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Promoting Healthy Relationships


Alejandra Aguilar

Brittny Bol

Maria Lira

Stephanie Okolo

Shikha H Kakkar

California State University, San Bernardino


Table of Contents

Executive summary………………………………………………………………… Page 3

Mission statement..……………………………………………………………….... Page 5

SMART goals and objectives……………………………………………………… Page 6

Program design and implementation………………………………………………. Page 7

a. Needs assessment………………………………………………………….. Page 8

b. Program purpose and rationale…………………………………………….. Page 9

c. Theoretical justification……………………………………………………. Page 11

d. Map determinants to theory ……………………………………………. … Page 13

e. Program description ……………………………………………………….. Page 13

f. Implemented changes ………………………………………………………Page 15

Program Evaluation………………………………………………………………... Page 16

a. SWOT analysis

b. Process Evaluation

Recommendations ………………………………………………………………… Page 19

Reflections ………………………………………………………………………… Page 19

References ……………………………………………………………………….... Page 23

Appendix…………………………………………………………………………... Page 24

Executive summary:

Unhealthy and abusive relationships awareness is an extremely important topic to address

as it is an issue that is overlooked, or perceived as unrelated in the lives of many undergraduate

college students. In reality, unhealthy and abusive relationships can happen at any point in a

person’s life; but during college there is a greater need for awareness due to the vulnerability and

inexperience of students during this stage in life.

Unhealthy and abusive relationships can have a detrimental impact on a person that can

affect them on an emotional, physical, psychological, social, and intellectual level. Creating

awareness and increasing knowledge on what a healthy relationship consists of for California

State University of San Bernardino (CSUSB) undergraduate students is a fundamental strategy

that can help students identify key markers of an unhealthy and abusive relationships. The

implementation of a healthy relationship curriculum at California State University, San

Bernardino for undergraduate students would allow college students to obtain self-efficacy by

being able to guide college students to find help for themselves or their loved ones if any of the

key markers for unhealthy and abusive relationships is applicable to their lives. Implementing a

healthy relationship curriculum would also help to teach positive behaviors and thus overall

decrease the percentage of domestic violence among college students.

The process evaluation report conducted for the program demonstrates the procedures

that were developed to accomplish the intended program for undergraduate college students at

CSUSB. The process evaluation created allows for the sustainability of the program and

therefore further develop it if need be. The outcome of the process evaluation can assist in the

full implementation of the program among all undergraduate college students in the following

quarters to come. This report reviews and assesses each area of the program to ensure that all

goals and objectives are being met. If there are areas of concern that require further adjustment to

better meet the objectives, the necessary adjustments can be done and advance the program as

efficiently as possible. The evaluators demonstrated the initial target population and what the

appropriate needs needed to be taken into consideration and therefore applied towards this

program. The needs of the population were presented to second year graduate students also as

part of process evaluation and identify if there is still a need for such a program. After feedback

was collected and analyzed the recommendations and suggestions were taken into account to

help better tailor this program and serve this population in the most efficient way.

Mission statement:

The mission of our program is to empower college students at California State University, San

Bernardino to make healthy and informed decisions about their relationships through our healthy

relationships course. Having a healthy relationship can also affect a person’s physical, emotional,

and mental health, therefore this program’s mission is an aid of enforcement for all CSUSB

students to have healthy relationships and overall well-beings.


SMART goals and objectives

Objectives of this program:

1. To spread awareness among undergraduate students about dating abuse.

2. To build skills and develop knowledge for distinguishing healthy relationship from

unhealthy relationship among students.

3. To strengthen self-efficacy among students for behavioral change so that they can

effectively handle the unpleasant situation in their relationship.

SMART Goals:

S: All undergraduate students at California State University, San Bernardino.

M: To increase knowledge by an additional 15% about dating abuse and unhealthy

relationships in the overall undergraduate student population.

A: Educational Curriculum on warning signs of dating abuse and key components of healthy

relationship is included as general part of the course. Students are required to participate

in pre and post surveys to complete the course.

R: Knowledge and Self Efficacy of students is built about dating abuse.

T: The program was started on October 1st, 2017 and completed by December 31st, 2018.

SMART Goals is an effective tool for setting up and defining the program objectives. It

provides more clarity, focus, and encouragement for the achievement of the program goals. The

program has a specific set date of completion for the facilitation of the goals and objectives to be


Program design and implementation

a. Needs assessment.

i. Target population

The target population for this program includes all of the undergraduate California State

University San Bernardino college students. Target population being targeted includes males and

females during their first and second year of undergraduate studies at California State University,

San Bernardino. The first graph provided below demonstrates a visual representation that

according to data collected from California State University, San Bernardino as of 2016, the

overall student population at California State University consists of 39% males and 61% females

(Facts and Stats CSUSB, 2017). As a result of higher population rates of undergraduate college

students attending CSUSB as displayed below in graph number two the decision to focus

primarily on undergraduate students was unanimous (Facts and Stats CSUSB, 2017).

Graph 1: California State University, San Bernardino Overall Student Population as of 2016

Graph 2: California State University, San Bernardino Education Demographics

This target population was also chosen due to undergraduates having to take required

general education courses. The implementation of a healthy relationship curriculum at California

State University, San Bernardino that educates undergraduate students is a key determinant to

solve the knowledge deficit currently occurring in undergraduates that is necessary to be able to

distinguish between an unhealthy relationship and healthy relationships. The implementation of

the course would be opportunistic if included during their academic career as a general education

course. This course would increase their awareness on how to know when they or someone they

know is in an abusive relationship. Implementing the course would also allow for a strong

development of social support networks which are key determinants as they help establish social-

emotional development necessary to have a positive and rewarding relationship with others.

ii. Needs assessment

The first type of needs assessment for the target population is “expressed needs

assessment.” According to the Centers for Disease Control and Prevention, the treatment of

injuries by domestic violence adds up to more than $4 billion annually (CDC, 2017). Among

college students 58% of college students say they do not know what to do to help someone who

is a victim of dating abuse (Break the Cycle, 2014). The rate of young adults who experience

some form of physical or sexual violence is 1 in 3 (Love is Respect, 2017). Implementing the

curriculum would help to decrease the overall total yearly amount of money spent on domestic

violence cases. While at the same time, improve the knowledge of undergraduate college

students so the rates of domestic violence rates also decreases among college students at CSUSB.

The second type of needs assessment that is used for this program is “relative needs

assessment.” Domestic violence or Intimate Partner Violence (IPV) does not solely occur in

heterosexual partners but also in lesbian, gay, bisexual, and transgender relationships. According

to the CDC’s National Intimate Partner and Sexual Violence Survey (NISVS), there is a higher

prevalence of lifetime experiences of Intimate Partner Violence (IPV) among bisexual women

than heterosexual women (CDC, 2017). One study that used a representative sample estimated

that 26.9% of gay men had experienced IPV in their lifetimes and 12.1% had experienced IPV in

the past year (Brown & Herman, 2015). This demonstrates that domestic violence and intimate

partner violence has no exceptions or discrimination against any type of relationship and the

need for a curriculum can impact every type of relationship and work towards decreasing the

yearly domestic violence health cost. Since the program covers all types of relationships equally

it is vital to include the use of a relative assessment, so that barriers such as the ones provided by

the CDC can be overcome and reduce the rates among undergraduate students at CSUSB.

b) Program purpose and rationale

The purpose of the program is to increase knowledge and awareness among undergraduate

students of CSUSB on how to distinguish what constitutes a healthy relationship, while identifying the

key markers of an abusive one. The rationale of the program is to build confidence among students to

say “No” to an unhealthy relationship. Also, to cultivate feeling of personal well-being which will keep

the individual alerted and motivates them to safeguard themselves from unhealthy relationship.

A review of related literature has been conducted to draw comparison, and further justify

the necessity of the proposed program. A cross-sectional study conducted on university level

students garnered their beliefs and attitudes regarding dating abuse, and sought to determine if

they could self-identify themselves as recipients or perpetrators of abuse. The study hypothesized

that a majority of students would fail to realize if they were recipients or perpetrators within an

abusive dating relationship; it concluded that initial speculation was correct and that 1 in 4

college students were involved in a physically abusive dating relationship but 85% of them failed

to self-identify as such. This is demonstrative of the need for a general education course geared

towards educating students about the various degrees of dating abuse, and arming them with the

knowledge necessary to adequately identify if they are involved in one.

From a mid-size university in Northwest Pennsylvania, a total of 1,530 upper level

undergraduate students were selected for this study. The demographics of the study included a

majority white students (89%), male and female, between the ages of 18 and 25 years who had

been in one or more dating relationships at least 1 month in length, and identified as


Data was collected and measured using in person surveys, specifically The Dating

Relationship Profile (DRP); a 42-item survey designed to obtain demographic/ descriptive

information, current dating relationship status, length/ intensity of current or most recent dating

relationship, beliefs about the acceptability of the use of abusive behaviors in dating

relationships, and self-identification of current and past participation in an abusive dating

relationship. The DRP did not include the terms “abuse” or “abusive behavior”, as to allow

participants to draw from their own personal beliefs and perceptions. (Miller, 2011) The Conflict

Tactics Scales 2 (CTS2), was also used; a 64-item survey instrument designed to obtain data

about conflict negotiation and the use and receipt of abusive behaviors in dating relationships,

with 22 of the items addressing physically abusive acts. (Miller, 2011)

Results from DRP saw that regarding self-identification rates: 10% of the total participation pool

identified themselves as past recipients of physical abuse, and 4% as past perpetrators (Miller,

2011). Data for the acceptability of abuse saw that 26% of participants believed abuse was

common in a dating relationship, but over 95% of participants agreed that abuse was not normal,

effective, or appropriate. Chi-square analysis saw that males were more likely to believe that

abuse was effective, appropriate, acceptable, and a necessary means of conflict resolution in a

dating relationship. Results also found much reciprocity in that 72.8% of abuse perpetrators were

also defined as recipients and 71.3% of the abuse recipients were also defined as perpetrators

(Miller, 2011). This parallel, as well as all findings of this study, attest to the need for general

education courses regarding dating abuse be mandated to university level students. At this stage,

college students have skewed perceptions and beliefs as to what constitutes a healthy versus an

unhealthy relationship; the implementation of a course embedded within their academic

curriculum would not only counter this, but drastically lower the prevalence of dating abuse

within this target population.

c) Theoretical justification

The Health Belief Model helps to understand and explain the behavior of individuals.

This model gives a form on an explanation of why an individual might behave in a specific way

and their attitude of why they might have turned towards that behavior. According to the

University of Twente, this model was first used in the year 1950 by the psychologists

Hochbaum, Rosenstock and Kegels (University if Twente, 2017). The different concepts that

construct the Health Belief Model are: perceived susceptibility, perceived severity, perceived

benefits, perceived barriers, cues to action, and self-efficacy. The following model is a depiction

of how each of the elements of the Health Belief Model are integrated for this program:

The elements of the health belief model are integrated in the healthy relationships

program by improving participant knowledge and self-efficacy in regards to dating abuse. Under

individual perceptions, it helps undergraduate students know the perceived susceptibility and

barriers that they might encounter as they learn about unhealthy relationships or dating abuse.

The modifying factors would be demographics which are things that are not as easily changed

for the target population unless elements such as perceived threat or a cue to action are used. The

last elements of this model are the factors such as perceived barriers or benefits that might

differentiate between the student taking action from their gained knowledge or self-efficacy

through this program.


d) Map determinants to theory

Knowledge and self-efficacy are the two key determinants of the program. Knowledge

would help to solve the information deficit prevailing among the students and help them to

distinguish between an unhealthy versus healthy relationship. At the same time including

knowledge regarding domestic violence and intimate partner violence will allow for

undergraduate college students at CSUSB to expand their knowledge and will further help

answer possible questions that students may have. Increasing knowledge will also help to

promote undergraduate college students to develop beneficial and rewarding relationship with


Self-efficacy is another very important determinant of the program as it motivate students

to take step toward personal safety and well-being. Self-efficacy will help undergraduate college

students at CSUSB to understand the implications of domestic violence or intimate partner

violence and gain confidence to take action on their health. By having confidence built up

undergraduate college students at CSUSB will also be able to promote healthy relationships and

well-being among themselves, family, and friends or in general to anyone in need of help

regarding a healthy relationship or unhealthy relationship.

e) Program description

This is portion of the program was designed to promote healthy relationships and to

reduce dating abuse among the undergraduate students of CSUSB. The program was based on

the researchers which say that more than half of the students (57%) find difficulties in

identifying the dating abuse (Break the Cycle, Inc., 2005). Henceforth, we have developed the

intervention after conducting multiple meetings with the stakeholders and the group members.

Thereafter, we have created a two-minute “Public Service Announcement” to show students

what dating abuse looks like.

In this quarter, we also created an educational video which covers information about the

different types of dating abuse, what makes the people stay in the abusive relationship, how to

identify if their relationship is healthy and what they can do to build a healthy

relationship. Under each heading we discussed the following information:

 Type of Dating Abuse:

1. Physical Abuse: Any intentional and unwanted contact with you or something

close to your body.

2. Emotional/ Verbal Abuse: Includes non- physical behaviors such as threats,

insults, humiliation, excessive texting, intimidation, stalking.

3. Sexual Abuse: Any action that pressures or forces someone to do something

sexually they don’t want to do such as oral sex, rape, restricted access to birth

control, stealthing.

4. Digital abuse: Use of technology such as for texting and social networking to

bully, stalk, harassment or intimidation of the partner

 What makes the people to stay in abusive relationships?

1. Conflicting emotions

2. Pressure

3. Distrust of adults or authority

4. Reliance on the abusive partner

 Methods to identify their relationship is healthy?


The students were asked to evaluate their relationship by asking the following question to

yourself like

1. Is this what I deserve in a relationship?

2. Is this healthy for me and for my well-being?

3. Is this kind of the partner that I deserve?

 What can be done for building the healthy relationship?

1. Communication is a key part to build a healthy relationship.

2. Find the right time to talk to your partner, when you and your partner are calm,

not distracted.

3. Try to talk face to face and avoid talking about serious matters or issues by

writing, as talk over email, text message, letters can be misinterpreted.

4. To be honest in your relationship. Sometimes the truth hurts, however it is key to

a healthy relationship.

5. Apologies when you make mistake instead of making excuses. This will help in

strengthening your relationship.

In our program, we incorporated all the above-said information so that student would develop

knowledge to identify unhealthy relationship and build self-efficacy to avoid such unpleasant

situations. It will improve their knowledge and spread awareness. This will ultimately help in

reducing rate of domestic violence among students.

f) Implemented changes

Implemented changes for the video project portion of this program as recommended by

the stakeholders were to add a content warning message before the initiation of the video, a

portion of the text messages was too fast and not legible, adding more emphasis on the resources

provided, changing the background music to a more neutral tone, and the voiceover was weak.

These changes to the video project were not done due to time limitations for this Winter 2018

quarter. All changes will be made during the Spring 2018 quarter. The only recommended

change that will not be done is the voiceover. The program is of serious matter and therefore

must have more of a neutral voice over rather than a more enthusiastic tone.

Program Evaluation

a. SWOT analysis

Strengths Weaknesses

· Gender inclusive · No evidence based curriculum created or

· We are improving the knowledge of the found to teach the course.
students and innovating their inner resources so · We do not have any pre- or post to evaluate
that they can cope with possible situations by our program.
increasing self-efficacy. · We have not mentioned sample size and
· Using theory of planned behavior to form the design of the program.
program. · Add graphic content disclosure

Opportunities Threats

· We can help impact domestic violence rates · Dropouts

and more specifically to all groups. · No set curriculum, no grade scale, no textbook,
· Stakeholders want to see innovative things no syllabus (students failing)
· Openness to the program

SWOT analysis for this program helps understand and distinguish the strengths,

weaknesses, opportunities, and threats. Each portion of the analysis helps to specify and

objectivize the project by identifying the external and internal factors that are favorable and

unfavorable for this program. The table below encompasses the strengths, weaknesses,

opportunities, and threats relevant to the program created. The programs biggest strength is that

the program is gender inclusive and will impact on a larger scale the amount of undergraduate

college students at CSUSB. The biggest weakness perceived is that there is yet an evidence

based curriculum developed that can be implemented into the program proposed. Having a

SWOT analysis created will help to further develop and capitalize on the programs strengths and

help to overcome the weaknesses in the future continuation of this program.

b. Process Evaluation

i. stakeholder evaluation

The comments and suggestions were from the second year Masters of Public Health

students. They filled out a health education product review rubric. For message the average score

given was: message was present but not consistent throughout the video. For content: video

appeared to contain factual information but not verified. For purpose: video mostly tries to

motivate, there is evidence of use of theoretical framework. For target audience: all ideas apply

to the lives of target audience. For creativity and originality: video includes interesting ways of

presenting original idea or message but is used inconsistent throughout the video. For audience

response: presenters were able to answer audience questions easily and shows teamwork. The

overall score for our video project was 66 out of 90 points.


ii. Description of the process used to design the program

This program was designed by first identifying a need that all undergraduate students

share at California State University, San Bernardino. We identified the need for healthy

relationship education through our research and we found that more than half of all college

students (57%) say it is difficult to identify dating abuse (Break the Cycle, 2005). We then

identified what the intervention program would be, the stakeholders involved, and how the

program would be implemented. We then created a one-minute public service announcement to

show students what digital abuse looks like. During this quarter we used theories to develop our

program. We identified the health belief model as the theory for our program. The next step in

our program was to create an educational video about the different types of dating abuse to

increase knowledge and self-efficacy.

iii. Timeline

iv. Recommendations

Recommendations for our program include being more consistent on what our topic is.

We want our target audience to learn characteristics of a healthy relationship and signs of an

unhealthy relationship and dating abuse. We want to empower our students and have the

knowledge to make informed decisions about their relationships. To address content we can cite

in our video where our information came from and add more statistics and data. To address the

purpose we will change the tone of the song to change the mood and make it more motivating for

our audience watching that even though someone may identify with some of the dating abuse

that we showed, there is help and they can be educated on next steps.

Reflection for 613:

a) Lessons learned on teamwork and time management (leadership and management skills)

One lesson I learned the hard way this quarter is time management in accordance to

teamwork. Everyone in our group has a very busy schedule both in their personal and

professional life. This type of busy schedule at one point seemed to create conflict due to

everyone having a different schedule to work with. I learned or more of reinforced that the use of

google docs was very helpful for our group. Google Docs helped us stay on track of one another

in regards to our assignments as well as helping each other out. Being respectful of everyone’s

time availability was also very important since some of us have very long commutes yet we still

managed to put in the effort to accomplish our work.

b) New tools/software/skills you learned (practical skills)

One new tool that I learned to use this quarter in this course was PowToons. I had never

used this online program. I believe it will help me in the future both professionally and

academically since there are a lot of times that in the Public Health field the requirements of

projects like the one done for this class are required. I’m glad I leaked new skills from this

program from some of my peers. Another skill that I learned was how to convert mp4s into mp3s

which were compatible with the PowToons program. I used this type of conversion for my

voiceover even though towards the end I realized that I could’ve used the program’s feature

which would have made things a lot simpler and faster.

c) New theories or concepts learned (academic skills)

One new concept that I learned during this program implementation course is pilot

testing. Pilot testing can help to see whether a program will be effective for the targeted

population. It is a way of seeing somewhat of a sample of the intended program would be yet it

might cost less money. I also believe this will help me in the work field because at one point in

the writing of grants if it is made an objective to start off as a pilot the stakeholders will be able

to see if in future years it is worth investing in that program again.

D) What other items you would like to have learned or covered in both or either course(s)

One item that I would like to have learned or covered during HSCI 613 course would

have been if there has been a specific type of pilot program that has been the most successful or

whether it all just depends on the program trying to be implemented. I believe this would be

important for any program implementation.

Reflection for 615:

a) Lessons learned on teamwork and time management (leadership and management skills)

As I mentioned for HSCI 613 I will also reiterate for HSCI 615 in regards to time

management and teamwork. This course did not require as much time outside of class to have to

work in our teams at least not in person therefore it was a bit simpler to accomplish our class

assignments. Once again the different work schedules were sometimes a factor for when we

actually did try to get together in person but we were not very successful. Once again we use

sources such as google docs to help us with our assignments. Dividing our work fairly helped us

to complete our assignments in a timely manner. A major lesson that was learned in both 613 and

615 was that communication between all of our teammates is crucial otherwise there can be

misunderstandings. Clear communication helped us achieve the tasks that were required of one


b) New tools/software/skills you learned (practical skills)

One new tool that I learned to use this quarter in this course was google slides. I never

used that form of presentation software during my undergrad time therefore to be able to work

with my team at the same time on the same presentation was fantastic. I really feel that this is

another tool that can be easily accessible and very productive for the work field. There are days

where I do not get to go into the office and are out in the field and to be able to use programs

such as this to work with the rest of the staff can help increase our productivity.

c) New theories or concepts learned (academic skills)

One new concept that I learned was process evaluation for implemented programs. For

most of the programs I’ve worked in out in the work field have mostly done summative

evaluations. Now that I know how important process evaluation is I believe it should be

implemented more often if no on any program. Another concept that I learned is how to do

SMART goals as well as create mission statements. Each of these concepts are major

components when writing grants therefore learning how to effectively use them and most

importantly how to create them I believe is very important and will help me in the near future.

D) What other items you would like to have learned or covered in both or either course(s)

One thing that I would like to have expanded during either of these courses is how to

reach hard to reach target audiences or whether they can be excluded. I have heard of different

target audiences being hard to reach and would wonder if a pilot program which is less costly

would benefit them the most to start off.





CDC. (2017, August 24). Consequences|Intimate Partner Violence|Violence Prevention|Injury

Center|CDC. Retrieved December 2, 2017, from


Break the Cycle. (2005, June 20). Retrieved March 22, 2018, from



Facts and Stats CSUSB. (2017, Fall). Retrieved March 22, 2018, from


Miller, L. M. (2011). Physical Abuse in a College Setting: A Study of Perceptions and

Participation in Abusive Dating Relationships. Journal of Family Violence, 26(1), 71–80.



615 Minimum Requirements:

a.) Minutes for all meetings relevant to 615

First Meeting-Agenda Items: Identify Health Education Program

Meeting minutes:

Location: California State University, San Bernardino

Date: 1/31/2018

Time: [6pm -9:50pm]

Attendees: Alejandra Aguilar, Brittiny Bol, Maria Lira, Stephanie Okolo

Shikha H Kakkar

Second Meeting-Agenda Items: Identify Health Education Program

Meeting minutes:

Location: Panera Bread Restaurant, Chino Hills

Date: 2/16/2018

Time: [6:30pm- 8:30pm]

Attendees: Alejandra Aguilar, Brittiny Bol, Maria Lira, Shikha H Kakkar

Third Meeting-Agenda Items: Worked on Powtoons Presentation

Meeting minutes:

Location: California State University, San Bernardino


Date: 3/3/2018

Time: [10am- 1pm]

Attendees: Alejandra Aguilar, Brittiny Bol, Maria Lira

Fourth Meeting-Agenda Items: Need Assessment & Powtoons Presentation

Meeting minutes:

Location: California State University, San Bernardino

Date: 3/5/2018

Time: [7pm-10:30pm]

Attendees: Alejandra Aguilar, Brittiny Bol, Maria Lira, Shikha H Kakkars


Group Text Conversation Minutes:

Week 1 60 minutes

Week 2 60 minutes

Week 3 60 minutes

Week 4 60 minutes

Week 5 60 minutes

Week 6 60 minutes

Week 7 60 minutes

Week 8 120 minutes

Week 9 120 minutes

Week 10 300 minutes

Week 11 350 minutes

b.) any graphs, tables, figures relevant to 615


613 Minimum Requirements:

a.) Minutes for all meetings relevant to 615

First Meeting-Agenda Items: Worked on Powtoons Presentation

Meeting minutes:

Location: California State University, San Bernardino

Date: 3/3/2018

Time: [10am- 1pm]

Attendees: Alejandra Aguilar, Brittiny Bol, Maria Lira

Group Text Conversation Minutes:

Week 1 60 minutes

Week 2 60 minutes

Week 3 60 minutes

Week 4 60 minutes

Week 5 60 minutes

Week 6 60 minutes

Week 7 60 minutes

Week 8 120 minutes

Week 9 120 minutes

Week 10 300 minutes

Week 11 350 minutes

b.) Health Education Program (documents, pdf, link, etc.)

Program Publication on Youtube: https://www.youtube.com/watch?v=3K81-KAGRzw

c.) HSCI 612 feedback: