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Nancy J. Gal Page 2

Version June 2, 2009.doc 2009 ROA and 2010 POW

2. BRIEF DESCRIPTION OF JOB DUTIES

This position provides leadership, teaching, management, and coordination for the planning,

implementation and evaluation of Family and Consumer Science (FCS) educational programs in Health, Nutrition and Food Safety. Target audiences are families (adults and youth) throughout the lifecycle. Programs are directed at achieving balance reflective of the county’s population and to address the unique and dynamic educational needs of county residents. Develop and sustain partnerships with community agencies and organizations sharing common goals. Establish and maintain a grass roots advisory committee representative of the community to help identify programmatic priorities for assigned areas of responsibilities. Assume other assignments and responsibilities in support of the total Extension program; follow all University and county policies and procedures.

Specific duties by percentage of FTE

I. Health and Nutrition 65%II. Food Safety 25%III. 4-H and Other Youth 10%

100%

I. Health and Nutrition 60%II. Family Nutrition Program 20% III. Food Safety 10%IV. 4-H and Other Youth 10%

100%

3. AREAS OF SPECIALIZATION

■ Health and Nutrition - Prevention and better management of chronic health conditions including type 2 diabetes, heart disease, hypertension, and obesity.

■ Food Safety - Protection of the food supply from microbial, chemical, and physical contamination.

4. ASSIGNED ACTIVITY SINCE LAST PROMOTION

Activity 2009-10 2008-09 2007-08 2006-07 2005-06 2004-05Teaching 0% 0% 0% 0% 0% 0%Research 0% 0% 0% 0% 0% 0%Service 0% 0% 0% 0% 0% 0%Extension 100% 100% 100% 100% 100% 100%TOTAL 100% 100% 100% 100% 100% 100%

5. EDUCATIONAL BACKGROUND

Educational Background

University Program Area Degree YearUniversity of Florida Ag and Extension M. Ag. 1991University of Georgia Food and Nutrition B.S. 1981

SUNY - Farmingdale Food Processing A.A.S. 1977

6. EMPLOYMENT

Employment ListingUniversity/ Organization Title

PermanentStatus* Year

UF/IFAS/ Marion County Extension

Extension Agent IV Yes 7/2002 - 2009

UF/IFAS/Marion County Extension

Extension Agent III Yes 8/1996 - 7/2002


Extension Agent IIActing County Extension

Director

Yes 3/1996 - 10/1996


Extension Agent II Yes 7/1992 - 7/1996


Extension Agent I Accruing 7/1987 - 6/1992

*Permanent status accruing or not

7. YEAR TENURE/PERMANENT STATUS WAS AWARDED BY UNIVERSITY OF FLORIDA - 1992

8. UF TENURE, PERMANENT STATUS, AND PROMOTION CRITERIA

9. TEACHING, ADVISING, AND/OR OTHER INSTRUCTIONAL ACCOMPLISHMENTS - NA

Nancy J. Gal Page 3

10. TEACHING EVALUATIONS – NA

11. GRADUATE FACULTY STATUS – none

12. GRADUATE COMMITTEE ACTIVITIES – none

13. RESEARCH NARRATIVE – none

14. CREATIVE WORKS OR ACTIVITIES (20)

Activity Worksheets (3)

Gal, N.J. 2010. Wellness Begins with Healthy Lifestyles: My Nutrition and Activity Plan. Marion County Extension Service. Will be developed for a special school-wide health program for high school science students.

Gal, N.J. 2009. The Art of Being Organized. Marion County Extension Service. Developed for the Marion County Human Resources training program. 2 pp.

Gal, N.J. 2009. Diabetes Meal Planning - Using the Caribbean Food Wheel. Marion County Extension Service. Developed for Take Charge of Your Diabetes Train-the-Trainer workshop for the Antigua and Barbuda Ministries of Health. 3 pp.

Gal, N.J. 2009. Life Skills for Success. Marion County Extension Service. Developed for a careers education program for high school students. 2 pp.

Exhibits and Displays (11)

Gal, N.J. 2010. Healthy Lifestyles for Youth. (2)

Health and nutrition education programs at Belleview High and Howard Middle schools, Ocala, Florida. Exhibits will feature a variety of printed information from sources including the University of Florida Extension Service, USDA MyPyramid, American Diabetes Association, National Dairy Council, Centers for Disease Control Fruits and Veggies Matters, Nemours Foundation, and the Food and Drug Administration. Visual aids will include rubber food models; food packages; test tubes illustrating sodium, sugar, and fat content of common foods; stretch bands and weights to promote physical activity; activities to estimate daily calorie and activity needs; and activities to practice meal and snack planning.

Nancy J. Gal Page 4

Gal, N.J. 2009. Surviving the Storm - Maintaining a Safe Food and Water Supply (2)

Food safety education programs at Munroe Regional Hospital’s Prestige 55 Education Program and On Top of the World Education Center, Ocala, Florida. Exhibits featured

University of Florida and United States Department of Agriculture Food Safety and Inspection Service printed materials, various ready-to-eat foods (healthy and non- healthy choices), water storage containers, appliance and food thermometers, small cooler (for medication and essentials), unscented bleach, antiseptic wipes, disposable towels, gel packs, and hand-held can opener.

Gal, N.J. 2009. Keeping Your Blood Pressure Down (3)

Hypertension education programs presented at Marion County’s main library, Munroe

Regional Hospital’s Prestige 55 Education Program and On Top of the World Education Center, Ocala Florida. Exhibits featured the National Heart, Lung and Blood Institute’s Dietary Approaches to Stop Hypertension (DASH) and University of Florida patient-centered printed materials, sodium-free and sodium-containing seasonings, low and high sodium food packages, blood pressure monitor, and test tubes

illustrating sodium content of fast and convenience foods.

Gal, N.J. 2009. Type 2 Diabetes (3)

Diabetes education programs presented at the Marion County Extension Office, St. Paul A.M.E. Church, and On Top of the World Education Center, Ocala, Florida. Exhibits featured University of Florida’s Take Charge of Your Diabetes and National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) patient-centered printed materials, meal planning/carbohydrate counting food display, Idaho Plate Method - placemat, blood glucose monitoring supplies, insulin and type 2 diabetes visual aid, fiber in common foods visual aid, and food label reading activity.

Gal, N.J. 2009. Pre-diabetes (3)

Pre-diabetes education programs presented at the Marion County Extension Office, Munroe Regional Hospital’s Prestige 55 Education Program and On Top of the World Education Center, Ocala Florida. Exhibits featured National Diabetes Education Program’s Small Steps … Big Rewards patient-centered printed materials, University of

Florida ENAFS (Elder Nutrition and Food Safety Program) and Take Charge of Your Diabetes patient-centered printed materials, meal planning and carbohydrate counting food display, Idaho Plate Method – placemat, insulin and type 2 diabetes visual aid, and food label reading activity.

Instructional Multi-Media Presentations (5)

Nancy J. Gal Page 5

Gal, N.J. 2010. Blood Glucose Monitoring: The Link to Better Diabetes Control. Will be developed for pre-diabetes and diabetes education programs.

Gal, N.J. 2010. Proper Foot Care for People with Diabetes. Will be developed for diabetes education programs.

Gal, N.J. 2010. How to Become a Savvy Food Shopper: Purchasing Healthy Foods on a Budget. Will be developed for healthy lifestyles programs.

Gal, N.J. 2010. Sick Day Management for People with Diabetes. Will be developed for diabetes education programs.

Gal, N.J. 2009. Food Safety Tips for Your Home Garden. Developed for an educational session at the Marion County Annual Master Gardener Spring Festival, Ocala, Florida. (34 slides).

Gal, N.J. 2009. Healthy Lifestyles for Youth – Making a Difference with Nutrition Education. Developed for an abstract presentation at the 23rd Annual Conference of the Extension Professional Associations of Florida, Orlando, Florida. (23 slides).

Gal, N.J. 2009. Diabetes Meal Planning Guide - Using the Caribbean Food Wheel. Developed for Take Charge of Your Diabetes Train-the-Trainer workshop for the Antigua and Barbuda Ministries of Health. (25 slides).

Gal, N.J. 2009. The Art of Organization. Developed for the Marion County Human Resource training program. (39 slides).

Gal, N.J. 2009. Life Skills for Success. Developed for a careers education program for high school students. (10 slides).

Visual aid (1)

Gal, N.J. 2009. Take Charge of Your Diabetes – Program Implementation Flow Chart. Developed for Take Charge of Your Diabetes Train-the-Trainer workshop for the Antigua and Barbuda Ministries of Health. Marion County Extension Service, Ocala, Florida. 2 pp. (11 x 14).

15. PATENTS AND COPYRIGHTS – none

16. PUBLICATIONS

a. Books, Sole Author - none b. Books, Co-authored – nonec. Books, Edited – noned. Books, Contributor of Chapter (s) – none e. Monographs – none

Nancy J. Gal Page 6

f. Refereed Publications – noneg. Non-refereed Publications (38)

o County Fact Sheets (2) Published by the Marion County Extension Service, Ocala, Florida.

Gal, N.J. 2010. Proper Foot Care for People with Diabetes. Will be developed for diabetes and pre-diabetes education programs.

Gal, N.J. 2010. Sick Day Management for People with Diabetes. Will be developed for diabetes education programs.

Gal, N.J. 2009. Blood Glucose Monitoring: The Link to Better Diabetes Control. Developed for diabetes and pre-diabetes education programs. 5 pp.

Gal, N.J. 2009. Reliable Food Safety Resources. Developed for home food handler education programs. 3 pp.

o Curricula: UF/IFAS Extension - Peer Reviewed (3)

Gal, N. J., Masciarelli, N. and Samuel, N. R. 2009. 4- H Munchy Adventures Project Book. University of Florida/IFAS Extension, Gainesville Florida. SPFN 10: 36 pp. For sale publication. http://ifasbooks.ufl.edu.

Jordan, J.C., Kochert, J., and Gal, N.J. 2009. 4-H Munchy Adventures Leader/Helper’s Guide. University of Florida/IFAS Extension, Gainesville, Florida. SPFNL 20: 34 pp. http://florida4h.org/projects/munchy-adventures/MunchyAdventures_LeadersGuide.pdf

Bobroff, L.B. and Gal, N.J. 2009. (major revisions; published 2007) Take Charge of Your Diabetes. Nine-session collaborative program designed to help adults with type 2 diabetes improve blood glucose control, reduce their health risks and improve quality of life. University of Florida/IFAS Extension, Gainesville, Florida. SP 345. http://ifasbooks.ufl.edu

Curricula - Peer Reviewed (1)

Gal, N.J., Masciarelli, N. and Samuel, N.R. 2009. Florida Agriculture: Growing Up Healthy with Food from Florida. Florida Ag in the Classroom. Orlando Sentinel Newspaper, Orlando, Florida. 8pp. (11 x 12)http://www.flagintheclassroom.org/

o Electronic Database Information System (EDIS) (1)

Nancy J. Gal Page 7

http://www.flagintheclassroom.org/

http://florida4h.org/projects/munchy-adventures/MunchyAdventures_LeadersGuide.pdf

http://florida4h.org/projects/munchy-adventures/MunchyAdventures_LeadersGuide.pdf

http://ifasbooks.ufl.edu/

Bobroff, L.B. and Gal, N.J. 2009. Diabetes-Related Websites. University of Florida/IFAS Extension, Gainesville, Florida. EDIS Extension Fact Sheet FCS – 8875 1 pp. http://edis.ifas.ufl.edu/pdffiles/FY/FY110300.pdf

o Evaluation Instruments (5) Published by the Marion County Extension Service, Ocala, Florida.

Gal, N.J. 2009. Food Safety. Practice change assessment. Developed to evaluate home food handler education programs. Pre-assessment: 12 items, 1 pp. Post-assessment: 14 items, 1 pp.

Gal, N.J. 2009. Healthy Lifestyles. Practice change assessment. Developed to evaluate cardiovascular, weight maintenance and U.S.D.A. MyPyramid education programs. Pre-assessment: 10 items, 1 pp. Post-assessment: 10 items, 1 pp.

Gal, N.J. 2009. Healthful Eating for Youth - What I Have Learned. Post-assessment to evaluate a five-part youth nutrition education program: seven items, 1 pp.

Gal, N.J. 2009. Pre-diabetes. Practice change assessment. Developed to evaluate pre-diabetes education programs. Pre-assessment: 12 items, 1 pp. Post-assessment: 14 items, 1 pp.

Gal, N.J. 2009. Nutrition Educator Volunteer Service/Evaluation Form. Developed to collect volunteer contact and practice change information. 2 pp.

o Newsletters (6)

Gal, N.J. 2010. Nutrition and Food Safety Connection. Bi-monthly electronic newsletter for adults to feature educational articles and program announcements. Marion County Extension Service, Ocala, Florida.

o Newspaper Articles (13)

Gal, N.J. 2010. Eating Wisely. Ocala Star Banner, Ocala, Florida. Quarterly question and answer column on food safety and nutrition.

Gal, N.J. 2009. Eating Wisely. Ocala Star Banner, Ocala, Florida. Periodic question and answer column on food safety and nutrition. 12 items: 300-400 words.

Gal, N.J. 2009. Food Safety Tips for Your Garden Grocery. Marion County Master Gardener Spring Festival tabloid. Ocala Star Banner, Ocala Florida.

Nancy J. Gal Page 8

http://edis.ifas.ufl.edu/pdffiles/FY/FY110300.pdf

h. Bibliographies/Catalogs – none

i. Abstracts (3)

Gal, N.J., Bobroff, L.B., and Jensen, N. 2010. Internationalizing UF/IFAS Take Charge of Your Diabetes Train-the Trainer Program for the Antigua and Barbuda, WI Health Ministries. 24th Annual Proceedings of the Extension Professional Associations of Florida.

Gal, N.J., Bobroff, L.B., and Jensen, N. 2010. Internationalizing UF/IFAS Take Charge of Your Diabetes Train-the Trainer Program for the Antigua and Barbuda, WI Health Ministries. UF/IFAS Extension Central District Symposium.

Gal, N.J. 2009. Healthy Lifestyles for Youth - Making a Difference with Nutrition Education. 23rd Annual Proceedings of the Extension Professional Associations of Florida: pg. 45.

Gal, N.J., Masciarelli, N., and Samuel, N. 2009. 4-H Munchy Adventures Project Book. 44th Annual Proceedings of the Caribbean Food Crops Society: 44 (2): 180-181. 2008.

Gal, N.J. and Samuel, N. 2009. 4-H Garden Project Builds Positive Life Skills in Youth. 44th Annual Proceedings of the Caribbean Food Crops Society: 44 (2): 193-194. 2008.

j. Reviews – none

k. Miscellaneous

Educational News Releases (10)

Gal, N.J. 2010 Will develop six educational news releases for publication in the Ocala Star Banner, Ocala Florida and the Daily Villages Newspaper, The Villages, Florida.

Gal, N.J. 2010. Will develop six educational news releases for publication in the Master the Possibilities Adult Continuing Education Center - Quarterly Catalog and website, On Top of the World Communities, Ocala, Florida.

Published by On Top of the World Communities, Ocala, Florida. Master the Possibilities Adult Continuing Education Center – Quarterly Catalog and website. http://masterthepossibilities.com/

Gal, N.J. February 6, 2009. Using the Nutrition Facts Label to Choose Healthier

Nancy J. Gal Page 9

Foods. Gal, N.J. March 12, 2009. Small Steps … Big Rewards: An Educational Program for Adults with Pre-diabetes.

Gal, N.J. March 20, 2009. Food Safety at Home.

Gal, N.J. May 12, 2009. Take Charge of Your Diabetes.

Gal, N.J. July 23, 2009. Surviving the Storm: Preparing for Disasters – Protecting Your Food and Water Supply.

Gal, N.J. August 19, 2009. Keeping Your Blood Pressure Down.

Gal, N.J. October 19, 2009. Strategies for Achieving and Maintaining a Healthy Weight.

Gal, N.J. October 26, 2009. How Can You Reduce Your Risk for Disease?

Published by the Ocala Star Banner, Ocala Florida.

Gal, N.J. October 28, 2009. Food Safety for the Holidays.

Gal, N.J. December 2009. Exciting Nutrition Projects for Youth.

17. LECTURES, SPEECHES OR POSTERS PRESENTED AT PROFESSIONAL CONFERENCES/MEETINGS

International

o Invited

Lecture/Training Gal, N.J. (presenter), Bobroff, L.B., and Jensen, N. 2010. Take Charge of Your Diabetes Train-the-Trainer program for the Antigua and Barbuda, WI Health Ministries. Three day training for approximately 25 medical professionals in Antigua. (audience - peers)

State

o Contributed

Poster Gal, N.J. (presenter), Bobroff, L.B., and Jensen, N. 2010. Internationalizing UF/IFAS Take Charge of Your Diabetes Train-the Trainer Program for the Antigua and Barbuda, WI Health Ministries. University of Florida/IFAS

Nancy J. Gal Page 10

Extension Central District Symposium. (audience - peers)

o Selected

LectureGal, N.J. (presenter), Bobroff, L.B., and Jensen, N. 2010. Internationalizing UF/IFAS Take Charge of Your Diabetes Train-the Trainer Program for the Antigua and Barbuda, WI Health Ministries. 24th Annual Conference of Extension Professional Associations of Florida, Orlando, Florida. (audience - peers)

LectureGal, N.J. (presenter) 2009. Healthy Lifestyles for Youth - Making a Difference with Nutrition Education. 23rd Annual Conference of Extension Professional Associations of Florida, Orlando, Florida. (audience - peers)

Poster Gal, N.J. (co-presenter) and Samuel, N.R. 2009. 4-H Munchy Adventures Youth Project. 23rd Annual Conference of Extension Professional Associations of Florida, Orlando, Florida. (audience - peers)

Local

o Invited

Gal, N.J. 2009. (presenter) What is Diabetes? Sumter County/IFAS Extension Service’s Take Charge of Your Diabetes Program, The Villages, Florida.(audience – clients)

18. CONTRACTS AND GRANTS -

a. Funded Externally

Years

Contractor or Grantor Project Title

Grant Amount

PI, Co-PI or Investigator

If Co-PI, Specify %

2010 Florida Department of

Health - Diabetes Prevention and

Control Program

UF/IFAS Take Charge of Your Diabetes Train-the-Trainer

State Workshop

$19,222 Co-PI 50%


2008-2009

Florida Agriculture in the

Classroom

Florida Agriculture: Growing Up Healthy with Food From Florida Youth Curriculum

$3600 Co-PI 33%

Total $3600

Summary of External Grant Funding Received (current) Summary of External Grant Funding

Role Total Direct Costs Indirect CostsPrincipal Investigator $ 00 $ 00 $ 00Co-Principal Investigator $ 3600 $ 3600 $ 00Co-Principal Investigator $ 19,222 $ 17,475 $ 1747

TOTALS $ 3600 $ 3600 $ 00

b. Funded Internally .

Years Contractor or Grantor Project Title

Grant Amount PI, Co-PI or Investigator

If Co-PI, Specify %

2010 UF/IFAS Extension FYCS Department –Family Nutrition Program (Cost-reimbursement program)

Family Nutrition Program $50,000

(approximate)

PI

2009 Florida Dept. of Health - Diabetes Prevention and Control Program

Administered through UF/IFAS Family, Youth

Take Charge Of Your Diabetes (TCYD)Train-the-Trainer Program

Mini-grant

$2244.00 PI


and Community Sciences Department – Dr. Linda Bobroff

2009 UF/IFASAdministration (Goal 7 Project)

Turning Point

Evaluation State

Training

$600.00 Co-PI 30%

Total $2844.00

Summary of Internal Grant Funding (Current) Role Total

Principal Investigator $ 2244.10Co-Principal Investigator 600.00

TOTALS $ 2844.10

e. In-kind Contributions Volunteer hour is $17.78

Year Type Donor Amount2010 Volunteer Hours - 175 Nutrition Educator Volunteers $31122010 Professional Medical

Services – TCYD Program and West Ocala Community Education and Health Clinic

85 Hours

- blood pressure measurements

Local Health Professionals:Advanced Registered Nurse Practitioner (1)

Licensed Physical Therapist (1)

Paramedic

Registered Dietitians/Certified Diabetes Educators (2)

$7820


- group teaching- small group consults Registered Nurse/Certified

Diabetes Educator (1)

Registered Nurses (3)

2009 Volunteer Hours - 159 Nutrition Educator Volunteers $2827.022009 Professional Medical

Services - TCYD Program

70 Hours

- blood pressure measurements- group teaching- small group consults

Advanced Registered Nurse Practitioner (1)

Licensed Physical Therapist (1)

Paramedic

Registered Dietitians/Certified Diabetes Educators (2)

Registered Nurse/Certified Diabetes Educator (1)

Registered Nurses (3)

$6285.00

2009 Blood Glucose Meters

15 ($60.00 per monitor)

Johnson and Johnson – Life Scan Pharmaceutical Company

$900.00

2009 Organ Wise Guys Total Elementary School Core Instructional Kit

Marion County School DistrictNutritional Services Department

$1523.00

Total $11,735.02Monetary Contributions

Year Donor Amount2010 Antigua, WI Health Ministries – Full financial

sponsorship for five member UF/IFAS and Florida Department of Health diabetes training team to travel to Antigua for five days. * US State Dept. Office of Allowances for per diem and air travel ($2,000 per member)

$10,000 *

2010 Florida Department of Health – Diabetes Prevention and Control Program - sponsorship to attend two meetings

$300

2010 Take Charge of Your Diabetes - 40 registrations (25 at $25 and 15 at $75)

$1750

2010 4-H Munchy Adventures Summer Day Camp registrations (25 at $50)(Team Program - Norma Samuel, Extension Agent II and Xiomara Diaz, Extension Agent I)

$1250

2009 Florida Department of Health – Diabetes Prevention and Control Program – sponsorship to attend two meetings

$302.69


2009 Take Charge of Your Diabetes - 27 class registrations $2025.002009 4-H Munchy Adventures Summer Day Camp

registrations (Team Program)$770.00

Total $3097.69

19. UNIVERSITY GOVERNANCE AND SERVICE

Years Name of Activity

Your Role

2004 - 2010 Florida Diabetes Advisory Council

- Governor appointed - Diabetes Prevention and Control

Program

Member representation (Interested Citizen with Diabetes)

Member – Children’s Workgroup

1997 - 2010 University of Florida Dietetics Program Advisory Board

Member

1997 - 2009 University of Florida Food Science and Human Nutrition - Dietetics Masters Program

Preceptor - Community Nutrition Rotation

2004 - 2010University of Florida/IFAS Extension Statewide Goal and Focus Area

Goal Team 5 - Individual and Family Development

Focus Team 3 - Health, Nutrition and Food Safety

Member - Goal 5, Team 3

Chair - Action Team for Diabetes Self Management for Children and Adolescents

2004 - 2010University of Florida/IFAS Extension Statewide Goal and Focus Area

Goal Team 7 - To Promote Professional Development Activities Designed to Enhance Organizational Efficiency and Effectiveness-

Focus Area 4 - Personal and Organizational Health.

Member - Goal 7, Team 4


2009 Sponsored an undergraduate dietetics student for a six-week paid internship.

Supervisor and mentor

2009University of Florida/IFAS Extension Family, Youth and Community Sciences Department -Dr. Linda Bobroff

- Keeping the Pressure Down curriculum

Lesson # 6 – Enhancing Your Lifestyle

Reviewer

20. CONSULTATIONS OUTSIDE THE UNIVERSITY - none

21. EDITOR OF A SCHOLARLY JOURNAL, SERVICE ON AN EDITORIAL ADVISORY BOARD OR REVIEWER FOR A SCHOLARLY JOURNAL - none

22. INTERNATIONAL ACTIVITIES

I was contacted in August 2008 by the Chief Medical Officer in Antigua regarding interest in the UF/IFAS Take Charge of Your Diabetes (TCYD) program.

I am the lead contact and coordinator for the UF/Florida Department of Health team invited by the Antigua, WI government to provide on-site diabetes education to a select group of medical professionals.

In response to this request, I recruited the training team; coordinated all travel preparations and arrangements; researched Antigua’s health delivery system; and facilitated team meetings. We developed a three day training program based on their responses to a customized needs assessment. This activity is being fully funded by the Antigua government. Anticipated travel dates are January 17th to January 22, 2010.

Training Team: (Five members including myself)

Linda Benjamin Bobroff, Ph.D., RD, LD/N Department of Family, Youth & Community Sciences University of Florida

Paul Doering, Distinguished Service Professor of Pharmacy Practice College of Pharmacy University of Florida


Nan Jensen, Extension Agent IVPinellas County Extension ServiceUniversity of FloridaTrina Thompson, Program AdministratorDiabetes Prevention & Control ProgramFlorida Department of Health

International Partner: Leslie Walwyn, M.D., M.P.H., Medical Officer responsible for the educational component of the Medical Benefits Scheme (MBS) in Antigua. MBS is a form of social health insurance that ensures free access to treatment for nine chronic diseases (including diabetes).

Purpose: To provide TCYD Train-the-Trainer program to select health professionals within the MBS responsible for adult diabetes education. The training will expand the outreach of the University of Florida Extension diabetes self-management program to help the government of Antigua reduce the health and financial consequences of type 2 diabetes.

23. EXTENSION PROGRAM –

I am responsible for providing comprehensive educational programming in the areas of health, nutrition and food safety for adults and youth in Marion County. I teach all classes with the exception of medications, physical activity and cardiovascular disease for people with diabetes. In addition to my direct teaching efforts, I also develop support materials such as newspaper articles, PowerPoint presentations, fact sheets, curricula, activity worksheets, learning activities, evaluations and displays. Programmatic efforts are guided by University of Florida/IFAS Extension administration and specialists; national, state and local research; and my local Health, Nutrition, and Food Safety Advisory Board.

Role and Activities of Your Advisory Committee:

The Health, Nutrition, and Food Safety Advisory Committee is a programmatic committee. Recruitment and retention are based in part by the willingness of a qualified individual to serve in a participatory manner for a select term. Members advise as well as collaborate on programs by teaching, facilitating, and advocating. The Committee formally meets twice a year with additional communication throughout the year.

The bi-annual meetings follow different formats. The June meeting serves as a mid-year program review to validate and/or re-direct current efforts as well as discuss new opportunities. The December meeting serves to discuss and identify new and existing critical health, nutrition and food safety issues (national, state, and local); prioritize issues; review current efforts; assess resources; and advise for the coming program year.

Meetings also include discussions regarding opportunities for collaboration; strategies


to enhance existing program efforts; assistance in building new relationships; identification of new audiences; approaches to improve marketing; identification of resources (money, in-kind and human); and affirmative action. Meeting dates were June 17th and December 3rd. Committee profile: six white females, two white males, one Hispanic female and three black females. Minutes sent to DED and CED. Two members also serve on the Overall Extension Advisory Committee.

In particular, two members were very instrumental in providing new programming opportunities.

Representation on the Board

* Marion County School Food Service Coordinator - Family Nutrition Program (FNP)

This member offered to be a partner on this project and has worked since mid-year in preparation for implementation in October 2010. She has helped recruit key school officials for commitment, advised on classroom implementation, provided documentation of program need (health status of Marion County youth), and offered school food service support.

* St. Paul A.M.E Church - Parish Nurse and UF Nutrition Educator Volunteer - TCYD Program and Community Health Clinic

This member represents the Nutrition Educator Volunteer program on the committee. She is very active in cancer and diabetes education within the community.

As a result of my receiving a $2400 TCYD Train-the-Trainer mini-grant from Florida Department of Health, this member applied to participate in the training. Several positive programming outcomes were realized as a result. Specifically, I was recruited as a main partner in the development of a Community Health and Education Clinic to serve West Ocala. My contribution would include group health and nutrition education to youth and adults.

Titles of Programs

Program titleI. Health and Nutrition 65%II. Food Safety 25%III. 4-H and Other Youth 10%


I. Health and Nutrition

A. Situation

According to the Centers for Disease Control and Prevention (CDC) the estimated totalmedical costs for diabetes in the U.S. in 2007 were $174 billion. CDC reports that outpatient training to help people self-manage their diabetes prevents hospitalizations and that every $1 invested in such training can cut health care costs by up to $8.76. If only one of the participants who improved their hemoglobin A1C (gold standard for blood glucose control) avoids a major health complication related to their diabetes during the next year, tens of thousands of dollars will be saved. For example, the estimated cost of an amputation related to diabetes is $30,000 to $60,000 and the cost of kidney dialysis per year per patient is $44,000. The incidence of blindness due to diabetic retinopathy is 25 times higher in people with diabetes than in the general population.

In Florida, heart disease and stroke have consistently been the number one and number three causes of adult death followed by diabetes at number five. These diseases and conditions contribute most heavily to death and disability and are among the most prevalent, costly and preventable of all health problems. However, diabetes ranks #1 as the most costly & prevalent chronic disease. It costs about seven billion dollars annually and affects 7-8% of the adult population (2008, CDC). A major contributor to the rising prevalence of pre-diabetes and diabetes as well as risk of death from cardiovascular disease and cancer is the epidemic proportions of overweight and obese adults and youth. Type 2 diabetes, heart disease and hypertension (number one risk factor for stroke) are related to lifestyle choices, and risk for these conditions can be reduced through behavior change. Lifestyle choices such as diet and physical activity affect short- and long-term health risks. Extension can encourage healthful eating and physical activity patterns that promote wellness through prevention and improved disease management. Educational programs will give people the knowledge, motivation, and skills they need to adopt behavior changes that promote positive nutritional status and reduce health risks.

Local Situation: The chronic disease status of Marion County is reflective of the statesituation. In Marion County 9.3% of adults ≥ 20 years has diabetes (2007, CDC). The demand for nutrition education for adults with type 2 diabetes and cardiovascular disease (CVD) has increased in relation to the obesity and pre-diabetes epidemic. Since diabetes has a strong CVD component, programming efforts overlap. The Diabetes Control & Complications Trial showed that good control can delay onset and/or progression of health complications. People with diabetes who engage in self-care practices maintain healthier blood glucose levels and are at reduced risk of developing heart, kidney, eye, and nerve problems. Fifty percent of people with diabetes reported having attended a diabetes self-management class. Locally, there are two American


Diabetes Association recognized diabetes education programs. One is hospital based and the other is private (Dia-Trition, Inc.). The hospital accepts only those individuals with insurance, is limited in the number of sessions provided, and too expensive ($850) for persons with limited means. The Agent provides the UF Take Charge of Your Diabetes program, an affordable ($75) comprehensive program in cooperation with certified diabetes educators from Dia-Trition, Inc. The TCYD program is an evidence-based program that has been shown to improve blood glucose control, one of the key goals of any diabetes self-management education program. The Agent has provided quality diabetes education for 12 years and has been recognized by the health community as a leader in closing the gap to help people with diabetes reduce risk of debilitating and costly health complications.Reference: http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx

Target Audiences:

Prevention: Adults interested in maintaining wellness and preventing illness.

Treatment: Adults at risk for developing type 2 diabetes and cardiovascular disease.

Adults diagnosed with type 2 diabetes and cardiovascular disease.

B. Program Objectives (4)

1.Cardiovascular Disease

At least 50% of program participants surveyed will adopt at least two therapeuticlifestyle practices to reduce risk of cardiovascular disease. Targeted therapeutic lifestyle practices: reduce saturated fat intake, increase dietary fiber intake, reduce sodium intake, adopt DASH eating plan (at least one component), and increase physical activity. According to the National Heart, Lung and Blood Institute’s Adult Treatment Panel III and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7).

Objective will be measured with a written pre/post assessment.

2. Pre-diabetes - Small Steps … Big Rewards

At least 50% of program participants surveyed will adopt two or more healthyeating/physical activity practices toward achieving a 5-7% weight loss and/or maintaining a healthy weight. Targeted practices: calorie appropriate eating plan, reduce fat intake, improve food selections as identified by the USDA MyPyramid (increase intake of whole grains, certain fruits and vegetables, fat-free and low-fatdairy products, etc.) and increase moderate physical activity to 150 minutes per week.

According to the National Diabetes Education Program.


http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx

At least 30% of program participants surveyed will adopt one basic carbohydratecounting practice. Targeted practices: label reading; Idaho Plate method; and counting carbohydrate grams and choices.

Objectives will be measured with a written pre/post assessment.

3. Diabetes - Take Charge of Your Diabetes Program

At least 50% of program participants surveyed will adopt two or more diabetes self- management practices by the conclusion of the five - six month program. Targeted practices: use of an accepted food system, blood glucose monitoring, 2 hour post-prandial blood glucose monitoring, carbohydrate counting (grams or choices), daily foot checks, and daily physical activity.

According to the 2010 American Diabetes Association Standards of Medical Care.

At least 30% of program participants will improve their blood glucose control as evidenced by a reduction of their A1C value. According to the American Diabetes Association “good control” is less than 7% (154 mg/dl average blood glucose).

Objectives will be measured with a written pre/post/follow-up assessment.

4. Healthy Lifestyles – Improve Nutrition Status

At least 50% of participants surveyed will increase their knowledge about healthy nutrition and physical activity lifestyle choices. Target practices based on the USDA MyPyramid: increased consumption of select fruits and vegetables, whole grains, low-fat and fat-free dairy products, lean meats and poultry; appropriate calorie intake; and at least 30 minutes of daily physical activity.


1.Cardiovascular Disease

At least 50% of program participants surveyed will adopt at least two therapeuticlifestyle practices to reduce risk of cardiovascular disease. Targeted therapeutic lifestyle practices: reduce saturated fat intake, reduce cholesterol intake, increase soluble fiber intake, reduce sodium intake, weight loss/healthy weight maintenance, adopt DASH eating plan (at least one component), and increase physical activity. According to the National Heart, Lung and Blood Institute’s Adult Treatment Panel III and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7).


2. Pre-diabetes - Small Steps … Big Rewards

At least 50% of program participants surveyed will adopt two or more healthy


eating/physical activity practices toward achieving a 5-7% weight loss and/or maintaining a healthy weight. Targeted practices: calorie appropriate eating plan, reduce fat intake, improve food selections as identified by the USDA MyPyramid (increase intake of whole grains, certain fruits and vegetables, fat-free and low-fatdairy products, etc.) and increase moderate physical activity to 150 minutes per week.

According to the National Diabetes Education Program.

At least 30% of program participants surveyed will adopt one basic carbohydratecounting practice. Targeted practices: label reading; daily carbohydrate distribution; Idaho Plate method; and counting carbohydrate grams and choices.

Objectives will be measured with a written pre/post assessment.

3. Diabetes - Take Charge of Your Diabetes Program

At least 50% of program participants surveyed will adopt two or more diabetes self- management practices by the conclusion of the five - six month program. Targeted practices: use of an accepted food system, blood glucose monitoring, 2 hour post-prandial blood glucose monitoring, carbohydrate counting (grams or choices), daily foot checks, and daily physical activity.

According to the 2009 American Diabetes Association Standards of Medical Care.

At least 30% of program participants will improve their blood glucose control as evidenced by a reduction of their A1C value. According to the American Diabetes Association “good control” is less than 7% (154 mg/dl average blood glucose).

Objectives will be measured with a written pre/post/follow-up assessment.

4. Healthy Lifestyles – Improve Nutrition Status

At least 50% of participants surveyed will increase their knowledge about healthy nutrition and physical activity lifestyle choices. Target practices based on the USDA MyPyramid: increased consumption of select fruits and vegetables, whole grains, low-fat and fat-free dairy products, lean meats and poultry; appropriate calorie intake; and at least 30 minutes of daily physical activity.


C. Educational Methods and ActivitiesMajor Educational/Programmatic Topics: Cardiovascular disease Type 2 diabetes (diabetes and pre-diabetes)Healthy Lifestyles

West Ocala Community Health and Education CenterI have entered into a partnership with St. Paul A.M.E. Church officials to collaborate


on a community health project. It will be a free health clinic for adults and youth in West Ocala. The coalition includes a lead physician, attorneys, grant writers, local medical professionals, Munroe Regional Medical Center, and Marion County Health Department. Multiple grants and other funding sources are currently being pursued for 2010 start-up. My contribution will be to provide group nutrition and health education to adults and youth.Inputs

Advisory Committee Memberships

- Advisory Committee for the Get Real Diabetes Program of Dia-Trition, Inc. - Florida Diabetes Advisory Council

Community PartnershipsThe strength of the successes can be attributed in part to the long-standing partnerships I have established through my tenure in this position. The main partners include: Cardiology Associates of Ocala; Munroe Regional Medical Center Prestige 55 program; Marion County Senior Services; Marion County Government; Marion County Health Department; Dia-Trition, Inc. (An American Diabetes Association recognized Diabetes Education Center); Mt. Moriah and St. Paul A.M.E. Churches; diabetes practitioners; Nutrition Educator Volunteers; and nutrition/health support groups.

GrantsI received a $2244.10 mini-grant from the Florida Department of Health Diabetes Prevention and Control Program to conduct the Take Charge Of Your Diabetes Train-the -Trainer program. This is an internal grant administered by Linda Bobroff, Ph.D., RD, LD/N, Dept of Family, Youth & Community Sciences at the University of Florida. I trained two Nutrition Educator volunteers to provide the program at their respective churches as part of the health ministry.

VolunteersThere were five Nutrition Educator volunteers who donated 93 hours of service: healthy lifestyles group teaching - 25 hours, diabetes group teaching - 44 hours, and diabetes health assessments - 24 hours. Total - 93 hours.

Outputs

I taught 81 classes/workshops reaching 1695 adults, representing 165 hours of direct stand-up teaching. These classes were two to three hours in length and generally taught in a series format ranging from three to 11 sessions including follow-up classes. The length and duration of the instructional sessions were determined by the characteristics of the audience and the subject matter.

Educational Methodology:■ Lectures■ Media - news articles, program announcements, media releases, etc.■ Meetings


■ Trainings (volunteers)■ Website – Marion County Extension Service Health & Nutrition page Contains subject matter related questions and answers and program announcements/class schedules. ■ WorkshopsProgram locations: ■ City of Ocala Senior Activity Center■ Disabled Services Training Center ■ Local churches - Joy Lutheran, Mt. Moriah Baptist, St. Paul A.M.E., etc.■ Marion County Government McPherson Complex ■ Marion County Extension Service■ Marion County Libraries - Main, Belleview, Marion Oaks, and Dunnellon■ Marion County Senior Services Meal Program - Harvey Fellowship Dining Site■ Munroe Regional Medical Center (Hospice and Collins Resource Center)■ On Top of the World - Master the Possibilities Adult Continuing Education Center■ Rainbow Lakes Estates Community Center■ Silver Springs Shores Community Center■ Sumter County Extension Service - Community Bank Program audiences: All programs are offered to the general public.

Support materials:■ activity work sheet 1■ curriculum revision TCYD 1■ displays 11 ■ EDIS publication 1■ evaluations 4■ fact sheet 1■ newspaper articles 8■ news releases 6■ PowerPoint 2■ visual aid - flow chart 1

Professional presentations:

■ 81 presentations featuring a combination of PowerPoint presentations, educational displays, hands-on activities, and activity worksheets

Educational Materials/Curriculum:

The educational materials used came from a variety of reliable sources to compliment materials from the Florida Cooperative Extension Service and the National Extension network. Some of the main resources include: American Dietetic Association; American Heart Association; National Heart Lung and Blood Institute; National Center For Disease Control; American Diabetes Association; American Cancer Society;


Food and Drug Administration; American Medical Association; Mayo Clinic; and the United States Department of Agriculture. The curriculum included detailed information on cardiovascular disease and diabetes focusing on the etiology, common symptoms, controllable and uncontrollable risk factors and the nutrition interventions (healthy lifestyles) to better manage (reduce risk for complications) or prevent/forestall health problems.The strategy used to promote behavior change focused on timely delivery of relevant educational programs to precisely targeted audiences. Series of educational classes were matched to specific health concerns of individuals with existing/newly diagnosed health problems. A combination of frequent contacts involving a variety of teaching methods were employed to instill a sense of confidence to stimulate desired practice changes.

Summary of group teaching events for Program I. Program I – Health and Nutrition

Instructor Type of Event TopicsNumber of

Events/HoursNumber of

ParticipantsSelf Group Teaching Cardiovascular

Disease20 450

Group Teaching Diabetes andPre-diabetes

45 675

Group Teaching Healthy Lifestyles 15 350Self Group teaching Cardiovascular

Disease22 506

Group teaching Diabetes andPre-diabetes 37 596

Group teaching Healthy Lifestyles 22 593

Total 81/165 1695

Volunteersfive adults

Group teaching Healthy Lifestyles 6 60Group teaching Diabetes 8 150

Health Assessments Diabetes 3 38

Volunteers Group teaching Healthy Lifestyles 12/25 110five adults Group teaching Diabetes 8/44 154

Health Assessments Diabetes 4/24 51 Total 24/93 315


Summary of clientele reached for Program I.Program Title: Health and NutritionNumber of Educational Materials Developed 33Number of Clientele Contacts

field consultations noneoffice consultations 8

telephone consultations 374group teaching participants 2010

e-mail consultations 10Web site visits unknown

D. Outcomes and Impacts

Objective 1:

Cardiovascular DiseaseAt least 50% of program participants surveyed will adopt at least two therapeuticlifestyle practices to reduce risk of cardiovascular disease. Targeted therapeutic lifestyle practices: reduce saturated fat intake, reduce cholesterol intake, increase soluble fiber intake, reduce sodium intake, weight loss/healthy weight maintenance, adopt DASH eating plan (at least one component), and increase physical activity.

Outcomes for Objective 1: Practice Change/New Behavior

* 92% (n=192) of program participants surveyed adopted at least two positive lifestyle practices. The most common practices adopted were: increased consumption of whole grains, fruits and vegetables; reduced consumption of sodium and saturated fat; and using a recommended portion control strategy (measuring food and/or the plate method) to control serving size.

Objective 2:

Pre-diabetes – Small Steps … Big Rewards

At least 50% of program participants surveyed will adopt two or more healthyeating/physical activity practices toward achieving a 5-7% weight loss and/or maintaining a healthy weight. Targeted practices: calorie appropriate eating plan, reduce fat intake, improve food selections as identified by the USDA MyPyramid


(increase intake of whole grains, certain fruits and vegetables, fat-free and low-fatdairy products, etc.) and increase moderate physical activity to 150 minutes per week.

At least 30% of program participants surveyed will adopt one basic carbohydratecounting practice. Targeted practices: label reading; daily carbohydrate distribution; and counting carbohydrate grams and choices.

Outcomes for Objective 2:

Practice Change/New Behavior* 80% (n=105) of program participants surveyed adopted at least two healthy eating/physical activity practices. The most common practices adopted were: portion control, reduced fat intake, increased physical activity, and basic label reading for healthier food choices.

New Behavior

* 70% (n=105) of program participants surveyed adopted the basic carbohydrate counting practice of 15 grams carbohydrate per starch exchange or choice.

New Behavior

* 90% (n=105) of program participants surveyed adopted the Idaho Plate Method as their main strategy for diabetes meal planning. This is a basic meal planning approach that helps to control and evenly distribute carbohydrate intake throughout the day for improved blood glucose control.

Objective 3: Diabetes - Take Charge of Your Diabetes Program (TCYD)

Objectives:

At least 50% of program participants surveyed will adopt two or more diabetes self - management practices by the conclusion of the five - six month program. Targeted

practices: use of an accepted food system, blood glucose monitoring, 2 hour post- prandial blood glucose monitoring, carbohydrate counting (grams or choices), daily foot checks, and daily physical activity.

At least 30% of program participants will improve their blood glucose control as evidenced by a reduction of their A1C value. According to the American Diabetes Association “good control” is 7% (154 mg/dl average blood glucose).


The TCYD was taught four times in 2009; two at the Marion County Extension Office, one at On Top of the World Community and one at St. Paul A.M.E. Church. The program at St. Paul Church will conclude in February and will be reported in 2010.

Outcomes for Objective 3:

#1 August 2008 - January 2009 (Extension Office)

Initial participation n= 17 Post-assessment participation n= 13 Follow-up participation n= 10

Results reported for the 10 participants who completed the three evaluations.

#2 April 2009 - September 2009 (Extension Office)

Initial participation n= 12 Post-assessment participation n= 11 Follow-up participation n= 12

Results reported for the 11 participants who completed the three evaluations. The 21 total participants ( # 1 and # 2 above) completing the pre/post/follow-up (five month duration) health and self-management assessments are reported below.

Health Assessment (n=21)

66% reduced weight 71% reduced blood pressure 48% reduced both weight and blood pressure

Self-management Practices Survey (n=21)

The eight self-management items listed below reflect an increase in the number of days practiced (from baseline) within the past seven days.

71% used an accepted food system

76% adjusted calorie intake to support a health weight

62% spaced carbohydrates evenly

62% participated in at least 30 minutes of physical activity

48% checked blood glucose at least once

81% checked blood glucose two hours after eating

43% checked feet

33% dried between toes after washing


A1C Values (n=19)

53% reduced their A1C value

42% maintained their A1C value

(two participants did not report A1C)

#3 May 12 - June 9, 2009 (On Top of the World Education Center)

Initial participation n=16 Post-assessment participation n=11

Results reported for the 11 participants who completed the two evaluations.

Due to the abbreviated duration of this program; weight, blood pressure, and A1C values were not collected. Although A1C values are considered the gold standard for measuring diabetes control, program length (five weeks) did not coincide with the American Diabetes Association’s Standards of Care recommendations for A1C testing.

Self-management Practices Survey (n=11)

The eight self-management items listed below reflect an increase in the number of days practiced (from baseline) within the past seven days.

55% used an accepted food system

45% adjusted calorie intake to support a health weight

27% spaced carbohydrates evenly

36% participated in at least 30 minutes of physical activity

18% checked blood glucose at least once

36% checked blood glucose two hours after eating

45% checked feet

18% dried between toes after washing

Diabetes – General Education

At least 50% of program participants surveyed will increase their knowledge about type 2 diabetes and the importance of at least two self-management practices to reduce risk of complications. Targeted practices: blood glucose monitoring; 2 hour post-prandial blood glucose monitoring; carbohydrate counting (grams, choices, or Idaho Plate Method); daily foot checks; daily physical activity; and proper medication administration.


Knowledge

* 87% of program participants surveyed (n=124 - five groups) increased their knowledge of type 2 diabetes (general understanding of insulin resistance) and at least three of the six concepts of self-management. Impacts for Objectives 3 and 4: (Diabetes and Pre-diabetes programs)

The goal of diabetes care is to prevent or reduce the risk of complications by controlling

the levels of blood glucose, blood pressure, and blood lipids, and by receiving preventive care according to the American Diabetes Association’s Standards of Care. The TCYD program empowers participants to make changes in their lifestyles to improve their control and enhance overall health.

The gold standard for measuring diabetes control is the glycosolated hemoglobin test (A1C). Research has shown that maintaining good control (A1C less than 7%) significantly reduces the risk for macrovascular and microvascular complications.

According to the Centers For Disease Control’s 2007 National Diabetes Fact Sheet:

Blood Glucose - Each 1% reduction in A1C helps reduce the risk of eye, kidney, and nervous system diseases by 40%.

Blood Pressure - Good blood pressure control helps reduce the risk of cardiovascular disease by 33% to

50%, and the risk of eye, kidney, and nervous system diseases by approximately 33%.

- For every 10 mm Hg reduction in systolic blood pressure, the risk for any diabetes complication is reduced by 12%.

Blood Lipids (Fats) - Improved LDL cholesterol can reduce cardiovascular complications by 20% to 50%

Preventative Care – Standards of Medical Care

- Early detection and treatment of diabetic eye disease with laser therapy can reduce the development of severe vision loss by approximately 50% to 60%. - Proper foot care can reduce amputation rates by 45% to 85%.

- Early detection and treatment of diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30% to 70%.


- The use of angiotensin receptor blockers (hypertension medications) can reduce proteinuria, a risk factor for developing kidney disease, by 35%.

Objective 4:

Healthy Lifestyles – Improve Nutrition Status

At least 50 % of participants surveyed will increase their knowledge about healthy nutrition and physical activity lifestyle choices. Target practices based on the USDA MyPyramid: increased consumption of select fruits and vegetables, whole grains, low-fat and fat-free dairy products, lean meats and poultry; appropriate calorie intake; and at least 30 minutes of daily physical activity.

Outcomes for Objective 4: Knowledge

* 88% (n=150) of program participants surveyed increased their knowledge of two or more healthy nutrition lifestyle choices.

* 85% (n=150) of program participants surveyed increased their knowledge of the importance of daily physical activity.

Additional Results for Objective 4: Practice Change

* 60% (n=150) increased consumption of whole grains * 80% (n=150) increased consumption of potassium-rich fruits and vegetables (to support good blood pressure control)

Success Story: Pre-diabetes Education – Accuracy and Reliability is Critical to Patient Outcomes

While many adults are diagnosed with pre-diabetes or diabetes every day in this country, sometimes the diagnosis does not always follow the guidelines of the American Diabetes Association. A misdiagnosis can be physically and emotionally harmful for the patient. The Extension Family and Consumer Sciences Agent provides on-going pre- diabetes and diabetes education for adults. One of the requisites of both programs is defining the main types of diabetes as well as stating the American Diabetes Association’s diagnostic guidelines for pre-diabetes and diabetes.

A participant in my diabetes program had been recently diagnosed by her physician as having type 2 diabetes. During the course of the program it was determined that she had been misdiagnosed. She actually had pre-diabetes. The initial diagnosis had


negative employment implications due to the nature of her work. She consulted with our certified diabetes educator/registered dietitian and her physician to officially correct the diagnosis in her medical record. As a result of her participation in our program she was able to receive the proper medical treatment plan from her physician and learn about diabetes self-management skills without negatively impacting her employment.

Race and Ethnicity Data for Program I1. Food Safety

A. Situation

Food safety and quality are major concerns of Florida consumers as well as local residents. While America's food supply is one of the safest in the world, the Centers for Disease Control's annual estimates indicate foodborne disease in the United States is responsible for 76,000,000 cases of illness, 325,000 hospitalizations and 5,000 deaths. Florida ranks as one of the top 10 states in the incidence of foodborne illness. It is critical for home and commercial food handlers to be educated on the importance of practicing recommended safe food handling procedures to help reduce risk of food borne illnesses.

In Marion County, the Extension Service is the lead agency responsible for providing consumer and commercial food safety education. The combination of diverse food consumption trends along with a global food supply has presented unique challenges in educating consumers on how to select and safely handle foods. The globalization of the marketplace, changes in eating habits, increased dining out have exposed


Race and Ethnicity

Projected Target

Audience(for 2009)

Audience Reachedin 2009

*Parity (± 4%)

Reached

Projected Target Audience(for 2010 POW)

No. % No. % Yes or No No. %Hispanic 87 4 No 250 10

Multi-racialPacific

IslanderAmerican

IndianNo 12 .5

Asian 20 1 Yes 38 1.5Black 540 22 No 300 12White 1755 73 Yes 1900 76

UnknownTotal 100 2402 100 2500 100

GenderMale % 718 30% No 1200 48%

Female % 1684 70% No 1300 52%Unknown % %

Total 100 2402 100 2500 100

consumers to new pathogens. Longer life spans, the AIDS epidemic, and proportion of persons with chronic illness have increased the population of persons who are high risk of foodborne illness. Many "new" diseases have probably been around for a very long time, but increased knowledge of infectious disease has allowed medical science to ascertain the cause of food-borne infections whose origins were previously unknown. Extension's role is to provide food safety education programs in accordance with the Food and Drug Administration (Food Code) and United States Department of Agriculture's Food Safety Inspection Service. Home food handler training will be based on the general concepts of clean, separate, cook and chill. The commercial food handler training will follow the National Restaurant Association's Serv Safe training and exam.

Target Audiences:

The primary target audiences are adult and youth home and commercial food handlers. Special emphasis will be given to care givers of high risk individuals (very young, elderly and immune compromised) at greater risk for foodborne illness.

B. Program Objectives

1. At least 50% of program participants (home food handlers) surveyed will adopt at least two safe food handling practices based on the principles of clean/sanitize, separate, cook, chill, and storage.

According to recommendations by the USDA Food Safety and Inspection Service and the United States Food and Drug Administration.

Objective will be measured with a written pre/post survey.

2. At least 60% of registered Serv Safe program participants will achieve at least 80% on their certification exam. Note: 75% is a passing score.

Objective will be measured with the National Restaurant Association’s Serv Safe Exam.

1. At least 50% of program participants (home food handlers) surveyed will adopt at least two safe food handling practices based on the principles of clean/sanitize, separate, cook, chill, and storage.

According to recommendations by the USDA Food Safety and Inspection Service and the United States Food and Drug Administration.

Objective will be measured with a written pre/post survey.

2. At least 60% of registered Serv Safe program participants will achieve at least 80%


on their certification exam. Note: 75% is a passing score.

Objective will be measured with the National Restaurant Association’s Serv Safe Exam.

C. Educational Methods and Activities

Inputs

Community PartnershipsThe main partners include: Marion County Environmental Health (food inspector); Marion County Senior Services; On Top of the World Community Education Center; and Munroe Regional Medical Center Prestige 55 program.

VolunteersNutrition Educator Volunteers provide minimum support to the food safety program. Their main emphasis is health and nutrition. There food safety education contribution is reported in the 4-H and Other Youth section.

Outputs

I taught 26 classes/workshops reaching 541 adults, representing 82 hours of direct stand-up teaching. The home food handler classes were one to three hours in length and the commercial food handler classes were six hours in length (one session).

Educational Methodology:■ Lectures■ Media - news articles, program announcements, media releases, etc.■ Meetings■ Trainings (volunteers)■ Website – Marion County Extension Service Food Safety page Contains subject matter related questions and answers and program announcements/class schedules. ■ Workshops

Program locations:■ Denny’s Restaurant■ Dunnellon’s Women’s Club■ Local churches - Joy Lutheran, Mt. Moriah Baptist, Unity Baptist, etc.■ Marion County Extension Service■ Marion County Libraries - Dunnellon and Marion Oaks■ Marion County Master Gardener Spring Festival■ Marion County Senior Services Meal Program - Harvey Fellowship Dining Site■ Munroe Regional Medical Center (Hospice and Collins Resource Center)■ On Top of the World - Master the Possibilities Adult Continuing Education Center


■ Rainbow Lakes Estates Community Center

Program audiences:All programs are offered to the general public. ■ Serv Safe is specifically targeted to commercial food handlers.

Support materials:■ displays 2 ■ evaluation 1■ fact sheet 1■ newspaper articles 5■ news releases 3■ PowerPoint 1


■ 26 presentations featuring a combination of PowerPoint presentations, educational displays, hands-on activities, and activity worksheets

Educational Material/Curriculum

The curriculum included detailed information for home and commercial food handlers regarding the prevention of foodborne illness through proper handling, storage, preparation and serving of foods.

The educational materials came exclusively from the following sources: University of Florida/IFAS Extension and Research; United States Department of Agriculture - Food Safety Inspection Service; Food and Drug Administration (FDA); FDA Food Code; National Restaurant Association Educational Foundation; National Home Food Preservation Web Site; Florida Department of Agriculture and Consumer Services; Florida Department of Health; and the Florida Department of Business and Professional Regulation.

This educational effort was divided into two distinct programs relevant to the needs of the target audiences: voluntary attendance by home food handlers and mandatory attendance by commercial food handlers. The instructional methods and content were different for each group based on the recommendations from the governing/responsible agency.


Summary of group teaching events for Program II

Program II – Food Safety


Events/HoursNumber of

ParticipantsSelf Group teaching Food Safety -

Home Handlers12 300

Group teaching Food Safety-Commercial

Serv Safe

4 24

Self Group teaching Food Safety - Home Handlers

18/32 461

Group teaching Food Safety-Commercial

Serv Safe7/48 52

Group teaching Food Safety -Commercial

Safe Staff

1/2 28

Total 26/82 541

Summary of clientele reached for Program II.

Program Title: Food SafetyNumber of Educational Materials Developed 12Number of Clientele Contacts

field consultations noneoffice consultations 2

telephone consultations 562group teaching participants 541



Objective 1:

At least 50% of program participants (home food handlers) surveyed will adopt at least two safe food handling practices based on the principles of clean/sanitize, separate, cook, chill, and storage.


Outcomes for Objective 1: Practice Change/New Behavior

* 86% (n=245) of program participants surveyed adopted at least two safe food handling practices. Most common practices adopted were: maintaining safe refrigeration temperature; following the two-hour rule; cleaning before sanitizing; washing hands during food preparation; and proper cooking and cooling of foods.

Objective 2:

At least 60% of registered Serv Safe program participants will achieve at least 80% on their certification exam. Note: 75% is a passing score.

Outcomes for Objective 2: Knowledge

* 88% (n=52) of Serv Safe participants passed the National Restaurant Association’s Serv Safe Exam.

Impacts for Objectives 1 and 2:

It is well documented that foodborne illness is a serious public health hazard affecting approximately 76 million people in the United States each year. Preventing foodborne illness is a top priority for the United States Department of Agriculture’s Food Safety and Inspection Service. Since research has shown that improper handling, preparation, and storage of food can cause foodborne illness, it is critical that all food handlers and consumers are well educated in proper food handling and sanitation to help reduce risk of illness. The Centers for Disease Control have identified poor personal hygiene, failing to cook food properly, and holding food at incorrect temperatures as three of the top five causes of foodborne illness. Of those who attended this food safety program, 86% adopted key practices consistent with research recommendations to help reduce risk of foodborne illness.

Success Story:

A Church’s Extraordinary Efforts To Provide Safe Food For their Community

Many houses of worship provide food service for their parishioners as well as residents within their community. The extent to which religious organizations comply with state and local food safety regulations is variable. However, one local church went beyond the call to make sure their food outreach program met or exceeded the commercial food safety regulations as outlined by the Food and Drug Administration’s Food Code. The two main components of their plan were to construct a certified commercial kitchen and ensure all involved church members received approved food safety training. The Extension Family and Consumer Sciences Agent worked with the church pastor and lead project members to develop an appropriate food safety education program. The Agent, in cooperation with the local health inspector, advised the pastor and church


members regarding training requirements. The Agent provided the Serv Safe training and exam for the pastor and lead project member as well as on-site in-depth food safety training for 21 church members who will be directly involved in the food service project. As a result of this effort, their certified kitchen is operational and serving approximately 75 to 90 parishioners each week.

Race and Ethnicity Data for Program II

2. 4-H and other Youth

A. Situation

The purpose of this educational program is to provide youth appropriate and current research based information to promote good nutrition and well being for proper growth and development through the adoption of healthful eating behaviors.

Today’s youth are faced with many lifestyle choices, some of which can negatively impact their health. Early intervention of positive lifestyle behaviors is the key to promoting normal growth and development, disease prevention, and wellness.

Recent nutrition and health research emphasize how long term dietary patterns can influence the risk of developing certain lifestyle related illnesses. Significant dietary problems which have been identified among our youth include inadequate calcium and excessive fat, cholesterol, sodium and calories. By encouraging prudent eating behaviors the incidence of lifestyle related health problems such as cardiovascular disease, obesity, and type 2 diabetes could be prevented or forestalled.


Race and Ethnicity

Projected Target

Audience(for 2009)


*Parity (± 4%)

Reached


No. % No. % Yes or No No. %Hispanic 49 4 No 90 10

Multi-racialPacific

IslanderAmerican

Indian5 .5

Asian 5 ≤ 1 Yes 13 1.5Black 235 21 No 108 12White 824 74 Yes 684 76

UnknownTotal 100 1113 100 900 100

GenderMale % 304 27% No 432 48%

Female % 809 73% No 468 52%Unknown % 1113 100% 900 100%

The potential results from this effort will encourage an understanding of the importance of good nutrition and physical activity through the life cycle to support health and prevent disease.

The significance of youth adopting healthy eating behaviors is far reaching and translates into better quality and quantity of life as well as a positive economic impact on the health care system as this generation moves into adulthood.

Target Audience:

Marion County youth ages 5 to 18 years.

B. Program Objectives (2)

1. At least 50% of program participants surveyed will increase their knowledge of at least two healthy nutrition/physical activity practices as recommended by the USDA MyPyramid. Targeted knowledge items: increase intake of fruits, vegetables, whole grains, fat-free and low-fat dairy products; and maintain a minimum of 60 minutes of daily physical activity.

2. At least 50% of program participants surveyed will demonstrate their knowledge gain by planning healthful meals and snacks according to their daily requirements.

According to the USDA MyPyramid.

Objectives will be measured with a written pre/post survey and diet recall

1. At least 50% of program participants surveyed will increase their knowledge of at

least two healthy nutrition/physical activity practices as recommended by the USDA MyPyramid. Targeted knowledge items: increase intake of fruits, vegetables, whole grains, fat-free and low-fat dairy products; and maintain a minimum of 60 minutes of daily physical activity.

2. At least 50% of program participants surveyed will demonstrate their knowledge gain by planning healthful meals and snacks according to their daily requirements.

According to the USDA MyPyramid.

Objectives will be measured with a written pre/post survey and diet recall.



Inputs

Advisory Committee MembershipMarion County Children’s Alliance - Nutrition Workgroup

Community PartnershipsThe main partners for this program include Marion County School Food Service Department; Marion County Health Education Department; and select elementary, middle, and high school faculty.

GrantsA $3600 grant was received from Florida Ag In the Classroom to develop an educational newspaper for Florida youth in grades 3rd through 5th. As part of a three member team from Marion County Extension (Norma Samuel, Horticulture Agent and Natasha Masciarelli, Marketing and Public Relations Specialist), we developed Florida Agriculture: Growing Up Healthy with Food from Florida. The funds from this project will be used to support youth programming in nutrition, health, food safety, and horticulture.

VolunteersThere were three Nutrition Educator Volunteers who donated 67 hours of service to the following 4-H programs: Munchy Adventures Summer Day Camp, Junior Master Gardener, Seminole Garden Project, South Eastern Youth Fair, Holiday Bake-Off Community Service Project, and the Sears Barbecue Contest.

Outputs

I taught 34 classes reaching 670 youth, representing 75 hours of direct stand-up teaching.

Educational Methodology:■ Day Camp■ Interactive discussions (classroom instruction)■ Media - program announcements, flyers, and media releases■ Website - program announcements ■ Workshops

Program locations:■ Belleview High School■ Eighth Street Elementary School■ Hammett Bowen Elementary School ■ Howard Middle School■ Marion County Extension Service

Program audiences:


Target audiences for this program were:

■ 4-H Munchy Adventures (camp and classroom) ages 8 to 14 years■ Healthy Lifestyles (classroom) ages 11 to 18 years

Support Materials:■ 4-H Munchy Adventures Project Book (512 books have been sold)■ Growing Up Healthy with Food From Florida – Ag in the Classroom


■ 34 presentations featuring a combination of nutrition, health and food safety visual aids, activity worksheets, and hands-on activities. PowerPoint presentations were used sparingly and limited to the high school classes.

■ 4-H Munchy Adventures Summer Day Camp

A five day nutrition and health summer camp was provided for 21 youth (ages 8 to 14 years). The 4-H Munchy Adventures Project Book was the curriculum used. The program focused on the theme of the project book with supplemental activities and a field trip to the UF/IFAS Research Farm in Citra, Florida. (Team taught with Norma Samuel, Horticulture Agent and Xiomara Diaz, 4-H Agent)

■ Healthy Lifestyles for Youth

A five-part (seven month) series was taught to three 4th grade classes (56 youth). The USDA MyPyramid for Kids was the foundation for the lessons, complemented

by UF/IFAS publications. Activities reinforced key concepts and offered opportunity for reflection and application at school and home. Teaching strategies: group discussion, handouts (puzzles, completions, math exercises, etc.), and classroom and take-home activities. Visuals included MyPyramid cloth display, food cards, rubber food models, and food packages. Proper hand washing was taught using a special hand washing kit.

Educational Materials/Curriculum


Educational materials for this program came from a variety of sources including the USDA MyPyramid for Kids, USDA Fight Bac® Program, Florida Department of Agriculture - Fresh From Florida, and Centers for Disease Control Fruits and Veggies Matter program.

Summary of group teaching events for Program III

Program III - 4-H and other Youth


Events/Hours Number of

ParticipantsSelf Group teaching Healthy Lifestyles 30 600Self Group teaching Healthy Lifestyles 34/75 670

Total 34/75 670

Volunteersthree adults

Group teaching/judgingsmall group support

Healthy Lifestyles 5

Volunteersthree adults

Group teaching/judgingsmall group support

Healthy Lifestyles 7/67 ------

Total 7/67

Summary of clientele reached for Program III.

Program Title: 4-H and other YouthNumber of Educational Materials Developed 4Number of Clientele Contacts

field consultations noneoffice consultations none

telephone consultations nonegroup teaching participants 670




Objective 1:

At least 50% of program participants surveyed will increase their knowledge of at least two healthy nutrition/physical activity practices as recommended by the USDAMyPyramid. Targeted knowledge items: increase intake of fruits, vegetables, whole grains, fat-free and low-fat dairy products; and maintain a minimum of 60 minutes of daily physical activity.

Outcome for Objective 1: Knowledge

* 100 % (n=77) of program participants surveyed increased their knowledge of at least two healthy nutrition/physical activity practices.

Objective 2:

At least 50% of program participants surveyed will demonstrate their knowledge gain by planning healthful meals and snacks according to their daily requirements.

Outcome for Objective 2: Skill

* 100% (n=77) of program participants surveyed learned how to plan a balanced meal and snack of adequate calories.

4-H Munchy Adventures Summer Day Camp (n=21) All youth completed the curriculum activities, presented an illustrated talk on a learned concept, and demonstrated proficiency in planning healthful meals and snacks.

Healthy Lifestyles for Youth school-based program (n=56) All youth demonstrated proficiency in knowledge and practices of healthy living. Concepts learned: five food groups and oil, meal planning, healthy food choices, and hand washing. Behaviors adopted: increased intake of fruits, vegetables and low-fat milk and decreased intake of soda and sports drinks.


Race and Ethnicity Data for Program III

II.

Family Nutrition Program (FNP) October 2010

A. Situation NOTE: Since the target audience for this program is youth, the situation is similar to to 4-H and Other Youth.

The purpose of this school-based educational program is to provide appropriate research based information on proper nutrition and regular physical activity to support proper growth and development through the adoption of healthful eating and activity behaviors.

Recent nutrition and health research emphasize how long term dietary patterns can influence the risk of developing certain lifestyle related illnesses. Significant dietary problems which have been identified among our youth include inadequate calcium and excessive fat, cholesterol, sodium and calories. By encouraging prudent eating


Race and Ethnicity

Projected Target

Audience(for 2009)


*Parity (± 4%)

Reached


No. % No. % Yes or No No. %Hispanic 104 15 No 68 9.5

Multi-racial 22 3 Yes 7 1Pacific

Islander2 ≤ 1

American Indian

3 ≤ 1 Yes 3 .5

Asian 14 2 Yes 7 1Black 133 20 No 86 12White 393 59 No 544 76

UnknownTotal 100 671 100 715 100

GenderMale % 332 50% Yes 357 50%

Female % 339 50% Yes 358 50%Unknown % 671 100% 715 100%

behaviors the incidence of lifestyle related health problems such as cardiovascular disease, obesity, and type 2 diabetes could be prevented or forestalled.

According to the 2008-2009 Marion County School Health Body Mass Index screening for 3059 third-grade students (target group for indicators): 17% were overweight/at risk of overweight and 20% were obese for a total of 38%. The potential results from this effort will encourage an understanding of the importance of good nutrition and physical activity through the life cycle to support health and prevent disease.

The significance of youth adopting healthy eating behaviors is far reaching and translates into better quality and quantity of life as well as a positive economic impact on the health care system as this generation moves into adulthood.

Target audience: Elementary school youth (k-5) in Food Stamp and/or Food - Stamp Eligible schools in Marion County. B. Program Objective (1)

1. 50% of youth participating in at least three consecutive lessons (October through December 2010) will adopt at least one new nutrition and physical activity behavior as recommended by the USDA Dietary Guidelines and MyPyramid.

Objective will be measured with written pre/post/follow-up assessments.


I will administer and coordinate the program which will involve the employment of one program assistant who will provide nutrition education to youth in grades K-5 in approximately two to three elementary schools. Instruction schedule will be determined when the administrative commitments have been received and the schools and teachers have been identified.

The Organ Wise Guys ® Total Elementary School Core Instructional Kit will be the

main curriculum for the program. This is a comprehensive curriculum containing lesson plans, classroom and home activities, DVDs, and visual aids complimented by

regular taste-testing sessions.

My efforts to date on the progress of this program.

- Met with Kimberly Klinger, Program Coordinator for Administration, UF/FNP - Developed a partnership with representatives from Marion County School Food Service and Health Education to work cooperatively in the administration and


implementation of the program - Received full support from my Health, Nutrition, and Food Advisory Committee on December 3, 2009. - Meeting with school officials (principals and assistant principals) to determine interest, commitment and to identify prospective schools. - Preparing three-year proposal including budget for May 1, 2010 submission to the State FNP office. The plan is to begin with one program assistant and judiciously grow the program based on management and outcomes.

Summary of group teaching events for Program II

Program II Family Nutrition Program


Classes Number of

ParticipantsSelf Group teaching Healthy Lifestyles 5 110

Program Assistant

Group teaching Healthy Lifestyles 112 2400

Race and Ethnicity Data for Program II (Actual will depend on locations of schools)

24.

CLINICAL SERVICE OR CLINICAL ACTIVITIES – NA


Race and Ethnicity

Projected Target

Audience(for 2009)


*Parity (± 4%)

Reached


No. % No. % Yes or No No. %Hispanic 238 9.5

Multi-racial 25 1Pacific

IslanderAmerican

Indian13 .5

Asian 25 1Black 301 12White 1908 76

UnknownTotal 2510 100

GenderMale % 1205 48%

Female % 1305 52%% 100%

25. SERVICE TO SCHOOLS – In 1984, the Legislature determined that service to the public schools (K-12) would be considered for permanent status and/or promotion purposes. Such service should be listed in this area.

Mini-mester Health Workshop Belleview High School 9th and 10th grade science students

Regional Science Fair Judging National Guard Armory

Careers Exploration in Food and Nutrition Belleview High School 9th & 10th graders (ESE students)

26. MEMBERSHIP AND ACTIVITIES IN THE PROFESSION

AssociationRole (e.g., member, committee chair, elected office, etc.)

Years (e.g., 2009)

National Extension Association of Family and Consumer Sciences

Member 1987 - 2009

Florida Extension Association of Family and Consumer Sciences

Member

Secretary

1987 - 2009

2008 - 2010

27. HONORS - none

32. COPIES OF THE LAST FIVE (or since last promoted) ANNUAL LETTERS OF EVALUATION –

Year Your Overall Rating Scales

2008 Exemplary Not Acceptable - Exemplary




2004 7 1-7

2003 7 1-7


2002 7 1-7

33. THE FURTHER INFORMATION SECTION

Selected to Participate as a Peer Reviewer of a National Extension Education Module

I was nominated by Dr. Nayda Torres, UF/IFAS Family Youth and Community Sciences Program Leader to participate as a County Agent in a peer review process of a new educational module to educate and train county agents and educators. This project originated in the Southern Region with the Cooperative Extension Curriculum Project (CECP) and is currently transitioning to eXtension on a national level. The module was Nutrition and Healthy Eating During Pregnancy” located at the eXtension website: PDC.eXtension.org. August 17, 2009.

Marion County Human Resources Training Program - Instructor

I was invited to develop and teach a leadership track course on organization for Marion County employees. I developed The Art of Organization, a three hour class with a 39 slide PowerPoint presentation and a two-page worksheet. I presented the class April 30, 2009 and am scheduled to teach it again on April 27, 2010. This class is in addition to my regular class offerings to county employees.

Community Service

Salvation Army Bell Ringing Campaign


34. PROFESSIONAL DEVELOPMENT

Title No. of Days17th Annual Diabetes Care Program - UF Division Of Continuing Education 1 1/16/09Florida Department of Health - Diabetes Prevention and Control ProgramPartner Advocacy Training

½ 11/12/09

Marion County School Board - Health Educators TrainingOrgan Wise Guys – Nutrition Education Curriculum

½ 9/16/09

Total 2

University of Florida/IFAS Extension TrainingsFamily and Consumer Sciences Summit 3 2/9-11/09Multi-state Food Safety & Quality Update - conference callNational Trends in Food Safety/Preservation

½ 4/9/09

Multi-state Food Safety & Quality Update - conference callFood Safety Regulatory Updates

½ 4/16/09

Multi-state Food Safety & Quality Update – conference callHot topics/New Technologies

½ 4/23/09

Small Steps to Health and Wealth 2 9/29-30/09Preventing Sexual Harassment 4/30/09 Total 6 ½ days

Marion County Government TrainingProcurement Ordinance Changes 7/23/09Defensive Driving Course 8/6/09


pdec.ifas.ufl.edupdec.ifas.ufl.edu/.../upload/Marion/2010_POW_2009RO… · Web viewVersion June 2, 2009.doc. 2009. ROA. and . 2010. POW. 2. BRIEF DESCRIPTION OF JOB DUTIES . This

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