The Research

Introduction

East Price Hill is a neighborhood located two miles west of downtown Cincinnati. As of the most recent census, East Price Hill has 15,340 residents, of whom 52% are white, 38% are black, and 7% are Hispanic.1 The median family income is $30,896, which is 10% less than the median in Cincinnati ($34,116) and 36% less than the median in Ohio ($48,308).2 Eighteen percent of residents over the age of 25 have earned a college degree, compared to 31.5% for the city of Cincinnati and 25.2% for Ohio as a whole.1,2 The life expectancy for residents of East Price Hill is 70.8, which is nearly 6 years less than that of the average Cincinnati resident (76.6 years).1
Our community partner, Santa Maria Community Services is a non-profit organization that focuses on providing the Greater Price Hill area with resources to promote healthy living, strong families, and neighborhood revitalization. Their services target Hispanic/Latino populations and reach over 3,000 individuals annually. Santa Maria’s offerings include a youth development program, workforce development program, health and wellness program, early childhood development/parenting programs, and international welcome center.3

Determinant of Health

Representatives of Santa Maria informed us that nutrition is an area of wellness that still needs to be addressed in the East Price Hill community. This observation is consistent with recent studies in the region. For example, the 2013 Greater Cincinnati Community Health Status Survey found that only 19% of adults in Price Hill felt they ate the recommended daily amount of fruits and vegetables, and 50% reported eating fast food at least once per week.4 Our group conducted a focus group with parents of students at Roberts Academy to learn more about the needs of East Price Hill residents with respect to knowledge about the availability and preparation of healthy foods, in addition to barriers to accessing these items. Based on their responses, our group decided to focus on the impact of education and family assets on balanced, healthy eating as our determinant of health.

Service Learning Objectives

1. Develop an effective educational curriculum geared toward students in grades 4-8 2. Educate student participants on healthy eating, drug use prevention, and drug safety

Methods

Working with Santa Maria on ways to engage the community to address our determinant of health, we were put in contact with Daniel Minera of Amigo Ministries and an after-school program, Price Hill Champions, at Roberts Academy. The existing program combined soccer skills training with character building lessons for 4th-8th graders at the public school. Mr. Minera wanted to expand the program to include nutrition and drug use prevention lessons because he observed that students seemed to be lacking adequate exposure to these topics through the curriculum at Roberts Academy. Due to our last semester of work assessing nutritional knowledge and access in East Price Hill, we thought working with Mr. Minera to develop a targeted curriculum would provide a great means of designing an intervention that could impact its audience relatively early in their lives and thereby foster the development of lifelong habits conducive to sustainable nutritional health. By expanding the scope of the after-school program’s curriculum to include information on the negative health consequences of substance use, we hoped to augment the potential impact of the curriculum on the health of these students, surpassing the initial goals for our service-learning project.

Through meeting with Mr. Minera, we gained a sense of what he wanted to be included in the curriculum. He felt that there were no existing curriculums that met the educational needs of his students and wanted a new curriculum that could be meshed with the extant character-building and soccer skill provisions of Price Hill Champions. The program runs for two days a week over six weeks. The general schedule each day was to be an after-school snack, followed by a nutrition lesson for 15 minutes, drug prevention lesson for 15 minutes, soccer skills lesson for 45 minutes, and finally dinner with a talk on character traits. Mr. Minera was very open to what we thought would be best to teach them in each lesson, as any education on these topics would be better than none.

From there, we brainstormed possible topics to be included in the nutrition and drug use prevention elements of the curriculum. We researched existing curriculums to gain a sense of the core goals to be achieved by our project. As group members discussed the potential lessons, we soon realized that our time would be better spent having one day a week focus on nutrition and one day on drug prevention. That way, we could teach a total of six 30-minute lessons for each component of the curriculum. With longer lessons, we would have the ability to incorporate fun, hands-on activities that could actively engage the students in the material. We decided to cover the following topics for each subject: nutrition – macronutrients, the USDA’s MyPlate and serving sizes, how to read a nutrition label, sugar limitation, salt limitation, and healthy food options that taste good; drug use prevention and safety – tobacco, alcohol, marijuana, hard drugs, medicine and household chemical safety, and a final day for follow-up questions about drugs. We divided up the lessons so each member of our group was responsible for researching and designing one. Each lesson was built on a template that outlined general goals of the lesson, procedures, vocabulary, and materials needed. We designed a “teachers’ manual” version and a “student lesson” version for each topic. The teachers’ manual included a procedure on how to teach the lesson and discussion topics. The student lesson included copies of activity worksheets and learning outcomes with vocabulary words. After all lessons were created, we synthesized them into a booklet with uniform format and sent them to Mr. Minera for review and input. He took care of printing booklets for students in the after-school program.

As a learning community, we decided that we wanted to help implement the lessons that we had created, so we each signed up for one day to go to Roberts Academy and teach the indicated drug or nutrition lesson. Through this involvement, we were able to observe first-hand the strengths and weaknesses of the curriculum, but, more satisfyingly, we got to see the kids engaged and excited about the lessons we taught. We were also able to administer an assessment before and after the implementation of the curriculum to assess the knowledge of students related to its topics and the impact of our teachings. The pre- and post-tests were identical and consisted of one question derived from each lesson to assess all components of the program. The questions were multiple choice and each featured five answer options.

Results
Pre-test
The 42 students who attended the first day of the Price Hill Champions program were administered the pre-test. While the pre-test was comprised of eleven questions, the responses to the question on marijunana were not considered in our data analysis due to student confusion

about the layout of the question, leading to more than one response being selected. The average score on the remaining ten questions was 27%, with a standard deviation of 17%. As there were five answer options for each question, this result is just slightly better than students selecting answers at random. The individual student performances on the pre-test ranged from 0-70% correct. An analysis of the responses by question illustrated that no single question was answered correctly by more than 50% of students (Figure 1).