WELLNESS CENTERS

Year Two Evaluation Report

Final Report—June 7, 2004

Introduction

The purpose of the Wellness Centers is to provide health education to students and assist students in locating health care providers and services within the school and community. The ______Foundation, with funding from ______, is sponsoring the operation of Wellness Centers in the senior high and alternative learning center. These friendly, youth-oriented environments are designed and operated so students can access wellness education and counseling about skills that promote health.

The ______Foundation has contracted with the Minnesota Institute of Public Health to evaluate the Wellness Centers. The focus of the evaluation is multi-dimensional and will look at both the processes and outcomes of implementing the Centers. See attachment A for the program logic model and attachment B for the list of evaluation questions.

Methodology

Data collection strategies used during this evaluation included:

Activity Logs

______, Wellness Center coordinator, compiled logs of activities during the 2002-2003 and 2003-2004 school year. She documented activities done at each school (senior high and alternative learning center), community and school wide contacts and outreach. Documentation of activities provides program staff with an overview of the types and numbers of activities that have occurred during program implementation. Not only do these data provide a snapshot of the previous year’s activity they will also show gaps in the services provided that can help direct future programming. The section titled “Findings” includes a summary of data from the logs.

Satisfaction Feedback Forms

The Wellness Center Coordinator asked groups to complete a feedback form about the session they just attended. The purpose of this feedback was to understand what participants liked, disliked and learned from the session they just attended. In addition, participants were also asked to rate their satisfaction and make suggestions for topics they would like to see covered during future Wellness Center activities. See attachment C for session summaries.

Student and Staff Questionnaires

The student and staff questionnaires were implemented once at the end of the two-year project. The purpose of the questionnaires was to understand whether students and staff were aware of the Wellness Center, had used any of the Center’s services and were satisfied with the service they had received. See attachment D for copies of the questionnaires and attachment E for the summary report.

Focus Groups

The focus groups (see attachment F for the full report and attachment G for the protocols) were conducted in mid March 2004 with representatives of students and staff involved in the Wellness Program. MIPH staff conducted the groups on site at the senior high and alternative learning center. One group was comprised of teachers and staff from the senior high and alternative learning center (n=6, duration of approximately 30-40 minutes). The remaining 2 groups were done with students from the Alternative Learning Center (n=6, duration of approximately 30-40 minutes) and senior high students who have accessed services (n=6, duration of approximately 30-40 minutes). The purpose of the focus groups was to understand the impact the Wellness Centers are having on students and staff. More specifically, the focus groups intended to:

  • Learn how the Centers have increased knowledge of wellness among students.
  • Learn how the Centers have increased staff awareness of the importance of wellness.
  • Determine which services and resources are most requested by students.
  • Understand student satisfaction with services.
  • Learn about outreach efforts used to increase awareness of the Centers.
  • Learn the extent to which schools should be involved in health promotion activities.
  • Learn the extent to which Wellness Center staff demonstrate cultural competence, address the issue of student confidentiality and provide accurate health information.
Key Informant Interviews

Seven members of the Wellness Center Steering Committee were selected to participate in a key informant interview. This was a purposive sample that included representatives of the School District and Medical Center. These interviews (see attachment H for the interview protocol) were added to this year’s evaluation plan in an effort to understand:

  • Who has heard about the Wellness Center.
  • The specific impact the Wellness Center is having on students and the value it has added to the school system.
  • Any changes that could be made to future implementation of the Wellness Center.

The Wellness Center Coordinator, also participated in a key informant interview (see attachment I for the interview protocol). The purpose of this interview was to better understand her perspective of the successes and barriers that occurred during the second year of implementation. This 45-minute conversation also included a discussion of what went well and what challenges were encountered during year two, student satisfaction with services, staff awareness and improvements for future implementation.

Data Analysis Approach

Data for this evaluation wereanalyzed using a systematic review process of the information obtained from all the various methods used during the evaluation. A systematic review process is done in order to synthesize the information gathered and determine common themes that occurred in multiple data sources. Data were also examined to identify divergent perspectives from different program audiences.

Findings

The findings from this evaluation are organized based on the various data collection methods used. The first four sections contain data obtained from the activity logs. The sections that follow have findings from the presentation feedback forms, student and staff questionnaires, focus groups and key informant interviews. Please note that numbers may not add up due to missing data.

Wellness Center Contacts at the Senior High

The Wellness Center was visited 104 times throughout the school year. This is down from 168 visits in project year one. The following tables summarize additional information about contacts at the senior high.

Number of Visits

/ Ethnicity /

Number of Visits

Girls / 56 / Caucasian / 57
Boys / 23 / Hispanic / 31
Staff members / 25 / Somali / 6
African American / 3
Source of Referral / Number of Visits
Self-referred / 62
Teachers / 11
Wellness Center Coordinator / 4
Guidance Counselor / 3
School Nurse / 3
Peers / 2
Parent / 1

Referrals to Other Resources

/ Number
Doctor / 3
Tobacco Cessation Coordinator / 3
Planned Parenthood / 2
Social Worker / 2
Teacher / 1
Social Services / 1
Fairview / 1

Purpose of Visits

/ Number of Visits
General Information / 44
Consultation (usually involved topics of a more personal nature) / 35
Healthstyle Quiz (General Information) / 9
Kindness Challenge / 8
Video Loans / 3
Resource Library / 1
Referral / 1
Suicide Prevention / 1
Interview / 1

Topics of Interest

/ Number of Requests
Depression / 13
Tobacco, Alcohol, Marijuana / 11
Acne / 5
Sexual Orientation / 4
Anorexia and Bulemia / 4
STDs / 4
Family Issues / 3
Tobacco Cessation / 3
Self-cutting / 2
Sexual Activity / 2
Domestic Abuse / 2
Relationships / 2
Pregnancy / 2
Birth Control / 1
Eating Disorders / 1
Personal Problems / 1
Hygiene / 1
Chronic Illness / 1
Weight Loss / 1
Dietary Guidelines and Nutrition / 1
Obesity / 1
Over-the-counter Medications / 1
Date Rape / 1
Living Will / 1
ACHF Display / 1
PET Program / 1
Stress / 1
Self-esteem / 1
Suicide / 1
Emphysema / 1

Wellness Center Contacts at the Alternative Learning Center

The Wellness Center was visited 21 times throughout the school year. This is down slightly from 27 visits in project year one. The following tables summarize additional information about contacts at the alternative learning center.

Number of Visits

/ Ethnicity /

Number of Visits

Girls / 14 / Hispanic / 13
Boys / 7 / Caucasian / 8
Source of Referral / Number of Visits
Self-referred / 19
Teachers / 1
Group Home / 1

Referrals to Other Resources

/ Number
Human Services / 1
Tobacco Cessation Coordinator / 1
WIC / 1

0urpose of Visits

/ Number of Visits
Contest / 17
Consultation (usually involved topics of a more personal nature) / 3
General Information / 1

Topics of Interest

/ Number of Requests
Drug Use / 15
Kindness Challenge / 2
Smoking Cessation / 1
Pregnancy / 1
Alcohol/Marijuana / 1
Self Tattoo / 1

Wellness Center Community and School Wide Contacts

Between June 2003 and April 2004, there were 120 contacts made with over 2600 individuals. This compares to 165 contacts with over 4400 individuals during project year one. There were several events that had unlimited access and total numbers of attendees were not tracked. The types of community contacts include: presentations, material displays and distribution and attendance at meetings, conferences and fairs.

Number of Contacts Directed to Specific Populations / Number of Contacts Directed to Specific Sites
Students / 66 / Senior High / 36
Girls Group Home / 5 / Alternative Learning Center / 14
Parents / 5 / Prairie Lakes Detention Ctr. / 7
Community / 4 / Elementary School / 3
School Staff / 3 / Junior High / 2
ACHF Board Members / 1 / Adolescent Treatment Unit / 1

Presentation Topics

/ Number of Requests
Wellness / 20
Assertiveness / 8
Healthy Eating and Nutrition / 8
Depression / 4
Suicide Prevention / 3
Pregnancy Prevention / 3
Alcohol / 3
Internet Health Services / 2
Curriculum / 2
Hygiene / 2
Weight Loss / 2
Stress / 2
Yoga / 2
Tobacco Cessation / 2
Relationships / 2
Planning / 1
Shelter House / 1
Kindness / 1
Tobacco / 1
Eating Disorders / 1
STDs and STIs / 1
Fall Plans / 1
Fitness / 1
Dental Health / 1
Marijuana / 1
Environment / 1
Cancer / 1
HIV and AIDS / 1
Interpersonal Skills / 1
Abstinence / 1
Infectious Disease / 1

Wellness Center Outreach and Marketing

One-third (17 of 51) of the contacts were targeted and/or distributed to both the High School and Alternative Learning Center. The target population for the events were students (32), the community (12), parents (9) and school staff (1).

Newspaper articles, advertisements and Cardinal Clips were presented throughout the year to provide information to parents, staff, students and community. Topics included: fitness, adolescent health, nutrition, bullying, STDs and HIV, kindness, listening to teens, child/teen checkups, sex education and suicide prevention.

Posters were put up at least once a month in the schools. Topics included: mental health, kindness, HIV and STD prevention, HIV testing, suicide prevention, alcohol, seat belt use and the Wellness Center in general.

A display box was used at the High School and Alternative Learning Center to feature various topics throughout the year. Topics included: nutrition, alcohol, cancer, marijuana, child abuse and heart disease.

Ongoing projects were used throughout the year to share information on a variety of topics for parents, staff and students. Both schools had a brochure display within the Wellness Center and a bulletin board. A site on the world wide web was also utilized.

Satisfaction with Presentations

The Wellness Center coordinator began asking presentation participants to complete a feedback form mid-way through the first project year. The following summary is based on 405 surveys received after 16 events during project year two. Event topics include: yoga (2), assertiveness (9), nutrition (1), prenatal care (1), suicide prevention/depression awareness (1), health promotion (1) and the Alternative Learning Center’s Health Fair (1). See attachment C for copies of presentation summaries.

More females (59%) than males (41%) attended the presentations. This is inconsistent with the demographics of the School District, which is comprised of 50% females and males. Seventy-seven percent of the participants were Caucasian, 18% were Hispanic, 3% were African American, 1% was Native American and 1% was Asian. This breakdown is well dispersed considering the school district is comprised of 73% Caucasian and 24% Hispanic. Ninth graders made up 54% of the participants, while 33% were 10th graders, 8% were 11th graders and 5% were 12th graders.

Overall satisfaction with the presentations was high. Eighty-three percent of the respondents reported a 4 or 5 on a scale of 1-5 with five being the most satisfied. The average response was 4.2. The most common response was 4.

Content specific to the sessions was most often reported as what the students liked best. For example:

“Many of the things that I thought were healthy really are not like peanut butter.” (Nutrition)

“Learning how to do the moves.” (Yoga)

“I liked that you gave us bits of info and taught us how to identify the signs of depression.” (Suicide prevention/depression awareness)

“I liked discussing how to be assertive and talking about drugs and stresses.” (Assertiveness)

“Saying ‘no’ to peer pressure.” (Assertiveness)

For others, the things they liked best were not necessarily related to the content area:

“Good workout and relaxing.” (Yoga)

“How prepared the presenters were.” (ALC Health Fair)

“The movie was good.” (Suicide prevention/depression awareness)

“The interaction with students and using volunteers.” (Assertiveness)

“Instructor, stretching, the end relaxation, being with friends.” (Yoga)

“We got candy.” (Assertiveness)

In response to the question regarding what was liked least about the session, the majority responded “nothing.” The most frequent dislike was logistical or dealt with unruly classmates:

“Not to complain, but the lights buzzing are really annoying.” (Yoga)

“It was too cold in the room.” (Yoga)

“The cold. BRRR.” (Health promotion)

“It was too early.” (Nutrition)

“People in the classroom were being immature.” (Assertiveness)

“All the people who were disrespectful to you.” (Assertiveness)

The most important things that were learned related to the content of the session:

“How to be assertive.” (Assertiveness)

“Never leave someone that wants to do suicide.” (Suicide prevention/depression awareness)

“Dangers of alcohol.” (ALC Health Fair)

“How being assertive can affect your wellbeing.” (Assertiveness)

“To eat healthy, not only for baby but for both.” (Prenatal care)

“That I have to cut down on pop and I need to cut down on deep-fried foods.” (Nutrition)

“To let go of stress and love yourself.” (Yoga)

“Maslow’s hierarchy of needs.” (Health promotion)

Summary of Responses from the Student and Staff Questionnaires

A full report of the student and staff questionnaires is included in attachment E. The summary provided here is an overview of key questions that were of interest to Steering Committee members and the project evaluator.

Student Questionnaire

  • The majority of respondents have heard about the Wellness Center.
  • Those who were exposed to the Wellness Center in both years of the project had a greater number of actual visits to the Wellness Center.
  • Students at the High School were most likely to have heard about the Wellness Center from a poster at school, while those at the Alternative Learning Center heard about it from a teacher or other staff member.
  • Of those students who have used the Center, the majority are very or somewhat satisfied with the services and materials received.
  • More female respondents find it important to have health promotion activities offered at school than their male counterparts.
  • Whether based on ethnicity, grade or school, the majority of respondents feel that it is very or somewhat important to have health promotion activities offered at school.

Staff Questionnaire

  • The majority of respondents have heard about the Wellness Center.
  • Respondents at the Alternative Learning Center have made more referrals to the Wellness Center.
  • Administrators, teachers and para-professionals have made the most referrals to the Wellness Center.
  • Alternative Learning Center staff repeatedly report greater student satisfaction with services and materials than staff at the High School. Staff at the Alternative Learning Center is also more likely to believe that students are using the materials or information provided.
  • The majority of staff at each school believes it is important to have health promotion activities offered at school.
  • The majority of respondents believe that students are receiving accurate health and wellness information.
  • Alternative Learning Center staff is surer than staff at the High School that the Wellness Center is doing a good job of serving students from diverse cultural backgrounds.

Summary of Responses from the Focus Groups

A full report of the three focus groups was prepared as a separate document and is included in attachment G. The summary provided here is an overview of program strengths, challenges, option for improvement and similarities and differences between project years one and two.

Strengths

•The Coordinator of the Wellness Centers continues to be liked and respected by students and staff.

Words used to describe the coordinator include warm, creative and responsive. She is perceived as being willing to go the extra step to provide students with the attention or information they need.

•High School students and staff are noticing signs that have been posted to promote health and the Center’s resources.

Every month, the coordinator selects a health promotion theme such as smoking, eating disorders or recycling. Posters and displays are created that are put around school to increase awareness of the particular topic.

•The High School Wellness Center serves as a place to find accurate health information for assignments and personal reference.

Health promotion in the schools has been limited to consultations with student services staff and the health curriculum. The Wellness Center has expanded the topics and resources that are currently available to students and has become a place for students to go for information on health topics.

•The High School Wellness Center is a place for students to go for personal support or reflection.

Wellness Center staff is providing personal support to students and the Center’s atmosphere is conducive to studying and personal reflection.

•Students and staff at the ALC liked the Health Fair.

The Wellness Center staff coordinated a Health Fair at the ALC. This Health Fair created awareness about health and wellness and provided information and resources for those attending.

•Staff members believe students are receiving accurate health information from the Wellness Center.

Participants in the staff focus group were asked about the extent to which they believe students are receiving accurate health information. All members of the focus group concurred that the information is accurate.