1. Project Title & Shipment Detail

    Name of Project: Health and Wellness Education for Children in Rural Communities

    Shipping Address You've Verified:

    Joan Francioni
    175 West Mark Street
    Winona State University
    Winona, MN 55987

    Number of Laptops (or other hardware) You Request to Borrow:  5

    Loan Length—How Many Months: 18 months

  2. Team Participants

    Name(s) & Contact Info: (include all email addresses & phone numbers)

    Joan Francioni, Computer Science Professor, Winona State University, jfrancioni@winona.edu, 507.457.2336
    Ann Smith, Computer Science Professor, Saint Mary’s University, asmith@smumn.edu, 507.457.1430

    Sr. Anne Francioni, Director, Whole Kids Outreach, Ellington, MO, casassnd2@juno.com, 573.663.3257
    Angela Scott Dixon, Director, Child Advocacy Studies Training Program, Winona State University, ascott@winona.edu, 507.459.1266
    Jan Dimmitt-Olson, Director, Master of Arts in Instruction, Saint Mary's University, jdimmitt@smumn.edu, 507.457.6600

    Employer and/or School:

    Winona State University, Winona, MN (Joan Francioni, Angela Dixon)
    Saint Mary’s University, Winona, MN (Ann Smith, Jan Dimmitt-Olson)
    Whole Kids Outreach, Ellington, MO (Sr. Anne Francioni)

    Past Experience/Qualifications:

  3. Both Joan and Ann are Computer Science professors, each with over 20 years teaching experience. Specific qualifications relative to this proposal: Ann has recently taught a course on iPhone App Development. Joan is a leader in promoting service-learning and has served as Director for the Engaged Teaching and Scholarship Center at WSU for the past three years.

    Sr. Anne Francioni is the founder and director of Whole Kids Outreach (WKO), a maternal-child health service organization committed to the unmet needs of women and children. The goal of WKO is to improve maternal-child health and to decrease child abuse and neglect by promoting positive parenting through education, support, and networking in the six-county service area. Of the many programs supported by WKO, the Family Enhancement Program, which addresses the needs of children who have unmet health developmental needs and/or experience any of the many problems associated with living in poverty, is particularly relevant to this project. In addition, WKO is currently partnering with Missouri Highland Healthcare in a HRSA Delta project to reduce chronic illness and promote health literacy, as well as with the Mark Twain Forest Regional Health Alliance, which serves 5 of the 6 WKO counties. Included in the latter partnership are established relationships with all of the service area schools, at least one of which will be chosen to participate in this project.

  4. Objectives

    The overall objective of this project is to develop a framework for a set of activities that can be used to teach children in rural, isolated regions, about health and wellness, in general, and help them to become caring adults, in particular. Initially, we will target 1st graders. The project will address strategies to prevent abuse by increasing child resiliency, and to improve health by teaching obesity prevention. We will also incorporate culturally sensitive, animal-human relationship lessons to improve the likelihood of decreasing transgenerational child maltreatment. The now well-noted Humane Society study [First Strike: The Violence Connection], identifies the connection between poverty, domestic violence and animal cruelty. Additionally, studies show that supporting families to care well for their children also correlates with increased positive animal treatment. Whole Kids Outreach has experience utilizing this principle in addressing the welfare needs of women, children, and families, both directly as well as indirectly, through efforts to teach respectful, kind and appropriate care of animals.

    The XO computer provides a perfect platform for getting this kind of information to young children in this part of the U.S. It can also serve to increase digital literacy among the children and provide access to important information for the parents through the children.

    As we will have college students in Minnesota developing the software for 1st graders in rural Missouri, our secondary goal is to develop a strong partnership with the education providers of the region. This partnership will help ensure that our college students develop effective and meaningful XO activities for the children and also that they develop a meaningful understanding of the power of technology to help people less fortunate than themselves.

    Specific Project Objectives:

    1. At least one fully implemented and tested XO activity will be developed that is fun, engaging, and educational for 1st graders in rural southeastern Missouri and that addresses health and wellness issues for young children.

    2. Computer Science college students will gain experience working in partnership with community members to develop technology solutions for social problems.

    3. A Computer Science course will be designed as a service-oriented, capstone course for majors at both Saint Mary’s University and Winona State University.
  5. Plan of Action

    The project will be done in three phases, carried out during the Spring 2011, Summer 2011, Fall 2011 and Spring 2012 semesters. Whole Kids Outreach serves a 6-county region of Missouri: Butler, Carter, Iron, Shannon, Reynolds, and Wayne. Our target population will be 1st graders in this region.

    Phase 1.

    The goal of Phase 1 will be to develop a prototype for at least one XO activity that meets the needs of the target population.

    A pilot course will be taught at Saint Mary’s University in the Spring 2011 semester. Five Computer Science majors are registered for this course – CS 397: Computing for Good (C4G) [C4G course syllabus]. In addition, at least 1 and possibly 3 Winona State students minoring in Child Advocacy Studies Training will take the course as an independent study.

    As part of the C4G course, students and faculty will travel to Whole Kids Outreach (WKO) in Ellington, MO for an orientation to the area and a site-visit at one of the elementary schools. Initial requirements for the XO activity will be defined at this time. Specifically, the staff at WKO will work with the C4G students to define health and wellness outcomes for children that the XO activity can address. Upon returning to Winona, the class will proceed with designing a prototype program in Python for the XO activity.

    At this point, a number of elementary schools in the region are interested in the project. WKO will invite key personnel from each interested school to meet with the C4G class in January. After that meeting, a decision will be made about which school(s) will continue on with the project.

    In addition to regular email communication, we will plan for bi-weekly Skype conference calls with the Missouri partners. At the end of the semester, the class will present their final design and prototype implementation to our community members via Skype.

    Phase 2.

    The goal of Phase 2 will be to have at least one robust XO activity fully implemented.

    In the Summer and Fall 2011 semesters, a Usability Study will be carried out with volunteer 1st graders in Winona and Missouri, using the prototype implementation from Phase 1. Results from this study, along with feedback from our Missouri partners, will then be incorporated into Version 2 of the implementation.

    Students from the C4G class will be given the opportunity to take an independent study course during the Summer 2011 semester to carry out the Usability Study and define the changes needed for Version 2. A contingent of faculty/students will make a summer trip to Ellington, MO to get feedback from the partners there.

    During the Fall 2011 semester, implementation and testing of the final version of the XO activity(ies) will be completed. Additionally, students who participated in the C4G course will be evaluated to determine the impact of the service component of the spring C4G class in meeting academic outcomes as well as civic-engagement outcomes of the course.

    Phase 3.

    The goal of Phase 3 will be to deploy our XO activity(ies) on actual XO machines for each 1st grader in one of the target elementary schools and to assess the outcomes of the project.

    By Phase 3, we hope to have approval for an OLPC Trial School Project and have XO machines ready for each 1st grader in at least one of the elementary schools in the target region of rural, southeast Missouri. Depending on the timing of this parallel effort, we will recruit students from the initial C4G course to make a trip to the region and observe the 1st graders working with the XO machines. We expect there may be minor code changes identified.

    Our intent is to continue with the C4G class in the Spring semesters at both Saint Mary’s and Winona State universities, as a capstone course option for Computer Science majors. The platform and community partner for this course will not always be the XO computer and Missouri 1st graders. However, we do expect that, once a full Missouri 1st grade class is using the XO machine, we will identify a number of other ideas for future XO games. Thus, for the Spring 2012 semester, the focus of the C4G course will likely be to design and implement additional XO activities for this target population. During this phase, we will adjust the initial syllabus for the C4G class based on the experiences of the first course offering.

    Whole Kids Outreach will take the lead in formally assessing the effectiveness of the XO activity(ies) developed in this project at meeting the specific health and wellness outcomes for children defined during Phase 1. They have an established relationship with the elementary schools in the 6-county region and will be able to ensure accurate documentation of progress towards goals and objective attainment, and follow-up for evaluation and reporting purposes. 

  6. Needs

    Why is this project needed?

    The main reason for this project is related to the children in the 6-county region of southeast Missouri (Butler, Carter, Iron, Shannon, Reynolds and Wayne counties) many of whom live in Appalachian-like poverty and are socially and geographically isolated. Additional reasons are related to rural outreach for health and wellness services in general, and for the college students' understanding of the power of civic-engagement.


    Research demonstrates that early family experiences profoundly influence both mental and physical health.  Intervention and prevention, therefore, has the greatest potential to prevent future health crises. By working directly within the home, family structure, and the local community schools, Whole Kids Outreach’s (WKO) programs help address many of the social barriers to health and wellness that children and families living in rural poverty-stricken areas face. In particular, WKO is committed to the prevention/intervention model in order to offer the most effective long-term solution for rural health.

    The target population for this project represents a socially and geographically isolated, economically depressed, underserved population of the rural U.S. The service area's infant mortality rate is 11.72 per 1,000 live births, as compared to 6.9 in the nation. This disproportionately high level of infant mortality is the result of a variety of socioeconomic, as well as geographic factors, which converge in the beautiful Missouri Ozarks. This natural beauty hides an Appalachian style of poverty, and results in trans-generational suffering endemic for child and animal abuse.

    The living conditions vary greatly in this region, from safe and clean houses to trailers that are at times pulled out of a dump and have neither electricity nor running water. Families often live miles from their nearest neighbor; telephone service is not always available; and many do not have access to functioning automobiles. In such impoverished and isolated areas, limited communication and transportation options severely affect access to health care and social services.

    There are County Health Clinics in this area, but access to pediatricians is not available in the most rural parts of the county. Social Services programs are limited to local church, community volunteer organizations, or state agencies. Small expensive local grocery stores are located in most towns, but often families live far down gravel roads, miles from the closest town. For example, in Reynolds County, only one full service grocery store is available in over 800 square miles. The concept of healthy choices, even with something as basic as daily diet, is often completely foreign to our client families. In this seemingly idyllic rural landscape hides the ugly reality of rural poverty in America. A combination of factors, including lack of community resources, local healthcare options and transportation access, add to the preventable poor health and high rates of abuse in the area. 

    In the greater OLPC/Sugar community?

    The basic issues of health and wellness for children that will be addressed in this project are relevant to other under-served populations as well. Like many impoverished rural areas in the U.S., the target population’s service area has very little ethnic diversity, being almost exclusively Caucasian with all other ethnic populations combined representing less than 4% of the population. Although the population is not a racial/ethnical minority, they represent a social and geographically isolated, underserved population of rural United States. Educational attainment is low in these populations, with births to mothers without a high school diploma being common.  Almost twice as many (31%) school-aged children live in poverty in the service area as compared to the overall state of Missouri average (18%). Adult unemployment in these counties is two-to-three times higher than that for the state. These kinds of statistics are widespread across many impoverished rural communities. 

    Although the specific XO activities developed will be tailored to a specific Missouri region, our approach will be to separate the framework of the overall activity(ies) from the specific regional content. In this way, we hope our solutions can be adapted to other regions/target populations in a straight-forward manner.

    With respect to our college students, we are interested in preparing them for future OLPC development efforts -- either as part of their coursework or on their own. Being able to work on a project that will directly impact children whom they are able to meet will be a strong incentive for their learning.

    Outside the community?

    Lifestyle choices add to the risk of chronic disease. Specifically, smoking, physical inactivity, poor dietary choices and obesity are among the prevalent risks of people in impoverished rural areas. Prior disease promotion efforts have been shown to increase awareness of these causes and effects, but they have not achieved sufficient change in behavioral risk factors. The relative isolation of communities in rural areas, along with the resultant sociologically autonomous groups that are formed, create additional barriers for health professionals to provide access to preventive services to this population.

    Although not the panacea for all problems, we believe technology offers a special way to engage students as well as their parents in learning about important and relevant health and wellness issues. Thus, with this project, we hope to gain insight for defining a general model for rural outreach of health/wellness information using technology.

    Why can't this project be done in emulation using non-XO machines?

    Or project is not limited to developing code. It includes a formal usability study involving children and an initial deployment of a full implementation in an elementary school. Although emulators can be useful for fleshing out concepts, our experience (most recently with iPhone App development) is that they do not offer students the ability to see exactly how their implementation will work on an actual machine. This may be with respect to performance, or positioning of graphics on a screen, or just general usability. Given our relatively short timeline, we feel it is imperative that our students have the actual machines to work on from the start.

    Why are you requesting the number of machines you are asking for?

    We want one per student in the class. Also, 5 is a reasonable number for our planned usability studies.

    Will you consider (1)salvaged/rebuilt or (2) damaged XO Laptops?

    This depends on the usability of the laptops with respect to the children testing the activity(ies). We expect to use the machines quite heavily during the year so we would need to have machines that are reliable for the year..

  7. Sharing Deliverables

    Project URL—where you'll blog specific ongoing progress: http://Winona360.org

    Initially, we will use http://cs.winona.edu/olpc as the website for this project. Once approved and started, we will use the Winona360.org site for ongoing progress updates.

    How will you convey tentative ideas & results back to the OLPC/Sugar community, prior to completion?

    Regular updates will be posted on our blog/website. In addition, students will be responsible for updates to the site as part of their course requirements.

    How will the final fruits of your labor be distributed to children or community members worldwide?

    We will work with an OLPC mentor to determine the best way to distribute our finished activity(ies) to the broader OLPC community. We expect that we will be able to publish the documented code on the OLPC wiki.

    Will your work have any possible application or use outside our community?

    As mentioned in Question 7, we hope to design a model for our XO activity(ies) that they can be implemented on different platforms in a straightforward manner.

    If yes, how will these people be reached?

    We intend to disseminate our results via publications and conference presentations relevant to computer science education, service-learning, and health and wellness. Specifically, we will submit papers to the annual computer science education conference (ACM's SIGCSE Conference www.acm.org/sigcse), the Journal of Higher Education Outreach and Engagement, and the Preventing Chronic Disease and Health Promotion Practice journals.

    Have you investigated working with nearby XO Lending Libraries or Project Groups?

    There are no Lending Libraries in our region. We have tried to contact the Minnesota olpc user group: "ICCA-MN OLPC Exploration" but have received no response. It appears this group is no longer active.

  8. Quality/Mentoring

    Would your Project benefit from Support, Documentation and/or Testing people?

    No. Our students will be able to do this under our supervision.

    Teachers' input into Usability?

    No. We will work directly with faculty/students in our Education departments.

    How will you promote your work?

    We will use our blog, local newsletters, the OLPC Wiki, and academic publications to promote our work. We also hope that the students involved in the C4G class will promote the work via their own communications channels (e.g., Facebook).

    Can we help you with an experienced mentor from the OLPC/Sugar community?


    If YES: specify the kind of Ongoing Mentoring that will benefit you most.

    We have web-publishing experience but could benefit from a mentor in the OLPC community with respect to identifying appropriate venues and conventions for disseminating the results.

    If NO: specify who will help you share your progress, creations & results.

  9. Timeline (Start to Finish)

    As described in Section 4, our project is broken down into three phases. In this section we define milestones for each phase, corresponding to school semesters.

    Phase 1: Spring 2011
    1. January: Site-visit to Ellington, MO with C4G students
    2. February: C4G students understand basics of Sugar/XO platform
    3. March: Specific health and wellness outcomes defined for 1st graders; Specific Requirements of XO activities defined
    4. May: Prototype Implementation of activity design
    Phase 2: Summer 2011
    1. June: IRB Approval for Usability Study with Winona and Missouri children volunteers
    2. July: Usability Studies carried out; site-visit to Ellington, MO
    3. August: Recommendations Report for Version 2 complete
    Phase 2: Fall 2012
    1. October: Version 2 implemented and tested in-house
    Phase 3: Fall 2012
    1. November: Initial deployment of XO activity(ies) on XO machines for Missouri 1st graders
    2. December: Fine-tuning of implementations, as needed
    Phase 3: Spring 2012
    1. January: Site-visit to Ellington, MO with new C4G class.
    2. February: Definition of course project(s)
    3. May: Assessment Report of specific health and wellness outcomes for 1st graders

    Specify how you prefer to communicate your ongoing progress and obstacles!

    Ongoing blog and Wiki updates, as appropriate.

    [X] I agree to pass on the laptop(s) to a local OLPC group or other interested contributors in case I do not have need for the laptop(s) anymore or in case my project progress stalls.