[The purpose of the project]
The purpose of Loudon County School System’s project is to assist in preventing and combating diabetes in Loudon County by providing age appropriate educational programs to all 5,000 plus students in all 9 schools in Loudon County. This includes the communities of Lenoir City, Loudon City, Philadelphia, and Greenback. Areas of concentration for this project will be physical activity, nutrition education, and general diabetes education. By providing informative, education programs and offering varied physical activity programs for our students and their families, we hope to improve the lifestyles of multiple generations of Loudon County citizens.
It is our belief that healthy behaviors developed in school will become lifelong behaviors. Our goal is to encourage physical fitness, prevent childhood obesity, and promote healthy lifestyles in our students and their families leading to a healthier community and reducing the risk of diabetes. In focusing on eliminating unhealthy barriers, our project will be three pronged: (1) playing for a healthy life; (2) eating for a healthy life; (3) making choices for a healthy life.
Funds from this award, if granted, will be used to complete a walking/running track at Loudon High School, which will be used by students, staff, and community to increase physical activity and improve physical fitness, reducing the risk of diabetes. This is one part of our Fitness Is Fun Initiative, which was initiated in 2008.
The Loudon County School System was one of the ten original Tennessee Coordinated School Health pilot sites. Because of the data that has been collected as a Coordinated School Health pilot site, we quickly confirmed with data what we already knew. Many of the children in Loudon County were not only overweight or obese; they were not physically fit, had poor nutritional habits, and led unhealthy lifestyles.
In 2008, under the umbrella of the system’s Office of Coordinated School Health, our district implemented a Fitness Is Fun Initiative. This is a system-wide fitness, nutrition, and wellness initiative promoting healthy lifestyles and healthy choices. Fitness Is Fun spans all grade levels and reaches out to families and the entire community. Our initiative is grounded in the belief that a comprehensive physical activity and wellness program in the Loudon County School System will improve the number of students that are not only able to meet Tennessee State Standards in Physical Education and Wellness, but they will also develop life-long healthy lifestyles. Additionally, Fitness Is Fun has a companion component that focuses on family and community education and awareness.
The system’s Office of Coordinated School Health [CSH] has taken the lead in implementing this Initiative. Our CSH office consists of a Coordinator, Assistant Coordinator, and Health Educator.
Our initiative, Fitness Is Fun, is a collaborative effort with families and community partners. Our schools serve as the central point for convening a community around all of our children’s needs. We have developed collaborative relationships with many community partners. Some of our most significant partners are: Loudon County Health Department, Health Education Alliance of Loudon County [Health Council], University of Tennessee Extension Office, Loudon County Interagency Council. These agencies provide resource materials, training programs, staff development, and educational programs related to healthy lifestyles with a focus on nutrition and physical activity. The Loudon County Family Resource Center provides parent involvement activities, nutrition classes for families, and programs for families about making healthy choices. Many community partners are involved with this Initiative, however for this proposal, letters of support from agencies that will be directly involved with this project are attached.
Background and Need
[Information about the community; statistical and census data]
Loudon County located in East Tennessee approximately 20 miles south of Knoxville, has an estimated population of 46,725. [Source: US Census Bureau]. In addition to needs and gaps typical in rural communities, Loudon County is now witness to challenges faced by sections of the country populated with different cultures and ethnic backgrounds.
The county’s Hispanic population has tripled in the last ten years. The Hispanic population migrated to Loudon County to work as laborers at the mushroom plant, other factories, and on farms. [Loudon County Economic Development Agency]
In 1990, only 83 of the 31,255 county residents were Hispanic, in 2000, 894 of the 39,087 residents were Hispanic; and in 2007, 1,918 of the estimated county population of 45,448 were identified as Hispanic. In 2000, the Hispanic population made up 2% of the county population, which increased to 4% of the county population in 2007. [Source: PEW Hispanic Center] Loudon County was unprepared as a community to address the language and cultural barriers created by this shift in population. The Hispanic population is at greater risk for diabetes than some other groups.
Loudon County School System has nine schools that serve approximately 5,000 students. Student body demographics: 53.5% economically disadvantaged; 66.4% Title I; 12.4% students with disabilities; 8% Hispanic; 89.1% white; 1.9% African American; .8% Asian; .2% Native American. [Source: TN Dept. of Education 2009 Report Card]
[Need for funding to support project activities]
Our community is plagued by many factors that impact the financial ability of our School System to expand and improve our physical education curriculum and programs. There is a financial crisis in our county that prevents the County Commission from allocating the needed funds to operate our system effectively and adequately. We have essentially the same tax base we did 20 years ago with today’s needs and expenses. Additionally, all of our schools are in need of major renovations or expansion. All our schools now have portable classrooms because of overcrowding. Roofs are leaking and heat/air units are so old that parts cannot be ordered to repair them. Thus, a major and extensive capital projects program, out of necessity, is handicapping any other educational program or project. Physical Education is not a critical financial concern to those who allocate the funds. It is difficult for them to understand the importance of physical education/physical activity when students are having classes in closets and there is no heat in the classrooms during the winter. Many of our schools were built about 30 years ago; one school was built about 50 years ago. All of our buildings suffer from age with little maintenance or repair. Even though our teachers and administrators recognize the need for more and better physical activity programs, it will be virtually impossible to expand or improve our program to better meet the needs of our students without funding from other sources. We cannot dedicate the funds that would be required to create a shift in our curriculum or provide the needed equipment to improve the fitness and well-being of our students. Neither can we increase the number of students that can meet or exceed Tennessee State Standards for Physical Education with conditions as they are currently without outside funding.
However, after polling the teachers and surveying parents, we found that we do have a staff and parents that are ready and willing to adopt fitness and activity based programs for the benefit of our students and their families. Project Fitness Is Fun initiated a comprehensive physical education and wellness program in the Loudon County School System to improve the number of students that are able to meet Tennessee State Standards in Physical Education and Wellness. This Initiative will improve the health, fitness, and quality of life for our students and their families through daily physical activity.
Funding from this grant will support project activities and will expand our Fitness Is Fun Initiative by the construction of a community walking/running track at Loudon High School. This track will not become a reality with grant funding.
[Information about the burden of diabetes in county/region to demonstrate need by the target population]
In 2007, the Center for Disease Control and Prevention estimated 31.1% of the Loudon County population was obese and 10.8% of the County’s population had been diagnosed with diabetes. This is above the 2009 state and national levels for adults diagnosed with diabetes: state 10.2% and nationwide 8.3%. Tennessee ranked second highest among all states in obesity by the Trust of America’s Health and 15.8% of high school students are overweight. Loudon County BMI data indicates that 45% of our students are overweight or at risk of being overweight. Low-income preschool obesity rate for Loudon is 18.3% while the state’s is 13.5%. [City-Data.com]
The target population for the Fitness Is Fun Initiative is the entire student population of Loudon County Schools and their families. This would be 5,000 plus students and families.
However, the target population for the portion of the Initiative that is funded with Project Diabetes Program Implementation dollars will be the students attending Loudon High School and their families, students from the feeder schools, their families, and Loudon City residences. Student population for Loudon High School is 686, Fort Loudoun Middle is 383, Loudon Elementary is 454, and Steekee Elementary is 267. [TN State Report Card] Loudon City population is estimated to be 4,970 [Loudon County Economic Development Agency]. It is expected that approximately 5,000 individuals will be impacted by use of a track at Loudon High School.
The Hispanic population of Loudon County is greater in Loudon City and areas surrounding Loudon City. This is also the section of the county with the lowest socioeconomic status. This is represented by the demographics of the schools located in this area of Loudon County. Loudon High School has 686 students, with a Hispanic population of 12.8%, and 54.3% considered economically disadvantaged. [TN State Report Card] The feeder schools to Loudon High School are Fort Loudoun Middle School, Loudon Elementary School and Steekee Elementary School. The demographics for these schools are as follows: Fort Loudoun Middle has 383 students, 19.9% Hispanic, and 70.7% economically disadvantaged; Loudon Elementary has 454 students, 28.7% Hispanic, 77.8% economically disadvantaged; Steekee Elementary has 267 students, 3.9% Hispanic, 74.6% economically disadvantaged.
[How has input of the target population been included in determining the need for the project?]
It was apparent from the School Health Index, Body Mass Index, Youth Risk Behavior Survey, and parent/staff surveys that we were not providing the skills our students needed to maintain a lifetime of fitness and wellness.
Loudon County School System has taken many steps to improve the health and wellness of our students and their families. In 1999, Loudon County School System had 1 nurse for all 9 schools. Today, there is a school nurse in every school, every day. Loudon County School System has been a Coordinated School Health school system since 2001. Students in grades K, 2, 4, 6, 8 and high school Wellness Class have annual health screenings, including Body Mass Index (BMI). Almost half (45%) of all our students are overweight or at risk of being overweight. This startling number also holds true for our elementary students. In surveying our elementary teachers, it was determined that they do not think our students are meeting Tennessee State Standards in Physical Education. Teachers also observed that fewer students are able to meet the President’s Fitness Challenge today than five years ago.
The emphasis in our system, as with many others, has been core academics. Couple this with budget cuts and Physical Education and Health Education fall by the way side. One rationale has been that students will be physically active at home, especially younger students. In today’s world, this is not the case. Television, video games, and other sedentary activities occupy their time. Also, today’s life style is not generally conducive to healthy, balanced meals. Many families opt for “fast food” and other unhealthy, less nutritious choices. It is apparent from the School Health Index, Body Mass Index, Youth Risk Behavior Survey, and parent/teacher surveys administered by our system that we are not providing the skills our students need to maintain a lifetime of fitness and wellness.
Healthy School Teams are active in all 9 schools. The School Health Index [SHI], developed by the Center for Disease and Prevention Control, has been completed at all schools and is reviewed and updated annually. Based on these indexes, all schools have implemented programs relating to student wellness.
The Youth Risk Behavior Survey is administered in our high schools and middle schools every other year. It is interesting to note that the percentage of students with a perception of being overweight is less than what the BMI data suggests. On the 2008 Youth Risk Behavior Survey, only 30% of the students considered themselves as overweight. However, the BMI data indicates that approximately 45% of our students are overweight or at risk.
Program Goals and Objectives
The Fitness Is Fun goal is that Loudon County Schools will decrease the number of children and adolescents that are overweight by providing programs and services to our students, parents, and faculty with a focus on healthy lifestyle choices, which includes increased physical activity and improved nutrition. This incorporates the Healthy People 2020 goals: (1) Nutrition and Overweight and (2) Physical Activity and Fitness. All objectives, activities, and strategies in this Initiative will contribute to diabetes prevention or delay of the onset of the disease.
1. By June 30, 2011, the number of children measuring overweight will decrease by 1%, as determined by the annual BMI scores. 45.4% of the students were measured as overweight or at risk in Loudon County Schools in 2008-2009. [Adapted from Healthy People 2020 Objective, NWS HP2020-5]
1.1 Annual BMI will be completed by Healthy School Teams and CSH staff in grades K, 2, 4, 6, 8, and Wellness high school class by December 2010.
1.2 A Healthy lifestyle awareness campaign for students and parents will be implemented by the CSH staff. This will be on-going and be available on the CSH webpage.
2. By June 30, 2011, the number of Loudon County students exceeding 90 minutes a week will increase by 80%, as determined by student fitness/activity logs and teacher observations.
2.1 Elementary and middle school students meet this objective. Activities and programs will be implemented to encourage high school students to increase their weekly physical activity to 225 minutes. Assistant CSH Coordinator will monitor this data monthly.
2.2 Installation of the Outdoor Fitness Center by January 2011 to increase student participation. CSH Coordinator will be responsible for overseeing the installation and training of teachers.
2.3 Construction of community walking/running track at Loudon High School to increase student and community physical activity programs. The Assistant CSH Coordinator will work with all appropriate finance and purchasing departments to assure completion of the track by the Spring of 2011.
3. By June 30, 2011, the number of Loudon County students and adults will increase the proportion of trips, 1 mile or less, made by walking will increase by 25%, as determined by self-reporting, fitness logs and annual Mile Run data. [Adapted from Healthy People 2020 Objective, PAF HP2020-10]
3.1 Healthy School Teams and PE teachers will be responsible at the school level for the successful completion of this objective. The data will be submitted to the Assistant CSH Coordinator to compile for all quarterly and annual reports.
4. By June 30. 2011, the number of adolescents that meet current physical activity guidelines for aerobic physical activity and for muscle-strengthening activity will increase by 25%, as determined by the YRBS, Mile Run, and teacher assessment. [Adapted from Healthy People 2020 Objective, PAF HP2020-7]
4.1 The PE teacher will be responsible for the Mile Run and other fitness assessments and for collecting data on the school level and submitting to the CSH office. The PE teacher will be responsible for submitting data quarterly to the CSH office.
5. By June 30, 2011, our schools will increase access to their physical activity spaces and facilities for all persons outside of normal school hours by 80%, as determined by community surveys, sign-in sheets, and self reporting measures. [Adapted from Healthy People 2020 Objective, PAF HP2020-6]
5.1 Completion of the community track will provide Loudon city with opportunities not previously available to the community. There is no existing track on the school campus or in the area. See 2.3.
6. By June 30, 1211, the number of Loudon County students who have benefited from nutrition education will increase by 90%, as determined by the number of nutrition classes taught and the number of students present.
6.1 The Health Educator is responsible for overseeing and implementing nutrition classes. This is on-going.
The time-line for key activities and responsible staff are noted in the previous section.
Community partners are well established and letters of support are attached to the proposal.
Because our Fitness Is Fun Initiative began in 2008, we have already implemented several of our programs and activities and they are now fairly sustainable as a result of community and family support. We took a three year approach to our Initiative. Our target population in year one was elementary students, year two was middle school students, and year three (this year) is to be focused on high school students.
In year one, elementary students exceeded the required 90 minutes per week of physical activity. They increased their number of minutes to 150 minutes per week. In year two, middle school students increased their number of minutes per week to 225. This year the high school students are targeted to increase their minutes of physical activity per week to 225.
This was accomplished by walking programs established at each elementary school. Girls on the Run program has been introduced into the elementary schools by the Health Educator. This program combines running with self-esteem and healthy behavior lessons. As the result of a successful Federal PEP grant, we were able to provide additional physical activity equipment, programs and professional development for teachers. We have introduced the SMART program into our kindergarten classes. SMART (Stimulating Maturity through Accelerated Readiness Training) is a researched-based neuro-stimulation program of K-2 foundational skills developed by the Minnesota Learning Resource Center. It operates on the premise that certain physical activities stimulate specific areas of the brain and promote learning. Significant attention is paid to gross and fine motor activities.
TAKE 10, a curriculum tool created by teachers for teachers and students has been implemented in our elementary schools by the health educator. It integrates academic learning objectives with movement and the age-appropriate physical activities can be completed in 10 minutes.
Michigan Model Health Curriculum has also been introduced into our schools by our health educator, who is a certified Michigan Model trainer. This curriculum facilitates interdisciplinary learning through lessons that integrate health education into other curricula.
Energizers, a classroom based physical activity program and the State of Tennessee Office of Coordinated School Health’s Physical Education Handbook have also been introduced into the classrooms.
Fitness activities beyond the traditional school sports are being identified to encourage a broader interest and participation. All school PE classes have Wii Fit programs, some schools offer line dancing and roller skating in their PE classes. Outdoor Fitness Activity Centers were installed on all elementary campuses in year one. These were created by Beanstalk Journeys and include a low ropes course that can meet the need of all children in our system, including those with special concerns. Year two witnessed Outdoor Fitness Activity Centers for the middle schools and middle school students are now reaching 225 minutes per week of physical activity. These Outdoor Fitness Centers include both aerobic and anaerobic exercises. They provide the opportunity to increase cardiovascular health endurance, muscular endurance and strength, flexibility, and improve body composition.
We are now in year three and the emphasis is on high school students. However, we have not completely ignored the needs of the high school students since we began implementing our Initiative. Our high school students have participated in the Go Trybe-Tennessee program since January 2008. This is a computer –driven, internet-based program developed by Olympic trainers, physical education experts and certified nutritionists. It has four components: physical fitness, nutrition, wellness, and motivation. It has been useful in helping high school students meet the state mandated weekly 90 minutes of physical activity.
Get With It is another program that is for the women in our community. This program offers free fitness and nutrition classes and wellness workshops and is held at Loudon High School.
With the other components of our Fitness Is Fun in place and established, we will now focus on the high school students. It is a little more challenging to engage young adults in physical activities when their behavior patterns have already been established. Again, we will be installing an age appropriate Outdoor Fitness Activity Center on the high school campuses, which are made possible by the PEP grant.
The staff in the system’s office of Coordinated School Health will be responsible for this project. No new positions are requested. The expected workload for this project is consistent with current job duties already established and related to the broader Fitness Is Fun Initiative. We rely heavily on community partners to supplement and support our efforts to reduce obesity, increase physical activity, improve nutrition, and consequently reduce the risk of diabetes. Biographical sketches are attached to this proposal. The Health Educator, Melisa Fuhrmmeister is responsible for the nutrition lessons and some physical activity programs. The CSH Coordinator, Lois Snow is responsible for volunteer recruitment, community collaboration, and overseeing the entire program. The Grants Coordinator/Assistant CSH Coordinator, Kathy Proaps is responsible for grant administration and overseeing the specifics of the project.
This project is part of our Fitness Is Fun Initiative. Evaluation pieces include an independent evaluator at the University level. For the past 5 years it has been East Tennessee State University. BMI and Mile Run data are collected annually. The YRBS is administered to middle and high school students every other year. However if permissible, we can pull the YRBS questions relating to physical activity and nutrition and survey students annually. Physical Activity/Physical Education minutes are logged at each school for each student. Teachers also identify the types of activities that were participated in to log the minutes. These are submitted to the CSH office every grading period. We also administer annual parent/community/student surveys that we use to help direct us when developing programs for our schools and community. We have an Advisory Council made up of school personnel and community partners that provide support, resources and direction.
We are happy to share our Fitness Is Fun Initiative. Any part or all of it can be used by other systems as is or can be easily adapted to meet their individual needs.
If funded, our most challenging barrier will be the completion of the Community Track in Loudon by June 2011. Many of the barriers that are typical when attempting to change attitudes and behaviors have already been identified and are being addressed.
If funded, we agree to submit success stories from project participants.
This project funded by the Project Diabetes Program Implementation Grant will allow for a community track to be built on the LHS campus. Loudon High School and its feeder schools have a high percentage of economically disadvantaged families. This is the area of the county that also has the greater Hispanic population. There are few opportunities in this community for programs that offer and encourage physical activity. The track will be used by all high school students and will also offer opportunities for the lower grades to utilize it. This will be a community track to encourage walking and running to adults in the community as well as students. There will be no cost for use by the community. Our schools are our centers for community and family. A community track offers families a way to develop healthy lifestyles and togetherness.
Loudon County School system employs approximately 650 people and manages a 38 million dollar budget. The system is responsible for funding from various sources, such as local, state and federal governments, as well as state and federal grants. Our system offers many programs in addition to teaching core academics. We have a school nurse in every school. We have had a Coordinated School Health program since 2001. Our CSH office has expanded from a CSH coordinator to include an assistant coordinator and a system-wide health educator. The health educator was employed in 2007 after surveys, focus groups and the CSH evaluation identified a significant need for such a position in our system.
Current programs focused on diabetes prevention are presented by the school nurses and the health educator. We have several on-going educational programs related to obesity, physical activity, nutrition, and diabetes prevention in all grade levels.
The health educator is a certified Michigan Model Health curriculum trainer and TAKE 10 physical activity program trainer. She has conducted professional development in both Michigan Model and Take 10 for the last two years. These programs have been implemented in our elementary grades and Michigan Model is being introduced into the middle school.
Loudon County Schools Office of Coordinated School Health spearheaded the Fitness Is Fun Initiative and the CSH office is currently overseeing and administering a federal Carol M. White PEP grant of approximately $500,000. The focus of this grant and the Fitness Is Fun Initiative is overcoming barriers to good health by increasing physical activity and improving nutrition. Part of our focus has been student and community awareness of diabetes. The CSH office has been responsible for distributing diabetes education materials at all schools and community functions. Healthy Habit Hints, which include information on healthy weight, diabetes prevention, physical activity, and improved nutrition, are electronically sent to the schools to include in their school newsletter.
The system’s CSH office has an annual independent evaluation as required by the TN Department of Education Office of Coordinated Health. Additionally, there is an active staff coordinating committee, healthy school teams, and a community advisory council that offers assistance to the CSH staff.
The Coordinated School Health staff: Lois Snow, CSH Coordinator; Melisa Fuhrmeister, Health Educator; and Kathy Proaps, Grant Coordinator/Assistant CSH Coordinator will be charged the responsibility of administering this project. Their background information is attached to this proposal.
Kathy Proaps is the primary contact for this program. A few of the grants that Kathy has monitored and coordinated are the federal Carol M. White PEP grant, the state Coordinated School Health grant, a federal 21st Century Community Learning Center grant, several state Lottery for Education: Afterschool Program grants, a federal COPS grant, and a state Character Education grant. Several of the grants required a match. The Loudon County School system has a budget manager that works closely with Kathy to manage all grant related funds. Loudon County Government has a centralized accounting system that is responsible and accountable for the accuracy of all funds and budgets. This includes Loudon County School system’s budgets. Kathy will be responsible for all data collection and reporting. The CSH staff and healthy school teams submit all relevant data and activities to Kathy Proaps on a monthly basis. As the grants coordinator, she has had the responsibility of collecting appropriate data, completing required reports and managing several active grants at once.
The CSH staff all work well with community and statewide partners. All are members of various boards and task forces that focus on the health issues of Loudon County and the state. All are members of the Rural Health Association of Tennessee; the TNCEP/CSH Advisory Committee; the Loudon County Teen Pregnancy Task Force; the Loudon County Substance Abuse Prevention Coalition; the Loudon County Interagency Council; the Tennessee School Health Coalition; and have previously been members of the Loudon County Health Council, [HEAL].
The majority of Project Diabetes Program Implementation funding would be used for the construction of a walking/running track at Loudon High School. This will enhance the physical activity opportunities for the students and community in that section of the county, where there are few resources to encourage physical activity. All staff orientation or training will be conducted by the Health Educator or an expert in the area of professional development.