report on healthy habits child version · report on healthy habits – child version: p. 2 overview...

Report on Healthy Habits – CHILD Version: p. 1

Report on Healthy Habits – CHILD Version

(Administered Spring 2010)

Prepared by: Lara L. Watkins and Jeffrey A. Anderson

Center for Adolescent and Family Studies


Overview The data summarized in this document were supplied to the external evaluation team by

Providence Full Service Community Schools (PFSCS). The Healthy Habits Survey was

developed by the Providence YMCA in connection with PFSCS. The survey contains 24

questions that focus on two health related domains, physical activity and eating habits. The

evaluators worked with PFSCS personnel to design a scoring algorithm for this survey. While

the scoring system helps us better understand the responses to the survey and the questions

appear to have strong face validity, the reader is cautioned that, thus far, no formal psychometric

properties have been reported for this version of the Healthy Habits Survey. (The survey scoring

guide, which was developed as part of the analysis for this report and its complementary parent

version, is provided in the appendix.)

Surveys were administered to out-of-school time (OST) participants at three PFSCS OST

sites: Bailey, Lima/Fortes, and Woods/Young elementary schools in spring 2010. Lima/Fortes

and Woods/Young each receive OST participants from their two corresponding PFSCS

elementary schools. At the time of survey administration, Bailey had been a FSCS for two years,

while Lima and Fortes had been FSCS for one year. Woods and Young were slated to begin

formal PFSCS implementation in fall 2010. As part of the PFSCS evaluation, the Healthy Habits

Survey will be administered at enrollment in OST and after reaching 30 days of attendance in

OST to assess child reported healthy behavior and attitudes.

Findings Sample Description. In spring 2010, 173 students completed the survey, including 112

students from Bailey, 33 students from Lima/Fortes, and 28 students from Woods/Young.

Survey participants were between 5 and 11 years old and were in kindergarten through 6th

grades

(see Table 1 and Figures 1 & 2). The average student represented in the survey was 8.1 years old

(N=173) at the time of administration. Analysis of variance (ANOVA) indicated that there was a

statistically significant difference (p < .05) in the average age of respondents among the three

schools. Specifically, students who took the survey from Lima/Fortes and Woods/Young were

older than students from Bailey (see Figures 1 and 2 for more information about the age and

grade levels of the sample). For future administrations of the Healthy Habits survey – child

version, data analysis could be conducted by age or grade, particularly if there are specific

interventions that target different age or grade levels. This degree of specificity might better

target the outcomes of FSCS interventions.

Although Bailey had more males completing the survey as compared to the other two

OST sites, the difference did not reach the threshold of statistical significance. Finally, the

average number of times students indicated that they had moved during the previous year was

1.6 (n=173). About 60% reported moving at least one time during the past year. A striking 42%

reported moving two or more times in the past year. There were some differences across

schools; however they were not statistically significant (see Table 1 and Figure 3).


Table 1. Demographic Descriptions of the Entire Sample and by School

FSCS Overall

(n=173)

Bailey

(n=112)

Lima/Fortes

(n=33)

Woods/Young

(n=28)

Age, mean years* 8.1 7.6 8.7 8.8

Child’s gender (male) 50% 55% 39% 46%

Number of moves in past year

1.6 1.6 1.9 1.3

No TV in child’s bedroom 21% 19% 19% 32%

*ANOVA p<.05.

Figure 1. Age distribution of the overall sample (N=173).


Figure 2. Grade Level of the Overall Sample (N=173).

Figure 3. Number of Times Students Reported Moving During the Past Year (N=155).


Physical Activity Students overwhelming reported that they believe physical activity is important or

somewhat important (92%). About 60% of the sample reported that they participate in physical

activity at school “everyday" or “most days". On the other hand, 32% of the sample reported

that they participate in regular physical activity at school only on "some days", with about 8%

answering "very little" to this question (see Table 2).

Table 2. Participation in Regular Physical Activity at School

School Very Little Some Days Most Days Everyday

Overall Sample

(n=171) 7% 32% 19% 41%

Bailey

(n=110)

7% 32% 26% 35%

Lima/Fortes

(n=33)

3% 42% 6% 49%

Woods/Young

(n=27)

15% 19% 11% 56%

The response patterns differed somewhat when students were asked how often they

participated in regular physical activity in their neighborhood. Slightly less than half responded

"very little" or "some days" to this question; 15% responded “most days” and almost 39%

responded “everyday”. While sample sizes were relatively small, Woods/Young had

significantly more students reporting that they participate in physical activity “very little” in their

neighborhood as compared to Lima/Fortes (44% compared to 3%). In terms of students who

reported participating in physical activity “everyday”, Lima/Fortes had the highest percentage

(57%) followed by Bailey (38%), and then Woods/Young (24%). (see Table 3). When

respondents were asked if they participated in physical activity with parents or other adults, 42%

answered "no". Differences among the three schools were not significant.

When asked if appropriate safety equipment is worn during physical activities, only 29%

of students indicated "yes". More than half the sample of students reported that they do not use

safety equipment during physical activities, while 18% said they use safety equipment

"sometimes". Differences among the three schools were not significant.

Table 3. Participation in Regular Physical Activity in Your Neighborhood

School Very Little Some Days Most Days Everyday

Overall Sample

(n=171) 25% 20% 17% 39%

Bailey

(n=110) 27% 17% 18% 38%

Lima/Fortes

(n=33) 3% 27% 13% 57%

Woods/Young

(n=27) 44% 20% 12% 24%


Television Viewing. Students were asked how much television they watch on weekdays and on

the weekend. Response patterns were similar for weekdays and weekends, with about one third

of students reporting that they watch television seven hours per day both during the week and on

weekends. Scores were also similar across the three schools. See Tables 4 and 5.

Table 4. Number of Total Hours of Television Watched on Weekdays

Number of Hours of Television Watched

School 0 1-2 3-4

5-6

7 or more

Overall Sample

(n=163) 6% 22% 21% 18% 33%

Bailey

(n=103) 5% 22% 20% 17% 32%

Lima/Fortes

(n=33) 3% 18% 24% 15% 39%

Woods/Young

(n=27) 11% 11% 19% 30% 30%

Table 5. Number of Total Hours of Television Watched on Weekends

Number of Hours of Television Watched

School 0 1-2 3-4

5-6

7 or more

Overall PFSCS

Sample

(n=160)

7% 23% 25% 13% 32%

Bailey

(n=103) 8% 24% 28% 15% 25%

Lima/Fortes

(n=32) 3% 25% 16% 9% 47%

Woods/Young

(n=25) 8% 16% 24% 12% 40%

Total Scores for Physical Activity. A scoring rubric was developed to create a summary

score for the questions about physical activity. The summary score was comprised by assigning a

numeric score to four of the questions about physical activity and also to the question on the

amount of television watched. Answers reflecting the “healthiest” responses were scored as 2;

somewhat healthy answers were scored as 1, and answers indicating the unhealthiest habits were

assigned 0. Scores could range from 0 to 10 (the scoring guide is provided in the appendix).


Summary scores across the three schools were quite similar and, statistically, did not differ from

each other or from the overall average (see Table 6).

Table 6. Child Mean Physical Activity Score by School (Range 0-10)

Overall Sample

(N=149)

School Bailey

(N= 98) Lima/Fortes

(N=29) Woods/Young

(N=22)

Mean Score 5.5 5.4 5.7 5.5

Standard Deviation 1.4 1.5 1.2 1.3

Healthy Eating The second part of the survey queried students about their eating habits. Over 87% of

those responding to the survey reported that they felt healthy eating is important, while 9% said

it is "somewhat important". On the other hand, almost 5% of students answered that healthy

eating is not important. There were no statistically significant differences among the three

schools.

Students were also asked how many servings of fruits and vegetables they eat each day

(see Table 7). Only 30% of the overall sample reported that they eat five or more servings of

fruits and vegetables each day. Over 50% said that they eat two or fewer servings of fruits and

vegetables each day. Although there were some differences in response patterns across the

schools, they were not statistically significant.

Table 7. Average Servings of Fruits and Vegetables Eaten Each Day by School

Number of Servings

School 0 1 2

3

4 5 6+

Overall

Sample

(n=138)

3% 19% 20% 17% 12% 9% 21%

Bailey

(n=84) 2% 17% 22% 17% 9% 10% 25%

Lima/Fortes

(n=29) 3% 18% 18% 12% 30% 6% 12%

Woods/Young

(n=25) 8% 35% 15% 23% 12% 4% 4%

Students were queried about the number of times each week they eat dinner together as a

family, at a table (see Table 8). More than a third of the sample reported eating together every

night, while approximately 24% of respondents said they eat together either 5-6 times or 3-4


times a week. Slightly more than a quarter of the sample said that they eat together 1 or 2 times a

week, with 14% of students saying that they never eat together. Statistically, there were some

significant differences in the patterns among schools. Specifically, it appears that more students

at Lima/Fortes reported never eating together as a family when compared to students at Bailey.

Table 8. Average Number of Times Students Reported Eating Dinner as a Family Each

Week, By School

Number of times each week

School None 1-2 3-4 5-6 7

Overall Sample

(n=160) 14% 26% 11% 13% 37%

Bailey

(n=103) 10% 21% 14% 17% 39%

Lima/Fortes

(n=32) 16% 45% 10% 0% 29%

Woods/Young

(n=25) 28% 20% 0% 12% 40%

Students were queried about the number of times each week they eat breakfast (see Table

9). More than half of the sample reported eating breakfast every day, while approximately 22%

of respondents said either 5-6 times or 3-4 times a week. About 19% of students only eat

breakfast 1-2 times each week and 6% of the sample said they never eat breakfast. Again, some

differences across schools were noted; however, they were not statistically significant.

Finally, students were asked about the number of times they eat fast-food each week (see

Table 10). More than half of the sample, 59%, reported that they each fast food 0 to 2 times

weekly; 17% said 3 to 4 times a week, 10% said 5-6 times a week and 13% of the sample

reported eating fast food at least 7 times a week. Again, some differences across schools were

noted and it appears that significantly more students at Woods/Young reported never eating fast

food as compared to the respondents at Lima/Fortes.

Total Scores for Eating Habits. A scoring rubric was developed to create a summary

score for the questions about eating habits. Answers reflecting healthy responses were scored as

2; somewhat healthy answers were scored as 1, and answers indicating unhealthy habits were

assigned 0. Scores could range from 0 to 8 (the scoring guide is provided in the appendix).

Scores across the three schools showed some statistical differences. The mean total healthy

eating score was significantly higher for Bailey as compared to Lima/Fortes (see Table 11).


Table 9. Average Number of Times Students Report Eating Breakfast Each Week, By

School



Overall Sample

(n=160) 6% 19% 8% 14% 53%

Bailey

(n=103) 6% 15% 7% 14% 58%

Lima/Fortes

(n=32) 7% 30% 10% 7% 47%

Woods/Young

(n=25) 8% 19% 8% 23% 42%

Table 10. Average Number of Times Students Report Eating Fast Food Each Week, By

School



Overall Sample

(n=160) 15% 44% 17% 10% 13%

Bailey

(n=103) 16% 44% 12% 14% 15%

Lima/Fortes

(n=32) 6% 49% 30% 6% 9%

Woods/Young

(n=25) 26% 41% 22% 0% 11%

Table 11. Mean Healthy Eating Total Score by School (Range 0-8)

Overall Sample

(n=124)

School

Bailey

(n=97)

Lima/Fortes

(n=29)

Woods/Young

(n=24)

Mean Score 4.0 4.3 3.2 3.8

Standard Deviation 1.8 1.7 1.8 1.9


Data Recommendations

Survey Administration

Similar to the parent Healthy Habits survey report, we offer several recommendations

about the Child Habits Survey. Primarily, we suggest closely reviewing the survey to see if there

are unneeded questions. Now that the survey has been pilot tested and analyzed, it may be that

PFSCS personnel are not interested in all of the questions. We also suggest examining the

wording of the question about mobility. As with the parent survey, some of the sample was

missing a response for the mobility question and we speculate that that those at risk for high

mobility may be less likely to respond to this question. We also suggest removing the open-

ended questions, unless PFSCS personnel are making use of this information for programming

purposes. PFSCS should compare the original Healthy Habits survey – child version with the

revised Healthy Habits survey – adult version to see if similar changes should be implemented.

Moving forward, it is also important to keep track of the number of surveys that are

administered and the process of administration, in addition to the number of surveys that are

completed. This will allow us to determine more specific response rates and better characterize

survey respondents and the population to which findings might be generalized.

Survey Scoring

We have designed a total score for both sections of the child survey (physical activity and

eating habits). We thus ask if these scores are appropriate. As noted in the parent report, we want

to be able to triangulate data. Questions for future consideration by PFSCS administration and

the EAB include:

To what extent are the surveys psychometrically sound?

Do PFSCS personnel want additional scores to be created?

Can we link child surveys with parent surveys?

Also, would it be possible to objectively measure actual physical activity and

eating behavior? What are some potential measures?

To what extent do the Healthy Habit scores correlate with other indicators of

health and well-being?

Finally, as we pointed out in the parent survey, because there is no standardized scoring

mechanism and this is the first review of the Healthy Habits – child version, the survey needs to

be closely examined and calibrated to best match the specific programming goals and objectives.

Such efforts will help to ensure that the results are meaningful and that the survey is measuring

the behaviors and attitudes that the PFSCS seeks to impact. Additionally, future efforts need to

clearly describe and document the sampling population (i.e. all potential survey participants).

Also, as technological advances are made and datasets are better linked and integrated, it will be

helpful to link survey data to PFSCS services, supports, and activities. Then, we might be able

to examine participation in PFSCS components in connection with Healthy Habit scores and

other indicators of student and family well-being.


Performance Measure

The following is the cited PFSCS Performance Measure: Within one year of

beginning services, 90% of children participating in after-school will increase their knowledge

and improve their attitudes around healthy eating habits as measured by the Healthy Habits

Survey. We anticipate being able to comment on this performance measure after the next

administration of the Healthy Habit survey – child version. This is contingent on being able to

link surveys administered to students prior to and after involvement in OST “interventions”.

Limitations

Again, as discussed in the parent report, this report has a number of limitations that need

to be considered when interpreting these results. First, while the findings of this work can be

used to inform the PFSCS initiative, it is suggested that this be done with caution because we

lack information about the extent to which results are representative of the larger populations of

OST participants and PFSCS students. Indeed, these findings from this survey may be limited to

describing the students who responded. Even though there were some differences among the

three OST programs that reached statistically significance, we encourage program administrators

not to compare the schools to each other. Instead, these findings should be considered solely as

preliminary and used to set program benchmarks. A second substantive limitation that should be

noted is that the survey itself is new and its reliability and validity are unknown.

Conclusions

Similar to the parent report, we were encouraged by the large percentage of respondents

who perceived physical activity and healthy eating to be important. Indeed, many of the findings

in this report were encouraging and indicate that the students who completed the survey perceive

themselves to be making healthy choices in a number of areas. Still, many of these findings can

offer a baseline or starting point. We encourage each school to consider using these findings to

develop short and longer term goals related to healthy habits.

The findings of this report also suggest several areas that could become the focus of

efforts to improve children's healthy habits. For example, parents may believe their children are

more active at school than the children perceive themselves to be, the indicators about physical

activity, both at school and a home, appear to need some attention. PFSCS may want to

reexamine its focus on physical activity, perhaps developing an indicator of 1-hour/day as a goal.

Moreover, this could be a combined school/home goal. Another finding of this survey that

PFSCS personnel may want to focus on is increasing the use of safety equipment, such as a

wearing a helmet when riding a bike. More than 1 out of every 2 children said that they do not

use such equipment or only use it sometimes. The high percentage of OST participants who

watch seven or more hours of TV, do not eat many fruits and vegetables, have few “family

meals”, and often do not eat breakfast also are areas for potential programming focus.

As always, further analyses are recommended prior to making substantive decisions based on

this information; a variety of additional analyses can be conducted using these data.


Providence YMCA Youth Services Healthy Habits Survey for Children

Scoring Guide

Scoring instructions. The Youth Services Healthy Habits Survey for Children is scored the

similar to the parent version. In the table below, the survey question is listed in the left column

and the score for that question is listed in the right column. There are 2 sections of the survey: (I)

Physical Activity and (II) Healthy Eating.

I. Physical Activity

Question Score

Do you participate in regular physical

activity (30 minutes or more on most days of

the week)

2 - Yes

0 - Don’t know

0 - No

How often do you participate in physical

activities in school?

2 - Everyday

2 - Most days

1 - Some days

0 - Very little

How often do you participate in physical

activities in your neighborhood?

2 - Everyday

2 - Most days

1 - Some days

0 - Very little

How many hours a day do you watch

TV/movies or sit and play video/computer

games during the week?

2- Less than 1

1 - 1-2

0 - 3-4

0 - 5-6

0 - More than 7

How many hours a day do you watch

TV/movies or sit and play video/computer

games on the weekend?

2- Less than 1

1 - 1-2

0 - 3-4

0 - 5-6

0 - More than 7

Child Physical Activity Score Sum 0-10

II. Healthy Eating

Question Proposed Score

How many servings of fruits or vegetables 0 - 0 servings


do you eat each day? (One serving is about

the size of the palm of your hand)

0- 1 serving

0 - 2 servings

1- 3 servings

1- 4 servings

2 - 5 servings

2 - 6 servings

How many times a week do you eat dinner

at the table together with your family?

0 – None

0 1-2

1-3-4

2-5-6

2-7

How many times a week do you eat

breakfast?

0 - None

0 1-2

1-3-4

2-5-6

2-7

How many times a week do you eat takeout

or fast food?

2 - None

1 1-2

0-3-4

0-5-6

0-7

Child Healthy Eating Score Sum 0-8

Providence YMCA Youth Services Healthy Habits Survey For Children

Name: __________________________ Date: _______________________

How old are you? 5 6 7 8 9 10 11 12

Are you female or male? Female Male


What grade are you in? K 1 2 3 4 5 6

During the past year, how many times have you moved (changed where you lived)

__________________

Do you think physical activity is important? Yes Somewhat No

Do you participate in regular physical activity (30 minutes or more on most days of the week)

Yes I Don’t Know No

If not, why?

_____________________________________________________________________________

Do you participate in physical activities in school? Yes No

If so, which

ones?_________________________________________________________________________

How often do you participate in physical activities in school?

Every Day Most Days (3 or more) Some days (1-2) Very little (<1)

Do you participate in physical activities in your neighborhood? Yes No

If so, which ones?

_________________________________________________________________________

How often do you participate in physical activities in your neighborhood?


Do your parents or other adults participate in physical activity with you? Yes No

If so, which ones?

__________________________________________________________________________

How often do your parents or other adults participate in physical activity with you?



Do you use appropriate safety equipment (for example, helmet, wrist guards, elbow and knee pads)

when you participate in a physical activity? Yes Sometimes No

Do you always have something available to drink during and after physical activity?

Yes Sometimes No

Do you think healthy eating is important? Yes Somewhat No

How many servings of fruits or vegetables do you eat each day? (One serving is about the size of the palm of

your hand)

0 1 2 3 4 5 6 or more

How many times a week do you eat dinner at the table together with your family?

None 1 – 2 3-4 5-6 7

How many times a week do you eat breakfast?

None 1 – 2 3-4 5-6 7

How many times a week do you eat takeout or fast food?

None 1 – 2 3-4 5-6 7

How many hours a day do you watch TV/movies or sit and play video/computer games during the

week?

Less than 1 1 – 2 3-4 5-6 more than 7

How many hours a day do you watch TV/movies or sit and play video/computer games on the

weekend?

Less than 1 1 – 2 3-4 5-6 more than 7

Do you have a tv in the room where you sleep?

Yes Sometimes No

How many 8 ounce servings of the following do you drink a day?

____ 100% juice ____ Water ____ Fruit drink or sports drinks


____ Whole milk ____ Soda or punch ____ Nonfat or reduced fat milk

Based on your answers, is there ONE thing that you would be interested in changing now?

Eat more fruits and vegetables

Take the tv out of the bedroom

Play outside more often

Switch to skim or lowfat milk

Spend less time watching TV/movies and playing video/computer games

Eat less fast food/take out

Drink less soda, juice or punch.

Drink more water.

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