Obesity: On-Campus Diet & Exercise Based

Intervention
Intervention Criteria Analysis
University of Rhode Island,
Advanced Interdisciplinary Health Studies
12-07-15

Authors
Beatrice Ake
University of Rhode Island, Beatrice_ake23@my.uri.edu
Samantha Anderson
University of Rhode Island, Sanderson1@my.uri.edu
Genesis Garcia
University of Rhode Island, Genesis_Garcia@my.uri.edu
Paige Tonra
University of Rhode Island, PaigeTonra@gmail.com
Danielle Woods
University of Rhode Island, Danielle_Woods@uri.edu

TABLE OF CONTENTS

Page
COVER PAGE...1
TABLE OF CONTENTS.......2
APPENDIX TABLE OF CONTENTS......3
INTRODUCTION.........4
THEORETICAL BASIS & BEST PRACTICES..........6
DESCRIPTION & SEQUENCE OF THE INTERVENTION..........9
SESSION GOALS & OBJECTIVES...........12
EVALUATION PLAN.................14
APPENDIX...16-22
REFERENCES......23-24

APPENDIX TABLE OF CONTENTS

Page
PART A: Budget Necessities Evaluation .........16-19
PART B: Student Syllabus........19-21

PART C: Sequence of Intervention.......22

THEORY AND METHODS

Criteria for Evaluating on-Campus University

Students Health Interventions
B Ake, S Anderson, G Garcia, P Tonra, and DM Woods

Department of Health Studies at the University of Rhode Island 2015

Introduction:
Obesity is becoming a widespread epidemic in the United States. Although obesity is a
global problem, the United States is about 10 years ahead in terms of obesity compared to Europe
(Haslam, 2006). This disease is a preventable condition, which kills millions of people and costs
billions of dollars in healthcare dollars. Obesity is one of the leading causes of death and
disability in the United States and one of the major causes for serious chronic diseases such as,
diabetes and strokes (Chronic, 2015).
Evidence suggests that obesity amongst college students is becoming a prevalent issue.
The factors that contribute to a person becoming obese range from genetics to environment.
Through our primary data deducted from our needs assessment we have concluded that the most
tangible research statement is, Students that live on campus are more likely to be overweight. So
as a result, living on-campus was positively correlated with students weight status, X2 (2, N=
976) = 7.48, P= .028, because obesity became more of a significant risk, with 32% of on campus
URI students classifying themselves as overweight than off-campus students. Figure 1.1
showcases our SPSS Data Table for this specific intervention.

Figure 1.1: Illustrates the collapsed data

information our group has obtained through
a chi-square distribution to test our re-coded
data. This data was taken from URI Health
Behavior Survey and re-coded in IBM SPSS
Software

The purpose of the needs assessment was to examine and to better understand the health
behaviors and lifestyles of University of Rhode Island students and identify risk behaviors to help
guide future research and interventions. Subsequently,the purpose of our intervention is to
implement a cost efficient and effective intervention that will better students lifestyle habits. In
addition, the intervention will implement measurable goals and objectives to continue support,
implement satisfactory evaluation design, and contribute to our scientific community for the
University of Rhode Island and Universities alike.
For this specific intervention our target audience will be the incoming freshmen class for
the fall 2016 semester. We will strive to address specific individual, interpersonal, organizational,
community, and policy factors. Individual needs that we will address include individuals personal
beliefs, attitudes, expectancies, benefits, self-efficiency degree, ethical obligations, moral
obligations, barriers, self-identity, ethnicities, knowledge and skills. Interpersonal aspects we will
address include social norms and cultural norms. Organizational factors that we will specifically
represent will include all first year students at the university that are active participants in this
required healthy lifestyle behavior on-campus course. The community that we will represent is
the University of Rhode Island and Universities alike with statistically significant data that
demonstrate this prevalent issue of obesity on campus. Factors that need to be considered are
social and cultural norms on campus, social relationships, cultural practices, campus
informational environment (media, education, advertising), resources, cost, technology, and food
availability (Promoting, 2010). On-campus we must also consider that there is a lot of access to
unhealthy foods, unlimited dining hall food that leads to overconsumption, meal plans with fast
food benefits, and the lack of transportation to grocery stores.

Predisposing factors that we have included to test throughout our intervention include
motivational level, physical activity self-efficiency, attraction to physical activity, and attraction to
healthy food choices, eating patterns, and other psychological factors. Some enabling factors that
may be statistically significant are healthy food availability, resources, and cost. Some reinforcing
factors may include classroom communities, peers, recognition, and ability to complete the
required course. To conclude, our policy factor would be completing/passing this three credit
healthy lifestyle behavior course in order to graduate (Promoting, 2010).

Theoretical Basis & Best Practices:

The choices that people make regarding their health are a complex topic. The emergence
of chronic illnesses in the developed world, mainly obesity, is linked to certain types of poor
health choices. Obesity is not a behavior but a range of different behaviors that includes patterns
of eating and physical activity (Booth, 2012). Modifying behavior is very challenging. One
approach is to focus on modifying behaviors as a form of intervention. This approach is based on
the assumption that changing our daily choices will have an impact on our health. There have
been several theoretical models developed to help us better understand how to influence change in
an individuals behavior. Health psychology can help us to understand what is involved in
behavior and behavior change and therefore to design appropriate interventions in order to enable
people to take control on their health with a view to maximizing health gain (Booth, 2012).
The Health Belief Model is a theoretical framework which believes the key to influencing
behavior is to alter beliefs about susceptibility to illness and severity of illness (perceived threat),
alter beliefs about the benefits and barriers of carrying out a specific behavior, and alter beliefs
about the ability to be able to do something (self efficacy), (Booth, 2012). The HBM operates
under the assumption that people are logical and make thoughtful decisions based on a cost
benefit analysis where the positives must outweigh the negatives. What impacts that calculation
6

may be very different between individuals. The mandatory three credit course offered at the
University of Rhode Island will outline the real risks of not maintaining a healthy lifestyle and
attempt to alter the balance toward taking action and making more health conscious choices. For
example, week #10 and 11 regarding obesity and diabetes will discuss the long-term increased
healthcare cost, loss in productivity, and increased risks of complications related to medical
procedures. Obesity is a risk factor for developing diabetes, high blood pressure, and certain
cancers.
Figure 2.1: Health Belief Model

The transtheoretical model also known as the Stages of Change is a model that provides us
the specific process of behavior change. It suggests that people move through five stages. This
model can be used as a mechanism to determine someones "readiness to change" and measure
where a person is at with regards to changing behavior. (Booth, 2012) Based on the readiness
level each student would have a personalized set of goals depending on their readiness. The
mandatory three-credit course and MyPlate plates in the dining hall will be the support that
students need to motivate themselves to move from pre-contemplation into action. Since the
course is 12-weeks long they will have the necessary time to move through the stages. The
7

MyPlate plates in the dining hall will play an important role in the maintenance phase in the
students eating habits. Making this course mandatory every year would likely be the most
effective intervention since progression through these stages takes time. Twelve weeks will still
be enough time to help students progress from one stage to the next; however, changing their
behavior to have an effect on weight would likely require a longer intervention period.

Figure 2.2: This diagram illustrates the stages of the

transtheoretical model that as interventionalists we will be
utilizing during this obesity intervention.

A study designed by Rachel Gow was also targeted for preventing weight gain in the first
year of college. This design was specifically to prevent the, freshman fifteen. The study
randomized 170 students into four groups: 1.) no
treatment 2.) 6-week online intervention 3) 6-week
weight and caloric feedback only (via email), and
4) 6-week combined feedback and online
intervention. The results showed that all the
intervention groups had a statistically significant
difference in the BMIs. Previous studies of first
year college students have reported an average weight gain between 4.2 and 7.8 pounds.
(Hoffman, 2006) In contrast, the average weight gain ranged from -.12 to 1.47 pounds across the
current studys groups. (Gow, 2010) Our intervention is designed similarly, however, the course is
in a classroom and lasts 12 weeks instead of 6 weeks. Therefore, we expect a more significant
weight change and a sustained behavior change.

Description

& Sequence of the Intervention:

Our intervention will consist of a three credit course that freshman are required to take.
This course will have two different components to it; a dialectic portion and an activity portion. A
study was done at Kent State University about the effects of a nutrition class on students eating
habits. The study found that at the end of the class, students consumed 50% more fruit. It also
found that students were more aware of their eating and exercise habits at the conclusion of that
class. (Caine-Bish, 2009) Using this source as an example, we created a healthy lifestyle course.
Internships will be offered through URIs Nutrition, Health Studies and Kinesiology
programs to teach this course. Those students will go through a free, online, basic training
program from the nationally recognized organization MyPlate. The dialectic portion will be held
on Tuesdays and consist of different topics such as nutrition, weight-related diseases and physical
activity. As for the activity portion, class will not be held on Thursdays. Each week the class will
discuss the benefits of different types of workouts cardio, weightlifting, yoga and the students
will be expected to attend the gym on Thursdays. Here is where they will apply their knowledge
of what they learned in class. Students will be required to take a tour of one gym (Mackel Field
House or Fascitelli Fitness & Wellness Center) to familiarize themselves with where they will
spend the second part of the class. We will be able to see if the student actually did attend the gym
because they must swipe their ID before entering the gym. The table below is a snapshot of what
material will be taught each Tuesday for the dialectic aspect of the class.
Week

Topic

Week 1

Introduction to course & Syllabus

Week 2

Dining Hall Dos and Donts

How to Utilize URIs Gyms

Week 3

Fruits & Cardio Discussion

Week 4

Vegetable & Outdoor Exercise Discussion

Week 5

Protein & Weight Lifting Discussion

Week 6

Dairy & Stress Relief Discussion

Week 7

Carbohydrates Discussion

Week 8

Managing Caloric intake & Measuring Biometric Discussion

Week 9

Eating Disorders Discussion

Week 10

Obesity Discussion

Week 11

Diabetes Discussion

Week 12

Cardiovascular Disease Discussion

**See Appendix PART C for full schedule and dates, Fall 2016 Syllabus.
There will be several assignments throughout the semester that include; keeping a food
log, taking surveys and writing a one page reflection each
week about the workout. A survey will be given in the
beginning of the semester which questions the students
health beliefs and their diet. At the end of the semester,
they will take the same survey and we will compare the
results.
In addition, the students will be introduced to the
MyPlate challenge. We will be putting new plates into both Hope and Butterfield Dining Hall that
represent MyPlate portion sizes. These plates will show the correct portion sizes for each type of
food of them. In addition, there will be infographics and healthy eating tips posted throughout the
dining halls. The University of New Hampshire has introduced MyPlate into their dining halls in
2012. They say it is a passive, but effective way to get students to think about their portion sizes.
We will also require students create a video as part of an assignment encouraging the use of

10

MyPlate. Choosemyplate.gov suggests that creating a MyPlate video challenge will increase
awareness of portion control. See Appendix PART D for the sequence of intervention chart.

Session Goals & Objectives:

For this intervention to be effective we have initiated specific targets that we would like to
attain throughout the process. We have aligned specific objectives that we believe will help us
reach the maximum potential of our intervention and create a successful outcome. Our first
intervention consist of a three credit course that will be offered to the freshman class. This class
will educate freshmen on the importance of nutrition, physical activity and the need to apply these
healthy habits to their daily routine. Our first objective will help us determine whether or not the
educational portion will be or has been effective. By providing the resources needed to boost
awareness we have established a goal for 100% of class participants to be aware of the importance
of physical activity and a well-balanced diet. To measure our objective we will provide an
incoming survey during the first day of class to address each individuals attitude towards a
healthy lifestyle and we will also conduct a post survey during the last day of class to see if there
has been a change in an individuals perspective of a healthy lifestyle.
A second objective that we hope to achieve is to the increase a students physical activity.
Physical activity is one of the major causes of obesity. And with students developing a busy
schedule during their college years it is difficult to set aside an allotted time for exercise. Dr.
Kilpatrick an assistant professor at Southeastern Louisiana University indicated that 20% of
college students participated in moderate physical activity. A 6% decrease from High School
students who reported to engage in moderate activity (Kilpatrick, 2005). Through this benchmark
data we have constructed a measurable goal that will reflect Dr. Kilpatricks statistic. For our
intervention to be considered a success we have set a goal for 35% of our freshman class to
participate in moderate physical activity.
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Objective

Goal (Measurable)

Increase awareness of a students

perception of a healthy lifestyle

100% of the freshman class will attend the

class

Improve physical activity

35% of the freshman class will develop a

regular routine for moderate physical activity .

Dining Hall Intervention

Our awareness objective is to reach out 100% of the student body who have access to the
dining halls. To measure whether or not the incorporation of MyPlate plates efficiency, we have
established three specific goals for the program. During our needs assessment we measured
vegetable consumption based on off and on campus living. Only 9% of a sample size of 846
students reported that they consumed more than two servings of vegetable per day. After
introducing the MyPlate plates for a completed school year our goal is to have an increase of 21%
who will consume two or more servings of vegetables per day.
Our last goal for our MyPlate intervention is for 50% of students to utilize the Myplate
plates correctly. Jo Porter, deputy director of the New Hampshire Institute for Health Policy and
Practice, whom have introduced the MyPlate plates to the UNH student body, mentions that not
everyone uses the plates appropriately. That being said our goal is for 50% of students who have
access to the dining hall will utilize the MyPlates as intended.

Objectives

Goal (Measureable)

Encourage students to adapt a well

balanced diet.

Increase the intake of on campus URI students

amount of vegetable consumption from 9% to
30% .

Bring awareness to the whole student body

whom have access to the dining hall about
the recommendations for a healthy diet.

100% whom have access to the Dining Hall

will be introduced with the MyPlate plate.

Encourage students to utilize MyPlate

Through the implementation of the MyPlate

12

plates.

plates 50% of URI students will pick up a

behavioral change.

Evaluation Plan:
Transition to college has often been identified as a potential critical period for increase
weight among young adults. The current study consisted of a 3-credit course in which freshmen
are required to take and the integration of new plates in the dining halls that represent MyPlate
portion size. We hoped to target 100% of class participants to increase nutrition and physical
activity awareness. We also hoped to target 50% of students who used MyPlate plates in the
dining halls; but most importantly, we wanted students to learn a simple and sustainable approach
to fitness and weight loss that leads to a healthy lifestyle.
MyPlate plates had a positive effect on students because dinning halls continued to request
them. MyPlate helps consumers make better food choices. Its designed to remind Americans
before they eat to think about what goes on their plate. They are reminded by visual images
(Choose, 2015).
At the beginning of the semester students took a survey and results were that fruits and
vegetable consumption did not meet the recommended intake. Through our intervention the
recommended vegetable and fruit intake will increase significantly. At the end of the study,
students will be required to take a post survey that is the same survey from the beginning of the
class . We concluded that class-based nutrition/education was effective. By implementing this
policy. we hope to have similar results as the Caine-Bish study where vegetable consumption
increased. We also strive decrease the 32% of students who are perceived overweight to 25% of
the population. As mentioned before, there was a study at Kent State University that used a class-

13

based nutrition education and they concluded that these classes increase awareness and changes
eating behaviors in college settings. (Caine-Bish, 2009)
Over all, class-based nutrition education and MyPlate plates will have a positive effect by
increasing awareness to the college students. Long-term effect of the study was not included.
Future research should examine long-term effect of class-based nutrition education on changes in
dietary behavior.

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-AppendixAppendix- PART A

Budget Necessities Evaluation

When creating your intervention budget, as a group we took into account budget considerations
that reflect your budget and allocation of funds that may differ annually. For example, in Year 1,
many of your funds may go into buying supplies or investing money in materials for start-up.
During this intervention it is vital that included in this report is your annual budget to reflect the
costs/expenses for Year 1 of this intervention.

Personnel
Position

Base
Salary

Principal
Investigators (5
people)

Project Staff
(Undergraduat

Total

% of
Effort

Project
Salary

Fringe
%

Fringe
Amount

(Project Salary + Fringe

Amount)

35,360x
5
people
176,800

25%

44,200

30%

13,260

57,560

15

e Interns)
Administrative
Staff

35,000

25%

8,750

30%

2,625

11,375

Total
I.

$68,935
Other Direct Costs: These are direct non-personnel cost of any materials and
resources that are necessary for completing the research or intervention.
General Office Supplies and Materials

Total

Statistical Software

200

Laser Printer

589.99

Office Furniture

1,500

Office Telephones

200

Office Computers ( 5 @$700)

35,000

Total office equipment:

37,289.99

Intervention Materials

Total

Pre Online Surveys (Survey Monkey)

Post Online Survey (Survey Monkey)

1 page flyer X 40 copies= 40 pages

40 pages @ $.05 per page

20

21 MyPlate Tool Kit X 3,300 incoming freshmen= 69,300 pages

69,300 pages @ $.05 per page

3,315

Total intervention survey cost:

$3,335

Price of Course**
Course Price (225x 3 credits=675)

Total
2,227,500

16

675x 3,300= 2, 227, 500

AV Equipment Rental (6x3,300)

19,800

Total course cost:

$2,247,300

**Total course cost incoming freshmen will pay for this required course

Other Direct Costs

Total

MyPlate Plates (9.95 x 15,000)

149,250

Total other cost:

$149,250

II.
Purchased Services: This refers to fees paid to individuals or companies for a specific
service, usually occurring temporarily during the intervention that is not completed by the
regular project staff. Purchased services may vary from project year to project year.
Contracts

Total

Contract with MyPlate Campus to Design On-Campus Plates

700

Total contract cost:

$700
Technical Assistance

Total

Computer technical support for 12 hours @ $40/hour

480

Total technical assistance cost:

$480

III. Indirect Costs: This is a percentage that includes costs incurred by the organization as a
result of the intervention, but that is not easily identifiable with any specific component of the
intervention.
Indirect Costs(F&A)

Total

Total Direct Costs (Personnel + Other Direct Costs)

106,224.99

Indirect Cost %

35%

Total indirect cost (30% x $106,224.99 ):

$37,178.75

17

IV.

Grand Total: Project budget total (Personnel Total + Other Direct Cost Total + Indirect
Cost Total) for Year 1.
Grand Total Cost

Total

Total Direct Costs (Personnel + Other Direct Costs)

106,224.99

Total Indirect Costs:

37,178.75

Grand Total Year 1:

$143,403.74

Appendix- PART B
Student Syllabus

Fall 2016 Healthy Lifestyle Syllabus

Class Times: Tuesday & Thursday 11-12:15

Description: This course is a designed to inform students about healthy living. We will cover
topics such as nutrition, food and exercise related diseases and physical activity. The class will
have two parts to it: lecture and a physical activity portion.
Schedule:
Fall 2016 Course

Tuesday

Thursday

Week of September
12

No Class

Introduction to the Course, syllabus and course

expectations, measure body weight
Assignment: Pre-Healthy Lifestyle Behavior
Survey - perceptions of healthy eating

Week of September
19

Dining Halls Dos

and Donts

How to Utilize URI Gym

Week of September
26

Fruits Discussion &

Cardio

Perform Cardio workout

Assignment: One page reflection

18

Week of October 3

Week of October 10

Week of October 17

Week of October 24

Week of October 31

Vegetable Discussion
& Outdoor exercise

Exercise Outdoors

Protein Discussion &

weight lifting

Weight Lifting

Dairy Discussion &

Stress relief

Stress Relief Activity

Carbohydrates
discussion & cardio

Perform Cardio workout

Managing Caloric
Intake

How to measure biometrics

Assignment: One page reflection

Assignment: One page reflection

Assignment: One page reflection

Assignment: One page reflection

Assignment: Week
long food log
Week of November 7

Eating Disorders

Weight Lifting
Assignment: One page reflection

Week of November
21

Obesity

Week of November
28

Diabetes

Week of December 5

Cardiovascular
disease

Cardio work out

Assignment: One page reflection

Weight Lifting
Assignment: One page reflection
Measure body metrics

Assignment: 1 page
reflection of what

19

student learned &

their future plans for
healthy eating
Week of December
12

Evaluate, measure
body weight &
compare differences
from beginning of
course
Final Assignment:
MyPlate video
challenge
Post- Survey Due

Appendix PART C
Sequence of Intervention

20

References
Booth-Warwick, L., Cross, R., Lowcock, D. (2012). Contemporary Health Studies. Cambridge:
Polity Press.
Choose MyPlate. (2015, February 3). Retrieved December 7, 2015, from
http://www.choosemyplate.gov/MyPlate
Chronic Disease Overview. (2015, August 26). Retrieved December 3, 2015, from
http://www.cdc.gov/chronicdisease/overview/
Gow, R., Mazzeo, S., Trace, S.(2010). Preventing Weight Gain in First Year of College Students:
An Online Intervention to Prevent the Freshman Fifteen. Eating Behaviors, Vol 11:1,
33-39. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790428/#R31
Ha, E., Caine-Bish, N. (2009). Effect of Nutrition Intervention Using a General Nutrition Course
for Promoting Fruits and Vegetable Consumption Among College Students. Journal of
Nutrition Education and Behavior, Vol 41:4, 103-109.
http://www.sciencedirect.com/science/article/pii/S1499404608007550
Ha, E., Caine-Bish, N. (2011). Interactive Introductory Nutrition Course Focusing on Disease
Prevention Increased Whole-Grain Consumption by College Students. Journal of

21

Nutrition and Education Behavior, Vol 43:4, 263-267.

http://www.sciencedirect.com.uri.idm.oclc.org/science/article/pii/S149940461000059X
Harvey- Berino, J., Pope, L., Gold, B., Leonard, H., Belliveau, C. (2012). Undergrad and
Overweight: An Online Behavioral Weight Management Program for College Students.
Journal of Nutrition Education and Behavior, Vol 44:6, 604-608.
http://www.sciencedirect.com.uri.idm.oclc.org/science/article/pii/S1499404612004022
Haslam,
D., Sattar,
N., Lean,
M. (2006)
ABC of
obesity.from
Obesity--time to wake up. BMJ:
British Medical
Journal.
Retrieved
December
3, 2014,
http://www-ncbi-nlm-nih-gov.uri.idm.oclc.org/pmc/articles/PMC1570821/
Hoffman, DJ., Policastro, P., Quick, V., Lee, SK. (2006). Changes in body weight and fat mass
of men and women in the first year of college: A study of the freshman 15. Journal of
American College Health. 55(1):4145.
Kilpatrick, M., Hebert, E., & Bartholomew, J. (2005). College Students' Motivation For
Physical Activity: Differentiating Men's And Women's Motives For Sport Participation
And Exercise. Journal of American College Health, 54, 87-94.
Kingkade, T. (2013, September 18). UNH's Wildcat Plates Aim To Promote Healthy Eating.
Retrieved December 1, 2015, from http://www.huffingtonpost.com/2013/09/18/unhwildcat-plates_n_3947611.html
Promoting Healthy Behaviors for Obesity Prevention. (2010, August 25). Retrieved December 3,
2015, from http://ucanr.edu/sites/PSU/files/173282.pdf Ramsey, L. (2012). Portion Plate
Offers Educational Surprise. FoodService Director.
http://www.foodservicedirector.com/ideas-innovation/health-wellness/articles/portionedplate-offers-educational-surprise.
Sabharwal, A., Sabharwal, M. (2015). Effectiveness of Lifestyle Interventions Among College
Students: An Overview. Nutrition and Food Sciences. Vol. 5.
http://www.omicsonline.org/open-access/effectiveness-of-lifestyle-interventions-amongcollege-students-an-overview-2155-9600-1000363.pdf

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