Story Board Decreasing the Number of Times I Eat Fast Food on Week Nights BH, MSN, RN George Mason University Class Member HSCI Fall Semester 2004

Story Board Problem Statement Monday through Friday I eat fast food 100 % of the time and do not eat fast food 0% of the time.

Story Board Routines Pre-Intervention List of routines TimeActivityImpact on habit 5:30AMGet up and showerNone 6:00AMGet dressed and ready for workNone 6:30AMCare and feed dogNone 6:45AMLeave for workNone 7:00AMArrive at workNone 5:00-6:00PMLeave work for homeSometimes I'm not home until 7:00PM 5:30-7:00PMDecide what to have for dinnerOften leads to fast food purchase 7:30PMDinner cleared away and dishes done 8:00-10:00PMStudy 10:00PMWatch TVNone 11:00PMBedNone

Story Board Routines

Story Board Post-Intervention List of Routines TimeActivityImpact on habitOther benefits 5:30AMGet up and showerNone 6:00AMGet dressed and ready for work None 6:30AMCare and feed dogNone 6:45AMLeave for workMake sure the evening meal for this day is ready to put in oven or crock-pot with directions for the process owner who is responsible. Involves others in process of responsibility for dinner 7:00AMArrive at workNone 5:00-6:00PMLeave work for home Try to get home around 5:30PM to get meal on table and last minute preparations. Helps me leave work in timely fashion. Required hours are 8:00AM-4:30PM 5:30-7:00PMHave dinner that was prepared at home - no dining out SuccessHealthier eating. Less money spent on fast food. Family eats together. 7:30PMDinner cleared away and dishes done Leaves time to prepare for following day Meets criteria for collecting data 8:00PMMake preparations for next day meal Success in keeping to plan Sense of accomplishment for next day. 8:30PM-10:00PMStudyNone 10:00PMRelax, watch TVNone 11:00PMBedNone

Story Board PLANSept. 5 I had a meeting of the process owners for decreasing dining out. The process owners are my husband and our 2 sons, ages 23 and 18. They agreed they would like to have meals prepared at home and to help. My husband and older son are often home and could assist in preparation. One of the problems was they did not want to be responsible for planning a meal but would help prepare it. Another problem was knowing who would be home for dinner on what night and what time we would be home. PDCA - PLAN

Story Board PDCA - PLAN The planned interventions are: 1. Plan a weekly menu on Sunday 2. Shop according to the menu on Sunday 3. Buy a magnetic calendar for the refrigerator-list meals and when we would not be home 4. Prepare some meals ahead of time 5. Use the crock-pot for meal preparation when there was no one to prepare a meal that day 6. I would come home between 5-5:30PM more consistently 7. The process owners would assist as needed 8. Do storyboard

Story Board PDCA - DO DOSept Bought a magnetic calendar - listed menu and each process owners daily activities 2. Completed a daily routine and work routine list - there was a relationship between the number of hours I work and how tired I am. 3. Sept. 13, Added another process owner from work to actively help me leave work at 5PM. 4. Started the above plan on Sept. 7

Story Board PDCA - CHECK This personal improvement is a school project for 12 weeks. I will collect data daily and report to Dr. Alemi as requested. Week 1 & 2 trend above the UCL because I dined out every evening. Day 11 the interventions were introduced and immediate improvement was realized. Days 19, 30 and 33 were days when I ate dinner out but were only one day in duration therefore did not represent a significant variance in process. However on the chart where I recalculated the UCL for the post-intervention timeframe those 3 data points were at the UCL. Weeks 3-12 were consistent with process change.

Story Board Time Between Chart-Constant UCL

Story Board Time Between Chart – Pre and Post Intervention UCL

Story Board ACT The interventions were effective in producing process change Maintain the gain with the changes Spread the concept of change to other behaviors and utilize “time between charts” to verify process improvement