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Background Results
Conclusions
References
Caile E. Spear, Mary Pritchard, Alicia Anderson, Vicky Jekich, Kyle Young, and Mikayla Finley
Health Habits, Healthy U: A Cancer Prevention Program
Healthy Habits, Healthy U (HHHU) is a collaboration among St. Luke’s
Mountain States Tumor Institute (MSTI), Boise State University (BSU), and the
Boise School District (BSD). HHHU started in April 2013 as a community
outreach initiative designed to teach and reinforce positive health habits in
children. HHHU focuses on the positive connection between increased physical
activity and healthy food and beverage choices, and reduced cancer risks.
HHHU is two-day educational program that is integrated into the Boise School
District 8th grade health curriculum. Currently HHHU is in ten Title 1
elementary schools. Since 2014, HHHU has reached over 3,000 fourth and
eighth-grade students, along with parents and guardians.
This collaborative program leverages the existing partnership between Boise
State University and St. Luke’s MSTI and adds the important public school
health component. Boise State students benefit by serve as teaching assistants
and apply their skills and knowledge in a community setting. St. Luke’s MSTI
expands their outreach and the public students have a unique learning
experience.
Reason for the HHHU Program
Methods: Healthy Habits, Healthy U LessonHHHU is a two day primary prevention cancer education program taught in
the 4th and 8th grades.
Day one is taught by the teacher and focuses on cancer basics and how
healthy habits can reduce cancer risks. The 4th graders complete several
nutrition and physical activity worksheets. The 8th graders read
evidence-based articles and complete a write-up/ poster or similar.
Day two is taught by St. Luke’s MSTI and Boise State University
undergraduate teaching assistants. They reinforce the previous lesson by
using interactive discussions and hands on activities. St. Luke’s pathology
provides students with a unique opportunity by donating cancerous and
noncancerous tissue samples for the students to examine in small groups.
The samples give the students a better understanding of how poor health
habits can increase cancer risks and impact the function of various organs.
After a recap of the lessons, the students answer some knowledge questions,
identify three poor health habits and three corresponding replacement habits.
The 8th graders select health behaviors they will work on improving over
the next two weeks.
St. Luke’s MSTI provides each 8th grader a water bottle to facilitate water
consumption. Each 4th grader receives a small beach ball and game
directions as a way to promote physical activity.
Since Spring 2014, over 3000 students in the 4th and 8th grade have
participated in HHHU. Current evaluation results indicate HHHU is an
effective program. Students knowledge about cancer and associated risks
increased from pretest to posttest and they showed an increase in behavioral
intent to change their risky health behaviors after the program.
In Spring 2016, six hundred ninety-one eighth-grade health students
participated in the program. Students were able to master the key elements
taught by the program. Scores on the post-test significantly increased from the
pre-test on students’ knowledge about what cancer is, t (653) = 18.08, p <
.001, that our bodies usually destroy mutated cells, t (680) = 9.97, p < .001,
that physical activity decreases cancer risk, t (652) = 18.69, p < .001, that
eating fast food/processed food increases cancer risk, t (661) = 15.50, p <
.001, that consumption of two or more sodas in a week is linked to cancer, t
(550) = 17.87, p < .001, that sedentary behaviors (e.g., watching
TV/computer, sitting too much) increases cancer risk, t (666) = 22.50, p <
.001, the definition of the word “mutation” as it applies to cancer, t (672) =
9.48, p < .001.
Students also decreased their belief that chemotherapy only targets cancer
cells, t (676) = 9.18, p < .001, that eating fruits and vegetables does not
increases cancer risk, t (670) = 8.93, p < .001. They also understood more
about how drinking sugar-sweetened beverages increases cancer risk, t (558)
= 5.58, p < .001, as well as health habits that can reduce cancer risks, t (554) =
3.70, p < .001. There was no effect of the program on students’ understanding
of how exercise improves health, t (672) = 1.45. Finally, students were able to
correctly identify which of their own health habits were unhealthy and how to
create a healthy replacement habit (M = 88.46% correct, SD = 23.67%).
The 4th grade assessment is being revamped and we anticipate pilot data
collection starting Spring 2018.
HHHU is an example of an effective partnership between a hospital system,
university, and school district. The program helps the hospital reach some
of their community health outreach goals, university students can apply
their learning and public school students have a unique experience to see
inside of the human body.
The school students learn more about the importance of adopting healthy
behaviors. Students respond favorably to the HHHU program and are eager
to share what they learn with their parents. The TAs serve as positive roles
models to the youth they are teaching. The TAs apply their course work
learning in a practical setting and can use this experience on their resumes.
This is a positive partnership with the school teachers. Many of the teachers
have family members with cancer and are invested in reducing cancer in
Idaho. They love the program and have been active partners in helping us to
improve the program delivery model.
Over the past three years we have shown that HHHU is an effective,
low-investment intervention that may help reduce negative health habits and
increase positive health habits in participating students. Reinforcing these
positive health behaviors can help reduce their future risk of developing
cancer.
Healthy Habits, Healthy U’s was created to help students learn how
positive health behaviors can reduce their risk for developing cancer. The
habits students make now can be life long and life giving. The program
provides factual information about the link between health habits and
cancer risks. This is done through interesting, hands-on learning activities
guided by teachers, university teaching assistants, and hospital staff.
Cancer Problem In IdahoAccording to the Comprehensive Cancer Alliance for Idaho (CCAI, 2014)
since 2008 cancer has been the leading cause of death in Idaho for both men
and women. In 2012, the top two leading causes of cancer deaths in Idaho were
lung/bronchus cancer and colorectal cancer (CCAI, 2014). In 2013, 21.8% of
Idaho deaths were caused by cancer and it was the leading cause of death for
people 45-74 (Idaho Department of Health and Welfare, 2015). The American
Institute of Cancer Research (2015) states that lifestyle choices can reduce
cancer risk and about 50% of the most common cancers could be prevented.
Nationwide, approximately one-third of cancer deaths are a result of poor
nutrition and sedentary behaviors (American Cancer Society, 2015). The
Centers for Disease Control and Prevention (CDC, 2015) reported only 48.0%
of adults meet the recommended 30 minutes of physical activity a day.
Furthermore, less than 30.0% adolescents meet the required 60 minutes a day
of physical activity. Physical activity, good nutrition and other good health
habits can improve health. Active people, with good nutritional behaviors, who
abstain from alcohol and other drugs live longer and are at a lower risk for
disease, such as cancer (CDC, 2015).
American Cancer Society. (2015). What is cancer?: A guide for patients and families. Retrieved from http://www.cancer.org/cancer/cancerbasics/what-is-cancer
American Institute of Cancer Research. (2015). Prevent nearly half of all common cancer – mostly through choices you make everyday. Retrieved from http://www.aicr.org/can-prevent/need-to-know/cancer-prevention-psa.html
Centers for Disease Control and Prevention. (2011). Fruit and vegetable consumption among high school students – United States, 2010. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6046a3.htm
Idaho Department of Health and Welfare: Division of Public Health. (2015). 2013 Idaho vital statistics. Retrieved from http://www.healthandwelfare.idaho.gov/Portals/0/Users/074/54/1354/2013_web_opt.pdf
HHHU 8th Grade Pre and Post Survey
