Proposal

KINE 3645VitalEdge Consulting

Healthy Eating and Physical Activity Contribution Program

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Jeff Di BaccoProgram OfficerPhysical Activity and Healthy Eating Unit200 Promenade Eglantine DrivewayPL 1908C1Tunney’s PastureOttawa, ONK1A 0K9

08/03/08

Dear Mr. Di Bacco,

RE: Physical Activity and Healthy Eating Contribution Program

My name is Ranko Bulatovic and I represent the health promotion firm VitalEdge Consulting. On behalf of our firm, please find enclosed, the proposal in response to the above mentioned Request for Proposal - RFP.

VitalEdge Consulting has become a household name in Canadian health promotion. In the past 18 years we have pioneered a multitude of national, provincial, and community wide health initiatives that have successfully increased physical activity, healthy eating, and other critical health practices amoung the Canadian population. Our people-first, multi-disciplinary and integrative approach has been applauded by all levels of government and sectors involved with our initiatives. In addition, VitalEdge has been a multiple recipient of awards for both, “Best Business Practices” and “Business Organization”.

Our staff has shown much enthusiasm at the prospect of working on your project. After you have perused the proposal I anticipate that you will consider hiring VitalEdge for the Physical Activity and Healthy Eating Contribution Program. I am confident that you, as well as the stakeholders involved, will be very satisfied with the work we have put into this project.

Please feel free to contact me should you have any further questions about our proposal, VitalEdge Consulting, or what we are able to offer you.

Regards,

Ranko Bulatovic



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ProposalVersion 1.0 Last Update: 11/03/08

Physical Activity and Healthy Eating Contribution Program



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Table of Contents

Introduction………………………………………………………………………………………………………….4

Situational Overview………………………………………………………………………………………………5

Goals and Objectives………………………………………………………………………………………………6

Guiding Principles…………………………………………………………………………………………………..7

Proposed Approach and Methodology….…………………………………………………………………..8

Action Plan..…………………………………………………………………………………………………………10

Team Member Bios……………………………………………………………………………………………….12

References………….……………………………………………………………………………………………….17



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Introduction

VitalEdge Consulting, a leading team in Canadian health promotion, is composed of experts in various fields of health and health promotion. The purpose of the following document is to express VitalEdge Consulting’s interest in undertaking the Request for Proposal, and to present our proposal for fulfilling the requirements of the project.

VitalEdge Consulting strongly agrees with the scope and goals of the project, namely the 20% increase in the proportion of Canadians who are physically active, eat healthily and are at healthy body weights. However, at this time, VitalEdge Consulting believes that the project itself would benefit from a smaller scale initially that would eventually lead to one of a national scope. We therefore request the approval and funding for a Pilot Project focused at a single community instead. Should the pilot project be successful, our team will carry out further field studies and collaborate with organizations such as the Coalition for Active Living to ensure the action plan is applied on a national scale. Until then, we have decided to focus our community approach on Barrie, Ontario.

As a result of the limited focus of our proposal, we will only require a fraction of the $350k allocated budget. As the allocated budget was intended for the entire nation, we realize the impracticality of spending a large portion of it on a single community. Therefore, with consideration of our community’s relative size, and overall number of communities nationwide, we are confident that we can successfully run and evaluate this program with a budget of no more than $30,000.

Furthermore, as a part of this pilot project, and the subsequent potential national level plan, we wish to focus on the high school level. This is because children and youth spend a large portion of their waking hours in school, where there are many opportunities for educating and implementing healthy eating and active living behaviors. As well, the Ontario government has recently mandated physical activity and recommended nutritional guidelines for elementary schools. To continue the trend of early life education and habit forming, our target population is high school teenagers, in the age range of 13-19.

Various determinants of health create challenges for certain individuals to adopt a healthy lifestyle, with the greatest barrier being socioeconomic status. However, being of aboriginal status, as well as being female, have significant impact. By implementing the pilot project in a high school setting, we will be able to control for various determinants of health within that population.



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Current Situational Overview

Healthy eating and participation in regular physical activity are widely accepted as powerful tools in weight management and as such, prevention of obesity. Subsequently, they also play central roles in long-term health management, through the prevention or delay of the onset of many chronic diseases. 1

Although inactivity and poor diet have been identified as high risk factors for chronic disease, it has been documented that 40% of Canadians are at risk, and more than half reported as being overweight or obese. These factors contribute, in one way or another, to the onset and development of cardiovascular disease, cancer, Type 2 diabetes, and respiratory disorders/diseases, which account for over two thirds of annual deaths in Canada. Additionally, these chronic diseases carry a price tag of over $70 billion annually, whether through direct medical care or lost productivity from poor health. The economic impact of direct medical expenses alone due to physical inactivity and poor diet were estimated at $10.6 billion in 2001.

Even though these trends tend to indicate that they exist in the entire population of Canada, certain groups contribute to them more than others. For example, over 50% of teenagers are inactive (girls significantly more than boys), and 82% do not meet international physical activity guidelines for optimal development. Fruit and vegetable consumption recommendations are satisfied in about half of the adult population and even less than that in children and infants. 1

Furthermore, within Canada, significant health differences and increases in risk are associated with a lower socio-economic status (lowest 20% is worst off), and aboriginal status, as well as gender and geographic location. 1

Obesity and inactivity do not just carry health risks. Studies by Rogge et al (2004) 2 found that obese people are more socially stigmatized and discriminated against by their peers, family members and health care providers. Jansen, Craig, Boyce & Pickett (2004) 3 supported those findings and found that obese or overweight youth were more disliked and socially stigmatized than skinny or normal weight children. Additionally, it was shown that obesity tends to cluster in families and that parents often do not perceive a weight problem in their overweight or obese child (Jeffery, Voss, Metcalf, Alba & Wilkin, 2005) 4. This suggests that weight control might not find optimal support in the home environment.

And while the current state of health in our population is bleak, it is important to point out the long-term trend. Compared with measurements taken in 1978/9, today’s youth obesity rates have tripled, and the percentage of overweight children has gone up by 150%. Similar measurements amongst adults show a doubling of obesity rates to 23%, and another 36% overweight, adding up to a staggering 60% of overweight or obese adults. Left unchanged, these trends will surely lead to an irreparable state of national health in the future. 1

The above information supports the fact that obesity and physical inactivity are:1) At an epidemic level in the Canadian population, 2) Carry extreme long term health risks and economic expenses, and 3) Will unquestionably increase unless immediate action is taken.



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Goals and Objectives

In accordance with the Pan Canadian Healthy Living Strategy, VitalEdge aims to organize its program to increase the percentage of our population that is at a healthy weight, eating healthy and participating in regular physical activity. The purpose of this pilot project is to implement a Health Promoting School Model in order to improve physical activity participation, healthy eating and increase the percentage of participants at a healthy body weight. The specific objectives include:

An improvement in BMI or maintenance of BMI, corrected for body composition, across the time the youths are in high school, and

An increase in overall physical fitness as measured by the beep test and other generalized fitness tests, with specific minimum requirements for improvement of a school as a whole.

In general, we aim to evaluate the needs and preferences of teenagers, high school teachers and administrators, and the students’ families. Having done so, we will determine the best way to improve the physical activity participation and healthy eating while utilizing the environment and support structures available.



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Guiding Principles

The Pan-Canadian Healthy Living Strategy emphasizes integration of different sectors, as well as health issues, partnership and shared responsibility, and best practices as the guiding principles for health promotion strategies. 1 Vital Edge will adopt these principles while applying the guidelines of the Ottawa Charter:

IntegrationIntegration refers to cooperative efforts to promote physical activity and healthy eating by addressing individual issues together (e.g. healthy eating, physical activity and healthy weights). An integrated approach in policy development, research and programming can lead to greater health improvements and a more effective use of resources. As part of the Healthy Living Strategy, an integrated approach may target common risk factors for chronic diseases, consolidate efforts within specific settings (where people live, learn, work, and play), and engage partners from various jurisdictions and sectors. The Healthy Living Strategy supports improved inter-organizational, inter- and intra-sectoral, multi-jurisdictional engagement. 1

Partnership and Shared ResponsibilityImplementation of the Healthy Living Strategy will result from collaborative partnerships involving community, business, non-governmental and national voluntary organizations, and government sectors. This will reflect a shared responsibility in improving health and health outcomes. 1

The Healthy Living Strategy will support the development of partnerships to strengthen the capacity for collaborative action in research, policy, programming, legislation, knowledge transfer, surveillance and communications. Consideration will be given to how existing partnerships can be strengthened and how new partnerships can be created for these purposes. 1

Best PracticesBest practices are defined as those practices that are grounded in sound scientific evidence. But best practices in health promotion involve more than a scientific rationale for effectiveness. They include activities that are consistent with health promotion values, theories, evidence and understanding of the environment, and are most likely to achieve health promotion goals in any given situation. 1



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Proposed Approach and Methodology

VitalEdge plans to utilize Voices and Choices – Planning for School Health as a tool to guide our approach. Our approach will be broken down into seven stages:

Stage 1 - Building Commitment

This program is important to everyone. We propose to gain commitment and support from a wide audience that includes students, administration, faculty, non-teaching staff, parents, governing councils, and the community. Time and resources will be allocated to make this work, and a spirit of flexibility and working together to improve "OUR" school community needs to prevail. 5 Perspectives of key stakeholders on the issues of youth physical activity, healthy eating, and weight maintenance or healthy weight achievement, and the best way to approach them will be gathered. This will be done through discussions with teachers, parents, and students independently. Ideally we will try to set up at least three discussions with each group, aiming for 20-30 participants per discussion. As a further step, a website will be made supporting anonymous suggestions or feedback on the issue.

Stage 2 - Establishing the School Health Committee

In order to be successful, Maple Leaf Secondary School will need a committee that is comprised of more than two people. Participation should come from all parts of the school community, including administration, teaching and other staff, students and parents. Since students are critical to this process, we will aim to engage students of varying ages and from diverse backgrounds. The support from the school administration is also important. Securing time and energy in this area will definitely help the Committee to succeed. 5

A literature review of past practices will be completed to evaluate the past effectiveness of interventions at the school setting that were designed to improve body weights, healthy eating and physical activity participation. Research will also look into current mandates and guidelines that may affect our ultimate result.

A Political, Economic, Environmental, Social and Technological (PEEST) analysis will also be completed in order to alert us to factors that might impact our work. In general, where hard information exists it will be found through research, however highest value will be given to reports from the focus groups as that information will be considered to be the closest to the case at hand.

Stage 3 - Conducting the Needs Assessment

Based on the results of the focus groups, the Voices and Choices – Student Needs Assessment Questionnaire will be distributed to a further random sample of the high school population to find their opinion on the matter. This is an essential part of Voices and Choices and it provides students with an opportunity to voice their needs and preferences in an objective and confidential manner. 5 The results of this survey will be quantified and statistically examined for trends.



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Once the data is analyzed, school-specific School Health Profile will be created. The Profile will help the Committee create a vision for a healthier school and from there, develop short, medium and long-term plans. 5 Based on the outcomes of these surveys our recommendations and an action plan (program) will be formulated.

Stage 4 - Interpreting The School Health Profile

The School Health Profile contains valuable information on students' needs and preferences. This extensive document contains a large volume of data. For example, smaller sub-committees may be formed during this process to examine the School Health Profile from different perspectives. The sub-committees would report back to the larger Committee, at which point the information can then be shared with students, parents, administration, faculty and staff. It will be the foundation to developing the School Health Plan (Stage 5). 5

Stage 5 - Creating the School Health Plan

The School Health Plan will be the Committee's vision of a healthy school. The School Health Committee will develop a vision that considers the School Health Profile, as well as, plans for the short (1 year), medium (2-3 years) and long (5 years) term.5

Stage 6 - Developing the Program Action Plans

An Advisory Committee will then be formed to assess the formed School Health Plan in terms of feasibility, perceived sustainability and other variables. The assessment of the committee will be considered, the program changed where possible, and recommendations issued for the implementation of the program.

Stage 7 - Reviewing, Evaluating and Celebrating

Pending approval and implementation of the program, a follow up evaluation will be completed 3 months and 1 year after the start of the program to determine whether the program is operating successfully, and if there is any room for improvement. Subsequently, the School Health Plan will be reviewed twice each year - at the start and end of the school year. By reviewing the programs regularly, it will be determined whether it is still relevant or has achieved what was intended. 5



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Action Plan

Note: Recommendations and timelines regarding the launching of the designed program will be made in the final report, once all the information has been considered.

Phase I: Gathering of InformationItem Process Responsibility

and FundingDue Date

- Literature Review of previous programs/interventions- PEEST Analysis - Set up of feedback website

- Analyses and Lit Review to be completed via online research and contacting health promotion agencies. - Website set up via domain registration and subcontracting work to web design firm

Lit Review and analyses completed by VitalEdgeemployees and interns. Website formed by subcontracted designers.

Costs: regular wages + website design and hosting

1 month post-

approval

Phase II: Stakeholder Feedback- Information gathering at School Council meetings and staff meetings- Committee formation- Launch and promotion of website

- information gathering by attending at least three school council and staff meetings, at three different schools, and holding a discussion on healthy eating and exercise, with all comments being noted- advisory committee consisting of two trustees, two principals, two teachers, two parents and three students will be formed by contacting random members of each group until the required sum is reached. Students, parents, teachers, and principals will be chosen at random with one from each school. - Website to be advertised by posters in schools and by teachers in class. Teachers will be informed via email and letters to principals, to be distributed at staff meetings

Meeting transcripts and committee formation and contacting to be completed by a VitalEdge member. Website launching completed by web design firm

Costs: Regular wages for time worked

3 months post-

approval

Phase III: Second Stakeholder FeedbackInformation integration and survey forming

- using information gathered from the PEEST analysis, meetings, and website, the survey will be created. The

Senior VitalEdgemembers will meet and create the survey. Test-retest

3.5 months post-

approval



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survey will be made available online for a period of two weeks at which point any interested parties may respond. The survey will be encoded so a person may only answer once.

reliability and other tests will be conducted by interns. Web work completed by same design firm as before.

Costs: web work and regular wages

Phase IV: Analysis of Gathered Information- final analysis of survey and gathered information- forming of plan and recommendations- committee analysis of plan- modification of plan and second committee analysis

- statistical software will be used to find significance in the survey results. Qualitative analysis will note pertinent details from the surveys regarding future action- using the information gathered a plan will be formed to deal with the issues at hand- the advisory committee will be convened and briefed on the plan. Their feedback will be recorded and the plan will be modified as required- the committee will be convened once more to assess the modified plan.

Information analysis and program creation by VitalEdge senior team. EachCommittee meeting will be headed by two VitalEdgemembers.

Costs: regular wages, possible rental fee for space for advisory committee meetings, snacks for advisory committee meetings

6 months post-approval



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Bios

RankoBulatovicPresident

Ranko Bulatovic is the founder and President of VitalEdge Consulting, an innovative and growing health-consulting firm based in Toronto, Canada. Bulatovic created VitalEdge in 1998, after he saw a need to provide a comprehensive, consultative approach for both the private and public sectors. The company was founded to provide Health solutions within the spirit of the Ottawa Charter. As the company president, Bulatovic has successfully led VitalEdge for ten years and has made the company a leading consulting firm in the province.

Prior to founding VitalEdge, Bulatovic worked for the Canadian Heart and Stroke Foundation as an Information and Project Coordinator in the Strategic Research Initiatives Department. While very successful in this role, Bulatovic felt that he would be better able to accomplish more as a private consultant and so after 5 years at Heart and Stroke Canada, Bulatovic left in 1997.

Bulatovic graduated from University of Toronto in 1990 with a Bachelor’s degree in Kinesiology and Health Sciences. Bulatovic was the president of the Student Wrestling Club and captain of the varsity wrestling team for three years. He led the wrestling team to the CIS championships where he won gold for his weight class and the team placed second overall. Bulatovic went on to graduate from the Rothman School of Business Two-Year MBA program.



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Bios

Slav FeldmanVice-President and Lead Project Manager

Slav Feldman is currently the vice-president and the lead project manager of VitalEdge Consulting, an innovative and growing health-consulting firm based in Toronto, Canada. Feldman is also a founding member of VitalEdge and has been with the company since 1998. Feldman has been the Company’s Lead Project Manager since 2003. Prior to his current position, Feldman worked as a researcher and program designer.

Before joining VitalEdge, Feldman worked for Health Canada as part of the “Vitality” health promotion program that was created by ParticipAction in 1991 to 1995. He was also part of “Sharing a Healthy Future” from 1996-1998, which was also created by ParticipAction.

Feldman graduated with Honours from Stanford University in California in 1991 with a Bachelor’s degree in Public Health Policy. Feldman was a member of Student council as the senior year representative and also the President of the Kappa Alpha fraternity. Upon completion of his undergraduate, Feldman took a position with Health Canada in the fall of 1991.



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Bios

Luke BaxterSenior Program Designer

Luke Baxter is currently a Senior Program Designer at VitalEdgeConsulting, an innovative and growing health-consulting firm based in Toronto, Canada. Baxter joined VitalEdge in 2002 and has since worked in various departments and has been in his current position since 2005.

Before joining VitalEdge, Baxter worked as a Senior Research Assistant to Dr. Rick Bell, at the Coalition for Active Living from 1997 to 2002. During his time there, Baxter was instrumental in leading new research on the

potential negative impact of ‘screen time’ on the physical and mental health of children. Baxter also assisted Dr. Bell in writing two articles on ‘screen time and health’ both of which were published in the Journal of American Medical Association. Baxter received “Canadian Health Researcher of the Year” award in 2001 for his work with Dr. Bell.

Baxter graduated from Louisiana State University in 1995 with a Bachelor’s Degree in Kinesiology and Fitness. While at University, Baxter was a starter on the Football team and also worked as an Undergraduate Research Assistant. Baxter worked at Fun 4 Kids, an underprivileged afterschool centre for elementary children in Baton Rouge, Louisiana. Baxter was there for two years before returning to Canada to take a position at Coalition for Active Living.



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Bios

Dr. Kieran MaxwellChief Medical Consultant

Dr. Kieran Maxwell is currently the Chief Medical Consultant at VitalEdgeConsulting, an innovative and growing health-consulting firm based in Toronto, Canada. Dr. Maxwell joined VitalEdge as a partner when the company started in 1998. She has always been a key contributor to thesuccess of the company and is responsible for providing a medical perspective on all company projects.

Prior to joining VitalEdge, Dr. Maxwell held a fellowship position as a Nutritionist at University Medical Centre at Princeton. During her time

there, Dr. Maxwell participated as a researcher in clinical studies on the detrimental effects of soda pop products on infant health and proper development. In recognition of her outstanding work in the field of nutrition, Dr. Maxwell was the recipient of the “Princeton Doctor of the Year” Award. Dr. Maxwell received high praise from her colleagues and is still highly regarded as a pioneer in infant nutrition studies.

Dr. Maxwell graduated from University of Notre Dame in 1988 with a Bachelor’s of Science degree in Biological Sciences. While at University, she was an editor of the school’s science newspaper, the “Science Weekly” and also played on the varsity volleyball team. After her undergraduate studies, Maxwell accepted an offer at Harvard University to complete her M.D-PhD in Nutrition. Maxwell graduated from Harvard in 1995.



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Bios

Alex MailisResearch Analyst

Alex Mailis currently works as a Research Analyst at VitalEdge Consulting, an innovative and growing health-consulting firm based in Toronto, Canada. Mailis joined VitalEdge in 2004 and is a valuable member of the team. In his current position, Mailis is responsible for presenting formal proposals and analyzing survey data.

Prior to joining VitalEdge, Mailis worked for Health Canada as part of Health Promotion and Programs; Program and Policy Analysis Division.

Mailis started working there in 1996 and was there for 8 years fulfilling numerous positions throughout his time there before choosing to leave and join VitalEdge.

Mailis graduated from the University of Toronto in 1993 with a Bachelor’s degree in Kinesiology and Health Sciences. Mailis was a member of the Student Chess Club and is also a member of the Toronto Business Toastmasters Club. In 1995, Mailis completed his Master of Science Degree in Statistics at the University of Toronto.



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References

1. Centre for Health Promotion Public Health Agency of Canada (2006). Physical Activity and Healthy Eating Contribution Program. Retrieved on Jan 20, 2008, from Public Health Agency of Canada. Web site: http://www.phac-aspc.gc.ca/pau-uap/fitness/pacp/rfp-2007_e.html

2. Rogge, M. M., Greenwald, M. & Golden, A. (2004). Obesity, Stigma, and Civilized Oppression. ANS. Advances in Nursing Science, 27(4), 301-315.

3. Janssen, I., Craign, W. M., Boyce, W. F. & Pickett, W. (2004). Associations Between Overweight and Obesity with Bullying Behaviors in School-Aged children. Pediatrics, 113(5), 1187-1194.

4. Jeffery, A. N., Voss, L. D., Metcalf, B. S., Alba, S. & Wilkin, T. J. (2005) Parents’ Awareness of Overweight in Themselves and Their Children: Cross Sectional Study Within a Cohort (Early Bird 21). BMJ (Clinical Research Ed.) 330(7481), 23-24.

5. Public Health Agency of Canada. (2008). Voices and Choices – Planning for School Health. Available online: http://www.phac-aspc.gc.ca/vc-ss/intro_e.html

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