Running head: NUTRITION EDUCATION AND OBESITY PREVENTION

Nutrition Education and Obesity Prevention (NEOP) Program

Albanez-Echeverria, Y., Ignatowski, B., Jansen, A.,

Jreisat, T.,Marmolejo, C., Naim, N., & Van Dyke, W.

California State University, San Bernardino

NUTRITION EDUCATION AND OBESITY PREVENTION 2

Abstract

Obesity is a growing concern in the United States and is also affecting residents of San

Bernardino County. Within the United States, approximately one-third of all adults are obese

(Center for Disease Control and Prevention, 2016). Obesity is classified as having an excess of

body fat, or a Body Mass Index (BMI) above 25. Unfortunately, San Bernardino County

residents struggle to combat obesity due to various barriers, one of which is food deserts. Food

deserts are zones within communities that have limited access to healthy and affordable foods.

People affected by these areas suffer from nutrition-related consequences. Lack of access to

nutritional foods may lead to chronic diseases and primarily affect African-American, Latino,

and low-income residents. San Bernardino County suffers from food deserts and can benefit

from grocery stores that promote fruits and vegetables within them. San Bernardino residents can

also benefit from learning healthy food recipes and nutritional education classes. This can

improve their self-efficacy and knowledge with regard to their eating and dietary habits. In order

to combat this problem in San Bernardino County, our plan is to team up with the San

Bernardino Department of Public Health and Nutrition Services, San Bernardino County Health

and Human Services, California Department of Public Health, Women, Infants, and Children

(WIC), Supplemental Nutritional Assistant Program (SNAP), retail partners, and various

community partners to provide education, services, and resources that will improve nutrition and

obesity rates of San Bernardino County residents. The Saint Sophia Nutrition Education and

Obesity Prevention (NEOP) Program (Retail and Community Events) is a program that aims to

reduce obesity in San Bernardino County through various objectives. The specific objectives of

the program are: (1) work to increase education regarding nutrition and factors that contribute to

obesity; (2) seek to improve access to healthier food options for the residents of San Bernardino
NUTRITION EDUCATION AND OBESITY PREVENTION 3

County. Saint Sophia has more than 10 years working with San Bernardino County residents

targeting the SNAP-Ed audience. Through the NEOP program, Saint Sophia can educate and

inform the underserved population of San Bernardino County about the health effects of a

healthful diet and prevent obesity among them.

NUTRITION EDUCATION AND OBESITY PREVENTION 4

Table of Contents

Specific Aims.pp. 5-7

Needs/Problems.pg. 5

Working Hypothesis...pp. 5-6

Literature Review...pp. 6-7

Proposed Interventions/Activities and Expected Outcomes..pg. 7

Target Populations..pp. 7-9

Approaches and Methods.pp. 9-14

Goals.pp. 9-10

Objectives...pp. 10-11

Activities.pp. 12-14

Outcomes.pg. 14

Program Evaluation Plan....pp. 15-16

Agency Capacity and Project Management....pp. 16-17

Budget..pg. 17

Budget Justification....pp. 18-20

Community Support...pp. 20-21

Appendixes.pp. 22-24

Referencespg. 25
NUTRITION EDUCATION AND OBESITY PREVENTION 5

Statement of Problems or Needs

The needs assessment was created to determine the disparities, barriers, and needs for

improvement among San Bernardino County residents regarding nutrition:

Access and affordability is key in determining food buying practices among San

Bernardino residents.

Adolescents learn more about eating habits and diet patterns from their parents.

Children can be influential in parents grocery shopping decision making.

The biggest unmet needs are the lack of knowledge in healthy nutrition and several desert

areas in San Bernardino County.

San Bernardino County Residents need more sources that help them learn ways to

prepare healthy and affordable meals, as well as more information on how to practice

smart grocery shopping.

The needs assessment determined there are two areas of San Bernardino County that have

more nutrition disparities and are in need of improvement: High Desert area and the City of San

Bernardino. The rationale for this program includes: high obesity rates, several food desert areas,

high rate of nutritional illiteracy, and high rate of unhealthy nutritional eating patterns.

Working Hypothesis

Promoting fruits and vegetables and expanding access to grocery stores will give San

Bernardino residents a greater opportunity to obtain healthy foods, while making the process

easy. Also, demonstrating food recipes and promoting healthy nutrition education will help
NUTRITION EDUCATION AND OBESITY PREVENTION 6

increase San Bernardino residents self-efficacy and knowledge to improve their grocery

shopping practices and eating patterns.

Literature Review

The prevalence rates of obesity continue to rise in the United States. According to the

Center for Disease Control and Prevention (CDC), one-third of U.S. adults are obese (Center for

Disease Control and Prevention, 2016). A person is diagnosed as obese when they have an

excess of fat accumulation, which leads to body increase and their Body Max Index (BMI)

exceeds 25. The BMI is identified by identifying a persons weight and dividing it by their

height. This will help provide an indication of how much body fat a person has. In addition,

obesity is a concern because it is linked to an increase risk of developing chronic diseases and

comorbidities (Agborsangaya, et el, 2013). According to research studies on chronic diseases,

approximately 50% of 117,000,000 adults in the United States have one or more chronic disease

(Center for Disease Control and Prevention, 2016).

According to the CDC, this unhealthy pattern of poor eating behaviors is causing the rise

in obesity rates, and as of 2008 it is believed to have cost a total of $147,000,000,000 in Medical

costs. In summary, the medical costs for treating obesity is $1,429 more than for those whose

weight is around the normal range (Center for Disease Control and Prevention, 2016).

The needs assessment determined that food deserts are risk factors for obesity as well as

barriers to obtaining healthy foods. Food deserts are identified as zones with little to no access to

healthy and affordable foods which can directly influence social disparities in nutrition and

nutrition-related consequences, such as chronic diseases. Food deserts have a high number of
NUTRITION EDUCATION AND OBESITY PREVENTION 7

low-income, African-American, and Latino residents who are underserved by food retailers

(Beaulac, et el., 2009).

Proposed Interventions/Activities and Expected Outcomes

Our program plan is to partner up with the San Bernardino Department of Public Health

and Nutrition Services, community partners, San Bernardino County Human Services, California

Department of Public Health, retail partners, Woman, Infants, and Children (WIC), First 5,

Supplemental Nutritional Assistant Program (SNAP), city partners, farmers markets, hospital

departments, registered doctors and nurses, and the local government.

Furthermore, our program activities include: volunteer and staff training, food

demonstrations, health fairs, project connects, SNAP education, and conferences. In addition, it

aims to involve youth and adult residents of San Bernardino County, SNAP recipients, and

Latino and African-American residents.

Finally, our program includes short, medium, and long-term goals. These goals are listed

as follows: short-term goals include retail action plans to reduce obesity, acquired additional

funding sources, and completing training conferences. Medium-term goals include reaching 20

grocery stores with permanent signage, successfully conducting 100 food sampling events,

reaching 500 individuals through food demonstrations, and disseminating recipe cards.

Long term goals are to increase fruit and vegetable consumption, reduce obesity in San

Bernardino County, and increase knowledge of healthy eating in San Bernardino.

Target Populations

California Department of Public Health has identified that 40% of San Bernardino

County residents live within a food desert, 38% of San Bernardino County residents are

overweight, and 40% are obese. As a nonprofit organization, we recognize our responsibility in
NUTRITION EDUCATION AND OBESITY PREVENTION 8

maintaining and improving the access to healthy foods, as well as promoting the consumption of

fruits and vegetables for San Bernardino County Residents, to assist with reducing obesity.

According to the United States government census data, the total population of San

Bernardino County between the years 2009-2013 was an estimate of 2,056,915. In addition, San

Bernardino County subpopulations from larger race to smaller race are: the largest race was

White race in San Bernardino at a total of 1,294,675, second largest Hispanics or Latinos

population at 1,026,596, and Blacks or African American population was third largest with a

total population of 179,372. In addition, in the years 2009-2013 the total housing units within

San Bernardino County were at an estimate of 701,332. Furthermore, the median household

income in San Bernardino County is about $55,090. Finally, the estimate number of the

unemployed in San Bernardino County is about 129,122 individuals.

Saint Sophia will be responsible for administering the day-to-day fiscal and

administrative oversight and accountability of San Bernardino County Department of Public

Health (NEOP) Program (Retail and Community Events). It is understood that the first year of

funding is reported as $70,000 with an on-going annual funding of $84,000. Upon submission, a

San Bernardino County Department of Public Health form will provide detailed information for

review and evaluation by the first date of submission acceptance, August 16, 2017, or within the

noted time frame for submission.

Poverty level in San Bernardino County is about 32.3%, the number of Unemployed

individuals is about 129,122 and the families who are below poverty line are about 15%.

However, the percentage of householders who have less than high school diploma present 28.7%

of the county population and the householders with high school diploma present 17.2% of the

county population. This data can help explain some health disparities data among adults and
NUTRITION EDUCATION AND OBESITY PREVENTION 9

children in San Bernardino County. Four out of 10 students in San Bernardino County schools

are considered overweight or obese. In 2013, an average of 39.4% of San Bernardino County

students in the grades tested had an unhealthy body composition, compared to 38.3% statewide.

Saint Sophia has more than 10-years in providing services to the residents of San

Bernardino County, particularly targeting the SNAP-Ed audience. Currently, Saint Sophia

administers several grant funded programs including Mountain Fruit Program, which provides

fruits access to low-income residents in the mountain regions and Food desert project, which

works to minimize food deserts within high-desert communities. Saint Sophias interest in the

forthcoming allocations from the San Bernardino County Department of Public Health, for the

Nutrition Education and Obesity Prevention (NEOP) Program (Retail and Community Events)

will benefit 6000 recipients in the first year and up-to 15,000 recipients in total for the whole

project period. Saint Sophia will target volunteers, retail partners, community partners, and cities

within San Bernardino County to promote the NEOP Program. The program will be promoted

using systematic activities that range from health fairs, farmers market, project connects,

resource fairs, and volunteer training to promote the benefits of the NEOP program to its target

population. The short outcome impacts of the NEOP program to create an action plan to reduce

obesity in San Bernardino County by acquiring funding and to successfully complete nutrition

education of 6,000 participants within the first year. Finally, the NEOP program will assist in

reducing obesity and increasing family retention of nutrition education.

Goals
The goal for the Saint Sophia Nutrition Education and Obesity Prevention (NEOP)

Program (Retail and Community Events) is to lower rates of obesity in San Bernardino County.

Forty percent of the population of San Bernardino County is overweight. This is a serious health
NUTRITION EDUCATION AND OBESITY PREVENTION 10

epidemic that can be averted with care, community investment, and an increased sense of social

capital (CMS, 2015). Consider Marsha. She is a sixteen-year-old girl in San Bernardino City

High School. She is obese. She wants to be like normal, healthy kids her age. She wants to look

like the kids she sees in magazines and television. Her community upon which she lives is a

resistant factor for her to lose weight. She cannot gain the knowledge she needs to eat healthy

and lose weight. She cannot go to the grocery store to get healthy food. She lives in a food

desert. The nearest store to her home is a liquor store that has three bananas on the counter near

the register. The remainder of the store is stocked with unhealthy, prepackaged, processed foods

that will not provide her with a healthy dietary alternative to her food predicament. Marsha needs

to eat. She needs access to healthy foods. She needs to feel her community investing in her at the

most basic elemental level. She wants to gain knowledge. She wants to learn to eat healthy. She

wants to learn how to prepare healthy foods that will help her with her weight. She wants to walk

to a farmers market to attain healthy foods. She wants to feel her community investing in her.

She wants to grow a sense of social capital through pride in her city. If we invest in her health,

we will see positive results in the battle against obesity for San Bernardino County and for

Marsha.

Objectives

The Saint Sophia Nutrition Education and Obesity Prevention (NEOP) Program (Retail

and Community Events) will achieve the goal of reducing obesity in San Bernardino County

through the following objectives. First, the program will work to increase education regarding

nutrition and factors that contribute to obesity. Public health research shows that education can

make a difference in health determinants associated with obesity. Further, ignoring public health

education has a negative effect on controlling the public health epidemic faced by the general
NUTRITION EDUCATION AND OBESITY PREVENTION 11

population when considering obesity. This program will work to improve knowledge and access

to information for the residents of San Bernardino County. Armed with this tool, our constituents

can make informed decisions and wiser choices that affect their health, nutrition, and their bodies

(Nutbeam, 2000). The Health Belief Model (HBM) shows us that information can lead to an

understanding of risk factors, perceived threats, perceived barriers, and perceived benefits. This

understanding can lead to a change in behavior leading to self-efficacy in controlling obesity.

Second, the program will seek to improve access to healthier food options for the residents of

San Bernardino County. By increasing access to healthier food options, people can improve

personal, family, and community diets. They can encourage their friends and families to partake

in more appropriate food choices. They can celebrate an afternoon in their communities by

enjoying a day at a local farmers market where fruits and healthy foods are the bounty set before

them (Walker, 2010). Bronfenbrenners Ecological Theory shows that changes in the

microsystem, or the individual, can have rippling effects that will exert pressure and changes on

larger systems. An individual who is given a choice to buy foods at a farmers market can be a

living example for modeled behavior for their peer groups. Additionally, the mesosystem or

neighborhood can have positive impacts on the individual by giving them access and a pathway

to buy healthy foods. In turn, the exosystem represented by the government can be affected by

individual choices. Government representatives can advance policies that benefit the fight

against obesity (Bronfenbrenner, 1999). By combining education for nutrition and increasing

access to healthier food choices, Saint Sophia will work to reduce obesity in San Bernardino

County.
NUTRITION EDUCATION AND OBESITY PREVENTION 12

Activities

The Saint Sophia Nutrition Education and Obesity Prevention (NEOP) Program (Retail

and Community Events) will employ the following activities to generate success in the fight

against obesity for San Bernardino County. First, we will focus on community education by

targeting a core group of volunteers. These individuals will receive detailed training on health-

related topics regarding obesity and healthy eating, healthy cooking methods, shopping for

success, and morbidity and mortality factors associated with obesity. They will become our

community champions in the fight against obesity. Community health volunteers are vital assets

in affecting a change in public health. They will be selected from the communities in which we

are working. They will have detailed knowledge of the environmental pressures and the factors

that affect our constituents at an intimate level of understanding. Second, we will employ

Supplemental Nutrition Assistance Program (SNAP) education conferences to better educate

community members that are involved in this program. Reaching these individuals is a vital

component of our program. We strive to limit socioeconomic variables as a stratifying element

of public health. By reaching this group, we can help limit these disparities ensuring protective

factors for better living and eating are shared by all. Third, we will implement food

demonstration health fairs where community members can participate in cooking

demonstrations. They can sample healthy foods, get access to good recipes, and experience the

joys and benefits to eating healthy. They will discover that healthy eating has changed. With

modern cooking techniques, access to good foods and recipes, healthy eating is a sustainable and

enjoyable process for any individual, family, or community. Fourth, we will hold resource fairs

to educate people on where they can access healthy food choices. Our community partners will

be invaluable assets. Additionally, they will generate benefits for their organizations in this
NUTRITION EDUCATION AND OBESITY PREVENTION 13

endeavor. One community partner, the local farmers market consortium, has agreed to sponsor

our Afternoon on the Farm weekly events. They will spearhead delivery and sales of locally

sourced fruits and vegetables in San Bernardino County. Additionally, we have established a

partnership with Stater Bros. to provide us with venues, logistical support, and resources for

healthy eating resource fairs. As you know, Stater Bros is invested in the health of San

Bernardino County as they were founded here. They have agreed to price reductions on healthy

food choices for consumers that are served by the SNAP program. This benefit will be shared as

a resource along with any additional partnerships the Saint Sophia organization can develop.

Fifth, Saint Sophia will run a project connect telephone access line designed to assist people with

questions about healthy eating. It will serve as a portal for constituent questions regarding access

to healthy foods including locations they can receive discounts and benefits to ensure healthy

eating. Individuals who serve on the phone lines will be community health advocates who

understand community pressures. They will have knowledge of public transportation routes,

access opportunities for healthy eating, and schedules of all upcoming events. Sixth, Saint

Sophia will run a robust social media campaign including a website, Facebook, Twitter,

Snapchat, Instagram, and Woof. We will run this campaign primarily with volunteer public

health students from California State University, San Bernardino. These individuals are

knowledgeable regarding social media in conjunction with community based public health

efforts. Additionally, they will receive invaluable internship hours and work experience in the

field of Public Health. They will drive our message into every digital corner of San Bernardino

County. This is an important communication piece for our program. The Diffusion of Innovation

theory shows that San Bernardino County is an early adopter to the cellular phone with internet

capabilities (Dearing, 2009). This is an indication that a large segment of our population can be
NUTRITION EDUCATION AND OBESITY PREVENTION 14

reached with well-placed social media generated advertising campaigns. These campaigns

operate at a fraction of the cost of radio and traditional print advertisements. Finally, Saint

Sophia will run a public transportation advertising campaign to reach San Bernardino County

residents. This effort will place advertisements on bus stop benches and on marquees of city

busses. We anticipate that these combined efforts will net us substantial market saturation. With

this level of reach, we are confident in success of our goal to reduce obesity in San Bernardino

County.

The Saint Sophia Nutrition Education and Obesity Prevention (NEOP) Program (Retail

and Community Events) timeframe for success is a ten-year effort to reduce obesity in all age

groups by five-percent in San Bernardino County. Please see the attached Gantt chart for

additional timeframes, Appendix B.

Outcomes

The outcome for this program is a healthy reduction in obesity rates for San Bernardino

County. We understand this is a lofty goal with many challenging obstacles to overcome, but

San Bernardino County is ready for this change. We have run 261 focus groups to determine if

San Bernardino County resident are prepared to make a change in their diets. We have asked

them if they understand the ramifications of 40% of the population of the county remaining

overweight. The general consensus is that people are tired of being overweight. They want a

change and are ready for this public health initiative. They want to reverse the trend of childhood

diabetes, obesity, and skyrocketing rates of coronary heart disease. Based on the transtheoretical

model of change, they are in contemplation and prepared to take action. Our timeframe to meet

our five-percent reduction in obesity is achievable. This change will net substantial benefits for

public health and personal rewards for the residents of San Bernardino County.
NUTRITION EDUCATION AND OBESITY PREVENTION 15

Program Evaluation Plan

The evaluation plan for the Nutrition Education and Obesity Prevention (NEOP) Program

(Retail and Community events) will be implemented in every stage of the program. San

Bernardino County Department of Public Health Nutrition Program Coordinators and Managers

will provide most of the evaluation tasks for this NEOP program that will be contracted through

Saint Sophia. Saint Sophia will also subcontract an external consultant to provide feedback for

the program. Through various methods to collect, analyze, and interpret data, evaluators will

determine the effectiveness of the program, as well as the degree of successful implementation of

specific program activities and community engagement events. Consultant and County will

provide any necessary guidance in areas that may or may not need improvements for adherence

to grant protocols, as well as to establish a greater recurrence of funding for future cycles.

The purpose of the program evaluation is to maintain NEOP standards and ensure proper

protocols and implementation of the program with 100% fidelity for the most impact and benefit

to targeted populations of SNAP-Ed Latino and African Americans in San Bernardino County.

There are various methods that will be conducted to ensure proper implementation of NEOP

program practices. This will be completed through record-keeping standards that have been

established by the funding source. San Bernardino County workers will partake in onsite

monitoring visits and desk reviews, analyze monthly supporting documentation, reports, and

data, as well as continually evaluate Saint Sophias efforts in implementing NEOP Retail and

Community Events grant. Saint Sophia will provide proof of community reach through event

flyers and photos, qualitative stories, tracking of indirect/direct nutrition education, educational

materials and healthy recipes disseminated, taste testings distributed, food demonstrations

conducted, as well as indirect data collection of the communitys reaction, behaviors, and
NUTRITION EDUCATION AND OBESITY PREVENTION 16

attitudes as they pertain to food tastings, purchasing of and knowledge about fruits and

vegetables.

From gaining results through each objective, the evaluation report will demonstrate

successful implementation of the program activities, community engagement, and participation.

These activities will result in aiding in the NEOP goal to increase fruit and vegetable

consumption to reduce obesity in SNAP-Ed Latino and African American residents in San

Bernardino County. There will be an increase in not only knowledge of the benefits to healthy

eating, but also in the preparation and cooking of fruits and vegetables. Residents will feel self-

efficacy in purchasing, preparing, and eating healthy foods to reduce obesity rates in the County.

Agency Capacity and Project Management

To make San Bernardino healthier, Saint Sophia, a private nonprofit organization located

on 8008 Mercy street, Xavier, California, 99099 has provided services to the residents of San

Bernardino County for the last 10 years. The California Department of Public Health has

identified that 40% of San Bernardino County residents are obese. Our responsibility is

providing services to the residents of San Bernardino County, particularly targeting the SNAP-

Ed audience. Currently, Saint Sophia administers several grant funded programs including

Mountain Fruit Program and Food Desert Project.

Last year, its annual budget was $84,000. A total of 2,500 individuals and their families

in the community have received services through its various service program. These programs

include a list of more sources to prepare healthy and affordable meals, teaching healthy eating

habits and diet patterns, providing fruit access to low-income residents in the mountain regions,

and minimize food deserts within high-desert communities.

NUTRITION EDUCATION AND OBESITY PREVENTION 17

The structure and functions of the board of directors in Saint Sophia is very strong and

important. Attached is a list of current directors and the structure of the board in appendix A.

Budget
NUTRITION EDUCATION AND OBESITY PREVENTION 18

Budget Justification

Category
PHA
1. Salaries Request Leverage

.10 FTE Program Director (PD) $10,053 $0

This position will act to provide administrative support with contract preparation, fiscal
responsibilities, and oversee the health education specialists.
1.0 FTE Health Education Specialist $28,437 $0
Responsible for the daily activities associated with the selected (20) grocery stores in San
Bernardino County. The specialist will provide nutrition education and obesity prevention through
community engagement. The Health Education Specialist will coordinate schedules with each
grocery store, and assist with marketing and outreach activities. Provide program updates to
program director, and the funding source.

0.75 FTE Health Education Specialist $26,490 $0

Responsible for the daily activities associated with the selected (20) grocery stores in San
Bernardino County. The specialist will provide nutrition education and obesity prevention through
community engagement. The Health Education Specialist will coordinate schedules with each
grocery store, and assist with marketing and outreach activities. Provide program updates to
program director, and the funding source.

0.5 Administrative Assistant $ 3,450 $0

To assist with the San Bernardino County Department of Public Health contract and invoices and
required documentation.

0.10 Consultant $7,933

Provide direction and assistance in developing survey tools to evaluate program, monitor data
collection, analyze data, and report results.

2. Fringe Benefits $35,323 $0

Fringe benefits due to employees will be 41.72% of each employees salary. This will
include Medicare Taxes, Social Security, sick leave, and health insurance.
NUTRITION EDUCATION AND OBESITY PREVENTION 19

3. (a) Travel Local Private Vehicle $4,500 $0

Mileage and motor pool expense for program staff to travel to selected grocery stores and
various NEOP meetings sites throughout the grant cycle.

PHA
4. Consumable Supplies and Materials Request Match

General Office Supplies $3,000 $0

Costs associated but not limited to pens, binders, paper, ink, cartridges, toner, envelopes,
folders, etc.

5. Services $7800 $0

Communications $2600 $0

Cost associated with phone service, fax, and cell phones

Printing Services $4000 $0

Cost for printing and reproduction services, including printing of archival documents,
education materials, announcements and other mail outs for the Saint Sophia- Nutrition
Education and Obesity Prevention program. .

Staff Training $1200 $0

Cost associated with purchasing materials, and providing meals and snacks for participants.

PHA
Request Match

6. Other Costs $600 $0

NUTRITION EDUCATION AND OBESITY PREVENTION 20

Computer Equipment
Cost associated with upgrading desk top computers.
Copier Maintenance
Provide service to maintain copier for use with reproducing print material for the Saint Sophia-
Nutrition Education and Obesity Prevention program.
7. Indirect

External/Internal Administrative Costs $11,511 $0

10% of total personal cost

Community Support

In order to help reduce obesity rates in San Bernardino County, the involvement and

support of community members is crucial. The ongoing challenge at the community-level is

attempting to create a shift in changing behavior and social norms in order to encourage

everyone to adapt to a healthier lifestyle. The Saint Sophia Nutrition Education and Obesity

Prevention (NEOP) Program has partnered with community health workers, grocery stores, and

county and city stakeholders to ensure that residents have the availability of the services

provided by this program.

The support of community health workers as a strategy to address health issues among

low income neighborhoods can greatly improve the wellness of San Bernardino County. Saint

Sophia strives greatly in providing evidence-based information to the communities that they

serve, and studies have demonstrated that involving community health workers can effectively

provide a positive impact. For instance, community health workers understand the health
NUTRITION EDUCATION AND OBESITY PREVENTION 21

behaviors of their communities and know how culture plays a strong role. Therefore, individuals

are more comfortable in participating in the services provided.

Furthermore, Saint Sophia has partnered with 20 grocery stores in underrepresented

locations in the Inland Empire and scheduled training dates to invite the public to receive free

resources and education. At the local level, a symposium conference has been scheduled with

county representatives and city officials to work with community partners to improve the health

of San Bernardino residents and open the conversation on the multiple risk factors that are

causing residents to be overweight. Hence, building healthier communities and helping residents

have feasible access to healthier foods can help reduce the prevalence of chronic illness.
NUTRITION EDUCATION AND OBESITY PREVENTION 22

Appendixes

Appendix A

Board Members- 2017

President- Connie Marmolejo, MPH C

Vice-President- Yessenia Albanez-Echeverria, MPH C

Executive Director- Brandon Ignatowski, MPH C

Regional Directors

North America- Autumn Jansen, MPH C

South America- Tamara Jreisat, MPH C

Africa- Nooshin Naim, MPH C

Legal Counsel- Saul Goldman, Esq.

Webmaster- William Van Dyke, MPH C

NUTRITION EDUCATION AND OBESITY PREVENTION 23

Appendix B

Gantt Chart-
NUTRITION EDUCATION AND OBESITY PREVENTION 24
NUTRITION EDUCATION AND OBESITY PREVENTION 25

References

Adult Obesity Facts. (2016).

Retrieved April 27, 2017, from: https://www.cdc.gov/obesity/data/adult.html

Agborsangaya, C., Ngwakongnwi, E., Lahtinen, M., Cooke, T., & Johnson, J. (2013).

Multimorbidity prevalence in the general population: The role of obesity in chronic

disease clustering. BMC Public Health, 13, 1161.

American FactFinder. (n.d.). Retrieved from

http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF

Beaulac, J., Kristjansson, E., Cummins, S. (2009) A systematic review of food deserts. Prev

Chronic Disease, 6(3), A105. http://www.cdc.gov/pcd/issues/2009/

Bronfenbrenner, U. (1999). Environments in developmental perspective: Theoretical and

operational models. Measuring environment across the life span: Emerging methods

and concepts, 3-28.

Dearing, J. W. (2009). Applying diffusion of innovation theory to intervention development.

Research on social work practice.

Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health
education and communication strategies into the 21st century. Health Promotion
International, 15(3), 259-267.
Walker, R. E., Keane, C. R., & Burke, J. G. (2010). Disparities and access to healthy food in the
United States: A review of food deserts literature. Health & Place, 16(5), 876-884.
http://cms.sbcounty.gov/Portals/21/Resources%20Documents/CIR_2015_Report.pdf