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Worksheet 7
7-1 Step 1a. Identify Issue or Problem and Primary Group or Intended Audience
ASSESSMENT INFORMATION and INFORMATION SOURCES1
A. Expert inputs: Science research findings and inputs of food and nutrition experts
Findings:
Health issues: A key health issue for college students is fad dieting, primarily low-
carbohydrate diets.
 Freshman entering college are fearful of gaining the “freshman 15”, so they
resort to fad diets. The most popular diets used are the Atkins diet and the South
Beach diet (20%), in which they are lacking much needed carbohydrates
(Malinauskas, Raedeke, Aeby, Smith, & Dallas, 2006).
 Twenty-seven percent of American dieters had goals of losing more than the
recommended 1-2 lbs a week; 10% aim to lose 4-5lbs a week. (essentialnutrition.org)
 Forty-five percent of Americans believe that by consuming less carbohydrates it will
be beneficial to their heart even though they know that low-fat and high-fiber diets
can reduce the risk of heart disease (essentialnutrtion.org)
 The American public lacks even the basic understanding of what carbohydrates are
and the role in the diet (essentialnutrition.org).
 Most consumers have no understanding of the recommended number of grams of
carbohydrates, only nineteen percent knew that they needed a minimum 130g daily
(essentialnutrion.org)
 More than a third of the public believes that by decreasing the consumption of
carbohydrates (fruits vegetables and whole grains), it will reduce the risk of certain
cancers (essentialnutrtion.org)
 According to American College Health Association, 34% of college student’s diet to
lose weight within the last 30 days of being surveyed (The American College Health
Association, 2007).
 Low carbohydrate diets usually are low in fruits, vegetables, and whole grains which
can be the cause of constipation because the lack of dietary fiber. It may also cause
fatigue, weakness, and nausea. (win.niddk.nih.gov)
 Of those trying to lose weight, one in five adults is doing so by primarily by reducing
the amount of carbohydrates they consume (essentialnutrition.org).
 The consumption of fewer than 130 grams of carbohydrates a day can cause ketosis.
Ketosis can cause the body to produce high levels of uric acid, which can lead to gout
and kidney stones. (win.niddk.nih.gov)
 Forty-three percent of Americans on a low-carbohydrate diet say that they are more
concerned about the carbohydrate intake then they do about the amount of calories
they consume (essential nutrition.org).
1
Include information sources at the end of each statement and cite references at end of
worksheet or in footnotes at bottom
Food system issues: Food practices that contribute to sustainable food systems.
 The food production, processing, and marketing systems provide numerous
products that appeal to individuals trying to lose weight. These products are often
easy to grab, and eat on the go and claim to aid in weight loss. Students could be
made aware of the false health claims of such weight loss products.
 Students could be made aware of the products that contain whole grains compared to
those that are simple carbohydrates. (our opinion)
Social issues: Impacts of food production labor and trade practices on communities and
farmers
 Local downtown farmers’ market can be a source of carbohydrate and whole grain
rich foods.
B. Societal inputs: National food and nutrition policy goals and documents
Findings:
The U.S. Department of Agriculture (USDA) and Health and Human Services issued in
2005 the Dietary Guidelines for Americans, which included the following
recommendations:
 The acceptable macronutrient distribution range (AMDR) for carbohydrates is 45 to
65 percent of total calories consumed.
 Follow a balanced eating pattern and meet the recommended intakes within energy
needs. Examples of proper eating patterns include the USDA Food Guide and
Dietary Approaches to Stop Hypertension (DASH) eating plan.
 Encourage the consumption of whole grain foods. At least half of the total grains
eaten a day should come from whole grains. This includes eating at least 3 or more
ounce equivalents of whole grain products a day. The rest of the grains eaten should
be from enriched or whole grain products.
 In relation to carbohydrates, select fiber rich fruits, vegetables, and whole grains
frequently.
 Eating recommended whole grain amounts may help in weight maintenance, lower
the risk of certain chronic diseases, and reduce the risk of coronary heart disease
(CHD).
C. Audience inputs: Concerns about and from the intended audience/group
Findings:
Epidemiological and empirical data (objective data):
 YRBS survey indicates that majority of college students believe they are overweight,
when they are actually not.
 Recent dieting is one of the top four reasons freshman gain weight, and one of the
most common diets practiced in one in which carbohydrates (whole grains) are
limited. Therefore, college age students would be a good audience for an
appropriately designed program that focuses on consuming adequate amounts of
carbohydrates daily.
Perceptions and desires of intended audience (subjective data):
• College students desire to be thin based on social expectations from family, friends,
and the opposite sex. They would engage in healthy eating behaviors if they knew how
and was easy to understand and do (Our opinion)
• According to a national opinions survey conducted for the partnership for essential
nutrition, nine in ten adults (88%) agree that a supportive atmosphere is important for
losing weight and keeping it off (essentialnutrition.org).
D. Administrative Inputs: Concerns of the agency or organization sponsoring the
intervention
Findings: The mission of San Jose State Healthy Campus, a university-affiliated
organization, “is to improve awareness, knowledge, access, and ultimately behaviors
related to healthy eating and active living among students, faculty and staff at SJSU. It is
in alignment with national health goals (Healthy People 2010 and the American College
Health Association’s Healthy Campus 2010 Initiative).”(nufs.sjsu.edu)
Designing an educational program to address the unhealthy practice of low
carbohydrate fad diets in college students would contribute to the organizations goal of
improving behaviors related to healthy eating. Students will be informed about relevant
health issues and be able to prevent health consequences and promote health.
It is expected that university groups like the nutrition education action team
(N.E.A.T.), would be able to use this lesson plan. Existing staff and or students with
existing resources could deliver it.
7-2 Step 1b. Identify Behaviors or Practices of Intended Audience That Are of
Concern and Contribute to the Problems or Issues
ASSESSMENT INFORMATION and INFORMATION SOURCES2
Describe the group’s food related behaviors and practices as they are relevant to the
issues and problems identified in worksheet 7-1.
 Intakes of specific foods:
 Behavioral practices:
 Eating patterns:
Findings:
General:
Forty-five percent of Americans went on at least one diet within the last 5 years; forty-
one percent were trying to lose weight within the last year (essentialnutrition.org).
Whole grains:
According to the U.S. Grain Consumption Landscape report from the Economic Research
Service, the American diet showed a strong preference for refined grains over whole
grains. Ninety-three percent of Americans didn’t meet the recommendation to consume at
least 3 ounces of whole grains per day for a 2,000-calorie diet (Lin & Yin, 2005,p.iii).
2
Include information sources at the end of each statement and cite references at end of
worksheet or in footnotes at bottom
“Food-label use matters, as do personal perceptions about grains in the diet. Either food-
label use (or non-use) and an individual’s perception of whether grains affect health
influenced the person’s total grain intake, with perception having the greater impact.
Those who considered it important to eat enough grains were 36 percent more likely to
consume whole grains than those who did not.” (essentialnutrition.org).
Behaviors or Practices of Concern:
The target behavior that will be the focus of our program will be to increase the
consumption of whole grain foods.
7-3 Step 1c. State the Behavioral Goals of the Sessions or Program
What is the Title of the program?
Whole Grain: The Crucial Carb
List behavioral goal of the program:
1. Increase intake of whole grain foods to meet Dietary Guidelines for Americans
recommendations.
References
Lin, B.H., and Steven T. Yen. The U.S. grain consumption landscape: Who
eats grain, in what form, where, and how much? ERR-50. U.S. Dept. of
Agriculture, Econ. Res. Serv. November 2007.
Malinauskas, B. M., Raedeke, T. D., Aeby, V. G., Smith, J. L., & Dallas, M. B. (2006).
Dieting practices, weight perceptions, and body composition: A comparison of
normal weight, overweight, and obese college females. Nutrition Journal, 5,
11-18.
Partners for Essential Nutrition. (2004, June). The impact of the low-carb craze on
attitudes about eating and weight loss: A national opinion survey conducted for
the partnership for essential nutrition. Retrieved November 9, 2008, from
http://www.essentialnutrition.org/survey.php
Partners For Essential Nutrition. (2006, September). Attitudes and beliefs about effective
ways to lose weight: A national opinion survey conducted for the partnership for
essential nutrition (PEN). Retrieved November 9, 2008, from
http://www.essentialnutrition.org/pdf/survey_exec_sum.pdf
San Jose State Healthy Campus. What is Healthy Campus: San Jose State University
Retrieved November 7, 2008, from http://www.nufs.sjsu.edu/healthycampus/
The American College Health Association. (2007). National College Health Assessment
Spring 2007 Reference Group Data Report (Abridged). Journal of American
College Health, 56, 469-479.
Weight-control Information Network. (2006, August). Weight-loss and nutrition myths:
How much do you really know? Retrieved November 10, 2008, from
http://win.niddk.nih.gov/publications/myths.htm#dietmyths
U.S. Department of Health and Human Services. (2005, January). Dietary Guidelines for
Americans 2005. Retrieved November 9, 2008 from
http://www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf
Worksheet 8
NuFS 190 Fall 2008
Step 2a. Identify the person-related psychosocial determinants that are potential
mediators of the target behaviors
Identify determinants of behavior or potential mediators of action or behavior
change
Identify potential mediators motivating the behavior, based on theory constructs.
Use ONLY those determinants that research evidence suggests are important for the
identified issue and audience. For each of these determinants, assess motivating factors
for current behavior(s) as well as potential motivations for engaging in the program-
specified behavior(s). The latter are the potential mediators of behavior change. Record
findings for the relevant variables listed below:
The following motivating factors for current behaviors are our own personal
opinions.
 Outcome expectations or beliefs: What are their beliefs about the outcome of their
current behavior?
Current Motivation: College students believe that consuming fewer
carbohydrates including whole grain will cause them to lose weight.
Potential Motivators: Eating the recommended amounts of whole grain daily can
help in long-term weight management the healthy way. They provide long-lasting
energy for athletic performance.
 Barriers: What are the barriers to engaging in the program behaviors or practices?
Current Motivation: They lack the knowledge as to what whole grain is, they
don’t know the significance of the health benefits, and they don’t associate good
taste with whole grain.
Potential Motivators: Whole grains are easily available if know what to look for
on food packaging. They reduce the risk of diabetes, cardiovascular disease,
stroke, digestive cancers, and belly fat. Whole grain can also reduce acne
significantly to improve facial appearance. They taste good.
 Attitudes and feelings: What are their attitudes or feelings about engaging in the
behavior identified?
Current Motivation: Carbohydrates, which include whole grains, will make them
gain weight.
Potential Motivators: Incorporating adequate amounts of carbohydrates high in
whole grains can control weight gain and improve appearance.
 Self-efficacy: how confident are they in taking the actions identified?
Current Motivation: Students are unaware of the food products that contain
whole grains and are not confident they will like the taste.
Potential Motivators: Exposure to complex carbohydrates that is high in whole
grain as well as the ability to identify them.
 Social norms or peer-pressure: What are the participants’ social norms? What do
they see as useful ways to resist social pressure?
Current Motivation: Friends are not consuming a diet high in whole grains.
Potential Motivators: Make eating whole grains acceptable within their peer
groups.
Identify behavioral capabilities and self-regulation skills: factors that facilitate
taking action or behavior change.
Identify potential mediators that facilitate taking action based on theory variables.
For each variable, assess current knowledge and skills and potential knowledge and
skills.
The following current knowledge and skills are our own personal opinions.
Behavioral capabilities
 Food and nutrition related knowledge (How-to knowledge):
They do not know how many servings of whole grains they should be consuming
daily or how to incorporate them into their diet. They are also unaware of the proper
ratio of carbohydrates that should be included in their diet. They would like to know
how eating the recommended amount of carbohydrates and whole grain could help
them lose weight.
 Food and nutrition related skills:
They have don’t have the ability to read food labels to determine the amount of
whole grain in a product. They would like the ability to know how to identify whole
grain foods.
 Misconceptions:
Students perceive low carbohydrate diets to be beneficial in obtaining or maintaining
an ideal body weight.
Self-regulation skills
 Ability to make action plans, goal setting and self-monitoring skills.
As college students, they posses the ability of goal setting, making an action plan, and
the skill to self-monitor. These are the basic skills that college students must possess
to succeed in school.
 Emotion-coping skills: do they cope with stress by eating food? Do they have
specific difficulties in certain situations?
The stress brought on by college life can contribute to unhealthy eating
practices. This includes eating food to cope with stress and as a consequence
weight gain can occur.
2b. Identify environmental factors that might mediate the program-specified
behaviors or practices.
Information about environments to plan appropriate educational activities
Social environment
 Social networks:
 Social and cultural support: what degree of family and community support is
there for the targeted behaviors? How could support be increased?
Not applicable due to the fact that there were no surveys or interviews conducted
with their social networks. It is difficult to predict their attitudes toward helping
the intended audience.
Food environment
 Availability and accessibility of food needed to enact the targeted behaviors.
Are the foods they need in their stores, workplaces, or schools?
Dining commons provide breakfast, lunch and dinner to the students living in
dorms but the whole grain content is limited. Other choices are available on
campus including student store and student union food court but only provide
mainly whole grain meal options during breakfast.
Resources: Students living in dorms are required to purchase a prepaid meal plan
that includes meals in the dining commons and obtain gold points on their tower
card which allows them to purchase meals through other food vendors on campus.
Informational environment: There are no posters promoting the consumption of whole
grain products on campus.
Information about environments so as to educate decision makers and policy
makers
Food environment
 Potential food availability and accessibility:
It is feasible for the students to access a diet high in whole grains because of the
availability of such products on campus?
The school has overall limited options for the availability of whole grains that are
available. More specifically the dining commons lack sufficient adequate options
for whole grains during lunch and dinner.
 Organizational policy environment
 Policies related to food at school or work that might impede or facilitate healthful
behaviors. What policies need to be enacted?
•The campus dining commons provides whole grain products mainly as breakfast
items. There are not enough options for lunch and dinner meals.
• We are unaware of any policies that the school may have in effect in regards to
the whole grain availability on campus.
Worksheet 9
NuFS 190 Fall 2008
Issue and audience:
A Major issue of concern is the high prevalence of young adults, specifically
college students, engaging in unhealthy eating behaviors that involve fad diets. Our
mission is to work with college students and the primary audience is SJSU students living
on campus. The focus of the program is to promote healthful eating in college students.
Target Behavior, practice or action that is the focus of the program: (as identified in
Step 1, worksheet 7).
To increase the intake of whole grains
Philosophy of Educational Approach
We will thus develop a program that is for SJSU students to address the issue of
fad diets, specifically low carbohydrate diets. The issue of fad diets will not be addressed
directly; instead the importance of whole grain consumption will be emphasized.
We believe that the students are responsible for their choices in the foods that they
consume, but they need the necessary understanding, motivation and tools to aid in their
decisions. We also believe that it is necessary for their school and environment to
provide healthful, whole grain meal options that are easily accessible.
The aim of our program is to assist SJSU students in their awareness of their own
behaviors and of environmental factors influencing their choices. Activities in our
program will provide students with the knowledge and skills necessary to carry out the
behavior of increasing whole grain consumption.
The aim will be carried out through a program directed at personal and
environmental mediators that includes two phases: a phase that focuses on knowledge
and a phase that focuses on skills and peer support.
Perspective on nutrition content and issues
It is also a goal of our program to encourage SJSU students to decrease simple
carbohydrates by replacing them with whole grain options.
Components of program
The program will consist of three components:
• An educational, knowledge based component
• Food demo video component
• Tasting component
Title of project
Whole Grains: Get On the Grain Train
Theoretic Model: (name)
Theory of planned behavior
Worksheet 10
1. Restate the program’s target behavior from step 1.
 To increase the consumption of whole grains
2. Determine the educational goals of the program to achieve these behavioral
goals.
 Increase awareness in college students of the importance of adequate whole
grains in the diet and enhance motivation to eat them through a knowledge
based curriculum.
 Facilitate the ability to act by providing opportunities to gain relevant
nutrition knowledge and learn food related skills through a food demo video.
3a. Restate theory you are using
Theory of planned behavior
3b. From the theory model developed in Step 3, state the potential personal theory
mediators (theory constructs) of the target behavior that you will address in the
intervention
Motivation related mediators:
• Perceived barriers
• Outcome expectations: taste, convenience and other benefits
• Social outcome expectations (social norms)
Action-related mediators:
• Self efficacy
4. Using the information from 3b above and taking into account the findings from step 2
(just cut and paste here), write specific educational (same as learning) objectives for the
personal mediators you have selected and then indicate the specific learning domain.
Personal mediators of
behavior
Findings from step 2:
needs analysis
Specific Learning
(educational) objective
for each mediator
Learning domain
Perceived Barriers Current Motivation:
They lack the
knowledge as to what
whole grain is, they
don’t know the
significance of the
health benefits, and
they don’t associate
good taste with whole
grain.
Potential Motivators:
Whole grains are easily
available if know what
to look for on food
packaging. They
reduce the risk of
diabetes, cardiovascular
disease, stroke,
digestive cancers, and
belly fat. Whole grain
can also reduce acne
significantly to improve
facial appearance. They
taste good.
Describe the importance
and benefits of whole
grains in the diet, and
provide tasty meals high
in whole grains to try.
Cognitive domain:
Comprehension
Affective domain:
Valuing level
Outcome Expectations Current Motivation:
College students
believe that consuming
fewer carbohydrates
including whole grain
will cause them to lose
weight.
Potential Motivators:
Eating the
recommended amounts
of whole grain daily
can help in long-term
weight management the
healthy way. They
provide long-lasting
energy for athletic
performance.
Recognize that whole
grains taste good. State
benefits: reduce chronic
illness, belly fat, acne and
improves athletic
performance.
Affective domain:
Valuing level
Cognitive domain:
Comprehension level
Social outcome
expectations (social
norms)
Current Motivation:
Friends are not
consuming a diet high
in whole grains.
Potential Motivators:
Make eating whole
grains acceptable
Recognize that whole
grains are cool to eat with
peers.
Affective domain:
Valuing level
within their peer
groups.
Self efficacy Current Motivation:
Students are unaware
of the food products
that contain whole
grains and are not sure
if they will like the
taste.
Potential Motivators:
Exposure to complex
carbohydrates that is
high in whole grain as
well as the ability to
identify them.
Increase knowledge of
how to select whole grain
products.
Possess skills by
observing quick and easy
preparation methods and
tasting delicious recipes
using whole grain
products
Cognitive domain:
comprehension level
Psychomotor domain:
observing level
Affective domain:
Valuing level
Worksheet 11
Step 5a: Sample Lesson Plan Outline for a Motivational, Pre-action Phase Lesson
Title of Workshop 2: Pro-Whole Grain
60-65 minutes
Behavioral Goal:. To increase the consumption of whole grains
Educational Goal: Enhance awareness, contemplation and motivation.
General Educational Objectives: Program participants will be able to…
-Demonstrate understanding and recognize the importance of eating whole grains
-Identify the whole grain stamp on products
-Prepare at least one recipe that contains whole grains
-Express enjoyment of, and positive attitudes toward, consuming whole grains
-State intention to increase own whole grain consumption
Overview on content
(40 minutes)
1. Introduction, overview, gain attention
2. Brainstorm what foods might contain whole grains
3. Discuss health risks associated with not consuming a diet with adequate whole
grains
4. Emphasize the importance and benefits of incorporating whole grains into the diet
5. Discuss what whole grains are and where to find them
6. Practice label reading and identifying the whole grain stamp
7. Test knowledge on what has been covered
8. Observe video demo
9. Appreciate whole grains by tasting
10. Goal setting and wrap-up
Phase of
Nutrition
Education &
Educational
Goal
Sequenced
Events of
Instruction
Mediator of
Behavior
Change
Specific Educational
Objectives for
Mediator
Review
Learning
Domain
Practical
Educational
Activities,
Learning
Experiences,
Messages, or
Content
Pre-action,
Motivational
Phase
Educational
Goal:
Enhance
awareness of
personal risk,
contemplation
, self-efficacy,
and
motivation.
Gain attention At the end of the
session, learner will
be able to:
Gain attention
by asking
students if they
have ever heard
of whole grain
foods and what
foods might
contain whole
grains.
Present new
material
Outcome
expectations
or beliefs
State the health
benefits of whole
grain; reduce chronic
illness, belly fat, acne
and improves athletic
performance.
State the important
reasons to eat the
proper amount of
whole grain daily.
Cognitive
domain:
Comprehens
ion
Affective
domain:
Valuing
level
Cognitive
domain:
Comprehens
ion
Affective
domain:
Valuing
level
Use audience
participation to
discuss the
benefits of
whole grain
along with
PowerPoint
slides.
Provide
scientific
evidence that
eating whole
grain provides
health benefits.
Provide
guidance
Barriers Identify reasons why
not eating enough
whole grain foods.
Describe ways of
incorporating whole
grains in meals.
Cognitive
domain:
Comprehens
ion
Cognitive
domain:
Comprehens
ion
Affective
domain:
Valuing
level
Group
discussion on
current whole
grain
consumption.
Practice looking
at whole grain
labels.
Self-
Efficacy
Increase knowledge
of how to select
whole grain products.
Cognitive
domain:
Comprehens
ion
Affective
Group work to
compare what
they thought
was whole grain
and actual.
LESSON PLAN: narrative format
Overview on content
(40 minutes)
Materials:
Paper
Pens or pencils
Laptop for power point
Back up flash drive with power point presentation
Copies of seven day sample menu handout
Copies of recipe link handout for videos
Prepared pancakes and syrup
Plates, forks, napkin, orange juice and water
Food items that contain whole grain stamp
Lesson Plan
1. Introduction: Overview, gain attention (4 min)
Begin by asking students if they have ever heard of whole grain foods? What
foods might contain whole grains? Facilitate group conversation by encouraging
participation of entire audience.
2 . Whole Grain foods: brainstorm what foods might contain whole grains (4 min)
Observe and practice
cooking skills to
produce a whole
grain meal.
domain:
Valuing
level
Psychomoto
r domain:
observing
level
Practice label
reading with
classmates.
Watch cooking
video.
Social
Norms
Recognize that whole
grains are cool to eat.
Affective
domain:
valuing level
Provide whole
grain pancakes
for tasting with
peers.
Elicit
performance
and feedback
Behavioral
Intention
Participants will state
intention to increase
their consumption of
whole grains.
Affective
domain:
valuing level
Encourage
students to
make a clear
statement out
loud about what
actions they will
take in the next
week to
increase their
intake of whole
grains.
Brainstorm what foods might contain whole grains and pass out paper so students
can write down all the foods they think contain whole grains and what they have
eaten in the last week that might have contained whole grains
3. Risks of inadequate whole grains: Discuss health risks associated with not
consuming a diet with adequate whole grains (2 min)
Begin power point presentation and discuss health risks students are susceptible
to. Be sure to include in discussion weight gain, chronic illness, acne and
decreased energy.
4. Benefits of whole grains: Emphasize the importance of incorporating whole grains
in the diet (2 min) (outcome expectations)
Emphasize the importance of consuming adequate amount of whole grains into
the diet, elaborate on the benefits whole grains can have on energy levels and
appearance.
5. Identify and find foods containing whole grains: Discuss what whole grains are
and where to find them (4 min) (self-efficacy)
Continue second part of power point presentation, focusing on what whole grains
are and where they can find them and how much they should be consuming. Ask
them to refer back to their list they made at the beginning of lesson plan and ask
the following question allowing for group discussion: Does their items on their
list match with sources of whole grains based on what they now know contain
whole grains? Did they actually consume foods that contained whole grains
within the last week? Why or why not? Do they believe that they can now find
foods that contain whole grains and incorporate them into their diet on a daily
bases
6. Labels and whole grain stamp: Practice label reading and identifying the whole
grain stamp (5 min)
Pass out food items such as cereal, oatmeal, bread, ect., that display the whole
grain stamp. Ask group if they have ever seen the whole grain stamp and if they
can determine the amount of whole grains found in the product. Encourage class
to mingle with one another, sharing their food item and comparing the content of
whole grains.
7. Quiz: Test knowledge on what has been covered (3 min)
Test knowledge on what has been covered in class through an interactive quiz on
power point. Encourage participation from those you have not heard from.
8. Observe video demo and whole grain meal ideas and recipes (6 min) (Barriers)
Pass out 7-day sample menu handout and go over ways they can incorporate
whole grains into their daily meals. Discuss any barriers that may prevent them
from obtaining foods high in whole grains. Follow by watching a video demo on
how to prepare tasty whole grain pancakes that are easy to make. Pass out
additional whole grain recipes sheet with links to videos that they can try at home
with their friends and family.
9. Tasting party: Appreciate whole grains by tasting (7 min) (Social norms)
Provide pancakes (same as ones prepared in video) for the students to taste and
enjoy together.
10. Goal setting and wrap-up (3 min) (Goal setting)
Ask the students what they have learned and review the reasons why whole grain
consumption is so important in the diet. Encourage participants to make a clear
statement about what actions they will take in the next week to increase their
intake of whole grains.
Thank the group and provide an email that they can contact if they have any
question, feedback or concerns.

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Final grain train part 3[1]

  • 1. Worksheet 7 7-1 Step 1a. Identify Issue or Problem and Primary Group or Intended Audience ASSESSMENT INFORMATION and INFORMATION SOURCES1 A. Expert inputs: Science research findings and inputs of food and nutrition experts Findings: Health issues: A key health issue for college students is fad dieting, primarily low- carbohydrate diets.  Freshman entering college are fearful of gaining the “freshman 15”, so they resort to fad diets. The most popular diets used are the Atkins diet and the South Beach diet (20%), in which they are lacking much needed carbohydrates (Malinauskas, Raedeke, Aeby, Smith, & Dallas, 2006).  Twenty-seven percent of American dieters had goals of losing more than the recommended 1-2 lbs a week; 10% aim to lose 4-5lbs a week. (essentialnutrition.org)  Forty-five percent of Americans believe that by consuming less carbohydrates it will be beneficial to their heart even though they know that low-fat and high-fiber diets can reduce the risk of heart disease (essentialnutrtion.org)  The American public lacks even the basic understanding of what carbohydrates are and the role in the diet (essentialnutrition.org).  Most consumers have no understanding of the recommended number of grams of carbohydrates, only nineteen percent knew that they needed a minimum 130g daily (essentialnutrion.org)  More than a third of the public believes that by decreasing the consumption of carbohydrates (fruits vegetables and whole grains), it will reduce the risk of certain cancers (essentialnutrtion.org)  According to American College Health Association, 34% of college student’s diet to lose weight within the last 30 days of being surveyed (The American College Health Association, 2007).  Low carbohydrate diets usually are low in fruits, vegetables, and whole grains which can be the cause of constipation because the lack of dietary fiber. It may also cause fatigue, weakness, and nausea. (win.niddk.nih.gov)  Of those trying to lose weight, one in five adults is doing so by primarily by reducing the amount of carbohydrates they consume (essentialnutrition.org).  The consumption of fewer than 130 grams of carbohydrates a day can cause ketosis. Ketosis can cause the body to produce high levels of uric acid, which can lead to gout and kidney stones. (win.niddk.nih.gov)  Forty-three percent of Americans on a low-carbohydrate diet say that they are more concerned about the carbohydrate intake then they do about the amount of calories they consume (essential nutrition.org). 1 Include information sources at the end of each statement and cite references at end of worksheet or in footnotes at bottom
  • 2. Food system issues: Food practices that contribute to sustainable food systems.  The food production, processing, and marketing systems provide numerous products that appeal to individuals trying to lose weight. These products are often easy to grab, and eat on the go and claim to aid in weight loss. Students could be made aware of the false health claims of such weight loss products.  Students could be made aware of the products that contain whole grains compared to those that are simple carbohydrates. (our opinion) Social issues: Impacts of food production labor and trade practices on communities and farmers  Local downtown farmers’ market can be a source of carbohydrate and whole grain rich foods. B. Societal inputs: National food and nutrition policy goals and documents Findings: The U.S. Department of Agriculture (USDA) and Health and Human Services issued in 2005 the Dietary Guidelines for Americans, which included the following recommendations:  The acceptable macronutrient distribution range (AMDR) for carbohydrates is 45 to 65 percent of total calories consumed.  Follow a balanced eating pattern and meet the recommended intakes within energy needs. Examples of proper eating patterns include the USDA Food Guide and Dietary Approaches to Stop Hypertension (DASH) eating plan.  Encourage the consumption of whole grain foods. At least half of the total grains eaten a day should come from whole grains. This includes eating at least 3 or more ounce equivalents of whole grain products a day. The rest of the grains eaten should be from enriched or whole grain products.  In relation to carbohydrates, select fiber rich fruits, vegetables, and whole grains frequently.  Eating recommended whole grain amounts may help in weight maintenance, lower the risk of certain chronic diseases, and reduce the risk of coronary heart disease (CHD). C. Audience inputs: Concerns about and from the intended audience/group Findings: Epidemiological and empirical data (objective data):  YRBS survey indicates that majority of college students believe they are overweight, when they are actually not.  Recent dieting is one of the top four reasons freshman gain weight, and one of the most common diets practiced in one in which carbohydrates (whole grains) are limited. Therefore, college age students would be a good audience for an appropriately designed program that focuses on consuming adequate amounts of carbohydrates daily. Perceptions and desires of intended audience (subjective data):
  • 3. • College students desire to be thin based on social expectations from family, friends, and the opposite sex. They would engage in healthy eating behaviors if they knew how and was easy to understand and do (Our opinion) • According to a national opinions survey conducted for the partnership for essential nutrition, nine in ten adults (88%) agree that a supportive atmosphere is important for losing weight and keeping it off (essentialnutrition.org). D. Administrative Inputs: Concerns of the agency or organization sponsoring the intervention Findings: The mission of San Jose State Healthy Campus, a university-affiliated organization, “is to improve awareness, knowledge, access, and ultimately behaviors related to healthy eating and active living among students, faculty and staff at SJSU. It is in alignment with national health goals (Healthy People 2010 and the American College Health Association’s Healthy Campus 2010 Initiative).”(nufs.sjsu.edu) Designing an educational program to address the unhealthy practice of low carbohydrate fad diets in college students would contribute to the organizations goal of improving behaviors related to healthy eating. Students will be informed about relevant health issues and be able to prevent health consequences and promote health. It is expected that university groups like the nutrition education action team (N.E.A.T.), would be able to use this lesson plan. Existing staff and or students with existing resources could deliver it. 7-2 Step 1b. Identify Behaviors or Practices of Intended Audience That Are of Concern and Contribute to the Problems or Issues ASSESSMENT INFORMATION and INFORMATION SOURCES2 Describe the group’s food related behaviors and practices as they are relevant to the issues and problems identified in worksheet 7-1.  Intakes of specific foods:  Behavioral practices:  Eating patterns: Findings: General: Forty-five percent of Americans went on at least one diet within the last 5 years; forty- one percent were trying to lose weight within the last year (essentialnutrition.org). Whole grains: According to the U.S. Grain Consumption Landscape report from the Economic Research Service, the American diet showed a strong preference for refined grains over whole grains. Ninety-three percent of Americans didn’t meet the recommendation to consume at least 3 ounces of whole grains per day for a 2,000-calorie diet (Lin & Yin, 2005,p.iii). 2 Include information sources at the end of each statement and cite references at end of worksheet or in footnotes at bottom
  • 4. “Food-label use matters, as do personal perceptions about grains in the diet. Either food- label use (or non-use) and an individual’s perception of whether grains affect health influenced the person’s total grain intake, with perception having the greater impact. Those who considered it important to eat enough grains were 36 percent more likely to consume whole grains than those who did not.” (essentialnutrition.org). Behaviors or Practices of Concern: The target behavior that will be the focus of our program will be to increase the consumption of whole grain foods. 7-3 Step 1c. State the Behavioral Goals of the Sessions or Program What is the Title of the program? Whole Grain: The Crucial Carb List behavioral goal of the program: 1. Increase intake of whole grain foods to meet Dietary Guidelines for Americans recommendations.
  • 5. References Lin, B.H., and Steven T. Yen. The U.S. grain consumption landscape: Who eats grain, in what form, where, and how much? ERR-50. U.S. Dept. of Agriculture, Econ. Res. Serv. November 2007. Malinauskas, B. M., Raedeke, T. D., Aeby, V. G., Smith, J. L., & Dallas, M. B. (2006). Dieting practices, weight perceptions, and body composition: A comparison of normal weight, overweight, and obese college females. Nutrition Journal, 5, 11-18. Partners for Essential Nutrition. (2004, June). The impact of the low-carb craze on attitudes about eating and weight loss: A national opinion survey conducted for the partnership for essential nutrition. Retrieved November 9, 2008, from http://www.essentialnutrition.org/survey.php Partners For Essential Nutrition. (2006, September). Attitudes and beliefs about effective ways to lose weight: A national opinion survey conducted for the partnership for essential nutrition (PEN). Retrieved November 9, 2008, from http://www.essentialnutrition.org/pdf/survey_exec_sum.pdf San Jose State Healthy Campus. What is Healthy Campus: San Jose State University Retrieved November 7, 2008, from http://www.nufs.sjsu.edu/healthycampus/ The American College Health Association. (2007). National College Health Assessment Spring 2007 Reference Group Data Report (Abridged). Journal of American College Health, 56, 469-479. Weight-control Information Network. (2006, August). Weight-loss and nutrition myths: How much do you really know? Retrieved November 10, 2008, from
  • 6. http://win.niddk.nih.gov/publications/myths.htm#dietmyths U.S. Department of Health and Human Services. (2005, January). Dietary Guidelines for Americans 2005. Retrieved November 9, 2008 from http://www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf
  • 7. Worksheet 8 NuFS 190 Fall 2008 Step 2a. Identify the person-related psychosocial determinants that are potential mediators of the target behaviors Identify determinants of behavior or potential mediators of action or behavior change Identify potential mediators motivating the behavior, based on theory constructs. Use ONLY those determinants that research evidence suggests are important for the identified issue and audience. For each of these determinants, assess motivating factors for current behavior(s) as well as potential motivations for engaging in the program- specified behavior(s). The latter are the potential mediators of behavior change. Record findings for the relevant variables listed below: The following motivating factors for current behaviors are our own personal opinions.  Outcome expectations or beliefs: What are their beliefs about the outcome of their current behavior? Current Motivation: College students believe that consuming fewer carbohydrates including whole grain will cause them to lose weight. Potential Motivators: Eating the recommended amounts of whole grain daily can help in long-term weight management the healthy way. They provide long-lasting energy for athletic performance.  Barriers: What are the barriers to engaging in the program behaviors or practices? Current Motivation: They lack the knowledge as to what whole grain is, they don’t know the significance of the health benefits, and they don’t associate good taste with whole grain. Potential Motivators: Whole grains are easily available if know what to look for on food packaging. They reduce the risk of diabetes, cardiovascular disease, stroke, digestive cancers, and belly fat. Whole grain can also reduce acne significantly to improve facial appearance. They taste good.  Attitudes and feelings: What are their attitudes or feelings about engaging in the behavior identified? Current Motivation: Carbohydrates, which include whole grains, will make them gain weight. Potential Motivators: Incorporating adequate amounts of carbohydrates high in whole grains can control weight gain and improve appearance.  Self-efficacy: how confident are they in taking the actions identified? Current Motivation: Students are unaware of the food products that contain whole grains and are not confident they will like the taste. Potential Motivators: Exposure to complex carbohydrates that is high in whole grain as well as the ability to identify them.
  • 8.  Social norms or peer-pressure: What are the participants’ social norms? What do they see as useful ways to resist social pressure? Current Motivation: Friends are not consuming a diet high in whole grains. Potential Motivators: Make eating whole grains acceptable within their peer groups. Identify behavioral capabilities and self-regulation skills: factors that facilitate taking action or behavior change. Identify potential mediators that facilitate taking action based on theory variables. For each variable, assess current knowledge and skills and potential knowledge and skills. The following current knowledge and skills are our own personal opinions. Behavioral capabilities  Food and nutrition related knowledge (How-to knowledge): They do not know how many servings of whole grains they should be consuming daily or how to incorporate them into their diet. They are also unaware of the proper ratio of carbohydrates that should be included in their diet. They would like to know how eating the recommended amount of carbohydrates and whole grain could help them lose weight.  Food and nutrition related skills: They have don’t have the ability to read food labels to determine the amount of whole grain in a product. They would like the ability to know how to identify whole grain foods.  Misconceptions: Students perceive low carbohydrate diets to be beneficial in obtaining or maintaining an ideal body weight. Self-regulation skills  Ability to make action plans, goal setting and self-monitoring skills. As college students, they posses the ability of goal setting, making an action plan, and the skill to self-monitor. These are the basic skills that college students must possess to succeed in school.  Emotion-coping skills: do they cope with stress by eating food? Do they have specific difficulties in certain situations? The stress brought on by college life can contribute to unhealthy eating practices. This includes eating food to cope with stress and as a consequence weight gain can occur. 2b. Identify environmental factors that might mediate the program-specified behaviors or practices.
  • 9. Information about environments to plan appropriate educational activities Social environment  Social networks:  Social and cultural support: what degree of family and community support is there for the targeted behaviors? How could support be increased? Not applicable due to the fact that there were no surveys or interviews conducted with their social networks. It is difficult to predict their attitudes toward helping the intended audience. Food environment  Availability and accessibility of food needed to enact the targeted behaviors. Are the foods they need in their stores, workplaces, or schools? Dining commons provide breakfast, lunch and dinner to the students living in dorms but the whole grain content is limited. Other choices are available on campus including student store and student union food court but only provide mainly whole grain meal options during breakfast. Resources: Students living in dorms are required to purchase a prepaid meal plan that includes meals in the dining commons and obtain gold points on their tower card which allows them to purchase meals through other food vendors on campus. Informational environment: There are no posters promoting the consumption of whole grain products on campus. Information about environments so as to educate decision makers and policy makers Food environment  Potential food availability and accessibility: It is feasible for the students to access a diet high in whole grains because of the availability of such products on campus? The school has overall limited options for the availability of whole grains that are available. More specifically the dining commons lack sufficient adequate options for whole grains during lunch and dinner.  Organizational policy environment  Policies related to food at school or work that might impede or facilitate healthful behaviors. What policies need to be enacted? •The campus dining commons provides whole grain products mainly as breakfast items. There are not enough options for lunch and dinner meals. • We are unaware of any policies that the school may have in effect in regards to the whole grain availability on campus.
  • 10. Worksheet 9 NuFS 190 Fall 2008 Issue and audience: A Major issue of concern is the high prevalence of young adults, specifically college students, engaging in unhealthy eating behaviors that involve fad diets. Our mission is to work with college students and the primary audience is SJSU students living on campus. The focus of the program is to promote healthful eating in college students. Target Behavior, practice or action that is the focus of the program: (as identified in Step 1, worksheet 7). To increase the intake of whole grains Philosophy of Educational Approach We will thus develop a program that is for SJSU students to address the issue of fad diets, specifically low carbohydrate diets. The issue of fad diets will not be addressed directly; instead the importance of whole grain consumption will be emphasized. We believe that the students are responsible for their choices in the foods that they consume, but they need the necessary understanding, motivation and tools to aid in their decisions. We also believe that it is necessary for their school and environment to provide healthful, whole grain meal options that are easily accessible. The aim of our program is to assist SJSU students in their awareness of their own behaviors and of environmental factors influencing their choices. Activities in our program will provide students with the knowledge and skills necessary to carry out the behavior of increasing whole grain consumption. The aim will be carried out through a program directed at personal and environmental mediators that includes two phases: a phase that focuses on knowledge and a phase that focuses on skills and peer support. Perspective on nutrition content and issues It is also a goal of our program to encourage SJSU students to decrease simple carbohydrates by replacing them with whole grain options. Components of program The program will consist of three components: • An educational, knowledge based component • Food demo video component • Tasting component Title of project Whole Grains: Get On the Grain Train Theoretic Model: (name) Theory of planned behavior
  • 11. Worksheet 10 1. Restate the program’s target behavior from step 1.  To increase the consumption of whole grains 2. Determine the educational goals of the program to achieve these behavioral goals.  Increase awareness in college students of the importance of adequate whole grains in the diet and enhance motivation to eat them through a knowledge based curriculum.  Facilitate the ability to act by providing opportunities to gain relevant nutrition knowledge and learn food related skills through a food demo video. 3a. Restate theory you are using Theory of planned behavior 3b. From the theory model developed in Step 3, state the potential personal theory mediators (theory constructs) of the target behavior that you will address in the intervention Motivation related mediators: • Perceived barriers • Outcome expectations: taste, convenience and other benefits • Social outcome expectations (social norms) Action-related mediators: • Self efficacy 4. Using the information from 3b above and taking into account the findings from step 2 (just cut and paste here), write specific educational (same as learning) objectives for the personal mediators you have selected and then indicate the specific learning domain.
  • 12. Personal mediators of behavior Findings from step 2: needs analysis Specific Learning (educational) objective for each mediator Learning domain Perceived Barriers Current Motivation: They lack the knowledge as to what whole grain is, they don’t know the significance of the health benefits, and they don’t associate good taste with whole grain. Potential Motivators: Whole grains are easily available if know what to look for on food packaging. They reduce the risk of diabetes, cardiovascular disease, stroke, digestive cancers, and belly fat. Whole grain can also reduce acne significantly to improve facial appearance. They taste good. Describe the importance and benefits of whole grains in the diet, and provide tasty meals high in whole grains to try. Cognitive domain: Comprehension Affective domain: Valuing level Outcome Expectations Current Motivation: College students believe that consuming fewer carbohydrates including whole grain will cause them to lose weight. Potential Motivators: Eating the recommended amounts of whole grain daily can help in long-term weight management the healthy way. They provide long-lasting energy for athletic performance. Recognize that whole grains taste good. State benefits: reduce chronic illness, belly fat, acne and improves athletic performance. Affective domain: Valuing level Cognitive domain: Comprehension level Social outcome expectations (social norms) Current Motivation: Friends are not consuming a diet high in whole grains. Potential Motivators: Make eating whole grains acceptable Recognize that whole grains are cool to eat with peers. Affective domain: Valuing level
  • 13. within their peer groups. Self efficacy Current Motivation: Students are unaware of the food products that contain whole grains and are not sure if they will like the taste. Potential Motivators: Exposure to complex carbohydrates that is high in whole grain as well as the ability to identify them. Increase knowledge of how to select whole grain products. Possess skills by observing quick and easy preparation methods and tasting delicious recipes using whole grain products Cognitive domain: comprehension level Psychomotor domain: observing level Affective domain: Valuing level
  • 14. Worksheet 11 Step 5a: Sample Lesson Plan Outline for a Motivational, Pre-action Phase Lesson Title of Workshop 2: Pro-Whole Grain 60-65 minutes Behavioral Goal:. To increase the consumption of whole grains Educational Goal: Enhance awareness, contemplation and motivation. General Educational Objectives: Program participants will be able to… -Demonstrate understanding and recognize the importance of eating whole grains -Identify the whole grain stamp on products -Prepare at least one recipe that contains whole grains -Express enjoyment of, and positive attitudes toward, consuming whole grains -State intention to increase own whole grain consumption Overview on content (40 minutes) 1. Introduction, overview, gain attention 2. Brainstorm what foods might contain whole grains 3. Discuss health risks associated with not consuming a diet with adequate whole grains 4. Emphasize the importance and benefits of incorporating whole grains into the diet 5. Discuss what whole grains are and where to find them 6. Practice label reading and identifying the whole grain stamp 7. Test knowledge on what has been covered 8. Observe video demo 9. Appreciate whole grains by tasting 10. Goal setting and wrap-up
  • 15. Phase of Nutrition Education & Educational Goal Sequenced Events of Instruction Mediator of Behavior Change Specific Educational Objectives for Mediator Review Learning Domain Practical Educational Activities, Learning Experiences, Messages, or Content Pre-action, Motivational Phase Educational Goal: Enhance awareness of personal risk, contemplation , self-efficacy, and motivation. Gain attention At the end of the session, learner will be able to: Gain attention by asking students if they have ever heard of whole grain foods and what foods might contain whole grains. Present new material Outcome expectations or beliefs State the health benefits of whole grain; reduce chronic illness, belly fat, acne and improves athletic performance. State the important reasons to eat the proper amount of whole grain daily. Cognitive domain: Comprehens ion Affective domain: Valuing level Cognitive domain: Comprehens ion Affective domain: Valuing level Use audience participation to discuss the benefits of whole grain along with PowerPoint slides. Provide scientific evidence that eating whole grain provides health benefits. Provide guidance Barriers Identify reasons why not eating enough whole grain foods. Describe ways of incorporating whole grains in meals. Cognitive domain: Comprehens ion Cognitive domain: Comprehens ion Affective domain: Valuing level Group discussion on current whole grain consumption. Practice looking at whole grain labels. Self- Efficacy Increase knowledge of how to select whole grain products. Cognitive domain: Comprehens ion Affective Group work to compare what they thought was whole grain and actual.
  • 16. LESSON PLAN: narrative format Overview on content (40 minutes) Materials: Paper Pens or pencils Laptop for power point Back up flash drive with power point presentation Copies of seven day sample menu handout Copies of recipe link handout for videos Prepared pancakes and syrup Plates, forks, napkin, orange juice and water Food items that contain whole grain stamp Lesson Plan 1. Introduction: Overview, gain attention (4 min) Begin by asking students if they have ever heard of whole grain foods? What foods might contain whole grains? Facilitate group conversation by encouraging participation of entire audience. 2 . Whole Grain foods: brainstorm what foods might contain whole grains (4 min) Observe and practice cooking skills to produce a whole grain meal. domain: Valuing level Psychomoto r domain: observing level Practice label reading with classmates. Watch cooking video. Social Norms Recognize that whole grains are cool to eat. Affective domain: valuing level Provide whole grain pancakes for tasting with peers. Elicit performance and feedback Behavioral Intention Participants will state intention to increase their consumption of whole grains. Affective domain: valuing level Encourage students to make a clear statement out loud about what actions they will take in the next week to increase their intake of whole grains.
  • 17. Brainstorm what foods might contain whole grains and pass out paper so students can write down all the foods they think contain whole grains and what they have eaten in the last week that might have contained whole grains 3. Risks of inadequate whole grains: Discuss health risks associated with not consuming a diet with adequate whole grains (2 min) Begin power point presentation and discuss health risks students are susceptible to. Be sure to include in discussion weight gain, chronic illness, acne and decreased energy. 4. Benefits of whole grains: Emphasize the importance of incorporating whole grains in the diet (2 min) (outcome expectations) Emphasize the importance of consuming adequate amount of whole grains into the diet, elaborate on the benefits whole grains can have on energy levels and appearance. 5. Identify and find foods containing whole grains: Discuss what whole grains are and where to find them (4 min) (self-efficacy) Continue second part of power point presentation, focusing on what whole grains are and where they can find them and how much they should be consuming. Ask them to refer back to their list they made at the beginning of lesson plan and ask the following question allowing for group discussion: Does their items on their list match with sources of whole grains based on what they now know contain whole grains? Did they actually consume foods that contained whole grains within the last week? Why or why not? Do they believe that they can now find foods that contain whole grains and incorporate them into their diet on a daily bases 6. Labels and whole grain stamp: Practice label reading and identifying the whole grain stamp (5 min) Pass out food items such as cereal, oatmeal, bread, ect., that display the whole grain stamp. Ask group if they have ever seen the whole grain stamp and if they can determine the amount of whole grains found in the product. Encourage class to mingle with one another, sharing their food item and comparing the content of whole grains. 7. Quiz: Test knowledge on what has been covered (3 min) Test knowledge on what has been covered in class through an interactive quiz on power point. Encourage participation from those you have not heard from. 8. Observe video demo and whole grain meal ideas and recipes (6 min) (Barriers) Pass out 7-day sample menu handout and go over ways they can incorporate whole grains into their daily meals. Discuss any barriers that may prevent them from obtaining foods high in whole grains. Follow by watching a video demo on how to prepare tasty whole grain pancakes that are easy to make. Pass out additional whole grain recipes sheet with links to videos that they can try at home with their friends and family. 9. Tasting party: Appreciate whole grains by tasting (7 min) (Social norms) Provide pancakes (same as ones prepared in video) for the students to taste and enjoy together. 10. Goal setting and wrap-up (3 min) (Goal setting)
  • 18. Ask the students what they have learned and review the reasons why whole grain consumption is so important in the diet. Encourage participants to make a clear statement about what actions they will take in the next week to increase their intake of whole grains. Thank the group and provide an email that they can contact if they have any question, feedback or concerns.