home.lagrange.eduhome.lagrange.edu/educate/advanced programs/m.ed. d… · web viewanorexia...

LEARNING THROUGH DISCUSSION: USING FOCUS GROUPS IN HEALTH EDUCATION

Except where reference is made to the work of others, the work described in this thesis is my own or was done in collaboration with my Thesis Chair. This thesis does not include

proprietary or classified information.

__________________________________________________________

Torri Leigh Bridge

Certificate of Approval:

_________________________ _________________________

Donald R. Livingston, Ed.D. Sharon M. Livingston, Ph.D.Co-Thesis Chair Co-Thesis ChairEducation Department Education Department

Learning Through Discussion ii

LEARNING THROUGH DISCUSSION: USING FOCUS GROUPS IN HEALTH EDUCATION

A thesis submitted

by

Torri Leigh Bridge

to

LaGrange College

in partial fulfillment of

the requirement for the

degree of

MASTER OF EDUCATION

in

Curriculum and Instruction

LaGrange, Georgia

May 11, 2011

Learning Through Discussion iii

Abstract

This study provided information about female students attending LaGrange

College when discussing the issues of body image, self-esteem, and eating disorders. The

information was gathered using three focus groups, assessment data, a survey as well as

student and teacher journals. In all three groups, the students had gains in knowledge

from the pre-test to the post-test. Although the sample size was small, this research

showed that learning through discussion could be an effective method of teaching health

education. Permission for this study was obtained through LaGrange College Education

Department and LaGrange College Institutional Review Board. Completion of this action

research thesis was mandatory requirement for the completion of the Masters of

Education degree at LaGrange College.

Learning Through Discussion iv

Table of Contents

Abstract……………………..…………………………………………………………….iii

Table of Contents…………….……………………………..…………………………….iv

List of Tables……………….……………………………………………………………..v

Chapter One: Introduction………………………………………………..…….…………1 Statement of the Problem…………………………………………………………...1 Significance of the Problem………………………………………………………...1 Theoretical and Conceptual Frameworks………………………………..…………2 Focus Questions…………………………………………………………………….6 Overview of Methodology………………………………………………………….7 Human as Researcher……………………………………………………………….9

Chapter Two: Review of Literature …………………………………...………..…...…..10 Focus Groups in Health Education………………………………………………..10 Student Achievement in Health Education Focus Groups………………………..12 Student Attitudes about Focus Groups in Health Education……………………...14

Chapter Three: Methodology………………………………………………….…………19 Research Design…………………………………………………………….……..19 Setting……………………………………………………………………………..19 Subjects and Participants………………………………………………………….20 Procedures and Data Collection Methods…………………………………………21 Validity, Reliability, Dependability, and Bias……………………..……………...25 Analysis of Data…………………………………………………………………...28

Chapter Four: Results……………………………………………………………..……..30

Chapter Five: Analysis and Discussion of Results…………………………..…………..46 Anaysis of Results……………………………………………………………….. 46 Discussion………………………………………………………………………... 50 Implications………………………………………………………………………..51 Impact on Student Learning……………………………………………………… 53 Recommendations for Future Research…………………………………………...53 References……………………………………………………………………………..…55

Appendices………………………………………………………………………………58

Learning Through Discussion v

List of Tables

Tables

Table 2.1 Matrix for Assessing Consensus……………………………………..…..…17

Table 2.2 Matrix for Assessing Non-Verbal Information…………………….….….. .17

Table 3.1 Data Shell…………………………………………………………....……...22

Table 4.1 ANOVA Results for Pre-Test…………………………………….….….….31

Table 4.2 ANOVA Results for Post-Test……………………………………….….…32

Table 4.3 Dependent t-Test Results For Freshman Pre-Test and Post-Test……..……33

Table 4.4 Dependent t-Test Results for Sophomore Pre-Test and Post-Test…………34

Table 4.5 Dependent t-Test Results for Junior and Senior Pre-Test and Post-Test..…35

Table 4.6 Chi-Square Self-Perception Survey…………………………...……………36

Learning Through Discussion 1

CHAPTER ONE: INTRODUCTION

Statement of the Problem

Students need to be more engaged in learning during health education class.

According to Eisenberg (1997), students prefer discussions, educational media, guest

speakers, case studies, and small group work when discussing health education topics. A

comprehensive health education program should include an opportunity for the students

to have open discussions about age-appropriate topics that are current to their generation.

Focus groups are an opportunity for students to have discussions rather than lectures;

conversations rather than note taking. It gives the student a chance to express feelings

they may not discuss in a whole group setting. It is a great method, when used correctly,

to obtain meaning and insight of the student when discussing certain facts or events

(Thackeray & Neiger, 2004). The purpose of health education is to give students the basic

knowledge necessary to make smart choices in the future. A student centered health

education curriculum is beneficial for students, so that they will be engaged to learn what

they need to know for real world application. The use of focus groups is an effective way

to view students’ attitudes and opinions about pressing health education topics.

Significance of the Problem

When faced with difficult choices and pressure from peers during adolescence, it

is difficult for young adults to make smart decisions if they are not taught the information

necessary to make these choices. Along the same lines, students are unable to make a

smart decision with regards to choices regarding healthy relationships, nutrition, and

intimate relationships if they are not educated with the necessary information to make


these types of decisions. The National Eating Disorders Association (2010) states that ten

million females are struggling with an eating disorder and eighty percent of American

women are dissatisfied with their bodies. Educators must reach these females early so

they understand the effects of eating disorders and unhealthy living on the human body.

The use of focus groups with different age groups allows educators to find if there is a

difference in self-perception as the female ages. The traditional method of lectures and

textbook review questions during teaching may not always get the job done. It is

necessary to a variety of teaching methods to engage students in ways that interest them.

The use of single gender focus groups gives the students a chance to voice opinions and

have a focused conversation on the issue of self-image, self-esteem, and eating disorders.

Theoretical and Conceptual Frameworks

While gathering information for this action research study, it was clear that the

use of focus groups in the classroom relates to the Constructivist Theory. Phillips wrote

an article in 1995 regarding the different views of constructivist thought. In The Good,

the Bad and the Ugly: The Many Faces of Constructivism, he wrote that humans are not

born with already formed knowledge or thoughts, but that humans construct knowledge

through inquiry and experiences (Phillips, 1995). He stated, “…human knowledge-

whether it be the bodies of public knowledge known as the various disciplines, or the

cognitive structures of individual knower’s and learners- is constructed” (Phillips, 1995,

p.5). The LaGrange College Education Department (LCED) believes in the Social

Constructivism theory. This is the idea that a student learns new information by taking

prior knowledge and linking it to the new curriculum being taught. This type of

instruction, “requires the teachers to be learning facilitators, rather than lecturers or


dispensers of information” (LCED, 2008, p.3). My thesis topic was directly related to this

type of instruction. The classroom should be a place where students are able to create

their own knowledge and the educator should be the facilitator of instruction. This fit

perfectly with the use of focus groups. The educator is the facilitator of discussion, but

not a participant. It is up to the students to have these discussions. Helen Longino, a

famous figure in social-constructivism believed that knowledge must be “constructed not

by individuals but by an interactive dialogic community” (Phillips, 1995, p.10). Longino

was stating that learners learn best by using the classroom as a community in which to

learn. It is best for students to feel comfortable in the classroom. Only by knowing the

students strengths, weaknesses, abilities and interests can we provide them with a

meaningful curriculum that is beneficial to the students learning (LCED, 2008).

When relating my paper to the LaGrange College Conceptual Framework tenets

and their clusters of related competencies, I found that the chosen thesis topic relatives to

many of the clusters of the three tenets (LaGrange College Education Department

[LCED], 2008). Competency Cluster 1.3: Knowledge of Learners, discusses the many

ways a student can learn information. This went directly with my thesis topic of using

focus groups in the health education classroom. The Conceptual Framework (2008) states

that, “candidates understand how to provide diverse learning opportunities that support

students’ intellectual, social, and personal development based on students’ stages of

development, multiple intelligences, learning styles, and areas of exceptionality” (LCED,

2008, p.4). This was exactly what I was trying to create in the classroom environment.

Using focus groups gave me the chance to see if students were more engaged in learning

new information by being taught using this teaching strategy. Cluster 1.3 also discussed


that a teacher must be aware that there are factors in school as well as at home which

influence how a student learns. This is particularly true in health education because

students come into the classroom with different experiences and prior knowledge

depending on their family background and conversations with family. These differences

are shown through the students’ input in discussion and activities during the focus group.

Another cluster of the Enthusiastic Engagement in Learning Tenet involved instructing

the students by using the state standards as guidelines. The instructional plan used during

the study was based off the Georgia Performance Standards (GPS) for health education

grades nine through twelve. The state GPS standards in health education were generic in

text and could be interpreted different ways in classroom instruction. Therefore, these

standards were easy to follow during this action research thesis since these topics were

very broad in subject.

For the Tenet 2: Exemplary Professional Teaching Practices, the teacher will

“create learning environments in which students assume responsibility and participate in

decision making” (LCED, 2008, p. 6). The topic for my thesis included using a variety of

instructional strategies including verbal and written work, using technology in the

classroom when available, and the use of students’ critical thinking skills to make

educated decisions in the future. With regards to the third and final Tenet, Caring and

Supportive Classroom and Learning Communities, my thesis related to the second

Competency Cluster: Connections. When instructing students in health education, it is

very important to understand the boundaries created by mandated state laws and to

consider the rights had by students and teachers. It is also important to maintain a


professional relationship with the students in the class while discussing such

controversial topics (LCED, 2008).

I feel that my thesis related to all six domains of the Georgia Framework for

Teaching. There were two domains in particular (Domain 3: Learning Environments and

Domain 5: Planning and Instruction) that stressed the need for a differentiated classroom

environment. The Georgia Framework for Teaching states, “teachers must create learning

environments that encourage positive social interaction, active engagement in learning

and self-motivation” (LCED, 2008, p.11). The framework also stressed that teachers

should have all instruction based on knowledge of content, student experiences and

taught in the learning style that works best for the students learning the new material.

Some other key points of the Georgia Framework for Teaching which corresponded with

my thesis topic included: a consistent use of assessment techniques to ensure retention of

knowledge and the ability of the teacher to show a strong knowledge of the content being

taught. This study used many assessments both verbal and non-verbal to show the amount

of learning. The pre-test, pre-survey, post-test and journal activities were other measures

of assessment to show gains in knowledge and student attitudes.

The National Board for Professional Teaching Standards were the most difficult

to relate my thesis. The NBPTS included the five core propositions for experienced

teachers. Proposition 4 stated that teachers must “learn from experience” (LCED, 2008,

p.12). This M.Ed. program at LaGrange College helped in this learning process, and I

will also learn a great amount every year in my own classroom. The area I can relate to

with regards to the NBPTS would be the commitment to the students learning. Whether a

new teacher or an experienced educator, it should be the main concern of the teacher that


the students learn the knowledge they need to know in that subject area. The goal of this

thesis was to evaluate how college age female students reacted to the discussion of self-

image, self-esteem and eating disorders. The hope was to use different instructional

methods and differentiated instruction in focus groups to reach the selected students and

have a more educated student body with regards to content in health education.

Focus Questions

The following three focus questions were chosen to guide the research being

conducted. These questions breakdown the specific areas researched in this study, and

were used to see the effects of focus groups in a health education class. The questions

target implementation of seminar instruction as well the changes in attitudes and gains of

knowledge in health education class.

Focus Question 1: How can an instructional plan about seminar teaching be

implemented to yield evidence that discussion on health education topics is effective?

The purpose of this focus questions was to show evidence that using seminar

teaching in the classroom is an effective method of teaching. This question used an

instructional plan as the guide for unit instruction. This focus question explored if

seminar teaching is an effective method of educating students in the health education

classroom.

Focus Question 2: How can using seminar teaching in health education measure the

attitudes, knowledge base and self-perceptions of the student?

This focus question was chosen to represent the quantitative and qualitative

methods that will be used to measure student outcomes. This study measured gains in


knowledge but most importantly, measured student’s responses to essential questions

about their bodies and the attitudes they had about the subject matter.

Focus Question 3: In what ways will using seminar teaching in health education affect

the attitudes of the students?

Students learn more when they are engaged in what they are learning, and the

attitudes of the participants are essential to the effectiveness of the focus group. The

study used observations and journaling to show students engagement and participation in

the group discussions and activities.

Overview of Methodology

This study was conducted using action research. Data were gathered using

quantitative and qualitative methods. These methods included assessments such as pre-

test and post-test, journals recorded by participants and researcher, and surveys. The

setting for this study took place in LaGrange, Georgia at LaGrange College. The focus

groups were conducted on campus at the college, and participants were volunteers

consisting of only female students who are enrolled at the college. Each focus group had

six students and met with me one time for one hour. There was three focus groups, one

for first year students, one for sophomores, and one for juniors and seniors at the college.

This study used a pre-test and pre-survey of the participant’s attitude and knowledge of

the health education Georgia Performance Standards for high school students. The

participants were asked to journal about specific topics throughout the study to express

personal attitudes about the topic and about the instructional method. The reflective

journals were analyzed for students engagement in the topics and also be able to help

address specific comments the teacher had about the instructional technique. The teacher


journal was also used to record data during the focus groups regarding the amount of

engagement in discussion, interest in the topic, and behavioral patterns that were

observed during group time. There was also an exit slip for the students to record final

thoughts at the end of each meeting session.

An instructional plan was used to improve pedagogy. It was reviewed by three

members of the LaGrange College faculty that teach health classes to students. The

feedback from the instructional plan was used to improve the overall impact of the

research on the students. The instructional plan feedback as well as the use of pre-

determined journal prompts accounted for the qualitative data gathered for focus question

one. The organized discussion during the focus group was coded for themes for

additional qualitative data. The pre-test, post-test and pre-survey will be evaluated as

nominal data. This study was checked to ensure content and construct validity as well as

reliability and dependability. All instruments were checked for all forms of bias such as

unfair or offensive material as well as disparate impact. The data was analyzed using

dependent t-test to determine if there are significant differences between the means of the

pre-test and post-test. An anova was ran on all three groups pre-test scores to determine if

there was significant difference between the three groups before the focus group. There

was a second anova ran on all three post-test groups to see if a particular focus group

learned more than the others or if the amount learned was consistent. The journals were

coded for recurring, dominant and emerging themes. The survey was analyzed using chi

square and Chronbach’s Alpha to find out which questions were significant.


Human as Researcher

I chose this topic to research because it was something I am very passionate

about. In my years of educational experience, whether in the classroom as a student, or in

the role of educator, health education class has been looked upon as a joke. The

instructors who teach health education are usually physical educators who are forced to

teach health and are not passionate about the subject. Even though I have never had my

own classroom, it is necessary to show health educators the value of using a different

instructional technique in the classroom. The use of outdated materials and outdated

teaching strategies to educate the students is not working. Adolescents are not retaining

the knowledge needed to maintain proper nutrition, maintain a high level of self-esteem,

and to accept themselves just as they are. The use of focus groups can be a useful method

could help reach some of these students.


CHAPTER TWO: REVIEW OF THE LITERATURE

Focus Groups in Health Education

An instructional plan for an action research thesis should be considered

meticulously to include specific details of the unit for the best research results. It is best

to consider every aspect of the study to be fully prepared for the short amount of time

spent with the students in the focus group. The myth that focus groups can be done

cheaply and quickly has led to many inappropriate uses of focus group (Morgan &

Krueger, 1993).

The use of focus groups can be effective when implemented correctly. They can

be an assessment of attitudes, perceptions, beliefs, or experiences. These groups can also

be a strategy to develop communication (Thackeray & Neiger, 2004). Kitzinger (1994)

described how focus groups reach a part of the student that other methods cannot reach-

revealing a dimension that remains hidden by using other methods such as one-to-one

interviews or traditional questionnaires.

Tiggemann (2000) conducted a study about why adolescent girls want to be

thinner. This study used focus groups as the only method for assessment and addressed

the essential question of what causes body dissatisfaction in adolescent girls. A number

of studies over the past thirty years have shown that girls consistently indicate their ideal

figure is considerably smaller than their current figure, and this study wanted to

understand why. Tiggemann used focus groups consisting of eleven girls each from five

high schools in Australia. The girls were all sixteen years of age and randomly selected.

There were four pre-determined questions given to each group as well as transitional

questions in between. The moderator made judgments about the frequency of themes and


recorded the number of time the topic was mentioned as a tool of assessment. The two

most coded topics discussed were the influence of the media on wanting to be thin as well

as the desire to be more attractive and receive more attention. This study also used

frequently used words as themes for assessment. These words were used to see patterns

in girls’ attitudes and perceptions of themselves. Tiggemann stated that the girls in the

study thought there were clear benefits from hearing others speak and tell their stories.

Kitzinger (2004) agrees with this opinion, stating that group participants provide an

audience for each other encouraging a greater variety of communication that are not

within more traditional methods of data collection.

Thackeray and Neiger (2004), present an interesting outlook on the

misconceptions of focus groups with regards to the health education classroom. Although

some positive aspects of the use of focus groups are discussed in the article, these authors

believe that focus groups are not always the best method for instruction. A focus group

should not be used to answer questions that could be more easily and appropriately

assessed by a survey or questionnaire. However, they could be used to collect initial data

to provide knowledge to create a particular questionnaire or survey. Another problem

with a focus group setting is the idea of “group think”, or when students go along with

the group opinion because of the desire to be accepted or to not be different. The authors

also discuss the importance of the moderator of the group. This person must be prepared

for different scenarios while conducting the group discussions. The questions should be

open-ended to promote discussion as well as challenge the students thinking about the

subject material. The moderator should be educated on the subject while being a

facilitator for group discussion and projects.


There is an opinion of health educators that university and college students are an

important population for health promotion efforts (Kwan, Arbour-Nicitopoulos, Lowe,

Taman, & Faulkner, 2010). This could be because university students are part of a

community setting and more receptive to educational programs. Most college students do

report receiving health education information in the university or college setting (Kwan et

al., 2010). Approximately 78% of students report having prevention information on at

least one health topic, and drugs and alcohol was the most common (49%) while dietary

and nutritional information was at a much lower percentage (17%). Kwan (2010), also

discovered that college students were referring to the internet as a primary source for

knowledge of health topics. In the year previous to the study, 64% of students polled had

looked up needed health information on the internet.

Student Achievement in Health Education Focus Groups

Lilla Vicsek (2010) discusses the concerns related to the analysis of focus groups

by using numbers to assess the analysis. She addresses the question if quantitative data

should be used when evaluating focus groups. It is difficult to use numbers as data

because of the many factors that make up a focus group. These include the setting of the

group, dynamic of persons involved in the group, and the topic being discussed. If the

focus group is voluntary, you may have students who agree to help with the research due

to interest or strong opinions about the subject. This could form bias in the research

gathered when generalizing the statistical data. Vicsek believes that it is inappropriate to

take the statistical data from a small sample size and infer that all persons of a given

population believe the same way as that group. A large sample size or using multiple


focus groups would help to verify an opinion of a whole group. Researchers must be

careful not to generalize an opinion of a small group for the opinion of the masses.

When is it appropriate to use quantitative research methods when using focus

groups? Is it even a useful method? Researchers have mixed emotions about the idea of

using numbers to analyze focus groups. Many focus group experts believe it is not useful

to make analysis based on numbers, however some researchers believe it is legitimate to

make certain types of numerical analysis when conducting interviews. This numerical

analysis would consist of coding conversation dialogue for frequency of themes

mentioned. Another large population of researchers had the opinion is that it is useful to

combine quantitative and qualitative analysis in certain cases. Numbers are most useful

when using them to reflect on what happened in the group as opposed to using the

numbers to reach an overall opinion of the group.

Krueger (1994) believes that focus group analysts should use expressions such as

“most participants” or “the majority” instead of giving specific numbers. Using exact

numbers does not take into account the process of the questioning. The comments of the

persons in the focus group could lead the conversation to discussions not outlined on the

focus question guide. The use of numbers also does not consider that answers or

discussion might not be diverse because of students not wanting to go against the

majority group opinion.

When creating an action research thesis in the public schools, it is important that

the unit being researched directly correlates with specific performance standards

mandated by the state. Popham (2011) refers to this as alignment as when two or more of


the following meaningfully agree: curriculum, instruction, and assessment. The

curriculum should be chosen to meet the standards, the instruction correctly teaches these

standards, and the assessment should clearly show the outcomes from this instruction.

Student Attitudes about Focus Groups in Health Education

When reviewing the literature on the affective, the main concept to consider is

how the students feel when being taught a lesson. This can be shown through monitoring

student behavioral patterns, student artwork, and also student journaling. There is also the

ability to obtain the educators’ attitude through teacher journaling before, during, and

after the lesson. It is important to have many forms of assessment to clearly show the

overall affective of the student in question.

Hendricks (2009) states that reflection allows the educator to consider issues and

problems relevant to his own practice and then act in ways to study or resolve those

issues, guiding his own development as a professional educator. When reviewing the

literature on student and teacher journaling, it is clear that reflection allows the educator

and student to look back at the lesson or concept and write on paper what they learned or

understood about the subject matter being learned. In Hendricks book, Improving Schools

Through Action Research, she clearly states there are two forms of reflection. There is

reflection-on-action, which occurs as individuals reflect on actions and thoughts after

they have taken place. This could be the students reflecting on the main ideas after the

lesson, or by writing a free write on what they took from the topic. This could also be

used by the educator to note behaviors and attitudes of students as well as reflection on

the instructional method of the lesson and changes that will be made the next time


teaching the lesson. The second type of reflection is called reflection-in-action. This takes

place as the action occurs. This form of reflection would mostly be used by the educator

to make notes and take down ideas as the lesson is happening. This would be best used to

make sure the thoughts and ideas are remembered after the lesson is taught. Hendricks

strongly believes that students can use journals to record learning struggles, successes, or

personal accounts of growth and learning.

There is a strong push for the implementation of writing in non-traditional

subjects such as math and science. This journaling provides another means for the

students to connect writing skills with the knowledge learned in these core academic

classes. Where does journaling fit in health and physical education? Is it appropriate for

this subject area? Amy Rowland (2007) suggests that high school physical education

teachers can effectively implement writing into the health and physical education

classroom by journaling. She believes that journaling, when implemented correctly, can

improve the students’ knowledge on the health issues as well as helping make the

students a better writer. Journaling helps the students learn things about themselves,

while expressing the experience clearly and directly. Rowland believes that an important

application of journaling can be goal setting, nutritional journals, fitness logs, and

reflection of subject matter during class. One semester long concept is to begin the

semester with the students free writing ideas, thoughts, or goals forth semester. There is

no pressure for grammar and sentence structure during these free writes. At the end of the

semester, journals are collected. Giving the students an appropriate amount of time, they

are required to select journal entries and type them up with appropriate sentence

structure, grammar, and audience. These entries are collected and graded based only on


the writing requirements and not on content. The students are also encouraged to read

journal entries during class time to spark discussions and debate among the class about

certain health topics. The students, however, are not required to read journal entries,

promoting the security of writing personal ideas and thoughts that may not need to be

shared with the class.

A study presented in the Qualitative Report in 2010 suggests there are new and

innovative data collection strategies with regards to qualitative data (Onwuegbuzie,

Leech, & Collins, 2010). This group of researchers suggested that the use of a focus

group is a method of collecting data in a safe secure environment, from more than one

individual at a time, regarding a specific concentration of questions. Focus groups can be

used for the benefit of researchers because a large amount of data can be collected at one

time, and it is a means to collect social data in a social environment. Onwuegbuzie et al.

(2010) state that focus groups should be conducted for one to two hours and should

consist of six to twelve participants. Unlike other research found, this journal article

suggests having a moderator and an assistant moderator. The assistant would have the

role of recording the session through audio, video, or handwritten, handling latecomers

and interruptions, and assisting with data analysis.

It is important to record the responses of each member of the focus group when

hoping to record qualitative data. Onwuegbuzie et al. (2010) give an example of how to

record this data and it is shown in Table 2.1 below. This is one way of organizing verbal

information in a focus group setting.


Table 2.1 Matrix for Assessing Consensus

Focus Group Question

Member 1 Member 2 Member 3 Member 4 Member 5 Member 6

123

The following are examples of what could be entered into the cells:A= Indicated AgreementD= Indicated DissentSE= Provided Significant StatementNR= No Response

The assistant moderator could also be in charge of watching non-verbal behaviors

during the group which is shown in Table 2.2. This table is an example of how to

organize non-verbal data into substantial qualitative data.

Table 2.2 Matrix for Assessing Non-Verbal Information

Focus Group

Question

Member 1 Member 2 Member 3 Member 4 Member 5 Member 6

123

The following are examples of what could be entered into the cells:LLL= laughterSSS= sighingFFF=frowningPPP=passion in statementLF= lean forward while speakingLB=lean back while speaking= an equal sign indicates no silence between dialogue____ = anything underlined indicates stress or emphasis

Another means to attain the overall attitude of the group is the use of focus

groups. The students have an opportunity to voice opinions and thoughts on a particular

subject. While focus groups can be used to note common themes and collective

responses, it is important to not always assume the focus group opinion accurately


reflects or represents the opinions of the individuals in the group (Thackeray & Neiger,

2004). It is necessary to consider the idea that all participants in the group may not be as

verbal as some others in the group. The researcher is sometimes unable to identify

whether the group member is not contributing to the conversation because he or she has

nothing to add or because they disagree but do not want to voice opinions opposing the

group. A focus group may appear to think the same way but actually has varying opinions

from others who do not speak out due to being embarrassed they are different from the

group. The moderator should analyze the responses of the focus group at an individual

level and then at a group level. This will show the attitudes of individual students as well

as the overall opinion of the group.


CHAPTER THREE: METHODOLOGY

Research Design

The purpose of action research is for educators to investigate and improve their

practices (Hendricks, 2009). It is appropriate to use action research for this study because

this process will help show the benefits of using seminar teaching and focus groups in a

health education classroom. Charles and Mertler (2002), state that the focus for action

research should be specific problems in a specific educational setting that need a better

product of procedure. Action research involves identifying a problem, making a plan to

solve this problem, and then implementing the plan to see short term results. The idea for

this study was due to the problem of outdated teaching designs in health education

classes. This research design assessed prior knowledge of the females in the focus

groups, taught the class information about self-esteem, self-image and eating disorders,

and then saw the gains in knowledge in a focus group setting. The study also addressed

the concept of learning through discussion by using teacher led conversations followed

by open ended questions for the students to answer. The qualitative data in the study

included teacher and student journals, a peer reviewed rubric of the instructional plan,

observation of behavioral patterns and an exit slip. The quantitative data included a pre-

test, post-test, and pre-survey.

Setting

The students in this study were currently enrolled at LaGrange College in

LaGrange, Georgia for the 2011 spring semester. This setting was chosen based on

location and convenience. This study was approved by LaGrange College’s Institutional

Review Board.


LaGrange, Georgia is located in Troup County which, at the time of this study,

had a population of almost sixty-five thousand people. The county was 63 percent

Caucasian, 33 percent African American, 3 percent Hispanic, and less than 1 percent of

Asian, multi-racial and Pacific Islander. The city of LaGrange had over twenty-eight

thousand people.

LaGrange College had just over 1,000 students enrolled for the 2010-2011 school

year. The liberal arts college was affiliated with the United Methodist Church and was

founded in 1831. For 2011, 85 percent of LaGrange College freshman were from the state

of Georgia. The average high school GPA was a 3.47 on a 4.0 scale. The college was

comprised of 53 percent women and 47 percent men. Caucasian students made up 72

percent of the population, while 22 percent of the students were African American, 2

percent were Hispanic, and 2 percent were international students. LaGrange College is a

private college and 96 percent of students received financial aid of some type.

Subjects and Participants

The students were chosen on a voluntary basis. Various professors in all academic

concentrations were given the opportunity to promote this research opportunity to their

students. Many of the professors offered extra credit as an incentive to attend the focus

group. The female students were divided into groups based on their current academic

year. There were six freshman or first year participants, six sophomore or second year

participants, and the third group consisted of six juniors and seniors. The freshman group

consisted of five Caucasian students as well as one African American student. All six of

these participating students were a current college athlete at LaGrange College. The


sophomore group consisted of three Caucasian students, two African American students,

and one Hispanic student. This group had one student athlete. The final group consisted

of six Caucasian juniors and seniors. All six of these participants were student athletes at

LaGrange College. The academic level of these students was not asked, but assumed to

be under the high standard of all LaGrange College students. All students who attended

were given extra credit by a professor to attend the focus group.

There were three faculty and staff chosen to evaluate my rubric. These were

chosen based on their knowledge of educating students through the education department,

nursing department, and physical education department at LaGrange College. Each of the

faculty members chosen was given the instructional plan of the research along with open

ended questions to promote feedback to improve pedagogy.

Procedures and Data Collection Methods

The basis for the collection of data and validity of these collection methods can be

summarized by the attached data shell. This data shell shows the literature to support the

validity of each focus question and each data collection method. The sources used are

peer reviewed and show support for each focus question.


Table 3.1 Data Shell

Focus Question Literature Sources

Type: Method, Data, Validity

How are data analyzed

Rationale

How can an instructional plan about seminar teaching be implemented to yield evidence that discussion on health education topics is effective?

Thackeray & Neiger (2004)

Kitzinger, J. (1994)

Tiggemann, M. (2000)

Method: Instructional plan, rubric and interview

Type of Data: Qualitative

Type of Validity: ContentConstruct

Coded for themes

RecurringDominantEmerging

Qualitative: rubric feedback

How can using seminar teaching in health education measure the attitudes, knowledge base and self-perceptions of the student?


Krueger, R.A. (1994)

Vicsek, L. (2010)

Type of Method:

Student Survey

Pre-Test, Post-Test

Type of Data: Nominal

Type of Data: Content

Chi Squared

Dependent T

ANOVA

Desire to find what questions are significant and which ones are not

To determine if there are significant differences between means from two dependent groups.

To determine if there are significant differences among means from three independent groups

In what ways will using seminar teaching in health education affect the attitudes of the students?


Onwuegbuzie, Leech, & Collins (2010)

Hendricks, C. (2009)

Type of Method: student reflective journal, teacher reflective journal, behavioral patterns, focus groups,

Type of Data: Qualitative

Type of Validity: Construct

Coded for themes

Recurring Dominant Emerging

Looking for categorical and repeating data that form patterns of behaviors


This action research thesis used the method of seminar teaching to educate the

given population of female students in the subject of health education. The instructional

plan promoted open dialogue about the subject, partner projects, group projects, as well

as surveys about self-perception as a mean to see the students’ attitudes and knowledge

base about the subject. The gathered data showed prior knowledge, behavioral patterns

and self-perceptions as well as thoughts shared through journaling. The use of seminar

teaching, when used appropriately, can be used to show attitudes of the students and open

up a communication line that may not be reached in a mixed gender, large group setting.

Focus Question 1: How can an instructional plan about seminar teaching be

implemented to yield evidence that discussion on health education topics is effective?

An Instructional Plan (see Appendix A) was added to provide an in-depth look at

the unit plan for this study. This plan included all areas that are covered during the

seminar teaching sessions such as participants involved, setting of the study, and rationale

for the study to be done. The study aligns with the Georgia Performance Standards of

high school health education to ensure a necessity for this specific unit topic. The teacher

was used to facilitate the discussion and lead the students in individual and partner

projects as well as group discussion.

To provide feedback for improvement, a peer to review this instructional plan was

essential. Three education faculty or professors from a health related field of nursing and

athletic training were chosen to complete a Rubric (see Appendix B) with open-ended

feedback. After completion and return of the rubric, feedback was used to modify and


change specific areas of the study to make it as beneficial as possible for the students

involved and to obtain the desired outcome.

Focus Question 2: How can using seminar teaching in health education measure the

attitudes, knowledge base and self-perceptions of the student?

Although the majority of the data collected in this study is qualitative, the

measurement of student outcomes was calculated using nominal and interval data.

The students were given a pre-test (see Appendix C) of eight questions which was

read to them to prevent any erroneous answers due to reading comprehension

problems. These scores showed a baseline of previous knowledge on the subject

matter. The interval data were scored to see the students’ prior knowledge on the

subject material. The second quantitative data collection method used was a self-

perception survey (see Appendix D) which will show the students attitudes about

themselves and others who may or may not deal with body image and self esteem

issues. The purpose of this survey is to observe how the girls’ perceptions of

themselves change as they age and was given prior to instruction. The last form of

quantitative assessment used was the post-test. (see Appendix E) This was given as a

means to find out the gains of knowledge after the focus group session was

completed.

Focus Question 3: In what ways will using seminar teaching in health education affect

the attitudes of the students?

The teacher had different opportunities to gather data about affective or reflective

outcomes of the student. The icebreaker activity (see Appendix F) was given to each

participant who was asked to introduce their neighbor in order to initiate


conversation. Each girl in the study had the opportunity to write about two separate

journal topics (see Appendix G) to express attitudes about self-esteem. The

participants were involved in focus group discussion about the unit topic for a large

portion of the meeting time. This included previously written questions (see

Appendix H) that promoted conversation and dialogue from the participants about

self-esteem, self-perception, and eating disorders. This conversation was tape

recorded to review themes in dialogue, monitor participation of the girls in the

conversation and the knowledge base of the subject matter. The affect of the student

was also monitored by the journaling of the teacher. The pre-written teacher journal

prompts were used to show my reaction during and after the focus group session. The

final assessment was a combined post-test and exit slip which included multiple

choice and short answer questions to gain a better understanding of the information

learned by the participant as well as their overall impression of the method of

instruction.

Validity, Reliability, Dependability, and Bias

Focus Question 1

This focus question collected qualitative data by using written responses which

were coded for themes. The data were collected from peers in the form of written

feedback regarding the instructional plan for the research. The instructional plan was a

form of content validity because the assessments matched the content being taught and

the study was based on content standards. According to Popham (2008), content validity

is the extent to which an assessment procedure adequately represents the content of the

curricular aim being measured. This study also sought construct validity through the use


of peer attitudes in the written feedback to make improvements to the instructional plan.

To look into this further, Popham (2008) would call this an intervention study within the

category of construct-reliability. It is a type of study in which we hypothesize that

students will respond differently to the assessment after having received some type of

treatment or in this case after the focus group. This study ensured dependability for a

variety of reasons. The data collection and treatment of each focus group were consistent,

the appropriate amount of participants were in each focus group, and a detailed methods

section is written in order for the thesis to be replicated if necessary. This thesis has been

checked for all forms of bias and was not unfair or offensive to any specific group. All

instruments were checked for disparate impact. Popham (2008) warns that if a test has

disparate impact on members of a particular racial, gender, or religious subgroup, the

research should be looked at further to ensure it is not actually biased.

Focus Question 2

This focus question used nominal data to measure student outcomes of the content

being taught. The data were collected in the form of a student pre-test, post-test and pre-

survey. Content validity was used to measure if the content being taught was learned.

According to Popham (2010), content validity is the extent to which assessment

procedure adequately represents the content of the curricular aim being measured. This

study ensured reliability by using a Cronbach’s Alpha for the survey data collected. A

Chonbach’s Alpha uses multiple correlations for each question on the survey. Salkind

(2010) believes that to ensure reliability the tool used to measure data must be able to

remain consistent. The test-retest reliability remained constant because each participant

had the same pre-test and post-test. When using a dependent t-test, a Pearsons Correlation


is used to report test-retest reliability. This thesis has been checked for all forms of bias

and was not unfair or offensive to specific populations of people. The study results were

checked for disparate impact as well. Popham (2008) warns that if a test has disparate

impact on members of a particular racial, gender, or religious subgroup, the research

should be looked at further to ensure it is not actually biased.

Focus Question 3

This focus question used journal responses of teachers and students to collect

qualitative data. The attitudes of the student and teacher in the responses were used to see

the positive or negative feelings towards using focus groups in health education. This

information was used to ensure construct validity which Salkind (2010) describes as

when you want to know if a test measures some underlying psychological construct. The

data gathered provided dependability because the data were gathered in a controlled

setting. The study also provided the same amount of time for each focus group, had an

adequate number of participant responses, and maintained good organization of written

data. The journal responses and feedback were checked for bias, and all instruments were

checked to prevent any unfair or offensive actions. Most of the time, unfair penalization

and offensiveness are thought to impact students of a particular subgroup with lower test

scores than the rest of the participants. (Popham, 2008) The journal prompts also avoided

disparate impact. Popham (2008) warned that if a test has disparate impact on members

of a particular racial, gender, or religious subgroup, the research should be looked at

further to ensure it is not actually biased.


Analysis of Data

Focus question one was analyzed using qualitative data. The feedback received

from the instructional plan rubric was examined for emerging themes in order to improve

pedagogy. This feedback was from three peers and the data were reviewed for repeating

data that can help improve the research.

Focus question two was analyzed using quantitative data. The pre-test and post-

test were ran as a dependent t-test that determines if there is significant differences

between the girls responses at the beginning of the focus group until the end of the focus

group. The decision to reject the null hypothesis was set at p < .05. Due to the small

sample size, it was essential to calculate the effect size of the pre and post assessments.

An ANOVA was calculated using the pre-tests scores of each focus group to examine if

there was significant difference between these groups before any information was taught.

An ANOVA of the post-test scores compared the amount of information each focus

group learned. A chi square was used to determine which questions in the survey were

significant and which ones were not. The significance was reported at the p < .05, p < .01

and the p < .001 levels.

Focus question three was evaluated by qualitative data. The journals kept by the

participants and me were analyzed for dominant themes as well as reoccurring phrases

and attitudes. The discussion was audio taped then examined for repeating data that form

patterns of behavior. The exit slip given at the end of class were three questions the

participants answered to give the overall impression of the teaching instruction method.


The holistic analysis of this research reviewed the study as one unit, not as

individual focus questions. Consensual validity was guaranteed by the repeated review of

the faculty of the Education Department at LaGrange College as well as from the

feedback obtained from health professionals at LaGrange College. There was the

assurance of epistemological validation because the results of this study were compared

to the literature. The review of the literature also presented fairness because opposing

points of view are included. This study provided structural corroboration by using

multiple data sources to achieve triangulation. Rightness of fit was achieved because I

took great care to ensure precision and accuracy during data collection and analysis.

Procedures of this study are highly transferable and can be replicated by others for further

research on this topic which ensured referential adequacy. Catalytic validity was sought

through evidence that showed that the study had a transformative effect. The hope is to

use this research for positive change in the field of health education. It is important for

students to be actively engaged in pertinent health education topics and for teachers to

find new pedagogical methods to reach this generation of students.


CHAPTER FOUR: RESULTS

The results in Chapter four are organized by focus question. This chapter shows

the outcome of the research and presents all the qualitative and quantitative data. The

qualitative data are presented by coding the information for themes, while the

quantitative research gathered is shown by using tables and statistical data.

Focus question one addressed how using an instructional plan about seminar

teaching could be implemented to yield evidence that discussion on health education

topics is effective. The data gathered were in the form of feedback from three faculty

members at LaGrange College. All three faculty members taught in a health or education

related field and were willing to provide feedback on the instructional plan for this unit.

This information was used prior to the study to ensure the unit topic was appropriate for

the selected age group, the proper amount of participants were involved, and to explore

other suggestions these faculty members may have had to improve the overall impact of

the study. Faculty member A suggested that pamphlets be handed out for those who

wanted or needed help for themselves or a friend. Also, it was recommended that a

follow up time be provided if students would want to come back and share about more

experiences or ask further questions. Faculty member B found two grammar errors in the

assessment instruments for the study that had not been noticed. Also, the

recommendation was given to have more specific teacher journal prompts. For example,

one question regarded monitoring behavioral patterns and this faculty member suggested

having the specific behavioral patterns listed that would be monitored during the focus

group. Faculty member C, noticed that although it was mentioned in the instructional

plan, there was no distinguished post-test in the appendices. It was decided during the


follow up interview to use the same pre-test and post-test to ensure reliability. This

faculty also gave the opinion to use as much data as possible to allow multiple sources to

gather data and ensure structural corroboration. It was said by Faculty member C, “even

if there is no difference, or no significance, that may be just as important as a big

difference in results.”

This information helped to improve the instructional plan before the research

began. It was important to only include the most vital instruction and assessments, due to

the time constraints of a focus group. This group of faculty provided meaningful and

appropriate feedback to ensure a study with reliability and lack of bias.

Focus question two addressed how using seminar teaching in health education

measures the attitudes, knowledge base and self-perceptions of the student. This was in

the form of pre-test and post-test and student surveys. To ensure reliability, the pre-tests

and post-tests given to the participants were the same. The calculations shown below in

Table 4.1show the means for three groups were not significantly different from one

another. The pre-test, as well as the post-test were scored out of eight possible correct

answers.

Table 4.1 ANOVA Results for Pre-Test

Groups Count Sum Average Variance

Pre-Test Freshman 6 34 5.666667 2.266667

Pre-Test Sophomores 6 33 5.5 1.9

Pre-Test Junior & Senior 6 35 5.833333 2.166667

Source of Variation SS df MS F P-Value F-Crit

Between Groups 0.333333333 2 0.166667 0.078947 0.922447 3.68232

Within Groups 31.66666667 15 2.111111

Total 32 17


F(2, 15)= 0.078947, p > .05

When calculating the data for the pre-tests, the results show that F(2, 15)= 0.078947,

p > 0.5. This shows there is no significance between the scores of the pre-test among all

eighteen participants. A result of no significance means these students are starting on the

same basic level before learning any knowledge. A second ANOVA was calculated using

the scores from the students post-test. This was given to the students at the end of the

focus group and was a replica of the pre-test to ensure test-retest reliability (see Table

4.2).

Table 4.2 ANOVA Results for Post-Test

Groups Count Sum Average Variance

Post-Test Freshman 6 44 7.333333 0.666667

Post-Test Sophomores 6 43 7.166667 0.566667

Post-Test Juniors and Seniors 6 45 7.5 0.7

Source of Variation SS df MS F P-Value F crit

Between Groups 0.333333333 2 0.166667 0.258621 0.775489 3.68232

Within Groups 9.666666667 15 0.644444

Total 10 17

F(2, 15)= 0.258621, p > .05

These data gathered from the post-test showed that F(2, 15)= 0.258621, p > .05

means no significant difference between groups. There is however, a jump in the

averages of the pre-test to the post-test. The range of the mean scores from the pre-test

was from 5.5 to 5.83. The range of the mean scores in the post-test was from 7.16 to 7.5.

These results showed an increase in scores of all three groups.


The next quantitative test was a dependent t-test to show the differences in the

pre-test and post-test in each individual focus group (see Table 4.3).

Table 4.3 Dependent t-test results for Freshman Pre-Test and Post-Test

Pre-Test Freshman Post-Test Freshman

Mean 5.666666667 7.333333333

Variance 2.266666667 0.666666667

Observations 6 6

Pearson Correlation -0.542326145

Hypothesized Mean Difference 0

df 5

t Stat -1.976423538

P(T<=t) one-tail 0.052528702

t Critical one-tail 2.015048372

P(T<=t) two-tail 0.105057405

t Critical two-tail 2.570581835

T(5) = 1.97642538, p > 0.5

When reviewing the data, the pre-test average for the freshman students was 5.67

and the post-test average was 7.33. The results of this dependent t-test show that T(5) =

1.97642538, p > 0.5. Therefore, the null hypothesis that there was no difference must be

accepted which shows that there was no significant difference in the pre-test and post-test

scores. Because of the small sample size, it was necessary to calculate the effect size of

this pre-post test to measure the magnitude of a treatment effect. The effect size

calculated at 0.567 measured to be a large effect size. The Pearson Correlation is used to

show how strong the relationship between the two variables. The Pearson Correlation for


the freshman focus group was 0.54, showing a fairly strong reliability correlation

between these two variables. Table 4.4 shows the pre-test and post test results of the

sophomore focus group.

Table 4.4 Dependent t-Test Results for Sophomore Pre-Test and Post-Test

Pre-test Sophomores Post-test Sophomores

Mean 5.5 7.166666667

Variance 1.9 0.566666667

Observations 6 6

Pearson Correlation 0.096373885


df 5

t Stat -2.711630723

P(T<=t) one-tail 0.021096998


P(T<=t) two-tail 0.042193997


T(5) = 2.711630723, p < 0.5

When reviewing the data, the pre-test average for the sophomore students was 5.5

and the post-test average was 7.167. The results of this dependent t-test showed that T(5)=

2.711630723, p < 0.5. Therefore, the null hypothesis that there was no difference must be

rejected showing that there was significant difference in the pre-test and post-test scores.

Because of the small sample size, it was necessary to calculate the effect size of this pre-

post test to measure the magnitude of a treatment effect. The effect size found to be 0.60

measured to be a large effect size. The Pearson Correlation was calculated at 0.096,


showing a very weak reliability correlation between the two variables. Table 4.5, below,

shows the pre-test and post test results of the junior and senior focus group.

Table 4.5 Dependent t-Test Results for Junior and Senior Pre-Test and Post-Test

Pre-Test Junior and Senior Post-Test Junior and Senior

Mean 5.833333333 7.5

Variance 2.166666667 0.7

Observations 6 6

Pearson Correlation -0.243599383


df 5

t Stat -2.192645048

P(T<=t) one-tail 0.039915063


P(T<=t) two-tail 0.079830126


T(5)= 2.192645049, p < 0.5

When reviewing the data, the pre-test average for the junior and senior students

was 5.833 and the post-test average was 7.5. The results of this dependent t-test show that

T(5)= 2.192645049, p < 0.5. Therefore, the null hypothesis that there was no difference

must be rejected showing that there was significant difference in the pre-test and post-test

scores. The Pearson Correlation measured to be 0.24, showing a weak relationship

between the two variables. Because of the small sample size, it was necessary to calculate

the effect size of this dependent t-test to measure the magnitude of a treatment effect. The


effect size found to be 0.57 measured to be a large effect size. This shows there is a

strong significance in the two variables even though the sample size is small.

A pre-survey was also used during the research. A ten question self-perception

survey was given and assessed using chi-square statistics. Table 4.5 shows the questions

in the survey as well as the significance of each question. The answers were calculated

using a scale where an answer regarding positive self-perception received the most points

and an answer regarding a negative self-perception was awarded the least amount of

points.

Table 4.6 Chi-Square Self-Perception Survey

n=10 Χ2

Question 1: The media plays a part in how girls my age feel about their bodies. 19***Question 2: Girls my age are affected by comments from peers about weight, appearance, and dress.

18***

Question 3: I think I would have more friends if I looked different. 27***Question 4: I feel good about myself 15**Question 5: I have been made fun of because of my weight. 11**Question 6: I eat when I feel nervous, anxious, lonely or depressed. 7Question 7: I think about my weight, eating habits, and body size…. 6Question 8: I would consider myself to have high self-esteem. 2Question 9: I am terrified of being overweight. 6*Question 10: I think I am pretty. 13**

*p<.05, **p<.01, ***p<.001

A chi square was used to measure each question for significance. A high level of

significance meant that p<.05, p < .01 or that p < .001 for the highest level of

significance. Questions 1, 2, 3, 4, 5, and 10 were all found to be significant using the chi-

square statistic. This means that a high percentage of students answered close to the same

if not the same on these questions. All eighteen girls in the study agreed or strongly


agreed that girls are affected by the media as well as comments from their peers,

questions one and two respectively. Question three found that seventeen out of the

eighteen girls disagreed or strongly disagreed that they would have more friends if they

looked different. All but one participant answered they felt good about themselves

sometimes or often found in question four. Only three girls answered that they had

sometimes been made fun of because of their weight, and the remaining fifteen rarely or

never were made fun of because of their weight. The final question on the survey was

found to be significant because thirteen of the eighteen girls believed they were pretty.

To ensure reliability, the written assessments were given to each group at the

same point during each focus group session. Each of the focus groups was given the same

question in the same order, and the survey used was found from a previous peer-reviewed

research study. The Cronbach’s Alpha reliability coefficient was calculated at α = .71.

This showed that the questions in the survey had a relatively high internal consistency

with each question.

Focus question three researched how using seminar teaching in health education

could affect the attitudes of the students. This focus question was measured by student

and teacher journals as well as short answer written responses from an exit slip given to

the students. This focus questions was also measured by the verbal responses of students

during a series of pre-determined focus group questions.

The teacher journal prompts regarded the impression of the group, the behavioral

patterns which changed throughout the class, the willingness of the girls to participate

during the activities, and what changes should have been made during the study to make


the best use of the allotted time. All three groups were initially quiet and reserved. Many

of the participants did not talk to others around them and were anxious to see what the

session would entail. In each group session, the talking and interaction increased after the

introductory activity or the “icebreaker” activity. This gave the participants the chance to

interact with people they may not know in the group. All eighteen girls were very willing

to participate in the activities as well as share thoughts and opinions on the focus group

questions. The teacher journal entries noted that more time should have been allotted to

the focus group discussion. The conversations could have lasted longer in order to gather

more data, and the implications of this finding will be discussed further in Chapter five.

The students were asked to complete two journal topics. The first was simply to

list three things they like about themselves. These responses showed that 52% of the

answers were a part of their body such as height, eyes, legs, belly button, and curly hair.

Personality trait such as outgoing personality, a bubbly spirit, good listener, and hard

worker were the answers of 31% of the participants. Lastly, 13% answered with a

specific skill they have such as athletic ability or making cupcakes. Four percent of the

answers were regarding the participant’s intelligence or common sense. The second

journal question asked them to write a note to a student who was their age who was

struggling with self-esteem issues because of people who were bullying her. It was asked

of the participants to write her a note of encouragement. One student in the freshman

focus group wrote the following, “I know it’s hard right now, but this will pass. Don’t let

others dictate who you are and will become. Often the person bullying you has less self-

esteem than you do.” A participant in the sophomore group wrote, “Regardless of the

opinions of these few insecure people, you are beautiful no matter what.” Another


sophomore student wrote, “My advice to you is to find something that you are really

good at and focus on it. Never give up on your dreams and goals because there are always

going to be people who want to put you down.” A member of the junior class wrote this

note,

“Dear Girl,

You have no idea how beautiful you really are. God made you to be who you are- you are

perfect. You can’t let what some ignorant, people say affect you to the point that they

make your decisions for you. If you let them control your body image and self-esteem,

you aren’t your perfect self anymore. Love yourself the way God loves you, and take care

of yourself. Be your own person and don’t be afraid to be different. The people who

make fun of you are just cowards who don’t know how to think for themselves.”

These journal responses differed in format and length, but they all encouraged an

adolescent going through a tough time at school. They had consistent themes of

encouraging a hobby and surrounding themselves in a positive environment. Many had

religious references but all offered positive words of encouragement.

A series of pre-determined focus group questions were asked to each of the

groups in order to spark conversation regarding self-esteem, eating disorders, and self-

image. The questions were open ended to allow the student to interpret the questions and

answer in their own words. There was no time limit on these questions, but each group

used fifteen to twenty minutes of the group time to answer and discuss these questions.

Question 1: What do you think of when you think of self-esteem/self-image?

This question was answered with many common themes such as, weight, how you

portray yourself, how you feel when you look in the mirror, and how good one feels


about him or herself. One freshman student stated the following, “It is definitely a

positive thing to have lots of self-esteem, because I would rather have too much than too

little.” This question was the beginning of the conversation, and dialogue was not as

strong as towards the end of the focus group conversation.

Question 2: What role does the media/TV/internet play in teenager’s self-esteem?

There was a resounding consensus from all females in the study who agreed that

the media has a huge impact on the way young girls view themselves and their bodies.

One senior student summed it up by saying the following, “I think it (the media) plays a

negative role. When you turn on the TV you see skinny, glamorous people. It makes us

feel like we aren’t good enough.” One sophomore student got the conversation going

with the following statement, “Nobody wants to watch ugly, fat people do anything, so

we are always shown images of really beautiful people.” This question had the girls

talking more than any other question. It frustrated them trying to live up to this standard

that the media set for girls their age.

Question 3: Is the media geared more at females than males?

Question three brought about conversation of the double standard in society

concerning body image and body type. This conversation had two differing opinions.

Many participants thought that males had just as many pressures as females. One

sophomore student added this comment, “The media forces guys to be built up and have a

six-pack. We think that is hot because we saw it on the television.” The girls, however,

did consent in the fact that females are often the gender who looks past those

imperfections of their significant other. “Guys see that as the stereo-type of the perfect


woman,” said one senior student when discussing how males sometimes can’t look past

the imperfections.

Question 4: What can someone your age do to increase their self-esteem?

This subject brought about many different ideas to increase self-esteem. A

freshman student thought they could, “talk to a counselor or make sure they are doing

what they think is right for themselves.” A sophomore participant had this idea, “watch

the people you hang out with and find something you like to do or collect. I like to buy

shoes and you should always be able to do something nice for yourself.” A member of

the senior class had this suggestion, “Turn off your TV and deactivate your Facebook.

Sometimes you need a break from comparing yourselves to others.”

Questions 5, 6, and 7 were used as assessment tools to show gains in learning

from the lesson that was taught before the focus group question session. These questions

were open ended, but were directed toward having the participant verbally tell the

definition they had just been taught during the power point.

Question 5: What is your definition of anorexia nervosa?

The freshman focus group had all correct responses of appropriate definition of

anorexia. One student said, “A person who doesn’t eat enough and worries about their

food.” Another student commented, “Someone who doesn’t eat and worries about their

weight”. The sophomore group had three girls respond with a correct definition of

anorexia nervosa. One student answered incorrectly with the following statement, “girls

with anorexia are always throwing up and barely eat.” The point of this exercise was to


cross check the information that was just taught in the lesson. The majority of the girls

answered correctly, while only one answer was considered to be incorrect.

Question 6: What is your definition of bulimia nervosa?

The topic of bulimia in the sophomore focus group sparked a personal statement

from one of the participants. One student shared the following on her own accord. “I used

to be anorexic and bulimic. My friend and I were both fat and got tormented daily.” This

student was not prompted to discuss personal stories, but said that she felt comfortable in

this group setting to share. The other answers from the other participants ranged from a

person who denies they have a problem, a person who makes frequent trips to the

bathroom and someone who likes the social aspect of eating with people but they don’t

like what the food does to them. When reviewing the answers as an assessment, the

responses all fit the description of bulimia nervosa.

Question 7: What is the difference between binge eating disorder and a person who is

bulimic?

This question was combining two of the topics in the lesson in order to check for

understanding. Bulimia nervosa and binge eating disorder have many similarities

regarding shame of food consumption and still being able to appear normal to friends and

family. This question was answered correctly by all of the people who volunteered to

answer. One freshman student simply said, “you don’t throw up after you binge eat.” One

sophomore student added, “The difference is not throwing up after you eat.” A senior

participant added this true fact. “You eat in secret while binge eating.” The assessment of


these answers show understanding of the differences between binge eating disorder and

bulimia nervosa.

Question 8: What would you do if you had a friend who you suspected had an eating

disorder?

The conversation about this question was almost identical in each of the three

focus groups. Every girl that answered said they would first confront their friend about

the problem and if that did not work, they would go talk with a school counselor or an

adult about the problem.

Question 9: If you had a minute with a school bully, what would you tell them about the

effects they have on the people they bully?

This question was answered with a sense of passion in their voices. These girls

know how much people’s words and actions can affect the lives of the people being

bullied. Some knew this from experience. “I told a guy that used to bully me in high

school that I had to have psychotherapy and go to lots of counseling because of you.”

One junior student added this comment, “(I would) have them walk in some else’s shoes.

How would you feel if you looked like so-and-so and someone told you (that) you could

never amount to anything?” Another senior student said they would try to show the bully

what they were doing to these students long term. “I would tell them to look in the mirror

because they aren’t perfect either. I would try to help them understand what they are

actually doing to these people. Nobody deserves that.”


Question 10: What other factors effect girls and their self-esteem and body image?

The final question was used to measure other factors that effect self-esteem in

young female’s lives. The freshman group believed that boys are a big influence on girl’s

perceptions of themselves. The sophomore focus group though that peer pressure from

other friends and boys they may like affect these thoughts. The junior and senior group

thought it was difficult being around skinny friends and that parents are a really big

influence. One junior student added, “sometimes the pressure is just too much.”

The last form of qualitative assessment used was a three question exit slip

regarding the student’s opinions and attitudes about the class. The questions asked what

the student enjoyed most about the group time, what they liked or disliked about a small

group setting, and how this lesson compared with their high school health education

class. These are presented as percentages due to the girls answering with multiple

responses on some of the questions. The girls most enjoyed the discussion during the

group with 65% of the participants including this in their answer. There were 24% of the

students who included feeling comfortable and open to talk about the subject. The third

answer theme regarded a high interest level in the selected topic and the information

learned which 11% of the participants included in their answer.

The second question asked what the students liked or disliked about the meeting

time. The responses showed 55% of the participants like the openness of the group time

and how they felt comfortable to talk and respond. The enjoyment of the small group

setting was included on 27% of the answers. The remaining responses included that they

like or disliked nothing at 9%, they liked everything at 5%, and 4% liked the selected

topic.


The final question regarded how this class compared with their high school health

education class. The focus of this study was to use other forms of instructional techniques

to reach this new generation of teenagers and young adults. The responses to this

question varied greatly. There were 32% of the answers that discussed the session being

more in depth than high school health education. About 16% of students thought this

group time had more conversation and was a much smaller setting than their high school

health class. A response from 12% of the students said it was more personal and opinions

could be shared instead of just learning. There were two students who thought this class

was exactly like their health class in high school as well as two students who simply

stated they liked this more than high school health class. One student made comments on

their exit slip regarding having a man teacher in a co-ed setting of 35 students. She

thought this was much more personal and felt like her opinions and questions were heard.

Surprisingly, one student in the research study had no health education classes throughout

high school. This is one student’s response to this final question. “I learned more about

the subject by being more involved in discussion. High school health was more of a

lecture with homework deal.”

The data in this chapter will be further analyzed in the next chapter to discuss the

implications of this data and recommendations for further research on this subject.

CHAPTER FIVE: ANALYSIS OF DATA AND RESULTS

Analysis of Results


Focus question one used peer feedback from an instructional plan to increase the

validity and reliability of the research as well as to ensure the best possible results from

the study. The data were analyzed by coding reoccurring themes in the feedback. The

data was used to make appropriate changes in the instructional plan before initiating the

study. Themes discovered in the feedback helped to ensure reliability of the research. The

validity was made certain because the faculty members checked to make sure the

assessment tools used were measuring what they intended to measure. The results of this

feedback were significant to the study because they ensured the most was being made out

of the hour spent with the participating students.

The second focus question used a pre-test, post-test, and pre-survey and the data

were analyzed statistically. The pre-test of each group was measured by an ANOVA and

found there was no significant difference between the three groups. This means all three

groups started off on the same knowledge level regarding the subject matter. A second

ANOVA was run to calculate the scores of all three group’s post-test scores. This test

proved to have no significant difference between the three groups. These data can be

interpreted to mean that all three focus groups finished at the same knowledge level. The

question is whether or not the groups increased knowledge between the pre-test and the

post-test. A dependent t-test was calculated for each group using the pre-test and post-test

scores. The freshman students’ post-test mean scores, although increasing from 5.6 to a

7.3, were calculated at no significant difference.. The results of this dependent t-test show

that T(5)= 1.97642538, p < 0.5. Therefore, the null hypothesis that there was no difference

must be accepted which shows that there was no significant difference in the pre-test and


post-test scores. The effect size, however, calculated at 0.567, which indicated a large

magnitude for the treatment effect.

The pre/post test scores from the sophomore focus group were also calculated in a

dependent t-test. The results of this dependent t-test show that T(5) = 2.711630723, p <

0.5. Therefore, the null hypothesis that there was no difference must be rejected showing

that there was significant difference in the pre-test and post-test scores. The effect size of

the sophomore group was found to be 0.60 which measured to be a large effect size also

showing that the treatment had a large effect on this group as well.

The answers from the junior and senior focus group pre-test and post-test were

also calculated in a dependent t-test. The results of this dependent t-test show that T(5) =

2.192645049, p < 0.5. Therefore, the null hypothesis that there was no difference must be

rejected showing that there was significant difference in the pre-test and post-test scores.

The effect size of the junior and senior group was found to be 0.57, which measured to be

a large effect size.

When comparing the gains from the pre-test to the post-test, all three groups had

an increase of correct answers from the pre-test to the post-test. The test was reliable

because it was reviewed by peers to prevent bias and the same test was given to all

students for the pre-test and post-test. The data showed validity because it was used to

measure prior knowledge as a pre-test, and then used to measure gains in knowledge as a

post-test. All three groups made gains in test scores from the beginning of the focus

group to the end of the group meeting time.

Another form of quantifiable data was the use of the pre-survey. The data was

analyzed using a chi square as well as a Cronbach’s Alpha. The data showed that six of


the ten questions asked were significant. This survey was not an assessment tool for

knowledge, but a survey of self-perception of the participants. The students believed that

the media and peers have a strong impact on their self-esteem and self-image. The

majority of the participants were terrified of being overweight, however they feel good

about themselves on a regular basis, and have rarely, if ever, been made fun of about their

weight. These results were not calculated to show learning patterns or to show gains in

knowledge. The survey was taken to show the pre-determined attitudes of the participants

in the study. The majority of the students, although not all, answered these questions in a

way a self-confident and healthy female should answer them. This was important to know

the type of person who was participating in the conversation of the focus group, as well

as the type of person was answering the student journals and taking the tests given.

When comparing this research to the research found in the literature, the results

correlated the most with the writings of Kitzinger. In 1994, Kitzinger described how

focus groups reach a part of the student that other methods cannot reach- revealing a

dimension that remains hidden by using other methods such as one-to-one interviews or

traditional questionnaires. In 2004, he stated that group participants provide an audience

for each other encouraging a greater variety of communication that is not within more

traditional methods of data collection. This research proved this theory to be correct. It

forced six girls who may or may not have known each other to be placed in a room and

talk about sensitive issues with regards to their bodies and self-esteem. It immediately

provided a setting where these girls felt comfortable talking to each other and an

understanding that these girls were going through the same problems as a college age

female student.


Thackeray and Neiger (2004) also wrote about how focus groups can be a

strategy to develop this communication. However, these two authors wrote in the same

article that focus groups are not always the best method for instruction. They believed

that the students may rely on “group think” or when students go along with the group

opinion instead of being different. The participants in the research study proved this

method to be incorrect. The girls were open about having differing opinions on certain

subjects. They were okay with debating and getting their voice heard to the rest of the

group. Although it is difficult to rule out group think completely, there was little

hesitation to converse within the focus group.

Lilla Vicsek (2010) stated that it is inappropriate to take data from a small sample

size and infer that all persons of a given population believe the same way as that group. I

agree with her and the other literature that shares this opinion. It is a researcher’s hope

that the data gathered is pertinent to the larger masses but that cannot be assumed without

further research due to the small sample size of this action research study.

Hendricks (2009) stated that reflection allows the educator to consider issues and

problems relevant to his or her own practice and then act in ways to study or resolve

those issues, guiding his or her own development as a professional educator. The act of

teacher journaling was used as an effective tool during this research. The ability to look

back at the writings taken while the focus group was in session was helpful during the

research analysis. The use of the data gathered from the first group was to better the

instruction of the second group, which was also used to help make the third group even

more successful. The notes taken during and after session gave me an idea of who these

girls were from when the class began and when the class ended.


This research was conducted using three separate focus groups of six girls. The

focus group time was set for an hour. Onwuegbuzie et al. (2010), along with many other

researchers state that focus groups should be conducted for one to two hours and should

consist of six to twelve participants. This was the appropriate number of students for this

study. Each participant had plenty of opportunities to speak and voice their opinion. The

focus group could have been extended to an hour and a half to ensure that everyone had

the appropriate, if not some excess time allotted for each instructional assessment.

Discussion

One possible reason this study produced these results is because these girls are

eager to learn information relevant to what is going on in their life or the lives of people

around them. If these girls are coming from a public high school, there is no sound reason

why they should not know this information already. Each state has standards which

should teach them this vital information about their bodies. These participants were

willing to learn new information and participate in engaging activities. This increased

their knowledge, which is shown by the pre-post test, and also gave them information to

think about with regards to their own life. This study’s findings are very relevant to the

high school age population. This is not only about the subject itself, but about the use of

different instructional techniques to reach children.

This study ensures credibility by with the use of structural corroboration. This is

also known as triangulation or the use of multiple data sources in the research. This study

used focus group questions, journals by the teacher and students, as well as written tests

and surveys to guarantee credibility. This study presented all opposing views in the


Literature Review found in Chapter two of this thesis to ensure fairness. This research

presents a strong argument for the use of discussion as an instructional method. Although

the sample size was small, the students shared many of the same opinions and thoughts

on the subject. The data from the pre-test and post-test was the strongest evidence to

suggest that this style of learning works. The pre-test and post-test of all three groups

showed an increase in scores. To guarantee these same results on this population as a

whole, this instructional technique would need to be used on a larger group of students or

for a longer amount of time. This is a great starting point to show the benefits of learning

through discussion.

Implications

With the use of a small sample size, it would be hopeful to generalize these

findings to the larger population but not necessarily accurate. It would be best to try this

form of instruction on a larger group of individuals from the high school age to college

age. With a less sensitive topic, the middle school population could also be included with

this learning style. In regards to the pre-survey, I feel that the majority of young females

would have the same responses. Almost all would agree that the media, television and

boys play a large part on self-image and self-esteem of young girls. Many responses to

questions were not statistically significant because the answers varied immensely. These

responses would most likely match the general population as well.

The major themes found in the qualitative research started with the teacher

journals. In each group, the students seemed nervous and timid due to not knowing what

to expect from the lesson. Also, in all three groups these same students became more


comfortable talking and participating as time passed. The focus group questions

presented many common themes. All three groups felt that the media played a huge role

in how girls feel about themselves and their bodies. Also, the emerging theme was that

boys have some pressure from the media, but that females feel the most pressure to look

like the perfect image. Every response regarding on how to approach a friend with a

suspected eating disorder was answered by the idea of confronting them with the problem

and if that does not work to contact another adult or counselor. The last question

discussed the other factors that impact girls and their self-esteem. The main themes

throughout the sessions were boys, peer pressure, and pressure by parents. This study

would be important to any health professional trying to reach what seems to be an

unreachable generation of students. If an educator is passionate about reaching his or her

students, s/he are looking for any instructional technique that could help. I believe this

could be that technique for some educators.

This study required very few participants, but selfishly I wish many more could

have participated. To hear the responses of the students on their exit slips, and the

positive things they said about one hour of class made it a success. Some of these

students had never been exposed to any form of health education class, and the goal of

any health educator is to get students the information they need to live the healthiest

lifestyle possible. This study helped me realize that health education is my passion.

Teaching young students health education is the best way for me to reach these young

and impressionable students. We must teach children and young adults by the

instructional techniques that allow them to understand the information which will make

them productive citizens in the future.


Impact on Student Learning

The pre-test and post-test of this research show the impact this lesson had on

student learning. In each focus group, the students showed an increase in information

learned from the time the class started, until the time the class ended. The freshman focus

group went from an average of 5.6 on the pre-test to a mean of 7.3 on the post-test. The

sophomore focus group scored an average of 5.5 on the pre-test and finished with a mean

of 7.2 on the post test. The junior and senior focus group scored an average of 5.8 on the

pre-test and finished with an average of 7.5 on the post test. Because the test was only out

of eight questions, the statistical data was used to interpret that there was significance in

the test scores of the sophomore students as well as in the junior and senior focus group.

The students were also assessed during the focus question section of the focus group.

This included questions regarding the information learned in the power point lesson. The

responses, recorded in chapter four, show that only one student out of the thirteen who

answered, responded incorrectly.

Recommendations for Future Research

After completing this study, it would have been better to spend more time on each

instructional tool in the lesson. An hour was enough for the population of people in this

study, however, if a group would be able to meet more than once it would have shown

the learning results over time. It would also be better to spend more time on the focus

group questions. In all three focus groups, more time could have been spent on the

discussion than the time allotted. These teenage girls wanted to be heard and sometimes

all they need is a chance to talk. The next step to extend this research would be a week or


two week unit on a topic using small groups and implementing discussion in each lesson.

This pre-test and post-test would provide better data for the long term learning from focus

groups.

This study has the ability to transform outdated health education curriculums.

These participants felt more comfortable talking about relevant health topics,

participating in discussions, and asking questions in one hour than they felt during their

entire experience in high school health education. There are serious consequences that

happen in our youth because of the lack of information and understanding. They range

from teenage pregnancy to eating disorders to sexually transmitted diseases. This is not

saying that this type of instruction would be a cure all for those problems, but we must

find a way to reach this new generation of students.

References


Charles, C.M., & Mertler, C.A. (2002). Introduction to Educational Research: 4th

Edition. Boston, MA: Allyn and Bacon.

Eisenburg, M. (1997). Viewpoints of Minnesota students on school-based

Sexuality education. Journal of School Health, 67, 322-326

Giarratano, S. (1991) Entering Adulthood: Looking at Body Image and Eating

Disorders. A Curriculum for Grades 9-12. Contemporary Health Series.

Hendricks, C. (2009). Improving Schools Through Action Research. Upper Saddle River,

NJ: Pearson Education, Inc.

Kitzinger, J. (1994). The methodology of focus groups: The importance of interaction

between research participants. Sociology of Health and Illness, 16(1), 103-121.

Krueger, R.A. (1994). Focus groups: A practical guide for applied research (2nd ed.)

London: Sage.

Kwan, M., Arbour-Nicitopoulos, K., Lowe, D., Taman, S., & Faulkner, G. (2010).

Student reception, sources, and believability of health-related

information. Journal of American College Health, 58(6), 555-562.

LaGrange College Education Department (2008). The conceptual framework. LaGrange,

Georgia: LaGrange College.


Morgan, D.L., & Krueger, R.A. (1993). When to use focus groups and why. In D.L.

Morgan (Ed.), Successful focus groups: Advancing the state of the art (p. 3-20).

London: Sage.

National Eating Disorders Association (NEDA). (2010). Facts and Statistics. Retrieved

from www.nationaleatingdisorders.com

Onwuegbuzie, A, Leech, N., & Collins, K. (2010). Innovative data collection strategies in

qualitative research. Qualitative Report, (15)3, 696-726.

Phillips, D.C. (1995). The good, the bad and the ugly: The many faces of constructivism.

Educational Researcher. (24)7, 5-12.

Popham, J. (2008) Classroom Assessment: What Teachers Need to Know (5th ed.).

Boston, MA: Pearson Education, Inc.

Rowland, A. (2007). Not just “gym” anymore: The role of journaling in physical

education courses. Clearing House: A Journal of Educational Strategies, Issues

and Ideas, (81)2, 59-60.

Salkind, N. (2010) Statistics for People Who (Think They) Hate Statistics, Thousand

Oaks, CA: SAGE Publications, Inc.

http://www.nationaleatingdisorders.com/


Thackeray, R., Neiger, B., (2004). Misconceptions of focus groups: implications for

health education practice. American Journal of Health Education, (35)4, 214-219.

Tiggemann, M. (2000). I would rather be size 10 than have straight a’s: A focus group

study of adolescent girls’ wish to be thinner. Journal of Adolescence,

(23)6, 645

-659.

Vicsek, L. (2010). Issues in the analysis of focus groups: generalisability, quantifiability,

treatment of context and quotations. The Qualitative Report, (15)1, 122-141.

Appendix A

Instructional Plan

Criteria Description


Participants Involved (Age)

Freshman, Sophomore, Junior and Senior female students enrolled at LaGrange College6-10 per group

Content Area Self-Image, Self-Esteem, Eating DisordersStandards Met

HE H.S. 2 Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors. e) explain the influences of the media on teen body imageHE H.S. 6 Students will demonstrate the ability to use goal-setting skills to enhance health.a)evaluate personal health and health practices

Time Frame Each focus group will be meeting for one hour. Rationale This study is designed to see the effect of seminar teaching in health

education on students’ attitudes and ability to discuss specific health education topics in a group setting.

Role of Teacher

The teacher is to facilitate discussion and lead activities. The students will be led through individual and group activities as well as guided discussions in a focus group setting.

Materials Pre-Test-PencilSurvey-PencilPower Point Presentation- Computer and ProjectorJournals (Student and Teacher)-Paper and PencilFocus Group QuestionsExit Slip-Pencil

Procedures All of the following are attached documents.Ice Breaker Activity-Introduce your neighborPre-Test/Survey-15 questions totalJournal ActivitiesPower Point-instruction about the unit topicFocus Group-discuss the pre-written questionsExit Slip

Assessments journal writings, pre-test, survey, behavioral patterns and participation during discussion, verbal answers to focus group questions, post-test, exit slip

Modifications The teacher may modify the lesson by reading the tests and assignments to the students when necessary.

Appendix B

Peer Evaluated Rubric


Criteria Description Open-Ended FeedbackParticipants Involved (Age)

Freshman, Sophomore, Junior and Senior female students enrolled at LaGrange College6-10 per group

Do you feel the number of students and focus groups is an appropriate number for this study?

Content Area Self-Image, Self-Esteem, Eating Disorders

Standards Met HE H.S. 2 Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors. e) explain the influences of the media on teen body imageHE H.S. 6 Students will demonstrate the ability to use goal-setting skills to enhance health.a)evaluate personal health and health practices

Do you feel these standards are appropriate for this unit topic?

Time Frame Each focus group will be meeting for one hour.

Do you feel that this enough time with the girls in this study?

Rationale This study is designed to see the effect of seminar teaching in health education on students’ attitudes and ability to discuss specific health education topics in a group setting.

Role of Teacher

The teacher is to facilitate discussion and lead activities. The students will be led through individual and group activities as well as guided discussions in a focus group setting.

What suggestions do you have to make the role of the teacher more effective?

Materials Pre-Test-PencilSurvey-PencilPower Point Presentation- Computer and ProjectorJournals (Student and Teacher)-Paper and PencilFocus Group QuestionsPost-Test/Exit Slip-Pencil

Please list any other materials that may not be listed that you feel may add to this study.

Procedures All of the following are attached documents.Ice Breaker Activity-Introduce your neighborPre-Test/Survey-15 questions total

Please list any comments about these instruments.Ice Breaker Activity-


Journal ActivitiesPower Point-instruction about the unit topicFocus Group-discuss the pre-written questionsExit Slip

Pre-Test-

Survey-

Journal Activities (Student)-

Journal Prompts (Teacher)-

Power Point Presentation-

Focus Group Questions-

Exit Slip-

Assessments Journal WritingsPre-TestPre-SurveyBehavioral PatternsParticipationVerbal answers to focus group questionsExit Slip

What other assessments could be included in this study?

Do you feel this is an adequate number of assessments to obtain the results desired?

Modifications The teacher may modify the lesson by reading the tests and assignments to the students when necessary.

Are there any other modifications not listed that would be beneficial to consider?

Appendix C


Pre-Test

Pre-Test

1. Which of the following are considered an eating disorder? (circle all that apply)

Bulimia Nervosa Anorexia Nervosa Binge Eating Disorder Obesity

2. Which of the following is NOT a symptom of Anorexia Nervosa?a) Extreme weight lossb) Obsession with calories, dieting, food, and weightc) Extreme exercise routinesd) Eating large amounts of food at one time

3. How many Americans struggle with the eating disorders Anorexia Nervosa and Bulimia Nervosa?

a) 1 millionb) 5 millionc) 100,000d) 10 million

4. What is NOT characteristic of Binge Eating Disorder?a) Feeling ashamed or disgusted by the amount of food consumedb) Feeling out of control while eatingc) Eating large amounts of food in short periods of timed) Eating in secret placese) None of the above

Match the Following:

Self-Esteem potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss

Body Image Self-esteem is all about how much people value themselves, the pride they feel in themselves, and how

worthwhile they feel

Anorexia Nervosa potentially life-threatening eating disorder characterized by a cycle of bingeing compensated by behaviors such as

self-induced vomiting designed to undo the effects of binge eating

Bulimia Nervosa How you see yourself when you look in the mirror or picture yourself in your mind, what you believe about your own appearance

Appendix D


Self-Perception Survey

1. The media (television, magazines, and internet) plays a part in how girls my age feel about their bodies.

Strongly Agree Agree Disagree Strongly Disagree

2. Girls my age are affected by comments from peers about weight, appearance and dress.


3. I think I would have more friends if I looked different.


4. I feel good about myself.

Often Sometimes Rarely Never

5. I have been made fun of because of my weight.


6. I eat when I feel nervous, anxious, lonely or depressed.


7. I think about my weight, eating habits, and body size…


8. I would consider myself to have high self-esteem.

Yes No Not Sure

9. I am terrified of being overweight.

Yes No Not Sure

10. I think I am pretty.

Yes No Not Sure

Giarratano, Susan. (1991) Entering Adulthood: Looking at Body Image and Eating Disorders. A Curriculum for Grades 9-12. Contemporary Health Series.

Appendix E


Post-Test

1. Which of the following are considered an eating disorder? (circle all that apply)

Bulimia Nervosa Anorexia Nervosa Binge Eating DisorderObesity

2. Which of the following is NOT a symptom of Anorexia Nervosa?e) Extreme weight lossf) Obsession with calories, dieting, food, and weightg) Extreme exercise routinesh) Eating large amounts of food at one time

3. How many American females struggle with the eating disorders such as Anorexia Nervosa and Bulimia Nervosa?

e) 1 millionf) 5 milliong) 100,000h) 10 million

4. What is NOT characteristic of Binge Eating Disorder?f) Feeling ashamed or disgusted by the amount of food consumedg) Feeling out of control while eatingh) Eating large amounts of food in short periods of timei) Eating in secret placesj) None of the above

Match The Following:

Self-Esteem potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss

Body Image Self-esteem is all about how much people value themselves, the pride they feel in themselves, and how worthwhile they feel

Anorexia Nervosa potentially life-threatening eating disorder characterized by a cycle of bingeing compensated by behaviors such as self-induced vomiting designed to undo the effects of binge eating

Bulimia Nervosa How you see yourself when you look in the mirror or picture yourself in your mind, what you believe about your own appearance


Post-Test Continued

1. What did you most enjoy about our group time?

2. What did you like or dislike about meeting in a small group setting?

3. How did this compare with your high school health education class?

How do you answer any health related questions you may have?

Pick your top 5 choices and rate them 1-5

(1 being used most frequently, 5 being used least frequently)

Internet___ Friends___ Parents___ Resources on Campus___ Doctor___

Magazines___ Leaflets/Pamphlets___ Religion___ Resident Advisors___


Appendix F

Icebreaker Activity

Name:

Brothers and Sisters:

Favorite Color:

Favorite Hobby Outside of School:

Favorite Sport:

Favorite Place to Shop:

Dream Vacation Spot:

Favorite Actor/Actress:


Appendix G

Journal Prompts

Student Journal Prompts

1) Write 3 things you like about yourself.

2) Write a letter to a girl your age that has low self esteem because others make fun of her at school.

Teacher Journal Prompts

1) What is your initial impression about this group of girls?

2) What behavioral patterns changed throughout the class?

3) How willing are the girls to participate in the activities?

4) What would you have done differently in the lesson to make more of an impact in the time allotted?


Appendix H

Focus Group Questions

Opening Question- Tell us who you are and your favorite holiday.

Introduction- What do you think of whenyou think of self-esteem/self-

image?

(Prompts: Tell me more…Think back…Explain further…Anything

else?...Describe what you mean…I don’t understand…Can you give me an

example?...Does anyone see it differently?...Are there other points of

view?)

Key Question 1- What role does the media/TV/internet play in teenager’s

self-esteem?

o Is the media geared more at females than males?

o Is this a fair double standard?

Key Question 2- What can someone your age do to feel better about

themselves or increase self-esteem?

Key Question 3- Tell me your definition of Anorexia Nervosa.

Key Question 4- Tell me your definition of Bulimia Nervosa.

Key Question 5- What is the difference between binge eating disorder and

a person who is bulimic?

Ending Question 1- Tell me what you would do if you suspected your

friend had an eating disorder.

Ending Question 2- If you had one minute with a school bully, what would

you tell him about the effects they have on the students they pick on?

Summary- What other factors effect girls and their self-esteem and body image?

Final Question- Is there anything we did not discuss that you would like to talk about?

home.lagrange.eduhome.lagrange.edu/educate/advanced programs/m.ed. d… · web viewanorexia...

Documents