BMI as a vital sign. Insured that all patients in local community clinics had their height and weight measured at each visit through provider education and training and referral system development (reached over 7,500 clinic patients). ? Breastfeeding policy. Implemented policies to promote breastfeeding in clinics, educated patients and clinic employees on the value of breastfeeding, and built capacity for more certified lactation specialists. Documented rates of exclusive breastfeeding from 7.7% in January 2005 to 20.2% in November 2009 (reached 900 staff and patients). ? School menu standards. Improved school meal/menu program during and after school to ensure meal compliance with nutritional standards and needs. Improved menu offerings and ingredients (e.g., added salad bars, changed to baked fries, whole wheat flour, etc). Expanded Universal Breakfast to five schools. Monitored compliance of policies for healthy fundraising, healthy vending, and alternative classroom rewards and incentives (reached over 7,700 students). ? PE standards. Implemented, at five elementary schools, the California standards-based physical activity curriculum and Game Days during school (reached 3,450 students). ? Worksite wellness. Worked with employers to adopt and implement worksite HEAL policies in the workplace; all county departments now have a worksite wellness coordinator. Received the worksite wellness bronze award for its accomplishments. (reached 4,000 employees in several worksites). ? Corner market produce. Implemented a grocery store Healthy Produce Basket project in neighborhood stores. Provided owners with educational materials and free produce in a basket and worked to identify ways to maintain the flow of produce. Some stores began purchasing from distributers. Worked with youth to provide free produce deliveries to these stores from unsold farmers’ market products to assist stores build a customer base for fresh fruits and vegetables (reached 4200 residents). ? Resident gardens. Local women from the Healthy Birth Outcome (HBO) Project grew produce in their backyards. Piloted selling excess produce at a stand in the park with the intention of creating a farmer’s market (reached 160 residents). ? Farmer's market. Organized and developed a four-month annual certified farmers’ market in West Modesto. Worked with Heifer International, a local organization that donated farm land and staff, and Project Uplift, a youth development project, to train youth to grow and sell organic produce with other vendors (reached 625 residents). ? After-school physical activity. Implemented a number of programs to increase the amount of exercise students get in afterschool programs, including the SPARK curriculum (offered daily), Powerplay (offered three times per week), and “Walk It Out” (offered three times per week). Increased daily after-school activity time from 15% to 45% (reached 1800 students). ? Walking school bus. Created a walking school bus at one school that increased the number of students walking approximately one half mile to school each day. Increased safety awareness through adult supervision, influenced traffic abatement, and reduced student tardiness (75 students walking daily). ? BMI counseling. Developed a routine counseling system to promote weight reduction among patients identified as being overweight in health care clinics (reached 140 patients). ? Youth awareness. Promoted student awareness of the importance of healthy eating and physical activity through the Educational Theater Program, Walk to School assemblies and other events (reached 2080 students). ? Community awareness of safe physical activity programs. Developed healthy messages for partners to insert into flyers, newsletters, bus ads, billboards, articles in local newspaper, and events (reached 17,000 residents). ? Worksite wellness promotion. Developed and implemented worksite wellness programs to decrease consumption of unhealthy foods and beverages and promote physical activity among employees. Received a state worksite wellness bronze award for its accomplishments (reached 4,000 employees in several worksites). After reading the description CAREFULLY, please organize the various objectives employed in this evaluation into the "bands" of the social-ecological model. You should briefly indicate WHY you feel these strategies fall within the specific categories of the model. From the list of objectives you have placed in the model, pick one objective from EACH of the "bands" of the model. Describe how you would evaluate that objective. Would you use formative or summative methods (and why)? What types of study design (qualitative or quantitative) and specific techniques would you use to collect the data in order to evaluate that objective? What sort of sampling might you use for each data collection approach? Remember to argue for your choices!

Imagine you are Person A. You just graduated from school and are now on your own. Your family is unable to help you in any way. You managed to find a job, but the pay is only enough to cover your rent in a tiny rundown apartment, transportation to and from work, limited cell phone service, and fast food or other cheap sources of calories. Your purchases of clothing and personal items are limited to what you absolutely require. You cannot buy anything simply because you like it. You need some new slacks to wear to work, so you are skipping breakfast this month to save for them. You cannot afford to see a doctor if you get sick. Your only choices for entertainment include hanging out with old friends from school, walking in a city park, watching a 9-year-old TV in your apartment, or reading books from the library. You do not have a computer or access to the Internet or cable TV at home. You do not know if or when you will be able to get a higher-paying job.

Now, imagine you are Person B. Like Person A, you just graduated from school. But unlike Person A, you have been put under house arrest for one year because of a conviction for drug possession. Although you live alone, you are the beneficiary of a family fortune and have more money than you could possibly spend in a lifetime. You are not allowed to leave your beautiful penthouse apartment, which is furnished with every kind of electronic entertainment device known to man. You do not need a job; you can surf the Internet; you can buy anything you want online and have it delivered; you can listen to the music you like and watch TV or streaming video whenever you wish; you can order food in from the best restaurants in town; and your friends can visit you.   

In legal terms, Person A is “free” and Person B is “not free.” Person A has the right to go anywhere in the world, while Person B is “imprisoned” in a beautifully decorated 3,000 squarefoot condominium.   

question

1. On page 4 of Handout S3, I describe an imagined Person A and Person B. Person A is legally free to go anywhere and do anything, but has very limited resources. Person B is confined to house arrest, but has no financial constraints. Go back and read the description, then answer the following questions:

If you had to spend a year living under the conditions of Person A or Person B, which would you choose? Which of the two has greater freedom? What if the timeframe were longer? Would that change your answers? (25 POINTS)

Answer EITHER 2a OR 2b below (25 POINTS):

2a. Happiness in the present moment has been described as being “in the flow,” a state of “being so absorbed and engaged in something that time falls away.” Here is a quote from page 14 of Handout S3:

“Being “in the flow” is not the same thing as relaxation, although both might make you lose track of time and both are important to happiness. Both can also bring about a sense of peace. Yet while relaxation generally implies a passive engagement or an avoidance of purpose, “flow” happens when you are actively focused on an intentional task or pursuit. All of your thoughts and emotions are simultaneously and purposefully directed toward this task, so much so that you may not even be aware of your feelings. You may not even be able to distinguish your awareness and intent from the actions themselves.

You might play ball, for example, either to relax or to intentionally hone your athletic skills. Either way, you might enjoy yourself and lose a sense of time, but working on skills requires more directed focus. Or, you might watch a movie either to relax or to gain information. The intention of the activity is what distinguishes “flow” from relaxation.”

What intentional activities do you engage in that take you away from time, place, and maybe even an awareness of yourself? Are there any similarities in these activities? Can you think of how to build more of them into your life?  

2b. Describe a situation in which you discovered synthetic happiness. What did you want that you did not get? What happened instead? How did you find happiness? What surprised you about the situation?

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