The Culture of Wellness in Preschools: Parent Wellness Workshop (COWP PWW)

Rocky Mountain Prevention Research Center-Colorado SPH-University of Colorado Anschutz

Overview

The Culture of Wellness in Preschools (COWP), Parent Wellness Workshop Series (PWW) is a direct education intervention designed to increase consumption of fruits and vegetables, increase moderate to vigorous physical activity, and reduce sedentary behaviors among preschool parents and their children. The COWP PWW’s 6-week series begins with an assessment of 9 obesity risk factors. Parents receive a Family Wellness Summary to increase parents’ awareness of their, and their preschool children’s, current eating and physical activity behaviors and areas which could be improved. COWP PWW facilitators use motivational interviewing counseling techniques to discuss the Family Wellness Summary results and set goals around healthy eating and physical activity for each course participant. The remaining 5 workshops educate parents on various nutrition and physical activity topics with techniques to improve their and their family’s health behaviors. Parents then receive a post-Family Wellness Summary with a counseling session at the end of the series to understand where improvements in healthy eating and physical activity were made.

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time

Intervention Type: Direct Education

Intervention Reach and Adoption

COWP PWW targets parents and guardians of preschool-aged children in child-care settings. In 2017-2018, COWP PWW partnered with approximately 100 low-income preschools in 13 counties in Colorado. Forty percent (40%) of the sites offered COWP PWW reaching 500 members of the target audience.

Setting: Child care (Learn)

Target Audience: Parents/Mothers/Fathers

Race/Ethnicity: All

Intervention Components

COWP PWW includes six 1-hour lessons delivered over six weeks that include a pre- and post-assessment of nutrition and physical activity behaviors and 9 obesity risk factors. These intervention components provide parents and caregivers the knowledge and motivation to improve health behaviors for them and their families. Nutrition behaviors assessed include the consumption of sweetened beverages, soda, fruit, and vegetables. Physical activity behaviors assessed include minutes engaged in physical activity/sedentary activity and the presence of a TV in the child’s bedroom. COWP PWW facilitators use motivational interviewing counseling techniques to discuss the Family Wellness Summary results and set goals around healthy eating and physical activity for each course participant. The remaining five workshops cover the following topics: 1) Feeding relationships, 2) Eating together at home, 3) Physical activity and screen time, 4) Choosing better beverages, and 5) Fruits and vegetables at meals and snack times. Food resource management is covered during three of the six workshops. Parents then receive a post-Family Wellness Summary with a counseling session at the end of the series to understand where improvements in healthy eating and physical activity were made. Workshop content is appropriate for other age groups and often all members of a household benefit.

For the COWP PWW workshop to be implemented with fidelity, all COWP PWW talking points must be covered and the pre-post survey must be administered and reviewed. Workshop facilitation must adhere to the following principles: using motivational interviewing techniques, facilitating change talk, hands-on learning, use of visual aids for English language learners, providing information in a variety of ways to meet different learning styles and skilled classroom, and/or group facilitation skills. Each workshop script has a list of required and optional activities. Optional activities provide the facilitator with flexibility in the choice of hands-on activities and recipes that may be modified to meet cultural needs. COWP PWW is based on the Dietary Guidelines for Americans 2015-2020, behavior change theory, and adult learning theory.

Intervention Materials

Intervention materials are available at no cost and are available electronically by request on the COWP website. Materials available include:

  • Workshop summary
  • Curriculum script
  • Six Parent Workshop Education flyers – designed -to be sent home to reinforce messages from each workshop. Each flyer contains a recipe and physical activity ideas.

Intervention Costs

Materials available at no cost.

Evidence Summary

In 2011, to develop the program, the COWP creators conducted focus groups with preschool directors and teachers to better understand the current wellness initiatives going on at the preschool sites, what were barriers and facilitators to eating healthy and being physically active, and what types of health-promoting activities preschool staff, children and families desired. Additionally, the COWP team conducted focus groups in English and Spanish with Head Start parents from six Denver Metro delegate agencies.

As part of the process evaluation for the COWP PWW, facilitators complete a survey following every workshop. Data are reviewed regularly to improve the COWP PWW series.

Outcome evaluation data are assessed using pre- and post-survey data (all results are statistically significant from pre- to post-, p<.001):

  • Adults increased fruit and vegetable consumption by 45%
  • Children increased fruit and vegetable consumption by 55%
  • Adults decreased sugar-sweetened beverages by 46%,
  • Children decreased sugar-sweetened beverages by 44%
  • Children increased number of active days per week by 50%
  • When the 9 obesity risk questions for parents and children are summed to create an overall obesity risk score at pre- and post-intervention, there was a statistically significant decrease in the risk score for both parents (adults) and children

Evidence-based Approach: Practice-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual MT1, MT3
Environmental Settings
Sectors of Influence
  • MT1g: statistically significant increase in daily water consumption from pre- to post-assessment (p<.01)
  • MT1h: statistically significant decrease in consumption of sugar sweetened beverages from pre- to post-assessment (p<.01)
  • MT1i: statistically significant decrease in whole milk consumption from pre- to post-assessment (p<.01)
  • MT1l,m: statistically significant increase in fruit and vegetable consumption from pre- to post-assessment (p<.01)
  • MT1k: statistically significant decrease in consumption of snacks (chips, cookies, candy) from pre- to post-assessment (p<.01)
  • MT3b: statistically significant increase in number of hours physically active/week from pre- to post-assessment (p<.01)
  • MT3g: statistically significant decrease in screen time (TV, video/computer games) from pre- to post-assessment (p<.01)

Evaluation Materials

Intervention materials are available at no cost and are available electronically by request on the COWP website. Materials available include:

  • Staff Focus Group Protocol and Questions (Formative)
  • Parent Focus Group Protocol and Questions (Formative)
  • PWW Facilitator Feedback Form (Process)

PWW Parent Pre- and Post- Surveys (Outcomes)

Additional Information

Website: The COWP PWW website includes information on COWP, who they serve, PWW lessons, and outcomes of the program.

Contact Person:

Deanna LaFlamme

COWP Program Director

303-724-4395

Deanna.laflamme@ucanschutz.edu