Tulsa City-County Health Department It s All About Kids Program

Transcription

1 Tulsa City-County Health Department Spring Report Prepared by: Megan Pittman, Evie M. Muilenburg-Trevino, PhD and Chan M. Hellman, PhD May 2011 Technical Report No.: ARC

2 Table of Contents Executive Summary 3 Study Overview 6 CATCH Nutrition Program 8 Body Mass Index and Blood Pressure Study 13 Personalized Exercise Program (PEP) 41 Oral Health Program 48 Program Activities and Events 53 Appendix A: List Schools 59 Appendix B: Center for Disease Control BMI Growth Charts 61 Appendix C: Blood Pressure Levels by Age and Height Percentile 64 Appendix D: Guide to Blood Pressure Measurement in Children 69 Appendix E: CATCH Nutrition Test 74 Appendix F: Oral Health Program Test 90 2

3 It s All About Kids Executive Summary Program Overview Tulsa City-County Health Department (TCCHD) implemented the It s All About Kids program in order to improve health outcomes for first through fifth grade students. It s All About Kids is a prevention program that encourages kids to make healthy choices and habits for a brighter future. The program has four goals: 1) improve healthy lifestyles, 2) reduce obesity, 3) improve school performance, and 4) build decision making. TCCHD implemented a health and nutrition program including the CATCH nutrition program including pre- and post-test analysis, body mass index (BMI) measurements of participating students in the spring of each year, blood pressure (BP) measurement of participating students in the spring of each year, a Personalized Exercise Program (PEP) for students whose BMI scores are 26 or higher, an oral health program, and a myriad of community events and presentations. Data was collected in the spring 2010,and spring 2011, and then analyzed to determine the effects of the programs on student knowledge retention of the nutrition program, BMI score changes, BP scores changes, student understanding of the oral health program, and a summary of community events and presentations. The purpose of this report is to provide the final results for the It s All About Kids program for school year. CATCH Nutrition Program The CATCH Nutrition program is a coordinated school health program that unites parents, teachers, children, and community partners in teaching children and their families about healthy practices. As a classroom health program, it teaches children healthy eating and physical activity habits. The CATCH Nutrition program was pre and post-tested in 5 schools with 99 participants. Results indicate significant differences between Section A and Section I scores examined. These findings suggest improvement in regards to student choices and perceptions. There were no statistically significant findings for Section C and Checklist scores. BMI and BP Study Body mass index (BMI) scores were collected in spring 2010 and spring Scores were then characterized as normal, at risk, or overweight based on percentiles defined 3

4 by the Center for Disease Control (Center for Disease Control and Prevention, 2007b). Matched BMI data were collected in the spring from 147 students attending 8 elementary schools. Blood pressure (BP) scores were collected in spring 2010 and spring 2011 semesters. Scores were then characterized as normal, prehypertension, Stage 1: hypertension, or Stage 2: hypertension based on percentiles defined by the US Department of Health and Human Services (US Department of Health and Human Services, 2007). Matched BP data were collected in the spring from 147 students attending 8 elementary schools. Anonymous student identifiers, which are used to protect the privacy of students, were used to track individual changes over time. Thus, comparisons can be made from spring 2010 to spring 2011 on an individual level basis with regards to BMI and BP scores. Because of the small sample size in the spring, mean scores were reported by grade and presented in graphs for the spring data. Chi-square analyses were computed to examine BMI rates of change for each school by grade; these analyses are presented in table format. On the whole, findings are mixed with some improvements observed and some negative changes observed. Personalized Exercise Program According to the TCCHD, the Personalized Exercise Program (PEP) is designed for the most at-risk children based on excessively high BMI scores. Fitness measures include BMI scores, push-ups, curl-ups, sit-and-reaches, and 3-minute step-test. TCCHD personnel record each measurement at three time increments. A total of 62 students participated in the program; however, missing data is present since not all assessments were collected for all participants. T-test analyses were used to examine group differences in fitness measurements and the PAS. Statistically significant improvements were present among the following measures: push-ups, curl-ups, sit-and-reaches, and the YMCA 3 minute Step-Test. Oral Health Program The Oral Health program provides instruction about caring for teeth to fourth grade students. The goals are to provide an understanding of the causes and prevention of tooth decay and gum disease, and instruct on proper tooth brushing and dental flossing. The program was implemented in 1 school with 20 students participating. T-test results indicate significant differences between the assessments. These findings suggest an increase in students knowledge of oral health. 4

5 Program Events and Activities The TCCHD produces a School Health Report on a quarterly basis. The report lists the quantitative and qualitative aspects of It s All About Kids presentations, events, and service provisions. The TCCHD categorized presentations, events, and services among nine groups including Parent/Student Events and Community Involvement, Physical Education, Dietician Services, Social Service, Nurse Case Manager, Health Education, Model Fitness Program, Oral Health Education, and Team Kids program. Presentations and events were conducted by the TCCHD in order to provide education regarding school health. Services conducted by the TCCHD provided participants with healthrelated care and activities. For purposes of this report, only quantitative data is presented. Please see the tables in the Program Events and Activities section to view the quantitative summaries events. 5

6 It s All About Kids Study Overview 6

7 It s All About Kids Study Overview Purpose of Study The It s All About Kids (IAK) program is a school health program provided by Tulsa City County Health Department (TCCHD). Based upon the Center for Disease Control s Coordinated School Health Program model, the program includes eight areas of focus including physical education, nutrition and healthy eating, community health services, social services, health education, parent/community involvement, health promotion for school personnel, and ancillary services such as dental education and outreach. The goal of the program is to provide a prevention model for elementary school-aged youth to improve healthy lifestyles, reduce obesity, improve school performance and enhance decision making and negotiation skills. The program is offered to lowperforming schools in Northeast Oklahoma, including schools with poor attendance rates, schools lacking a physical education instructor, schools with poor parental involvement, and schools with limited access to healthcare services. A list of participating schools is available in Appendix A. The purpose of the current report is to provide TCCHD with the spring 2010 and spring 2011 final results of the program evaluation for the It s All About Kids program. Methodology The purpose of this study was to analyze data collected from TCCHD to determine the effectiveness of the It s All About Kids program. The University of Oklahoma, Center of Applied Research for Non-Profit Organizations, analyzed data collected by the TCCHD. Data includes nutrition scores from the CATCH nutrition test, BMI and BP data, PEP data, oral health program test, and program activities and events. Because the study involves analysis of multiple program components, methodology, results and discussion sections are presented under individual headings. 7

8 It s All About Kids CATCH Nutrition Program 8

9 It s All About Kids CATCH Nutrition Program Study The CATCH Nutrition program is a coordinated school health program that unites parents, teachers, children and community partners in teaching children and their families about healthy lifestyle practices. As a classroom health program, children learn healthy eating and physical activity habits. Methodology The CATCH Nutrition program pre- and post-test was administered to 99 fourth grade students in 5 schools. TCCHD used a pre- and post-test model to measure knowledge retention. The test consisted of four sections: Pre and Post Section A, Pre and Post Section C, Pre and Post Section I, and Pre and Post Checklist. In the Section A portion, students are asked 13 questions in regard to food choices; for each item, two food choices are provided. Higher scores indicate healthier food choices. The Section C is comprised of 14 items and questions students knowledge of healthy food in a 2-point multiple choice format (example: Which of these foods is better for your health? ). Higher scores indicate more knowledge of healthy foods. The Section I is comprised of 15 items which deal with students belief in their ability to make healthy choices (examples: I can eat fruit every day. I can play hard during most of recess. ). Questions are presented in a 3-point Likert type response format (1 Not Sure; 2 A Little Sure; 3 Very Sure). Higher scores indicate a decrease in negative self-perceptions in regard to the ability to make healthy choices. The Checklist section is a food checklist comprised of 34 items with a yes or no response format. Students are asked, Yesterday, did you eat or drink any of these foods? Higher scores indicate healthier food choices. This makes the total number of student responses from the pre- and post-test 99 from 5 schools. A series of t-tests were computed to examine differences in mean scores on the preand post-test measures. Results The following graphs depict the results of the CATCH Nutrition program scores. 9

10 Graph 1: CATCH Participants by School CATCH Nutrition Program Number of Participants by School Greeley 11 Springdale 20 Garfield 25 Celia Clinton 28 Burroughs N=99, Fall 2010and Spring 2011 Data Number of Participants Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The graph above depicts the number of participating students in each school for the CATCH nutrition program. A total of 99 fourth grade students, representing 5 schools, participated in the program. 10

11 . Mean Scores Graph 2: CATCH Pre- and Post-Test Results 45 CATCH Nutrition Program Mean Scores for CATCH Tests Prettest Posttest Section A*** Section C Section I*** Checklist N=97, Fall 2010and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report CATCH Test Levels of significance: *p <.05 ** p <.01 *** p <.001 T-tests were used to assess differences in mean scores for all 5 school sites (N = 97). As the preceding graph illustrates, there are statistically significant differences between the Section A and Section I pre- and post-tests indicating improvement. Section A scores [t (98) = ; p <.001] significantly increased indicating students chose healthier foods. Section I scores [t (96) = ; p <.001] were significantly different suggesting a decrease in negative self-perceptions in regards to their ability to make healthy choices. Section C [t (97) = ; p.05] scores and Checklist scores [t (97) = ; p <.05] were not statistically significant. 11

12 Discussion The CATCH Nutrition program was designed to track differences in pre- and post-test scores which consisted of four segments. Results indicate significant differences between Section A and Section I scores examined in 5 schools with 99 participants. These findings suggest improvement in regards to student choices and perceptions. The CATCH Nutrition test is available in Appendix E. 12

13 It s All About Kids Body Mass Index and Blood Pressure Study 13

14 It s All About Kids Body Mass Index and Blood Pressure Study Study TCCHD collected student body mass index (BMI) scores and blood pressure (BP) from elementary school students who participated in the It s All About Kids program. The following analyses and results are from spring 2010 and spring Methodology TCCHD collected BMI and BP scores from 715 students during spring 2010 and from 570 students during spring Participating students were enrolled in grades first through fifth. Each time BMI and BP scores were collected, a TCCHD official recorded participants school, teachers name, student code, age, grade level, height, weight, systolic BP, and diastolic BP. TCCHD officials then calculated and recorded BMI scores based on the Center for Disease Control s (CDC) BMI calculation formula (Center for Disease Control and Prevention, 2007a): BMI = (weight in pounds x 703) (kg/m 2 ) height in inches 2 TCCHD provided the BMI information to the Center of Applied Research For Non-Profit Organizations for analysis. Student names were not identified with student scores; instead, TCCHD officials used codes in place of names for student tracking. OU researchers were given only codes to track student BMI scores. These procedures are followed to protect the privacy of participants. Because children s height and weight change as they mature, childhood BMI scores can be plotted onto the CDC s gender specific BMI-for-age Growth Charts (Center for Disease Control and Prevention, 2007c) to determine a percentile ranking. BMI raw scores were transformed into percentiles using the CDC s BMI percentile formula, which corresponds to the BMI-for-age Growth Charts; the formula is based on BMI, date of birth, gender, height, and age in months at time of assessment. Formulas are used rather than the growth charts to ensure greater accuracy. CDC s gender specific Growth Charts (Center for Disease Control and Prevention, 2007c) are located in Appendix B. The percentile ranking represents the child s BMI score among other children of the same age and gender. The BMI categories and the corresponding percentile are presented in Table 1 (Center for Disease Control and Prevention, 2007b): 14

15 Table 1: BMI Category and Percentile Ranking BMI Category Percentile Ranking Healthy Weight 5 th percentile to < 85 th percentile At risk of Overweight 85 th percentile to < 95 th percentile Overweight 95 th percentile In addition, TCCHD provided BP scores to researchers at the Center of Applied Research For Non-Profit Organizations for analysis. Student codes rather than names were used to track students. BP raw scores were transformed into percentiles based on systolic BP, diastolic BP, date of birth, gender, height, and age in months at time of assessment. The charts for blood pressure levels by age and height percentile are presented in Appendix C (National Heart Lung and Blood Institute, 2008). BP scores were then characterized as normal, prehypertension, Stage 1: hypertension, or Stage 2: hypertension based on percentiles defined by the US Department of Health and Human Services (2007; See Appendix D). Table 2: Systolic and Diastolic BP Category and Percentile Ranking BP Category Percentile Ranking Normal < 90 th percentile Prehypertension 90th percentile to < 95 th percentile Stage 1: Hypertension 95 th percentile to 99 th percentile Stage 2: Hypertension 99 th percentile It is important to note that the purpose of the present data is not to diagnose students with a given BP category. Further, doing so would be inaccurate since multiple measures of BP are required before a diagnosis can be made. Rather the purpose of this study is to obtain a general understanding of student BP categories. Participant demographics and BMI/BP categories from spring 2010 to spring 2011 semesters were analyzed to determine individual level changes of BMI categories between semesters. Results For the spring 2010 and 2011 semesters, 147 matched records were obtained from 8 schools. Frequency analyses were used to determine participant demographic characteristics. Graphs 3-5 depict demographic characteristics of for the entire sample of unmatched participants (N = 715 for Spring 2010; N = 570 for Spring 2011). Additionally, BMI category changes were examined by grade level (Note: 2010 spring grade level was used). Graphs 6-16 illustrate BMI changes and chi-square tests for matched data (N = 147). 15

16 Finally, BMI categories and BP categories were examined for spring 2010 and spring Graphs depict BMI and BP characteristics for matched data. 16

17 BMI Results Spring 2010 Spring

18 Graph 3: BMI Participants by School for Spring Body Mass Index Study Spring Number of Particpants by School Houston Burroughs Anderson Alcott Whitman Clinton Hawthorne Marshall n=715, Spring 2010; n=570, Spring 2011 Number of participants Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The above graph depicts the number of participants for each school for spring 2010 and spring Eight schools were involved. The percent of students participating from each school in spring 2010 is as follows: Marshall (16%), Hawthorne (22%), Houston (3%), Burroughs (5%), Anderson (9%), Alcott (16%), Whitman (4%)and Clinton (26%). The percent of students participating from each school in spring 2011 is as follows: Alcott (.4%), Anderson (2%), Burroughs (2%), Clinton (8%), Hawthorne (10%), Houston (.2%) and Marshall (5%). 18

19 Graph 4: BMI Participants by Grade for Spring Body Mass Index Study Spring Number of Particpants by Grade First Second Third Fourth Fifth n=715, Spring 2010; n=570, Spring 2011 Number of participants Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The above graph illustrates the number of participants by grade for spring 2010 and spring In regard to grade level for spring 2010, 160 (22.5%) participants were from the first grade, 168 (23.6%) participants were from the second grade, 133 (33.1%) participants were from the third grade, 144 (20.2%) participants were from the fourth grade, and 110 (15.4%) were from the fifth grade. In regard to grade level for spring 2011, 35(6.1%) participants were from the first grade, 45(7.9%) participants were from the second grade, 35(6.1%) participants were from the third grade, and 39(6.8%) participants were from the fourth grade. 19

20 Graph 5: BMI Participants by Gender for Spring Body Mass Index Study Spring Percentage of Particpants by Gender Male Female n=715, Spring 2010; n=570 Spring 2011 Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring. According to TCCHD BMI records, Graph 5 indicates that in spring 2010, 47% (n=336) of the students were male and 53% (n=379) of the students were female. In the spring of 2011, 44.2% (n = 252) of students were male and 55.8% (n = 318) of students were female for spring

21 Spring 2010 BMI Graph 6: BMI Changes for First Graders Spring Body Mass Index Study BMI Changes for First Graders Healthy At Risk Overweight Spring Spring n=34; Spring 2010and Spring 2011 Data Percent Scoring. Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report As Graph 6 illustrates, BMI categories were tabulated for spring 2010 and spring 2011 semesters. For the spring 2010 semester, 17 (50%) of all students were in the healthy category, 11 (32.4%) were in the at risk category, and 6 (17.6%) were in the overweight category. For spring 2011, 19(55.9%) of all students were in the healthy category, 8 (23.5%) were in the at risk category, and 7 (20.6%) were in the overweight category. Table 3: BMI Rates of Change for First Graders Spring 2011 BMI Healthy At Risk Overweight Healthy (n=17) 17(100%) 0 (0%) 0 (0%) At Risk (n=11) 2(18.2%) 8 (72.7%) 1(9.1%) Overweight (n=6) 0 (0%) 0(0%) 6 (100%) Table 3 presents the results of the chi-square test used to track individual level BMI rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = ; p <.05]. In the spring 2010, of the 17 students in the healthy category, zero moved to at risk or overweight. In spring 2010 of the 11 students in the at risk category, 2 moved to the healthy category and 1 moved to the overweight category. In spring 2010, of the 6 students in the overweight category, zero moved to at risk or healthy. 21

22 Spring 2010 BMI Graph 7: BMI Changes for Second Graders Spring Body Mass Index Study BMI Changes for Second Graders Healthy Overweight 41.5 Spring At Risk Spring n=41; Spring 2010and Spring 2011Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring. As Graph 7 illustrates, for the spring 2010 semester, 17(41.5%) of all students were in the healthy category, 8(19.5%) were in the at risk category, and 16 (39%) were in the overweight category. For spring 2011, 17(41.5%) of all students were in the healthy category, 8 (19.5%) were in the at risk category, and 16(39%) were in the overweight category. Table 4: BMI Rates of Change for Second Graders Spring 2011 BMI Healthy At Risk Overweight Healthy (n=17) 16(94.1%) 0 (0%) 1 (5.9%) At Risk (n=8) 0 (0%) 5 (62.5%) 3 (37.5%) Overweight (n=16) 1 (6.3%) 3 (18.8%) 12 (75.0%) Table 4 presents the results of the chi-square test used to track individual level BMI rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = ; p <.01]. In the spring 2010, of the 17 students in the healthy category, 1 (5.9%) moved to the overweight category in spring Of the 8 students in the at risk category in spring 2010, 3 (37.5%) moved to the at risk category in spring Of the 16 students in the overweight category in spring 2010, 4(25.1%) improved to the healthy or at risk categories. 22

23 Spring 2010 BMI Graph 8: BMI Changes for Third Graders Spring Body Mass Index Study BMI Changes for Third Graders Healthy Overweight At Risk Spring Spring n=35; Spring 2010and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring. As the above graphs illustrates, for the spring 2010 semester, 17(48.6%) of all students were in the healthy category, 5 (14.3%) were in the at risk category, and 13 (37.1%) were in the overweight category. For spring 2011, 17 (48.6%) of all students were in the healthy category, 5(14.3%) were in the at risk category, and 13 (37.1%) were in the overweight category. Table 5: BMI Rates of Change for Third Graders Spring 2011 BMI Healthy At Risk Overweight Healthy (n=3) 16 (94.1%) 1 (5.9%) 0 (0.0%) At Risk (n=4) 1 (20.0%) 2(40.0%) 2 (40.0%) Overweight (n=3) 0 (0.0%) 2 (15.4%) 11 (84.6%) Table 5 presents the results of the chi-square test used to track individual level BMI rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = ; p <.05]. In the spring 2010, of the 17 students in the healthy category,one student moved to the at risk category. Of the 5 students in the at risk category in the spring 2010, 1 (20.0%) moved to the healthy category and 2 (40%) moved to the overweight category. Of the 13 students in the overweight category in spring 2010, 2(15.4%) improved to the at risk category. 23

24 Spring 2010 BMI Graph 9: BMI Changes for Forth Graders Spring Body Mass Index Study BMI Changes for Fourth Graders Healthy At Risk Overweight Spring Spring n=37; Spring 2010 and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report As graph 9 illustrates, for the spring 2010 semester,17 (45.9%) of all students were in the healthy category, and 7 (18.9%) were in the at risk category and 13 (35.1%) were om the overweight category. For spring 2011, 14 (37.8%) of all students were in the healthy category, 9 (24.3%) were in the at risk category, and 14 (37.8%) were in the overweight category. Table 6: BMI Rates of Change for Clinton Fourth Graders Spring 2011 BMI Healthy At Risk Overweight Healthy (n=17) 14 (82.4%) 3 (17.6%) 0 (0.0%) At Risk (n=7) 0 (0.0%) 5 (71.4%) 2 (28.6%) Overweight (n=13) 0 (0.0%) 1 (7.7%) 12 (92.3%) Table 6 presents the results of the chi-square test used to track individual level BMI rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) = ; p >.05]. In the spring 2010, of the 17 healthy students, 3 (17.6%) moved to the at risk category in spring Of the 7 students in the at risk category in spring 2010, 2 (28.6%) moved to the overweight category in spring Of the 13 students in the overweight category in spring 2010, 1(7.7%) improved to the at risk category.. Percent Scoring 24

25 Spring 2010 BMI Graph 10: Overall BMI Changes for Spring Body Mass Index Study Overall BMI Changes Healthy At Risk Overweight Spring Spring n=147; Spring 2010 and Spring 2011Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report As graph 10 illustrates, for the spring 2010 semester, 68 (46.3%) of all students were in the healthy category, 31 (21.2%) were in the at risk category, and 48 (32.7%) were in the overweight category. For spring 2011, 67 (45.6%) of all students were in the healthy category, 30 (20.4%) were in the at risk category, and 50 (34%) were in the overweight category. Table 7: BMI Rates of Change for Spring Spring 2011 BMI Healthy At Risk Overweight Healthy (n=68) 63 (92.6%) 4 (5.9%) 1 (1.5%) At Risk (n=31) 3 (9.7%) 20 (64.5%) 8 (25.8%) Overweight (n=48) 1 (2.1%) 6 (12.5%) 41 (85.4%) Table 7 presents the results of the chi-square test used to track individual level BMI rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = ; p <.001]. In the spring 2010, of the 68 healthy students, 63 (92.6%) maintained a healthy category and 5 (7.4%) moved to the at risk or overweight category in spring Of the 31 students in the at risk category in spring 2010, 3 (9.7%) improved to the healthy category in spring 2011 and 8 (25.8%) moved to the overweight category. Of the 48 students in the overweight category in spring 2010, 6 (12.5%) improved to the at risk category and 1 (2.1%) improved to the healthy category in spring Percent Scoring 25

26 Blood Pressure Results Spring 2010 Spring

27 Spring 2010 Systolic Graph 11: Systolic Changes for First Graders Spring Blood Pressure Study Systolic Percentages for First Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring Spring n=35; Spring 2010 and Spring 2011 Percent Scoring Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report The above graph illustrates the systolic percentages for first graders. For the spring 2010 semester, 16 (45.7%) of all students were in the normal category, 7 (20%) were in the prehypertension category, 12 (34.3%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 24(68.6%) of all students were in the normal category, 6 (17.1%) were in the pre-hypertension category, 5(14.3%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 8: Systolic Percentages for First Graders Spring 2011 Systolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=16) 11(68.8%) 1 (6.3%) 4 (25.0%) 0 (0.0%) Pre-HTN (n=7) 4 (57.1%) 2 (28.6%) 1 (14.3%) 0 (0.0%) Stage 1 HTN (n=12) 9 (75.0%) 3 (25.0%) 0 (0.0%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 8 presents the results of the chi-square test used to track individual level systolic rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) = 5.279; p >.05]. In the spring 2010, of the 16 students in the normal category, 5 showed increased systolic blood pressure. Of the 7 students in the Pre-HTN category in 2010, 2 moved to Pre-HTN and 1 moved into the Stage 1 HTN category. Of the 12 students in the Stage 1 HTN category in 2010, 9 improved to the normal category and 3 moved to the Pre-HTN category. 27

28 Spring 2010 Diastolic Graph 12: Diastolic Changes for First Graders Spring Blood Pressure Study Diastolic Percentages for First Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring 10 Spring n=35; Spring 2010and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report The above graph illustrates the diastolic percentages for first graders. For the spring 2010 semester,15 (42.9%) of all students were in the normal category, 5 (14.3%) were in the pre-hypertension category, 15 (42.9%) was in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 27 (77.1%) of all students were in the normal category, 3 (8.6%) were in the pre-hypertension category, 5 (14.3%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 9: Diastolic Percentages for First Graders Spring 2011 Diastolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=15) 11 (73.3%) 2 (13.3%) 3 (13.3%) 0 (0.0%) Pre-HTN (n=5) 4 (80.0%) 3 (75.0%) 1 (20.0%) 0 (0.0%) Stage 1 HTN (n=15) 12 (80.0%) 1 (6.7%) 2 (13.3%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 9 presents the results of the chi-square test used to track individual level of diastolic rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) = 1.072; p >.05]. In the spring 2010, of the 15 students in the normal category, 5 showed increased diastolic blood pressure. Of the 5 students in the Pre-HTN HTN in 2010, 3 students moved to Pre-HTN and 1 student moved to the Stage 1 HTN. In the spring 2010, of the 15 students in the Stage 1 HTN, 13 students improved to Pre- HTN or Normal.. Percent Scoring 28

29 Spring 2010 Systolic Graph 13: Systolic Percentages for Second Graders Spring Blood Pressure Study Systolic Percentages for Second Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring 10 Spring Percent Scoring n=44; Spring 2010and Spring 2011 Data Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The above graph illustrates the systolic percentages for second graders. For the spring 2010 semester, 28 (63.6%) of all students were in the normal category, 6 (13.6%) were in the pre-hypertension category, 10 (22.7%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 35 (79.5%) of all students were in the normal category, 5 (11.4%) were in the pre-hypertension category, 4 (9.1%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 10: Systolic Percentages for Second Graders Spring 2011 Systolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=28) 23 (82.1%) 1 (3.6%) 4 (14.3%) 0 (0.0%) Pre-HTN (n=6) 6 (100.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Stage 1 HTN (n=10) 6 (60.0%) 4 (40.0%) 0(0.0%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 10 presents the results of the chi-square test used to track individual level systolic rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = 12.5; p <.05]. In spring 2010, of the 28 students in the Normal category, 5 moved to Pre-HTN or Stage 1 HTN. Of the 10 students in Stage 1 HTN, 10 improved to Pre- HTN or Normal. 29

30 Spring 2010 Diastolic Graph 14: Diastolic Changes for Second Graders Spring Blood Pressure Study Diastolic Percentages for Second Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spr ing Spr ing n=44; Spring 2010 and Spring 2011 Data Percent Scoring Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The above graph illustrates the diastolic percentages for second graders. For the spring 2010 semester, 21 (47.7%) of all students were in the normal category, 11 (25%) were in the Pre-HTN category, 12(27.3) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 34 (77.3%) of all students were in the normal category, 4 (9.1%) were in the pre-hypertension category, 6 (13.6%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 11: Diastolic Percentages for Second Graders Spring 2011 Diastolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=21) 18 (85.7%) 0 (0.0%) 3 (14.3%) 0 (0.0%) Pre-HTN (n=11) 9 (81.8%) 2 (18.2%) 0 (0.0%) 0 (0.0%) Stage 1 HTN (n=12) 7 (58.3%) 2 (16.7%) 3 (25.0%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 11presents the results of the chi-square test used to track individual level diastolic rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) = 7.090; p >.05]. In the spring 2010, of the 21 students in the normal category, 2 showed increased diastolic blood pressure in the spring of In the spring of 2010 of the 11 students in the Pre-HTN category, 11 showed improvement in diastolic blood pressure. In the spring of 2010, of the 12 students in the Stage 1 HTN category, 9 showed an improvement in diastolic blood pressure in the spring of

31 Spring 2010 Systolic Graph 15: Systolic Percentages for Third Graders Spring Blood Pressure Study Systolic Percentages for ThirdGraders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring 10 Spring n=35; Spring 2010 and Spring 20101Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report The above graph illustrates the systolic percentages for third graders. For the spring 2010 semester, 19 (54.3%) of all students were in the normal category, 7 (20.0%) were in the pre-hypertension category, 9 (25.7%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 31 (88.6%) of all students were in the normal category, 3 (8.6%) were in the pre-hypertension category, 1 (2.9%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 12: Systolic Percentages for First Graders Spring 2011 Systolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=19) 17 (89.5%) 2 (10.5%) 0 (0.0%) 0 (0.0%) Pre-HTN (n=7) 6 (85.7%) 1 (14.3%) 0 (0.0%) 0 (0.0%) Stage 1 HTN (n=9) 8 (88.9%) 0 (0.0%) 1 (11.1%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 12 presents the results of the chi-square test used to track individual level systolic rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) = 4.020; p >.05]. In the spring of 2010, of the 19 students in the normal category, 2 showed an increased systolic blood pressure in the spring of In the spring of 2010, of the 7 students in the Pre-HTN category, 6 students improved to the Normal category. In the spring of 2010, 0f the 9 students in the Stage 1 HTN category, 8 students improved to the Normal category in the spring of Percent Scoring 31

32 Spring 2010 Diastolic Graph 16: Diastolic Percentages for Third Graders Spring Blood Pressure Study Diastolic Percentages for Third Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring 10 Spring n=35; Spring 2010 and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring The above graph illustrates the diastolic percentages for third graders. For the spring 2010 semester, 21 (60.0%) of all students were in the normal category, 10 (28.6%) were in the pre-hypertension category, 4 (11.4%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 30 (85.7%) of all students were in the normal category, 2 (5.7%) were in the pre-hypertension category, 3(8.6%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 13: Diastolic Percentages for Third Graders Spring 2011 Diastolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=21) 19 (90.5%) 1 (4.8%) 1 (4.8%) 0 (0.0%) Pre-HTN (n=10) 9 (90.0%) 1 (10.0%) 0 (0.0%) 0 (0.0%) Stage 1 HTN (n=4) 2 (50.0%) 0 (0.0%) 2(50.0%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 13 presents the results of the chi-square test used to track individual level diastolic rates of change from spring 2010 to spring 2011; findings were statistically significant *χ 2 (4) = 10.48; p <.05]. In the spring 2010, of the 21 students in the normal category, 2 increased their diastolic blood pressue in spring In spring 2010, of the 10 students in the Pre-HTN category, 9(90%) students improved to the Normal category in Spring In the spring of 2010, of the 4 students in Stage 1 HTN 2(50%) students improved to the Normal category.. 32

33 Spring 2010 Systolic Graph 17: Systolic Percentages for Fourth Graders Spring Blood Pressure Study Systolic Percentages for Fourth Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring 10 Spring n=38; Spring 2010 and Spring 2011 Data Percent Scoring Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report The above graph illustrates the systolic percentages for fourth graders. For the spring 2010 semester, 23 (60.5%) of all students were in the normal category, 2(5.3%) of all students were in the Pre-HTN category,13 (34.2%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 29 (76.3%) of all students were in the normal category, 5 (13.2%) were in the prehypertension category, 4 (10.5%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 14: Systolic Percentages for Fourth Graders Spring 2011 Systolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=23) 19 (82.6%) 2 (8.7%) 2 (8.7%) 0 (0.0%) Pre-HTN (n=2) 1 (50.0%) 0 (0.0%) 1 (50.0%) 0 (0.0%) Stage 1 HTN (n=13) 9 (69.2%) 3 (23.1%) 1 (7.7%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 14 presents the results of the chi-square test used to track individual level systolic rates of change from fall 2010 to fall 2011; findings were not statistically significant *χ 2 (4) = 5.103; p >.05]. In the spring 2010, of the23 students in the normal category, 4 increased their systolic blood pressure. In the spring 2010 of the 2 students in Pre HTN category, 1 (50%) moved to the Normal category and 1(50%) moved to Stage 1 HTN in spring In the spring 2010, of the13 students in the Stage 1 HTN, 12 students improved to the normal or Pre-HTN category. 33

34 Spring 2010 Diastolic Graph 18: Diastolic Percentages for Fourth Graders Spring Blood Pressure Study Diastolic Percentages for Fourth Graders Normal Pre-HTN Stage 1 HTN Stage 2 HTN Spring Spring n=38; Spring 2010 and Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report The above graph illustrates the diastolic percentages for fourth graders. For the spring 2010 semester, 30 (78.9%) of all students were in the normal category, 5 (13.2%) were in the pre-hypertension category, 3 (7.9%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. For spring 2011, 36 (94.7%) of all students were in the normal category, 1 (2.6%) were in the pre-hypertension category, 1 (2.6%) were in the Stage 1 Hypertension category, and 0 (0.0%) were in the Stage 2 Hypertension category. Table 15: Diastolic Percentages for Second Graders Spring 2011 Diastolic Normal Pre-HTN Stage 1 HTN Stage 2 HTN Normal (n=30) 28(93.3%) 1 (3.3%) 1 (3.3%) 0 (0.0%) Pre-HTN (n=5) 5 (100.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Stage 1 HTN (n=3) 3 (100.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Stage 2 HTN (n=0) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Table 15 presents the results of the chi-square test used to track individual level diastolic rates of change from spring 2010 to spring 2011; findings were not statistically significant *χ 2 (4) =.563; p >.05]. In the spring 2010, of the 30 students in the normal category, 1 (3.3%) moved to the Pre HTN category and 1 (3.3%) moved to the Stage 1 HTN category in spring Percent Scoring 34

35 BMI and BP Comparisons Spring 2010 Spring

36 Graph 19: 2010 BMI and Systolic Blood Pressure Data Body Mass Index Study 2010 Spring BMI and Systolic Blood Pressure Data Normal Prehypertension Stage 1: HTN Stage 2: HTN Healthy At Risk Overweight N=150; Spring 2010 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring The above graph illustrates the BMI and systolic blood pressure of all students in spring Findings were statistically significant *χ 2 (150) = ; p >.001]. Of those who have healthy BMI scores, 65.3% fall in the category of a normal BP, 18.1% fall in the category of Pre-HTN BP, and 16.7% fall in the Stage 1: HTN category. In regard to at-risk participants, 58.1% have a normal BP, 9.7% fall in the Pre-HTN BP category, and 32.3% fall in the range for Stage 1 HTN. Of the overweight BMI scores, 42.6% fall in the range for a normal BP, 12.8% fall in the Pre-HTN BP, and 44.7% fall in the Stage 1 HTN category. There are no individuals who fall in the Stage 2 HTN category. 36

37 Graph 20: 2010 BMI and Diastolic Blood Pressure Data Body Mass Index Study 2010 Spring BMI and Diastolic Blood Pressure Data Normal Prehypertension Stage 1: HTN Stage 2: HTN Healthy At Risk Overweight N=150; Spring 2010 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Graph 20 illustrates the BMI and diastolic blood pressure of all students for spring Findings were not statistically significant *χ 2 (150) = 1.770; p >.05]. Of those who had healthy BMI scores, 59.7% fell in the normal BP category, 19.4% fell in the category for Pre-HTN BP, and 20.8% fell in the Stage 1 HTN category. In regard to at risk participants, 51.6% fell in the normal BP category, 29% fell in the Pre-HTN BP, and 19.4% fell in the Stage 1 HTN category. Of the overweight BMI scores, 55.3% had a normal BP, 19.1% fell in the Pre-HTN BP category, and 25.5% were in the Stage 1 HTN category. There were no individuals who fell in the range for Stage 2 HTN.. Percent Scoring 37

38 Graph 21: 2011 BMI and Systolic Blood Pressure Data Body Mass Index Study 2011 Spring BMI and Systolic Blood Pressure Data Normal Prehypertension Stage 1: HTN Stage 2: HTN Healthy At Risk Overweight n=551; Spring 2011 Data Center of Applied Research for Non-profit Organizations Percent Scoring TCCHD It's All About Kids Program Report Graph 21 illustrates the BMI and systolic blood pressure of all students for spring Findings were not statistically significant *χ 2 (551) = 6.583; p >.001]. Of those who had healthy BMI scores, 81.1% fell into the normal BP category, 8.4% fell in the category for Pre-HTN BP, and 10.5% fell into the Stage 1 HTN category. In regard to at risk participants, 77.9% fell into the normal BP category, 13.5% fell in the category for Pre- HTN BP, and 8.7% fell into the Stage 1 HTN category. Of the overweight BMI scores, 72.2% fell into the normal BP category, 15.2% fell in the Pre-HTN BP category, and 12.6% fell into the Stage 1 HTN category. There were no individuals who fell in the Stage 2 HTN category. 38

39 Graph 22: 2011 BMI and Diastolic Blood Pressure Data Body Mass Index Study 2011 Spring BMI and Diastolic Blood Pressure Data Normal Prehypertension Stage 1: HTN Stage 2: HTN Healthy At Risk Overweight n= 551; Spring 2011 Data Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Percent Scoring The above graph illustrates the BMI and diastolic blood pressure of all students for fall Findings were not statistically significant *χ 2 (551) = 6.079; p >.05]. Of those who had healthy BMI scores, 80.1% were in the normal BP category, 6.8% fell into the Pre- HTN BP category, and 13.2% fell into the Stage 1 HTN category. In regard to at risk participants, 78.8% fell into the normal BP category, 13.5% fell into the Pre-HTN BP category, and 7.7% fell into the Stage 1 HTN category. Of the overweight BMI scores, 78.8% fell into the normal BP category, 8.6% fell into the Pre-HTN BP category, and 12.6% fell into the Stage 1 HTN category. There were no individuals who fell into the category of Stage 2 HTN. 39

40 References Center for Disease Control and Prevention. (2007a). About BMI for children and teens. Retrieved January 16, 2010 from bmi/childrens_bmi/childrens_bmi_formula.htm. Center for Disease Control and Prevention. (2007b). Standard formulas. Retrieved January 16, 2010 from about_childrens_bmi.htm Center for Disease Control and Prevention. (2007c). Clinical growth charts. Retrieved August 26, 2011 from National Heart Lung and Blood Institute. (2008). Blood pressure levels for boys and girls by age and height percentile. US Department of Health and Human Services. (2007). A pocket guide to blood pressure measurement in children. National Institutes of Health. 40

41 It s All About Kids Personalized Exercise Program (PEP) 41

42 It s All About Kids Personalized Exercise Program (PEP) Study According to the TCCHD, the Personalized Exercise Program (PEP) targets first through fifth grade students whose BMI scores are 26 or higher. The program includes a personalized fitness program and the collection of fitness measurements. Methodology Fitness measures include BMI scores, push-ups, curl-ups, sit-and-reaches, and 3-minute step-test. TCCHD personnel record each measurement at three time increments. A total of 15 students participated in the program; however, missing data is present since not all assessments were collected for all participants. Results The following graphs depict the results of the PEP program scores. 42

43 Mean Scores Graph 23: PEP BMI Scores Personalized Exercise Program Comparison of Mean Scores Time 1 Time 2 Time BMI Scores** N=14, Spring 2010 and Spring 2011 Data TCCHD It s All About Kids Program Report Center of Applied Research for Nonprofit Organizations Levels of significance: *p <.05 ** p <.01 *** p <.001 A repeated measures ANOVA was computed to compare differences in mean BMI scores for measurement over three time periods. According to TCCHD PEP score reports, data was obtained from 14 participants. There was not a statistically significant difference between time 1, time 2 and time 3 BMI scores [F (2,26) = 1.684; p >.05]. 43

44 Mean Scores Graph 24: PEP Push-up and Curl-up Scores Personalized Exercise Program Comparison of Mean Scores Time 1 Time 2 Time Push-up*** N=14 Push-up, N= 15 Curl-up, Spring 2010 & 2011 Data TCCHD It s All About Kids Program Report Center of Applied Research for Nonprofit Organizations Curl-up*** Levels of significance: *p <.05 ** p <.01 *** p <.001 The preceding graph illustrates the comparison of mean scores for push-ups for 14 students, and curl-ups for 15 students. Repeated measure ANOVA results indicate statistically significant differences between both activity scores. Push-up scores increased from a mean of to [F (2, 26) = 3.571; p <.05]. Curl-up scores significantly increased [F (2, 28) = 9.968; p <.01]. Thus, students who participated in the program demonstrated improvement in both activity measures. 44

45 Mean Scores Graph 25: Sit-and-reach Scores Personalized Exercise Program Comparison of Mean Scores Time 1 Time 2 Time SRR*** N=15, Spring 2010 and Spring 2011 Data TCCHD It s All About Kids Program Report Center of Applied Research for Nonprofit Organizations SRL*** Levels of significance: *p <.05 ** p <.01 *** p <.001 The preceding graph illustrates the comparison of mean scores for sit-and-reaches for 15 students. Repeated measure ANOVA results indicate statistically significant differences between both activity scores. Sit-and-reach (right leg) scores increased from a mean of to [F (2, 28) =13.145; p <.001]. Finally, Sit-and-reach (left leg) scores increased [F (2, 28) =22.937; p <.001]. Students who participated in the program demonstrated improvement in both activity measures. 45

46 Mean Scores Graph 26: PEP 3 Minute Step Test/Heart Rate Scores Personalized Exercise Program Comparison of Mean Scores Time 1 Time 2 Time Time in Seconds*** N=15, Spring 2010 and Spring 2011 Data TCCHD It s All About Kids Program Report Center of Applied Research for Nonprofit Organizations Heart Rate Levels of significance: *p <.05 ** p <.01 *** p <.001 According to TCCHD PEP score reports, data was obtained from 15 participants. There was a statistically significant difference between fall and spring YMCA 3 minute step test times scores [F (2,28) = 4.894; p <.05]. The difference between the fall and spring YMCA 3 minute step test heart rate measurements were not statistically significant [F (2,28) = 4.396; p >.05]. This means students were able to participate in the step test for longer periods of time at each step test interval, and their heart rates were elevated at each step test interval. 46

47 Discussion Repeated measures ANOVA analyses were used to examine group differences in fitness measurements over three time periods. Statistically significant improvements were present among the following measures: push-ups, curl-ups, sit-and-reaches, and the YMCA 3 minute Step-Test. 47

48 It s All About Kids Oral Health Program 48

49 It s All About Kids Oral Health Program Study According to TCCHD, the Oral Health program provides instruction about caring for teeth to fourth grade students. The goals are to provide an understanding of the causes and prevention of tooth decay and gum disease, and instruct on proper tooth brushing and dental flossing. The two-session course was implemented in 1 school. Methodology The Oral Health program measure included a pre- and post-assessment that was developed by TCCHD personnel. The survey consisted of 6 questions in a multiple choice-type response format. Questions dealt with brushing one s teeth, dental plaque, cavities, toothbrushes, fluoride, and dental floss. Measurements were obtained by TCCHD personnel. A total of 20 students participated in the program Descriptive statistics are reported for the number of participants by school. In addition, a t-test analysis was used to examine differences in pre- and post-tests. Results The following graphs depict the results of the Oral Health program scores. 49

50 Graph 27: Oral Health Program Participants by School Oral Health Program Number of Particpants by School Roy Clark N=20 Number of participants Center of Applied Research for Non-profit Organizations. TCCHD It's All About Kids Program Report The graph above depicts the number of participating students in each school for the Oral Health program. A total of 20 students participated from 1 school. 50

51 . Mean Scores Graph 28: Oral Health Program Pre- and Post-Test Results 8 Oral Health Program Mean Scores for Oral Health Program Test Pretest Posttest Pretest Oral Health*** N=20 Center of Applied Research for Non-profit Organizations TCCHD It's All About Kids Program Report Posttest Level of significance: *** p <.001 A t-test analysis was computed to examine differences in mean scores. As the above graph illustrates, there is a statistically significant difference in pre- and post-test scores. Oral health scores increased from 3.3 to 4.8 [t (19) = ; p <.001]. These findings suggest that students knowledge of oral health increased from the pre- to the post-test. 51

52 Discussion The Oral Health program was designed to track differences in pre- and post-test scores. T-test results indicate a significant difference between the pre- and post-test. These findings suggest an increase in students knowledge of oral health. The Oral Health program test is available in Appendix G. 52

53 It s All About Kids Program Activities and Events 53

54 It s All About Kids Program Activities and Events Program Activities and Events A School Health Report is produced on a quarterly basis by TCCHD. Both quantitative and qualitative data of It s All About Kids presentations, events, and service provisions are reported. Presentations, events, and services are categorized among nine groups: Parenting/Student Events and Community Involvement, Physical Education, Dietician Services, Social Services, Nurse Case Manager, Health Education, Model Fitness Program, Oral Health Education, and T. The TCCHD provides participants with healthrelated care and activities. For purposes of this report, only quantitative data will be presented. Methodology The It s All About Kids School Health Report was compiled by the TCCHD and included three quarters of the school year. Quarterly totals were tabulated by TCCHD and then plotted quarterly and year-to-date totals were put into tables by OU personnel. Results Table 16: Parenting/Student Events and Community Involvement Quarter First Second Third Fourth Total Events Attendees 1, ,117 Table 17: Physical Education Quarter First Second Third Fourth Total Students Identified Students Enrolled Exercise Sessions # of Exercise Tests Number of Parent Meetings In-School PE Sessions

55 Table 18: Dietitian Services Quarter First Second Third Fourth Total Attempted Parent Meetings Completed Parent Meetings Lunch & Learns for Staff Dietitian Referrals Table 19: Social Service Quarter First Second Third Fourth Total Families Receiving Case Mgmt Families Receiving Medicaid Apps Families Completing Medicaid Apps Home Visits Conducted Phone Call to Parents Parent Meeting Child Meeting Transportation Pool uses Families referred to OU Clinic Families referred to THD Clinics Other Internal referrals Families referred to Vision Clinic Families referred to Dental Clinic Families referred Health Screening Families referred to Social Services Prescription Referral Families referred to Reg. Dietitian Families referred to PE Specialist Table 20: Nurse Case Manager Quarter First Second Third Fourth Total Families Receiving Medicaid Apps Families Completing Medicaid Apps Families Receiving Case Mgmt Home Visits

56 Phone Call to Parents Parent Meeting Child Meeting Transportation Pool Uses Families Referred to OU Clinic Families Referred to THD Clinics Other Internal Referrals Families Referred to Vision Clinic Families Referred to Dental Clinic Families Referred Health Screening Families Referred to Social Services Prescription Referral Families Referred to Reg. Dietitian Families Referred to PE Specialist Table 21: Health Education Quarter First Second Third Fourth Total Number of Presentations Number of Sessions ,141 Students Reached 1,005 6,401 2, ,995 Health Fairs Attended Number Community Presentations Number of Community Sessions Number Comm. Class Participants 3,640 6,751 6, ,078 Table 22: Model Fitness Program Quarter First Second Third Fourth Total Number of Participants Number of Miles ,864 2, , Table 23: Oral Health Education Quarter First Second Third Fourth Total Number of Presentations Number of Sessions

57 Completed Referrals Table 24: Team Kids Quarter First Second Third Fourth Total Number of Students Enrolled Number of Sessions Number of Sessions Attended

58 Discussion Quantitative data was presented in regard to the It s All About Kids Parenting/Student Events and Community Involvement, Physical Education, Dietician Services, Social Services, Nurse Case Manager, Health Education, Model Fitness Program, Oral Health Education, and Team Kids. A total of 2 events were held for the Parenting/Student Events and Community Involvement with 2,117 attendees. The Physical Education program had 88 students enrolled and included 191 in-school physical education sessions. The Dietician Services included the following services: 12 parent meetinfs and 14 lunch and learns for staff. For Social Services, the following services occurred: 48 home visits conducted, 58 phone calls to parents, and 9 parent meetings. Nurse Case Management completed 43 home visits, and provided case management to 70 families. The Health Education program held 225 presentations, reached 9,995 students, and held 1,141 sessions. The Model Fitness Program had 60 participants with 5, number of miles. For Oral Health Education, 139 presentations were conducted and 24 sessions were held. For the Team Kids Program, there were 206 students enrolled and 139 sessions. Totals used in this report were taken directly from the TCCHD reports. 58

59 Appendix A It s All About Kids List of Schools 59

60 It s All About Kids Schools Tulsa Union Sand Springs Comprehensive Sites Alcott Anderson Clinton Burroughs Hawthorne Houston Marshall Whitman Roy Clark Central Garfield 60

61 Appendix B It s All About Kids Center for Disease Control BMI Charts 61

62 62

63 63