In addition to the lesson outline we also discussed how it would be helpful to use the sentence, “ If ________, then ________” For example, “If I eat this piece of cake at lunch, then I will have a salad for dinner or exercise an extra 20 minutes today” or “If I work hard and do this 20 minute aerobic video, then I will reward myself with some relaxing time watching T.V. or reading” The idea is to think about it in the sense of “If I make this healthy choice, then how can I reward myself?” Or the opposite way where you can say, “If I indulge (give into temptation) on this unhealthy item, then how will it affect my long term goal of being healthy? Is it worth it? Or can I make up for it with something healthy?”
My participants can identify the healthy option, but the hardest obstacle they have identified has been the motivation to actually make that healthy choice and engage in the healthy behavior. By using this line of thinking and saying this “if-then” sentence, it will hopefully help them be able to negotiate their wants and needs towards accomplishing their wellness goals.
For this lesson, I made a copy of the vignette situations and cut them into strips so that as the participants broke into small groups they could pull the situations out of bag to talk about. This just seemed a simple way to make the activity more exciting. The discussions that followed the vignettes were really interesting. Then for the physical fitness portion to follow the lesson I gave the option for two different aerobic videos to let the group decide upon by using negotiation skills to decide on a compromise. For my group the votes were even so we had each side of the group negotiate their terms until we decided that the best compromise would be to do 10 minutes of each video versus 20 minutes of just one video. We followed the aerobic videos with the same situation by providing two choices of chair yoga videos. This time our participants had majority vote for one of the videos. The videos we used can be accessed at our video resource page that you can access here.
This lesson covered quite a bit of in depth material and prompted quite a bit of discussion. The participants did really well with it on the day of but struggled with recall at later lessons when we referenced the material. We used the following video to help cover the nutrients:
For the protein example, we did use grilled chicken breast pieces instead of tuna. We also used the example of super heroes and villains when it came to the good versus bad fats. This was a nice visual to help demonstrate the differences between the cholesterol causing trans and saturated fats versus the good for you cholesterol from unsaturated fats that works at de-clogging the bad cholesterol build up. In hindsight I do wish we had an avocado to taste because we did end up talking quite a bit about how avocados are a great food item example of good fat and they continued to list it as a healthy food the rest of the program.
In addition to the breathing techniques covered in the book we also added a few.
Imagine that there is a candle right in front of you. Place your hands over your stomach so that you can feel your breath expand deep in your lungs and your core muscles work, stretching and flexing as you breathe in and out. Think about your lungs filling with air deep in your chest and focus on moving the hand on your belly instead of your chest rising. As you exhale think about pushing your belly button into your tummy and towards the spine of your back as the breath leaves your body. Take several deep breaths thinking about these things. Next after you take your deep breath in, exhale in 6 quick short breaths like you are blowing out the imaginary candle in front of you with each breath. As you do this feel how your stomach and core muscles contract and push the air out of your lungs. As you exercise it is important to remember to engage those core muscles while you breathe in and out during your activity. As we exercise our bodies need more oxygen so taking nice deep breaths are better than short quick ones that don’t fill our lungs entirely with air. Also, focusing on breathing helps you keep from holding your breath and keeps your core muscles constantly working to build more strength. A healthy core and stomach muscles are an important foundation for a healthy body.
Guided Meditation Breathing Techniques are helpful to focus on breath and relaxation and are very helpful with stress reduction. You can use videos accessible online like the following one from Quiet Mind Cafe: Guided Meditation . You can sit comfortably in a chair but the best position is to simply lay on a mat or towel on the floor with your arms out at your sides, palms facing the ceiling and feet comfortably shoulder distance apart.
At the end of class I asked the participants who enjoyed the breathing techniques and who enjoyed the meditation. It is not for everybody and I did have a participant who said he didn’t like it and wouldn’t want to do it on his own. Which is perfectly acceptable! The thing is that we want to take this lesson opportunity to provide the participants with knowledge of as many options and ways to de-stress as possible so that they can chose what is most appropriate and enjoyable for them. As individuals we each have our own preferences which need to be respected and as many as possible options explored so that each participant can find the best fit for them when it comes to how they chose to be healthy. It is also important as a lesson leader that you don’t allow the things that you like/dislike to guide the lesson discussion and activities.
The most common theme throughout our group’s participant goals focused on trying new foods and trying to like healthy foods. Participants could name examples of healthy food choices but they didn’t admit to eating them often or even at all. I cold-called several local grocery stores and spoke to the managers about the possibility of getting a small tray of fruit and veggies donated. Not every manager was as helpful or friendly but what I found out was that one larger grocery store chain had an online donation request form that was very cumbersome. The managers I spoke with from this chain said that my request was small enough that it should be fine for me to work directly with my nearest store. I even spoke with one manager who agreed to work with the store nutritionist and his produce department to come up with the items they could have available for us to donate that would be most beneficial. The morning of this lesson I went to the grocery and picked up an entire basket full of fruits and vegetables that the grocery store manager had reserved for me. The items were scanned in as samples and provided more than enough food for our group to taste and even take some home.
In addition I wanted my group to try some whole grains so I also provided cous cous or quinoa and hummus because we had talked about these food items in class. Instead of asking for a donation, myself and my partner made these items ourselves to bring in and share. The participants were encouraged to at least taste and try everything and they could spit it out if they didn’t like it. I made a sheet that listed all the foods we tried and what food group they belonged to and had a spot for them to circle if they liked it yes or no. This allowed for participants to take these papers home so that their friends and caregivers could see the healthy foods they tried and the ones they liked so that hopefully opportunities for those same healthy foods to be eaten would be provided in the future.
During the discussions guided by the textbook, participants also asked questions about quality of tap water when there is a storm and what it meant for a bottle to be BPA free. We talked about how sometimes a lot of rain from a storm or if there is construction in the ground near the water pipes that it may decrease the quality of tap water. We even talked about how when a water main breaks or an emergency happens that makes the tap water unsafe to drink that the government will tell people to boil the tap water to make it safe for humans. BPA is a chemical that is commonly used in making plastics. Recently research has shown that BPA is harmful to humans and there has been a big push to make BPA free plastics for items such as water bottles. So it is always good to check the label of your sports water bottle to look for a BPA free label. Lastly we went around the room saying how much water we drank a day and made a new goal to drink more water. Several participants didn’t even drink one bottle a day so they started with the goal of one bottle per day while other participants were unsure how much water they drank so we gave them ideas and tools to keep track so we could add it to their goals next time we met. To aid with the discussion of water importance we viewed the videos below.
When I asked our group of participants if they knew what the word influence meant, the response was no. So to demonstrate the meaning of influence I had someone stand and try to walk forward representing that she was moving forward with a healthy lifestyle and I represented influence. When I was GOOD influence I pushed my partner lightly on the back and helped her go forward faster more confidently. When I was BAD influence I held my partners arms back to keep her from going forward. She pretended to struggle against me to demonstrate how bad influences can hold you back from a healthy lifestyle. This really helped to demonstrate the meaning of influence to our group and was a visual that they continued bringing up in future lessons. As we worked together to complete the participant hand out I kept going back to that example to explain what influence meant. The next part of the discussion involved what internal or external influences were. Our group came up with some fantastic examples that went above and beyond the curriculum examples and are shared below:
Internal Influences – self-esteem, self-image, feeling good, how you think of yourself
External Influences – shopping (how clothing doesn’t fit and it makes us feel bad), culture (how we were raised or what we traditionally eat or do for activity), media (TV, movies, games, magazines), family/friends, enemies (people who are jealous or talk negatively about us and make us feel bad – we are sometimes our own worst enemies when we talk bad to ourselves saying that we can’t do something or aren’t good at certain things)
For our group this was really a fantastic discussion where everyone had an idea or example to share and they felt validated by others who could relate. I would really encourage you to explore thoughts and feelings on what motivates and holds us back from being successful – especially as it pertains to individual healthy lifestyle goals.
I was able to borrow two blood pressure cuffs, one from the university health and wellness department and another from a co-worker whose father had a personal one he allowed us to borrow for the day. If your program didn’t have access to a blood pressure cuff you could perhaps work with your local health department or on site nurse to help you out.
After we discussed the lesson points from the curriculum book, each participant took their resting blood pressure measurements. Next we did our warm up and then started into aerobic activity such as marching in place, jumping jacks, and step touches making sure to incorporate arm movements so we got our heart rates up. Since we didn’t have individual blood pressure cuffs we did aerobic activity for 2-5 minutes post the warm up before I had my partner pull participants out one by one to check their blood pressure during activity. Since it only takes roughly 1 minute for the blood pressure to be checked, the participant was able to grab a drink of water, see their blood pressure during activity and then jump back into the aerobic activity with the rest of the group. This allowed us to do aerobics for 15-20 minutes total and for all participants to measure their active blood pressure. We completed the activity with a cool down while incorporating balance exercises and stretching.
I was lucky enough to have a stethoscope available so we started with each participant listening to their own heartbeat. Since we didn’t have access to any heart rate monitors I taught them how to feel for the pulse on their neck, wrist, and even by just putting a hand over their chest. We talked about what our heartbeat sounded and felt like. We talked about the work our hearts were doing to pump blood through our bodies. Here are some video options that we found to help visualize what we were talking about.
The next part of the lesson we did different physical activities and then checked to see how that affected our heart rate. First we did our warm-up and checked our heart rate every few minutes to see how it was beating harder and faster over time. Next we did some aerobic activity with jumping jacks and high knees marching so that the heart rate was even more elevated and we could feel it beating hard and fast. From there we brought our heart rates down a little by doing some body weight strength training only on our arms. By isolating our arms and keeping our feet planted we had a moderate heart rate because we weren’t moving our bigger leg muscles but keeping those still and only moving our smaller arm muscles. We did sets of 30 arm exercises repetitions where we had no added weight but concentrated on flexing our muscles. Exercises consisted of arm circles, starting with big rotations and then the size of a quarter, followed by some bicep curls, and triceps extensions with small movements extending arms straight behind with a locked elbow and squeezing inwards while lifting up, almost like you are trying to touch your hands behind your back with your elbows straight. We also did shoulder presses to work the muscles and flexibility in our shoulders by taking our hands from our shoulders with elbows in touching the rib cage and extending our arms straight up trying to keep our arms close to our ears.
After checking our heart rate again we did one more round of higher intensity aerobic exercise by dancing around moving both our arms and legs. We did step touches slow and then fast and moved our arms like we were swimming or running and then finished with fast feet like football players or MC Hammer (depending on your preference). After taking a few moments to check heart rates again to see what it felt like at the higher intensity, we did a cool down and then some stretches with deep breathing and learned how cooling down and stretching was a safe way to bring our heart rate down back to normal versus just sitting down and having it drop too fast.
We talked about what it means to make healthy choices; like eating the right foods, being active, and knowing what is healthy versus what is not. We discussed that it is okay to not always eat healthy or be active every day but that moderation is key; unhealthy choices should be limited and few. We also discussed how we can be an advocate for others to be healthy by leading by example and educating our friends and families about healthy options. For example, Brandy made spaghetti dinner with her mother and advocated to use whole wheat pasta and turkey meat instead of beef to help make the meal healthier. We discussed how good choices come with good and positive reactions and bad choices come with negative consequences. Based on the beer can and cigarettes on the form we did talk about how those unhealthy choices came with more negative consequences than other unhealthy choices such as eating a candy bar. Tobacco use is always unhealthy and alcohol can be enjoyed in moderation but is something that we as a group agreed should not be a choice of ours for a healthy lifestyle. The curriculum refers to a self-advocacy video for participants to view, however that video is no longer available. We have found this video as a replacement. You can also visit the National Gateway to Self-Determination website which has many other videos and resources.
Healthy Choices Activity:
We wanted to have two options for activities on this day so that the participants could choose which they would prefer as this demonstrated that we all have the right to make our own choices. For our activities, one group went to do strength and aerobic exercises while the other group worked on their balance and overall activity level by playing some games with noodles, cones, and balls.