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Final Project
Shauna Cheney
Kaplan University
HW425
Dr. Aguilar
March 8, 2017
FINAL PROJECT 2
Final Project
Part 1
Community health promotion programs are developed and implemented to meet the
needs of the community residents. Furthermore, health promotion programs are an effective way
to address specific health needs for a targeted group of people and focus on areas for
adequately. The steps of health promotion programming can include assessing needs,
identifying goals and objectives, choosing a theory, establishing a timeline, outlining activities,
organizing evaluations, and implementing the program (Hodges & Videto, 2011). Following a
program-planning outline and making sure each step is accomplished leads to successful
Health promotion program planning begins with a needs assessment to determine what
the communitys needs are and decide what needs are a priority for preventative public health
programs. Sometimes a target population is already identified and available and target group
members are part of implementing the needs assessment. However, other times the needs
assessment leads to narrowing a community to a target group that is most affected by a certain
health condition or most lacking in a specific factor determining health. Identifying what the
program should address, as well as the target population that it should be geared to, provides the
groundwork for a successful program. Determining the target population is achieved with
various data collection methods, the needs assessment, and the U.S. Census. Learning more
about a target population and creating sub-groups is achieved with demographic and
Community or County
The U.S. Census Bureau gathers data that helps to determine the demographic and
socioeconomic profiles of communities and counties. According to the data gathered for Placer
County, U.S. Census Bureau (2015b) shows that the total population is 375,391 and is growing
(para. 1). The Census further reveals that the population is made up of almost equal parts male
and female with the highest proportion of individuals below 18 years of age, followed by those
who are 65 and older. In addition, the data reveals that the community is made up of a single
race of mostly white individuals with 85.5% as of 2015 (U.S. Census Bureau, 2015b). Most of
the population is younger than 18 or older than 65, white, and educated. The five-year census
data from 2011-2015 reveal that 94.1 of the population has graduated high school and that
36.4% have obtained four years or more of college education (para. 7). Due to an educated
population, the socioeconomic profile of Placer County is favorable to being employed, owning
a home, and having a substantial income. The U.S. Census Bureau (2015b) data show that the
average household income is $73,948 and the average home cost as $358,500 (para. 11 &
para. 5). Further, the job force is mostly comprised of sales, followed by healthcare. The Census
Bureau provides clear indicators and data for assessing the demographic and socioeconomic
profile of Placer County to determine factors that affect the target population.
Dividing Placer County into sub-groups can help to narrow the population that will be the
focus of a health promotion program. In Placer County, the sub-group of individuals who will be
assessed are those that are 65 years or older. According to the U.S. Census Bureau (2015a),
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community facts there are 63,004 individuals 65 years or older (para. 1). The sub-group of
Placer County will be those that are white, 65 years or older, half-male and half-female,
educated, and receiving an average income. Assessing epidemiological data for the sub-group
population of Placer County can determine the health priority and need for a public health
promotion program.
Health needs assessments for Placer County show health needs compared with
surrounding counties and the United States as a whole. The Placer County Health and Human
Services department recommends epidemiological health data retrieval from the Be Well Placer
2017). Data is displayed from current needs assessments and statistical analysis. The needs are
displayed with a thermometer ranging from green to red and trends that that are going up are
displayed as red. According to the Be Well Placer (2017) website and a customized report,
needs in Placer County show cancer for the Medicare population in the red. Further, the report
shows the Medicare population, consisting of those 65 years and older, in Placer County are
developing more cancer than the California average and have higher cancer rates compared to
the U.S. total as a whole. The trend increasing with further cancer increases expected. The Be
Well Placer Community Dashboard (2017) report shows 8.5% of the Medicare population with
cancer (para. 1). By calculating the data from the U.S. Census Bureau (2015a) community facts,
there are 63,004 individuals 65 years or older, so dividing the percentage of those with cancer
equals 5,355 individuals. Comparisons show that the cancer rates are higher than the normal
average. California on average has 243,195 deaths from cancer a year and Placer Countys
mortality rate shows 2,833 (California Department of Public Health, 2015, p. 4). Comparing
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mortality rates with the state as well as with surrounding counties can be helpful.
Epidemiological data from the CDC (2016) shows Placer County cancer death rates moderately
worse than its surrounding county comparisons. Placer County indicates that there is a health
The quality of life for Placer County residents who are 65 years or older can be
researched to further determine the needs of the residents and investigate what methods and
approaches may be needed as part of a health promotion program for cancer. According to the
Centers for Disease Control and Prevention [CDC] (2016b), only assessing morbidity and
mortality or epidemiological data can create a narrow viewpoint with what creates health. In
addition, the CDC further elaborates that quality of life assesses health with a broad focus, which
includes emotional, physical, mental, social, and spiritual components. Quality of life can be
affected by many factors other than just physical health determinants. It assesses more than just
the absence of disease and existence of life but indicates whether life is fully enjoyed. The
quality of life for those within Placer County who are 65 or older is diminished when people are
suffering from cancer and have decreased social interaction, comfort levels, enjoyable free time,
emotional stamina, and mental energy. Quality of life can be illustrated based upon principles
such as being, belonging, and becoming. According to Kaplan University (2009), being
includes all that someone is as a person incorporating physical, psychological, and spiritual
aspects; belonging illustrates the belonging in a community, belonging socially with others, and
belonging physically; becoming defines achievements and growth opportunities that are practical
and relaxing.
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People generally feel that their quality of life is better when they know who they are and
are able to identify with key characteristics they value. A community can contribute to the
publics self-esteem and purpose by what it provides physically, mentally, and spiritually. The
residents of Placer County can have a clear feeling of being and increase their self-esteem as they
seek out available resources such as beauty salons, fashion centers, gyms, meditation facilities,
and religious groups. Gaining values and having a sense of being and connecting spiritually are
part of the quality of life in Placer County as outlined from a 2010 Religion Census. The census
results are reported in the Placer County, California Religion Statistics Profile and indicate that
there are numerous religious affiliations available in Placer County, that there are numerous
congregations, that many residents attend, and that a high percentage of adherents are Catholic,
psychological, and physical opportunities, residents of Placer County can identify with who they
Further data suggests that the quality of life for Placer County is fairly good. Quality of
life is assessed by the County Health Rankings and Roadmaps (2016) for California by
comparing 57 counties and their length of life, quality of life, health behaviors, physical
environment, social and economic factors, and clinical care. According to the rankings, Placer
County ranks fifth out of 57 counties, indicating the quality of life is higher in Placer County
than most surrounding neighborhoods. The rankings show lower than the California average for
physical or mental sick days, smoking, teen births, uninsured, housing problems, violent crimes,
income inequality, unemployment, and long commutes; however, the rankings show higher than
average obesity, social relationships, education, diabetic monitoring, excessive drinking, and
food environment indicators (County Health Rankings and Roadmaps, 2016). These rankings
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indicate that Placer County residents show belonging by having social relationships,
employment, income, and education. In addition, county residents have belonging and increased
quality of life because of the community social events that occur. Each month there are at least
five to fifteen community events that provide social interaction and community connection
(Center for Strategic Economic Research, 2014). Community connection and social interaction
Another data source that illustrates Placer Countys quality of life is a report done for the
County of Placer Office of Economic Development. The Center for Strategic Economic
Research (2014) compiled data about the quality of life in Placer County and stated, Todays
healthy and mature economy, attractive business environment, and residents who benefit from a
opportunities (p. 3). The quality of life for Placer residents is positively affected by all of the
factors that promote overall well-being. Residents who have all of the basic needs met and who
are able to have work, school, and enjoyable activities fulfill the requirement for becoming
(Kaplan University, 2009). Placer County residents are able to achieve goals and be successful
educationally, professionally, and personally with the resources Placer County provides.
Community Capacity
requires collective resources to address a health need and accomplish the desired outcomes.
Based on the needs assessment, Placer County needs sufficient community capacity to deliver a
public health program that can reach the senior population and address cancer prevention.
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Evaluation of the communitys capacity is best achieved with interviews, Web searches,
newspaper reading, and community drives. According to Hodges & Videto (2011), community
capacity encompasses the competence, means, and capability that a community has to address a
need and is portrayed in local listings, written media, interviews, and online. Placer County has
many resources currently that target those 65 and older and/or address cancer. A few community
resources that the local American cancer Society provides include wig and makeup help for
women with cancer, volunteers for transportation to cancer care, cancer prevention events,
professional education about risks and behaviors, and community outreach programs (Janet,
Personal Communication February 10, 2017). Community programs that are already addressing
cancer can prove helpful to an additional cancer prevention program targeted at those 65 years
and older.
Another community capacity strength that Placer County has is access to doctors, cancer
screenings, and medical facilities. Healthcare infrastructures and organizations are plentiful in
Placer County and are available throughout the community (Center for Strategic Economic
Research, 2014). Other health related resources that are beneficial for cancer prevention,
support, and education are organizations such as the local American cancer Society, Camellias
Womens Health, Placer County Community Clinics, Pink Pearls of Hope Breast Cancer
Program, California Department of Healthcare Services and Sutter Roseville Medical Center
cancer support groups. Resources that address health and cancer currently will strengthen new
and additional programs and increase the capacity to meet the program objectives.
In addition to healthcare and cancer resources, there are many senior organizations that
provide healthy resources, education, nutrition counseling, social support, activities, recreation,
FINAL PROJECT 9
and physical activity. A few examples of senior organizations in Placer County include Seniors
First, Auburn Senior Center, Loomis Senior L.I.F.E center, Maidu Community Senior Center,
and Rocklin Parks and Recreation Adult Program. In addition to sufficient healthcare providers
and senior support centers, Placer County has a Health and Human Services Department and a
Placer County Community Health Department. Professionals and leadership are vital to the
communitys capacity but also valuable are the skills and talents of the collective senior
population. Various individuals with experience in different professions may prove helpful in
the process of the health program. Certain local listings asking for volunteers can gather the
resources from individuals within the community. There are many retired people in the local
area that are part of the Del Web Sun City communities within Placer County that substantially
increase the target groups capacity for support. There are 6,703 homes and 80
condominiums in Sun City Lincoln Hills (Sun City Lincoln Hills, 2016). Furthermore, the Sun
City Lincoln Hills offers a long list of activities, events, and clubs, which promote lifestyle
behaviors that could help to prevent cancer. Connected communities of people who fall into the
category of the target group will provide resources for health solutions.
Resources for healthy solutions, community support, and senior programs all increase the
communitys capacity and quality of life. The assessment of Placer Countys community
solid framework for program development and implementation. The narrowed sub-group that is
the target of a health promotion program in Placer County can be defined as those that are 65
years or older with cancer. The current strengths in Placer Countys quality of life status and
community capacity will enrich the new cancer prevention strategies for the program to decrease
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the cancer burden in Placer County. Decreasing the cancer burden, saving lives, and reducing
human suffering is the mission and result of the research on Placer County.
Mission Statement
A mission statement, goals, and objectives will provide a framework for the Placer
County health promotion program. If purpose and intent are clearly articulated, programming
leaders can better formulate strategies to best achieve the desired outcomes. Having a mission
statement, goals, and objectives will allow the health promotion team to maintain a clear focus
and direction, allow the funding sources to know the philosophy of the program, and allow the
The Placer County Cancer Awareness and Prevention Programs mission is to reduce the
cancer rates of Placer County residents 65 years and older by increasing awareness, expanding
resources, providing support, educating the public, and promoting prevention with diet, physical
activity, and regular screenings. The purpose of the program is to save lives and increase the
quality of life for the residents. Placer Countys philosophy is that some cancer is preventable
and the community will see less suffering and more people who are living a fulfilling and
enjoyable life with a cancer prevention program. Placer County will strive to create a unified
community that is supportive of improving Placer County residents health, happiness, and well-
being.
Cancer can lead to human suffering, loss of loved ones, and a poor quality of life.
According to a needs assessment, Placer County data shows senior residents of the community
have higher rates of cancer compared to other counties in California and the United States as a
whole (Be Well Placer, 2016). Something must be done to intervene, reduce the cancer burden,
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and decrease the incidence of the disease. According the American Cancer Society (2017),
cancer is the second leading cause of death worldwide and over 1500 people per day are
expected to die from cancer this year. Many cancers are preventable with diet and physical
activity. Diet and physical activity are two of the most effective ways to reduce cancer and
maintain a healthy weight (American Cancer Society, 2017). Due to the high rates of worldwide
cancer and higher than average rates of cancer in Placer County, an awareness and prevention
program is crucial to protecting the residents lives. Focusing the awareness and prevention
program on diet and physical activity amongst seniors in Placer County will prevent disease and
increase overall quality of life. The rationale for the mission statement clearly reflects the
Program Goals
To decrease the rates of cancer among the 65-year-old population in Placer County.
To create a supportive environment for those who struggle with cancer and make it easier
To become an educated community that is aware of the risks associated with cancer and
To increase healthy eating, physical activity, and the quality of life of senior residents
Goals Discussion
The goals for the Placer County Cancer Awareness and Prevention Program reflect the
goals identified in the needs assessment because they are focused on reducing cancer among the
senior residents of the community. According to Hodges and Videto (2011), goals are designed
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to present an overall purpose of a program with results that are intended to be achieved over an
extended period of time. The goals outlined are in alignment with the mission statements
purpose to reduce cancer incidence and improve the quality of life for senior citizens. The goals
address the scope of the mission statement by concentrating on education, support, and
prevention. The goals also reflect the goals of the Healthy People 2020 from the Office of
Disease Prevention and Health Promotion (2017a) directed at decreasing the incidence of cancer
cases. The goals for the Placer County Cancer Awareness and Prevention Program are clearly
stated to support the needs in Placer County, the mission of the program, and the national
Program Objectives
The program objective levels are outlined by Keyser, Morrow, Doyle, Ogletree and
reduction objective, and Health status objective (as cited in Hodges & Videto, pp. 168-169).
The objective levels support the mission and goals of the Placer County Cancer Awareness and
Prevention Program. The objectives are measurable and will be compared to baseline data
retrieved from surveys, interviews, and questionnaires. The target population will provide
baseline data to be able to indicate where they are currently in regards to cancer awareness,
cancer knowledge, attitudes towards healthy lifestyle changes, and exercise routines. In addition,
the baseline data obtained before the start of the program will also gather information about
Placer County seniors current access to cancer resources, the current number of daily fruits and
vegetables consumed, the current number of nights they cook at home, current cancer screenings
obtained, and current BMI. The baseline data before the start of the program will be compared at
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certain time intervals to determine if the objectives have been met and what percentage of
change occurred.
1. Awareness objective: In six months 70% of Placer County residents over 65 will have
read information and attended a cancer prevention event becoming aware that cancer is
the second leading cause of death, that incidence rates are expected to increase
worldwide, that Placer County seniors have more cancer than the California and United
States average, and that many cancers can be prevented with risk reduction measures.
2. Knowledge objective: After the first large community event in six months, 70% of senior
residents in Placer County will be able to fill out an event evaluation form showing that
they have a knowledge of what cancer is, what the risk factors are, and what preventive
3. Attitude objective: In six months, 60% of Placer Countys senior population will respond
4. Skill development objective: In eight months, 60% of the Placer County senior citizens
will have attended local workshops and senior fitness programs and be able to effectively
5. Access objective: In six months after a large cancer prevention program kick off
campaign and event, 39,589 senior citizens will be signed up on the Placer County
Cancer Prevention and Awareness resource website receiving access to resources for
local cancer organizations, cancer support groups, cancer screening information, senior
fitness facilities, farmers markets, cancer prevention events, educational workshops, and
healthy eating tutorials. Data retrieved from the County of Placer Office of Economic
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showing how many seniors there are in 50% of the Placer County senior population.
6. Behavior objective: In eight months, 50% of Placer Countys senior residents will have
attendance will cook at home 80% of the time and eat an unprocessed plant-based food
7. Risk reduction objective: By the end of February 2018, Placer County seniors will show a
20% increase in cancer screenings and a 20% reduction in obesity rates. In addition, end-
of-year surveys will show that 40% of senior citizens are eating 5-9 servings of fruit and
vegetables, and that 50% participate in moderate exercise for 30 minutes 5 days a week.
8. Health status objective: By the end of 2019 the statistical data for Placer County senior
residents will show a reverse in cancer incidence trends from 8.5% to 7.0% and a lower
than average incidence rate compared to the California and United States average (Be
The mission statement, goals, and objectives were created to achieve the outcome of
reducing cancer amongst the seniors of Placer County. A mission statement that clarifies the
philosophy, purpose, and scope of the program gives the reader a broad-based view of why the
program exists. Long-term goals for the program help to achieve the purpose of the mission
statement by outlining the direction that the activities and interventions will need to take.
Specific and measurable objectives to reach each goal have been provided to address each
component that will be addressed and what measurable outcome is intended. The Placer County
Cancer Awareness and Prevention program will be organized based upon its mission statement,
To implement the mission statement, goals, and objectives, financial resources will be
needed. A funding source will be identified according to the program mission and an
organization will be sought after that is aligned with the main program intention. Funding will
be used to carry out the program and financial resources will be allocated based upon a budget.
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Figure 1
Long-Term
Outcomes
Short-
Decreased
term incedence of
outcomes cancer
Activities Improved
Increased quality of life
Pre-program cancer Reduced
Input evaluation awareness cancer risk
Kick-off event Improved People live
Community attitudes to longer
health Quarterly
make lifestyle healthier
promotion cancer
changes lives
leaders prevention
events Seniors Lowered BMI
Health signed up on and
educators Regular
resource maintanace
workshops
Local website of a healthy
and
physicians Increase in weight
informational
Target seminars seniors Educated
population visitng fitness community
8 week
volunteers centers about cancer
healthy
Nutritionists eating course High A supportive
Fitness attendance of community
Community
instructors events and with helpful
garden
Cancer workshops resources
started
organization Completion Increased
Development
representativ of an eight- physical
of resource
es week healthy acitivty
website
Senior care eating course Increased
Senior
facility Increase in fruit and
fitness
presidents regular vegetable
tutorials
Health cancer consumption
Doctors to screenings
deparment Increased
integrate
Data Less eating gardening
screening
consultants out and more
notification at
home
Prevent primary care
cooking
Cancer visits.
Foundation Cancer
Grant detected in
early stages
Data from
needs
assessment
Pre-
evaluation for
baseline data
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The logic model for The Placer County Cancer Awareness and Prevention Program as
shown in figure 1 was created to provide a visual description of the program and provide a map
of how it will operate. It clearly depicts how the strategies chosen will accomplish the desired
goals and objectives. In addition, it is aligned with the philosophy, purpose, and scope of the
mission statement. Furthermore, the logic model expands upon the mission statement and is
beneficial in implementing the necessary steps to achieve the outcomes. Additional benefits of a
logic model include identification of the initial involvement needed, methods for
implementation, and expected end results upon evaluation (Hodges and Videto, 2011).
Following the logic model for the Placer County program will be beneficial in promoting cancer
awareness, motivating risk reduction behaviors, decreasing incidences of cancer, and improving
residents quality of life. The logic model shows that the program will bring about the desired
outcome, which is to reduce the cancer burden in the seniors of Placer County and save lives.
The logic model, funds, and budget for The Placer County Cancer Awareness and
Prevention Program all help lay a foundation for program planning, implementation, and
evaluation. The funding source provides the necessary income to carry out the program, and a
budget specifies where the funds will go. Furthermore, a clear funding source and budget
provide the resources needed to begin work on the program. The workings of the program and
the direction it will go can be followed based on the logic model. As the health promotion team
implements the funds, outlined budget, and logic model, they can stay on course and be
organized in advancing the developing of The Placer County Cancer Awareness and Prevention
Program.
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The Placer County Cancer Awareness and Prevention Program will require adequate
funding and financial resources to meet the goals and objectives of the program and effectively
target seniors in Placer County at risk for cancer. To target seniors and fund the needed
resources and supplies, a potential grant-funding source was identified and confirmed to be a
viable means of financial assistance. Grant funding and financial assistance will be sought after
from The Prevent Cancer Foundation. The Prevent Cancer Foundation is a nonprofit
organization that focuses its efforts on cancer prevention for the public by doing research,
providing education, supporting communities, and campaigning for improved policies (Prevent
Cancer Foundation, n.d.-a). The Foundation contributes funding and grants that help
organizations and communities in their cancer prevention efforts. E. C. Warner, the Senior
Director at Prevent Cancer Foundation, confirmed that The Placer County Cancer Awareness
and Prevention Program would qualify for funding since it is focused on prevention, and is
eligible for an award grant of $25,000 (personal communication February 15, 2017). Each year
multiple recipients are awarded grants of $25,000, and there is a long-standing history of
Financial support for The Placer County Cancer Awareness and Prevention Program will
be obtained before the start of the program by applying for the 2017 grant cycle. An application
can be obtained on the community grant section of the Prevent Cancer Website and E. C.
Warner, the Senior Director of the foundation will send out the required information (Prevent
Cancer Foundation, n.d.-b). The Foundation further explains on the website that eligibility for
the funding requires a program to be focused on the community and cancer prevention rather
than treatment. The purpose of the funding will be to support the prevention efforts in Placer
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County and provide the financial resources needed to implement an effective cancer prevention
program. Program funding will be used for written material, office supplies, promotional
material, seminars, workshops, campaigns, events, health assessment and evaluation consultants,
postage, and community garden supplies. The funding from the community grant provided by
the Prevent Cancer Foundation will be allocated to individual needs based upon a budget shown
in Table 1.
Program Budget
Table 1
Budget $25,000
printer,
telephones, etc.
Planning & Development
Program Implementation
Program Evaluation
The administrative tasks will involve multiple people who are involved in making the
program a success. According to Hodges and Videto (2011), creating administrative tasks and
objectives will help to make sure duties occur as they are planned. Making sure that
administrative tasks are clearly defined will ensure that they get accomplished and that the
administrative objective for the Placer County Cancer Awareness and Prevention program is that
within one month of the program adoption, the health promotion program leader will assign five
volunteers to gather data from at least 100 Placer County seniors to establish preliminary
baseline information about the current lifestyle choices amongst Placer County seniors. Besides
assigning volunteers to do data collection, the community health promotion program leaders will
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oversee the administrative tasks for each professional participating in the program and designate
who is in charge of what. For example, the health educators will be providing the education at
the events, while the local physicians deliver relevant health information. In addition,
presidents, and the data consultant will all participate in their assigned duties and tasks.
A clear description of the program activities, timeline, and budget all help participants to
know the assigned duties. Further, meetings will be held at the community center once per
month for those who will be involved with the next months events. The many volunteers who
are donating their time will also have assigned duties that are specified at the regular meetings.
For example, volunteers will be involved with pre-program data collection and post-program
evaluations. The volunteers will also distribute marketing material. Besides distributing
material, the volunteers will be assigned the task website creation. The lead website developer is
a volunteer from the target population and will involve other seniors in gathering and compiling
local resources to include on the website. Local volunteers and various health professionals are
all needed to make the program a success. A successful program will require that each
implementation can proceed uninhibited. As participations follow through with the planned
interventions and administrative tasks, activities can occur to meet the goals and objectives of the
program.
The Placer County Cancer Awareness and Prevention Programs mission is to reduce the
cancer rates of Placer County residents 65 years and older by increasing awareness, expanding
resources, providing support, educating the public, and promoting prevention with diet, physical
FINAL PROJECT 23
activity, and regular screenings. The purpose of the program is to save lives by reducing cancer
risk factors and increasing the quality of life for the residents. The goals and objectives to reach
the intended outcomes include increasing awareness, fruit and vegetable consumption, physical
activity, access to resources, community support, motivation to change, and regular cancer
that support the Social Cognitive Theorys (SCT) philosophy and concepts.
Developing activities that are aligned with the SCTs concepts will ensure that activities
fall under categories that are proven effective in health promotion programming. According to
Hodges and Videto (2011), programs based on the SCT need to include interventions that will
affect the individual people, their behaviors, and their environment. In addition, the authors
behavioral capabilities, modeling, and reinforcement (Hodges and Videto, 2011). Two activities
related to each SCT construct will provide direction in the planning and implementation process
and assure that objectives are met based on proven theory and evidence-based research.
Behavioral Capability
(2011) advise health promotion programs to include activities that use web-based
Awareness and Prevention Program website will include many different Internet
resources. For example, the website will include physical activity and nutrition
information that is interactive and has trackers. Videos will be included that show
how to perform exercises safely and cook nutritious food. Further, goal-setting
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forms will be included, along with daily journals to write about the experiences or
any barriers. In addition, the website will also include information on community
resources, local fitness facilities, healthy eateries, senior center locations, free
seminars.
Task Force (Task Force), a branch of the U. S. Department of Health and Human
example, brochures and flyers will go out as part of the campaign with key
Environmental
1. Resources will be provided so that local seniors know where they can access
outdoor physical activity opportunities such as bike trails, parks, trails, and
walking paths. The website will have meet up groups and social media networks
so that seniors can go with others if they do not feel safe, do not like driving
FINAL PROJECT 25
alone, or need a ride to attend. Macera (n.d.), with the CDC, stated that
recommends and is aligned with the goals for Healthy People 2020. There will
also be field trips from the local community center after fitness workshops to visit
local senior fitness facilities and become familiar with what is available in the
seniors out in nature will increase the environmental factors that are conducive to
2. A community garden will be started with donated land and finances provided by
Estlund, Duggan, Barnhart & Brownson, 2013). The garden will serve as a
vehicle for growing and producing healthy food, overcoming barriers to the cost
Self-efficacy
center and groups of seniors will be invited to attend. The healthy eating course
will go over how to eat a more plant-based diet, how to minimize processed
foods, how to shop on a budget, how to prepare healthy food at home, and how to
incorporate more fruits and vegetables in the diet. Demonstrations will be given
FINAL PROJECT 26
but a nutritionist and participants will have opportunities to try various cooking
techniques. Confidence will be built among participants that they have the
coach. Regular sessions over 8-weeks and personalized coaching to set goals,
approach used for the Research Tested Intervention Program to address weight
Institute, 2016). The self-efficacy and SCT methods to eating healthy and
building capacity for behavior change have proven effective and are valid
intervention techniques.
health fairs, and by telephone interaction from local volunteers. Seniors who are
signed up on the website will be able to register for cancer screening reminders.
patients.
Outcome Expectations
1. A kick-off community health fair will introduce the growing need for cancer
prevention within the community and educate seniors on the main risk factors that
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put them at risk. The expectations of the cancer prevention techniques will be
eating, and cancer screening will be the target of the fair and local presenters will
2. Physical activity workshops will be provided and the benefits of exercise will be
will set goals with a fitness instructor and map out plans that help them to achieve
Modeling
participants watch cooking skills being demonstrated and then engage in cooking
will provide opportunities for participants to show that they have observed how to
prepare a healthy meal by bringing food to share. Health coaches that are
provided with the 8-week healthy eating course will also personally be an
2. Physical activity workshops will be held where seniors can come to learn various
exercise techniques and practice new routines and methods with a trained fitness
professional. As the group exercises and learns together, they can observe one
another and provide feedback. These group gatherings also offer a great way to
Placer County residents gather to learn about fitness, practice exercise techniques,
and meet up for outdoor activity, they will create relationships and provide
Reinforcement
1. Personalized health coaching will support seniors as they change behavior and
Prevention and Health Promotion, 2017b). Placer County seniors can compare
their diet the guidelines and reward themselves for coming close to the
recommendations. Health coaches can also reinforce positive dietary changes and
set their own incentives and rewards for reaching milestones in healthy lifestyle
improvements.
2. Health fairs and quarterly events will offer prizes to participants who can answer
and complete a healthy eating meal plan. Those who can say they have increased
physical activity, in-home cooking, fruit and vegetable consumption, and cancer
screenings will be entered into a raffle for large prizes. Fun, engaging activities
will be included during health fairs and events to reinforce healthy living and
3. The website that will be offered as a community resource to seniors will also
provide a place for testimonials so that individuals can receive positive feedback
from their peers. In addition, local support groups, and social media networking
The program activities developed based upon the SCT align with the intended outcomes
of the overall program mission and goals. The activities each contribute to reaching the desired
outcome of improving the health of Placer County residents and reducing the rate of cancer. The
rationale for choosing activities was founded on the goal to reduce cancer risk factors with
interventions focused on healthy eating, physical activity, and regular cancer screenings. The
program activities each support one of the program objectives. First, the behavioral capability
activities support the objective to have 70% of Placer County residents over 65 aware of cancer
and its effects. Both a resource website and campaigns will help to reach the objective to
increase awareness. Second, the environmental activities will support the program objective to
increase access to cancer prevention resources. Both a community garden and resources to local
trails, walking paths, and parks provide access to health resources that contribute to cancer
prevention.
Third, the self-efficacy activities will support the program objectives to increase fruit and
vegetable consumption through an 8-week healthy eating course and will support the program
objective to increase cancer screenings with one-on-one cancer screening support. Fourth, the
expectation activities will support the program objective to increase Placer County residents
knowledge. Fifth, the modeling activities will support the program objective to increase fruit and
vegetable consumption and regular physical activity level. Lastly, the reinforcement activities
FINAL PROJECT 30
will support the attitude program objective, the behavior objective, and the risk reduction
objective.
Each activity successfully helps to achieve the objectives, goals, and mission statement of
the Placer County Cancer Awareness and Prevention program. The activities that target Placer
County seniors at risk for cancer will be implemented by those in the target population, local
health educators, nutritionists, fitness professionals, and various other stakeholders of the
prevention plan. Activities that support the program objectives will be funded by the Prevent
Cancer Foundation, and a budget will be followed. Activities that were developed based on
theory, evidence-based activities, adequate funding, and a detailed budget all provide the
Methods to tailor program activities will be focused on addressing the needs of a senior
population. Various factors will be considered with the 65 and older population, and limitations
and barriers will be accounted for. Tailoring activities to seniors also involves previously
white, educated, males and females, who make an average income. According to Hodges and
Videto (2011), it is also important to tailor interventions to make sure that specific challenges are
accounted for and any population needs are addressed, which will ensure that the program
resonates with the intended group of people. Seniors are more susceptible to special needs
associated with being on a fixed income, reduced social support, and decreased balance. In
addition, they may have certain dietary restrictions based on health conditions that could affect
dietary choices. Also, the program activities will be tailored to seniors by being simple,
enjoyable, and steadily paced. By tailoring activities to be low cost, social, helpful for balance,
FINAL PROJECT 31
simple, enjoyable, and steadily paced, seniors can progress through the community-based
Tailoring activities to address the special considerations for the senior population can
easily be accomplished by involving the target population in the program planning process.
Certain needs can easily be addressed with slight modifications. Evidence-based tailoring
methods for seniors show that seniors prefer activities that are simple, free, and easily accessible
(King, 2001). Seniors are on a fixed income, and although most in Placer County have sufficient
income for their needs, many prefer to travel and enjoy leisure activities with their resources.
Activities that are free have been implemented into the Placer County Cancer Awareness and
Prevention Program due to the adequate funding received from an outside source. Providing
activities at no charge will be more appealing to seniors, so more are expected to participate.
In addition to being no charge, activities will be tailored to fit the seniors needs by
providing numerous opportunities for social interaction. Many seniors are retired, single, and
lonely, so interventions are targeted towards more group gatherings. Social events and
gatherings will address various components of the cancer prevention program, which will
include instruction on balance. Additionally, physical activity programs and workshops will
provide adequate education and support on safety and proper form to prevent falls from lack of
balance. Balance exercises will be encouraged as part of a regular physical activity routine.
Along with physical activity tailoring, a nutritionist and health coach will support dietary
changes and tailor eating changes to fit individual needs. Coordination with physicians may be
Further, the program will be tailored to seniors by being educational but enjoyable. The
activities will be upbeat, positive, and motivating. Instead of focusing on the negative side of
FINAL PROJECT 32
unhealthy lifestyles and the risks of getting cancer, the program activities will focus on the
positive side. Many seniors worry about aging and the ailments that come with it, so the
program is intended to provide a positive approach to aging. Some of the program focus will be
on aging in a healthy way, and how to increase the quality of life while avoiding cancer.
Also, the activities and workshops will be challenging to provide growth for the seniors
but not overwhelm them by asking too much too fast or expecting performance beyond their
capabilities. The strategies to carry out the SCT methods of program planning will be paced in a
way that a person 65 years and older can gradually change habits and routines. Many seniors
have established routines, and like the way they do things currently, so there can be some
resistance to change. If healthy habits are progressively added in that crowd out the bad
behaviors, then seniors will see that change can be comfortable and enjoyable. Dietary,
financial, social, and physical needs of seniors can all be accommodated for when tailoring
activities for health promotion programming. Tailoring the activities to seniors will be
accomplished by following the SCT method of developing activities and being culturally
According to Hodges and Videto (2011), the culturally appropriate material will be relevant to
the target populations language, style of learning, and location. Language, style of learning, and
location will be considered; also, material will be culturally appropriate for seniors by including
larger text, subheadings on videos, technology support, and multiple pictures. The CDC (2016)
recommends program planners to deliver health education to seniors in larger text, simple fonts,
and in black on white color. In addition, the language will be simple and not involve technical or
FINAL PROJECT 33
medical terms so that all the seniors will be able to understand it. Furthermore, all material and
correspondence will be in English since the data shows that the population predominantly speaks
English (U.S. Census Bureau, 2015a). Simple language that is English will include various
learning styles. The delivery of education will include various styles of learning such as visual,
auditory, written, and participatory. Some learning will be accomplished by performing the
skills after being instructed with verbal, written, or auditory material. A broad-based delivery of
material will ensure that all the seniors are able to learn in a way that resonates with them. To
increase the seniors abilities to learn and understand material will further involve a
consideration for technical differences and abilities. The seniors will be given support at the
events and workshops on how to use the Internet, resource website, and social media networking
groups. It is appropriate to include training since many seniors are not comfortable with
technology.
In addition to simple language, multiple learning styles, larger text, and lots of pictures,
the program activities will also be culturally appropriate in location. Seniors are more likely to
All events will remain within the centralized community, and no extensive travel will be
required. The locations and events will also be planned strategically for seniors so that they are
not in environments of extreme heat or extreme cold. Seniors can often be at risk of heat
exhaustion or getting cold easily. Also, the events will be held during the day since many
In addition to the location of the events, Hodges and Videto (2011) explained that
programs should offer a wide variety of strategies and include family when appropriate. Many
seniors do not live with family, but children and grandchildren will be invited to attend when
FINAL PROJECT 34
family support would be beneficial. It is culturally appropriate to include the family for the
senior population because many seniors have family members involved in their decision-making
process. The Healthy People 2020 initiative by the Office of Disease Prevention and Health
Promotion (2017c) also uses social support as an effective intervention for seniors in making
behavior changes. Including families will allow the seniors to feel supported in the changes they
are making and provide family members with an understanding of why attending the activities is
beneficial to their loved one. Also, family members may provide positive feedback and reinforce
the good behaviors that are being adopted. Having the program activities tailored around social
Including family, technology training, language, style, and location are all examples of
how the Placer County Cancer Awareness and Prevention program can adapt activities to the
senior population. Communication with seniors will occur throughout the program so that any
alterations can be made to help the seniors be more engaged in the program. Communication is
important because overcoming barriers is crucial to the delivery of the program and its overall
ability to meet the objectives. As program planners are culturally competent and understand the
senior population and the various aspects that may affect their behavior, they can create
successful interventions.
A Discussion of the Theory Guiding the Program and Citations to Relevant Literature
Health promotion program planning involves careful organization to make sure every
step of planning is done efficiently and effectively. Each step of the program planning process
builds upon previous steps and ultimately leads to a program that is ready to be implemented.
Part of the program planning process that is crucial to development is recognizing a theory or
model to base the program on, so that proven interventions can be utilized. A social or
FINAL PROJECT 35
behavioral theory or model is composed of concepts that guide and explain behavior and the
techniques to change it (Hodges & Videto, 2011). Understanding peoples behavior helps
program planners know how to address it. The professional literature contains many resources to
learn about different theories and models, and program planners can choose one that is best
The Social Cognitive Theory (SCT) is a valid and appropriate theory for the Placer
relevant, and has been applied to interventions similar to the Placer County program. The theory
has proven effective based on research for promoting positive behavioral change that reduces
risk factors associated with cancer development. The theory has successfully been applied to
key lifestyle determinants such as physical activity that reduce the rate, incidence, and recurrence
of cancer. The SCT that has been applied to the same target population and to the same
behaviors that the Placer County program will focus on which include cancer reduction, seniors,
physical activity, and behavior change. The SCT is specifically effective for the Placer County
Cancer Awareness and Prevention Program because the target population is senior citizens, and
the SCT principles will help seniors who are particularly susceptible to self-efficacy barriers.
Also, the SCT will be effective for seniors by implementing constructs that will affect
environmental and social factors that are influential to many seniors who are alone or have
limited access to resources. Program planners can include environmental components of the
outlined in the SCT will allow seniors the opportunity to learn new skills that are associated with
positive feedback will reinforce motivation as well as continue to confirm and build self-
efficacy. According to Hodges and Videto (2011), the SCT also emphasizes the development of
outcome expectations and addresses the need to establish a hope in individuals that certain
behaviors will result in beneficial outcomes. It is important for seniors who engage in a cancer
prevention program to believe the interventions will be beneficial and are worth the time and
effort invested to achieve the results. The broad scope of the SCT provides a framework for the
seniors make it a favorable choice in theory selection. The Placer County Cancer Awareness and
Prevention Program based on the SCT framework will guide program development and
implementation.
The Placer County Cancer Awareness and Prevention Program will utilize evaluations
throughout the program planning and implementation process. Evaluations will be a necessary
resource in providing data regarding the interventions and strategies, the program components,
the programs effectiveness, and the results of the program (CDC, 2010). The evaluation process
will help to determine if the target population was satisfied with the program and if the program
goals and objectives were met. Gathering the information will require various forms of
evaluations that will act as guides, resources for improvements, and as monitoring tools.
According to Hodges and Videto (2011), evaluation types include formative, summative process,
impact, and outcome. Each type of evaluation will act as a guide in choosing evaluation
questions for the Placer County Cancer Awareness and Prevention Program. Developing
questions for each type of evaluation will ensure that the evaluation is comprehensive and will
Formative: What sufficient preliminary data was gathered from the target population to provide
a baseline for future dietary, physical activity, and cancer screening progress? How is the
material culturally appropriate for the senior population and being understood? Are the seniors
showing progress towards heathier lifestyle changes by regular attendance at activities and
events? How are seniors engaging in the activities and learning new skills?
Summative: How were the resources utilized by the seniors of Placer County? How do Placer
County residents feel they are more knowledgeable about cancer, the risks, and the preventative
measures?
Process: How are the program interventions and activities being implemented? Is the budget
followed? Are marketing efforts adequate and sufficient throughout the program? Are seniors
enjoying the activities? Are program stakeholders participating throughout the process and
Impact: What short-term program objectives were met? By how much are the risks for getting
cancer decreasing with the implementation of healthier lifestyle behaviors? Do more seniors
engage in physical activity, healthy eating practices, and regular cancer screenings? Do Placer
County seniors feel they have greater access to resources for cancer prevention within the
community?
Outcome: Were long-term goals reached? Are there fewer reported cancer cases in Placer
County seniors following the program? Is the community more united in a fight against cancer
and committed to maintaining a health-promoting environment? How has the quality of life
Data Collection
After evaluation questions have been outlined, a plan for gathering the data relevant to
answering the questions will be organized and implemented. The formative, summative,
process, impact, and outcome evaluation methods will occur at appropriate times throughout the
program and at the end of the program to provide a wide range of data, information, and
feedback. Continuous evaluation will allow for any program alterations to take place. An
evaluation consultant who specializes in health program evaluations will take the lead, and
program stakeholders will take part with delegated responsibilities from the consultant. The
target population volunteers will also help with the data collection efforts. The planning for the
evaluations will include when the data will be collected, where the data will come from, how it
The type of data necessary to address the evaluation questions will include feedback from
the program participants, data from website usage, counts for attendance at program activities,
marketing reach descriptions, cancer screening records, program activity checklist, and cancer
registry data. According to the CDCs (2010) recommendations for evaluating cancer programs,
data sources can include the cancer registries, surveys and questionnaires, vital statistics,
program attendance records, interviews, and observations. Surveys and questionnaires will be
used to gather data before the program for the needs assessment and preliminary information
collection. Data collection for the needs assessment will come from research, the cancer
registries, the U.S. Census, public health statistics, and Placer Countys website. Data will
include information on the quality of life status, demographic and socioeconomic profiles,
Data for the preliminary surveys and questionnaires will be retrieved to show baseline
information on how many days of physical activity the seniors currently engage in, what their
level of knowledge is about cancer, how they perceive their quality of life, and how many
servings of fruits and vegetables are consumed per day. Volunteers trained in interviewing will
do personal interviews at the local senior housing communities and at local senior centers. Help
will be given to answer questions. Volunteers will do the data gathering instead of other
program stakeholders to reduce any bias. Interviews will be beneficial to seniors because
according to Hodges and Videto (2011) interviews can help individuals who may have difficulty
with technology, varying abilities to understand information, or who require cultural tailoring,
and accommodations. Interviews will be done to help seniors with completing, understanding,
reading, and interpreting the questions, but also written private data collection methods will be
used. For those who are uncomfortable with personal interviews, mail-in surveys, and
questionnaires will be given. In addition, interviews and surveys will be conducted over the
phone.
Other data will be obtained throughout the program in the development phase, as it is
being implemented, after events, and at the conclusion of the evaluation. Data that will be
collected during the program will include multiple methods and instruments. Focus groups or
group interviews will be held throughout the program to gather information and feedback from
participants and stakeholders. Focus groups and group interviews allow for elaborate responses
and exploratory discussions to gather more in-depth feedback (Hodges & Videto, 2011). Other
data collection methods will include gathering data after events and activities. Written surveys
will be at every event to be filled out anonymously and put in a box. In addition, data will be
gathered from rosters and attendance records for program events. Another method for collecting
FINAL PROJECT 40
information will include observations by the program planners and stakeholders, as they are
involved in the program activities. Observations may be biased, so they would not be used alone
but can provide a useful analysis of the programs success, participants enjoyment, participants
Lastly, methods to gather data to be evaluated and analyzed by the evaluation consultant
will include the same public records used in the beginning of the program evaluation such as
cancer screening records, cancer registry entries, U.S. Census data, and the Placer County
community health records. Gathering data at the end of the program, during the program, and at
the beginning will help the program to be analyzed and the effectiveness determined. Assessing
whether or not the goals and objectives were met will be crucial to decide if the program was
effective at meeting its intended outcomes. Evaluation is expected to occur long after the
program has completed to obtain sufficient evidence if the cancer rates have gone down. If the
program is a success, then consideration can be given to continuing the program and what the
long-term sustainability would be. A detailed report will be given to program stakeholders and a
simple result brief will be given to the senior population of Placer County. Following an
evaluation process is a key component of a health promotion plan and will be included in the
Placer County Cancer Awareness and Prevention Program to help seniors reduce cancer.
The Placer County Cancer Awareness and Prevention Program has all of the components
to implement successful interventions. The program was founded on evidence-based theory and
activities and is aligned with appropriate goals and objectives. Proper funding has been
identified, and a plan is in place to evaluate the program. In addition, the staff roles and
administrative tasks have been outlined in the section entitled administrative tasks. Many parts
FINAL PROJECT 41
of the program are complete and organized; however, a program implementation and
sustainability plan are still needed to make sure the program is delivered as outlined and has the
potential to be maintained long-term. According to Hodges and Videto (2011), a program cannot
progress towards the intended goals and objectives unless there is acceptance of the program,
paramount in the implementation process, so the health promotion program leaders will guide the
committee of stakeholders during monthly meetings. The Placer County Cancer Awareness and
the program, sufficient resources, and will provide volunteer training as needed. In addition, the
Placer County implementation plan includes an evidence-based theory, logic model, timeline,
program budget, clear administrative tasks, and activity objectives that will assist in the
implementation efforts. Lastly, the implementation plan is set up for success by involving the
target population.
An implementation plan will be more successful if the target population is involved and
will create a better chance for long-term sustainability (Hodges & Videto, 2011). The target
population of seniors in Placer County will be key participants in every step of the program
including implementation. When people are part of the decision process, they generally like the
ideas that are accepted and are more likely to support them. Also, the target population can help
with implementation because the volunteers are at the forefront of seeing their peers and can
recognize favorable or negative responses to the program implementation. Lastly, involving the
Barriers can impede the programs success if they are not recognized and removed
quickly. First, a potential barrier could include the ability of the program participants to follow
FINAL PROJECT 42
through. For example, if an agreed upon arrangement with a physician, fitness instructor, or
nutritionist did not end up happening it could cause a delay in the implementation trying to find
replacements. Second, the seniors ability to use technology may create a barrier since many
resources are delivered online; however, training may compensate. Third, unforeseen costs
could exceed the program budget and require limitations or alterations in the program activities.
Nevertheless, barriers can be recognized and modifications can be made with proper evaluating,
(Hodges & Videto, 2011). For example, a helpful implementation objective for the Placer
County program will include an objective stating that health promotion program leaders will
hold one board meeting each month with the program participants and volunteers to designate
specific duties and report on previous tasks. Regular meetings will allow the potential barriers to
be discussed and offer a chance to find solutions. In addition, discussions at monthly meetings
effective implementation plan will be determined by evaluating if the interventions are being
delivered as planned, if the activities are being fully completed, and if the interventions occurred
as many times as they are supposed to (Hodges & Videto, 2011). Evaluating the success of the
programs implementation can help program leaders address whether or not the program is being
delivered in a way that will accomplish the goals and objectives. Effective implementation plans
Although the program is planned with organized principles and practices, the program
needs to be sustainable. According to Hodges and Videto (2011), a sustainable program is one
that continues to provide a positive health impact over time and has become an ordinary practice
FINAL PROJECT 43
within the associated organizations. Creating a sustainable program will ensure that the goals
and objectives can be achieved long-term. Cancer reduction can take some time, and a continued
program will benefit the seniors in Placer County by reducing cancer risks longer than the length
of the program. In addition to decreasing cancer risks with an ongoing program, a continuing
program will also increase the quality of life and the overall health of the residents.
resources. Maintaining the program will require adequate funding after the primary funding
source is depleted. Possible solutions to gain further funding can include fund raising, applying
for grants, and soliciting donations. Finding ways to be resourceful and utilize the skills and
tools available within the community can help to save on costs. In addition, utilizing volunteers
instead of hiring professionals reduces costs. However, financial resources will still be required
leader work to obtain additional funding, the sustainability of the program will be enhanced.
Another important factor to consider in order to sustain the program over time is the
ability the program has to become part of the senior citizens culture within the community and
the organizations involved in the program. According to Hodges and Videto (2011), the process
of a program becoming part of the culture and way of life for the organizations involved in the
program is called institutionalization (p. 198). The senior centers, community center, and
health educators can all be part of the program becoming a regular routine in their services. As
they begin to promote healthy lifestyle behaviors like physical activity and healthy eating, they
can get in the habit of promoting cancer-reducing habits. By doing this, the program can become
Lastly, to help the program become sustainable long-term the target population will be
involved in the planning, implementation, and evaluation. By involving the community in the
process of the program, skills can be built to help the seniors know how to carry out their own
program. Building the abilities of the seniors to help one another in organizing activities and
gathering resources will cut back on costs and create unity as seniors work together. Examples
of seniors working together could be, teaching one another workshops and inviting volunteer
speakers, holding physical activity gatherings, planning healthy meal potlucks, supporting one
another in cancer screenings, maintaining a current website of cancer resources, etc. As seniors
work together, they can identify a potential leader to oversee the sustainability efforts.
Planning for future funding and building the communitys capacity to maintain a program
will remove a few barriers to continued implementation over time. Also, as the initial program
builds momentum, more and more people may become involved creating a culture of health and
providing a framework for further adoption. Helping the program to become a way of life
amongst the seniors in Placer County will decrease the likelihood of it dissolving and increase
the likelihood that there will be continued success. Once the community sees the benefits of the
program after a successful evaluation, motivation will increase to see the positive impacts
continue.
Continuing the Placer County Cancer Awareness and Prevention Program will help
Placer County seniors to reduce cancer rates, maintain a healthy lifestyle, increase the quality of
life, and create a unified community. The Placer County program is created to be comprehensive
so that overall mission to reduce cancer can be accomplished. The comprehensive community
program includes a needs assessment, program committee, adequate funding, detailed budget,
mission statement, goals and objectives, proven theory, outlined logic model, strategic activities,
FINAL PROJECT 45
planning outline and making sure each step is accomplished can lead to a successful program
delivery. With a successfully delivered health promotion plan the seniors of Placer County will
have every tool, skill, and resource they need to reduce their cancer risks and live healthier,
longer lives.
Part 2
Workplace wellness involves promoting health and well-being within the workplace
environment. Most people spend at least eight hours a day at work, which creates an ideal
program are that there can be decreased absenteeism, stress, workers compensation claims, and
healthcare costs. A workplace wellness program can also create a happier workplace culture.
Integrating workplace wellness programs into any business can enhance the lives of employees
and increase their overall quality of life. As people improve lifestyle behaviors, they generally
feel better, think better, and perform better. In addition, healthy lifestyle habits can decrease the
incidence of disease. Healthier lifestyle behaviors should be promoted and supported while
Multiple organizations have integrated health and wellness programs into their employee
offerings and have had much success. According to the Wellness Council of America (2016),
successful programs include those from large and small business such as Kimberly Area School
District, SC Johnson, Werner Electric Supply, and FVSBank. Workplace wellness programs can
be customized for any organization large or small with varying professional specialties. The
FINAL PROJECT 46
CDC (2015b) discussed various components of a workplace wellness program that can be
included such as improving access and time for physical activity, increasing health education
through lunch-and-learns, providing healthier break room snacks, and changing policies to be
aligned with health and wellness. The components of a workplace wellness program can be
based on employee needs assessments and interest surveys to make sure implementation is
targeted at what will be most effective. Developing a program based on the target population,
health needs, interests, and organizational factors will likely engage more people and show
implementing workplace wellness is a program created for a small dental office in Placer
County, California.
The dental office for the workplace wellness program has its own individual, community,
organizational, and socio-demographic factors that are relevant to health and program planning.
Organizationally, the business is healthy financially and has provided a stable work environment
for many employees for over twenty-five years. There are 11 people in the office including the
dentist. The dentist is male, but all other employees are female. The primary race of the dental
office is white with one woman being half-Hispanic. When compared with the community, the
racial variance is consistent. Placer County is composed of mostly white individuals according
to the U.S. Census Bureau (2015b). The Bureau also provides other county information that can
be compared to the socio-demographic profile of the dental office. For example, educational
attainment and income can be looked at to determine if it is consistent with community averages.
The skills and educational level of the dental employees vary by the role and the specific
job duties entailed. All of the employees graduated college, have specialized certifications or
FINAL PROJECT 47
licenses, and are experienced professionally. According to the dental team (personal
communication, February 20, 2017), only thirty-percent have a four-year college degree. The
Placer County community data also shows that about thirty-percent of the residents have a four-
year degree and over ninety-percent have graduated high school (U.S. Census Bureau, 2015b).
The income diversity in Placer County and the dental office can also be compared.
The dental office employees income is based on education, certifications, and licenses,
with no variance depending upon experience. Based upon employee conversations (personal
communication, February 20, 2017), the salary ranges from approximately $76,000 to $25,000
according to what is standard in the dental industry for dental hygienists, dental assistants, and
front office managers. Placer County community residents make on average a little over $70,000
with a low percentage of people in poverty (U.S. Census Bureau, 2015b). In many ways, the
dental community and Placer County share commonalities demographically and socio-
economically.
The Placer County residents and dental office employees also have commonality in
regards to health needs. The employees are at risk for obesity and chronic disease associated
with poor lifestyle choices. Based upon observations made in the dental office, there is a lack of
healthy eating, physical activity, and stress reduction. In comparison, the Placer County
residents as a whole are statistically showing poor diet and exercise behaviors, and a needs
assessment done by a local hospital declared healthy eating and physical activity intervention to
be a main health need for local residents (Lawless & Rosenbaum, 2016). The hospitals needs
assessment did not gather data related to stress reduction, but the community, organizational, and
individual observations indicate that stress reduction is also a health need and concern for
positive intervention.
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The individual, organizational, and community data illustrate that the small dental office
would be an appropriate target population for a workplace wellness program. The educational
level and the economic level of the individuals and the organization provide the opportunity for
increased understanding of why workplace wellness could be beneficial. The income level of the
employees and organization will allow for the adequate implementation of healthy eating and
physical activity within the organization as well as at home. The gathering of relevant
program can be initiated. The workplace wellness program for the dental office in Placer County
will be initiated and formulated based on a clear mission statement, goals, and objectives.
The dental office of Placer County is committed to providing a work environment where
employees can engage in meaningful work, serve the community with compassion, and
experience an enjoyable life by being healthy and well. The mission of the dental offices
workplace wellness program is to improve the quality of life for the employees at work and at
home through diet, physical activity, and stress reduction promotion. The dental office believes
that employees who are healthier in mind and body will get sick less, have more energy, save
more money on healthcare costs, avoid disability, be less stressed, decrease obesity, avoid
chronic diseases, and experience greater happiness. The dental office team is committed to
providing a workplace culture that is supportive to living a healthier and happier life.
Goals
To motivate employees to want to make behavioral and lifestyle changes that will
To increase physical activity and healthy eating amongst employees at work and
at home
Objectives
1. Six out of 10 employees to increase moderate aerobic exercise from 0-1 days to 3-5 days
for 30 minutes and 2 days of strength training on most weeks by the eleventh month of
the program.
2. An increase in consumption of fruits and vegetables from 2 per day to 3-5 per day
amongst 60% of the dental employees and 5 days of cooking at home by the eleventh
3. Ninety percent of employees by the eleventh month of the program will exhibit greater
happiness and less stress by implementing a stress reduction technique into their
4. A report of fewer sick days for the whole office reported one year after the program
A Program Timeline
Implement Program
Evaluation
FINAL PROJECT 51
Month 1
Month 2
Develop a timeline
Obtain
Gathera data
funding
andsource
conduct a health needs assessment
dfd
Determine a budget
Choose
Write astrategies
missionand activitiesgoals,
statement, for program
and objectives
Assign duties to wellness committee
Begin to implement program
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Month 9
Month 10
Month 11
Month 12
The program timeline and flow chart displayed in figures 1 and 2 represent how the
program will be organized and operate. The steps to develop a workplace wellness program are
outlined as well as the monthly activities that will take place while implementing the program.
To implement the program, the wellness committee will address program planning and
workplace governance by communicating with each other. A wellness leader will be decided
upon and each month the team will gather to have meetings and plan events. Responsibilities
will be delegated and each month someone new will be in charge of that months activity. It is
purposed that five people be on the wellness committee from the target group and that someone
from each department is present. Decisions will be voted upon and choices will be made based
upon what alternatives are aligned with the mission statement, goals, and objectives. As the
wellness committee plans and works as a team, they will be able to implement the program
A Program Budget
Planning
Mission statement, goals, and Office supplies/printing $15 1 $15
objectives posters
Wellness committee Meetings Meeting materials, $25 10 $250
office supplies, snacks, meetings.
etc. Once per
month
Kick-off marketing Posters and flyers for $20 1 $20
kick-off event
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Appropriate health promotion programs require adequate funds to effectively reach the
target population and address needs through activities. Funding for the dental offices workplace
wellness program will come from three sources. First, the employer of the dental office will
provide $2500 for the first year of the program. He sees the value in a health promotion program
and believes that it will save him money in the end. He looks forward to having employees feel
better with increased energy, because he thinks it will help them to interact with the patients
better and lead to more efficient work. More efficient work will lead to less overtime pay as
well. He also is concerned with how many sick days are taken each year. Sick employees result
in expensive staffing solutions when they are absent. He is happy to support a positive
workplace culture within the dental office and sincerely desires to provide an environment that is
Second, funding will be received from the dental supply company as a pilot program to
see if they want to engage in dental and medical workplace wellness in the future. As a supplier,
they can distribute information, healthy office supplies, ready-made programs, stress reduction
tools, and much more. They would also like their name to be marketed as the first supply
company to promote workplace wellness as it is evaluated and possibly discussed in the local
newspapers. According to a leader at Henry Schein supply for medical and dental offices, J.
Sorenson (personal communication, February 19, 2017) expressed that she thinks it is a good
opportunity to promote dental employee health. Henry Schein will donate $1500 to the program.
Lastly, funding is anticipated from a local fitness facility upon written proposal. The
owner of the California Family Fitness has been a patient, and it can be assumed that he would
be a willing contributor. Funding the program will provide exposure to the fitness club since
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brochures, cards, and discounts will be displayed at the dental office. At least thirty-two people
from the community enter the dental office each day and it provides for an inexpensive way to
market. In addition, shirts will be provided displaying the support of the dental office and the
clubs name for employees to wear in attendance at any community fitness races or events. Free
gym memberships are expected for each employee. The contribution expected will be $1500
The total funding to be obtained for the dental office workplace wellness program will
amount to $5500, which will adequately meet the budgeting needs and provide for extra
resources if additional supplies are needed. The internal and outside funding sources unite the
dental office with the companies in the community to promote greater health and well-being.
Sufficient funds will allow the activities to be implemented that will help to achieve the goals
and objectives. Any additional funds will be carried over into the next year. Receiving three
sources of funding will help to make the health and wellness program a success.
With access to adequate funding various strategies and activities will be provided to help
employees meet the goals and objectives outlined in the program and to increase motivation for
making healthy lifestyle changes. Various components and strategies will be implemented based
upon the needs that were recognized. Decreasing stress, increasing healthy eating, and
increasing physical activity will be the focus of the programs. A full timeline of the activities
and what will be included each month can be found in figure 2. The program will start with a
kick-off event to introduce the program and some of the program participants. The wellness
committee will explain in a presentation what workplace wellness is, why it is beneficial, and
how it can help the organization and team. The doctor will give a speech and acknowledge his
FINAL PROJECT 59
support and the support of the funding sources. Next, a local physician will give a presentation
about the risks of a sedentary lifestyle, unhealthy eating, and high stress. He will discuss the
benefits of adopting healthy lifestyle changes and the long-term positive implications with
avoiding chronic diseases and obesity. The health benefits will be addressed in detail so that the
team understands all that diet, physical activity, and stress reduction techniques can do for their
After the presentations, the wellness committee will introduce the teachers and supporters
that will be involved in the program such as the nutritionist, fitness instructor, yoga teacher, and
health coach. The health coach will be available free of charge throughout the program to
provide individualized support and encouragement when making behavioral changes. Once
introductions are over the team will receive their free California Fitness Gym memberships.
Next, the team will receive and overview of the activities to follow in the next few months.
Activities that will be included over the course of the program will include a different
theme for each month. One month the focus will be on physical activity and the office will do a
fitness challenge together and receive fitness instructions so that they feel confident starting an
effective exercise routine. Goals will be set, and a Facebook support group will be created.
Another months activity will address heathy eating, and a nutritionist will discuss how to eat
healthy on a budget, cook more at home, prepare healthy snacks, and implement more fruits and
vegetables into the diet. She will discuss ways to crowd out processed food and eat a more
plant-based diet. A cooking demonstration will follow and each team member will make goals
Other months will focus on seminars, workshops, lunch and learns, and events. One
month will focus on stress, and a Stress Master Associate and yoga teacher will teach techniques.
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Breathing exercises will also be demonstrated as well as chair massages. A different month will
focus on how to prevent getting sick. An additional month will include a fun race to give the
opportunity for team members to engage with the community. In the summer, there will be a
healthy BBQ. The team will also have another chance in the summer to get together with
Each month, there will also be a healthy walking meeting for the team and a healthy
potluck lunch. Additional resources that will be available at the office will include a wellness
resource library. The library will give team members access to fitness equipment to use during
lunch, and videos and books to check out and take home. With all the tools and resources that
will be available, employees will be encouraged to set their own personal goals, overcome
barriers, and take steps to improving their health. The health coach will provide each employee
with monthly information packets, goal workbooks, and personalized coaching as they progress
The program will add new things each month as the employees progress, and at the end
of the program there will be a wrap-up and program evaluation. The various activities that are
targeted towards healthy eating, physical activity, and stress reduction are all aligned with
meeting the program objectives. At the completion of the program, the activities will be
evaluated to see if they were effective. The activities effectiveness will be determined based
upon pre and post-questionnaire responses. Management and stakeholders will be notified of the
A program will not be successful if management does not support it, if there is not a
health improvement plan, if resources are not accessible, if communication methods are not in
place, and if the program is not based on relevant literature and theory. To begin a successful
workplace wellness program, the support of the management must be obtained. The owner and
manager of the dental office gave their support of the program at the beginning and agreed that it
would have positive benefits to the organization and the team. According to the Wellness
meeting objectives and getting results. Support from the management in the dental office will
Another factor that will help the employees take action is a workplace health
improvement plan. The employer himself will take action to improve the environment to be
healthier for the employees. Action steps such as allowing water in the operatory, giving breaks
for healthy snacks, encouraging stretch breaks, and reducing overbooking will all create a
healthier workplace. In addition, stress will be reduced and employees can feel more nourished
and energized. The workplace health improvement plan will not only include the organizational
plan but the health promotion program plan as well. As outlined in figures 1 and 2, a clear plan
is included to achieve the mission statement, goals, and objectives. The workplace health
improvement plan includes the mission statement, goals and objectives, the activities, the
strategies, the wellness committee and duties, the communication plan, and the evaluation
process (CDC, 2015c). The combination of organizational improvements and wellness program
FINAL PROJECT 62
improvements will create a healthier workplace culture. With a healthy workplace culture and
Another factor that will promote healthier choices is an abundance of resources available
to the employees. There will be a full wellness library in the office containing videos, books,
and fitness equipment. Also, employees will have access to resources such as a health coach,
fitness instructor, yoga teacher, Stress Master Associate, and local physician. All of the local
resources, which include presenters and teachers of the program, will take part in the designated
monthly activities. Community resources for healthy living will be included in the program such
as local trails, community 5k races, nearby parks, and a local gym. The internal resource of a
dental employee that is also a health coach, will be utilized. Various resources will give the
Another factor that will help employees make positive lifestyle changes is adequate
communication plan can increase employee knowledge, promote awareness, initiate action,
improve relationships, increase program participation, improve behaviors, and increase health.
Communication will be paramount to the success of the workplace wellness plan in the dental
office. Communication will occur throughout the program amongst the wellness committee and
then be delivered to the employees. Daily communication will occur in the morning huddles and
any flyers or reminders can be given at that time. Communication will also include
correspondence through a private Facebook group and office email. In addition, communication
about events will occur with posters, flyers, meeting announcements, and break room reminders.
The team will have a healthy potluck each month and a walking meeting to communicate and
engage further. Lastly, each employee will have access to a health coach in case they have any
FINAL PROJECT 63
various levels will increase the potential impact the program can have on the lives of the team
members.
The communication for the program will be based on the Health Belief Model (HBM).
This theory is the basis of how the program objectives and activities were chosen. The HBM is a
theory about how people perceive a health need and how ones viewpoint affects the probability
that they will change lifestyle behaviors (Hodges & Videto, 2011). Hodges & Videto explained
further that the HBM can promote change by defining the risk, explaining the repercussions of
the risky behavior, illustrating how to take action and the benefits for doing so, providing support
and solutions to roadblocks, removing fears, and reinforcing ones capabilities to change. The
program plan and communications will align with the HBM by communicating the risks of
stress, unhealthy eating, and a sedentary lifestyle. In addition, those involved with the program
will illustrate the benefits of making change, explain how change can be made, provide support
to making change, and reinforce each employees own capabilities for improvements. The
health coach will be crucial to communicating in a manner that supports each component of the
HBM and each activity will focus on supporting change in a manner consistent with the theory.
The dental office workplace wellness program will be successful since it has management
support, a clear health improvement plan, adequate resources, a strategic communication plan,
and an evidence based theory. As employees engage in the workplace wellness promotion plan,
they will receive every necessary component that can motivate change. The internal motivation
present within each employee may be enhanced with the monthly activities, support of the team,
and influence of the health coach. Many barriers to change have been removed since so many
FINAL PROJECT 64
resources have been provided to encourage change. Program success will ultimately be
A program evaluation plan for the workplace wellness program will need to be
comprehensive to provide adequate data for analysis. Those who have vested interest in the
program such as the employer and funding sources will want to know the outcomes of the dental
office health promotion program. In addition, doing evaluations throughout the program will
help to identify areas of improvement, the level of engagement, employee satisfaction, and
potential barriers. Multiple evaluations will be included such as a formative evaluation, process
evaluation, outcome evaluation, and impact evaluation. According to Hodges and Videto (2011),
the evaluations must identify various measures of the program such as if the program is being
productive, if it is being implemented as planned, if it is using the funds appropriately, and if the
activities are aligned with the goals and objectives. Evaluating the program with formative,
process, outcome, and impact evaluations and looking at how it is being implemented can help
program planners measure if it is successful or not. Recognizing areas for improvement and
Evaluations answer questions that help to focus the data collection methods and identify
what resources will be required to gather the information. Questions will need to be answered
before planning an evaluation such as when will the evaluation occur, who will do the
evaluation, how will the evaluation be done, and what will be evaluated? Formative and process
evaluation questions help to evaluate the program prior and during. Questions can include is the
correct need being addressed, is the interest present amongst the leadership and employees, is
there appropriate funding for the program, is the program being implemented as planned, and is
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the material being understood? In addition, evaluations can include asking outcome and impact
evaluation questions such as how many employees are actively participating, how many
employees are eating more fruits and vegetables, how many employees are being physically
active, and how much has the stress level gone done?
Once evaluation questions are in place, the plan to gather the data can be outlined.
Gathering data and feedback facilitates program enhancements, shows program value, measures
development, and builds accountability (WELCOA, 2007). The wellness committee and
wellness leader for the dental office of Placer County will gather crucial data as part of the
evaluation. The evaluation plan and date collection methods will be discussed and
methods will include health needs questionnaires, healthy lifestyle questionnaires, interest
surveys, workshop evaluations, informal interviews, informal lunchroom focus groups, and
program completion questionnaires. The wellness leader will delegate responsibilities to the
wellness committee. Since the office is so small and the employees meet together every day,
questionnaires and surveys will be put in each employees lockers. An anonymous box will be
left in the lunchroom. To incentivize employee participation, a raffle ticket will be obtained for
each submission. Drawings for incentive prizes will occur every other month.
At the conclusion of the evaluation, all data will be collected and analyzed by the
wellness committee. In addition, one final focus group and group interview will occur to discuss
the employee satisfaction with the program. Topics for discussion will also include what
worked, what did not work, and what improvements could be made. The wellness committee
will determine if the goals and objectives were met and what the sustainability is for a program
the following year. A report will be written to give to the employer, the funding sources, and
FINAL PROJECT 66
each employee. Wrapping up the program with a comprehensive evaluation plan will help all
A Program Implementation Plan and description of programs, policies, health benefits, and
environmental supports
The program implementation plan is explained in full detail throughout the wellness
program and is included in the description of the funding source, budget, timeline, activities, and
communication plan. All of these components make up the plan for implementation. According
to Hodges and Videto (2011), a plan for implementation makes sure that the activities and
interventions are being delivered as planned, that the planned amount of activities is occurring,
and that the activities are complete in their scope. Each month the wellness committee will meet
and make sure things are being implemented as planned, that the funding is being used
appropriately, and that the duties and tasks are being completed. Furthermore, the wellness
committee will follow the flow available in figure 1, and the program implementation timeline in
figure 2. Each month programs will be implemented that address strategies to reach objectives
by increasing physical activity, increasing fruit and vegetable consumption, and increasing stress
reduction practices. The health benefits for employees engaging in the health promotion
program and activities will be increased energy, decreased chronic disease risk, decreased
obesity risk, decreased stress, increased productivity, decreased sickness, and a better quality of
life.
In addition to the workplace implementation plan, the policies and environment will also
support positive change. According to Elia & Rouse (2016), the office environment and policies
should reflect the mission statement and be supportive of employees being healthy. The policies
of the dental office and the mission statement of the program will be supportive of healthy
FINAL PROJECT 67
lifestyle choices too. New policies will be implemented based on the workplace wellness
program and the dental office employees will be able to take healthy snack breaks, have water to
drink in their operatory, and have stretch breaks. Another healthy office policy will be a
reduction in overbooking and overtime hours. Meeting policies will include walking during
meetings. All other policies included within the program will be supported on an organizational
level. Also, the environment of the dental office will be conducive to less stress and healthy
lifestyle choices. The once a month potluck and healthy food that will be provided at work
functions creates an environment where nutritious choices can be made. Fitness equipment in
the breakroom also provides a physically fit environment. Team gatherings for the year will
include an environment that supports health while out on trails, in parks, or outside at a BBQ.
The full implementation plan, office policies, and the surrounding workplace
environment all create a positive atmosphere conducive to health. Having a clear plan for
implementation helps to organize activities and prevents any from being neglected or forgotten.
Each activity will promote the mission of the workplace wellness program. The office policies
will also promote the mission of the workplace wellness program and will create a culture of
wellness within the workplace. The environment within the small dental office will be
Program Sustainability
workplace wellness program. The workplace wellness program has clear needs addressed, a
defined mission statement, long-term goals, specific objectives, a funding source and budget, a
and a method for evaluation. Each component of the program has created a foundation for a
FINAL PROJECT 68
healthier workplace culture in the dental office. Now that the foundation is laid and the
groundwork has been done, a continuation of the program can occur. Sustainability could be
achieved on a smaller scale with less expensive activities and events. The workplace culture of
health is already established, so all that is needed is the continued effort of the wellness
committee in planning future motivational strategies. The team can continue low cost activities
such as walking for meetings, holding monthly healthy potlucks, gathering for healthy BBQs,
going on team trail hikes, attending community fitness races, practicing stress reduction
practices, and meeting at the gym. Sustainability is achievable long-term with the dental office
workplace wellness promotion program with a little creativity and planning. Healthy living can
become a way of life, and each employee can contribute to making it a way of life at the dental
office. As employees work together, take what they have learned from the health program, and
commit to improving their professional and personal lives through healthy living, they can
Improving the health and quality of life for employees can result from a workplace
wellness program. In addition, workplace wellness programs can reduce absenteeism, stress,
workers compensation claims, and healthcare costs. The small dental office of Placer County,
California has planned for an effective program to improve the workplace culture and health of
employees. The program includes multiple components: a clearly defined need, a program
mission statement, goals, and objectives, a program implementation timeline, a budget, a funding
source, a strategic plan for program activities, a method for evaluation, and a plan for
implementation and sustainability. As the health promotion program is carefully followed and
implemented, the dental employees of Placer County can make lifestyle changes that improve the
health of the organization and the health of each individual. The workplace wellness program
FINAL PROJECT 69
can lead to a better quality of life at work and at home and increase the potential to live a longer,
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