The Southern Nevada Health District partnered with the Clark County School District's School-Community Partnership office and a local professional sports team, the WNBA's Las Vegas Aces, to develop a new program that would be fun and effective at helping students understand and implement healthy eating and physical activity habits. The program content was based, in part, on the Physical Activity Guidelines for Americans and MyPlate guidelines. Using feedback from classroom teachers, the program was developed to be implemented in a classroom setting. The program was fun and interactive but did not require significant classroom time for implementation so as not to complete with required time needed for core subject areas. Optional lesson plans were provided for teachers who wanted to encourage healthy eating and physical activity by integrating them into core subject lessons (math, science, etc.) Very few supplies are needed for implementation and classroom materials are provided by SNHD. The involvement of a high-profile community partner (Las Vegas Aces) was an innovative collaboration that increased the utilization and participation in the program and partnership with CCSD facilitated access to students in the 5th largest school district in the country.
The goal of the Slam Dunk Health program (SDH) is to utilize creative and innovative partnerships with community organizations to influence and encourage youth to be more physically active and to increase fruit and vegetable consumption. Specific objectives of the SDH program are:
· To secure partnerships with at least 2 key community stakeholders in support of SDH
· At least 100 CCSD elementary schools will have at least 1 classroom participate in the program
· At least 65% of schools that participate in the program will have a free and reduced lunch rate of >50%
· At least 10,000 CCSD elementary school students will participate in the program
· Conduct program evaluation activities and share results with partners and stakeholders
Specific steps taken to implement the program include the following:
- Leverage relationships
- SNHD has a long-standing relationship with CCSD and has worked with CCSD on other health-related initiatives. SNHD previously worked with the newly appointed community relations manager for the Las Vegas Aces. SNHD leveraged the relationships with these two partners identify ways that everyone could partner on a health-related project. SNHD used their public health expertise to bring together the resources of the Las Vegas Aces and the support of the CCSD to create the Slam Dunk Health program.
- Develop goals and objectives
- SNHD worked with CCSD and Las Vegas Aces to develop goals and objectives for the program. The goals and objectives guided development of the Slam Dunk Health program.
- Develop program and leverage partner resources
- SNHD developed a program outline to determine necessary resources for the program. SNHD met with each partner to determine which resources they would be able to provide. SNHD supported the program with funding and in-kind staff time.
- Implement program
- SNHD developed the program materials and worked with CCSD to market and distribute the program to the participating classrooms. SNHD coordinated program sign up. The classroom teachers implemented the program in their classrooms and reported the results to SNHD. Winning classrooms were selected and given tickets to a Las Vegas Aces basketball game and classroom visit by the team. SNHD worked with Las Vegas Aces, CCSD and the winning classrooms to coordinate the classroom visit and ticket distribution.
- Evaluate program
- An evaluation plan was developed and pre and post data was collected from a sample of 10 participating classrooms. We utilized a partnership with the University of Nevada, Las Vegas (UNLV) to secure the assistance of a volunteer graduate student to assist with data entry and analysis.
The program was only open to CCSD schools and only available to 1-5 grade classrooms. Program planning took place throughout summer and fall of 2018 in collaboration with program partners. The program was implemented between January and May 2019 in collaboration with program partners.
SNHD engages with many community partners on a regular and ongoing basis and community engagement and partnership development are core to the function of the SNHD Office of Chronic Disease Prevention & Health Promotion. The Las Vegas Aces have made health and community engagement a major focus of their off the court team efforts. The Slam Dunk Health program is the first program they supported in the community upon relocation to Las Vegas. SNHD took the lead on planning the program but the Las Vegas Aces were very involved in the process. They were engaged in planning and identification of ways they could leverage resources or support to expand the program and increase effectiveness. The Las Vegas Aces provided 4, weekly videos of players encouraging participants to eat healthy and be active. These videos were provided to classroom teachers to play in participating classrooms to encourage students throughout the program. The Aces also provided individual prizes for the winning classrooms and players and coaches participated in classroom visits.
CCSD is a vital partner in connecting with schools and classrooms in our community. Their support and help in marketing the program to the teachers was critical. They have ability to reach teachers directly and encouraged them to signup for the program. They also ensured delivery of program materials directly to schools. They assisted with coordination of classroom visits. Their partnership brings credibility to our program and shows teachers this program is valuable to their classroom.
The program is very cost effective. Start up costs included $250 for supplies (envelopes); $1,000 for printing program materials; and $800 for incentives (pencils and stickers). Program development and evaluation costs were provided in-kind by SNHD. The Las Vegas Aces and CCSD also made in-kind contributions including prizes and delivery costs.
Ten (10) participating 5th grade classrooms from 9 CCSD schools were recruited to participate in the evaluation of the program. This was a convenience sample, but participating schools represented different geographic areas of Southern Nevada. Due to our focus on low-income schools, all schools that participated in the evaluation had free and reduced lunch rates of greater than 50%. The evaluation consisted of 2 components: a pre/post survey to assess physical activity and nutrition behaviors and intentions and a self-reported component where students reported their physical activity and fruit and vegetable consumption. The self-reported indicators were reported as ‘points' in both pre/post assessment. One point was earned for each 15-minute segment of moderate to vigorous physical activity and one point was earned for each serving of fruit or vegetable.
Written Instructions were developed and provided to classroom teachers who then provided instructions to their students on how to complete the pre/post tools and how to earn/track physical activity and nutrition points. Pre-intervention surveys and tracking tools were administered and completed at least one week before the Slam Dunk Health program started. Post-survey behavior/intention survey was administered within two weeks after completing the program. A weekly tracker was provided to students to track their pre-program physical activity and fruit/vegetable points. The post-program physical activity and nutrition points were taken from the classroom tracking poster for the last week of the program.
The pre/post data was collected, and SPSS was used to run a t-test to compare variables. The analysis found that post scores for the physical activity/fruit and vegetable points and 6 of the other 8 variables all improved. There were slight (but not significant) decreases in 2 of the 8 variables assessed. Total points from pre to post was the only significant change (p<.05). The evaluation indicated that the Slam Dunk Health Program likely contributed to increasing physical activity/fruit and vegetable consumption from pre to post among participants in the evaluation cohort. Most of the other variables showed positive increases from pre to post, though none of the changes were statistically significant. See Table 1 below for more information.
In addition to the pre and post analysis, SNHD also reached out to teachers in participating classrooms after program implementation to solicit their feedback on the program. Overall response to the program was positive but based on several recommendations from teachers, we will be adjusting the timeline for program implementation to allow for additional time for teachers to implement the program. We will begin promotion and open up registration earlier in the school year which will provide greater flexibility for the teachers who participate.
Table 1.
Variable | Pre | Post | Change |
Eat Vegetables | 2.73 | 2.9 | Increase |
Eat Fruit | 3.35 | 3.43 | Increase |
Chose F/V as Snack | 2.46 | 2.53 | Increase |
Try new F/V | 2.51 | 2.43 | Decrease |
Do PA | 3.20 | 3.47 | Increase |
PA is Fun | 2.79 | 2.89 | Increase |
PA is Good for Me | 3.01 | 2.98 | Decrease |
Beyond the evaluation findings on the impact of the program, we were also successful in leveraging relationships with CCSD and the Las Vegas Aces in support of the development, implementation and evaluation of the Slam Dunk Health Program. These relationships will be critical in efforts to sustain the program in the future.
The Slam Dunk Health (SDH) program was developed with sustainability in mind. We were intentional in designing a program that required few supplies and that could be implemented with little classroom time, while having the potential to reach thousands of youth. We sought out and secured partnerships with two community organizations (Las Vegas Aces and Clark County School District - CCSD) that could provide resources needed for program implementation.
We learned from teachers and CCSD that in order for a voluntary program to be implemented in a classroom setting, it had to be fun and interactive and not take much classroom time. This was an important lesson and one that drove development of the SDH program. We also learned that partnerships are critical to program development, implementation and sustainability. SNHD developed and leveraged strategic relationships with key community partners. We identified partners that could make in-kind contributions to support implementation and sustainability of the program. These partners were engaged in the development process, which increased partner buy-in and support of the program. We also learned that it was important to conduct evaluation of the program so that feedback could be shared with partners and participants and, when appropriate, changes could be made to the program to increase effectiveness.
While we did not conduct a formal cost-benefit analysis of the program, hard costs for the program totaled approximately $1,250 and we reached over 13,000 students. However, significant in-kind costs were contributed by partners which included staff time, evaluation assistance, program incentives (tickets, classroom visits) program support (classroom videos) and delivery assistance.
The SDH program was a success and program partners are currently collaborating on next year's program. The Aces have increased their contribution by covering the cost of printing program materials and are in conversations with other community partners to increase support and sponsorship of the program. SNHD has committed to providing staff time and to providing minimal program costs and CCSD - School Community Partnership Office has committed to continue with program promotion and delivery assistance.