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0 Elysse Andrews, Breanne Baines, Aimee Burnett, Ella Chaffin, Amy Hayden, Ryder Schittone Body Acceptance Program (BAP) (Working with culturally, 2016)

Body Acceptance Program

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Elysse Andrews, Breanne

Baines, Aimee Burnett, Ella

Chaffin, Amy Hayden,

Ryder Schittone

Body Acceptance Program (BAP)

(Working with culturally, 2016)

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Marybeth GoodwinGrants Manager, Healthy LivingThe Colorado Health Foundation501 South Cherry Street, Suite 1100Denver, CO 80246-1325

Dear Ms. Goodwin:

We at Beyond the Mirror are always striving to empower and improve the lives of individuals and families affected by issues pertaining to self-esteem and healthy nutritional choices.  We offer a variety of interventional counseling services including unique art and yoga therapies.  Our staff encompasses multiple counselors, nutritionists, and eating disorder specialists who share our agency’s passion for the genuine and sustainable betterment of lives of those struggling with unhealthy eating or exercise behaviors.  Since we have found our current intervention services to be effective, we are seeking to implement additional curriculum to an existing program for high school freshmen concerning the topics of nutrition, healthy cognitions regarding exercise, and body positivity.

Research indicates that people between the ages of 15 and 20 are at the highest risk for developing disordered eating habits.  The highest percentage of all reported eating disorders are from this age group.  This makes sense when considering the social pressures and comparisons associated with puberty.  With the particularly salient focus on fitness in Colorado, there are even greater feelings of pressure experienced by adolescents going through puberty.  Without resources and curriculum available to those at this sensitive and arguably fragile age, the prevalence of eating disorders will likely only continue to grow.

Consistent with your foundation’s emphasis and passion for improving the health and wellness of all Coloradans, we believe addressing the issues of body positivity, nutrition, and healthy exercise is crucial.  With a lack of current significant access to education pertaining to body image and healthy nutrition, this poses a staggering risk for adolescents to develop unhealthy behaviors, exercise, and/or eating habits.  Similar to your organization, we hope for Colorado adolescents to become America’s healthiest of this age group.  We believe that becoming trailblazers for education pertaining to these important topics will help achieve that goal.

With our proposed Body Acceptance Program (BAP), we are confident that we will be able to increase knowledge surrounding nutrition, exercise, self-esteem, and body image for freshmen at Bear Creek High School, and potentially students statewide.  Adding education on nutrition, exercise, and body image is an essential addition to the existing peer mentoring program at Bear Creek High School.  Our proposed curriculum will offer significant information on these topics in a supportive space with opportunities for discussion, support, and activities.  In order to achieve these goals, we request a total of $5,415 for the development and implementation of this

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valuable curriculum.  If you have further questions, please feel free to contact Ryder Schittone at (999) 999-9999.  Thank you kindly for your consideration.

Sincerely,

Elysse Andrews (Outreach Coordinator)   Breanne Baines (Nutritionist)   Amy Hayden (Therapist)

Ryder Schittone (Art Therapist)   Aimee Burnett (Yoga Therapist)   Ella Chaffin (Psychiatrist)

Agency Information

Beyond the Mirror is an agency that has offered counseling services and education to the population of Fort Collins and surrounding areas in Northern Colorado since 2012.  Our counselors specialize in helping individuals who suffer from multiple forms of disordered eating and body image issues through group and individual therapy.   Our population consists of 80% females, about half of which are adolescents.  We currently serve about 15 new patients a day who are most often suffering from eating disorders, depression, and anxiety.  On average, we serve an estimated 200 clients per year.  We have 12 counselors at Beyond the Mirror as well as a number of interns and volunteers.  Our mission is to help individuals and families receive the support they need to make healthy and positive choices that will benefit their overall well-being.  We are also extremely invested in community outreach through our 501c3 non-profit program, Love What You See.  

Love What You See focuses on empowering individuals to look beyond their physical appearance and focus on the other valuable qualities that they possess.  We strive to accomplish this mission by offering services that are free or low-cost to the community.  These services include presentations on topics such as eating disorder awareness and prevention.  In 2015, we gave approximately fifteen presentations to a total audience of over 3,000 community members of all ages.  Our community outreach services are offered through educational trainings and workshops for educators, coaches, and parents in local schools, as well as other community organizations.  Similarly, Love What You See provides parental guides to help develop children’s self-esteem, positive body image, self-acceptance, and self-care.  We also partake in local Eating Disorder Awareness Week events, such as the National Eating Disorder walk fundraiser and the Mountain Avenue Mile.

Problem Statement

During adolescence, it is well known that youth will undergo bodily changes associated with puberty.  A point of concern is that during this developmental stage, it is normal for adolescents to compare themselves and their body types with peers (Carney & Scott, 2012).  This comparison increases the risk of body dissatisfaction in this age group.  Relatedly, adolescents and young adults between the ages of 15 and 20 years old have the highest rate of eating disorder (ED) emergence compared to other age groups (Carney & Scott, 2012).  While this age group experiences a significantly higher rate of eating disorders (EDs), in 2012, 1 in 5 adolescents in the United States also experienced obesity (Centers for Disease Control [CDC], 2015a).  When the CDC (2015a) included adolescents who were overweight or obese, 1 in 3 adolescents were affected.  Research also suggests that cisgender persons, and transgender males and females, as

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well as individuals who identify outside of the gender binary are susceptible to the causes of low self-esteem, EDs, and other psychological issues (Jones, Haycraft, Murjan, & Arcelus, 2016; Murray & Touyz, 2012).  Therefore, it is important to include these individuals in prevention and intervention programs.  To our knowledge, there are few resources available to individuals who do not identify as heterosexual females.  Consequently, it is pertinent to include all students in our proposed universal prevention program, which is related to unhealthy eating and body image concerns.  The educational topics of this proposed program will include increasing healthy nutrition, healthy cognitions regarding exercise, and body positivity.

When considering nutrition concerns, the CDC (2015b) found that fewer than half of the United States’ children and adolescents met the minimal recommendations for fruits, vegetables, and whole grains.  However, nearly half of youths’ total calories came from empty calorie sources such as soda, desserts, and processed foods.  In this investigation, adolescents consumed on average, between 14 and 22 ounces of full-calorie soda each day (CDC, 2015b).  By providing nutrition education to teens in the Body Acceptance Program (BAP), we hypothesize that this will increase the salience of how to select healthier options, to think about the nutritional value of their food selections, and consequently, decrease the risk of obesity.  To more thoroughly address the topic of having a healthy weight, education on effective exercising must also be discussed.

In order to reduce people’s risk of becoming obese or developing an ED, in addition to addressing nutrition, it is also important that people understand healthy ways to view exercise. Potentially healthy (e.g., “to reduce tension”) verse potentially unhealthy (e.g., “to have a good body”) motivations to exercise are included in the Exercise Motivations Inventory (Markland & Hardy, 1993, p. 2).  Related to EDs is the finding that correlations between EDs and excessive physical activity exist (Keyes et al., 2015).  Keyes et al. (2015) found that although those with EDs, those without EDs but with moderate anxiety, and healthy controls reported exercising similar amounts, the control group and those with anxiety versus having Anorexia Nervosa (AN) reported different reasons to exercise.  Specifically, those with AN emphasized improving the appearance of their bodies (i.e., amount of tone) while the other two groups (i.e., moderate anxiety and healthy controls) emphasized health and leisure as motivations (Keyes et al., 2015). In programs, focusing on healthier reasons to exercise and thoughts about one’s body have been shown to be effective at improving body image (Levine & Smolak, 2016).  Rather than emphasizing weight or appearance, an after-school program for 10- and 11-year-old females emphasized valuing the uniqueness of body shapes, mindfulness, and focused on integrating mental and physical health (Levine & Smolak, 2016).  Mental health experts and school staff engaged the participants in yoga (i.e., physical activity) and trained them in relaxation techniques in order to “cultivate mindfulness, attentive self-care, physical strength and flexibility, and emotional regulation” (Levine & Smolak, 2016, p. 40).  The healthy exercise cognitions that were emphasized in the program by Levine and Smolak were improving strength and increasing flexibility.  These data showed that those who participated in the program had significant decreases in body dissatisfaction and impulsive overeating (Levine & Smolak, 2016).

Body comparison between peers is typical in adolescents, which increases the risk of having a poor body image (Carney & Scott, 2012).  This is related to the finding that having a poor body image is a risk factor for ED development (Levine & Smolak, 2016).  Undesirable consequences of having a poor body image do not just affect those at risk for EDs; they also affect children who are obese (Food Research and Action Center [FRAC], n.d.).  The FRAC (n.d.) stated that youth who are obese are more likely to become depressed or experience

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increased levels of anxiety.  Levine and Smolak (2016) summarized the results from a program for youth which emphasized more abstract ideas such as living powerfully, inner sensitivity, accepting and appreciating one’s body, and assertiveness.  The results indicated long term effects of reducing negative self-talk and the idealization to be slim, while increasing body satisfaction and self-esteem.  These after-school universal prevention programs suggest that valuing health, strength, and self-acceptance, as opposed to weight or thinness, could help reduce risk factors and increase protective factors for EDs longitudinally (Levine & Smolak, 2016).

Needs Assessment

We are proposing adding curriculum related to the prevention of eating disorders (EDs) to a peer mentoring program that currently exists at Bear Creek High School (BCHS) in Lakewood, CO, which is located in Jefferson County.  To our knowledge there are no available data regarding the percentage of adolescents specifically at BCHS who experience disordered eating.  However, in Colorado, the eating disorder (ED) rates are particularly worrisome because in 2015, the state had the 5th highest rate of EDs in the country (Columbia Broadcasting Systems [CBS], 2015).  While pressures to be slim and ED rates increase, conversely, 1 in 5 Colorado high school students is overweight or obese (Colorado Department of Public Health and Environment [CDPHE], 2015).  As Coloradans celebrate that their state has, overall, the healthiest Body Mass Index (BMI) compared to other states, Colorado also has the 2nd highest increasing rate of childhood obesity (Schmidt, 2012; The State of Obesity, 2015).  This is likely influenced by nutritional risk factors associated with obesity, which include poor dietary choices, accessibility to processed foods, and sugary drink consumption (CDC, 2015b; Martinez, 2015). Given the high rate of EDs and childhood obesity rates in Colorado, reform of school programs to increase education on health is imperative (CBS, 2015).  Specifically, increasing high school adolescents’ knowledge and understanding of 1) nutrition, 2) healthy cognitions regarding exercise, and 3) positive body image are necessary additions to Colorado’s school curriculum.

Given that many EDs are undiagnosed and/or untreated, and Colorado has the 5th highest rate of EDs, it is likely that a significant portion of the 1,700 total students at BCHS struggle with disordered eating behaviors (CBS, 2015).  There is a variety of resources for EDs that exist near Lakewood, CO such as counseling outside of school, support groups, and facilities geared toward recovery (Eating Recovery Center, n.d.).  However, these resources typically require private insurance to which some students may not have access.  Consequently this reduces access to those without the financial capability to utilize these services (Eating Recovery Center, n.d.). Schools also have high school counselors available to support students. These counselors, however, may feel unequipped to address specific eating related concerns in the school setting (Carney & Scott, 2012).  The current peer mentoring program at BCHS consists of topics such as bullying, academic support, communication etiquette, and accessing physical and behavioral health resources (R. Schittone, personal communication, February, 2016).  The program meets 4 times per week for 25 minutes during the lunch period.  We are suggesting that we reform the existing Tuesday curriculum to educate students on nutrition, healthy exercise cognitions, as well as body image and acceptance.  Our proposed curriculum change will educate and give an outlet to discuss these issues to high school students; a population that is known to be at an increased risk of body image concerns and the development of eating disorders (Carney & Scott, 2012). This proposed peer mentoring program will reach approximately four hundred twenty-five freshmen with 50 mentors over the course of one academic school year.  Counselors at BCHS

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will work with Love What You See, the non-profit sector of Beyond the Mirror Counseling and Wellness, to educate the peer mentors and school counselors, as well as to develop a schedule for the program.  Training will take place during the week before the start of the fall semester. Every Tuesday of the academic year, freshmen and their upperclassmen mentors will meet. They will discuss nutrition, healthy exercise habits, and body image concerns.  Without resources like our proposed Body Acceptance Program, the prevalence of eating disorders and obesity will likely continue to increase.

Target Population

Our target population will be freshmen at Bear Creek High School (BCHS) in Jefferson County.  According to Start Class (2016), on average, BCHS serves roughly four hundred twenty-five freshmen per year.  BCHS is comprised of a population consisting of students who identify as 56.5% Caucasian, 29.5% Hispanic, 9% Asian, 1% Black, 1% Native American, and 2% of students identifying as mixed race.  The data are not stated for the remaining 1%.  The gender distribution is fairly balanced with 52.6% of the population being male and 47.4% being female.  It is unclear whether or not these data represent the students’ self-identification or their biological sex.  The median household income in Lakewood, CO is $52,512 per year.  This is above the National School Lunch Program’s eligibility threshold for free or reduced lunch (Start Class, 2016).  In order to be eligible for free lunch, students’ annual household income must be equal to or below 130% of the poverty line.  Roughly 56.4% of students at BCHS are ineligible for free or reduced lunch, 37.8% of students are eligible for free lunch, and 5.8% are eligible for reduced-cost lunch (Start Class, 2016).  This trend demonstrates a wide socioeconomic bracket of students served at BCHS.  The incoming freshmen of the 2017-2018 school year will all be required to have participated in our program in order to advance to a sophomore status in our proposed program, Body Acceptance Program (BAP).  BAP will partner with the current peer-mentor program established at BCHS and will include our added content addressed once per week over the course of the 2017-2018 school-year.      

Goals and Objectives

Goal 1: To decrease the incidence of unhealthy behaviors and cognitions related to eating, exercise, and body image in high school freshmen students.

Objective 1.1: Participants, on average, will report a statistically significant increase in knowledge and understanding of nutrition and balanced diets by the end of the intervention as measured by pre and post-tests.Objective 1.2: Participants, on average, will report a statistically significant increase of healthy cognitions regarding exercise as measured by pre and post-tests. Objective 1.3: Participants, on average, will report a statistically significant increase in body image esteem, as measured by pre and post-tests. Objective 1.4: 25% of participants will report an interest in becoming future mentors within this program by the end of the intervention.

Methods

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As previously discussed, adolescents are at an increased risk for social comparison which consequently increases the risk of body dissatisfaction (Carney & Scott, 2012).  This aligns with the heightened risk of adolescents developing eating disorders (EDs), maladaptive cognitions and behaviors regarding nutrition, exercise, and body image (Carney & Scott, 2012).  As this risk of adolescents developing EDs exists, 1 in 3 Colorado adolescents is also overweight or obese (CDC, 2015a).  Our proposed universal prevention program, the Body Acceptance Program (BAP), aims to address these issues.  The BAP will target the approximately four hundred twenty-five incoming freshmen at Bear Creek High School (BCHS) in Jefferson County over the course of the 2017-2018 school-year.  BAP will partner with the school-counselor supervised peer-mentor program that is currently established in BCHS in order to include the underaddressed elements of nutrition, exercise, and body positivity, which significantly impact adolescent students.  BAP will take place every Tuesday of the 2017-2018 school-year from 11:20-11:50.  The students will then be released for lunch until 12:10.  Peer mentors will implement daily curriculum, with a supervising teacher in the classroom, for the first 10-15 minutes which will be followed by small-group discussions and/or activities for the remainder of the time period.  The goal of BAP is to decrease the incidence of unhealthy cognitions and behaviors related to nutrition, exercise, and body image through the implementation of a peer-mentor led educational program targeting freshmen.  The program will assess students’ initial levels of knowledge regarding balanced diets, cognitions surrounding exercise, and body image esteem through the use of pre-test measures administered at the start of the 2017 fall semester. Our program will implement curriculum related to nutrition, exercise, and body image once weekly during the normal peer-mentoring program delivery times over the course of the fall and spring semesters on BCHS campus.  The program’s efficacy will be measured by administering a posttest related to target cognitions and behaviors at the end of the 2018 spring semester and comparing the results to those of the pre-test.  The program will only run once over the course of the 2017-2018 school year.  If BAP yields statistically significant results, efforts will be made to continue the program at BCHS as well as other high schools in the area.      

Program Staff

Our proposed program staff will consist of a Program Coordinator (i.e., a therapist from Beyond the Mirror), 4 school counselors and 20 teachers from BCHS, and 50 peer mentor volunteers.  In addition to the program staff, there will be approximately four hundred twenty-five freshmen participants.  The paid Program Coordinator will develop the program’s curriculum, train the school counselors, teachers, and peer mentors, oversee any questions or concerns regarding the program, and conduct evaluations of the program’s success.  The program’s success will be measured by calculating the statistically significant differences (if any) between the pretests and posttests.  The Program Coordinator will dedicate a total of 55 hours to the program.  Thirty-five of the these hours will be spent developing the curriculum, 7.5 hours will be spent traveling to and from BCHS, 4 hours will be spent training the mentors and teachers, and 8.5 hours will be spent on data analysis.

The participants of our proposed Body Acceptance Program (BAP) will consist of a captive freshmen audience from Bear Creek High School (BCHS).  Incoming freshmen will be required to complete the yearlong program in order to advance to sophomore standing. Upperclassmen peer-mentors will be recruited from the already-established peer-mentoring

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program at BCHS.  Peer-mentors will need to have expressed a desire to participate in the program during the previous spring semester and completed an online application.  If they do not have access to a personal computer at home, they will be able to apply on one of the school-provided computers.  Students will be selected as peer-mentors based off of their personal application, previous active engagement in the currently established peer-mentor program, and personal qualifications that they state in their application.

There will be 20, 30 minute Body Acceptance Program (BAP) groups held throughout the 2017-2018 academic year.  These groups will meet at the beginning of each Tuesday lunch period and will be held in classrooms at BCHS.  There will be one teacher for each of the 20 BAP groups for a total of 20 teachers.  Since we cannot precisely predict how many students will actually enter the 2017-2018 freshmen class, each BAP classroom will have two to three peer-mentors depending on each classroom’s actual number of freshmen participants.  Hence, there will be 50 peer-mentors involved in the program.

We will establish 1 school counselor who will be the main point of contact for the BAP teachers, peer-mentors, and freshmen participants.  The salaried school counselors at BCHS will review the prospective peer-mentors’ applications and notify them of their acceptance or rejection.  Given the existing number of students at BCHS, we anticipate that approximately one hundred six students will apply for peer mentoring positions.  We predict that reviewing each application will take the school counselor approximately twenty minutes for a total of 35.3 hours to review all applications.  The application review process will not be considered an in-kind donation because school counselors’ primary responsibility that is accounted for in their salaries is to support students, help students enroll in specific classes, and provide counseling.  The school counselor will use a school-provided database to automatically enroll all freshmen in the program.  This counselor will also lead 15 minute, bi-weekly meetings with the mentors for 30 weeks to equate a total of 15 meetings.  This will be considered an in-kind donation because the counselor’s school-determined salary will cover the time spent on these meetings.  The school counselor will work approximately forty-three total hours.  The teachers involved in the program will each work for approximately twenty hours, including the time spent in training and supervising the BAP groups; this will also be considered an in-kind donation.

The program training will take place at BCHS the week before school begins in August. In addition to the 3-day training program that the mentors are currently required to take part in, our program will require 3-4 hours of additional training depending on the trainees’ program-title (i.e., 4 hours for teachers and counselors; 3 hours for peer mentors).  The Program Coordinator will meet with the school counselor and teachers for the first hour of the additional training day to instruct them on how to lead the peer mentors through the implementation of the program. The Program Coordinator, school counselors, and teachers will then lead the remaining 3-hour training session during the additional training day for the peer mentors.  They will teach the peer mentors how to implement the curriculum content, which is designed for freshmen.  They will also teach the mentors how to facilitate the activities and discussions related to the BAP.  During this training, the Program Coordinator will also educate the teachers and mentors on how to administer the pretest and posttest evaluations.  The Program Coordinator will not be present during pretest and posttest administration, but will return to BCHS 2 times in order to first, retrieve the pretest data, and second, to retrieve the posttest data at the end of the program. These data will be utilized for program analysis.

In the existing program, each peer mentor currently receives a binder that contains the necessary materials for implementing the freshmen mentoring program.  Each peer mentor will

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receive an additional 1 page, BAP handout per week for a total of 30 weeks.  Given that there are 50 peer mentors, this will add a total 1,500 additional 1-page handouts to the currently provided mentor binders.  The mentors will use the binder as a reference for leading the program’s activities.  

For each day of the intervention, the peer mentors will facilitate the group, which will be supervised by the teacher who is present in the assigned classroom.  Peer mentors will display the freshmen participants’ session activities and discussion prompts on a PowerPoint via the school’s provided projectors.  The peer mentors will volunteer their time for trainings, meetings, and leading the program sessions resulting in a total of 21 hours and 45 minutes.  The peer mentors will be given a certificate upon successful completion of the mentoring program, and will have the option to purchase honor cords for graduation.  At the end of the program, the coordinator will return to BCHS to retrieve the posttests, answer any questions or concerns regarding the BAP, and to get feedback for potential future sessions of the program.  After collecting the posttests, the Program Coordinator will conduct a data analysis in order to compare the statistical significance (if any) of the pretest and posttest results and the programs’ efficacy.

Activities

In order to decrease the concerns mentioned in our problem statement (i.e., nutrition knowledge, unhealthy cognitions about exercise, and poor body image in adolescents), our Body Acceptance Program (BAP) will incorporate both educational and interpersonal components.  To improve adolescents’ knowledge on nutrition and healthy eating, the students will participate in educational sessions, discussions, or activities related to nutrition, exercise cognitions, and body image.  This will be led by the peer mentors.  The components of the nutrition education sessions teach students how to reduce the consumption of sugary and/or processed foods and beverages. They will also educate students on selecting healthy portions, eating all foods in moderation, and consuming the daily recommended values of food categories.  The interpersonal components will be related to healthy cognitions regarding exercise and body self-esteem.  The activities to improve healthy cognitions regarding exercise will be, primarily, interpersonal in nature. Students will have small-group discussions on potentially healthy and unhealthy reasons people exercise.  An example of an activity is to have each group member state a healthy reason (e.g., to improve my blood pressure, to have a healthy weight etc.) and then engage in short discussions. BAP will also incorporate additional discussions on how to view exercise positively and healthfully.  To address the objective of improving body image, students will have interpersonal discussions.  The activities in these sessions will emphasize acceptance around unique body shapes, living with empowerment, and inner sensitivity.  To address the objective of encouraging freshmen participants to become future peer mentors, the peer-mentors will frequently remind the mentees that they have the opportunity to become future-mentors and encourage them to consider their participation as mentors.  At the end of BAP, the mentees will complete a survey that asks them whether or not they have a desire to participate as future program mentors and will provide the web link that leads them to the online application.

Schedule

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Tuesday Lunch Periods (11:20-12:10)

11:20- 11:35: Brief introduction to the day’s education information, discussion-content, and/or the activity-content (i.e., nutrition, exercise, or body image)

11:35-11:50: Implementation of peer-mentor led discussion or activity content related to nutrition, exercise, or body image

11:50-12:10: Students and mentors are released for lunch

Time Table

April 2016: Peer-mentor applications are due by April 6th.  Peer-mentors will be selected by school counselors and notified of their acceptance or rejection to the program by the end of April.

May – July 2017: Program Coordinator will begin to develop the curriculum for the Body Acceptance Program (BAP).  Curriculum content will reflect information related to nutrition and exercise awareness, as well as body positivity and related issues.  

August 2017: Program Coordinator will train school counselor, teachers, and peer mentors during a one day, 4-hour training session.  This session will be in addition to the existing 3 day training program.  Training will cover program curriculum, implementation methods, and evaluation procedures.  Teachers and school counselors will participate in a 1 hour training session in order to understand their responsibilities as supervisors.  Peer-mentors, teachers, and school counselors will attend a 3 hour training session where they will review the curriculum’s content related to BAP and discuss implementation methods as well as how to facilitate students’ discussions and activities.

August 2017- May 2018: BAP will run once weekly throughout the entire school-year.  Pre-tests will be administered during the first session, and post-tests will be administered during the final session.

Other Participating Organizations

Our proposed Body Acceptance Program (BAP) curriculum will be implemented at Bear Creek High School (BCHS) in Lakewood, Colorado.  BCHS is a part of Jefferson County Public School District. There will also be members of the school’s teaching staff who will be present during class times to provide supervision. Rather than hiring outside mentors and facilitators, sourcing volunteers from the school itself will save on a significant portion of the costs that would otherwise be necessary.

Future funding

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We will need significantly less funding in future years and academic semesters as we will not need to pay for curriculum development.  This will save $2,800 per year after one year, or two semesters.  After the first year, this will drop our total program cost down 13% and will change our requested amount to a $2,450 requested cost for the second year.  If we decide to continue for a third year, we will no longer need curriculum development which will bring our requested cost for the program down to $450 for one school year.  At this point, if we decide to continue, we will have the school board supply us the funds for this program.

Evaluation

During the first and last meetings of our intervention, the freshmen participants will take a 44 item survey developed by the University of Massachusetts’ Amherst Department of Nutrition (n.d.) to evaluate their existing knowledge of nutrition.  This survey evaluates knowledge concerning fats, oils, sweets, weight loss, serving sizes, protein, fiber, carbohydrates, fruits, vegetables, etc. (University of Massachusetts, n.d.).  The results will be documented and analyzed for a statistical significant change in knowledge and understanding regarding human nutrition (Objective 1.1).

In order to reduce people’s risk of becoming obese or developing an ED, it is important that people know healthy ways to view exercise.  Participants will complete the Exercise Motivations Inventory by Markland and Hardy (1993), which assesses people’s motivations to exercise.  Examples of healthy motivations to exercise include those from the Exercise Motivations Inventory such as, “to have a healthy body” and “to reduce tension” (Markland & Hardy, 1993, p. 2).  Depending on current BMI status, healthy reasons for exercise may be “to lose weight” or “to have a good body” (Markland & Hardy, 1993, p.2). To compare the pretest and posttest knowledge of participants’ exercise cognitions, participants will complete this survey at the first session, and then complete this survey again at the final session (Objective 1.2).

With a preliminary test and an exam upon completion of our program we plan to measure increase in body-esteem in our participants.  We will use the Measure of Body Apperception (Carver et al., 1998). This instrument was developed to determine the dependence one has on their body-image in relation to self-worth (Carver et al., 1998).  The goal of this assessment is to measure one’s appreciation of their body (Objective 1.3).

Finally we hope that at least 25% of the freshmen mentees will express interest in becoming mentors in this program when they are upperclassmen.  We will determine their interest by asking them with a one question written survey on the same day we do all of the other post-tests (Objective 1.4).

Budget 2017 - 2018 Academic Year

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Item Description Cost per item/hour

Total Requested

Total In Kind

Total

Program development by Program Coordinator (i.e., Therapist): 35 hours

$80 $2,800 $0 $2,800

Program Coordinator transport to training: 146 miles round trip x 1 trip

$1.89 $13.80 $0.00 $13.80

Program Coordinator peer mentor training: 3 hours

$80 $240 $0 $240

Program Coordinator teacher and school counselor training: 1 hour

$80 $80 $0 $80

Teacher and school counselor training time: 4 hours (20 teachers and 4 counselors)

$25/hour $0 $2400 $2400

Peer mentor training: 3 hours (50 mentors)

8.31/hour $0 $1,247 $1,247

Program Coordinator Travel Time and Data Analysis: 16 hours

$80 $1,280 $0 $1,280

Materials for training: 5 sheets per mentor x 50 mentors

$4.29/ream $0 $4.25 $4.25

Certificate paper (1 certificate/mentor x 50 mentors- completion certificates)

$4.99/pack $9.98 $0 $9.98

Printed program materials (Peer Mentors - 1 sheet per week) 50 peer mentors x 30 weeks; 500 sheets per ream x 3 reams

$4.25/ream $0 $12.75 $12.75

Ink for added binder content printing: 1,500 pages (1 HP C8543X Compatible Black Laser Toner Cartridge)

$99.99/ cartridge

$0 $99.99 $99.99

Peer mentors: 50 for 30 minutes for 30 weeks: 1 semester + 15, 15 minute

$8.31/hour $0 $ 7790.62 $7790.62

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meetings with school counselors

Teachers: 20 hours $25.00/hour $0 $10,000 $10,000

School counselor for Bi-weekly meetings: 1 (.25 hours/15 meetings)

$25.00/hour $0 $93.75 $93.75

School counselor application review time: 20 minutes per application, 106 applications

$25.00/hour $883.33 $0 $883.33

Program Coordinator: post-test debrief and semester wrap up: 1 hr (.5 hours / 2 weeks)

$80 $80 $0 $80

Gas to pick up pretest and  posttest materials: 2  tests (146 miles/trip x 2 trips)

1.89/gallon $27.60 $0 $27.60

Total per student/year: $63.50 $5,414.71 $21,648.36 $27,063.07

Analysis of Fit

Ride the Rockies Granthttp://www.ridetherockies.com/cause/            Ride the Rockies provides grant assistance to organizations that assist youth in education, recreation, or arts in the cities that Ride the Rockies passes through on their Colorado route. This includes Denver, which is less than ten miles from Lakewood, CO.  Ride the Rockies provides grants of $5,000 and does not have a requirement regarding the type of project or grant requested.  We believe that Ride the Rockies would be interested in funding our program because we service youth by providing education that they would not otherwise receive.

Kinder Morganhttp://www.kindermorgan.com/pages/community/km_foundation_guidelines.aspx            Kinder Morgan provides grants in the United States and Canada.  They are interested in funding academic programs for kindergarten through twelfth grade students.  Their grants run from $1000 to $5000 and may be used solely for programs (no general operating grants).  BAP participants are in 9th grade and, therefore, are within Kinder Morgan’s age-range of interest. This grant would help us further youths’ education on nutrition and body image, which are topics that are currently, not highly addressed in typical school settings.

John G. Duncan Charitable Trusthttps://www.wellsfargo.com/private-foundations/duncan-charitable-trust

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            Colorado serving and operating organizations may apply for this grant which ranges from $5,000 to $10,000 dollars and has a wide range of interest areas.  These areas include education and health, of which BAP incorporates both.  The foundation does not fund capital or general operating grants, simply program grants.  Since BAP is an education program designed to address health-related topics, this grant would be a good fit.

Bibliography

Page 15: Body Acceptance Program

14

Baker, J. H., Thornton, L. M., Lichtenstein, P., & Bulik, C. M. (2012). Pubertal development

predicts eating behaviors in adolescence. International Journal Of Eating Disorders,

45(7), 819-826. doi:10.1002/eat.22022

Bear Creek High School. (2014). Retrieved from

http://bearcreek.jeffco.k12.co.us/bchs/index.html

Beyond the Mirror. (2016, March 14). Retrieved from

http://www.beyondthemirror.org/Pages/default.aspx

Bucchianeri, M., Fernandes, N., Loth, K., Hannan, P., Eisenberg, M., & Neumark-Sztainer, D.

(2016). Body dissatisfaction: Do associations with disordered eating and psychological

well-being differ across race/ethnicity in adolescent girls and boys? Cultural Diversity

and Ethnic Minority Psychology, 22, 137-146. doi: 10.1037/cdp0000036

Bulik, C. M., Sullivan, P. F., Tozzi, F., Furberg, H., Lichtenstein, P., & Pedersen, N. L.(2006).

Prevalence, heritability, and prospective risk factors for anorexia nervosa. ArchGen

Psychiatry Archives of General Psychiatry, 63(3), 305.

Carney, J. M., & Scott, H. L. (2012).  Eating issues in schools: Detection, management, and

consultation with allied professionals.  Journal of Counseling and Development, 90(3),

290-297. doi: 10.1002/j.1556-6676.2012.00037.x

Carter, J. C., & Kelly, A. C. (2014). Autonomous and controlled motivation for eating

disorders treatment: Baseline predictors and relationship to treatment outcome. British

Journal of Clinical Psychology, 54(1), 76-90.

Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian,

R.P., . . .  Moffatt, F. L., Jr. (1998). Concern about aspects of body image and adjustment

Page 16: Body Acceptance Program

15

to early stage breast cancer. Psychosomatic Medicine, 60, 168-174. Retrieved from

http://www.psy.miami.edu/faculty/ccarver/sclMBA.html

Centers for Disease Control (2015a, August 27). Obesity prevention facts. Retrieved from

http://www.cdc.gov/healthyschools/obesity/facts.htm

Centers for Disease Control (2015b, August 28). Nutrition and the health of young people.

Retrieved from http://www.cdc.gov/healthyschools/nutrition/facts.htm

Clark, L., & Tiggemann, M. (2008). Sociocultural and individual psychological predictors of

        body image in young girls: A prospective study. Developmental Psychology, 44(4), 1124-

1134. doi: 10.1037/0012-1649.44.4.1124

Colorado Department of Public Health and Environment (2015, March). How many children are

overweight or obese in Colorado?  Retrieved from

https://www.colorado.gov/pacific/sites/default/files/DC_fact-sheet_Childhood-

Obesity_Mar_2015.pdf

Columbia Broadcasting System (2015, March 17).  Colorado ranks high in adolescent eating

disorders, stereotypes still persist.  Retrieved from

http://denver.cbslocal.com/2015/03/17/colorado-ranks-high-in-adolescent-eating-

disorders-stereotypes-still-persist/

Cook-Cottone, C.,, Serwacki, M., Guyker, W., Sodano, S., Nickerson, A., Keddie-Olka, E., &

Anderson, L. (2016).  The role of anxiety on the experience of peer victimization and

eating disorder risk.  School Mental Health, doi:10.1007/s12310-016-9178-z

Dancyger, I. F., Fornari, V. M., & Braun, D. L. (2009). Evidence based treatment for

eating disorders: Children, adolescents, and adults. New York: Nova Science.

Page 17: Body Acceptance Program

16

Eating Recovery Center. (n.d.). Retrieved from

https://www.eatingrecoverycenter.com/treatment/levels-of-care/child-services/inpatient-

treatment/

Field, A. E., Sonneville, K., Crosby, R., Swanson, S., Eddy, K., Camargo, C., . . . Micali, N.

(2014). Prospective associations of concerns about physique and the development of

obesity, binge drinking, and drug use among adolescent boys and young adult men.

JAMA Pediatrics, 168(1), 34. doi: 10.1001/jamapediatrics.2013.2915

Fischer, S., & Peterson, C. (2015).  Dialectical behavior therapy for adolescent binge eating,

purging, suicidal behavior, and non-suicidal self-injury: A pilot study. Psychotherapy,

52(1), 78-92. doi:10.1037/a0036065

Food Research and Action Center (n.d.). Consequences of childhood obesity.  Retrieved from

http://frac.org/initiatives/hunger-and-obesity/what-are-the-consequences-of-childhood-

overweight-and-obesity/

Get the Facts on Eating Disorders. (n.d.). National Eating Disorder Association. Retrieved from

http://www.nationaleatingdisorders.org/get-facts-eating-disorders

Gilliland, M., Windle, M., Grunbaum, J., Yancey, A., Hoelscher, D., Tortolero, S., & Schuster,

M. (2006). Body image and children's mental health related behaviors: Results from the

healthy passages study. Journal of Pediatric Psychology, 32(1), 30-41. doi:

10.1093/jpepsy/jsl008

Gonsalves, D., Hawk, H., & Goodenow, C. (2014). Unhealthy weight control behaviors and

related risk factors in Massachusetts middle and high school students. Maternal And

Child Health Journal, 18(8), 1803-1813. doi:10.1007/s10995-013-1424-5

Page 18: Body Acceptance Program

17

Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns

among women: A meta-analysis of experimental and correlational studies. Psychological

Bulletin, 134(3), 460-476. doi: 10.1037/0033-2909.134.3.460

Hartmann, A. S., Czaja, J., Rief, W., & Hilbert, A. (2012). Psychosocial risk factors of loss of

control eating in primary school children: A retrospective case‐control study.

International Journal Of Eating Disorders, 45(6), 751-758. doi:10.1002/eat.22018

Jones, B. A., Haycraft, E., Murjan, S., & Arcelus, J. (2016). Body dissatisfaction and disordered

eating in trans people: A systematic review of the literature. International Review of

Psychiatry, 28(1), 81-94. doi: 10.3109/09540261.2015.1089217

Karwautz, A. K., Wagner, G., Waldherr, K., Nader, I. W., Fernandez-Aranda, F., Estivill, X. ..,

& ... Treasure, J. L. (2011). Gene–environment interaction in anorexia nervosa:

Relevance of non-shared environment and the serotonin transporter gene. Molecular

Psychiatry, 16(6), 590-592. doi:10.1038/mp.2010.125

Keyes, A., Woerwag-Mehta, S., Bartholdy, S., Koskina, A., Middleton, B., Connan, F., &…

Campbell, I.C. (2015). Physical activity and the drive to exercise in anorexia nervosa.

International Journal of Eating Disorders, 48(1), 46-54. doi:10.1002/eat.22354

Le Grange, D., Lock, J., Loeb, K., & Nicholls, D. (2010). Academy for Eating Disorders position

paper: The role of the family in eating disorders. International Journal Of Eating

Disorders, 43(1), 1-5.

Levine, M. P., & Smolak, L. (2016).  The role of protective factors in the prevention of negative

body image and disordered eating. Eating Disorders 24(1), 39-46.

doi:10.1080/10640266.2015.1113826

Page 19: Body Acceptance Program

18

Lev‐Ari, L., Baumgarten‐Katz, I., & Zohar, A. H. (2014). Show me your friends, and I shall

show you who you are: The way attachment and social comparisons influence body

dissatisfaction. European Eating Disorders Review, 22(6), 463-469.

doi:10.1002/erv.2325

Linville, D., Cobb, E., Lenee-Bluhm, T., Lopez-Zeron, G., Gau, J. M., & Stice, E. (2015).

Effectiveness of an eating disorder prevention intervention in primary care medical

settings.  Behaviour Research and Therapy, 75, 32-39. doi:10.1016/j.brat.2015.10.004

Locker, T. K., Heesacker, M., & Baker, J. O. (2012). Gender similarities in the relationship

between psychological aspects of disordered eating and self-silencing. Psychology Of

Men & Masculinity, 13(1), 85-105. doi:10.1037/a0021905

Machado, B. C., Gonçalves, S. F., Martins, C., Hoek, H. W., & Machado, P. P. (2014). Risk

factors and antecedent life events in the development of anorexia nervosa: A Portuguese

case‐control study. European Eating Disorders Review, 22(4), 243-251.

doi:10.1002/erv.2286

Martin, J. B. (2010). The development of ideal body image perceptions in the United States.

        Nutrition Today, 45(3), 98-110. doi: 10.1097/nt.0b013e3181dec6a2

Markland, D. & Hardy, L. (1993). The Exercise Motivations Inventory (Version 2) [PDF].

Retrieved from

http://pages.bangor.ac.uk/~pes004/exercise_motivation/downloads/emi2.pdf

Markland, D., & Ingeldew, D.K. (1997). The measurement of exercise motives: Factorial

validity and invariance across gender of a revised Exercise Motivations Inventory.

British Journal of Health Psychology, 2, 361-376.

Page 20: Body Acceptance Program

19

Martinez, E. (2015, February 18).  Healthy school vending machines.  Retrieved from

http://www.livestrong.com/article/373921-healthy-school-vending-machines/

Mickley, D. (2015). Evidence based treatments for eating disorders: Children, adolescents and

adults (2nd ed.), edited by Ida F. Dancyger and Victor M. Fornari. Eating Disorders,

23(3), 277-278. doi:10.1080/10640266.2015.1013398

Monaghan, L. F., & Malson, H. (2013). ‘It’s worse for women and girls’: Negotiating embodied

masculinities through weight-related talk. Critical Public Health, 23(3), 304-319.

doi:10.1080/09581596.2012.754843

Murray, S. B., & Touyz, S. W. (2012). Masculinity, femininity and male body image: A recipe

for future research. International Journal Of Men's Health, 11(3), 227-239.

doi:10.3149/jmh.1103.227

National Association of Anorexia Nervosa and Associated Disorders (n.d.a). Eating disorder

statistics.  Retrieved from

http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

National Association of Anorexia Nervosa and Associated Disorders (n.d.b). Statistics: How

many people have eating disorders?  Retrieved from https://www.anred.com/stats.html

Practice paper of the American dietetic association: Nutrition intervention in the

treatment of eating disorders. (2015). American Dietetic Association.

Racine, S. E., Burt, S. A., Iacono, W. G., McGue, M., & Klump, K. L. (2011). Dietary restraint

moderates genetic risk for binge eating. Journal Of Abnormal Psychology, 120(1), 119-

128. doi:10.1037/a0020895

Reiter, C. S., & Graves, L. (2010). Nutrition therapy for eating disorders. Nutrition in

Clinical Practice, 25(2), 122-136.

Page 21: Body Acceptance Program

20

Rienecke, R. D., Accurso, E. C., Lock, J., & Le Grange, D. (2015). Expressed emotion, family

functioning, and treatment outcome for adolescents with anorexia nervosa. European

Eating Disorders Review, doi:10.1002/erv.2389

Rodgers, R. F., McLean, S. A., & Paxton, S. J. (2015). Longitudinal relationships among

internalization of the media ideal, peer social comparison, and body dissatisfaction:

Implications for the tripartite influence model. Developmental Psychology, 51(5), 706-

713. doi:10.1037/dev0000013

Schmidt, S. (2012, September 24). Child obesity awareness month: A Colorado update.

Retrieved from http://www.coloradohealthinstitute.org/blog/detail/child-obesity-

awareness-month-a-colorado-update

Start Class. (2016). Bear creek high school in Lakewood, Colorado. Retrieved from http://public-

schools.startclass.com/l/16561/Bear-Creek-High-School

Steinhausen, H., & Weber, S. (2009). The outcome of bulimia nervosa: Findings from

one-quarter century of research. The American Journal Of Psychiatry, 166(12), 1331-

1341. doi:10.1176/appi.ajp.2009.09040582

Supplies Outlet. (2016). Hewlett Packard LaserJet 9050 Toner Cartridges- C8543X Cartridges.

Retrieved from

http://www.suppliesoutlet.com/HP-LaserJet-9050-Toner-Cartridge-s/5329.htm?

gclid=CNDg1Lnez8sCFQqoaQodBSsC0w

Tate, C., Bettergarcia, J., & Brent, L. (2015). Re-assessing the role of gender-related cognitions

for self-esteem: The importance of gender typicality for cisgender adults. Sex Roles,

72(5/6), 221-236. doi:10.1007/s11199-015-0458-0

Page 22: Body Acceptance Program

21

The State of Obesity (2015, September 21). Adult obesity in the United States. Retrieved from

http://stateofobesity.org/adult-obesity/

University of Massachusetts, Amherst, Department of Nutrition. (n.d.). Nutrition quizzes: Test

your nutrition knowledge [Online training quiz]. Retrieved from

https://www.umass.edu/nibble/quizzes/quizlist.htm

Vocks, S., Tuschen-Caffier, B., Pietrowsky, R., Rustenbach, S. J., Kersting, A., & Herpertz, S.

(2010). Meta-analysis of the effectiveness of psychological and pharmacological

treatments for binge eating disorder. International Journal Of Eating Disorders, 43(3),

205-217.

Waterhous, T., Jacob, M.A. (2011). Practice paper of the American Dietetic Association:

Nutrition intervention in the treatment of eating disorders. Journal of the American

Dietetic Association, 1-13.  

Working with culturally and linguistically diverse (CALD) adolescents. (2016). [Online image].

Retrieved from https://aifs.gov.au/cfca/publications/working-culturally-and-

linguistically-diverse-cald-ad