Promoting Health and Leadership in Project SEARCH Programs Julie Christensen & Melissa Pennise ABSTRACT Promoting Health and Leadership in Project SEARCH Programs For people with intellectual/developmental disabilities, maintaining health and wellness is essential to achieving and maintaining independence, participating in society, and preventing the onset of secondary health conditions. Yet, people with disabilities (PWD) experience poorer health than the general population and alarmingly higher rates of obesity and related conditions. The University of Cincinnati UCEDD and Strong Center for Developmental Disabilities at University of Rochester implemented and evaluated the evidence-based HealthMessages curriculum with Project SEARCH students. HealthMessages is a 12-week health promotion program which uses peer to peer facilitation to learn about physical activity and hydration; as well as making healthy choices, lifestyle changes, and setting goals. This presentation will provide a summary of lessons learned from the pilot project. But, more importantly, we want to hear from you! Participants will engage in discussion about barriers, facilitators and strategies for supporting health literacy education in Project SEARCH classrooms. Feedback from session participants will help to inform the development of tools and resources for Project SEARCH instructors with the aim of increasing the number of programs that actively incorporate healthy living as part of the Project SEARCH curriculum.

Acknowledgements Pilot study – partnership between University of Cincinnati and University of Rochester UCEDDs Melissa Pennise, MPH & Julie Christensen, MSW, PhD – Rochester Erica Coleman, MS & Ilka Riddle, PhD - Cincinnati

Why health & employment? People with disabilities experience poorer health compared to the general population High rates of overweight and obesity Less likely to exercise regularly Need for purposeful health transition plannign to be incorporated into high school transition

In support of employment outcomes Goal for youth transition to a health and meaningful life Optimize overall well-being Prevention of secondary conditions PS focuses on preparation to “get” the job Employment skills preparation does not address health-related barriers to “keeping” the job

Project SEARCH High School Transition Project SEARCH is a one-year, school-to-work program for young people with intellectual and developmental disabilities. Goal of competitive employment Total workplace immersion Internship rotations for career exploration and job skills acquisition Customized job-search assistance 12/4/2018 PS copyright

Outcome of Employment The Project SEARCH Definition of a Successful Outcome: Competitive employment in an integrated setting Year-round work 16 hours/week or more Minimum wage or higher 12/4/2018 PS copyright

Project SEARCH Key Concepts Business-Led in collaboration with education, rehabilitation and long term support agencies Braided funding Immersion and impact Training in real work settings Low risk, low cost for business Hiring students who are “good fit” 4/24/2012 PS copyright All Project SEARCH programs are led by the business with the other organizations sending staff and supporting the students and programs. Braided funding implies that all the Project SEARCH partners use their existing funding streams to fund staff and other program materials, making it look seamless to the business. Students are immersed in the business all day, every day for an entire school year and positively impact the business through their contributions. They train each day in a real work environment, not simulated work. The program is low risk for the business – we are asking them to provide a training environment through the classroom and internships. We are asking them to be open to hiring students who might be a good fit for an open position.

Project SEARCH Prepare interns for challenging, complex jobs Teach essential, marketable skills Give interns a year to build stamina and skills Add value to a workforce Focus on hard and soft skills Use a strategic, collaborative approach to internship training and employment

Project SEARCH Partners Young Person With Disability Education Developmental Disabilities Family Other : WIB, Union, Advocacy Group , etc. Supported Employment Agency Vocational Rehabilitation 12/4/2018 PS copyright

Program Description One school year 10-12 students with a variety of intellectual and developmental disabilities Certified instructor and skills trainers Immersed in host business culture Rotations through unpaid internships with continual feedback Outcome of employment in the community 12/4/2018 PS copyright

Annual Project SEARCH Calendar mirrors local school calendar August June 1st Internship 10 weeks Graduate & Begin Work at Host Site or in Community 2nd Internship 10 weeks 3rd Internship 10 weeks 3 week Orientation Transition Week Begin PS Program Regular Employment Planning Meetings held twice each internship and led by intern

A Day in the life of a Project SEARCH Student 8:00 Employability Skills 9:00 Internship site 11:30 Lunch 12:15 Internship site 2:00 Review, Plan, Journaling 2:30 Depart 12/4/2018 PS copyright Can be modified to meet business needs.

Internships Marketable Skills 4 – 5 hours of day, 910 per year Work/ Social Skills Integrated Cascading skills For the benefit of the student, not the benefit of the host employer 12/4/2018 PS copyright

Project SEARCH Curriculum Team Building Workplace Safety Technology Self-Advocacy Maintaining Employment Financial Literacy Health and Wellness Preparing for Employment 12/4/2018 PS copyright

Our guiding questions How can content best be delivered without: creating a burden on instructional staff? taking time away from employment readiness curriculum? Will PS students understand the relationship between health and employment? Will this effort be a distraction or a disconnect from the rest of their training experience?

Pilot project goal Evaluate the delivery of health promotion information in a transition- to-work employment program Process and outcomes evaluation

Approach Implement 12-week, peer-to-peer curriculum (HealthMessages) in PS classrooms Building on established structure of classroom-based PS activities PS instructors and students to implement w/ supports from UCEDD health staff

What is HealthMessages? 12-week peer-to-peer health promotion curriculum Focus on increasing physical activity and hydration Seondary focus on promoting leadership skills and goal-setting Taught by students w/ IDD who are supported as Healthy Lifestyle Coaches (peer educators) Mentors (teachers, support staff, family members, etc.) provide support

Evaluation plan Multi-site / multi-state approach 6 PS classes Collaboration between UCEDDs at University of Cincinnati (OH) and University of Rochester (NY) 6 PS classes 3 in Cincinnati – Xavier, Fifth Third Bank, CCHMC 3 in Rochester – URMC, Wegmans, City of Rochester Adhered to full human subjects protections and protocols

Data collection activities Pre-project surveys (students and instructors: paper survey) Peer weekly self review (starting at Week 3; HLC assessed progress on previous week’s goals) Post-project survey (students and instrutors: paper survey) Focus groups (six participant focus groups; two teacher focus groups)

Project implementation Day 1: Brief introduction and participant consent Month 1: Making Healthy Choices Month 2: Changing Lifestyles Month 3: Keeping our New Lifestyle

Project data: Demographics (N=53)

Student survey results 13 questions assessing general knowlede about physical activity and hydration concepts (e.g., sugar & caffeine content, dehydration) Improvement demonstrated for 62% of those who took both pre- / post- surveys (N-42)

Student satisfaction (post-) (N=45)

A few student comments What were your favorite expeiriences? Teaching the class Learning how to eat better, drink more water, and learn different exercises Sharing my goal with others, completing my goal each week The health snacks, the good messages, the positive inflluence it has given me

More student comments Please tell us what would improve your experience? Show us more exercises Trying more new food items Walking more Make it more challenging Going into further detail during class and including a wake-up exercise

Instructor comments Need to plan for a wide variety of abilities Accomodating multiple learning styles Need to augment for “higher functioning” students Desire to broaden content Nutrition, managing health care (e.g., making doctor appointments) Peer as teacher component was of value Reinforces leadership and self-advocacy skill development

Additional findings / Lessons learned Instructor’s engagement in physical fitness as a factor What additional resources/strategies might be provided to instructors who are not as comfortable or experiences with this topic? Impact of business commitment to health & wellness on delivery and results Look for ways to engage with host business wellness activities

On feasibility This is doable! 30-minute lessons are adequate; easy to fit into PS structure Need for a champion to coordinate and facilitate May not be the instructor – who might you partner with? NOTE: UCEDD staff “pushed in” to support this project No “single” approach – need to customize implementation based on the flow of your project and culture of your host business Consistency from week to week (and accountability) is important

Recommendations Raise awareness of existing work-based resources (e.g., wellness programs) Making connections to community-based resources Broaden topics covered

Next steps Adapting Health Matters curriculum to more closely fit the structure of HealthMessages Partnership between PS, University of Illinois, the Ohio State University, University of Iowa Presentation this afternoon on this project! Please come – we need your input!!!

Questions for Practitioners What are you already doing to promote healthy living in your PS class? What resources have you found helpful that you can share with the group? How likely are you to include a focus on health as part of your PS program? (Why or why not?) What potential barriers to implementation do you worry about?

Comments and Questions?

Pilot Project Contact Information: Erica Coleman, MS, CHES, TTS (UC UCEDD) Erica.Coleman@cchmc.org 513-803-4399 Melissa Pennise, MPH (Rochester UCEDD) Melissa_Pennise@urmc.rochester.edu 585-275-3378 Julie Christensen, LMSW, PhD (Iowa UCEDD) julie-christensen@uiowa.edu 585-615-5934