University of Idaho

HS 490 Health Promotion

Interventions
Assignment 2
Name: Mason Molyneaux

Health Topic, Target (can be a primary and secondary target) and Location (must be
clearly defined): Safe Routes to School specifically with safe active travel and the
use of walking school buses. Location is McDonalds Elementary School in Moscow,
Idaho.

NAME: #1
Intervention Website Review- 15 pts.
Review a website with intervention strategies related to your topic.
Website and Link: http://www.saferoutespartnership.org/

APA citation of website: Expertise, network, and know-how. (n.d.). Retrieved April 16,
2017, from http://www.saferoutespartnership.org/

General Purpose of the Website

Directions
Safe Routes to school (SRTS) offers national support, network, and a knowledge of how to
make communities and schools safer, healthier, and more active. Their goal is to reverse the
The following pages guide you on each step of this assignment. You
decline in children walking and bicycling to schools, increase kids' safety and reverse the
alarmingwill look for trend
nationwide intervention resourcesobesity
toward childhood on web sites,
and class Some
inactivity. readings, class
of the main
notes and peer reviewed journals (Research Notes 1-3). You will pull it travel
populations they are addressing are school aged children and promoting safe active
with safe
allenvironments
together and (Expertise,
create annetwork,
evidenceandbased
know-how, 2017). on your findings
plan based
(Pulling
What did it All about
you learn Together) and include
effective references,
interventions APA format.
for your You maythe
topic? Answer
type
questions directly
below andon these
add pages but
additional it is not required. I put the
comments.
assignment in boxes to make it easier to follow but it may be easier for
- For my topic there are so many applicable interventions that can be effective. One
you to create
intervention thataI word document
think is with allfor
highly applicable thesafe
assignment components.
active travel is educational
activities. In February SRTS Moscow put on a polar walk for kids to encourage them to
Total
get out Point Value-
and walk 100 points-
to school. 20%
Rallying theof course and
students grade
the community to take part in
walking to school gets the kids out and excited about physical activity. Not only that
but it also
Website
reducesReview
the risk-15 pointsvehicle accidents and traffic congestion.
of motor
Intervention Research Readings- 15 points
- One recommendation that SRTS suggested was what they call the fire up your feet
isResearch
which Articles-Peer
an active school Reviewed
fundraiser 30 points
where schools compete against each other to
determine which school is more active.
Pulling it All Together- 35 points They then discuss different fun facts such as
walking 1,000 feet is equal to walking the length of 10 blue whales. Fun facts like that
encourage learning throughout life. School-based strategies increase physical activity
Unlike and
before, during, the other assignments
after school you
are crucial to will submit in
combatting thethis in hardobesity
childhood copy
epidemic.
in class and also on Bblearn.

Critical thinking and relation to your health promotion topic

What did you learn from the website that you can apply to your project? Organize by
answering # 1-3 below:

1) Intervention activities that are appropriate for your project, 2) Useful tools and resources,
including health education/promotion resources; 3) Other resources- give web links for at
least two other helpful resources the web page directed you to and write 1-2 sentences
about Professor
what you Helen Brown-about
was helpful Spring 2017
each site.

1- Intervention activities that could be beneficial for my project might be the fire up your
 feet campaign. I think the idea behind it encourages families, students, and schools to
work together by creating active lifestyles which inspire all children to be healthy and
physically active.

2- One tool that SRTS offers is a walkability test which helps to give insight into the
walkability of a neighborhood. Insightful questions allow the user to evaluate the
walkability of a neighborhood and the checklist provides both immediate answers and
long-term solutions to a potential problem.

A second tool is the student in-class travel tally that is filled out by teachers to record
information about how children arrive to and depart from school on any two given days
of the week. This is an important tool because it gets the teachers involved with the
SRTS process.

3- People for Bikes http://www.peopleforbikes.org/ was a direct link on the webpage and
this is because SRTS and People for Bikes have had a great national partnership that
has grown into a leading entity for active transportation an healthy community design
with reducing the likelihood of childhood obesity.

Action for Healthy Kids http://www.actionforhealthykids.org/ is a link directed towards

creating healthy schools by mobilizing school professionals, families and community
members to take action that lead to healthy eating, physical activity, and healthy
schools where kids can thrive.

Idaho Smart Growth http://www.idahosmartgrowth.org/ is a nonprofit group that helps

Idaho communities to become great places to live. The aim is to empower growth
planners, elected officials, teachers, parents, and others to create safe, healthy, vibrant
communities.

#2 Intervention Research Readings- 15 pts.

General Intervention Considerations- Answer the following using lectures and
readings. 1 paragraph for each.

1. Health Behavior Theory- Identify the theory (or theories) that is most important to
guide your intervention and discuss how that theory will guide interventions. (See
Theories at a Glance).

The theory that I associate my intervention with the most is the social cognitive theory.
This theory focuses on how people learn from individual experiences, the action of
others, and the interactions they have with the environment. One of my intended
interventions is a walking school bus and with this tool I can help instill in kids the self-
efficacy that they can be safe when walking to school, how to travel in the environment
around them making use of the sidewalks that we have, and reinforcing with positive
encouragement to make positive behavior change.

2. Spectrum of Prevention- Based on the reading from the Prevention Institute-what levels
of prevention are most important for your topic/target and location? The type/level of
change desired will direct you to types of interventions that will have the most impact.

Some of the major levels for change with my topic would be to foster coalitions and
networks. This starts with having positive interactions with the school district so that
they have a positive mindset with SRTS. This can help to develop strong membership.
A second level with importance for my topic would be promoting community education.
 Conducting parent surveys, using social media to promote walking to school days,
using new technology that allows parents to know their kids are safe while walking to
school can help with reducing the chance that a parent wont allow their kid to walk to
school because of a negative perception they might have. For example, the use of my
pivothead glasses with live streaming footage capability might help some of the
parents to be confident that their child is safe.

3. Discuss what you learned about the predisposing, enabling and reinforcing factors that
are most related to the health behaviors you are trying to change.

Predisposing Factors
Its not always easy to know what the hold up for parents is with not allowing their
children to walk or bike to school. Surveys are useful in assessing what the perceptions might
be, but even then its extremely difficult to have busy parents fill out surveys. In order to
make changes we must understand factors limit parents from sending their kids to school
walking.
Enabling Factors
I have been able to participate as the leader of a few walking school buses and I know
that the parents whose kids I walk to school greatly appreciate their children being able to
walk safely to school. This has motivated me to be the leader of a walking school bus and
promote walking Wednesdays so that kids can be active and travel to school. Sidewalks and
access to sidewalks are crucial for kids to be able to make it to school safely. As well,
McDonalds is fortunate enough to have a crossing guard there to help kids make it safely
across the street has been in my mind fundamental to success. One thing I feel needs
changed in time at McDonalds Elementary is an engineer assessment to help reduce car
congestion and traffic.
Reinforcing Factors
I am a parent and so I can relate to the community because I know the parents who
have kids going to McDonalds Elementary. School leaders such as the principal or even the
superintendent are crucial partners in this endeavor. Without their support and reason there
cant be any progress. Parent leaders who hold positions that entitle them to making
changes are also very important. Because of the unique set up we have here in Moscow and
because of the University of Idaho there are many athletes who come in and influence our
children. An athlete can make a lasting impact on a generation. An athlete coming in and
firing up the kids about physical activity could be very beneficial for years down the road
with helping kids to make smarter choices about physical activity and reducing the impact of
obesity.
 #3 RESEARCH ARTICLES PEER REVEIWED- 1 of 3
3 peer reviewed research articles needed- 1 can be a review article. You do not
need to use this box format, you can use a word doc and include the headings
below. 10 pt. each -30 pt. total
APA Citation of article

McDonald, N.C., Deakin, E., & Aalborg, A.E. (2010). Influence of the Social Environment on
Childrens School Travel. Preventive Medicine, 50(S1), S65-S68.

Participants or population reached

Surveys were conducted on 432 parents of 10-14 year olds in the San Francisco
Bay area during 2006 and 2007.

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

A cross sectional survey of parents 10-14 years old living in walkable neighborhoods in
the San Francisco area was conducted. This age group was specifically targeted
because previous research found that children in the United States begin to acquire
travel independence around the age of 10 and so it becomes easier to bike or walk to
school (Matthews, 1992). This study was interesting to me because it supported the
idea that parental perceptions of better social cohesion were associated with higher
rates of children walking to school for trips under 1 mile (Mcdonald, et al., 2010). It was
also found that social environment would limit girls walking and biking more than boys.

What did you learn about the effectiveness of the intervention?

While the intervention was effective in the parents who responded to the surveys I find
it biased that the representation is of suburban areas with high levels of diversity,
where the environment is supportive of walking. In these areas they found that other
adults were more likely to watch out and monitor for children walking to school. In
comparison to other areas that are not supportive of walking the data would not
represent the same walkability.

What they found in the study from the intervention was that there should be an
appropriate use of federal SRTS funds in encouraging informal connections among
parents and neighborhoods through non-infrastructure education and encouragement
programs (Mcdonald, et al., 2010).

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?

The social ecology model underlying much of this research suggests that multiple environments
influence behavior, yet most of the research on school travel considers demographic characteristics
and only one component of the neighborhoodthe built environment. This neglects the potential
importance of the social environment

For what were the main conclusions about the interventions reached by the author(s)
including limitations?

One of the main conclusions that the author provides is that parents are significantly more
likely to allow their children to walk and bike to school when they know other adults in the
 area will watch out and monitor for children. This correlation was strongly associated with
girls and non-Hispanic whites.

As well, while this conclusion is a strong one it can be viewed as a limitation. This is
because parents who want their children to walk to school may pre-select environments
that support this behavior (Mcdonald, et al., 2010). This can skew the results of the
intervention presented in the survey form.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

An appropriate use of SRTS non-infrastructure funds could be used towards making

connections between the parents. I have been working doing a walking school bus by
myself for a few weeks and the kids who I travel with to school love it. Branching out
and inviting more parents to be involved in the process of walking with me could open
up a broader range of availability towards walking more than once a week. With more
parents involved we could divide our time up and work towards having a different
parent walk each day of the week with the kids.

What would you need to do to adapt the intervention to fit your population and why?

The highest proportion of students walk to school when the built environment is
supportive and parents believe neighbors will monitor the behavior of children. This
finding suggests that programs that allow parents to interact and make connections
are an appropriate use of SRTS non-infrastructure funds. Potential interventions range
from assisting development of school- and neighborhood-based e-mail lists, to more
formal programs connecting families that live near each other and helping them
organize to walk their children to school.

#3 RESEARCH ARTICLES PEER REVEIWED- 2 of 3

APA Citation

Thomas, I. M., Sayers, S. P., Godon, J. L., & Reilly, S. R. (december 2009). Bike, Walk, and Wheel A Way of Life
in Columbia, Missouri. American Journal of Preventive Medicine,37(6), 2nd ser., S322-S328.

Participants or population reached:

Citizens of Columbia to use nonnotarized modes of transportation for recreation and

transportation.

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

The Active Living by design focused on two of the 5Ps of their model; programs and
promotions. Policy changes, such as activity-friendly street design standards, created
safe and attractive places for physical activity programs. A strong, diverse community
partnership supported all efforts. As a result the walking school bus program grew
rapidly resulting in improved street designs and a voter approved $3.5 million sales tax
 for sidewalks around schools (Thomas, et al 2009).

What did you learn about the effectiveness of the intervention?

One of the most important lessons they learned was to implement multiple strategies
because programs can leverage policy successes, and new policies often lead to more
funding for infrastructure. I also learned from their success that they started with early
elementary-age children instead of teenagers to build momentum on the excitement.

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?

They used a conceptual model based around a modified 5P model where programs and
promotions encourage active living behaviors. Behavior change through programs and
promotions and improvement of infrastructure using policy changes sustain and
strengthen each other.
They also used a conceptual model for stages of change of community members
moving from heavy automobile dependence to higher use of active travel.

For what were the main conclusions about the interventions reached by the author(s)
including limitations?

The discussion section focuses on the specific lessons that were learned from the
project that could be valuable for other pioneers advocating for a healthy community.
Some of the lessons mentioned in the study (Thomas, et al 2009) include:
1. targeting low-hanging fruit which means that elementary kids served as positive
role models for older children and adults to get the ball rolling with excitement.
2. Keeping the design for physical activity simple. One of the initiates the paper
discussed was that fitness challenges and documentation did not reinforce positive
behavior or encourage participation.
3. Implement multiple strategies. Multiple strategies were employed simultaneously.
Social marketing campaigns, policy and funding initiatives, and engaging for
partnership were all implemented at the same time. Because there was such a large
buzz about the WSB there became greater support and more was done.
4. Expect growing pains and gradual change. It has taken five to seven years to see
the progress that this paper discusses. One of the significant changes was a survey
conducted showing a 35% increase in bicycling among graduates.
5. Leverage innovative and unexpected opportunities. Its not easy to pull off a WSB of
this grand scale and so incentives were awarded to coordinators at schools. $500
stipends were awarded to four coordinators for managing the WSB for one semester
and for organizing a school wide event on international Walk to School Day.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

- A key success with this project and the acceptance of a walking school bus (WSB)
program was the social marketing campaign. Parents at first were resistant to the idea
of allowing their children to walk to school, but advertising delivered over a 3-year
period in print and radio advertising were factors that built awareness and trust in the
WSB program. For WSBs to take off in this area I need parent support and trust and
radio advertising and print could be pivotal factors in helping to promote the idea
(Thomas, et al 2009).

What would you need to do to adapt the intervention to fit your population and why?
 - My population that I want to impact is the children and the parents. By starting with
the low-hanging fruit as the article suggests younger children serve as positive role
models for other children and adults. Communities that focus on younger children will
have strong programs, deeper investments will be made in health awareness and
behavior, and in the end it helps to define the culture for the next generation of
teenagers (Thomas, et al 2009).

#3 RESEARCH ARTICLES PEER REVEIWED 3 of 3

APA Citation

Zhu, X., & Lee, C. (2009). Correlates of Walking to School and Implications for Public Policies: Survey Results
from Parents of Elementary School Children in Austin, Texas. Journal of Public Health Policy,30(S1).
doi:10.1057/jphp.2008.51

Participants or population reached

Parents and kids within the Austin Texas area were targeted to better understand why kids did
or did not walk to school.

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

For this intervention the study focused on surveying parents/guardians of 2,695 students
from 19 elementary schools in Austin, Texas with diverse sociodemographic and
environmental characteristics. What was unique was that they were able to better identify
positive and negative correlations for why kids did or didnt walk based on the parents
perceptions. Some of the cons for walking were associated with parents education, car
ownership, personal barriers, and school bus availability. Some pros for walking were
childrens positive attitude and regular walking behavior, and supportive peer influences
(Zhu, X, & Lee, C., 2009).

What did you learn about the effectiveness of the intervention?

The intervention focused on identifying what aspects were important to parents and
children to help support the idea of walking school buses. What they found was that
society should give a high priority to lower socioeconomic status populations and to multi-
agency policy interventions for changing the environment, making improvements with the
safety and education for both the parents and the children (Zhu, X, & Lee, C., 2009).

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?
 This study used the social ecological theory to identify three domains of correlating
walking to and from school with personal, social, and physical environment factors.
Research identified that low-income and minority children walk to/from school more often,
but they do so in environments that are unsafe that children in higher socioeconomic
status areas (Green, 2004). Barriers for the physical environment identifies long distances,
crime, and traffic danger, and pedestrian availability to sidewalks, traffic signals (Boarnet,
2005). This theory helped to identify the areas that correlate with walking to and from
school among elementary school children in diverse sociodemographic and physical
environments.

For what were the main conclusions about the interventions reached by the author(s)
including limitations?

The study identified the reasons that parents were inclined to have their kids walk or
not and it had important implications on policy interventions regarding the selection
of school locations. Another important area that was highlighted in the survey was
the importance of safety improvement as an action item for policy and environmental
interventions in promoting walking among children.

Some of the limitations were that the study was a cross-sectional study and doesnt
offer insight into the casual relationships among the variables. The samples for
conducting the surveys was not randomized and some schools had lower response
rates.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

I know that we conducted a parent survey a few weeks ago and I really like how we went
about the process. McDonalds Elementary school held a portfolio night for the kids to
show the progress they have made during the year. Parents were highly encouraged to go
and participate at the school during an allotted time 3-6pm. We as SRTS held a little booth
and encouraged parents to come into the gymnasium to fill out a survey assessing their
feelings towards SRTS and safe active travel. From what I read in the article some of their
limitations were that the sample was not completely random and a low response rate. The
way we conducted ours helped to lower the incidence of this. Im not sure how many
parents filled out the survey, but it was a well thought out idea and I felt that it was
executed well.

What would you need to do to adapt the intervention to fit your population and why?

Next time I would say suggest fine tuning our survey and using the models that the
article: Correlates of Walking to School and Implications for Public Policies: Survey Results
from Parents of Elementary School Children in Austin, Texas used. The first model
identified sociodemographic variables and the second model identified attitude, and
behavior. In the third and fourth models, the additions of social and physical
environmental variables were identified.
Pulling it All Together- 35 pts.

1. Select a performance measure target based on the Healthy People 2020

objectives or Healthy Campus 2020 as appropriate. 1 pt.

- Trips of 1 mile or less made to school by walking by children and adolescents aged 5 to
15 years will increase from 28.8% (2009) to 31.7% (2020).

Example: Youth 30 day use of tobacco will decrease from 15% to 10% by 2020.

2. Deciding on strategies for interventions 8 pt. each- 24 pts.

Educational Activities

o Organizing different events that encourage kids to walk to school. We have the
polar walk and the fill the racks event where kids are encouraged to bike to
school, however I feel like we could add more events. I have discussed the idea of
a walking Wednesday that promotes the idea of kids walking to school at least
once a week.

o Organizing bicyclist traffic safety classes to instruct and inform what the proper
hand signals are for biking. Also, its important for individuals to know their rights
on the road and how to bike on the road. This could be added to the annual
safety fair each year to have more participation.

o Pedestrian safety skills with safe walking and crossing the street. Teaching
children to ask a parent before walking anywhere without them, using sidewalks
or paths or if no paths are present using side of streets that face traffic. Its also
important to educate children about motor vehicles turning or pulling out of
driveways.

o Education for children may also benefit personal health. Health benefits usually
focus on the importance of physical activity and children are able to learn about
the cardiovascular and muscular systems and how physical activity can
strengthen them.

o Education about the environment and the impact of motor vehicle use on air
quality and limited energy resources. Children can learn that they can help keep
the environment healthy by walking and biking instead of traveling in a motor
vehicle.

Community Advocacy for safe walking environment

o Conduct Walking school bus and get different parents involved with their children
to encourage walking among friend with arent support. Five elementary schools
in Brockton, MA have had great success with their SRTS program because of the
community partners, school staff, superintendent, principals, teachers, crossing
guards, and the officials within the city of Brooklyn (Safe Routes to School Local
Stories, 2017).

o The City of Columbia hired a bicycle/pedestrian coordinator and plan to establish

a permanent department of nonnotarized transportation (Thomas, et al 2009).

o Organize community bike rides alongside the local bike shops in town to provide
new riders with a joyful and safe riding experience, and teach people safe routes
 to work/school/shopping, paired with effective cycling education. Create a
multicultural bicycling community advocated at teenagers to spend time
outdoors on a bicycle.

o One thing that was successful in the articles I read was that there was a few
classes on hand signal safety with biking (Thomas, et al 2009). This class
encouraged kids to get out and bike to school and to use the correct hand signals
when crossing streets or bicycling on the sidewalks.

o Sponsor events like Sunday Streets where the city closes downtown streets and
encourages residents to walk/bike/exercise.

Social Support systems

o Programs that allow parents to interact and make connections are an appropriate
use of SRTS non-infrastructure funds. Potential interventions range from assisting
development of school- and neighborhood-based e-mail lists, to more formal
programs connecting families that live near each other and helping them
organize to walk their children to school.
o On national fill the racks day in May encourage support from parents to ride with
their kids or have bike trains set up so that more students can ride with their
friends in a supportive environment.
o Have a SRTS bbq so that parents can get together along with the kids to discuss
walking school bus routes during the school year. The bbq could also be a time to
raise money for a raffle during the school year that would go towards water
bottles, bike locks, lights, bells, etc (Mcdonald, et al., 2010).
o Offer school- or community- based sports programs for youth bicycling and
walking (e.g. BMX, skateboard, mountain bike, road racing clubs and competitive
teams).

3. Potential for Success- 10 pts (critical thinking questions)

a.) Discuss why your intended approaches would work (e.g., how do they impact
predisposing, enabling or reinforcing factors?) Write no more than 2 paragraphs and
cite the literature you used to come up with your ideas/strategies.
One way to really encourage walking and biking at the beginning of every year might be
to use SRTS funds to promote a school BBQ with free helmet giveaways. This allows
parents to associate with other parents from the area. Parents are significantly more
likely to allow their children to walk and bike to school when they know other adults in
the area will watch out and monitor for children (Mcdonald, et al., 2010).
As I discussed with the walking school bus and starting at a young age with kids
because the younger generation are positive role models for older children and adults
and once they catch the fire with walking to school they influence not only others but
they are more likely to continue walking in the future (Thomas, et al 2009).

b.) Discuss sustainability of the intervention plan- what will help this work continue?
In order for this intervention plan to work there must be an increase in opportunities
for physical activity through increasing bicycling and walking. For example, the
overall broad-reaching policy could be to make bicycling and walking a safer and
more appealing means of transportation to get large numbers of community
members active. There should be a mix of policies like zoning, wise us of land,
completing streets, and school siting along with interventions that increase safety
and promote use of bicycling and walking.
 References
Green RS, Smorodinsky S, Kim JJ, McLaughlin R, Ostro B . Proximity of California public schools
to busy roads. Environ Health Perspect. 2004;112 (1):6166.

Boarnet MG, Day K, Anderson C, McMillan T, Alfonzo M . California's Safe Routes to School
program impacts on walking, bicycling, and pedestrian safety. J Am Plan Assoc. 2005;71
(3):301317.

Expertise, network, and know-how. (n.d.). Retrieved April 16, 2017, from
http://www.saferoutespartnership.org/

M. Matthews Making sense of place: children's understanding of large-scale environments

Barnes & Noble Books, Savage, MD (1992)
McDonald, N.C., Deakin, E., & Aalborg, A.E. (2010). Influence of the Social Environment on Childrens School Travel.
Preventive Medicine, 50(S1), S65-S68.
Safe Routes to School Local Stories: Addressing Community Needs. (n.d.). Retrieved April 03,
2017, from http://www.saferoutespartnership.org/sites/default/files/pdf/SRTS-Stories-11-4-
10.pdf
Thomas, I. M., Sayers, S. P., Godon, J. L., & Reilly, S. R. (december 2009). Bike, Walk, and Wheel A Way of Life
in Columbia, Missouri. American Journal of Preventive Medicine,37(6), 2nd ser., S322-S328.

Zhu, X., & Lee, C. (2009). Correlates of Walking to School and Implications for Public Policies:
Survey Results from Parents of Elementary School Children in Austin, Texas. Journal of Public
Health Policy,30(S1). doi:10.1057/jphp.2008.51