jrc's Wellness Initiatives
February 2006
WELLNESS STEPS FOR STAFF MEMBERS
Beginning in 2002, the Judge Rotenberg Educational Center (JRC) undertook a number of wellness steps to inform staff members how important good nutrition, exercise and stopping smoking are and how these steps can help one to avoid and cope with certain chronic diseases. The steps we have taken are listed below. We started our nutrition education with our staff, rather than with our students. We did this so that when we started educating our students, our staff members would be more likely to be supportive.
- Creation of a library of films on
nutrition. In September of 2002, JRC began collecting a set
of films on nutrition. We have tried to obtain every film on good
nutrition that we could find. These films have been organized into
categories (nutrition education, cooking, ethics/environment, etc.)
and are available for staff to view or borrow in VCR or DVD format.
Many of these films are also available to be viewed online by means of
the JRC staff website. Dr. Bill Harris has been especially helpful to
us by sharing films he has made of talks given at the Vegetarian
Society of Hawaii, one of the best vegetarian societies in the
country. A list of most of the films in the JRC nutrition film library
is shown in Exhibit 1.
- Attendance at national nutrition
conferences. In order to help JRC staff make good decisions
about nutrition for both its staff and students, Dr. Israel has been
attending conferences at which nationally prominent nutrition experts
speak about nutrition. Among the conferences he has attended are the
annual conference sponsored by Vegsource.com in Los Angeles, the
Summerfest Conference operated by the North American Vegetarian
Association and the Annual Boston Food Fest conference.
- Design of a JRC Basic Nutrition Course
presented through films. From our total list of nutritional
films, we chose a subset that would make up a good introductory course
in nutrition for our staff. The list of films that we chose for this
course is shown in section IV of Exhibit 1. Each of these films is
available to our staff for viewing through our staff website.
- Design of Comprehension Questions for the
films used in the JRC Basic Nutritional Course. For each
film in the Basic Nutrition Course, we designed a set of multiple
choice questions that covered some of the key points presented in the
film. The questions were designed to insure that the viewer of the
film is paying attention to, and has understood, the main points
presented in the film. We prepared approximately one comprehension
question for each five minutes of film. A one hour film, for example,
would have approximately 12 questions associated with it. When the
Basic Nutrition Course is given to staff members or students, the user
is required to answer the comprehension questions as he/she watches
the films and hand in his completed sheet of answers after watching
the film.
- Presentation of the JRC Basic Nutritional
Course to teachers, clinicians and other supervisors.
In July of 2004, we identified a group of our staff members,
including teachers, clinicians and nurses, whom we wanted to acquire more
information about nutrition. We required these staff members to watch
the films in the Basic Nutrition Course and to answer the associated
comprehension test questions. A different film was shown each day.
Once each day, the staff members in the chosen group devoted one hour
to watching the nutrition film presented on that day and answering the
associated test questions.
- Every-2-weeks, optional “RAVE” luncheons
with nutritional films. In April 2003 we started the
practice of offering a free, nutritious lunch, combined with a
nutrition film to those staff members who were interested in
attending. At these lunches, which continue to this day, the lunch
that is offered is in accordance with the
RAVE[1]
lifestyle principles (minimizing Refined foods, avoiding
Animal foods, avoiding Vegetable oils and
Exercise ). Approximately 30-50 persons attend these
RAVE Lunches.
- Invited speakers on nutrition and
wellness. From time to time we invite experts to speak at
JRC on nutritional or wellness topics to both our staff and our higher
functioning students. When we do this, we usually combine the talk
with our every-two-weeks RAVE luncheon. First, the attendees take a
buffet lunch in our Whimsy Reception Room. Then they go into the
Lindsley Auditorium, where they eat their lunch while the
nutritional/wellness talk is given. The invited speakers have
included: Harvey Zarren, M.D.; Joel Fuhrman, M.D.; Antonia Demas,
Ph.D.; Caldwell Esselstyn, M.D.; Jill Nussinow, R.D.; Neal Pinckney,
Ph.D.; Mike Anderson; Michael Greger, M.D. Howard Lyman and Dr.
Patricia Mantia.
- Clippings on nutrition that are sent to
all staff in their online mailboxes and office email addresses.
Starting in May of 2004, Dr. Israel began to identify clippings from
the New York Times online edition that dealt with nutritional
information or reports that support JRC’s nutritional approach.
Approximately one or two of these clippings are distributed to staff
members each week. They are sent to each staff member’s electronic
mail box and to all staff who have Outlook email addresses on our mail
server. A number of staff members have voiced their appreciation for
receiving these clippings and for what they have been able to learn
from them.
- Salad bar. One of our first
steps was to purchase a salad bar and to stock it with a wide variety
of fresh vegetables, fruit, and occasionally soup. We make this salad
bar available to our staff members at a nominal price that just covers
our costs. The contents of the salad bar are changed frequently to
insure variety. We insist on receiving vegetable supplies from the “A
palette” that our suppliers use for restaurants that demand the
freshest of supplies. We also provide, in addition to the salad
components, a prepared salad as well at each meal.
- Removal of all candy and soda machines.
We removed all of our candy and soda machines and purchased our own
refrigerated machines which we stock with nutritious snacks such as
fruits, fruit juices, etc. These machines are so popular that we find
it hard to keep them well stocked.
- Nutrition lounges. During 2004
and 2005 we created two nutritional lounges—one in our 240 Turnpike
Street building and one in our 250 Turnpike Street building. Each
lounge had comfortable seating, a set of books on nutrition, and
coin-operated refrigerated machine that dispensed nutritious snacks
such as fruit. In addition, in each lounge a nutrition film was
continuously playing each day. The film that was chosen was usually
the same film that had been shown at the last every-two-weeks RAVE
luncheon. As of 2006, we had to discontinue the nutrition lounges due
to lack of space; however, we hope to restore them at a future date.
- Wellness website. During 2003
and 2004 we created a wellness section of our staff website. On this
site we made available, among other things, a number of articles about
nutrition, the films that are part of our JRC Nutrition Course, and a
discussion board through which staff members are able to communicate
and discuss thoughts about nutritional issues. Exhibit 2 is a list of
some of the resources that are on our
Wellness Website and a brief explanation of each. Many of these
resources are available for use by the public at large from our main
JRC website (www.Judgerc.org )
- Staff wellness discussion board.
Our staff site contains a discussion board in which staff can post and
answer message concerning nutrition and wellness. The staff member’s
picture appears next to the message he/she is posting.
- Self-management component of staff
website. The wellness section of our staff website was also
given a “Self-Management” section in which a staff member (the
“self-manager”) could do the following: a. identify a weekly
health-related goal for him or herself (such as losing weight); b. set
up a behavioral self-management strategy for reaching that goal.
Normally this means setting up a self-penalty that the self-manager
agrees to pay for failing to reach the weekly goal; c. select a person
to serve as a monitor to make sure that the person gives accurate data
and carries out the self-penalty if required; and d. enter his/her
daily data online and view a chart that is automatically created from
the data that the staff member enters.
During the first of our Cholesterol Incentive Projects (CIP) projects, we encouraged the CIP participations to make use of this self-management feature of the wellness site to report their behavior data and make the data available for viewing by other CIP participants.
- Distribution of Michael Anderson’s film,
Eating. The most effective film that we have found
for introducing the basic facts relating to healthy eating and
lifestyle is a film by Michael Anderson called Eating.
We show this film to each new member of our staff. In 2004, we gave a
copy of this film as part of our annual holiday gift to each staff
member. We also placed a copy of this film on our staff website.
- Development of software (“JRC Tutor) for
converting filmed lectures into self-instructional training systems.
In August of 2004 we designed a proprietary piece of software that can
be used to convert a film into a self-training vehicle that can be
presented over the internet. We also designed software that enables
this program to be assigned to a designated group of staff members.
The software then keeps track of how much of the program that each
staff member has done and enables the staff member to pick up where
he/she last left off when resuming use of the program.
We call this software the JRC Tutor. Although the software was initially developed for the purpose of converting the film Eating into a self-teaching vehicle, it can also be used, and is being used at JRC, to convert any text or film into a self-teaching vehicle.
Here is how the software is being used with Mike Anderson’s film, Eating. We divided the film into a set of chapters. Each chapter consists of a segment of film, 3-10 minutes in length, plus a set of multiple choice questions that are presented at the end of that film segment. The student starts by viewing the film segment for chapter 1 on his computer. After viewing that segment, the student answers the set of multiple choice questions that appear at the end of the chapter and that are based on the content just presented in the film. The questions, which number approximately 600, are quite comprehensive and cover every important point that was presented in the chapter. The questions are designed in such a way that if you have watched and understood the material being presented in the film, you will most likely be able to answer each of the questions correctly.
After the user enters his answer to each question, the software tells the user immediately whether his/her answer is correct or not. Any questions that the user answers incorrectly are re-presented at the end of the current set of questions. As a result, the user is required to answer each question correctly at least once before he/she is allowed to complete the question set for that chapter and advance to the next chapter.
In addition, any questions that were answered incorrectly on Chapter 1 are also re-presented as part of the question set for the chapter that is two chapters ahead. For example, questions answered incorrectly on Chapter 1 are re-presented in the question set of Chapter 3, any questions failed on Chapter 2 are re-presented in the question set of Chapter 4, and so on.
There is a demonstration chapter for the Eating/JRC Tutor program on JRC’s public website. To try out this demo go to the JRC website (www.judgerc.org), click on “Software Samples” (in the left panel), and then click on “Eating Video Demo” which is under the heading “JRC Tutor.”
This demonstration shows how the film is presented and how the software presents and responds to the questions at the end of a chapter. In the actual program (as distinguished from the demonstration) questions that are answered incorrectly are re-presented (recycled) at the end of the question set as described above; however, in the demonstration chapter the incorrectly answered questions are not re-presented on a later chapter because the demonstration is only one chapter in length.
When you start the demonstration (by clicking on the “Start Instruction” button on the title page, and then clicking on the “Start Instruction” button under the film window), the first few chapter of Mike Anderson’s Eating film will start playing. If you want to skip over this film segment (which lasts several minutes) and go directly to the chapter question set, you can do so. To do this, drag the little moving slider that you see under the film window to the furthest point on the right. Then click on the button “Proceed to Next Content” and the questions that are associated with the Chapter 1 film segment will appear.
- Free cholesterol screenings offered to
all staff members. On several occasions since June 2003, we
offered a free cholesterol screening to all members of our staff in
which their total cholesterol was measured. This screening tended to
heighten awareness of cholesterol as a measure to be concerned with
and may have helped encourage certain members of our staff to
participate in the Cholesterol Incentive Program (described below).
- Development of information sheets for
interpreting blood test results. With the assistance of
Drs. Esselstyn and Zarren, we developed an explanation of the various
blood measures so that staff would have information to help interpret
them. This information is now available on our staff website.
- Stop smoking groups. During
2004 and 2005 we offered two Stop Smoking Groups to our employees.
Staff members who participated were able earn rewards provided by JRC
by stopping smoking for a certain period of time. In addition,
behavioral self-management assistance was offered to each participant
to help him/her succeed in the project.
- Cholesterol reduction incentive projects. During 2004 and 2005 JRC sponsored two voluntary projects to encourage its employees to change their eating habits in order to lower their total cholesterol. A description of the invitation that was sent to employees inviting them to participate is shown in Exhibit 3. A description of the procedures and results obtained in both projects is found in Exhibit 4.
WELLNESS INITIATIVES FOR JRC STUDENTS
- Daily physical exercise for students.
We have set a goal of 30 minutes of physical activity for each student
each day.
- Walking trails. We created
walking trails through the five acres of woods that JRC’s property
includes. The trails are more than a mile in length and their use is a
favorite activity for staff and students.
- Physical Education Consultant.
At one of our RAVE luncheons, we featured a consultant speaker who
spoke about physical education.
- Exercise Machines. JRC has a
full range of exercise machines, including: treadmills, stair
steppers, stationary bikes and rowing machines.
- Indoor basketball court. In
the remodeling of JRC’s buildings that JRC is currently underway, an
indoor gym/basketball court and separate exercise area will be built.
- Smoking ban at JRC. Students
are not allowed to smoke at JRC. If they have a smoking habit when
they enroll at JRC, we require them to cease their smoking over the
course of 10 weeks and we offer them the assistance of a behavioral
self-management program to help them quit.
- Changing of our students’ menus to a
mostly whole food, plant-based diet. In October, 2003 we
changed the menus served to our students so that they are largely in
accord with the RAVE nutritional principles (plant-based, largely
whole foods). The basic guidelines that we used were those designed by
Dr. Caldwell Esselstyn for his study in which he has successfully
reversed heart disease in a group of patients whom he has followed for
many years. The beginnings of heart disease have been found in
teen-agers and in children. By teaching and serving a menu that
follows the Esselstyn guidelines, we are reversing even any beginnings
of heart disease in our students and providing them with a
super-healthy diet at the same time.
We do make certain exceptions to this diet, however. On four of the meals each week the student has a choice between a plant-based food and an animal food of the same type. For example, at one meal the student can choose either a soy-based hot dog or a meat-based hot dog. At another meal each week, the student can order food from a fast food restaurant and can order whatever he/she wishes. Milk is offered as a choice at each meal (a federal requirement) but all of our students prefer the flavored soy milks instead.
- Evaluation of the effect of changing our
student menus on student on student cholesterol values. In
October 2004, we evaluated the effect of our menu change on our
students’ levels of total cholesterol. We were pleased to discover
that our menu change accomplished a major improvement in our students’
cholesterol levels. The mean total cholesterol of 158 students who
were measured decreased from 166 to 145, a drop of 13%. This study is
reported in Exhibit 5, which is our electronic newsletter for October,
2004.
- Nutrition lectures designed for our
students. Whenever we have nutrition speakers speak at JRC,
we invite students to attend the talk. In some cases the speaker has
given two talks—one aimed at our staff and one especially for our
students.
- Eating/JRC Tutor self-instruction course
used with students. Currently we require each of our
students to do the Eating/JRC Tutor self-instruction course.
- Basic JRC Nutritional Course used with
students. We have shown many of the films in the JRC Basic
Nutritional Course to our students. When we have done this we also
required the students to complete the set of associated comprehension
questions that we designed for each film.
- Student attendance at our RAVE luncheon
series. We require our higher functioning students to
attend our RAVE luncheon series. This gives them an opportunity to
learn more about good nutrition and to enjoy a nutritious and
attractive buffet lunch that is a part of each RAVE Luncheon.
- Vegetable Garden. In 2004 we
started a very successful vegetable garden in some land between our
two main buildings.
- Food is Elementary Nutrition
Curriculum. In 2004 we began using the award-winning Food
is Elementary Curriculum designed by Antonia Demas, Ph.D. Each teacher
of the higher functioning students teaches one unit from this
curriculum each week.
- Nutrition Lecture by Harvey Zarren, M.D.,
to parents. At our Parents Visiting Day during the spring
of 2005 Dr. Harvey Zarren gave a lecture on nutrition that was
attended by both our students and their parents.
- Hiring of a chef to oversee RAVE food
preparation. We are very fortunate to have found a very
talented chef who is enthusiastic about helping us to accomplish our
nutritional goals. He has been overseeing the catering of our meals,
making sure that the catered food that we currently use to fee our
studeents meets RAVE requirements (no small task!). Chef Chad is also
preparing to oversee our own food preparation which will begin in May,
2006.
- Cooking classes with Chef Chad.
Our chef, Chad Gould, gives a course on cooking skills to many of our
students. In it the students learn how to prepare foods appropriate to
a RAVE lifestyle and why these foods are good for one’s health.
- Staff tasting of all foods served to
students. Each day the student lunches and dinners are
tasted by a group of our senior management staff, including Dr.
Israel. Each taster emails a form back to the chef with comments in
which he or she evaluates the food and makes recommendations.
- Student feedback on meal quality
solicited. After each meal we ask
students to rate the meal and give us comments and suggestions to
enable us to keep improving on the food’s quality and taste.
- Remodeling our building to create a full
kitchen and teaching kitchen. We are currently remodeling
both of our school buildings. In one of them (240 Turnpike Street) we
are installing a full working kitchen and expanded dining area, as
well as a classroom/kitchen in which cooking classes will be given to
our students.
- Salad bar open to student use. Our salad bar is open for use to our students during their meals and is quite popular. One of the first training films that we developed with our JRC Tutor software was a film to teach students how to use the salad bar properly.
Exhibits
2. Resources Available on the JRC Staff Wellness Website
3. Invitation to Participate in a Cholesterol Reduction Incentive Project
4. Procedures and Results for JRC’s Cholesterol Incentive Projects
5. October 2004 Email Newsletter
[1] The RAVE acronym was developed by Michael Anderson. See www.ravediet.com .