HL 367 Major Project Winter 2014

Our Mission: To increase awareness of the nutritional demands of

pregnancy in pregnant women through education.

Jenea Wheeler

Marilyn Stone

http://www.healthytimesblog.com/wp-content/uploads/2011/01/Eat-for-two.jpg

Table of Contents
Introduction..page 3
Section 1: Missionpages 4-5
Section 2: Review of the Related Literature..pages 6-15
Section 3: Synthesis of Literaturepages 16-20
Section 3 Continued: Synthesis of Literature Programming.. pages 21-25
Section 4: Evaluation Design/Mission Fit..pages 26-27
Section 5: Marketing and Communication..page 28
Section 6: Granting Agency..page 29
Section 7: Webliographypages 30-32
Section 8: Reflection Paper..pages 33-34

Introduction
My name is Jenea Wheeler. I am a senior at Northern Michigan University, majoring in
Community Health Education. I was born in Virginia Beach, VA and have lived in
Marquette, MI for the past ten years. Currently I work full-time for a home health and
hospice agency in addition to going to college full-time. This upcoming May I plan on
graduating and pursuing my career as a Health Educator. As a Health Educator I want to
bring my attributes of being a compassionate, dedicated, knowledgeable, and hardworking woman into the community and help better lives. I believe that our future
depends on the generations being built today and that is why it is so important to educate
pregnant women about nutritional demands of their babies to enable and create more
healthy lives.

My name is Marilyn Stone. I was born in Libertyville, Illinois and have lived
there my whole life. I am a junior at Northern Michigan University, studying Community
Health Education and I am getting my certificate in the Licensed Practical Nursing
program. I am very passionate about nursing, and hope to one day become an RN. The
area that I am most interested in within the nursing profession is pediatrics and OB. I
have always been a very active and healthy person and there is a lot to change when
someone becomes pregnant because they have to care for their body and for the baby.
Nutrition is an important aspect in the change when someone becomes pregnant, and our
project will reflect the awareness of these nutritional changes.

Section 1: Mission
1. What is our mission?
Our Mission: To increase awareness of the nutritional demands of pregnancy in
pregnant women through education.
2. What are the variables in our mission?
Our variables are:
Dependent Variable: Awareness of the nutritional demands of pregnancy
Target Population: Pregnant Women
Independent Variable: Education
3. In what agency could we realize our mission?
We could realize our mission in the Women, Infants, and Children (WIC)
program. The WIC programs mission is To safeguard the health of low-income
women, infants, and children up to age 5 who are at nutrition risk by providing
nutritious foods to supplement diets, information on healthy eating, and referrals
to health care. (USDA,2013).

http://wic.fns.usda.gov/wps/pages/start.jsf

4. What job could we have in this agency and what is the job description for
that job?
A job/ position within this agency that would allow us to carry out our mission
would be a Nutritionist. The job description of a nutritionist is Nutritionists carry
out research and use scientific knowledge to provide information and advice

about the effects of food and nutrition on health and wellbeing.

(Nationalcareerservice,2012).
The link to job description:
https://nationalcareersservice.direct.gov.uk/advice/planning/jobprofiles/Pages/nutritionist.
aspx

4b. What is our job for this particular project?

Our job is to develop a program and evaluation plan to meet our mission to
increase awareness of the nutritional demands of pregnancy in pregnant women
through education. As such, we shall:
1. Assess the need to increase awareness of the nutritional demands of
pregnancy in pregnant women.
2. Identify measureable objectives designed to increase awareness of the
nutritional demands of pregnancy in pregnant women.
3. Plan an evidence-based program that has shown to increase awareness of
the nutritional demands of pregnancy.
4. Implement the Healthy Pregnancy Program that increases awareness of
the nutritional demands of pregnancy in pregnant women.
5. Evaluate to see if we have met our objectives/needs and increased the
awareness of the nutritional demands of pregnancy for pregnant women
through our program, and therefore, met our mission.

Section 2: Review of the Related Literature

5. What is our Mission and the four questions for analyzing the literature in order to
develop our program plan and evaluation plan in order to do our job as listed in 4b?
Our Mission is: To increase awareness of the nutritional demands of pregnancy in
pregnant women through education.
The mission variables are:
DV= Awareness of the nutritional demands of pregnancy
TP= Pregnant Women
IV= Education
The four Questions: To analyze the literature for relevant information, our four
questions with our mission dv and tp in are:
1. Does the piece identify need to increase awareness of the nutritional demands
of pregnancy in pregnant women?
2. Does the piece theoretically define awareness of the nutritional demands of
pregnancy?
3. Does the piece tell us how to measure awareness of the nutritional demands
of pregnancy?
4. Does the piece give us a model program or education that has shown to
increase the awareness of the nutritional demands of pregnancy in pregnant
women?
6. Which pieces shall we use to analyze the literature to develop our program plan
and evaluation plan designed to meet our mission?
We shall use the following pieces:
American Pregnancy Association. (2013) Pregnancy nutrition. Retrieved from:
http://americanpregnancy.org/pregnancyhealth/pregnancynutrition.html
Without a doubt, a nutritious, well-balanced eating plan can be one of the greatest
gifts you give to your soon-to-be-born baby. Pregnancy nutrition is essential to a
healthy baby. Ideally, adopting a healthy eating plan before pregnancy is best. No
matter how many weeks are left on your countdown calendar, its never too late to
start! Supplying your own body with a tasty blend of nutritious foods can not only
improve your fertility, keep you feeling healthy during pregnancy, and pave the
way for an easier labor, but it can also help to establish essential building blocks
of growth and overall health for your child.
The food we eat on a daily basis affects how our bodies work, how we heal and
grow, and how we maintain energy and strength for years to come. It also
determines the basic nutritional health that our children are born with, and
provides a model for their eating habits during childhood and beyond. Pregnancy
is the one time in your life when your eating habits directly affect another person.
Your decision to incorporate delicious vegetables, whole grains and legumes, lean
6

protein, and other wise food choices into your eating plan before and during
pregnancy will give your baby a strong start in life.
1. Does this piece identify need to change the dv in the tp?
Yes, the piece identifies the need to change the nutritional habits while pregnant
by providing information about proper protein, calcium, iron, folate/folic acid,
and vitamin C serving sizes per day.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy in pregnant women.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this article does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Children, Youth and Womens Health Service Nutrition Department. (2010). Nutrition
for Pregnancy and Breastfeeding.Government of South Australia and Womens &
Childrens Hospital. Retrieved from:
http://www.wch.sa.gov.au/services/az/other/nutrition/documents/Nutrition_for_Pregnanc
y_and_Breastfeeding.pdf
This article discusses being healthy before pregnancy, healthy eating during
pregnancy, common questions during pregnancy, healthy eating and
breastfeeding, and good nutrition for life. It goes through and explains different
quota in each of the categories up above and also gives visuals, like charts and
graphs and pictures, to show you how to properly maintain good nutrition at all
stages of pre and post pregnancy.
1. Does this piece identify need to change the dv in the tp?
Yes, this piece shows us the nutritional demands of pregnancy along with
questions that pregnant women have asked. These questions being answered in
the article gives us an understanding that there is a need to show pregnant women
how to properly go about nutrition during pregnancy.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece does not tell us how to measure awareness of the nutritional
demands of pregnancy in pregnant women.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this article does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.

Craig, G. J., & Dunn, W. (2007). Prenatal development and Childbirth. Understanding
Human Development (3 ed., pp. 73-74). Upper Saddle River, N.J.: Pearson/Prentice Hall.
Textbook contains maternal health and nutrition, along with prenatal health care.
It explains weight gain, malnutrition during pregnancy and the side effects.
1. Does this piece identify need to change the dv in the tp?
Yes, it talks about the nutritional demands for prenatal health and maternal health.
It also discusses the side effects of malnutrition for the mother and baby.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this book does not tell us how to measure awareness of the nutritional
demands of pregnancy in pregnant women.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, the book does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Healthline Editorial Team. (2012). Nutritional Needs During Pregnancy. Healthline.
Retrieved from: http://www.healthline.com/health/pregnancy/nutrition
During pregnancy your body has increased nutritional needs. Although the old
adage?eating for two? isn't entirely correct, you do require more macronutrients
(for example, calories, protein, and fluids) and micronutrients (for example,
calcium, folate, and iron).
1. Does this piece identify need to change the dv in the tp?
Yes, this piece describes that there is a need for change and it also shows a great
chart of what the recommendations are in order to change your nutritional health
as a pregnant women.
2. Does this piece theoretically define the dv?
Yes, it states that there is a need for the macronutrients and micronutrients as well
as increased nutritional needs including: calories, protein, calcium, folate, and
iron.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Herr, N. (2007). Passive vs. Active Learning. In The Sourcebook for Teaching Science.
Retrieved April 20, 2014, from http://www.csun.edu/science/ref/pedagogy/activepassive/active-passive-learning.html

This piece has an example of passive vs. active learning and shows it using a side-byside reference. This is based off of a science class and shows what the teacher and
student need to know and what is expected from each.
1. Does this piece identify need to change the dv in the tp?
No, this piece does not identify the need to change awareness of the nutritional
demands of pregnancy in pregnant women.
2. Does this piece theoretically define the dv?
No, this piece doesnt theoretically define awareness of the nutritional demands of
pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece does not show us how to measure the awareness of the nutritional
demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the dv
in the tp?
Yes, this piece gives us an overview of passive vs. active learning. This goes along
with our Healthy Pregnancy Program because we are teaching the mothers by using
active and passive strategies and each lesson is based off of it.

Hogan, P. (2014). Personal Interview with Patti Hogan.

She gave good advice on how to collaborate our ideas for our theoretical
definition.
1. Does this piece identify need to change the dv in the tp?
No, this piece does not identify need to change awareness of the nutritional
demands of pregnancy in pregnant women.
2. Does this piece theoretically define the dv?
Yes, she helped us piece out our ideas to create a sustainable theoretical
definition.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Ladipo, O. A. (2000). Nutrition in pregnancy: mineral and vitamin supplements 123.
The American Journal of Clinical Nutrition.
http://ajcn.nutrition.org/content/72/1/280s.full
Pregnancy is associated with physiologic changes that result in increased plasma
volume and red blood cells and decreased concentrations of circulating nutrientbinding proteins and micronutrients. In many developing countries, these
physiologic changes can be aggravated by undernutrition, leading to micronutrient
deficiency states, such as anemia, that can have disastrous consequences for both
mothers and newborn infants. Multiple micronutrients are often taken by pregnant
women in developed countries, but their benefits are limited, except for

prophylactic folic acid taken during the periconceptional period. Women in

developing countries may benefit from multiple-micronutrient prophylaxis in
pregnancy, but the underlying basis and rationale for changing from
supplementation with iron and folate to supplementation with multiple
micronutrients has not been debated in the context of existing program objectives.
There is an urgent need for this discussion so that both program effectiveness and
program efficacy can be improved.
1. Does this piece identify need to change the dv in the tp?
Yes, it discusses the need to change the nutrients and in pregnant women in
developing countries, states that micronutrient supplementation might reduce
maternal morbidity and mortality directly by treating a pregnancy-related illness
or indirectly by lowering the risk of complications at delivery.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not measure the awareness of the nutritional
demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
McGuire, M. K., & Picciano, M. F. (2009). Use of dietary supplements by pregnant and
lactating women in North America. The American Journal of Clinical Nutrition (89)2,
663-667. doi: 10.3945/ajcn.2008.26811B
Abstract
Nutrient requirements increase during periods of growth and development such as
pregnancy and lactation. In response, many clinicians recommend dietary
supplements during these important periods of the life cycle. Although there exist
some recommendations concerning the need for a limited number of nutrients in
supplemental form (eg, iron, folic acid, and iodine), there is a relative paucity of
data concerning the use of dietary supplements during pregnancy and lactation.
Limited data suggest, however, that usage is dependent on demographic,
sociologic, and economic factors. Thus, it is possible that the nation's most at-risk
populations may be those who are least likely to comply with these
recommendations. As researchers continue to study what is meant by optimal
nutrition during pregnancy and lactation, it is likely that additional
recommendations concerning dietary supplements will emerge. For example, it is
possible that increased consumption of some of the long-chain polyunsaturated
fatty acids during pregnancy or lactation may impart a benefit to infant health.
Understanding better the population dynamics related to supplement use during
these periods will be critical in implementation of campaigns designed to
encourage appropriate useand discourage inappropriate useof dietary
supplements during these important phases of human reproduction. The purpose
of this article is to briefly review what is known about the use of dietary

10

supplements in North America and, more specifically, in pregnant and lactating

women. In addition, information concerning barriers to supplement use is
discussed as are current recommendations for dietary supplement consumption
during these periods of the life cycle.
1. Does this piece identify need to change the dv in the tp?
Yes, the article states information on the nutritional requirements needed such as
vitamins that benefit infant health.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Ministry of Health. (2006). Food and Nutrition Guidelines for Healthy Pregnant and
Breastfeeding Women: A background paper. Wellington: Ministry of Health.
Retrieved from: http://www.health.govt.nz/system/files/documents/publications/foodand-nutrition-guidelines-preg-and-bfeed.pdf
This background paper brings together all the key areas of food and nutrition
affecting the health of pregnant and breastfeeding women. It is intended that
health practitioners, educators and caregivers will use this paper and the
accompanying health education booklets, Eating for Healthy Pregnant Women
and Eating for Healthy Breastfeeding Women, to provide sound advice and
support to pregnant and breastfeeding women and their families to achieve a
healthy lifestyle.
1. Does this piece identify need to change the dv in the tp?
Yes, the paper explains each individual macro and micro nutrient and how it is
helpful to pregnant women.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.

11

Texas Department of State Health Services. WIC Nutrition- Maternal Nutrition Lesson
Plans. 2013. Retrieved from http://www.dshs.state.tx.us/wichd/nut/mnlessons-nut.shtm
Provides maternal lesson plans through WIC on supplemental information and
activity levels during and after pregnancy.
1. Does this piece identify need to change the dv in the tp?
Yes, this piece gives information addressing the need to change the nutritional
demands of pregnancy in pregnant women.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define the awareness of the nutritional
demands of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece does not tell us how to measure awareness of the nutritional
demands of pregnancy in pregnancy women.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
Yes, provides WIC lesson plans to pregnant mothers.
USDA. ChooseMyPlate. (2008). What Should I Eat? Retrieved from
http://choosemyplate.gov/food-groups/downloads/resource/pregnancyposter.pdf
When you are pregnant, you have special nutritional needs. Follow the
MyPyramid Plan below to help you and your baby stay health. The Plan shows
different amounts of food for different trimesters, to meet your changing
nutritional needs.
1. Does this piece identify need to change the dv in the tp?
Yes, the MyPlate shows the recommended nutritional daily intake for pregnant
women.
2. Does this piece theoretically define the dv?
No, this piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, the chart does not tell us how to measure awareness of the nutritional
demands of pregnancy in pregnant women.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, the piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.
Williamson, C. S. (2006). Nutrition in pregnancy. Nutrition Bulletin, 31(1), 28-59.
doi: 10.1111/j.1467-3010.2006.00541.x
A healthy and varied diet is important at all times in life, but particularly so
during pregnancy. The maternal diet must provide sufficient energy and nutrients
to meet the mother's usual requirements, as well as the needs of the growing fetus,
and enable the mother to lay down stores of nutrients required for fetal
development as well as for lactation. The dietary recommendations for pregnant

12

women are actually very similar to those for other adults, but with a few notable
exceptions. The main recommendation is to follow a healthy, balanced diet based
on the Balance of Good Health model. In particular, pregnant women should try
to consume plenty of iron- and folate-rich foods, and a daily supplement of
vitamin D (10 g/day) is recommended throughout pregnancy. Summary:
There are currently no official recommendations for weight gain during
pregnancy in the UK. For women with a healthy pre-pregnancy weight, an
average weight gain of 12 kg (range 1014 kg) has been shown to be associated
with the lowest risk of complications during pregnancy and labour, and with a
reduced risk of having a low birthweight (LBW) infant. However, in practice,
well-nourished women with a normal pre-pregnancy bodyweight show wide
variations in weight gain during pregnancy. Low gestational weight gain increases
the risk of having a LBW infant, whereas excessive weight gain during pregnancy
increases the risk of overweight and obesity in the mother after the birth.
A birthweight of 3.13.6 kg has been shown to be associated with optimal
maternal and fetal outcomes for a full-term infant. LBW (birthweight <2.5 kg) is
associated with increased infant morbidity and mortality, as well as an increased
risk of adult diseases in later life, such as cardiovascular disease and type 2
diabetes. The fetal origins hypothesis states that chronic diseases in adulthood
may be a consequence of fetal programming, whereby a stimulus or insult at a
critical, sensitive period in development has a permanent effect on structure,
physiology or function. However, there is little evidence that in healthy, wellnourished women, the diet can be manipulated in order to prevent LBW and the
risk of chronic diseases in later life.
Maternal nutritional status at the time of conception is an important determinant
of fetal growth and development, and therefore a healthy, balanced diet is
important before, as well as during, pregnancy. It is also important to try and
attain a healthy bodyweight prior to conception [body mass index (BMI) of 20
25], as being either underweight or overweight can affect both fertility and birth
outcome. It is now well recognised that taking folic acid during the periconceptional period can reduce the incidence of neural tube defects (NTDs), and
all women who may become pregnant are advised to take a folic acid supplement
of 400 g/day prior to and up until the 12th week of pregnancy.
The UK Committee on Medical Aspects of Food Policy (COMA) panel has
established dietary reference values (DRVs) for nutrients for which there is an
increased requirement during pregnancy. This includes thiamin, riboflavin, folate
and vitamins A, C and D, as well as energy and protein. The energy costs of
pregnancy have been estimated at around 321 MJ (77 000 kcal), based on
theoretical calculations and data from longitudinal studies. In practice, individual
women vary widely in metabolic rate, fat deposition and physical activity level, so
there are wide variations in individual energy requirements during pregnancy. In
the UK, the recommendation is that an extra 200 kcal of energy per day is
required during the third trimester only. However, this assumes a reduction in
physical activity level during pregnancy, and women who are underweight or who
do not reduce their activity level may require more.

13

The COMA DRV panel did not establish any increment in requirements for any
minerals during pregnancy, as physiological adaptations are thought to help meet
the increased demand for minerals, e.g. there is an increase in absorption of
calcium and iron. However, certain individuals will require more calcium,
particularly teenagers whose skeletons are still developing. Up to 50% of women
of childbearing age in the UK have low iron stores, and are therefore at risk of
developing anaemia should they become pregnant. Moreover, around 40% of
women aged 1934 years currently have an iron intake below the lower reference
nutrient intake (LRNI). Pregnant women are therefore advised to consume plenty
of iron-rich foods during pregnancy and, in some cases, supplementation may be
necessary.
There are a number of food safety issues that apply to women before and during
pregnancy. It is advisable to pay particular attention to food hygiene during
pregnancy, and to avoid certain foods (e.g. mould-ripened and blue-veined
cheeses) in order to reduce the risk of exposure to potentially harmful food
pathogens, such as listeria and salmonella. Pregnant women, and those who may
become pregnant, are also advised to avoid foods that are high in retinol (e.g. liver
and liver products), as excessive intakes are toxic to the developing fetus. It is
also recommended that the intake of both alcohol and caffeine is limited to within
current guidelines.
As for the general population, pregnant women should try to consume at least two
portions of fish per week, one of which should be oil-rich. However, in 2004, the
Food Standards Agency (FSA) issued new advice on oil-rich fish consumption
and now recommends a limit of no more than two portions of oil-rich fish per
week for pregnant women (and those who may become pregnant). Oil-rich fish is
a rich source of long-chain n-3 fatty acids which are thought to help protect
against heart disease. Furthermore, these types of fatty acids are also required for
fetal brain and nervous system development. The upper limit on oil-rich fish
consumption is to avoid the risk of exposure to dioxins and polychlorinated
biphenyls (PCBs), which are environmental pollutants. Pregnant women are also
advised to avoid marlin, shark and swordfish, and limit their intake of tuna due to
the risk of exposure to methylmercury, which at high levels can be harmful to the
developing nervous system of the fetus.
There are certain considerations with regard to specific dietary groups during
pregnancy. For example, vegetarians and vegans may have difficulty meeting
their requirements for certain vitamins and minerals, particularly riboflavin,
vitamin B12, calcium, iron and zinc. However, most vegan and vegetarian women
should be able to meet their nutrient requirements during pregnancy, with careful
dietary planning, while those on very restricted diets may also need to consume
fortified foods or supplements.
Pregnancy during adolescence raises a number of nutritional concerns. Teenagers
already have high nutrient requirements for growth and development, and
therefore there is potential competition for nutrients. Furthermore, a large
proportion of teenage girls have low intakes of a range of nutrients that are
important during pregnancy, particularly folate, calcium and iron. Teenagers who
become pregnant often do not take folic acid supplements, either because the

14

pregnancy is unplanned, or because they are unaware of the importance of taking

folic acid. Teenage pregnancy therefore presents particular challenges for health
professionals.
As well as following a healthy, balanced diet during pregnancy, staying
physically active is also important, to promote general health and well-being, and
also to help prevent excess maternal weight gain. Studies that have looked at the
effects of maternal physical activity on pregnancy outcome have been of variable
quality, but there is little evidence that moderate exercise can have any adverse
effects on the health of the mother or the fetus. Studies do suggest that regular,
aerobic exercise during pregnancy helps improve or maintain physical fitness and
body image. It is recommended that pregnant women should continue with their
usual physical activity for as long as feels comfortable, and try to keep active on a
daily basis, e.g. by walking. Swimming is a particularly suitable form of exercise,
although it is advisable to avoid strenuous or vigorous physical activity during
pregnancy.
1. Does this piece identify need to change the dv in the tp?
Yes, the article talks about low iron intake in pregnant women in the UK.
2. Does this piece theoretically define the dv?
No, the piece does not theoretically define awareness of the nutritional demands
of pregnancy.
3. Does this piece tell us how to measure the dv?
No, this piece of literature does not tell us how to measure awareness of the
nutritional demands of pregnancy.
4. Does this piece give us a model program or iv that has shown to change the
dv in the tp?
No, this piece does not give us a model program or education that has shown to
change awareness of the nutritional demands of pregnancy in pregnant women.

15

Section 3: Synthesis of the Literature

ASSESSING GENERAL NEED (LITERATURE REVIEW) TO CHANGE
AWARENESS OF THE NUTRITIONAL DEMANDS OF PREGNANCY IN
PREGNANT WOMEN
7. What is the need for your mission? Please synthesize the literature for the first
question under each abstract from Section 2 showing general need for your mission.
Please document.
No matter how many weeks are left on your countdown calendar, its never too late to
start! Supplying your own body with a tasty blend of nutritious foods can not only
improve your fertility, keep you feeling healthy during pregnancy, and pave the way for
an easier labor, but it can also help to establish essential building blocks of growth and
overall health for your child (American Pregnancy Association, 2013).

Folate helps prevent neural tube defects and is also important later in pregnancy as it
helps to make red blood cells for both you and your baby. Breads, cereals, fruit and
vegetables are a good source of folate. The piece also expresses the need for calcium in
the diet, to help build the bones and tooth buds. Iron is needed in pregnancy to prevent
anemia, this helping the body better circulate blood flow. (Children, Youth and Womens
Health Service Nutrition Department, 2010).

Malnutrition during pregnancy can lead to higher rates of spontaneous abortion,

premature birth, and stillbirth. It can also increase low birth weight, smaller head size,
and smaller overall size for babies (Craig, G. J., 2007).

Provide active learning strategies for implementing our Healthy Pregnancy Program. The
strategies include case-based exercises, group presentations, pro-con debates, and grab
bag questions. (Elliott, 2012)

Pregnancy requires more macronutrients including: calories, protein, fluids and more
micronutrients including calcium, folate and iron as well as a need for increased water
intake (Healthline, 2012).
Our program requires active and passive learning strategies and this example model gives
excellent advice. It can help show how to implement our active and passive learning
through each lesson in the Healthy Pregnancy Program. Active learning requires actually
doing the activity and passive learning requires commitment and retaining the
information given (Herr. N, 2007).

16

Understanding why there is an increase in the nutritional needs and knowing what the
nutrients needed in pregnancy are (Hogan, 2014).

Micronutrient supplementation might reduce maternal morbidity and mortality directly

by treating a pregnancy-related illness or indirectly by lowering the risk of complications
at delivery (Ladipo, 2000).

During pregnancy and lactation there are nutrient requirements needed to be increased in
the diet to support fetal and then infant growth and development (McGuire, 2009).

Provides each of the food groups needed to include in pregnancy and the amounts needed
for intake. Includes nutrients such as: Iodine, Calcium, Folate, Protein, Vegetables,
Fruits, Carbohydrates (Ministry of Health, 2006).

The lesson plan provides adequate information on how to test and model the nutritional
demands of pregnancy and shows how to properly set up the program to and how to
implement a working model (Texas Department of State Health Services WIC, 2013).

The piece gives a guided proportion of each macronutrient and micronutrient is needed
daily to sustain a healthy pregnancy throughout the nine months. There are healthy food
choices listed for each macronutrient and micronutrient to refer to on the chart (USDA
ChooseMyPlate, 2008).

Maternal nutrition is important for various reasons, eating a healthy diet provides a
healthy weight gain throughout pregnancy that affects both fertility and birth outcome.
Folic acid is needed to provide healthy neural tube development (Williamson, 2006).

THEORETICAL DEFINITION OF AWARENESS OF THE

NUTRITIONAL DEMANDS OF PREGNANCY
8. What is the way (based on your literature review and your meeting with me) you
will theoretically define awareness of the nutritional demands of pregnancy? Please
document and there should be nothing/no source in this definition that is not in
Section 2.
Understanding that pregnancy requires increased nutritional demands including more
macronutrients (calories, protein, and fluids) and micronutrients (calcium, folate, and
iron) and why, and requires knowing what those needs are and how much. (American
Pregnancy Association, 2013) (Healthline, 2012) (Hogan, 2014)

17

8a. How can you model the theoretical definition for awareness of the nutritional
demands of pregnancy.
Awareness of the nutritional demands of
pregnancy in pregnant women

Understanding that pregnancy requires increased nutritional demands including more macronutrients (calories,
protein, and fluids) and micronutrients (calcium, folate, and iron) and why, and requires knowing what those
needs are and how much. (American Pregnancy Association, 2013) (Healthline, 2012) (Hogan, 2014)

Macronutrients

Micronutrients

WHAT:

WHAT:

WHAT:

WHAT:

WHAT:

WHAT:

Calories

Protein

Fluids (water)

Calcium

Folate

Iron

(Healthline,
2012)

(Healthline,
2012)

(Healthline,
2012)

(Healthline,
2012)

(Healthline,
2012)

(Healthline,
2012)

HOW MUCH:
HOW MUCH:

75-100 g per day

*fetal growth
tissue, including
the brain, breast
and uterine
tissue grow
throughout
pregnancy, helps
play a part in
increasing blood
supply

300 extra
calories per/day
(American
Pregnancy
Association,
2013)

WHY:
To have a healthy
pregnancy to full
term.

(American
Pregnancy
Association,
2013)

(Hogan, 2014)

HOW MUCH:

HOW MUCH:

HOW MUCH:

8-10 glasses
per/day

1000-1200
milligrams per day

(Healthline,
2012)

(American
Pregnancy
Association,
2013) (Healthline,
2012)

600 to 800
micrograms (.6
to .8
milligrams) per
day

WHY:
To have a
healthy
pregnancy to
full term.
(Hogan,
2014)

WHY:
Protein in your foods positively
affects the growth of fetal tissue,
including the brain. It also helps
your breast and uterine tissue to
grow during pregnancy, and it
plays a helping part in your
increasing blood supply.

HOW MUCH:
27 milligrams
per day
(American
Pregnancy
Association,
2013)

(American
Pregnancy
Association,
2013)
WHY:

WHY:
Calcium helps
your body
regulate fluids,
and it helps
build your
babys bones
and tooth
buds.
(American
Pregnancy
Association,
2013)

Folic
acid/Folate
plays a key
role in
reducing the
risk of neural
tube defects,
including
spina bifida.

WHY:
Iron helps
increase blood
volume and
prevent
anemia.
(American
Pregnancy
Association,
2013)

(American
Pregnancy
Association,
2013)

(American Pregnancy
Association, 2013)

18

ASSESSING SPECIFIC NEED (FINDING A VALID TEST TO MEASURE

AWARENESS OF THE NUTRITIONAL DEMANDS OF PREGNANCY IN
PREGNANT WOMEN)
9. A test is valid if it measures what it says it will measure, and you say you will
measure awareness of the nutritional demands of pregnancy as theoretically
defined. Please show the test that you developed or that you found from the
literature for your dv. PLEASE ALSO INCLUDE THE EVALUATION DATA
WHAT IS A GOOD, POOR TEST SCORE, ETC.
1. I know that pregnancy requires increased nutrition (5 points)
SA
A
U
D
SD
2. Why do you need increased macro- and micronutrients during pregnancy? (5 points)
List 5
needs:__________________________________________________________________
3. I know that pregnancy requires increased macronutrients (11 points)
SA
A
U
D
SD
3a. Explain what they are and how much is needed __________________________
4. I know that pregnancy requires increased micronutrients (11 points)
SA
A
U
D
SD
4a. Explain what they are and how much is needed __________________________
Test evaluation is based out of 32 points.
Per question: lowest awareness 1, low awareness 2, fair awareness 3, high awareness 4,
highest awareness 5
Question 3a and 4a: Participants get 1 point for each named of macro- and
micronutrient,1 point for each correct amount needed, and 1 point for why it is needed.
The higher the pregnant women score on the test, the more awareness of the nutritional
demands of pregnancy they have.
9a. Test Validity: Please argue that your test has logical or content validity, that it
actually measures awareness of the nutritional demands of pregnancy (all content
areas) per the theoretical definition of awareness of the nutritional demands of
pregnancy.
The test is valid because it measures what it purports to measure, in that it reflects our
theoretical definition of awareness of the nutritional demands of pregnancy.

19

9b. Please say how you would develop test-retest reliability (test consistency) for
your test.
We will give the test to pregnant women in Gogebic Health Department on a Monday
and the following Wednesday. Their scores should be similar on Monday and
Wednesday, this is test-retest reliability. If we get reliability here, we should use the test
for our pregnant women in Marquette Health Department.

IDENTIFYING MEASURABLE OBJECTIVES (USING VALID TEST TO

DETERMINE HOW MUCH OF AWARENESS OF THE NUTRITIONAL
DEMANDS OF PREGNANCY IS IN PREGNANT WOMEN)
9c.Pretend you gave your test in a pretest situation for pregnant women. Please
identify at least 4 measurable objectives using the proper format (i.e., Ms. Jones will
lose 10 lbs by the end of the 10 wk program).
Mrs. Jones will go from scoring a 10/32 points to 26/32 points on the nutritional
awareness test for pregnancy by the end of the 2 month program.
Mrs. Jones will go from scoring a 2/5 to 4/5 points on her understanding that pregnancy
requires increased nutrition by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/5 to 4/5 points on her explanation of why pregnancy
needs increased macro- and micronutrients by the end of the 2 month program.
Mrs. Jones will go from scoring a 2/5 points to 4/5 points on her understanding that
pregnancy requires increased macro-nutrients by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/3 points to 3/3 points of what the macro-nutrients are
by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/3 points to 2/3 points on her explanation of how
much macro-nutrients are needed during pregnancy by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/5 points to 4/5 points on her understanding that
pregnancy requires increased micro-nutrients by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/3 points to 3/3 points of what the micro-nutrients are
by the end of the 2 month program.
Mrs. Jones will go from scoring a 1/3 points to 2/3 points on her explanation of how
much micro-nutrients are needed during pregnancy by the end of the 2 month program.

20

Section 3 Continued: Programming

PLANNING AN EVIDENCE BASED PROGRAM AND IMPLEMENTATION
PLAN
10. Based on the literature review, which program model from will you use?
Identify the model and then identify the steps in the model. Then, right next to it,
show how you will adapt the model for your content or time needs. Please go into
very specific detail about what your program is, WHAT YOU WILL COVER, and
how you will implement it. THIS IS THE PROGRAM YOU WILL USE TO TRY
TO CHANGE YOUR DV IT IS IMPORTANT THAT YOU FLESH IT OUT IN
DETAIL. MAKE SURE YOU FOLLOW THE MODEL COMPLETELY.
Our Mission of Program: To increase awareness of the nutritional demands of pregnancy
in pregnant women through education.
We will be using the model program based off a WIC Nutrition- Maternal Nutrition
Lesson Plan developed by the Texas WIC State Agency titled CCNE: Pregnancy - Giving
Your Baby the Best Start (Texas Department of State Health Services, 2013).
This specific maternal nutrition lesson plan is targeted towards pregnant women to
educate them in ways to stay healthy during pregnancy. The class description includes a
Fact or Fiction activity to address healthy habits during pregnancy, then moves onto a
meal makeover activity, following a discussion where the participants share ways to
overcome their barriers to healthy eating habits. In our created educational program A
Healthy Pregnancy based off the Texas WIC State Agency titled CCNE: Pregnancy Giving Your Baby the Best Start, we will be conducting a 8wk/8 lesson that meets once a
week. Theses lessons will be made up of two parts: Passive Learning and Active learning.
The Passive learning will be composed of the lecturing material. The Active learning that
will consist of group discussion, food logs and worksheets on meal planning, and our
hands on healthy cooking class.

Texas WIC State Agency:

A Healthy Pregnancy:

A Healthy Pregnancy:

Pregnancy- Giving your baby a

Passive Learning

Active Learning

healthy start

Introduction

Pre-Test (no results given

afterwards)

Handout on Pregnancy Fact of Fiction?

MyPlate My Pyramid Plan Handout

Introduction
Group Discussion: What the
pregnant women believe healthy
eating habits are during pregnancy,
along with providing them with
information on what not to eat

Lecture- Educate on Vegetables: What

21

Meal Makeover Activity

Created handout on macro and

micronutrient amounts needed
Meal Makeover Activity on
Vegetables
Introduction to Food Logs: In your
logs this week we want you to go
home and write in your regular
meals for the week and anytime you
eat the correct serving of a vegetable
please highlight it to show yourself
how many vegetables you are
consuming on average.

Brochures on additional relevant information:

Check the Texas WIC catalog at
http://www.dshs.state.tx.us/wichd/WICCatalog/contents.shtm
for a list of current materials.
Additional resources:
Texas WIC Prenatal Nutrition & Breastfeeding Modules,
Texas WIC brochures, www.choosemyplate.gov,
http://wicworks.nal.usda.gov/pregnancy

Meal Makeover Activity on Fruits

Food Logs

vegetables are high in Iron, Folic Acid and

Calcium
2 cups per day 1st trimester
3 cups per day 2nd and 3rd trimester
High in Iron and Folate: Collard, turnips,
spinach, lettuce, and cabbage
Important for proper nutrition, to help avoid
the possibility of having a baby with low birth
weight.

Lecture- Educate on Fruits: What fruits are

high in Iron, Folic Acid and Calcium
2-3 cups per day
Good source of vitamins- folate and vitamin
C, carbohydrates and fiber
High in Vitamin C- oranges, mandarinshelps with tooth and bone development, and
promotes metabolic processes

Meal Makeover Activity on

Grains/Breads
Food Logs

Lecture- Educate on Grains/Breads: What

grains/bread products are high in Iron, Folic
Acid and Calcium
6 oz. per day in the 1st trimester
8oz per day in the 2nd and 3rd trimester
Whole grains are better than refined grains.
Brown, mixed grains, fruit, rye or flat breads
Bread, cornmeal, cereal, and oatmeal are a
good source of folate and iron.
Grains contain fiber, and help the body feel
fuller.
Important to remember that you need an
extra 200- 300 calories per day and grains
are a great way to do it.
This good group contains a great source of
folic acid which plays a key role in reducing
the risk of neural tube defects, including
spina bifida.
As well as a good source of Iron helps
increase your blood volume and prevent
anemia.

22

Meal Makeover Activity on Meats

Food Logs

Lecture- Educate on Meats: What meat

products are high in Iron, Folic Acid, Calcium
and Protein.
Average serving size needed is 2-3 servings.
You should be consuming 75 to 100 grams
of protein per day.
Lean meats, fish, tuna and chicken provide a
great source of protein. (avoiding raw fishes,
sushi, and albacore)
These meats have iron, niacin, and vitamin
B12.
Protein in your foods positively affects the
growth of fetal tissue, including the brain. It
also helps your breast and uterine tissue to
grow during pregnancy, and it plays a
helping part in your increasing blood supply.

Review and Evaluation

Meal Makeover Activity on Dairy

Food Logs

Lecture- Educate on Dairy: What dairy

products are high in Iron, Folic Acid, Calcium
and Protein.
Dairy also have a high source of protein like
we talked about in meat products.
You should be consuming 75 to 100 grams
of protein per day.
Cooked eggs, cheeses (avoiding
unpasteurized cheeses), milk, yogurts
It is important to consume dairy products.
Bone growth is very important for proper
development of motor skills such as:
walking, standing, crawling, etc.

Meal Planning for health cooking

class for next week

Lecture- Educate on proper caloric intake

and which food items contain how many
calories.
You need an extra 300 calories per day.
Any of the discussed food groups in the
class and examples are good choices to get
these extra calories that the baby needs.

Hands on healthy cooking class

End of session: Post- Test (results
afterwards

Lecture- Educate on fluid.

Intake and proper amounts needed for each
day, including amount needed when activity

23

level is increased.
Should have around 8-10 glasses of water
per day.

11. What apps are out there that would help you with your programming? Id them,
explain them, show a pic of them if possible, and link to them.
WebMD Pregnancy App: http://www.webmd.com/pregnancyapp
WebMD is a free app that tracks each day of pregnancy, that can be
used online and offline. This app provides the expecting mother with
information about the baby's development as well as how the adult body
is changing. There is a tab on nutrition that provides information on
what to eat, what not to eat, what is safe, the nutrients needed, along
with prenatal vitamins which each are and how much. The app also
provides a resource to track the dates of prenatal appointments and
important questions for each visit to ask the healthcare provider. As well
as a resource to track signs and symptoms, weight, blood pressure, and
kick-counter measurements, and a gallery to save pictures of the mothers belly growth
throughout the 9 months.
Expecting Nutrition App. http://pregnancy.about.com/od/pregnancyapps/fr/ExpectingNutrition-App.htm
This app can also be used as a website, it tracks your daily food intake
and makes sure that you are making healthy choices. Also provides the
mother with the resource to log the food, servings, calories, total fat,
saturated fat, trans fat, sodium, carbohydrates, fiber, sugar and protein.

12. First do NO harm and then do good. What safety considerations for your
program are there? Explain. Include forms, liability waiver, PARQ, etc. if
appropriate.
Safety considerations for the pregnant women while learning about the importance of
increased nutritional demands during pregnancy would be providing the participants with
a food allergy form and anaphylaxis emergency care plan. This form will ensure safety of
all participants when introducing and using macro- and micronutrients food products,
since we will be using these during our educational program. This also provides the
educators with a care plan incase of an allergic event, how to provide care if there was an
event and who to contact. Form/Care Plan:

24

http://www.foodallergy.org/document.doc?id=234
BEHAVIOR CHANGE JUST BECAUSE YOU BUILD THE PROGRAM FOR
CHANGE IN THE DV IN YOUR TP DOES NOT MEAN THAT YOUR TP WILL
ENGAGE IT FINDING BARRIERS AND FACILITATORS
13. Social Cognitive Theory Light says people are more likely to engage the
prescribed program behaviors if they know what to do (change the dv), know how
to do it (enact your program), want to do it (are motivated), believe they can do it
(have good self-efficacy), and have a supportive environment. How would you
determine that: Your tp knows what to do? Your tp knows how to do it? Your tp
wants to do it (is motivated)?Your tp believes it can do it (is self-efficacious)?Your
tp has a supportive environment?
1) Pregnant women know what to do to increase their awareness of nutritional demands
in pregnancy by coming to our educational program.
2) Pregnant women know how to increase their nutritional demands by following our
educational program provided after successfully completing our educational program.
3) Pregnant women are motivated in increasing their awareness of nutritional demands.
Facilitators- Pregnant women want to maintain a healthy growing fetus during pregnancy.
Pregnant women want to provide their baby with a healthy life.
4) Pregnant women believe that they are capable of increasing their awareness of
nutritional demands during pregnancy is important.
Facilitators- Pregnant women believe they are capable of doing so by taking our class.
5) Pregnant women have a supportive environment while changing the nutritional
demands for their pregnancy.
Facilitators- We will reinforce the pregnant women by having a supportive environment.

25

Section 4: Evaluation Design/Mission Fit

12. What evaluation design will you use? Please show it in Os and Xs and label
each group if you use a control group (e.g., program group or control group) and
label what each O and X is. Document whose program model you are following.
The evaluation design that we will be using is the One-Group Pretest-Posttest Design (O
X O).
Pretest

Intervention

Posttest

O
Nutritional Awareness
Pre-test

X
Healthy Pregnancy
Adapted from: WIC Program
(Texas Department of State Health
Services, 2013)
and Passive vs. Active Learning
(Herr, 2007)

O
Nutritional Awareness
Post-test

Intervention/Our Program: The model program we are using is based off a WIC
Nutrition- Maternal Nutrition Lesson Plan developed by the Texas WIC State Agency,
titled Pregnancy - Giving Your Baby the Best Start. We also used a passive vs. active
learning source these learning strategies are used in our program throughout each lesson in
the 12 week program.
13. Internal validity has to do with your ability to say that your
iv/intervention/program caused the change in the dv, and not something else
(Oprah). What threats to internal validity accompany the evaluation design you
selected in #10? Identify and briefly explain please.

Maturation can affect the evaluation design if the participant(s) in the group mature at
different rates due to lack of energy, focus, or educational background.
Testing can affect the evaluation design if the pre-test cues the subjects about the posttest or if one cheats.
History can affect the evaluation design if the participant(s) misses one of the weekly
lessons due to transportation issues, pregnancy complications, or an unexpected event.
Mortality can affect the evaluation design if the participant(s) drops out of the program at
any time prior to the post-testing due to miscarriage or preterm birth.

14. Evaluation in program planning is about mission fit. What is your mission fit
question and what is the evidence that you met your mission? Our mission fit
question is: Did we increase awareness of the nutritional demands of pregnancy in
pregnant women?
Did we increase awareness of the nutritional demands of pregnancy in pregnant women?

26

The evidence that we met our mission is that if the participants significantly increase their
awareness post-test scores compared to the initial awareness pre-test scores that is if we
met our objective of reaching from 10/32 to 26/32.

27

Section 5: Marketing and Communication

15. How can you use social media or traditional media to market your program
(make your pregnant women aware that it exists and make them want to come to
the program)? Develop at least one marketing tool related to your program and
show it/and link to it. Please place your agency logo on the material.
We created a public service announcement, this announcement is targeted towards
pregnant women. We will be addressing information about our upcoming A Healthy
Pregnancy program. Through this announcement we include why increased nutrition is
required in pregnancy, as well as the negative effects that improper nutrition can lead to.
This announcement is based off of love and fear in relation to the expecting mothers
unborn baby. We also included a flyer that can be posted around Marquette County that
provides information on the course to better promotion of the course.
16. How can you use social media or traditional media to communicate with the
members in your program about the program? Develop at least one communication
tool related to your program and show it/link to it. Please place your agency logo on
the material.
We created a Facebook page called Healthy Pregnancy. This page is strictly for the
members of our program and is invitation only. The page contains information on the
program details, a flyer that will be posted around Marquette County, as well as a place
for the pregnant women to share their thoughts and concerns in a respectful setting.
Link: https://www.facebook.com/pages/Healthy-Pregnancy/315552731903224?ref=hl

28

Section 6: Granting Agency

17. Identity a granting agency to help you fund your program. It should have a
similar mission to yours and give its mission. Indicate the agency and the mission
and tell what the grant is and how it is compatible with your mission. Put it in the
granting agency logo and link to the granting agency.
The granting agency that will help us fund our program is National Institutes of Health
(NIH). The grant that they are funding is the Maternal Nutrition and Pre-pregnancy
Obesity: Effects on Mothers, Infants and Children (R01)National Institutes of Health
Department of Health and Human Services. The mission of this grant is encourages R01
applications to improve health outcomes for women, infants and children, by stimulating
interdisciplinary research focused on maternal nutrition and pre-pregnancy obesity.
Maternal health significantly impacts not only the mother but also the intrauterine
environment, and subsequently fetal development and the health of the newborn. This
grant ties together with our mission of increasing nutritional demands of pregnancy in
pregnant women because it brings in the funds to research the nutrition that these mothers
need to carry a health fetus to full term. It also is a great tool to find more research on
macronutrients and micronutrients needed during pregnancy and why you need those
nutrients during pregnancy.

Above Image: http://www.nih.gov

Link: http://grants.nih.gov/grants/guide/pa-files/PA-12-061.html

29

Section 7: Webliography
About.com. (2014). Expecting Nutrition App.[picture]. Retrieved from
http://pregnancy.about.com/od/pregnancyapps/fr/Expecting-Nutrition-App.htm
Active Learning. (2014, March 21). In Wikipedia. Retrieved April 20, 2014, from
http://en.wikipedia.org/wiki/Active_learning
Alexander, S., Cox, D., & Safer, S. (Producer). (2010). Embrace Life-always wear your
seatbelt [Online video]. United States: YouTube. Retrieved April 12, 2014, from
https://www.youtube.com/watch?v=h-8PBx7isoM
American Pregnancy Association. (2013) Pregnancy nutrition. Retrieved from:
http://americanpregnancy.org/pregnancyhealth/pregnancynutrition.html
Children, Youth and Womens Health Service Nutrition Department. (2010). Nutrition
for Pregnancy and Breastfeeding.Government of South Australia and Womens &
Childrens Hospital. Retrieved from:
http://www.wch.sa.gov.au/services/az/other/nutrition/documents/Nutrition_for_Pregnanc
y_and_Breastfeeding.pdf
Craig, G. J., & Dunn, W. (2007). Prenatal development and Childbirth. Understanding
Human Development (3 ed., pp. 73-74). Upper Saddle River, N.J.: Pearson/Prentice Hall.
Department of Health and Human Services. (2011, December 15). Maternal Nutrition and
Pre-Pregnancy Obesity: Effects on Mothers, Infants and Children . In grants.nih.gov.
Retrieved April 4, 2014, from http://grants.nih.gov/grants/guide/pa-files/PA-12-061.html
Elliott, J. P., Koerner, P. H., & Kamal, K. M. (2012). The Impact of Elective ActiveLearning Courses in Pregnancy/Lactation and Pediatric Pharmacotherapy. In American
Journal of Pharmaceutical Education. Retrieved March 15, 2014, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305935/
Expecting Nutrition App. (2014). In About.com Pregnancy & Childbirth. Retrieved
March 16, 2014, from http://pregnancy.about.com/od/pregnancyapps/fr/ExpectingNutrition-App.htm
Food Allergy Research & Education. (2013). Food Allergy & Anaphylaxis Emergency
Care Plan. In FoodAllergy.org. Retrieved March 20, 2014, from
http://www.foodallergy.org/document.doc?id=234
30

Healthline Editorial Team. (2012). Nutritional Needs During Pregnancy. Healthline.

Retrieved from: http://www.healthline.com/health/pregnancy/nutrition
Healthy Times Blog. (n.d.). Eat for Two. [picture]. Retrieved from
http://www.healthytimesblog.com/wp-content/uploads/2011/01/Eat-for-two.jpg
Herr, N. (2007). Passive vs. Active Learning. In The Sourcebook for Teaching Science.
Retrieved April 20, 2014, from http://www.csun.edu/science/ref/pedagogy/activepassive/active-passive-learning.html
Hogan, P. (2014). Personal Interview with Patti Hogan.
Ladipo, O. A. (2000). Nutrition in pregnancy: mineral and vitamin supplements 123.
The American Journal of Clinical Nutrition. Retrieved from:
http://ajcn.nutrition.org/content/72/1/280s.full
McGuire, M. K., & Picciano, M. F. (2009). Use of dietary supplements by pregnant and
lactating women in North America. The American Journal of Clinical Nutrition (89)2,
663-667. doi: 10.3945/ajcn.2008.26811B
Ministry of Health. (2006). Food and Nutrition Guidelines for Healthy Pregnant and
Breastfeeding Women: A background paper. Wellington: Ministry of Health.
Retrieved from: http://www.health.govt.nz/system/files/documents/publications/foodand-nutrition-guidelines-preg-and-bfeed.pdf
NIH. (n.d.). National Institutes of Health Turning Discovery Into Health. [picture].
Retrieved from http://www.nih.gov
Nutritionist. (2012). In National Career Services. Retrieved January 27, 2014, from
https://nationalcareersservice.direct.gov.uk/advice/planning/jobprofiles/Pages/nutritionist.
aspx
Passive. (n.d.). The American Heritage Stedman's Medical Dictionary. Retrieved April
23, 2014, from Dictionary.com website:http://dictionary.reference.com/browse/passive

31

Stone, M. G. (2014, April 15). Healthy Pregnancy. In Facebook. Retrieved April 15,
2014, from https://www.facebook.com/pages/HealthyPregnancy/315552731903224?ref=hl
Texas Department of State Health Services. WIC Nutrition- Maternal Nutrition Lesson
Plans. 2013. Retrieved from http://www.dshs.state.tx.us/wichd/nut/mnlessons-nut.shtm
USDA. ChooseMyPlate. (2008). What Should I Eat? Retrieved from
http://choosemyplate.gov/food-groups/downloads/resource/pregnancyposter.pdf
WebMD Pregnancy App. (2014). In WebMD. Retrieved March 16, 2014, from
http://www.webmd.com/pregnancyapp
WebMD. (n.d.). WebMD Pregnancy App.[picture]. Retrieved from
http://www.webmd.com/pregnancyapp
Wheeler, J., & Stanley, K. (Actor). Wheeler, J. (Producer). (2014). Public Service
Announcement [Online video]. YouTube. Retrieved April 22, 2014, from
https://www.youtube.com/watch?v=-StyQPhNqkE&feature=youtu.be
WIC. (2014). Special Supplemental Nutrition Program for Women, Infants and
Children.[picture]. Retrieved from http://wic.fns.usda.gov/wps/pages/start.jsf
Williamson, C. S. (2006). Nutrition in pregnancy. Nutrition Bulletin, 31(1), 28-59.
doi: 10.1111/j.1467-3010.2006.00541.x

32

Section 8: Reflection
Please write a combined 1 - 2 page reflection piece on how this project helped:
1) your professional growth relative to the program plan/eval process (do you think you
can assess a general need to have a warrant for proceeding, a specific need to identify
measurable objectives, find an evidence-based program, implement it, and then
evaluate?);
2) your independent/self-directed learning,
3) your critical thinking (determining what research is valid, and finding/using valid
materials); and
4) collaborative learning working with others to achieve common goals..
This project helped our professional growth through focusing on our researched
literature to see if there was a need to increase awareness of the nutritional demands of
pregnancy in pregnant women. We found that there was indeed a need and that many women
are unaware of proper nutrition during pregnancy. During pregnancy certain vitamins and
minerals need to be increased to provide a healthy pregnancy and support the growth and
development of the unborn baby.
As future Community Health Educators we now are prepared to assess any specific
need in a given community. We feel that the project has immensely helped our intellect
through learning how to implement and evaluate evidence-based programs effectively. We
were able to determine that our research for our major project was valid because our material
came from professional resources and correlated with our mission.
Working as a team has tremendously helped with the specificity, the effort, and the
creativity put into this project. We have had so much fun learning about our mission and
creating an exciting and effective program for pregnant mothers.
We also found this program to work to our advantage when we have children of our
own. We are now knowledgeable in knowing what the proper macro and micronutrients

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needed during pregnancy are, as well as knowing how much of each nutrient is needed in
order to maintain a healthy pregnancy and support a developing fetus.

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