The document summarizes a program evaluation of the Girls in the Game elementary after-school program. The evaluation found that compared to girls not in the program, Girls in the Game participants reported: eating fewer unhealthy foods and exercising more; having greater nutrition knowledge; choosing less emaciated ideal body images and smaller discrepancies between actual and ideal body images; and parents reported trends of increased self-control. Program quality assessments found the curriculum was implemented well across sites. The evaluation suggests the comprehensive program positively impacts participants' physical activity, nutrition, body image and social behaviors.

1. Promotion of Health & Wellness in After-School: Lessons from the Field

2. Either/Or

3. Increase awareness about the epidemic of childhood obesity, the greatest public health crisis facing youth in history II. Understand the relevance of after-school time in the prevention of overweight and obesity Learn about Girls in the Game , a successful program model that uses an integrated curriculum of physical activity, nutrition education and leadership/self-esteem development

4. Experience a hands-on demonstration of Girls in the Game program activities & learn about Spring Training (the Girls in the Game Best Practices Manual and Curriculum) Assess your program’s method for recruiting, instructing and retaining participants and learn Girls in the Game best practices Learn how you can become a part of Spring Training

5. Parking Lot ?

6. Childhood Obesity Epidemic: How Bad Is It?

7. Trends in Obesity for US Children and Adolescents

8. Copyright restrictions may apply. Ogden, C. L. et al. JAMA 2010;303:242-249. Prevalence of High BMI for Age in Boys and Girls Aged 6 Through 19 Years, 1999-2008

9. Obesity Among Racial/Ethnic Groups among Boys

10. Obesity Among Racial/Ethnic Groups among Girls

11. Obesity Epidemic May Cut Life Spans of Young Adults Childhood Obesity May Predict Early Mortality Childhood obesity is a hefty problem Overweight Kids Often Become Obese, Unhealthy Adults Experts warn of surge in cardiovascular troubles by 2035 Child obesity expected to soar worldwide Nearly half of kids in North and South America could be overweight by 2010

12. What is at Stake? Obese children and adolescents are at risk for health problems including high blood pressure, type 2 diabetes, nonalcoholic fatty liver disease Approximately 80% of obese adolescents become obese adults Significant economic consequences and costs 3.4 billion to annual health costs in Illinois alone!

13. After-School as a Protective Factor Low-income, minority school-age children enrolled in after-school programs were significantly less likely to be obese three years later than those who were not involved (Mahoney et al., 2005). Adolescents in after-school programs reported spending less time snacking as compared to adolescents who did not participate (Vandell et al., 2005). Data from the 2007 National Survey of Children’s Health suggest that minimal involvement in after-school activities had significant effects on the probability of being overweight or obese among youth ages 10-17 ( Bethell et al., 2010).

14. The Importance of Providing High Quality After-School Programming Enhancing adolescents’ involvement in structured after-school activities may have the potential to reduce childhood obesity After-school programs offer an opportunity to increase physical activity without interrupting academics, and can provide up to 1/3 of a child’s daily recommended MVPA (Beets et al., 2009). Healthy children learn better! Results of recent research show statistically significant relationships between physical activity and academic achievement (Chomitz et al., 2009; Eveland-Sayers et al., 2009; Trudeau & Shephard, 2008).

15. Sports. Health. Leadership. Life.

16. Mission Girls in the Game provides and promotes sports & fitness opportunities, nutrition & health education, and leadership development to enhance the overall health and well-being of all girls. Since 1995, has emerged as a leading girls' health and fitness organization in Chicago. Every year, Girls in the Game empowers more than 3,000 girls to make healthier choices and develop the confidence and leadership skills they need to succeed on and off the field. From yoga and lacrosse to soccer and dance, Girls in the Game, exposes girls to a wide and energizing mix of sports and fitness activities year round. Our Programs: Girls’ Advisory Board After School Summer Camp Varsity Squad Game Days Leadership Development Parent and Family Initiatives Spring Training Girls are encouraged to get in the game —any game—so they can learn teamwork and determination, and to make choices that lead to a happier, healthier life.

17. About the Girls Girls in the Game welcomes girls from diverse backgrounds and abilities, ages 6-18. Participants live in a cross-section of neighborhoods on the north, south, and west sides of Chicago, as well as in the suburbs.

18. About our Model Girls in the Game is one of the only organizations, in Chicago and the nation, that addresses girls’ physical, mental, and emotional health with a comprehensive approach to their well-being. Unlike many traditional youth programs, Girls in the Game: addresses the needs of the whole girl exposes girls to multiple sports and fitness activities always integrated with nutrition & health education and leadership development engages girls and young women ages 6-18 year-round and for the long term provides peer-to-peer education as well as parent and community involvement uses a comprehensive program that’s proven to work

19. An innovative citywide collaborative with schools, parks, and community centers to provide after-school programming for girls in grades 3-5 Evidence based Integrates physical activity, nutrition & health and leadership development 30 weeks of programming, 90 minute sessions Age appropriate, girl-specific Aligned to standards Offers healthy snack Includes community service Girls in the Game on the Go (parent and family take-homes) Girls in the Game After School Elementary

20. 2008-2009 Girls in the Game Elementary After- School Program Evaluation

21. Recommendation: State of the Art Program Evaluation (Beets et al., 2009) Multiple reporters Comprehensive objective measurement of PA away from the program Implementation measurement Assess exposure to the program

22. GIG Program Evaluation 2008-2009: Adheres to State of the Art Recommendations Parent and Child Report, BMI, Accelerometers Multiple reporters Accelerometer data for weekday and weekend activity Comprehensive objective measurement of PA away from the program Implementations checks for every module filled out by coaches Implementation measurement Assessed implementation & attendance rates Assess program exposure

23. Evaluation Parents and youth filled out a survey in the fall of 08’ and spring of 09’ Time 1 (T1) Survey: 86 Program girls; 31 Control girls Time 2 (T2) Survey: 62 Program girls; 30 Control girls **Total N for girls with data @ T1 & T2 = 52 Program girls; 24 Control girls Total N for parents with data @ T1 & T2 = 22 Program; 5 Control Height, weight, and body mass index (BMI) were measured at T1, and again at T2 At one school, girls (N=11) also wore an accelerometer for one week at T1 and at T2 to assess physical activity An outside observer, certified in program assessment, conducted a program quality assessment (Youth PQA) at all five schools in the winter

24. Participant Information Ethnicity: Program Attendance: 13.5% no/minimal involvement (0-50% attendance) 42.3% moderate involvement (51-80% attendance) 44.2% significant involvement (>80% attendance) Safe Access to After-School Programming: 41.3% of parents said their children had “not at all safe” or only “slightly safe” access to after-school programs

25. Measures Nutrition Behavior e.g., “ Yesterday did you eat fruit like bananas, apples, or oranges?” Physical Activity** e.g., “ During the past week, how many times did you do exercise to strengthen your muscles?” Nutrition and Physical Activity Knowledge e.g., “Which of the food groups should you eat the most of each day?” Behavioral Outcomes (social skills & self-esteem) e.g., “I say nice things to others when they have done something well.” “ I feel like I am as important or special as other people.” Body image (ideal and discrepancy) e.g., “Which picture looks the most like you?” Attitudes about why girls exercise and do sports e.g., “ I exercise or do sports because I want to be fit and healthy” (agree/disagree)

26. Nutrition Knowledge Number answered correctly ** p < .01

27. Child Report “ Yesterday, did you eat french fries, potato chips, or snack foods?” * p < .05 Parent Report “ Yesterday, did your CHILD eat cookies, doughnuts, pie, cake, sweets, or candy?” * p < .05 Nutrition Behavior # of Servings # of Servings

28. Child Report “ During the past week, how many times did you participate in sports or exercise for at least 20 minutes …or strengthen your muscles?” Parent Report “ During the past week, how many times did your CHILD do exercises to strengthen their muscles?” *p < .05 p < .08, trend towards significance Physical Activity

29. Number of kcals expended * p < .05 Physical Activity

30. Ideal Body Image T1 (1.59) T2 (2.00) T2 (1.61) T1 (1.83) 1 2 3 4 5 6 7 8 **p < .01 Program Non Program

31. Discrepancy Between Actual and Ideal Body Image ** p < .01 Program girls had a smaller discrepancy between ideal and current body image at T2 than T1

32. Social Skills: Self-control Parents report a trend that program girls’ self-control increases and non program girls’ self-control decreases from T1 to T2 (e.g. “Avoids situations that are likely to result in trouble.” p < .12, trend towards significance 0 = Never 1 = Sometimes 2 = Always

33. Program Quality : Youth PQA tool evaluates program quality and effectiveness across all five schools Implementation checks : Coaches rate how well the program was implemented based on curriculum guidelines Evaluating Program Quality & Implementation

34. Outside Evaluation of Program Quality: Program Quality Assessment (PQA) Score Ratings: 1 , 3, 5

35. Program Implementation GIG Module Completion Status 0 = not completed, 1 = partially completed, 2 = completed

36. Nutrition Behavior GIG participants and parents reported girls ate less unhealthy foods at T2 than T1 Nutrition Knowledge GIG participants answered more nutrition knowledge questions correctly at T2 as compared to T1 Physical Activity GIG participants’ exercise levels increased based on multiple reporters Body Image GIG participants chose less emaciated bodies at T2 as compared to T1, and had a smaller discrepancy between their actual and ideal body types Social Skills Parents report a trend that program girls’ self-control increases and non program girls’ self-control decreases from T1 to T2 Safe and Engaging Program is safe and engaging

37. Conclusions What can we conclude about Girls in the Game Elementary After-School program based on these findings? High Quality Programming Curriculum engages girls and teaches them how to make healthy choices through provision of a safe & supportive environment Replicable Curriculum User-friendly design enables successful implementation across diverse program sites Successful Outcomes State of the art program evaluation suggests that girls who participate in the program experience attitude, knowledge and behavior change related to physical activity, nutrition, body image and social control. Girls in the Game is having a positive impact on youth.

39. Spring Training Best Practice Manual Chapters BUILD the team ESTABLISH the program RECRUIT participants LEAD the program INVOLVE parents and guardians ENSURE safety and health EVALUATE program effectiveness

40. Recruit Participants SELECT the age group ESTABLISH enrollment criteria DEVELOP a recruitment process COLLECT registration packets WELCOME participants

41. RECRUIT PARTICIPANTS ASSESSMENT (Rank yourself: 3=completed, 2=started, 1=not started) 1. We have identified a target age group or population that is best served by the program. 3 2 1 2. We have enrollment criteria which determine who can participate and who is placed on a waiting list. 3 2 1 3. Coaches follow a standardized process for recruiting participants. 3 2 1 4. We have a standardized and effective method for collecting completed registrations. 3 2 1 5. We have a standardized and effective process for welcoming participants to the program. 3 2 1

42. RECRUIT PARTICIPANTS ACTION PLAN Review the items in the Recruit Participants Assessment sheet. Record each item that received a rank of 1 or 2 in the Action Plan below. This tool can help provide a measurable plan to improve skill or operations, as needed. What needs improvement? What will be done? Who is responsible and what resources are needed? When will this be completed? 1. We have identified a target age group or population that is best served by the program. 2. We have enrollment criteria which determine who can participate and who is placed on a waiting list. 3. Coaches follow a standardized process for recruiting participants. 4. We have a standardized and effective method for collecting completed registrations. 5. We have a standardized and effective process for welcoming participants to the program.

43. RECRUIT PARTICIPANTS ASSESSMENT (Rank yourself: 3=completed, 2=started, 1=not started) 5. We have a standardized and effective process for welcoming participants to the program. 3 2 1

44. Recruit Participants WELCOME Participants Send welcome letter to all parents or guardians Coordinator or Coach calls each parent or guardian Coaches call parents to give positive feedback with in the first two weeks Coaches track all calls in a call log

45. Sample Call Script When speaking with a parent or guardian: “ Hello, this is Coach __________ with Girls in the Game Elementary, and I am calling to welcome (participant name). Our program will take place on (day of the week) from (time) at (location). The goals of the program are for girls to learn how to be active, make healthy choices and feel good about themselves, all while having fun and meeting friends. We sent home information on the program which describes the sports and fitness, nutrition and health education and leadership development activities she will learn. Do you have any questions? Thank you for your time. May I speak with (participant) to welcome her personally?”

46. Lead the Program CREATE a welcoming environment DEVELOP a set routine ESTABLISH group norms and expectations GUIDE AND MANAGE challenging behavior ENGAGE resistant or withdrawn girls MINIMIZE exclusion or separation CONCLUDE each session with a wrap up UTILIZE retention strategies

47. LEAD THE PROGRAM ASSESSMENT (Rank yourself: 3=completed, 2=started, 1=not started) 1. Coaches are familiar with the activity space in advance of the first day of programming. 3 2 1 2. Coaches model best practices for youth (i.e. no gum, pop, cell phones). 3 2 1 3. Programming follows a regular schedule and routine. 3 2 1 4. Participants understand and follow rules. 3 2 1 5. We have a policy for managing challenging youth behavior. 3 2 1 6. Our coaches are trained on and understand the reasons for youth misbehavior. 3 2 1 7. Our coaches effectively use behavior management strategies before using time outs, breaks or other discipline methods. 3 2 1 8. Our coaches effectively encourage youth to support each other and attempt to successfully resolve conflicts on their own before adult intervention. 3 2 1 9. Our coaches help develop a positive learning environment by using positive reinforcement and giving participants choices. 3 2 1 10. Our coaches are trained to effectively engage resistant or withdrawn youth. 3 2 1 11. Our coaches are trained to effectively minimize exclusion or separation. 3 2 1 12. We have a standardized and effective process to wrap up each session. 3 2 1 13. We implement effective retention strategies that result in high attendance. 3 2 1

48. LEAD THE PROGRAM ACTION PLAN Review the items in the Lead the Program Assessment sheet. Record each item that received a rank of 1 or 2 in the Action Plan below. This tool can help provide a measurable plan to improve skill or operations, as needed. What needs improvement? What will be done? Who is responsible and what resources are needed? When will this be completed? 6. 7. Our coaches effectively use behavior management strategies before using time outs, breaks or other discipline methods. 8. 9. 13. We implement effective retention strategies that result in high attendance.

49. LEAD THE PROGRAM ASSESSMENT (Rank yourself: 3=completed, 2=started, 1=not started) 7. Our coaches effectively use behavior management strategies before using time outs, breaks or other discipline methods. 3 2 1

50. Lead the Program GUIDE AND MANAGE challenging behavior Consistent coaching among both coaches Provide specific praise and encouragement Encourage participants to support each other Utilize multiple strategies to reinforce participants positive behavior Strategy: Nonverbal Reinforcement When to use: A participant displays positive behavior and the Coach cannot verbally acknowledge the action because she is far away or the activity is too loud. Description: Warm smile, reassuring nod, high five or thumbs up. Example: A participant retrieves a basketball ball and gives it to her teammate to take a turn and then looks toward the Coach who responds with a thumb-up.

51. Lead the Program MINIMIZE exclusion or separation Recognize participants for a variety of skills Avoid tactics that may make participants hostile or anxious Coaches select teams and partners using various methods Assign each participant a different number and have each participant with an odd number pair up with a participant with an even number. Group participants by favorite subjects, birthday months, how many siblings they have, etc.

52. Lead the Program UTILIZE retention strategies Set attendance expectation and goals Take attendance and keep records on file Implement retention strategies 1 st absence- Send miss you cards 2 nd absence- Call home and gets confirmation of rejoining 3 rd final attempt to confirm participation and if needed send withdraw notice

53. Curriculum design Components of an effective curriculum Consistency Content Leadership Sport Health Skill building Opportunities to learn and practice skills Spring Training Playbook

54. Module Sport Health Leadership Life Lesson objectives Girls in the Game Take Home Module 1, Sessions 1-3 Rhythm and Movement Self Care and Injury Prevention Commitment to Self/ Commitment to Team Review and Agree to 5 Finger Contract and Athlete of the Day Letter of Introduction and On The Go Module 1 Module 2, Sessions 4-6 Soccer Body Basics and Hygiene Sports-woman-ship and Teambuilding Develop a Team Chant and Athlete of the Day On The Go Module 2 Module 3, Session 7-9 Flag Football Body Image and Smart Eating I Goal Setting/Problem Solving Practice Team Chant and Athlete of the Day On The Go Module 3 Module 4, Sessions 10-12 Volleyball Healthy Relationships Friends and Classmates Create a Positive Sign to Encourage Each Other and Athlete of the Day On The Go Module 4 Module 5, Sessions 13-15 Tennis Personal Safety Families and Guardians Acknowledge Others’ Contributions and Athlete of the Day On The Go Module 5 Module 6, Sessions 16-18 Basketball Body Image and Smart Eating Part II Peer Pressure in Your School and Neighborhood Listen to Your Inner Voice and Athlete of the Day On The Go Module 6 Module 7, Sessions 19-21 Lacrosse Emotional Health Diversity: Celebrating Similarities and Differences Be Your Own Role Model and Athlete of the Day On The Go Module 7 Module 8, Sessions 22-24 Softball Drug, Alcohol and Nicotine Awareness Media and Messages about Gender Girl Power and Athlete of the Day On The Go Module 8 Module 9, Session 25-27 Golf Body Image and Smart Eating Leadership and Peer Education Energy In/Energy Out and Athlete of the Day On The Go Module 9 Module 10, Sessions 28-30 Track and Field Review of All Review of All Keep it Going and Athlete of the Day for All On The Go Module 10

55. Commitment to Self and Team Sports-woman-ship Goal Setting and Problem Solving Peer Pressure Friends and Classmates Families and Guardians Diversity Messages in the Media Peer Education Review Leadership

56. Leadership Sports-woman-ship Whip Around (3 minutes) Set Up Participants stand in a circle. The coach has one small ball. Purpose “ When we work together as a team we need to practice good sports-woman-ship, individually and as group.” Instruction 1. The coach begins with the ball and gives a quick one word response to the word sports-woman-ship. 2. After saying the word the coach passes it to another participant in the circle and they give their one word response. 3. Each participant will give a one word response and then pass the ball on. 4. The group that gets the ball passed to each participant the quickest wins. Key Message “ Practicing good sports-woman-ship helps build a strong team.”

57. Rhythm and Dance Soccer Flag Football Volleyball Tennis Basketball Lacrosse Softball Golf Track and Field (Review) Sport and Fitness

58. Sport Soccer Head or Catch (5 minutes) Set Up Participants get into two circles, standing arms length apart. A Coach stands in the middle of each circle. Purpose “ Now we are going to practice one last way to move the ball in a soccer game - heading.” Instruction 1. To head the ball, start with your feet shoulder-width apart and your knees slightly bent. As the ball comes toward you, keep your eyes open and hit the ball with your forehead. Try not to hit the ball with the top of your head. I’m going to toss you the ball and say “head” or “catch.” 2. Make eye contact with a participant, say either “head” or “catch” and softly toss the ball to her. 3. If the Coach calls “catch” while the ball is in the air, the participant needs to catch the ball with two hands like a goalie. If the Coach calls “head” while the ball is in the air, the participant has to head the ball back to the coach. 4. Have the participants do the opposite next. They will catch the ball when they hear “head” and head the ball when they hear “catch.” 4. Continue around the circle several times so each participant has various chances to head and catch the ball. 5. Use a softer ball such as a beach ball or gator ball depending on the participants age and ability. Key Message “ Heading is a great way to gain control of the ball. Keeping your eyes open helps you see the ball coming and helps you control where you make contact with and direct the ball.”

59. Self Care and Injury Prevention Body Basics and Hygiene Smart Eating and Body Image (Part I, II and III) Healthy Relationships Personal Safety Emotional Health Smoking and Alcohol Awareness Review Health and Nutrition

60. Health Personal Hygiene Germ Explosion (8 minutes) Set Up Participants sit in a circle close enough that they can touch their neighbor’s hand. Place a small amount of glitter into each participant’s hands. Participants rub their palms together to spread the glitter. Purpose “ Your hands may look clean, but they have germs on them that could make you or someone else sick. You can’t see germs spread, but this activity shows you how it happens.” Instruction 1. Participants place their right hand on top of their right-side neighbor’s left hand. Their left hand should go under their left-side neighbor’s right hand. Everyone’s palms should face the ceiling. 2. Recite the team chant (or another agreed upon song). 3. As the song begins, identify one participant to start the game by high-fiving her left-side neighbor’s right hand with her right hand. 4. When she receives her neighbor’s hand, that participant moves her right hand and places it on her left-side neighbor’s right hand, and so on. 5. The first participant then returns her hands to the palm up position. 6. This pattern repeats around the circle as the song continues. 7. Once the song finishes, whoever’s hand is tapped is out of the game. The remaining participants yell “reverse” and change directions. 8. Continue until there are two participants remaining. Key Message “ Take a look at your hands and bodies and see how much glitter is on them from this game. Pretend that glitter is germs. Washing your hands and covering your mouth with your arm or sleeve when you sneeze or cough helps prevent the spread of germs.”

61. Spring Training Professional Development Certification Program Best Practice Manual Spring Training Curriculum Follow up support Conference Calls Web Based access Resources Tools For more information on Spring Training please go to our website www.girlsinthegame.org

62. Amy Skeen, MSW, LCSW, Executive Director , holds her Master ﾕ s Degree in Social Work from the University of Illinois at Chicago. Amy has fifteen years of experience in nonprofit program operations and has received numerous awards for her leadership including One of Chicago’s Top Women Making a Difference for Girls, 2009. Kristi Skala, MS, Training and Evaluation Manager, holds her Masters in School and College Health Programs from Indiana University. Upon graduating from her Master ’ s program she became the Curriculum Developer for the Physical Education Walk Across Illinois School Fitness Program. M onique Turner, Programs Director , holds a Masters of Arts in Educational Leadership/School Leadership from Northeastern Illinois University. Prior to joining Girls in the Game, Monique led programs at the Chicago Park District and Chicago Public Schools. Amy Bohnert, Ph.D. is an Assistant Professor in Clinical and Developmental Psychology at Loyola University Chicago . She is a leading expert on how various contexts, especially organized extracurricular activities, might serve a protective role in youth development. Amanda Ward is a first year Clinical Psychology graduate student at Loyola University Chicago . She served as the project manager of the 2008-2009 Girls in the Game evaluation.