... Running head: A PILOT WELLNESS PROGRAM 1 A Pilot Wellness Program for Pageant Participants in the Miss Indiana Organization Kaytlyn Eberly Doctoral Occupational Therapy Student May, 2018 A capstone project submitted in partial fulfillment for the requirements of the Doctor of Occupational Therapy degree from the University of Indianapolis, School of Occupational Therapy. Under the direction of the faculty capstone advisor: Dr. Beth Ann Walker, PhD, OTR A PILOT WELLNESS PROGRAM 2 A Capstone Project Entitled A Pilot Wellness Program for Pageant Participants in the Miss Indiana Organization Submitted to the School of Occupational Therapy at University of Indianapolis in partial fulfillment for the requirements of the Doctor of Occupational Therapy degree. By Kaytlyn Eberly Doctoral Occupational Therapy Student Approved by: Faculty Capstone Advisor Date . Doctoral Capstone Coordinator Date . Date . Accepted on this date by the Chair of the School of Occupational Therapy: Chair, School of Occupational Therapy A PILOT WELLNESS PROGRAM 3 Abstract Background: Participants of the local and Miss Indiana pageants, experience a surge in occupations which potentially imposes a threat to overall wellness. In order for these women to maintain their wellness during each phase of competition, they need a balance between mind body and spirit. These young women are key members and leaders in society through their platform advocacy and community service, and considered role models to many. In order to positively impact the wellness of the younger population, it is important to increase the overall wellness of these contestants. Purpose: The purpose of this project was to a) determine the need for wellness programming, b) design and implement a wellness program. Method: A needs assessment was conducted through distribution of online surveys to Miss Indiana board members, local pageant directors, and past participants. Results: Based on wellness program literature and the needs assessment, a three-hour wellness program, entitled balance2bewell, was created. Program interventions included wellness education, two activities and introduction and practice of several wellness techniques. Four programs launched around the state of Indiana produced a total of 12 wellness group participants. A pre-posttest design demonstrated increased wellness based on self-report after the program. Conclusion: It is recommended that MAO provide wellness education for participants at all levels of competition to ensure healthy role models and further demonstrate the mission to empower women. A PILOT WELLNESS PROGRAM 4 Acknowledgements I would like to express my appreciation for the support and guidance provided by the Miss Indiana Executive Director, Aren Straiger. She has shown her good character by meeting with me, answering all my questions, and working hard to help spread awareness of the wellness program to increase participation. I would also like to thank Dr. Beth Ann Walker for her time spent to help me with program development and writing this paper. I had the pleasure of working with wonderful people from four universities where programs were held including the University of Indianapolis, Indiana University of Kokomo, Manchester University, and Indiana State University. All of the balance2bewell participants, Miss Indiana board members, local directors, and past participants provided information crucial to this project, so I thank them for their time and dedication to the organization. None of this would have been possible without the love and support of my family and friends. Thank you to Danyele Clingan for constant calls and texts as well as spending time with me while on campus. Thank you to my parents, Scott and Darla Eberly for pushing me to step out of my comfort zone and helping me to believe in something bigger than myself. Finally thank God for giving me the most wonderful man I soon get to marry that has put up with long distance so I can work toward my dream, and that has never let me give up on myself. A PILOT WELLNESS PROGRAM 5 A Pilot Wellness Program for Those Participating in the Miss Indiana Scholarship Pageants at All Levels Introduction The Miss America Organization (MAO) hosts one of the most renowned scholarship pageant competitions in North America, as it has existed for nearly 100 years with over 10,000 contestants at all levels each year (Miss America, 2017). Pageants within MAO exist at local, state, and national levels for young women between the ages of 17 and 25, who are U.S citizens, portray the MAO character criteria, are in good health, and have the ability to meet the time and commitment requirements (Miss America, 2017). A participant must first be crowned a local title, followed by state level competition, in which the winner continues on to the national level, one participant from each of the 50 states as well as one from the District of Columbia (Miss America, 2017). The Miss America Organization aids young women in becoming strong, confident leaders of society, good role models, and leaders in community service. The organization crowns a young woman that holds potential for all these attributes and represents the four points of the crown: scholarship, success, style, and service (Angeli, 2017). The scholarship point indicates that the representative strives to earn scholarship for the purpose of furthering her education and achieving [her] personal and professional goals ("Fourpoints of the crown and four winning tips", 2013). Success represents the life experiences gained while representing the organization, and working on worldly issues through the promotion of her platform ("Fourpoints of the crown and four winning tips", 2013). Unique personal qualities of each woman are celebrated by MAO through the style point of the crown, as well as what personally looks and feels good to the individual ("Fourpoints of the crown and four winning tips", 2013). The final A PILOT WELLNESS PROGRAM 6 point of the crown represents service, demonstrated through a title winners dedication to her platform and additional community service opportunities ("Fourpoints of the crown and four winning tips", 2013). Many former Miss Americas describe how their lives have been changed by obtaining this new title and being associated with this organization in interviews such as ones with Cosmopolitan. Mallory Hagan expressed how being Miss America helped her gain the ability to speak about various topics to culturally diverse populations, including speaking with five year olds as well as the president (Coyne, 2016). A majority of the women interviewed for this article discussed the positive impact of being Miss America which helped them become strong and confident role models and leaders in society (Coyne, 2016). For example, Heather French Henry felt like she could make a difference by promoting her platform at a national level (Coyne, 2016). Another former Miss America, Nicole Johnson became a major advocate for her platform, Type 1 Diabetes awareness, and continued full time advocacy for eight additional years beyond her year of service (Coyne, 2016). Today, Johnson continues advocating for increased awareness of Type 1 Diabetes and was appointed the Board of the Diabetes Empowerment Foundation in 2016 (Johnson, 2016). Many of the women also discussed that the organization provides a family and support system for contestants and volunteers that far surpasses the pageant contest (Coyne, 2016). Hagan, for example, expressed that even though the perks of obtaining the title end, the friendships made last a lifetime (Coyne, 2016). Many past Miss Americas still speak out for their platforms and are often still in the limelight as voices for the voiceless. This organization embraces incredible values and missions to empower women, including, but not limited to, providing scholarship to women in business and Science, Technology, Engineering, and Mathematics (STEM), thus giving them direction in their future A PILOT WELLNESS PROGRAM 7 endeavors and increase the overall wellness of girls while also instilling confidence (Miss America foundation, 2015). There are several different views about the impact on wellness result of pageant participation. An opposing view is of those who believe pageants have a negative impact on self-esteem and wellness of girls, for example a past participant reported that by participating in Miss America, she lost a part of her self-confidence that she could never reclaim (Maddox Deitering, 2001). Both views have been publicly debated throughout the years in magazines, news reports, blogs, and across social media platforms, even more recently in light of changes and issues within the Miss America Organization. Negative views of this organization have been more prominent in news stories and social media in recent months due to the actions of former Chief Executive Officer (CEO) of the organization, Sam Haskell, and other board members. Haskell began in the member of the board in 2005 then quickly progressed to the CEO position where he lead for nine years (Ali, 2017). With the help of his board members, Haskell destroyed the pageant that he was once given credit for restoring (Kuperinsky, 2017). Three years worth of internal email exchanges between Haskell and other board members were released which enclosed body shaming, slut shaming, name calling, and other derogatory comments about former Miss Americas (Stapleton & Andone, 2017). Social media was immediately flooded with comments of people believing this to be the end of MAO, as well as comments of people fighting for its continuation (Kuperinsky, 2017). Many sponsors, including Dick Clark Productions, cut ties with the organization after the news was released in order to no longer be connected to the bullying actions that were portrayed in these emails (Stapleton & Andone, 2017). Former Miss Americas, including Hagan who was often the topic of Haskells crude comments, immediately spoke up (Ali, 2017). Hagan stated that with light brought to this situation, she finally felt validated in her feelings, as this was A PILOT WELLNESS PROGRAM 8 something she had tried to share during and after she held her title in 2008 (Kuperinsky, 2017). Another former Miss America, Gretchen Carlson, stated that every person involved should resign immediately, and that the almost 100 year old tradition of female empowerment & scholarship, deserves better (Stapleton & Andone, 2017). Former Miss Americas pushed for Carlson to become the new CEO of the organization (Post, 2018). Carlson ensures that she plans for the organizations mission to be 100 percent about empowering women (CBS/AP, 2018). Carlson was crowned Miss America in 1989, and has since been a successful news anchor and T.V. personnel for Fox News and CBS News (Carlson, 2017). The organization sees her as an appropriate leader for MAO as she has dedicated her life to building confidence in women through mentorship, publications about empowering women, hosting pageants for women with disabilities, creating the Gift of Courage fund to help encourage women to fulfill their dreams of the future, and her constant voice to empower women (Carlson, 2017). Many believe MAO to be a good competition for women that inspires and empowers participants, and helps them to have a greater impact on society through the expression of their passions and platforms. Savvy Shields, Miss America 2017, promoted her platform Eat Better, Live Better throughout her year of service to encourage others to make healthy choices leading to a happier life, after she struggled herself with making bad choices (Cooper, 2016). Shields (2017) continues a blog, in which she dedicated one post, to expressing that even though she felt she had conquered all insecurities prior to being crowned Miss America, many quickly surfaced throughout her year of service. Although she claims to still be working on these insecurities, Shields (2017) discusses her immense change and how much MAO helped her achieve this growth. An outside business women, Ashley Margeson, expressed her appreciation for the Miss A PILOT WELLNESS PROGRAM 9 America pageant in terms of providing young girls with a positive role model to assist in demonstrating the importance of building peers up rather than tearing each other down (Margeson, 2017). A past Miss America, Sharlene Wells, stated, the pros outweigh the cons when referring to her participation in the pageant (Maddox Deitering, 2001). Alyssa Gum (2017) was crowned Miss Teen Ohio United States, and spoke about how pageants of all circuits empower women, by stating that the ability to advocate for a personal platform, as well as the platform of the pageant organization, increases confidence in the participants. Gum (2017) declines to agree with those that believe a swimsuit competition is sexist as she sees it as encouragement for women to embrace their body, and expresses that the modeling industry and media place a stronger focus on body image, while pageants embrace all types of women and thus increase the confidence of contestants. Negative views of participation also exist, and some of the most profound are expressed by past participants. One former Miss America, Kira Kazantsev, highlighted in a blog post how she and her fellow contestants vowed to make healthy life choices including self-love and viewing oneself as beautiful without comparing ones image to others, avoiding the mindset one once had when competing in swimsuit competitions (Kazantsev, 2017). This goes to show that even after being so successful in pageantry, insecurities may continue to linger. A history professor at California State University who has written on this topic many times, believes that the lifestyle and fitness category, or swimsuit competition, sexualizes the bodies of the contestants and pushes the women to attempt to live up to unachievable standards (Roberts, 2013). Further, a former Miss America contestant expressed that competing caused her to lose self-esteem and experience emotional bankruptcy (Maddox Deitering, 2001). A PILOT WELLNESS PROGRAM 10 One of the most discussed controversial issues related to MAO is the belief or disbelief that pageant participation increases eating disorders and body image issues. The Huffington Post conducted research of the Body Mass Index (BMI) of past Miss Americas in comparison to the average woman (Vagianos, 2015). When the Miss America pageant began in 1921, the BMI of the average American woman was considered underweight, while the BMI of Miss America was in the normal, healthy range (Vagianos, 2015). The BMI of the average American woman has steadily increased over the past several years to the overweight category, while the BMI of the past Miss Americas has steadily decreased into the underweight category (Vagianos, 2015). Eating disorders among contestants dominates public interest and the majority of literature, and many contestants have shared their stories of suffering from eating disorders. One past Miss America, Kirsten Haglund, developed anorexia nervosa as an adolescent and went through treatment before she ever started competing in pageants (Morrow, 2017). Today, Haglund is still very careful about how she shares her story as she never wants it to become thinspiration for others (Mapes, 2013). While her eating disorder was well managed prior to competition, another participant Leighton Jordan, Miss Georgia 2012, shared a story about her experience with eating disorders during her pageant competition (Rice, 2013). While Jordan expressed that she had developed and overcome anorexia nervosa as a child, during pageant competition she had begun to develop bulimia nervosa as well as habits of dieting with use of laxatives (Rice, 2013). Fear of developing a bad reputation for herself and the pageant system, kept her from sharing her story until she saw a little girl at an event with all too familiar signs of suffering from an eating disorder (Rice, 2013). Jordan wanted to inspire healing for others experiencing the same thing, which led her to get the help she needed (Rice, 2013). Occupations of Pageant Contestants A PILOT WELLNESS PROGRAM 11 Every participant must first compete in a local pageant within the Miss Indiana Organization, then if awarded a title, she continues on to the Miss Indiana pageant which is a preliminary contest for the Miss America pageant (Miss Indiana, 2017). In Indiana, 35 local pageants are held which begin in July and continue through March (Miss Indiana, 2017). Of these 35 pageants, 12 have are an open-entry status meaning that anyone meeting the requirements of MAO guidelines, and who is a resident, full-time employee, or full-time student at a college or university in Indiana can participate (Miss Indiana, 2017). The remaining pageants have a closed-entry status in which participants have to live, work, or go to school within a certain county in Indiana (Miss Indiana, 2017). For some girls, pageant preparation could consume an entire year, involving getting ready for the fitness competition with workouts and nutrition, interview practice, study of worldly and political issues, paperwork preparation, wardrobe shopping and altering, and talent development and practice. Prior to the start of competition at any level, each contestant is required to submit a resume, a signed local contract, and platform statement which is an opportunity for the participant to be a voice for something she is passionate about (Miss Indiana, 2017). Although they are encouraged to raise copious amounts of money, for each pageant in which they wish to compete, contestants are required to raise $100 for Childrens Miracle Network (Miss Indiana, 2017). This additional work has deadlines during their other occupations of schoolwork, working a job(s), and any other activities they are involved in. During each pageant level contestants compete in different areas worth different percentages including, a 10 minute private interview with a panel of judges by whom questions are formed about contestants worldly views and opinions, personal questions from resumes, and character questions, worth 25% of the total score ("2018 Miss America competition scoring A PILOT WELLNESS PROGRAM 12 guide", 2018). The remainder of the judging occurs in front of a live audience. These phases of competition include the lifestyle and fitness in swimsuit competition worth 15%, the talent portion worth 35%, evening gown competition worth 20%, and onstage question worth 5% (Miss Indiana, 2017 & "2018 Miss America competition scoring guide", 2018). Guidelines for local participants are expressed through the contract each girl is required to sign, which closely mimics the contract for both state and national levels (2018 local contestant contract, 2018; 2017 state contestant contract, 2017; 2018 national contestant contract, 2018). Some of the criteria for participation includes being of good moral character meaning demonstrations of honesty, good character, talent, poise, intellect, leadership and good judgement (2018 local contestant contract, 2018). Other criteria includes having no criminal record, never having been married or pregnant, never having performed any acts that MAO could consider indecent or immoral, and being in good health for ability to participate in all activities (2018 local contestant contract, 2018). Once being awarded with a local title, the young woman begins her year of service (Miss America, 2017). The year of service is well known within MAO competitions, where in the new title holder spends her year continuing community service while representing her local pageant, school, and/or region as well as promoting her platform on a larger level (Miss Indiana, 2017). Some local pageants provide an additional contract or set of guidelines to depict what is expected during this year thus providing an additional list of occupations for the year in which she holds her title. The Sweeps Scholarship Pageant (SSP), which crowns two participants, for example, requires title holders to have weekly communication with directors during the preparatory months leading to the Miss Indiana competition (SSP Year of Service). The title holder for the SSP is encouraged to participate in events and appearances with approval from the A PILOT WELLNESS PROGRAM 13 directors, however some are required for her to attend (SSP Year of Service). Also within this secondary contract, the title holder is required to devote the time necessary for preparation for the state competition, promote and further develop her platform, demonstrate good time management and punctuality, and only use ones cell phone for emergencies while representing the SSP during events and appearances (SSP Year of Service). All shopping for the state competition wardrobe must be completed with a SSP director, any communication with director (i.e. email, text, phone call) must be answered within 24 hours, directors are to be notified with out of state travel ahead of time, and the title holder must also do her best to recruit women for the following years competition while representing MAO (SSP Year of Service). Many of the local pageants have adopted these guidelines for their title holders year of service like the Miss Indiana University pageant, Miss Harvest Homecoming pageant, Miss South Central pageant, Miss Vincennes pageant, and Miss Central Indiana pageant, among others. The Miss Indiana competition, known as Miss Indiana Week, last six days, four of which are reserved for evening competition which requires the same preparatory measures and competition factors as the local pageants (Miss Indiana, 2017). Participation involves staying in a hotel with another contestant, traveling to several events and appearances around the city, and the competition itself (Straiger, 2017). Scheduled events include the opening ceremony, a tour and visitation at Rileys Children Hospital, visit with the Boys and Girls Club, self-defense class, rehearsals, Lions Club cookout, Joys of Life Luncheon, Princess Brunch, Princess Program rehearsal, Elks Brunch, and meals at local restaurants or the hotel (Straiger, 2017). Wellness The term wellness has been defined and discussed within the healthcare field in great detail since the 1950s thanks to Halbert L. Dunn (Kirkland, 2014). Dunn, father of the wellness A PILOT WELLNESS PROGRAM 14 movement, provided early definitions and ideals about wellness, "[wellness is] an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable (Manley, Ardell, Allen, & Heien, 2015; Kirkland, 2014). Dunn discussed an overarching goal for wellness including to maximize the potential of environments in which people function (Manley, Ardell, Allen, & Heinen, 2015). His ideals of wellness surrounded his argument that the absence of disease is only a small portion of what health and wellness truly represents (Kirkland, 2014). Dunns theories influenced the development of wellness over the next several years, as many others continued to add and further cultivate theories. University of California, Berkeley has published a Wellness Letter since 1984 and has since become the leading online wellness resource nationwide (Berkeley Wellness, n.d.). Here, wellness has been defined as optimal physical, mental and emotional well-being, a preventive way of living that reducessometimes even eliminatesthe need for remedies. This definition emphasizes personal responsibility for making the lifestyle choices and self-care decisions that will improve the quality of your life with a focus on preventative wellness (Berkeley Wellness, n.d.). In 2008, the World Health Organization identified that wellness is holistic and includes both an absence of illness and a state of wellbeing (Miller & Foster, 2010). Occupational therapists treat clients with a holistic view and focus on how to help his or her overall well-being. Within the wellness model of practice, occupational therapists work to promote wellness by increasing the clients participation in meaningful occupations or activities (AOTA, 2013). Ann Wilcock identified the importance of having a balance between physical, mental, and social wellness, and believed that these things are achieved and balanced through participation in meaningful occupations (Cole & Tufano, 2008). Like many wellness researchers A PILOT WELLNESS PROGRAM 15 before her, Wilcock mentioned the importance of a goal to improve the population as a whole as well as individually as people are unique with various goals and potentials (Cole & Tufano, 2008). Occupational therapists are skilled at helping specific populations, while also analyzing the individual to help them strive to reach their goals. These practitioners can take the person as they are and help them go where they want and need to be. These gains in wellness led to the development of many wellness models, including the Six Dimensions of Wellness and the Seven Dimensions of Wellness. The Six Dimensions of Wellness was developed by a co-founder of the National Wellness Institute (NWI), Dr. Bill Hettler (Hettler, 1976). Hettler identified and discussed the six dimensions as intellectual, physical, spiritual, occupational, emotional, and social (Hettler, 1976). The discussion of interconnectedness included that this model is holistic in nature and allows one to work toward an increase in well-being (Hettler, 1976). The University of California at Riverside proposed the Seven Dimensions of Wellness based on the Six Dimensions of Wellness with one addition of environmental wellness (Chobdee, n.d.). This seventh dimension was added to increase the holistic balance and places a stronger emphasis on wellness no matter where one may be (Chobdee, n.d.). The American Occupational Therapy Association (AOTA) (2013) identified that the role of an occupational therapy practitioner within the wellness model is to promote healthy lifestyles, emphasize occupation as an essential element of health promotion strategies, and provide interventions, not only with individuals but also with populations (p. S50). Prevention of health issues is defined by AOTA (2013) at three different levels entitled primary, secondary, and tertiary. Primary prevention is identified by teaching people about health and wellness in order to decrease the risk of illness and injuries (AOTA, 2013). Secondary prevention includes A PILOT WELLNESS PROGRAM 16 what is known as typical therapy and is comprised of screening, early detection, and intervention after disease has occurred (AOTA, 2013). Tertiary prevention is used when a disease already exists to focus on improving quality of life and reducing symptoms (AOTA, 2013). Occupational therapy practitioners can promote health and wellness by providing wellness programs that help the general population by providing prevention strategies (Gupta, Chandler, & Toto, 2013). Examples of programs currently run by occupational therapy practitioners include backpack awareness day and car safety recommendation programs (Gupta, Chandler, & Toto, 2013). Backpack awareness day, for example, is a program given to school aged children to teach them how to lift, pack and carry a backpack. It also includes providing education of the proper ergonomic fit and weight of a backpack which helps to avoid back pain or injury (AOTA Backpack Awareness, n.d.). This is an example of primary prevention as it is working to educate children so they can avoid injury. Another wellness program, for example, provided to a group of typically healthy individuals (ie without diagnosed disease or illness) could benefit from a wellness program through occupational engagement in a scholarship pageant. With the use of primary prevention strategies, education of wellness techniques can be provided to a group of pageant contestants to improve their overall wellness. With the research of many wellness models previously created, the balance of mind, body, and spirit can help to improve the overall wellness of the program participants. Purpose of the Project Participants of the local and Miss Indiana pageants, experience a surge in their occupations which potentially imposes a threat to balance in their everyday which further A PILOT WELLNESS PROGRAM 17 impacts overall wellness. In order for these women to maintain their wellness during each phase of competition, they have to have a balance between mind body and spirit. These young women are key members and leaders in society through their platform advocacy and community service, and therefore are role models to many, thus in order to positively impact the wellness of the younger population it may first help to increase the overall wellness of these contestants. There is a lack of wellness programming designed for pageant contestants between the ages of 17 and 25 participating in MAO. A majority of those who participate in Miss America pageantry are in a period of emerging adulthood (18 - 25) (Ng, Boey, Mok, Leung, & Chan, 2016). According to Ng et al. (2016), emerging adulthood is a phase in which one experiences a heightened sensitivity to the process of identity development, self-focusing, possibilities, and instability while transition into adulthood. Research suggests that this population naturally experiences increased levels of stress and anxiety when experiencing challenges associated with this transition (Ng et al., 2016; Lane, Leibert & Goka-Dubose, 2017). The purpose of this project is to promote wellness in Miss Indiana contestants by increasing balance of mind, body, and spirit through occupation in the context of a pageant while also providing them with the tools to increase wellness in daily life. From literature, it becomes clear that the increase in occupations when competing in MAO pageants can cause a decrease in overall wellness. For example, many contestants of the Miss America competition reported immediately comparing themselves to others, thus decreasing their confidence (Maddox Deitering, 2001). Tamara Hext, a former Miss Texas, admitted to decreased self-esteem and development of an eating disorder throughout her pageant participation (Maddox Deitering, 2001). Former Miss America, Donna Cherry, expressed that she struggled with body image before and after pageant competition (Maddox Deitering, 2001). A PILOT WELLNESS PROGRAM 18 Methodology Screening Due to the lack of evidence in literature about the local level competition, it was important to gather perspectives from those that will be affected by the implementation of the wellness program. Surveys which each shared an introduction (see Appendix A), were developed for board directors and local directors in the Miss Indiana Organization, as they spend a large amount of time with contestants and thus develop an additional perspective not found in literature. Board members are not required to be involved, however based on personal experience, it is known that those involved in the Miss Indiana Organization are engaged in every contestant and every local pageant. Board members are around during the entirety of the Miss Indiana pageant and all of the appearances and activities pertaining to the organization. Board members travel to the local pageants to meet and support all contestants, and are very involved at each level of competition. A board member acts as Miss Indianas professional assistance during her year of service (Guidelines for Miss Indiana's year of service, 2018). Local directors are the main contact for communication with all contestants including those that do or do not make it to the state level of competition (Miss Indiana Director Manual, 2017). They are encouraged to promote their local pageant on social media and once a woman is crowned they are to help her prepare for the state competition with all pageant preparations (Miss Indiana Director Manual, 2017). Gaining board members and local director's perspective through survey completion allows for detailed understanding of current wellness issues of those involved in the pageant circuit. For board members and local directors (refer to Appendix B and C respectively), information was first gathered about how long they had been involved in the organization, how they got involved, and how much time they spend with the contestants during A PILOT WELLNESS PROGRAM 19 competition. Each survey contained questions about how much time was spent with contestants in order to identify the weight of the responders perceptions. The survey continued to gather information about their perspective of the overall wellness of the contestants during pageant competitions. These surveys included wellness questions such as what wellness strategies are currently involved within the Miss Indiana organization, wellness concerns they have for current participants, and what they believe these participants could benefit from in a wellness program. Another survey was developed for past participants (see Appendix D), to gain yet another perspective. This survey asked past participants to explain why they stopped competing, how long they competed, and if/how often they continued to compete at the state level. It further elicited information about their perceptions of wellness while competing, as well as, perceived wellness of fellow participants. Even after the competition is over, former Miss America contestants discuss the Post-Pageant Crash wherein the immediate decrease in occupations also decreases their overall wellness (Maddox Deitering, 2001). For example, some express not knowing how to fill the void of occupations and others discuss struggling to deal with the loss of the title they had been competing for (Maddox Deitering, 2001). Hext expressed her real sense of loss after losing the national competition by stating, You work so hard to come here, and all of a sudden, its over. Theres nothing more to work for (Maddox Deitering, 2001). Another former contestant, Miss Connecticut, Joanne Caruso, confessed of falling into depression following her time competing at the national level (Maddox Deitering, 2001). In addition to the wellness questions, the past participant survey also asked more personal questions about eating disorders and other mental illnesses. Within articles pertaining to pageantry, not any one circuit in particular, the concern of eating disorders is profound. The Odyssey published an article about how pageants impact the ideal of beauty and stated that A PILOT WELLNESS PROGRAM 20 participation in pageants can be disastrous to ones self esteem, especially if her body type does not fit that of the medias expectations (Graham-Hyatt, 2016). Many believe pageants to be involved in the development of eating disorders, for example, Coppa (2016) conducted a study to survey and interview the 2012 MAO title holders for eating disorders. Coppa (2016) reported that 26% of the female pageant contestants were told or perceived that they had an eating disorder and gathered a variety of views from past participants (Garner et. al., 1982, p. 6; Thompson et al., 2003, p. 1). A majority of views from those interviewed included that of appreciation and disbelief that pageants contribute to eating disorders, and others report that the competition makes participants compare their body to others thus causing issues with body image (Coppa, 2016). Therefore, for the current project, past participants were additionally asked about their personal experiences, specifically if they experienced eating disorders and/or mental illnesses. Information compiled from the surveys assisted the development of a wellness program for current participants. Of the 18 board members within the Miss Indiana Organization, survey emails were sent with a return of 13 responses. Board members time with the organization varied from 5 to 52 years and 61.5% of respondents claimed to spend the entire day each day with contestants during Miss Indiana Week. Respondents indicated many wellness strategies which exist within the organization and related events, such as healthy meals, community involvement, support systems in new found friendships, scheduled relaxation time, and an open door policy with board members for support. Concerns for contestants indicated by respondents included stress, sickness, not eating enough, a busy schedule, lack of sleep, and increased pressure from directors and family members. Every board members response indicated that they felt contestants would benefit from learning stress management relaxation techniques for A PILOT WELLNESS PROGRAM 21 increased wellness specifically time management techniques, mindfulness strategies, and how to balance mind, body, and spirit. Of the 62 local directors, who were sent surveys, 32 responded. Length of time as a director varied from less than one year to 33 years of active participation in the organization. A majority, 56.3 %, reported spending all day with contestants at the local level, and the others report a combination of being the primary contact prior to competition, with contestants for entire day of pageant, and/or available to assist backstage for entire pageant. Directors also reported various amounts of time, based on the woman, spent with their title holder in preparation for the state pageant including: 40 hours of meeting time, constant communication via text and phone, meeting a couple hours per week, and working over 100 hours total in preparation. When asked for their perspective of what might be the demands of the participants wellness during preparation and participation in these pageants, responses included pressure to regularly exercise and eat healthy, risk of decreased mental health, pressure from the competition, family pressure, time management for already busy schedules, decreased sleep, and managing additional appearances, fundraisers, promotion of their platform, and community service. Within their personal local pageants, local directors reported wellness strategies already in place such as providing healthy meals the day of competition, rest and downtime, verbal encouragement, chair massages, prayers, encouragement to make healthy choices during preparation of pageant, and for local title holders specifically, exercise programs and positive communication with the title holder leading up to the state competition. A majority of the local directors noted that the implementation of a wellness program with stress management, relaxation, mindfulness, and time management education, as well as education for how to balance mind, body, and spirit could increase participants overall wellness. A PILOT WELLNESS PROGRAM 22 Perhaps the most eye opening perspectives came from the survey responses of past contestants. Of the 53 former contestants who received a survey, 22 women responded. Over half of the responses (55%) came from women who last participated in the 2016 and 2017 pageant year. Many stopped participating because they aged-out or moved out of state and no longer compete. However most respondents indicated making it to the state level at least once during their competitive years. Previous contestants reported a decrease in their overall wellness while competing as evidenced by loss of confidence in talent, abilities, and physical appearance, decreased mental wellness with increased pressure and stress to be successful, decreased sleep, unhealthy relationship with food, loss of relationships due to busy schedules, and overall decreased self-esteem. While preparing for pageants and throughout participation, respondents reported a significant increase in exercise and strict diets while maintaining busy schedules with work and school obligations, meeting deadlines and expectations, and long hours of both preparation and competition. They described concerns they held for fellow contestants or perhaps those still competing such as contestants being obsessed with posting the perfect social media feed during state competition, eating disorders, mental illnesses, increased stress and pressure, decreased balance of mental, physical and emotional needs, decreased self-esteem, falling into the perception to look a certain way, competing with injuries, and becoming obsessed with the competition. Eight of 22 (36.4%) of the respondents indicated they had experienced an eating disorder at some point, either before or after competition, and 85% reported experiencing depression, anxiety, or other mental health issues both during and after competition. They also reported decreased wellness upon completion of pageant participation such as, statements of never feeling as beautiful as [she] was when [she] competed, decreased confidence after gaining weight post pageant, and depression from moving on after the loss of Miss Indiana so A PILOT WELLNESS PROGRAM 23 many times. Past participants indicated that current participants would benefit from a wellness program that addresses stress management, mindfulness strategies, spiritual guidance, relaxation techniques, time management, and education to balance mind, body, and spirit. Evaluation To measure the effectiveness of the wellness program, a pre and post assessment (see Appendix E and F respectively) will be used. This will assess the level of knowledge each participant has of overall wellness as well as how they rate their current personal wellbeing, what they do for wellness, and how it applies to pageant competition prior to implementation of the intervention. Another assessment that will be used in conjunction with the program is the How Healthy Are You developed by Rebecca Donatelle and published in Health: The Basics (2009) (refer to Appendix G). The assessment is comprised of questions pertaining to ones physical, social, emotional, environmental, and spiritual health as well as personal health promotion (Donatelle, 2009). This assessment is thought to help the participant fully understand the importance of wellness and where they are currently within their wellness journey. Intervention Prior to the program implementation, a flyer was created to disperse the program information. This flyer was emailed to current participants based on email lists from the executive director of the Miss Indiana pageant which included some but not all current participants. It was also sent to local directors with a request that they share it with their local contestants. The program information was also provided directly to contestants during local pageants with the opportunity that they could ask questions or express concerns. Some reliance was placed the current Miss Indiana, and current contestants to relay information to other eligible participants. The flyer presented the dates, times and places in which the programs would be A PILOT WELLNESS PROGRAM 24 held, personal contact information, a quick wellness overview, and encouragement to visit the website. A website was created spread awareness of the program, provide education and be a continuous resource for the participants. The website was composed of the mission and values of the program director, a simple overview of the program directors background, purpose, and credentials, and information about the programs. Also included in the website are a wellness blog and wellness tips and resources. Resources included demonstrated techniques and strategies to maintain wellness with articles, videos, phone applications, and links to helpful websites. It is also an easy way to sustain contact with the girls while they continue on their wellness journey. Based on the results of survey responses and literature findings, a wellness program was designed around the wellness model which focuses on the balance of body, mind, and spirit through participation in the occupation of pageantry. Many wellness programs have been designed around this ideal, however with different populations. For example, a body-mind-spirit intervention program was conducted with emerging adults working toward their higher education in Hong Kong (Ng et al., 2016). According to Ng et al. (2016), the well-being increased after participating in a 2-day intervention program with a small group integrating mind, body, and spirit techniques. The program consisted of four sessions entitled, awareness of self and others, discovering inner strength, love, care, and forgiveness, and transformation and preparation for the future (Ng et al., 2016). Another wellness program structured to help decrease stress and anxiety in college students was compiled of lecture, discussion, practicing skills, and weekly discussion of practice (Deckro et al., 2002). The six week intervention, composed of relaxationresponse-based skills, cognitive behavioral interventions, individual practice and log, and lecture A PILOT WELLNESS PROGRAM 25 and discussion topics of stress and relaxation and mind/body connection, resulted in reduced stress and anxiety (Deckro et al., 2002). From the research a modified one day, three hour wellness program, entitled balance2bewell, was designed for contestants within the Miss Indiana Organization, offered in four different areas of the state. These pageant participants are very active and busy individuals, and experience increased occupations due to pageant preparation and participation that provides an additional source of stress. Therefore this program required efficiency within the short time available, rather than following the design of Ng et al. or Deckro et al. The balance2bewell program included two activities in conjunction with wellness education, teaching and practicing wellness strategies. Each activity is designed around the principles of Marilyn Cole in the text, Group Dynamics in Occupational Therapy, and tailored to pageant occupations (2012). In this book, activities are explained with an introduction, which includes the purpose and a brief outline of the group, the activity, and an opportunity to share with the group (Cole, 2012). The book is written to allow leaders to ask questions to the group assisting them in processing and generalizing the session, followed by an opportunity to summarize the session (Cole, 2012). The first activity implemented is known as the Coat of Arms activity which allows the individual to complete self-exploration by answering prompts with writing and/or drawing (Hayes, 2011). Hayes (2011), reports when completing this activity with various groups in which people share as much as they feel comfortable about achievements and challenges, the team as a whole becomes stronger. This is a great way to help the participants increase self-awareness prior to more in depth group activities (Bolster, 2013). Developing a personal coat of arms can also increase discussion, help participants to discover common traits among one another, and inspire strong emotional connections (Neimeyer, 2016). These opportunities to share and connect A PILOT WELLNESS PROGRAM 26 reflect the relationships or communication between people (Interpersonal Oxford Dictionary, n.d.). According to Colorado State University, These interpersonal interactions can provide group members an opportunity to deepen their level of self-awareness and learn how to relate to others (p.1.), therefore is a critical part of the program protocol. For balance2bewell, the activity prompts included: what you like about yourself, your greatest achievement, your most prized possession, what you value most in life, a symbol of your personality, and three words to be remembered by. The balance2bewell program outline for this activity is attached in Appendix H. Following activity one, group centered wellness activities were taught and practiced. Wellness techniques available were based on results from surveys, and personal requests of the current participants; all of which included strategies of stress reduction, time management, mindfulness, healthy eating and living strategies. First, meditation activities and breathing exercises were done in a group format. Meditation has become increasingly more popular as a wellness technique for increased mindfulness, meaning bringing attention to the present moment (Concotelli, 2007). There are many health benefits of meditation including increased relaxation, decreased blood pressure, anxiety, depression, and anger, and better sleep (Concotelli, 2007). Neuroscientist, Richard Davidson, presented research that meditation causes happier emotions and healthy immune system activities as evidenced by increased left-sided brain activity (Concotelli, 2007). One meditation that has presented positive effects for wellness is known as the Loving-Kindness Meditation derived from Buddha practices (Rana, 2015). This meditation has been known to cultivate an attitude of unconditional love, kindness and compassion for oneself and others (Rana, 2015). A study by Seppala et al,. (2014) shows that completion of this meditation for 10 minute sessions can increase feelings of connectedness, and can be a viable, A PILOT WELLNESS PROGRAM 27 practical, and time-effective way to increase mindfulness (Rana, 2015). With a print out of the words (refer to Appendix I), one can easily meditate and take the time needed at each level of the meditation (Loving-kindness meditation). Following the meditation, the group reflected, answering questions such as, Was this easy or hard for you?, What were you feeling during the meditation?, and How are you feeling now?. The group then stated how they were feeling in order to decide on a breathing exercise: stressed, tired, anxious, happy, etc. Based on group dynamics, a breathing exercise was then completed from a PDF by University of California at Berkeley (attached in Appendix J) which includes breathing exercises like paced breathing and abdominal breathing (Breathing exercises, n.d.). Breathing exercises of all types have several health benefits including increased oxygen and blood flow, mentality and overall health, and decreased stress (Gabbay, 2002). Then the group indicated activities they wanted to learn and practice after provided the options including: arts and crafts (coloring, playdough, Buddha Board, puzzle, spirographs), poetry reading and writing, journaling, prayer journaling and reflection devotionals, identifying gratitude (jar and journaling), organization and time management, and nutrition education. Participants completed each activity independently for 10 minutes after verbal directions, and followed by reflecting and sharing on the experience. Each activity described below was easily adapted to fit each member of the group as instructions were open to interpretation to allow for implementation of unique interventions. Participants were provided options for arts and crafts including coloring books, playdough, Buddha Board, puzzles, and spirographs, and given time to explore and create. Arts and crafts help to decrease stress as it allows one to fall into a meditative state, and has become more popular with the production of adult coloring books (Alban, 2018). This activity also A PILOT WELLNESS PROGRAM 28 encourages out-of-the-box thinking which encourages use of left and right hemispheres of the brain and promotes neuron growth (Alban, 2018). Completing arts and crafts has been found to increase the release of dopamine which promotes concentration and ambition (Alban, 2018). Participants were instructed to read from the provided poetry personally written by the program director. Reading poetry allows the emotional connection with others and when read aloud provides rhythmic sounds that promote joy (Gafford, et al., 2018). After participants read, they were reassured that there is no wrong way to write a poem, poems do not have to rhyme, and the most important thing is to write what is felt. They were then instructed to write a short poem without restrictions. Writing poetry can be therapeutic by providing an emotional outlet, increased self-awareness and reflection, and encourages critical thinking and cognitive function (Donovan, 2016). Both reading and writing poetry allows for cathartic release of emotions (Gafford, et al., 2018). Instructions were combined for both journaling and prayer journaling as participants were given the option to complete either one for a personal entry. Journaling regularly can help to decrease asthmatic and arthritic symptoms, and strengthen immune cells (Purcell, 2018). This activity also helps to reduce stress, and increase self-awareness (Purcell, 2018). Writing a prayer journal has similar health benefits including decreased stress (Routledge, 2014). Participants were given 1 minute to write down at least three things they were grateful for. The time for this activity was short in order to show participants how quickly this technique can be done. Completion of a gratitude jar or gratitude journal increases physical health, energy, attention span, determination, sleep, self-esteem, connectedness, and empathy, and decreases stress, frustration, and depression (Morin, 2017; Robinson, n.d.) A PILOT WELLNESS PROGRAM 29 It was important for each participant to write down a routine that currently exists in her life, and was asked to write either morning or nightly routine. Once completed, one on one conversation occurred to determine if there was any wasted time and where in her schedule a new wellness technique could fit. Education was provided about time management and organization which can help to reduce stress, inspire better eating and sleeping habits, and increase energy (Flourentine, 2016). One on one nutrition education was also provided and important for obvious reasons as good nutrition can reduce risk of disease and illness and increase energy and overall wellness (Tufts, n.d.). InBody testing was discussed to stress the importance of providing ones body the necessary amount of nutrients as this assessment provides a body composition of weight, fat, protein, mineral and water, and describes a basic metabolic rate which is how many calories ones body burns in a day doing nothing (What is body composition?, 2018). Participants were given the analogy of filling a car with gasoline: if one lets a car run out of fuel then the car no longer runs, and food is fuel for the body. Cookbooks, like Whole 30, and calorie counting applications were also discussed with some participants. Participants were also provided education and overview of techniques including: Advocare nutrition supplements, essential oils and diffusers, aromatherapy sleep spray, stress balls, sleep masks, head massager, noise maker, and crystals. Most activities were completed during each session, with the exception of one or two due to increased sharing time at some sessions. Advocare is a nutritional company that is based in science and faith to increase the health through products for wellness, performance, fitness, weightloss, and active lifestyles (Advocare, 2018). Essential oils and aromatherapy products are made for several different uses ranging from digestion assistance, increase energy, balance hormones, decrease headaches, and A PILOT WELLNESS PROGRAM 30 promote feelings of relaxation (Axe, 2018). These can be used in many formats including, rollers, sprays, lotions, and diffusers, and are now able to be placed on jewelry items. In order to demonstrate options, different types of stress balls were presented including the typical, foam ball one gets for free and one that is more malleable filled with small beads. Stress balls can help to reduce stress through the stimulation of the limbic system which is connected to emotions (Brooks, n.d.). Sleep masks are used to block out light and improve sleep (Ivey, 2018). Masks come in different styles from bulkier styles that cover but do not suppress the eyelids to slimmer gel filled masks (Ivey, 2018). Scalp massages provide a release of serotonin in the body which helps to decrease stress, can help to increase peace and allow for better sleep (Oliver, 2016). A sound machine during meditation or sleep can help to block the external noises that may negatively impact your sleep, like cars, trains, coyotes, ect (Osmun, 2015). Crystals are used to increase mindfulness, help with relationships, promote protections and decrease feelings of fear and mental illness (Askinosie & Jandro, 2018). Many also believe crystals to have physical healing powers like relief from asthma and bronchitis, and decrease physical pain regardless if the one in need of healing doubts the process (Vantol, 2008). The balance2bewell program continued on with the second activity. The second activity was adapted from an activity presented by Cole (2012) entitled Professional Self-Awareness Collage to better fit the population of pageant contestants. The activity involves participants using magazines to find pictures that represent personal qualities and are then pasted on a folded piece of paper in which the qualities shown to others are on the outside, and the qualities typically hidden are on the inside of the folded paper (Cole, 2012). In a study from the University of Central Lancashire, Preston, UK, Brandon Williams used a collage over any other forms of art as a communication tool between different professionals (Williams, A PILOT WELLNESS PROGRAM 31 2002). Williams discussed the decrease in anxiety with the use of a collage because the activity does not require an abundant of artistic ability, therefore participants would be more likely to share (Williams, 2002). Completing a collage has been identified as more powerful than other crafts as an activity (Carter, Nelson, & Duncombe, 1983; Nelson, Thompson, & Moore, 1982). A collage also allows for more self-expression and self-awareness (Nelson, Thompson, & Moore, 1982). Stefon Napier discussed the importance for student leaders to intentionally strive for selfawareness and stated it allows leaders to challenge and understand themselves more fully (Napier, 2016). An outline of the activity is attached in Appendix K. At the conclusion of the wellness program, a final opportunity was provided for reflection followed by one on one discussion about the addition of a new wellness occupation into ones schedule. At the completion of the program a personalized flyer was sent to each participant to summarize their experience (refer to Appendix L and M for examples). Each flyer contained wellness techniques each participant could benefit from based on assessment results and reflection and sharing during the program. These client centered flyers also help the longevity of balance2bewell and its effects by encouraging continuation of wellness techniques. Leadership Skills Leadership skills were demonstrated during program implementation following the development and analysis of a needs assessment via surveys for board members, local directors, and past participants. Leadership skills were also exhibited by completion and dispersion of flyers to provide information about the program through emails provided by the Miss Indiana pageant executive director, and directly to eligible participants during local pageant competitions. The writer has worked with local pageant directors to increase the overall wellness of their contestants. For example, after wellness education provided by writer, one local director A PILOT WELLNESS PROGRAM 32 implemented chair massages in her pageant day itinerary to help her contestants feel calm throughout their daily preparations. Leadership skills were continuously utilized when presenting the program at the local director meeting with demonstrations of activities at the program and educational components. Communication with the Miss Indiana pageant executive director has consisted of educational components in order to help the staff, i.e. local directors and board members, become more aware of ways to increase the wellness of the contestants. Outcomes The purpose of balance2bewell was to increase the overall wellness of pageant contestants within the Miss Indiana Organization, through the development of a one day wellness program. Outcomes were derived from a post-survey, related to the pre-survey, as well as completing the previously completed assessment again within a week post program. Of the 11 program participants (Program 1: 0, Program 2: 2, Program 3: 5, Program 4: 4), all completed the post-survey (see in Appendix F) immediately following the program in order to measure its effectiveness (N = 11). This outcome measure was designed to measure the change in participants self-reported perceptions of their wellness, including mind, body, spirit, and balance of these aspects. The survey also gathers information of what the participant does to maintain wellness for each aspect, what threatens their wellness, and questions specifically about balance2bewell. These survey responses were used to maintain quality of the intervention and allowed for changes to be made if necessary before the next program. Results of the pre and post surveys were compared and analyzed to determine the effectiveness of the program. These results indicated that little change occurred after one program, however implied possibilities of positive changes in participants wellness as indicated by feedback. When asked to expand on how the program helped them, three themes emerged including: education, A PILOT WELLNESS PROGRAM 33 encouragement, and connectedness. A majority of participants expressed that they gained knowledge of wellness and techniques to increase wellness. One participant stated, I loved learning about the different aspects of wellness and how I can focus on each one. Formerly, I would have combined mental wellness and spiritual wellness, but I learned techniques that can improve each one for better overall wellness (Participant 4). Participants were asked how the program could be improved, Many of the responders stated the program required no improvements. One participants stated, I cannot think of any ways that the program could be improved, I felt very comfortable and relaxed (Participant 3). Another participant wished the program could have been longer, and one requested all questionnaires to be completed prior to the program date. In hopes to increase participation, the program was kept to a concise three hours, though could have easily been extended. The pre-test survey was completed prior to the program, however a photo release form and the How Healthy Are You survey were completed the day of the program to ensure correctness as many responders had questions when completing these. Two participants requested more specific activities including more physical activity or more nutrition information. This was included in each program, however the techniques were adapted to appease each group as a whole, rather than one participant. Each session included an overview of several techniques in hopes of providing a well rounded pool of information. The How Healthy Are You assessment was given 66 days following the completion of the program in order to assess their wellness after given the chance to implement a newly learned technique (Donatelle, 2009). Due to the time restraints for the Doctoral Capstone Experience (DCE), assessments were not returned in time for submission of this paper, however will be included if given the chance to present at the AOTA Conference in 2019. Quality Improvement/Meeting Societal Needs A PILOT WELLNESS PROGRAM 34 The balance2bewell program helped the participants overall wellness as evidenced by results of the outcome measures previously discussed. Information derived from past participants surveys indicated that wellness issues can surpass pageant competition such as body image issues, depression and anxiety. Therefore, a wellness program like balance2bewell is important to provide pageant contestants with support and guidance to improve their overall wellness. Regardless if the participant plans to continue in pageantry with local, state or national levels, or not, her wellness is important throughout the entirety of her life. To ensure continuous quality improvements, there was constant communication and reflection with the Miss Indiana Organization executive director which helped the program stay on the right track throughout the entirety of the DCE. The program was an open format which allowed for individualized needs assessments in hopes of providing client centered care that will assist participants during pageant life and far beyond even as life stressors change. The post-survey included questions directly tied to balance2bewell to gather perceptions of how the program helped, how the program could improve, and what wellness technique does the participant plan to implement. Based on feedback from the participants, a small group size was maintained, and information on finances and nutrition were discussed within the group as well as expanded on the website. Beyond the postsurvey immediately following completion of the program, participants were also asked to complete the How Healthy Are You survey again. Analysis of this survey was able to assess the longer term effects the program had on participants, and help to further establish areas of quality improvement to promote best practice. The ultimate goal of this delayed follow up survey was to increase effectiveness for program continuation. Discontinuation/Continuation A PILOT WELLNESS PROGRAM 35 As four programs were offered in different areas of the state, discontinuation of balance2bewell occured after completion of the fourth program. The balance2bewell website acts as a continuous resource for contestants which remains available to them far beyond the pageant world due to its inclusion of wellness resources (Eberly, 2018). Available resources on this website are valuable to the continuation of wellness for participants after discontinuation of the program because it provides them with up to date information of wellness techniques and tips to balance mind, body, and spirit (Eberly, 2018). Possibilities exist that this program can continue as an annual opportunity for pageant participants, however remains unconfirmed. Although time of the DCE will have elapsed, a wellness program during Miss Indiana Week will be provided for both miss and teen contestants. Overall Learning Summary Through completion of this DCE, I feel much more prepared for my future with the further development of my professional and interpersonal skills. I have been able to increase my effectiveness with time management, self-directed learning, and communication by fully engaging in increasing my skills. The prioritization of all tasks and set goals helped me to stay on track. I spent most days alone in the University library therefore self-directed learning was imperative. I was able to reach out to the Miss Indiana executive director and my faculty advisor when assistance was required. I stayed in touch with the board members, local directors, past participants and current participants all of which required different types of communication. For example, board members and local directors required highly professional forms of communication with email and in-person meetings and presentations. For past participants, I was professional, however provided short communication in hopes of increasing participation to fill out surveys. For current participants, I was much more relaxed with communication in order to A PILOT WELLNESS PROGRAM 36 build rapport and encourage program participation. Development of this program has given me the opportunity to be creative and use my skills, which will further help my future practice. In the future I can develop programs for my workplace to better provide care and service to clients. As previously mentioned, I spent a majority of my DCE in solitude, however I learned a lot when working with the Miss Indiana executive director. We worked together to determine the best form of communication with those involved, recruitment of program participants and program development. With her on my team, I learned ways to motivate the apathetic and how to deal with rejection. Initial objectives were met upon the completion of the DCE including the development of a website, wellness program, and a written paper for publication. The development of the balance2bewell website required the acknowledgement to whom the audience would be in order to appeal to the population. Throughout program development, constant communication with the Miss Indiana Organization Executive Director transpired through email and phone call. This required professional manners to present ideals and questions appropriately. To secure placements for where balance2bewell could be held, communications via meetings, phone calls, and emails were completed with program services at four different universities in Indiana. Also requiring professional communication, a presentation was given to the local directors in hopes to spread awareness of the wellness program and encourage participation of their contestants. Surveys were sent professionally through emails to board members, local directors, and past participants. Current participants were also contacted through email and facebook in order to increase program participation. Although this communication was geared toward a younger population than other forms of communication, and sometimes occurred over social media, it A PILOT WELLNESS PROGRAM 37 remained professional. Professional and effective communication was also completed in order to present and confirm continuation of this project at the Miss Indiana State level competition. When working with a group of people one must remain professional while also using the therapeutic use of self to connect and build rapport. This was done with every group session and during every presentation. 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Retrieved from http://www.ashleymargeson.com/miss-america-career-woman/ Miller, G., & Foster, L. T. (2010). A brief summary of holistic wellness literature. Journal Of Holistic Healthcare, 7(1), 4-8. Miss America. (2017). Retrieved from http://missamerica.org/ Miss America foundation: Education mission. (2015). Retrieved from http://missamericafoundation.org/ Miss Indiana | An official preliminary to Miss America. (2017). Retrieved from http://missindiana.org/public_html/ Miss Indiana Director Manual. (2017). Retrieved from http://missindiana.org/public_html/index.php/director-manual/ Morin, A. (2017, November 27). 7 scientifically proven benefits of gratitude that will motivate you to give thanks year-round. Retrieved from https://www.forbes.com/sites/amymorin/2014/11/23/7-scientifically-proven-benefits-of-g ratitude-that-will-motivate-you-to-give-thanks-year-round/ Morrow, M. (2017, November 2). Former Miss America 2008 to speak at the College of New Jersey to raise awareness of eating disorders. PR Newswire. Retrieved from https://www.prnewswire.com/news-releases/former-miss-america-2008-to-speak-at-the-c ollege-of-new-jersey-to-raise-awareness-of-eating-disorders-300548669.html Myers, J. E., Sweeney, T. J., & Witmer, J. M. (2000). The wheel of wellness counseling for wellness: a holistic model for treatment planning. Journal Of Counseling & A PILOT WELLNESS PROGRAM 44 Development, 78(3), 251-266. Napier, S. (2016). The importance of self-awareness for student leaders. Campus Activities Programming, 49(1), 8-9. Nelson, D. L., Thompson, G., & Moore, J. A. (1982). Identification of Factors of Affective Meaning in Four Selected Activities. American Journal of Occupational Therapy,36(6), 381-387. doi:10.5014/ajot.36.6.381 Niemeyer, R. A. (2016). Techniques of grief therapy: Assessment and intervention. New York: Routledge. Ng A. H., N., Boey K., W., Mok, D., Leung E. K., T., & C. L. W., C. (2016). An integrative body-mind-spirit intervention program for enhancing holistic well-being of young people in emerging adulthood. International Medical Journal, 23(3), 214-218. Oliver, D. (2016, September 02). The health and beauty benefits of a scalp massage. Retrieved from https://www.huffingtonpost.com/entry/scalp-massage-health-beautybenefits_us_573b41e9e4b0646cbeeaf43f Osmun, R. (2015, September 22). How sound impacts your sleep cycle [Web log post]. Retrieved from https://www.amerisleep.com/blog/sound-impacts-sleep-cycle/ Pearlman, P. (2009). Pretty smart: Lessons from our Miss Americas. Bloomington, IN: AuthorHouse. Post, M. B. (2018, January 02). Gretchen Carlson takes over as Miss America chairwoman. Retrieved from http://www.pressofatlanticcity.com/news/breaking/gretchen-carlson-takes-over-as-missamerica-chairwoman/article_c2829462-0fa2-5576-9fc0-25c7b1338988.html Rana, N. (2015). Mindfulness and loving-kindness meditation: A potential tool for mental health A PILOT WELLNESS PROGRAM 45 and subjective well-being. Indian Journal Of Positive Psychology, 6(2), 189-196. Rice, M. (2013, May 12). Miss Georgia reveals deadly secret to help others. Ledger-Enquirer. Retrieved from http://www.ledger-enquirer.com/latest-news/article29295253.html Roberts, B. (2013, September 12). The Miss America pageant still sends the wrong message. The New York Times. Retrieved from https://www.nytimes.com/roomfordebate/2013/09/12/isthe-miss-america-pageant-bad-for-women/the-miss-america-pageant-stills-sends-thewrong-message Robinson, J. (n.d.). The surprising health benefits of practicing gratitude daily [Web log post]. Retrieved from https://josierobinson.com/journal/benefitsofgratitude Routledge, C. (2014, June 23). 5 Scientifically Supported Benefits of Prayer. Retrieved from https://www.psychologytoday.com/us/blog/more-mortal/201406/5-scientifically-supporte d-benefits-prayer Shields, S. J. (2017, September 1). The hardest part about being Miss America [Web log post]. Retrieved from http://www.savvyjanine.com/2017/09/01/the-hardest-part-about-beingmiss-america/ Straiger, A. (2017, May 29). Miss Indiana week schedule [Excel Spreadsheet]. Zionsville: Aren Straiger. Stapleton, A., & Andone, D. (2017, December 24). Report: Miss America Organization emails disparaged contestants. Retrieved from https://www.cnn.com/2017/12/22/us/missamerica-organization-emails/index.html Tufts. (n.d.). The Importance of Good Nutrition. Retrieved from https://www.tuftsmedicarepreferred.org/healthy-living/expert-knowledge/importance-goo d-nutrition A PILOT WELLNESS PROGRAM 46 Vagianos, A. (2015, September 11). The eye-opening evolution of Miss Americas body over 95 years. Retrieved from https://www.huffingtonpost.com/entry/the-eye-opening-evolution-of-miss-americas-body -over-95-years_us_55f078d9e4b002d5c077a6fb Vantol, L. (2008). Case Study: The Power of Crystal Therapy. Positive Health, (147), 40-41. Wellness | Definition of wellness in English by Oxford Dictionaries. (n.d.). Retrieved from https://en.oxforddictionaries.com/definition/wellness What is body composition? (n.d.). Retrieved 2018, from https://inbodyusa.com/pages/what-is-body-composition Williams, B. (2002). Using collage art work as a common medium for communication in interprofessional workshops. Journal Of Interprofessional Care, 16(1), 53-58. A PILOT WELLNESS PROGRAM 47 Appendix A Miss Indiana Wellness Survey WHO: My name is Kaytlyn Eberly and I am a student in the University of Indianapolis Occupational Therapy Doctoral program. In 2016 I participated in Miss Indiana and fell in love with the organization, however aged out after just one year of competition. WHAT: Occupational Therapists help people with anything that they need to do, want to do, or are expected to do on a daily basis. Therapists work with people to balance the mind, body, and spirit in order to increase his or her overall wellness. I am creating a wellness program for the contestants of Miss Indiana at the local and state levels, but I need your help to gather more valuable perspectives WHY: The purpose of this project is to promote wellness in the Miss Indiana Organization by balancing mind, body and spirit through occupations. As participants of the local and Miss Indiana pageants, young women are increasing their occupations with pageant preparations/participation, active role models, and service opportunities. This causes a loss of balance in their everyday lives and decreases their overall wellness. PURPOSE: The purpose of this survey to is obtain the perspective of those involved in the pageant, but are not participants. You have all seen several years of competition with different groups of wonderful young women. Please reflect upon your experiences to answer the following questions. ALL RESPONSES REMAIN ANONYMOUS - ANY IDENTIFYING INFORMATION WILL BE REMOVED A PILOT WELLNESS PROGRAM 48 Appendix B Board Member Survey * Required 1. Name * 2. Email Address * Involvement Volunteers with Miss Indiana 3. How long have you volunteered with the organization? * 4. How did you get involved? * Mark only one oval. -I was a participant that came back to help -My family member/friend talked me into it -Another volunteer asked me to help -I was looking for something to do -Other: ____________________________ 5. What is your role? Give a short description. * ____________________________________ ____________________________________ 6. About how much time do you typically spend with the contestants during Miss Indiana week?* Mark only one oval. -All day, every day -All day for a couple days, but not every day -Only for the nights of competition -Every day for only some of the time -Just a couple hours Less than an hour -I only see them from the audience -Other: ______________________________ Wellness For the purpose of this program, wellness is defined as the balance of the mind, body, and spirit through occupations. Occupations in this sense being anything a person wants to do, needs to do, or is expected to do in a day. Occupations, as well as wellness, are specific to each person and with a client centered approach, an occupational therapist can help to promote a holistic wellness for each individual. 7. What might be the demands of the participants' wellness during preparation and participation in these pageants? * ____________________________________ ____________________________________ 8. Describe wellness strategies that are already incorporated into this organization. (ex. healthy meals, prayer, etc). * ____________________________________ ____________________________________ ______9. Describe the wellness concerns you have had for participants. * ____________________________________ ____________________________________ ______10. What do you think pageant participants would benefit from in a wellness program to maintain their overall wellness prior to and during Miss Indiana week? Pick all that apply. * Check all that apply. Stress management techniques Mindfulness strategies to increase focus on the present moment Spiritual guidance Education on the balance of mind, body, and spirit Relaxation techniques Time management and organization strategies Other: ___________________________________ A PILOT WELLNESS PROGRAM 49 Appendix C Local Director Survey * Required 1. Name * 2. Email Address * 3. What local pageant do you direct? * Involvement Volunteers with Miss Indiana 4. How long have you been a local pageant director in this organization? * 5. How did you get involved? * Mark only one oval. I was a participant that came back to help My family member/friend talked me into it Another volunteer asked me to help I was looking for something to do Other: ____________________________ 6. About how much time do you typically spend with the contestants during the pageant?* Mark only one oval. All day, every day All day for a couple days, but not every day Only for the nights of competition Every day for only some of the time Just a couple hours Less than an hour I only see them from the audience Other: ______________________________ 7. Describe how much time you spend with the winner of your pageant in preparation for Miss Indiana. * ____________________________________ ____________________________________ Wellness For the purpose of this program, wellness is defined as the balance of the mind, body, and spirit through occupations. Occupations in this sense being anything a person wants to do, needs to do, or is expected to do in a day. Occupations, as well as wellness, are specific to each person and with a client centered approach, an occupational therapist can help to promote a holistic wellness for each individual. 8. What might be the demands of the participants' wellness during preparation and participation in these pageants? * ____________________________________ ____________________________________ rategies that are already incorporated into this organization. (ex. healthy meals, prayer, etc). * ____________________________________ ____________________________________ 10. Describe the wellness concerns you have had for participants. * ____________________________________ ____________________________________ 11. What do you think pageant participants would benefit from in a wellness program to maintain their overall wellness prior to and during Miss Indiana week? Pick all that apply. * Check all that apply. Stress management techniques Mindfulness strategies to increase focus on the present moment Spiritual guidance Education on the balance of mind, body, and spirit Relaxation techniques Time management and organization strategies Other: ____________________________________ A PILOT WELLNESS PROGRAM 50 Appendix D Past Participant Survey * Required 1. Name * 2. Email address * Pageant Participation 3. When did you last participate? * 4. How many years total, did you participate? (teen and miss) * 5. Why did you stop participating in the Miss Indiana Organization pageants? * Mark only one oval. -Aged out -Got married -Moved out of state, not competing anymore -Moved out of state, still competing -Too busy - My choice -Financial reasons -Too difficult -Other:____________________________ 6. Did you make it to the state level? If yes, how many times? * ________________________________________________________________________ 7. Approximately how many locals did you participate in total? * ________________________________________________________________________ 8. What ties do you currently have to the contestants competing in locals and Miss Indiana? * Check all that apply. -My friends still compete. -I have family that competes. -I come to watch locals/state each year. -I volunteer with locals/state. -I am now a judge for the organization. -I now emcee. -I am no longer connected. -Other:____________________________ Perception of Wellness For the purpose of this program, wellness is defined as the balance of the mind, body, and spirit through occupations. Occupations in this sense being anything a person wants to do, needs to do, or is expected to do in a day. Occupations, as well as wellness, are specific to each person and with a client centered approach, an occupational therapist can help to promote a holistic wellness for each individual. A PILOT WELLNESS PROGRAM 51 9. Describe any decrease in overall wellness you experienced while competing. * ________________________________________________________________________ 10. What were some of the demands of the participants' wellness during preparation and participation in these pageants? * ________________________________________________________________________ 11. Describe the wellness concerns have you had regarding other girls you observed while competing in pageants or now while watching. * ________________________________________________________________________ 12. What do you think pageant participants would benefit from in a wellness program to maintain their overall wellness prior to and during Miss Indiana week?* Check all that apply. -Stress management techniques -Mindfulness strategies to increase focus on the present moment -Spiritual guidance -Education on the balance of mind, body, and spirit -Relaxation techniques -Time management and organization strategies Other:____________________________ The following questions are NOT required, but would assist in providing more insight. ALL RESPONSES REMAIN ANONYMOUS - ANY IDENTIFYING INFORMATION WILL 13. Have you ever had an eating disorder? Mark only one oval. -No -Anorexia -Bulimia -Combination -Other:___________________________ 14. If yes, when did it start and how long did/have you been experiencing it? ________________________________________________________________________ 15. Have you ever experienced depression, anxiety, or other mental health issues? Please explain. ________________________________________________________________________ 16. How did participating in the Miss Indiana Organization POSITIVELY impact these wellness issues? ________________________________________________________________________ 17. How did participating in the Miss Indiana Organization NEGATIVELY impact these wellness issues? ________________________________________________________________________ A PILOT WELLNESS PROGRAM 52 Appendix E balance2bewell Program Pre-Test The purpose of this survey is to obtain general knowledge of your current exposure and understanding of holistic wellness through occupations: balancing the body, mind, and spirit. Information gathered here will be compared to post-test upon completion of this program in order to evaluate the effectiveness of the implementation of a wellness program in the Miss Indiana Organization. ALL RESPONSES REMAIN ANONYMOUS - ANY IDENTIFYING INFORMATION WILL BE REMOVED * Required 12. Rate your current wellness: mind? * 1. Name * Mark only one oval. 2. Email address * 13. How do you currently maintain you 3. Platform with short description. * wellness of mind? * ____________________________________ ____________________________________ ____________________________________ ____________________________________ 4. As of now, will you be competing in the 14. Rate your current wellness: body? * Miss Indiana Pageant this year? * Mark Mark only one oval. only one oval. 15. How do you currently maintain you wellness of body? * -Yes! ____________________________________ -Not this year. ____________________________________ -Not yet, but I still have a chance. 16. Rate your current wellness: spirit? * -Other:_____________________ Mark only one oval. 5. If yes, what is your title? * 17. How do you currently maintain you --------______________________________ wellness of spirit? * ______ ____________________________________ 6. How long have you participated in ____________________________________ pageants? * 18. Rate your current balance of these ____________________________________ three aspects. * Mark only one oval. 7. How long have you participated in the 19. What harms your wellness? Check all Miss Indiana Organization? * that apply. * Check all that apply. ____________________________________ -Too many things to do 8. Have you made it to the state level? If -Decreased sleep yes, how many times? * -Stress ____________________________________ -Anxiety or depression 9. Approximately how many locals did -Eating disorder you participate in total? * -Other mental/emotional illness ____________________________________ -Imbalanced life Wellness -Finances 10. What is your definition of wellness? * -Relationships ____________________________________ -Poor time management/procrastination ____________________________________ -Poor habits 11. Rate your current overall wellness? * -Your daily environment Mark only one oval. -No daily routine A PILOT WELLNESS PROGRAM -Other:___________________________ Pageant Wellness 20. When do you feel most unbalanced in wellness during the pageant process? * Mark only one oval. -Getting ready for the pageant -Local level -State level -After it is all said and done -Never - always fully balanced -Other:____________________________ 21. When do you feel most unbalanced in wellness in the pageant itself? * Mark only one oval. -Before the pageant -Backstage -Opening number -Introduction -Interview -Onstage question -Swimsuit -Talent -Gown -Waiting for results -After the pageant -Other: 22. What aspect of the Miss Indiana Organization local and/or state pageants has helped to increase your overall wellness the most? * ____________________________________ ____________________________________ 23. What aspect of the Miss Indiana Organization local and/or state pageants has decreased your overall wellness the most? * ____________________________________ ____________________________________ 53 A PILOT WELLNESS PROGRAM 54 Appendix F balance2bewell Program Post-Test The purpose of this survey is to obtain general knowledge of your current exposure and understanding of holistic wellness through occupations: balancing the body, mind, and spirit. Information gathered here will be compared to post-test upon completion of this program in order to evaluate the effectiveness of the implementation of a wellness program in the Miss Indiana Organization. ALL RESPONSES REMAIN ANONYMOUS - ANY IDENTIFYING INFORMATION WILL BE REMOVED * Required 1. Name * 2. Email address * Wellness 3. What is your definition of wellness? * ________________________________________________________________________ 4. Rate your current overall wellness? * Mark only one oval. 5. Rate your current wellness: mind? * Mark only one oval. 6. How do you currently maintain you wellness of mind? * ________________________________________________________________________ 7. Rate your current wellness: body? * Mark only one oval. 8. How do you currently maintain you wellness of body? * ________________________________________________________________________ 9. Rate your current wellness: spirit? * Mark only one oval. 10. How do you currently maintain you wellness of spirit? * ________________________________________________________________________ 11. Rate your current balance of these three aspects. * Mark only one oval. 12. What harms your wellness? Check all that apply. * Check all that apply. -Too many things to do -Decreased sleep -Stress A PILOT WELLNESS PROGRAM 55 -Anxiety or depression -Eating disorder -Other mental/emotional illness -Imbalanced life -Finances -Relationships -Poor time management/procrastination -Poor habits -Your daily environment -No daily routine -Other:_____________________________ Pageant Wellness 13. In what ways did the wellness program help you the most?* ________________________________________________________________________ 14. How can the program improve to better help the participants?* ________________________________________________________________________ 15. What new wellness technique to you plan to place into your daily life?* ________________________________________________________________________ A PILOT WELLNESS PROGRAM 56 Appendix G Assess Yourself: How Healthy Are You? By completing the following assessment, you will have a clearer picture of health areas in which you excel and those that could use varying degrees of work. Taking this assessment will also help you to reflect on various components of health that you may not have thought much about. Use the results from this assessment as a guide and as a way to begin analyzing potential areas for improvement and/or maintenance. Answer each question, then total your score for each section. Your scores will appear in the Personal Checklist at the end of the assessment for a general sense of your health profile. Think about the behaviors that influenced your score in each category. Would you like to change any of them? Choose the area that youd like to improve, then complete the Behavior Change Contract at the end of this book. Use the contract to think through and implement a behavior change over the course of this class. Each of the categories in this questionnaire is an important aspect of the total dimensions of health, but this is not a substitute for the advice of a qualified health care provider. Consider scheduling a thorough physical examination by a licensed physician or setting up an appointment with a mental health counselor at your school if you think you need help making a behavior change. Instructions: For each of the following, indicate how often you think the statements describe you Key 1 - Never 2 - Rarely 3 - Some of the Time 4 Usually or Always PHYSICAL HEALTH I am happy with my body size and weight. 1 2 3 4 I engage in vigorous exercises such as brisk walking, jogging, swimming, or running 1 2 3 4 for at least 30 minutes per day, 34 times per week. I do exercises designed to strengthen my muscles and increase endurance at least 2 times per week. 1 2 3 4 I do stretching, limbering up, and balance exercises such as yoga, pilates, or tai chi 1 2 3 4 to increase my body awareness and control and increase my overall physical health. I feel good about the condition of my body and would be able to respond to most demands placed upon it. 1 2 3 4 I get at least 78 hours of sleep each night. 1 2 3 4 I try to add moderate activity to each day, such as taking the stairs instead of the elevator and walking whenever I can instead of riding. 1 2 3 4 A PILOT WELLNESS PROGRAM 57 My immune system is strong and my body heals itself quickly when I get sick or injured. 1 2 3 4 I have lots of energy and can get through the day without being overly tired. 1 2 3 4 I listen to my body; when there is something wrong, I try to make adjustments to heal it or seek professional advice. 1 2 3 4 SOCIAL HEALTH When I meet people, I feel good about the impression I make on them. 1 2 3 4 I am open, honest, and get along well with other people. 1 2 3 4 I participate in a wide variety of social activities and enjoy being with people who are different than I. 1 2 3 4 I try to be a better person and work on behaviors that have caused problems in my 1 2 3 4 interactions with others. I get along well with the members of my family. 1 2 3 4 I am a good listener. 1 2 3 4 I am open and accessible to a loving and responsible relationship. 1 2 3 4 I have someone I can talk to about my private feelings. 1 2 3 4 I consider the feelings of others and do not act in hurtful or selfish ways. 1 2 3 4 I try to see the good in my friends and do whatever I can to support them and help them feel good about themselves. 1 2 3 4 EMOTIONAL HEALTH I find it easy to laugh, cry, and show emotions like love, fear, and anger and try to express these in positive, constructive ways. 1 2 3 4 I avoid using alcohol or other drugs as a means of helping me forget my problems. 1 2 3 4 A PILOT WELLNESS PROGRAM 58 When viewing a particularly challenging situation, I tend to view the glass as half full rather than half empty and perceive problems as opportunities for growth. 1 2 3 4 When I am angry, I try to let others know in nonconfrontational and nonhurtful ways, trying to resolve issues rather than stewing about them. 1 2 3 4 I try not to worry unnecessarily and try to talk about my feelings, fears, and concerns 1 2 3 4 rather than letting them become chronic issues. I recognize when I am stressed and take steps to relax through exercise, quiet time, or other calming activities. 1 2 3 4 I feel good about myself and believe others like me for who I am. 1 2 3 4 I try not to be too critical and/or judgmental of others and to understand differences 1 2 3 4 or quirks that I may note in others. I am flexible and adapt or adjust to change in a positive way. 1 2 3 4 My friends regard me as a stable, emotionally well-adjusted person whom they trust 1 2 3 4 and rely on for support. ENVIRONMENTAL HEALTH I am concerned about environmental pollution and actively try to preserve and protect natural resources. 1 2 3 4 I buy recycled paper and purchase biodegradable detergents and cleaning agents whenever possible. 1 2 3 4 I recycle my garbage, purchase refillable containers when possible, and try to minimize the amount of paper and plastics that I use. 1 2 3 4 I try to wear my clothes for longer periods between washing to reduce water consumption and the amount of detergents in our water sources. 1 2 3 4 I vote for pro-environment candidates in elections. 1 2 3 4 I write my elected leaders about environmental concerns. 1 2 3 4 I turn down the heat and wear warmer clothes at home in winter and use the air conditioner only when necessary or at higher temperatures in summer. 1 2 3 4 I am aware of lead pipes in my living area, chemicals in my carpet, and other potential hazards and try to reduce my exposure whenever possible. 1 2 3 4 I use both sides of the paper when taking class notes or doing assignments. 1 2 3 4 I try not to leave the faucet running too long when I brush my teeth, shave, or shower. 1 2 3 4 A PILOT WELLNESS PROGRAM 59 SPIRITUAL HEALTH I believe life is a precious gift that should be nurtured. 1 2 3 4 I take time to enjoy nature and the beauty around me. 1 2 3 4 I take time alone to think about whats important in lifewho I am, what I value, where I fit in, and where Im going. 1 2 3 4 I have faith in a greater power, be it a God-like force, nature, or the connectedness of all living things. 1 2 3 4 I engage in acts of caring and goodwill without expecting something in return. 1 2 3 4 I feel sorrow for those who are suffering and try to help them through difficult times. 1 2 3 4 I look forward to each day as an opportunity for further growth and challenge. 1 2 3 4 I work for peace in my interpersonal relationships, in my community, and in the world at large. 1 2 3 4 I have a great love and respect for all living things, and regard animals, etc., as important links in a vital living chain. 1 2 3 4 I go for the gusto and experience life to the fullest. 1 2 3 4 INTELLECTUAL HEALTH I carefully consider my options and possible consequences as I make choices in life. 1 2 3 4 I learn from my mistakes and try to act differently the next time. 1 2 3 4 I follow directions or recommended guidelines, avoid risks, and act in ways likely to 1 2 3 4 keep myself and others safe. I consider myself to be a wise health consumer and check reliable information sources before making decisions. 1 2 3 4 I am alert and ready to respond to lifes challenges in ways that reflect thought and sound judgment. 1 2 3 4 I have at least one hobby, learning activity, or personal growth activity that I make time for each week; something that improves me as a person. 1 2 3 4 A PILOT WELLNESS PROGRAM 60 I actively learn all I can about products and services before making decisions. 1 2 3 4 I manage my time well rather than let time manage me. 1 2 3 4 My friends and family trust my judgment. 1 2 3 4 I think about my self-talk (the things I tell myself) and then examine the evidence to 1 2 3 4 see if my perceptions and feelings are sound. PERSONAL HEALTH PROMOTION/DISEASE PREVENTION I know the warning signs of common sexually transmitted infections, such as genital 1 2 3 4 warts (HPV), chlamydia, and herpes, and read new information about these diseases as a way of protecting myself. If I were to be sexually active, I would use protection such as latex condoms, dental 1 2 3 4 dams, and other means of reducing my risk of sexually transmitted infections. I find ways other than binge drinking when at parties or during happy hours to loosen up and have a good time. 1 2 3 4 When I have more than 1 or 2 drinks, I ask someone who is not drinking to drive me 1 2 3 4 and my friends home. I have eaten too much in the last month and have forced myself to vomit to avoid gaining weight. 1 2 3 4 I have several piercings and have found that I enjoy the rush that comes with each piercing event. 1 2 3 4 If I were to have a tattoo or piercing, I would go to a reputable person who follows strict standards of sterilization and precautions against blood-borne disease transmission. 1 2 3 4 I engage in extreme sports and find that I enjoy the highs that come with risking bodily harm through physical performance. 1 2 3 4 I am careful not to mix alcohol or other drugs with prescription and over-the-counter 1 2 3 4 drugs. I practice monthly breast/testicle self-examinations. 1 2 3 4 A PILOT WELLNESS PROGRAM 61 SCORING Here are your scores in each of the health dimensions. Compare them to what would be considered optimal scores. Which areas do you need to work on? How does your score compare with how you rated yourself in the first part of the questionnaire? Ideal Score Physical health 40 Social health 40 Intellectual health 40 Emotional health 40 Environmental health 40 Spiritual health 40 Personal health promotion and disease prevention 40 Your Score Initial Self Rating *If you receive a "No Answer" result in the Initial Self Rating column of this table, then selections from the previous page were not received. Please return to the previous section, mark your selections, and click "Evaluate". What Your Scores in Each Category Mean Scores of 3540: Outstanding! Your answers show that you are aware of the importance of these behaviors in your overall health. More important, you are putting your knowledge to work for you by practicing good health habits that should reduce your overall risks. Although you received a very high score on this part of the test, you may want to consider areas where your scores could be improved. Scores of 3034: Your health practices in these areas are very good, but there is room for improvement. Look again at the items you answered that scored one or two points. What changes could you make to improve your score? Even a small change in behavior can help you achieve better health. Scores of 2029: Your health risks are showing! Find information about the risks you are facing and why it is important to change these behaviors. Perhaps you need help in deciding A PILOT WELLNESS PROGRAM 62 how to make the changes you desire. Assistance is available from this book, your professor, and student health services at your school. Consider making a change by filling out the Behavior Change Contract at the end of this book. Scores below 20: You may be taking unnecessary risks with your health. Perhaps you are not aware of the risks and what to do about them. Identify each risk area and make a mental note as you read the associated chapter in the book. Whenever possible, seek additional resources, either on your campus or through your local community health resources, and make a serious commitment to behavior change. If any area is causing you to be less than functional in your class work or personal life, seek professional help. In this book you will find the information you need to help you improve your scores and your health. Remember that these scores are only indicators, not diagnostic tools. A PILOT WELLNESS PROGRAM 63 Appendix H Activity One: Coat of Arms Overall Group title: Miss Indiana Wellness Group Session title: Personal Coat of Arms Format: Warm up- 5 minutes Introduce activity- 5 minutes Instructions for activity- 5 minutes Activity- 25 minutes Discussion- 15 Summary- 5 minutes Supplies: Copies of Coat of Arms Paper Colored pencils, markers, pens, and pencils Description: 1. Introduction (5 points) 1. Introduce self, name and title of group, member introductions 1. Each member states name and tells their favorite pageant memory. 2. Warm-up 1. Toilet paper task. 1. Participants will around a roll of toilet paper and instruct participants to take as much as you need. Participants will take turns identifying their personal passions in life; identify one passion per square. 1. Explain the purpose 1. This warm up activity will help break the ice as you share things about yourself others may not know. 2. The purpose of this activity is to complete self-reflection and explore your own personality before sharing it with others. It is a great to get to know yourself, express it in words, then when everyone has an opportunity to share, it will build in team strength and bond the group. 2. Brief outline of session/time frame 1. Warm up- 10 minutes 2. Introduce activity- 5 minutes 3. Instructions for activity- 5 minutes 4. Activity- 20 minutes 5. Discussion- 15 6. Summary- 5 minutes 1. Activity -- Personal Coat of Arms 1. Each participant will receive a worksheet to fill out with words and/or pictures with the instructions: 1. Draw a picture or a write a small explanation in each square to represent the following: A PILOT WELLNESS PROGRAM 1. 2. 3. 4. 5. 64 2. Each square is for each prompt: 1. What you like about yourself 2. Your greatest achievement 3. Your most prized possession 4. What you value most in life 5. A symbol of your personality 6. Three words to be remembered by 3. Reference where the activity came from 1. Hayes, P. (2011). Leading and coaching to success: The secret life of teams. Maidenhead: Open University Press. Sharing: How will individual work be shared 1. At the end, participants can share how as much as they are comfortable 1. Remind them that the best part is that everyones will be different and that is the way it should be. 2. Then ask someone to volunteer to start and make them feel comfortable to share anything else about their personal coat of arms they would like to. Processing: Members express how they feel about the experience, leader, each other 1. How did it feel, to think about these prompts? 2. Have you thought of this before? 3. Was your coat of arms different or similar than others? How does that make you feel? 4. How did it feel to share your coat of arms? 5. Which prompt was the most difficult to answer? The easiest? Generalizing 1. What did you learn about yourself from todays activity? 2. What did you learn about others today? Application How the principles learned during group can be applied to everyday life 1. How can this activity help you with your daily life, or pageant life? 2. How can this come in handy during your pageant experiences? Summary (5 points) 1. Does anyone have anything you want to share to summarize the session? 2. Does anyone want to share anything new they learned? 3. You are not alone and now that we know a little more about one another I think our bond is stronger! 4. Thank you for your participation! A PILOT WELLNESS PROGRAM 65 Appendix I A PILOT WELLNESS PROGRAM 66 Appendix J A PILOT WELLNESS PROGRAM 67 Appendix K Activity Two: Self Awareness Collage Overall Group title: Miss Indiana Wellness Group Session title: Self-Awareness Collage Format: Warm up- 5 minutes Introduce activity- 5 minutes Instructions for activity- 5 minutes Activity- 25 minutes Discussion- 15 Summary- 5 minutes Supplies: Magazines Computer Paper Pens, pencils, colored pencils, markers Scissors Glue and tape Description: 1. Introduction (5 points) 1. Introduce name and title of group, member introductions 1. Each member states name and tells their most embarrassing pageant memory. 2. Warm-up 1. Reading people nonverbally. 1. The group will sit in a circle and attempt to count to any number (usually 10 or 15) as a group. Only one person can talk at once and if two or more people talk at once then the counting starts over. One participant says one and another participant says two and so on. Read your fellow group members in order to decide when to say a number. Everyone should participate. 1. Explain the purpose a. This warm up activity will help the group become more cohesive and bonded as it is a personal thing to read someones body language. b. The purpose of this activity is to complete self-reflection and explore the things you keep inside and the things you want others to see about yourself. Then they have an opportunity to share. After becoming closer throughout the program, they may be more willing to share things that are more personal and thus realize they are not alone in hiding. 2. Brief outline of session/time frame a. Warm up- 10 minutes b. Introduce activity- 5 minutes c. Instructions for activity- 5 minutes A PILOT WELLNESS PROGRAM 1. 1. 2. 3. 4. 5. 68 d. Activity- 20 minutes e. Discussion- 15 f. Summary- 5 minutes 3. Educational concepts/reference 1. Cole, M. B. (2012). Group dynamics in occupational therapy: The theoretical basis and practice application of group intervention. Thorofare, NJ: Slack Incorporated. Activity -- Self-Awareness Collage 1. Each participant will receive a blank piece of paper with instructions to fold it in half 1. The outsides of the paper represent the way others see you or the way you want others to see you 2. The insides of the paper represent the things that you dont want others to know or see about you, the things you hide 2. They will cut pictures and words out of magazines and glue them to the appropriate aspects of the paper. 3. Reference where the activity came from 1. Cole, M. B. (2012). Group dynamics in occupational therapy: The theoretical basis and practice application of group intervention. Thorofare, NJ: Slack Incorporated. Sharing: 1. At the end, participants can share how as much as they are comfortable 1. Remind them that the best part is that everyones will be different and that is the way it should be. 2. Then ask someone to volunteer to start and make them feel comfortable to share anything else about the collage. Processing: Members express how they feel about the experience, leader, each other 1. How did it feel, identify the things about yourself you share or hide? 2. Have you thought of this before? 3. Was your paper different or similar than others? How does that make you feel? 4. How did it feel to share your papers outside? What about the inside? Generalizing 1. What did you learn about yourself from todays activity? 2. What did you learn about others today? Application 1. How the principles learned during group can be applied to everyday life? 2. How can this activity help you with your daily life, or pageant life? 3. How can this come in handy during your pageant experiences? Summary 1. Does anyone have anything you want to share to summarize the session? 2. Does anyone want to share anything new they learned? 3. You are not alone and now that we know a little more about one another I think our bond is stronger! 4. Thank you for your participation! A PILOT WELLNESS PROGRAM 69 Appendix L A PILOT WELLNESS PROGRAM 70 Appendix M ...