HH was developed in 1996 by Eloise Elliott while a doctoral student at Virginia Tech under the tutelage of Dr. George Graham. The web-based module provided the school environment with a much-needed instructional tool about healthy lifestyles, while taking advantage of the new educational technology in schools. In 1997, results from the initial pilot of HH in two 5th grade classes were promising as the module was determined to be both technologically functional and engaging to students. (Elliott, 1997). In Spring 2001 (Phase II), HH was piloted with 17 WV classes, with the study focused on assessing children’s knowledge, attitude and behavior related to physical activity before and after completing HH. The posttests revealed that the 5th grade children (N=233) made significant gains in knowledge and attitudes about physical activity (Palmer, 2001). There were also positive correlations between the students' attitudes and reported behaviors.

In Fall 2001, (Phase III) HH data collection instruments were revised based on the results of the previous phase, and pre/post evaluation measures were built into the module so that students complete the knowledge, attitude and behavior assessments as part of the module. HH was introduced to teachers in 18 WV counties through teacher training sessions conducted throughout the state. Preliminary findings from the knowledge pre/post tests show that the 5th grade users (N=32 classes) made significant gains in knowledge in all four topic areas (about the heart, nutrition, PA, tobacco). Preliminary analysis of the attitude-behavior pre/post survey indicate significant attitude changes related to physical activity and nutrition, and significant behavior changes in physical activity and tobacco use. (see Figures 1 and 2 below)

Figure 1: Knowledge Pre/Post Preliminary Analysis 2001-02

*Significant pre/post change at p<0.01   N=32 classes

Figure 2: Attitude/Behavior Pre/Post Preliminary Analysis 2001-02

*Significant pre/post change at p<0.01   N = 374 students

Beginning in Fall 2002 (Phase IV), HH became available for use in 47 WV counties.

Teacher Evaluations of Healthy Hearts

Classroom teacher evaluations reinforced the need for sound educational materials related to health education that can be used by children in school and at home. Of the 116 evaluations received from HH workshop participants last spring, 44 of the classroom teachers (45%) said they “briefly teach the HH concepts” in their current curriculum, 54 teachers (55%) said they teach most of the concepts currently, and 18 teachers (18%) said they do not teach the concepts. Of the teachers who briefly or mostly teach the concepts (n=98), 90 teachers (92%) rated the Healthy Hearts learning experiences “superior” or “above average” to the current health learning experiences they provide for their students.

Teacher questionnaires administered at the completion of the module during the 2001-02 school year revealed overwhelmingly positive attitudes about HH, and its use. Ninety-two percent of those surveyed said they would use the HH module again, 8% replied "maybe". None responded "no". Most all teachers agreed or strongly agreed that HH was a positive addition to the curriculum (87%) was beneficial to the children (99%) and met state standards in health (92%) and technology (92%). The fact is that classroom teachers may not be teaching these important concepts to children - or at least not teaching them as well as they might – probably due to time constraints and high-stakes testing pressures- especially in light of the obesity epidemic that is currently plaguing the country. In West Virginia alone, results from the CARDIAC project from 1999-2002 revealed that of 5887 5th grade children, almost 43% were considered to be overweight (BMI>85 percentile) and over 25% were obese (BMI>95 percentile). (Muratova et al, in press)