The proposed program will be undertaken by Better Women
Health Program and intends to address poor diet and inactive lifestyles among
low income women in Prabodhi
Narendra in Bihar, India, which makes
them susceptible to obesity, overweight and diseases such as heart disease and
diabetes. Under this program, twelve women will be selected from the target
group and trained in order to equip them with the skills to carry out one-on-one
personal encounters and group activities with their peers from the target area.
Such encounters and activities will encompass health education on exercise and
healthy eating. The program is intended to take a period of three years,
whereby intervention will start in September and end in August each year. The
program needs a funding of $148,000 per year. It will be facilitated by Better
Women Health Program’s staff, the trained women, collaborators and target
Identification of the Health issue
Better Women Health Program will develop, execute, and
appraise a health promotion program as a response to the prevalence of physical
inactivity, obesity and overweight, and diseases related to exercise and poor
diet and complex health barriers among low-income women in
Prabodhi Narendra, Bihar. The evidence-oriented approach utilizes community-based
promotion of health and community empowerment and organization’s principles to
deal with health issues and impart attitudes, behaviours, and knowledge from
within underprivileged communities.
The role played by physical activity and diet in reduction of
chronic diseases and promotion of health for a range of situations is well
founded. Research shows that diabetes, obesity, mental health, cancer, among
other health conditions are highly influenced by activity level and diet.
Obesity and overweight are clearly related to solemn health effects across all
ages and undermine social functioning and mental health. Nationally, obesity
amid adults is rapidly and clearly mounting among all sexes, ages, education
levels, and races. Nevertheless, a bigger percentage of evidence shows that
individuals with lower economic status, women, and minority groups bear an
uneven burden of obesity, overweight and other related diseases (National
Obesity Observatory 2011).
Physical activity has a close relation with management of
weight. A bigger percentage of adults in the India are not receiving the level
of physical activity required to attain good health status. The proportion of
people with inadequate exercise augments for women, minority groups, and people
with low income or formal education levels. For example, about 71 percent of
women report inactive lifestyles (Ng et al. 2009, p.34). In addition, adults aged between 18 and 44 years have a high
likelihood of leading inactive lifestyles compared to elderly adults with 65 and
above years. Considerably, these inactivity adult years have a high probability
of overlapping with childbearing age among women. Research shows that, obesity
and overweight have a likelihood of increasing poor childbirth results and
pregnancy risk. As a result, before and subsequent to pregnancy might be crucial
periods for interventions on healthy behaviour among women (Mandal
et al. 2011, p.486).
There is concrete proof that people from minority groups,
particularly minority women, have high chances of feeding on poor diet, be
inactive, and show weight-related diseases like diabetes (Leung & Stanner 2012).
The study by Leung and Stanner documents pregnant and low-income women’s
perceptions regarding physical activity, diabetes, and health. The study
recommends intercessions to promote supportive settings for high physical
activity levels in the family, as well as the social environment in general,
customized to the women lives’ reality. Most minority women tend to consider
physical activity a treatment for disease instead of prevention. In fact, since
low-income and minority women may not give high priority to undertakings that
they consider as solely benefiting themselves, the Better Women Health Program
puts positive lifestyle transformations in a domestic context. Under this
context, the transformation evidently benefits the whole family and undertakings
can easily encompass family members or children. Concurrently, this program will
foster individual change as well as broader policy and systems change.
Among low-income women in Prabodhi Narendra, obesity and
overweight problems have a close relation with poverty, cultural differences,
language, information gaps, unreachable health care, along with lack of
resources for promoting health, such as healthy, affordable food, and
acceptable, safe exercise areas. This area is characterized by low educational
attainment and health status, a big and growing population, and high
unemployment and poverty levels. Moreover, over 30 percent of the area’s
population do not have insurance covers, with the proportion of uninsured
females and males being roughly equal (Mehta & Shah 2001, p.46). All such factors are linked to lower status of health
generally, and particularly with obesity, inactivity, and related health
conditions like diabetes and heart disease (Sproston & Mindell
In summary, lack of preventative and primary health care
services is widespread in the target area, and so is a shortage of correct
information regarding accessible health resources, as well as a universal
incapacity to access the available services or resources. The region also has a
shortage of health professionals. Language differences, economic status, and low
education levels also makes a contribution to the poor health position of the
residents. Often, most residents lack awareness of health services, are not
aware of how to get services, or believe that seeking health services will
report feeling mistreated or disrespected by health providers. Furthermore,
getting transportation means to health facilities is a prevalent problem
especially in the interior parts of Prabodhi Narendra.
Better Women Health Program provides services, information,
and training on healthy lifestyles directly to low-income and minority women. It
also establishes connections to accessible health care services through reliable
peers and helps participants to overcome multiple obstacles to better
lifestyles. As advocates and educators, the members of the program are capable
of achieving impressive results since they share culture, experiences, and
language with the members of the community they serve. The suggested
intercession is an effective, innovative, and a holistic approach to community
and individual health promotion. It is intended to specifically assist
low-income, minority women to understand and enhance their personal health along
with their families’ health, by feeding on healthy diet and sparing time to do
exercises on a regular basis.
Similar to women in most cultures, Prabodhi Narendra’s women usually
address their families’ health prior to addressing their personal health.
Consequently, and since the rural women are more isolated compared to the males,
the former may utilize their families’ scarce resources to tackle their children
or other family members’ health issues. A member of Better Women Health Program
may help a woman in other close family health issues, such as an ill child,
prior to talking about the woman’s personal health, likely concern about obesity
or overweight, and involvement in the program’s intervention. This way, the
intercession will be able to address and influence a range of health problems or
concerns, as may be necessary.
The suggested program will train, recruit, and help peer
health tutors from the target group. Experience shows that peer tutors with
identical socioeconomic status as the community members they serve are ideal
Addressing multiple and
complex hindrances to health care services.
Advocating for better
health services in place of the community members.
Changing social norms.
Empowering members of the
community to alter conditions prevalent in the community that fail to support
and culturally competent services.
Moreover, a mounting literature body espouses the
formulation and execution of multilevel intercessions that involve working with
target community groups to develop affirmative personal health behaviours, as
well as uphold the behaviours through supportive policy and environmental level
changes (Perez, Fleury, & Keller 2011, p.341).
Just like the Prabodhi Narendra’s women
who have careers and families, most Better
Women Health Program’s members struggle to attain a balance among competing
demands. Thus, they constitute realistic and excellent role models showing the
way women with several responsibilities may also spare time to foster better
health, physical activity, nutrition, and better weight management both in their
families as well as communities. The suggested program’s approach is considered
to be effective since the members will not merely tell the target group that
exercise and improved nutrition are beneficial to them. The members will make
changes in dietary and engage in exercise alongside the women who will be
involved in the program. Moreover, under the suggested intervention, women will
work jointly to overcome former obstacles to healthy behaviours and to establish
networks for social support. Research indicates that such networks may be
crucial to lasting upholding of health changes in behaviour (Smith & Christakis
Project aims and objectives
Better Women Health Program aims at promoting the taking up
of healthy ways of life among low-income women in Prabodhi Narendra region in Bihar.
The aim will be achieved through the development, implementation, and evaluation
of a community-based health promotion initiative in order to augment the
incidence of healthy diet and exercise, as well as lessen prevalence of obesity
and overweight amid the target group.
To select, train, and
oversee twelve women from within the target group to work together with the
program’s members. For a period of sixteen weeks from December to March every
year for the next three years, each of the women will finish 350 hours of
experimental learning and training relating to exercise and healthy eating.
Consequently, each woman will show individual changes in intended health
knowledge, behaviours, and attitudes.
For fourteen weeks between
January and March every year, the trained women will direct the intervention of
healthy lifestyles among their peers residing in
Prabodhi Narendra. Each group of two trained women will:
Carry out 20 personal
encounters every week, recording a minimum of 1,400 individuals which they train
for the exercise and healthy eating intervention and give face to face resource
information, health education or follow-ups and referrals.
Organize and maintain three
health groups within the locality, reaching a minimum of 180 women for twelve
weeks. Each group will have a meeting once in a week with the trained women for
an education and activity session for 75 minutes.
behaviour changes by collaborating with the participants and all other
stakeholders in order to create policy and system modifications, such as
improving access to healthier choices of food in local outlets and setting up
acceptable, safe places for doing exercises in the region.
To develop a survey tool
suitable to the target group to show the impact of the intervention on the
knowledge, behaviours, and attitudes of participants in relation to affirmative,
healthy behaviours. Administration of the survey will take place three times
every year for three years: at baseline, end of the intervention for 12 weeks,
and around six months subsequent to the baseline.
To assist participants check their personal
exercise and healthy diet goals through the development of tools for personal
goal-setting and tracking by the Better Women
Health Program staff.
In the first and second year, the
director of the program will carry out 1-2 focus groups among women in the
target region in order to record community contribution and make suggested
changes to the initiative when feasible and required.
Project plan and budget
In this funding proposal, Better Women Health Program plans
to carry out a 14-week health promotion program on matter relating to exercise
and health eating, which are considered key to ensuring a healthy community. The
project targets low income women in Prabodhi Narendra in Bihar, India.
The program is intended to go for three consecutive years.
The suggested program will be starting in September every year and ending in
August. In order to successfully facilitate the program, the requested funding
and which constitute the project’s budget is $148,000 per year.
Implementation of the strategy
Several viable policies will be used to get the
forecasted yearly sample of 180 females. While some follow-up loss is likely due
to the regular movement of a considerable percentage of target group and other
factors, Better Women Health Program expects
getting pre, post, as well as six-month tracking data from around 80 percent of
the sample, that is 144 individuals. Consequently and during the three years,
compilation of data will be done for 432 women. Tactics for obtaining the sample
will include collaborating with community members to introduce the intercession
and to gather data, and carrying out a practically responsive and culturally
competent intervention. Other strategies will include providing meaningful
community contribution’s systems, carrying out all activities in reachable
locations at proper times, and trying to keep follow-up information and data of
the program’s dropouts.
Information on recruitment meetings will be
distributed among the target group either towards the end of October or in early
November. Interviews and placements in the program will be completed in November
with a joint two-week training occurring at the beginning of December. All the
selected and trained women will take part in this training, alongside
collaborators and community partners. This way, they women will gain core
competencies needed to fulfil their roles, create critical connections with area
social and health services and contact people, and receive specific training on
important subjects, such as leading healthy lifestyles. During the season, the
twelve women will devote around 25 hours every week to carry out their roles,
most of which they will spent facilitating particular community-based
undertakings in the target areas.
At the same period, that is, between September and
December every year, Better Women Health
Program’s staff will develop, complete or revise data gathering instruments as
well as tracking tools, and prioritize targeted community members together with
community collaborators and other personnel. The staff will also prepare or buy
educational equipment and supplies, and execute other start-up activities, such
as making plans for the focus groups.
The program’s intense intervention and outreach part will
start in January every year for three years. The trained women will be grouped
into twos, after which they will go to talk with the targeted community members.
With the guidance and support of the Better Women Health Program’s staff, the
women will go home-to-home in targeted group completing individual meetings and
recruiting other women for a period of 12 weeks. During this period, the women
will give personalized health education, as well as any referrals for social or
health care services or any suitable type of assistance. For around two weeks,
these women will focus principally on undertaking individual encounters,
discussing pressing health matters with participants, as well as recruiting
women on exercise and health eating.
During the two-weeks, the women will collect community
contribution and search and define suitable and reachable meeting locations,
which may include present community centres, nearby schools, parks,
neighbourhood streets, and churches. Existing joint relationships will back up
the process, as Better Women Health Program’s staff and the trained women work
towards developing and sustaining new relationships and establish locations and
community groups for intervention.
After the first two weeks, group intervention will begin with
each pair of the trained women directing three groups with a minimum of 12 women
every week. Each pair will persist with completing personal encounters across
the season in order to give follow-up, uphold high attendance levels, and if
required, continue recruitment. Every weekly group intercession will entail
group exercise, health education, and counselling on nutrition that will
encompass demonstrations on healthy cooking, and practical conversations on
eating healthy in terms of economic strains. The women will use group meeting
forms in planning, documenting, and assessing the group’s education, and
physical activity sessions. Moreover, these forms along with sign-in sheets will
help in tracking attendance.
During each group session, participants will be given time to
give feedback, proposals, or to look for individual support and advice from the
trainers or fellow participants. Towards the termination of every program
session, the Better Women Health Program’s staff will facilitate a minimum of
one evaluation gathering. The end-of-season gathering will present the trainers
with an opportunity to mull over the finished intervention undertakings and
provide written or oral recommendations.
The table below provides a yearly timeline for
carrying out the suggested program. Where YR1, YR2 and YR3 are used, an activity
relates to a specific year or several years.
Person in Charge
September and October
to collaborators and community about the program (YR1)
positions for trainees in the local newspaper
Identify and assess
relevant survey and tracking instruments for individuals (YR1)
Annual review and
revision of group and personal encounter forms
survey for 6 months with participants of the former January-March session
Carry out interviews
and choose the 12 women; carry out baseline interviews
instruments and amend (YR1)
monitoring instruments for assessing changes (YR1)
schedule for December; draft schedule for ongoing training
Collaborators; all staff
personnel records; notes
December training together with collaborators and all staff
through participant input
Plan scheduling of 1
or 2 focus groups
PC; PD; Trained
Recording of verbal
evaluation; written evaluations
January, February, and March
Start of intense
outreach and recruitment (Initial 2 weeks)
intervention for groups after the first two weeks
Record all community
and continued training, record keeping; feedback and problem solving
PC; Trained women
PC; Trained women
supervision notes; sign-in
for 12 weeks
April and May
evaluation; record oral and written feedback, individual changes and suggestions
personal and group data
assessing participant suggestions and feedback
PD; PC; AC; Trained
for coming year
June and July
for amendments to the plan of the program
materials and supplies for the coming outreach year; purchase new supplies
Plan for YR2’s
Data gathering plan
Evaluation of the strategy
Completed and tabularized group forms will give proof
of meeting suggested project objectives. Particularly, the trained women will
use personal meeting forms to record every direct health contact completed. The
form will gather basic demographic data, topics covered, referrals given,
actions taken and any needed follow-up. The completed forms will be handed over
to the Project Director on a weekly basis. The director will review the forms
and check any errors, necessary follow-up, and unresolved issues. Moreover, the
director will go over the forms on a monthly basis to monitor progress in the
achievement of set objectives and carry out quality assurance assessments.
Similarly, forms for group activity will record group undertakings, attendance
and locations. An appendage will be included in the form for
group activity to record discussions, actions, and activities relating to
changes in the environment that foster healthy lifestyles for participants.
These forms will be gathered and reviewed through a similar process as the
personal encounter forms. A spreadsheet or database will be used to track the
data in the two forms.
Sherwood et al. (2000), individual checking of exercise and eating may improve
self-efficacy for such behaviours. Accordingly, the suggested program will
formulate tools for setting goals and tracking for use by the participants. The
tools will also be planned to assist women establish realistic changes
appropriate for their lives. The suggested outcome objectives will be measured
using a pre and post assessment that will be formulated or amended and
administered verbally with small groups or individuals at the start of the
program, at the end of the 12-week intercession, and at a follow-up of six
My role in the development and implementation of the
During the development and execution of the strategy,
I will take on the role of Projector Director, and I will be charged with a
number of key responsibilities. In the first place, I will have five hours per
week to carry out training, record keeping, problem solving, and individual
support and training. In addition, I will assess the qualities of the suggested
recommendations by the trainers taking into account information from an array of
sources, such as focus groups, as well as implement the relevant recommendations
before the start of the succeeding program year. Moreover, I will pose
open-ended questions to all the twelve women as they enrol for training and
towards the end of each program year in order to record reported behaviour
changes and the program’s impact on them.
Strategies for use in working together with others
In working with other people in the formulation and
execution of the project’s strategy, I will use various strategies. First; I
will involve different stakeholders to the proposed program such as other
Better Women Health Program’s staff members, the 12
trained women, collaborators, and even participants in making decisions
pertaining to things like meeting locations, meeting schedules, and survey
methods. This will help enhance the effectiveness of the suggested program since
the interests and opinions of different stakeholders will be taken into
consideration (Griffiths, Maggs, & George 2007). Moreover, before I make
decisions, especially regarding implementation of suggested changes to the
program plan, I will consult the program coordinator, and associate director as
to the appropriateness of the changes.
Griffiths, J, Maggs, H & George, E 2007, Stakeholder
Involvement, Geneva, World Health Organization.
Leung, G & Stanner, S 2012, October 23, Is Diet to Blame
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Mandal, D, Manda, S, Rakshi, A, Dey, R, Biswas, S & Banerjee, A 2011,
Maternal obesity and pregnancy outcome: a prospective analysis, Journal of
the Association of Physicians of India, 59 (8), 486-9.
Mehta, AK & Shah, A 2001, July, Chronic Poverty in India: Overview Study,
CPRC Working Paper 7, New Delhi, India, Chronic Poverty Research Centre.
National Obesity Observatory 2011, May, Knowledge and
attitudes towards healthy eating and physical activity: what the data tell us,
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Ng, N, Hakimi, M, Minh, HV, Juvekar, S, Razzaque, A & Ashraf, A 2009,
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