Secondary target key strategies

Parents are an enormous influence on their children, therefore eating healthy and participating in
physical activities will improve the health of your child and reduce the incidence of childhood obesity
and its related diseases. Barriers affecting children are unfamiliar tastes when introduced to new fruits
and vegetables; or feeling like an odd ball because other children are eating Doritos and the intended
audience child is eating carrot sticks with hummus for a snack. Benefits are numerous for the secondary
audience such as; more quality time can be spent with parents preparing the new foods or taking a walk.
Other benefits include, maintaining ideal weight, building healthy bones and teeth, reduced ADHD

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PROGRAM PLAN
behaviors, and clearer complexion. According to the CDC, approximately 17% (or 12.7 million) of
children and adolescents aged 219 years had obesity. Channels to reach the secondary audience
would be interpersonal healthcare providers, teachers and the internet.

Pretest strategy
Pretesting channels and messages for women in menopausal transition is a fairly new communication
strategy which would require developing new messages and materials when trying to reach the
intended audience. Very little information is relayed to women about this transitional stage, therefore,
what the intended audience knows about menopausal transition is limited to the mere fact the period
will stop completely on average 51 years old. Typically, mass media portrays the aging, silver-haired
woman when delivering the message. Thus, it isnt surprising the intended primary audience has
resigned to believing suffering during this stage is every midlife womans fate. The ideal settings to
reach the intended audience for this program would be at home, work, in the car, on public
transportation or at the health care providers office. Message channels are avenues via delivering the
messages to women in menopausal transition include trusted interpersonal channels such as
physicians, friends, family members, counselors, parents, clergy, and coaches of the intended primary
audiences; group channels can reach the intended audience at work, school, church, meetings or during
their favorite activities. Utilizing community channels to place the programs messages in their
newsletter, is another channel to apply. The program is on a limited budget for advertising; therefore
selecting the most effective mass media to reach the intended primary audience would be radio,
although other mass media channels include cable television, magazines and newspapers. In addition,
with the growing field of technology, reaching the intended audience through interactive digital media
channels such as websites, chat rooms and news groups can reach the women globally.

Theoretical foundation
The health behavior change model most effective for the lifestyle change intervention program is the
Stages of Change Model. By applying the Stages of Change Model, planners are able to determine the
intended audiences level of motivation, or readiness to change. The five stages of this construct can
effectively apply to an exercise program for women 45-55 years old. Upon identifying the intended
primary audiences stage, planners are better equipped to set realistic program goals. The intended
primary audience are in the preparation stage and are ready to improve their health related quality of
life. The stages include:

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PROGRAM PLAN
1. Precontemplation

Not Ready

2. Contemplation

Getting Ready within 60 days

3. Preparation

Ready within 30 days

4. Action

Changed Overt behavior <6/mo

5. Maintenance

Changed Overt behavior >6/mo

Management chart

Program
Director

Program
Coordinator

Lifestyle Coach

Fitness
Instructor

Financial
Manager

Tasks
Program Director:

Provides overall area leadership and management of program goals and outcomes
Manages staff of four

Oversees the areas strategic planning process, plans, goals, priorities, and establishes
measurable objectives

Program Coordinator:

Serving as a liaison, ambassador, and advocate for the lifestyle program within public health,
physician, health care professional, and payer communities
Responding to inquiries about the lifestyle program from the general public and members of the
public health, physician, health care provider, and payer communities
Assisting with retention and commitment of lifestyle program participants

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PROGRAM PLAN
Lifestyle Coach

Creating a motivating environment that is friendly and noncompetitive

Fostering relationships with and between participants
Supporting and encouraging goal setting on a weekly basis
Recording session data for each participant (attendance, body weight, total weekly minutes of
physical activity, etc.)

Fitness Instructor
Demonstrate how to carry out various exercises and routines
Monitor clients progress and adapt programs as needed
Explain and enforce safety rules and regulations on sports, recreational activities, and the use of
exercise equipment
Give clients information or resources about nutrition, weight control, and lifestyle issues
Financial Manager

Plans, administers, and manages the areas operating budgets

Timeline: Program Implementation and Evaluation

March-December 2015
Mar
Hire and train program staff
Pilot test program
Revise program based on pilot
Promote the program
Prepare for program kick off
Phase in Program
Full implementation
Evaluate program
Write report

Ap

May

June

July

Aug

Sept

Oct

Nov

Dec

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PROGRAM PLAN
Budget
Developing a budget is essential to a Health Promotion program. The figures below are conservative for
the program. The revenues are estimated and could increase as the program is in operation such as
gifts or additional sponsors. Participant fees are not included in the budget; any fees are associated with
the Parks and Recreational Center for the cost of membership. In addition, the sale of curriculum
materials is an expense incurred by the participant. There will be four employees: (1) Program
Director (2) Program Coordinator; (3) a facilitator; and (4) Fitness Instructor; and a community
volunteer. Fringe benefits are paid to the two full-time employees based on a percent of the employees
salary such as the Program Directors fringe benefit calculation: 0.30 of 52,500 = $15,750; Program
Coordinators benefits included: 0.30 of 30240 +$9,072.0. The finance manager will only be employed
part-time, 20% of full-time equivalent of $40,000 = 40,000 x 20% = 8,000.00. The intended primary
audience meets the Federal Poverty Guidelines, therefore, included in the program is an incentive for
the intended primary audience to attend all the meetings on a weekly basis. Upon full attendance, a
weekly Public Transportation pass will be given to each participant as long as they attend class beginning
on Monday, Wednesday, and Friday. The StayHealthy Kiosk is estimated to be $2500.00 for the entire
year which an agreement with the seller will loan the kiosk to the program for one year at the above
price. The indirect costs are difficult to put a dollar value on, therefore a percentage of the direct cost
will be used to determine indirect costs: Formula: DC x 30%. In conclusion the balance after proper
calculation reflects the following:

Total Revenue and Support

Total Direct Cost
Total Indirect Cost
Total Expenditure
Balance

$200,00.00
150,162.00
45,049.00
minus 195,211.00
$4989.00

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PROGRAM PLAN

Budget
Revenue and Support
Contribution from Sponsors
Gifts
Grants
Participant fee
Sale of Curriculum Material
Expenditures
Direct Costs
Personnel
Salary and Wages

Monthly Amount
20 Sponsors @ $100/$2000.00
100.00
10000.00
0.00
0.00
Total

Year End
$24,000.00
1200.00
175,000.00
0.00
0.00
$200,200.00

Program Director: $4375.00

Program Coordinator:
$2520.00
Facilitator: $600.00
Fitness Instructor: $ 400.00
Finance Manager: 0.20 FTE
of $40,000 = $8000

Fringe Benefits

Program Director:
Program Coordinator:

15,750.00
9,072

Consultants
Supplies
Instructional Materials
Incentives
Meeting Costs
Equipment
Travel
Postage
Advertising

Indirect Costs

$91,740.00
24,822.00
10,000.00

Public Transportation (10/wk) 950.00

2500.00
11,400.00

StayHealthy Kiosk: $2500.00

0.00
100.00
500.00

2500.00
0.00
1200.00
6000.00

Total of direct costs

$150,162.00

Formula: Total Direct Cost x 30%

Total of indirect costs
Total expenditures
Balance

45,049.00
45,049.00
195,211.00
$4989.00

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PROGRAM PLAN

Evaluation Strategies
A summative evaluation will be conducted at the end of the program. Using the least expensive
data collection procedure, the program will use a questionnaire to evaluate the program. The
following are the steps in conducting an outcome evaluation:

Determine what information the evaluation must provide.

Define the data to collect.
Decide on data collection methods.
Develop and pretest data collection instruments.
Collect data.
Process data.
Analyze data to answer the evaluation questions.
Write an evaluation report.
Disseminate the evaluation report