Lesson Plan



Would you Like Fries with That?
Discovering the Dangers of Fast Food

Overview of Health Topic

Today’s fast-paced society has many families resorting to fast-paced eating.  More and more families are choosing fast food dining over family dining at home.  This choice results in increased consumption of calories, fat, sugar, and sodium.  During 2007 to 2010, approximately 11.3 percent of the calories which Americans consumed were from fast food (Centers for Disease Control and Prevention [CDC], 2013).  Furthermore, the percentage of calories consumed from fast foods increased as weight status increased.  CDC (2013) did find; however, that as age increased the calories consumed from fast food decreased.  Although this is good news for older Americans, it provides evidence that young families and children are at greatest risk for consumption of fast food which increases the risk of heart disease and other chronic diseases. 
Intended Audience
This unit lesson will be conducted with Gatesville Independent School District’s “Healthy Hornets” worksite wellness program.  Approximately fifty employees are expected to attend each session.  The average age of participants will be thirty-five years with average education level being a bachelor’s degree.   
Setting
“Healthy Hornets” is a newly developed and implemented worksite wellness program which will include a six weeks series focused on healthy living and lifestyle changes conducive to healthier living.  This lesson will serve as one of the lessons within the series. The Healthy Hornets series will be held from 3:45 to 5:00 pm at Gatesville Intermediate School band hall and will be open to all school district employees. 

Estimated Time

·         Introduction (5 minutes)
 
·         Pre-intervention Exercises (15 minutes) - containing:

A.    Fast Food Audience Survey

B.     Fast Food Selection Exercise

·         Importance of Topic – Fast Food  Facts (5 minutes)

·         Topic One (10 minutes) – Dialogue on effects of fast food on health.  Specific dialogue on dangers of increased fat and sodium consumption.
·         Topic Two (10 minutes) – Dialogue on maintaining health.  Specific dialogue on use of MyPlate and Dietary Guidelines.
·         Topic Three (10 minutes) – Dialogue and exercise on selecting fast food options.

·         Review (5 minutes) – Review of major concepts of making healthier choices when dining out
                                                                                                                                           
·         Closing remarks (5 minutes)

·         Post-intervention assessment containing (10 minutes) – containing

A.    Demographics

B.     Health knowledge assessment

C.     Customer satisfaction survey

Total Estimated Time:  75 minutes

Materials Needed

Round tables – 10

Chairs – 50

6 Foot Tables for Presenter – 2

Table cloths with agency logo to use on front tables – 2

Projector -1

Laptop -1

Screen – 1

Flash Drive with Presentation -1

Shortening – 1 container

10 Plastic spoons

10 Paper plates

1 package Handwipes

Plaque Model

Sodium Viles

50 Pencils

50 Incentive Items

Handouts (50 of each):           Fast Food Worksheet

                                                Fast Food Worksheet Answer Key

                                                MyPlate Handout

                                                Fast Food Guides

                                                Fast Food Makeover Worksheet

                                                Evaluation Materials

Guiding Health Education Theory or Model

Changing any behavior is difficult, especially those behaviors related to unhealthy nutrition practices.  One must be personally prepared and have the confidence to practice will-power and consistency in choosing healthy options (McAlister, 2008).  In other words, one must have self-efficacy in order to be successful; thus, the reason this lesson is grounded in Social Cognitive Theory (SCT).
SCT is concerned with three distinct factors which affect a person’s decision to change and sustain that change.  These factors include self-efficacy, goal setting, and outcome expectations (World Health Organization [WHO], 2012).  Additional key concepts include psychological determinants of behaviors, observational learning, environment determinants, self-regulation, and moral discouragement (McAlister, Perry, & Parcel, 2008; WHO, 2012).
Self-efficacy is the most recognized factor within SCT.  McAlister, Perry, and Parcel (2008) have identified that “behavior can be changed through new learning experiences.”  Furthermore, these learning experiences can develop sustainability for these changes.  Self-efficacy is important for initiating and maintaining the change as a result of the newfound knowledge presented in the learning experience. This self-efficacy leads the person to a position where they have the belief that they can practice skills on a regular basis that can enable them to eat healthier regardless of barriers such as limited menus, social situations, and societal pressures (McAlister, Perry, & Parcel, 2008).
This lesson plan, along with the entire Healthy Hornets worksite wellness program, addresses three key concepts of SCT.  More specifically it addresses observational learning by encompassing mass communication strategies such as newsletter, fliers, and personal encouragement from administrators (McAlister, Perry, & Parcel, 2008).  Environmental determinants via evidence of school support and implementation of the wellness program in order to create a healthier environment for and of employees.  Finally, personal health assessments, self-rewards (better management of blood pressure, weight, cholesterol, etc.), and social support within employees defines self-regulation within the program. 
Long Range Goals
The goal of the “Would you like fries with that” lesson and Healthy Hornets worksite wellness program is to
§  Increase knowledge and understanding of healthy eating practices.

§  Encourage behavior change conducive to healthy eating.

§  Encourage role modeling of healthy living for their family and students.

Objectives and Learning Domains

Behavioral Objectives
·         Ninety percent of participants will be able to identify three health risks associated with a diet high in fat and sodium on a post workshop evaluation (Cognitive Domain).
·         Ninety percent of participants will be able to identify 5 of 10 high fat and high sodium fast food choices on a retrospective post exam (Cognitive Domain). 
·         Ninety percent of participants will show a willingness to improve their eating habits while dining out on the post workshop evaluation. (Affective Domain)
·         Ninety percent of participants will accept responsibility for their personal health practices and identify three ways to improve these practices on the post workshop exam. (Affective and Cognitive Domains).
Process Objectives
·         To implement general health assessment to ninety percent of employees at Gatesville

·         Independent School District to determine current health behaviors and risks.

·         To distribute Healthy Hornets educational series flyers to school employees.

·         To recruit a minimum of fifty participants from GISD employees to participate in the Healthy Hornets educational series. 
·         To solicit feedback from participants of the Healthy Hornets series through questionnaires at end of each session.  (Subscales will include satisfaction with program content, delivery, setting, instructor, and future health topic needs.)
Procedures

A.    Welcome and Introduction

1.      Welcome
Welcome students to the Healthy Hornets worksite wellness series and applaud them for their efforts and dedication to making a positive change to their health and that of their families and students.
2.      Introduction of educator presenting the lesson
Introduce yourself and provide any relevant background information that might support your expertise or empathy with making changes to health. 
3.      Lesson Introduction
Inform participants that today’s lesson will focus on fast-food and how our health is affected by our food choices.
B.     Developmental:

1.      Fast Food Survey

Ask the participants the following questions.  Have them answer by raising their hands or provide verbal feedback.
·         How many of you eat fast food?
·         How often do you eat fast food?
·         What is your favorite fast food choice in town?  What is your favorite choice when you travel out of town?
·         What do you consider “fast food?”
As participants come up with typical fast food responses, remind them that fast food also includes such establishments as more formal restaurants, delivery, convenience stores, donut shops, truck vendors, etc.  Also remind participants that just because they pick it up or have it delivered and it is eaten at home, it is still fast food!
·         Do you think fast food is healthy or unhealthy? Why?

2.      Fast Food Selection Exercise

Distribute the Fast Food Menu Selection Worksheet.  Explain to students that they are to choose one restaurant and make selections for a dinner or lunch meal.  Drinks are not included on the sheet as we are focusing on the foods at this time. 
Once participants are finished with worksheet, provide the Fast Food Menu Selection Worksheet Answer Key to them.  Have participants add up the amount of calories and fat grams they would consume based on their selections.
Ask for two volunteers.  Have them come up to the front and ask them to divide their fat grams by five.  There are approximately 5 grams in a teaspoon so this division exercise will give them the number needed for the next step.
Have each of the volunteers scoop out shortening using the number of teaspoons based on the number they got when they divided their fat grams.  Have them place the teaspoons of shortening on a paper plate.
Share with the group the number of calories and fat grams the two volunteers would have consumed with their selections.  Ask the participants the following questions.
·         How did your choices compare to these we have before us?
·         Do you think these are choices we need to make on a regular basis?
·         Is it okay to “sometimes” make these choices?
·         If this plate of shortening was used as a display in the restaurant indicating the amount of fat in foods, would you still make the same choices? 
3.      Fast Food Facts

Share the following facts with participants:

·         Fast food is a way of life.  During 2007 to 2010, approximately 11.3 percent of the calories which Americans consumed were from fast food (Centers for Disease Control and Prevention [CDC], 2013).  During that same time, the CDC found that the percentage of calories consumed from fast foods increased as weight status increased. 
·         CDC also found; however, that as age increased the calories consumed from fast food decreased.  Although this is good news for older Americans, it provides evidence that young families and children are at greatest risk for consumption of fast food which increases the risk of heart disease and other chronic diseases. 
·         The fast food industry is big bucks today as compared to years ago.  In 1970, Americans spent $6 billion dollars on fast food.  In 2000, Americans spent $110 billion on French fries alone!
4.      Effects of Fast Food

Say the following to participants.

Not only does fast food affect our pocket book, but it affects our waistline and health as well! Fast food is higher in fat, calories, and sodium which can lead to increased risk for chronic diseases such as heart disease, high blood pressure, high cholesterol, diabetes, and stroke, not to mention weight gain that can lead to obesity.
Let’s take a look at the following examples of how fast food can be dangerous to our health. 
Eating too much fat can raise our cholesterol levels which can increase our risk for heart disease.  Show the participants the model of plaque buildup on arty walls.  Describe how saturated fats and trans fats can raise cholesterol to form this plaque which makes it difficult for blood to travel through the narrow artery.  This buildup can lead to complete or partial blockage that causes a heart attack.   
How many of you have trouble remembering where cholesterol comes from?  If you do, a good way to remember is that if it had a momma, then it has cholesterol.  In other words, only animal products have cholesterol! A diet that is high in fruits and vegetables is healthier.  How
Now let’s look at one more danger of fast food – sodium.  Too much sodium can lead to high blood pressure which can lead to stroke and heart disease.  Fast foods are not our only source of sodium, but just remember that any processed food is higher in sodium. 
Show the participants the sodium viles.  Explain and show the vile with the amount our body needs to function properly, followed by the vile with the recommend 2300 milligrams a day for most Americans (1500 if you have been diagnosed with high blood pressure) and finally the vile with the average amount of sodium consumed by Americans.
5.      Maintaining Health


Review the effects of fast food in the diet:  increased calories, fat and sodium.

Review the ways to maintain health:

·         Use the MyPlate and USDA Dietary Guidelines to assist you with maintaining health.  Distribute the MyPlate handout.  Discuss the 10 tips to healthy eating found on the handout.  
6.      Fast Food Makeover

Say to participants the following:

As we’ve said earlier, fast food is a way of life and I realize that on occasion we are ALL going to eat out.  The important thing to know is how to make smart choices when we eat out.  We want to choose foods that are lower in fat, calories, and sodium so let’s take a look at how we can do that.
Distribute the Fast Food Nutrition Guide and Fast Food Makeover worksheet.  Review how to use the guide and how to find specific nutrients such as calories, fat, and sodium. 
Have the participants select a burger restaurant, a Chinese restaurant, and a sandwich restaurant from the guide.  Have them select a meal that they would normal choose and record the calories, fat, and sodium on the sheet.  Then have them choose a healthier meal option. Remind them that the average American needs 2,000 calories per day and nor more than 65 grams of fat (less is best) so meal choices should average 600 calories and 25 grams of total fat.
Ask 2-3 participants to share their original choice and their healthier choices. 

Ask participants the following questions.

·         Is it possible to eat healthy at fast food restaurants? 
·         What are some other tips or hints to help us make fast food meals healthier?
·         Where can we find information that will help us make healthier choices?
·         What changes do you plan to make when dining out?
7.      Fast Food Review

Summarize the points of the lesson.
·         Make healthier choices when dining out.
·         Lower calories, fat, and sodium.
·         Smaller portions.
·         Remember the My Plate tips.  Review these once again.
8.      What did we learn?

Distribute the healthy eating post program assessment, along with pencils.

                        Ask participants if they have any questions.

                        Thank them for coming.

Collect the post healthy eating post assessments.  Provide each participant with an incentive item when they submit in their completed assessment.

Evaluation Tools

Outcome Objectives Measurement Tools

·         Outcome Objective One Measurement Tool:  Develop and conduct a retrospective post intervention questionnaire of knowledge of health risk associated with diets high in fat and sodium. 
·         Outcome Objective Two Measurement Tool:  Develop and conduct retrospective post intervention questionnaire whereas participants will identify a minimum of 5 high fat and high sodium utilizing a list of foods commonly identified as high fat and high sodium.
·         Outcome Objective Three Measurement Tool:  Develop and conduct a retrospective post intervention questionnaire whereas participated will indicate willingness to improve their eating habits. This measure will also indicate potential of self-efficacy development. 
·         Outcome Objective Four Measurement Tool:  Develop and conduct retrospective post intervention questionnaire which will enable participants to set goals for improving their health practices. 
·         Additional Measurement Tools:  Participatory sets such as oral fast food survey, fast food makeover, and review of key concepts with audience participation will enable educator to determine via observation if overall goal and objectives are being reached.
Process Objectives Measurement Tools

·         Process Objective One Measurement Tool:  Conduct a personal health assessment of school district employees and utilize statistical software to input and identify common health risks, behaviors, and concerns among employees.
·         Process Objective Two Measurement Tool:  Determine distribution status of electronic documents (fliers, newsletters, and others) through conversation with campus administrators and technology coordinators to ascertain if these are being properly delivered and percent of these items opened by recipients which will be determined via school district software reports.
·         Process Objective Three Measurement Tool:  Secure sign-in sheet at each educational session to determine number and percent of school employees participating in program.
·         Process Objective Four Measurement Tool:  Conduct post intervention survey to determine not only knowledge gain, but overall program satisfaction as well.
Anticipated Problems and Solutions

Technology Difficulties: Possible incompatibility with personal flash drive and school computer system; bulb burn out in projector.  SOLUTION:  Bring personal laptop and projector as backup system.
Attendance:  Greater attendance than expected.  SOLUTION:  Utilize additional tables and chairs in storage area of band hall as space will allow for more to be setup. 
Childcare:  Some employees may have personal children with them during session.  SOLUTION:  Provide activity sheets for children to complete and/or secure campus student leadership team to assist with activities for children. 
Handouts:  Too few handouts for attendance.  SOLUTION:  Bring ten extra copies of handouts for possible distribution. 
Participant Attitudes:  Some may be negative about program and feel no results will occur. SOLUTION:  Be a motivator and encourager; share personal success story with participants; share that program only expects them to make small and realistic changes to their behaviors. 





References

Drexel University (2011).  Making healthier fast food choices.  Retrieved from http://www.drexel.edu/nutritioneducation/Website_Materials/FY2012%20Lesson%20Materials/HS/Lessons/HS%20Breakfast%20Lesson%20Plan%20rev%207%2029%2011.pdf
McAlister, A.L., Perry, C.L., & Parcel, G.S. (2008).  How individuals, environments, and health behaviors interact.  In K. Glanz, B.K. Rimer, & K. Viswanath (Eds.), Health behavior and health education theory, research, and practice (pp.  169-188).  San Francisco, California: Jossey Bass.
Pennington Biomedical Research Center (2012, October).  Awesome 2cents healthy lifestyle curriculum.  Retrieved from http://www.slideshare.net/helix1661/fad-diet-homework-assignment-unit-8
United States Department of Agriculture (2011).  10 tips nutrition education series.  Retrieved from http://www.choosemyplate.gov/healthy-eating-tips/ten-tips.html
World Health Organization (2012).  Health education: theoretical concepts, effective strategies and core competencies.  Retrieved from http://applications.emro.who.int/dsaf/EMRPUB_2012_EN_1362.pdf

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