For my semester-long grant proposal, I created an intervention to help overweight/obese individuals who have gone through adverse childhood experiences growing up. This intervention would take place in Alachua County, Florida. Participants need at least a score of three on an ACE questionnaire. Becoming overweight/ obese in adulthood is one of the many health consequences that can occur due to ACEs. My proposed intervention would work to help these adults work through their past traumas while learning how to manage their weight through exercise and nutrition. Each week they would learn about fitness and follow a fitness program. They would also participate in a group-wide physical activity on one of the days. The participants would also receive education on nutrition and clean eating. They would go grocery shopping together one day during the week to learn how to properly fuel their bodies and read food labels. To work through their past trauma, biweekly group therapy would take place, and take home journal/workbook assignments. Together, the aspects of this intervention would help participants improve their mental and physical well-being.
Trauma-Informed Principles
The trauma-informed principles that will be built into the program aiding in the recovery of the childhood trauma would be the SAMHSA’s six principles for a trauma-informed approach. The principles of this approach include safety, trustworthiness /transparency, peer support, collaboration/mutuality, empowerment/ voice, and cultural/ historical/ gender issues (Abuse, 2014). The safety principle would be included in this program as the staff would help to make this a warm, welcoming, and comforting environment for each participant. Making each participant feel like they belong, are heard, and are important will help to make them feel safe. This program can build the next principle of trustworthiness between staff and participants by having this sense of safety and respect. Peer support will be incorporated into this program as participants will get to work together when they meet up for their group workout, nutritional education, and group therapy. Collaboration /mutuality will be a part of this program in one aspect as participants will get to work with staff and adjust the program's parts to best fit their needs. Empowerment /voice will be acknowledged as participants will get to voice their opinions and vote on group workouts each week. They will also get to build on their current strengths and form new ones through this program. Cultural/ historical/ gender issues will be addressed in this program by adding some cultural foods to represent the participants involved in the program. Each of these trauma-informed principles would be incorporated in all aspects of this program to help the participants involved make the most progress from the time spent in this program.
Level(s) of Social-Ecological Model
The social-ecological model has five levels: intrapersonal, interpersonal, organizational, community, and public policy (McLeroy, 1988). This program will utilize some of the levels within this model. The intrapersonal level will be used as this is the individual level that involves individual characteristics of knowledge, attitudes, behaviors, and skills (McLeroy, 1988). This level will be utilized as each participant will work to improve it as they learn about new lifestyle changes to add to their lives to help them lose weight. As participants work through their past traumas, they will also sharpen their skills and behaviors to help them now and in the future. The interpersonal level will be used in this program as this level is about the relationships a person has and how they can impact behaviors (McLeroy, 1988). This will be utilized as other participants can impact each other's progress. As they go through this program together, they will get the opportunity to build each other up and push each other to keep going. The community level will also be addressed as the structures within Alachua County can help participants through this program easier. The built environments within this county can help participants meet their physical goals, while local farmer's markets can help their nutritional goals. Each of these levels will be taken into consideration to help this program flourish as participants take back control of their lives and rebuild from the effects of their past traumas.
Public Health Framework
The public health framework that would help assist in the physical aspect of the project to help these individuals break bad habits and lose weight would be the Transtheoretical Model. This model helps to promote lifestyle changes as they would want to participate in physical activity and eat more nutritious foods. The stages of this model include pre-contemplation, contemplation, preparation, action, maintenance, and termination (Prochaska, 1997). Including this model can help get participants from one stage to the next based on their needs to make this project more successful.
A framework that would aid in the recovery of the childhood trauma ACEs has brought into their life would be the SAMHSA’s six principles for a trauma-informed approach. The principles of this approach include safety, trustworthiness /transparency, peer support, collaboration/mutuality, empowerment/ voice, and cultural/ historical/ gender issues (Abuse, 2014). Basing this project on these principles gives the participants the necessary tools for recovery and resiliency from their childhood trauma.
The public health levels of prevention are primary, secondary, and tertiary (Philidelphia, 2019). For this project, the level of prevention that will be targeted is tertiary, as it is for the treatment of ongoing health conditions to help improve an individual's quality of life (Philidelphia, 2019). This project's goal is to improve the overall well-being of individuals who have ACEs by helping them through the mental and physical effects. This makes tertiary the level of prevention that best meets the goal of this project to reverse the impact of ACEs and improve their quality of life.
Abuse, S. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://scholarworks.boisestat...06&context=covid
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health education quarterly, 15(4), 351-377.https://doi.org/10.1177/109019818801500401
Philadelphia, P. N. G. (2019). Trauma-Informed Philanthropy: A Funder’s Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley.
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American journal of health promotion: AJHP, 12(1), 38–48. https://doi.org/10.4278/0890-1171-12.1.38
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