Digital Repository Doctoral Projects Fall 2022 Family Media Plan Education and Access for Junior High Counselors to Support Students and Their Families Carrie Hanni Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Hanni, C. (2022) Family media plan education and access for junior high counselors to support students and their families Weber State University Doctoral Projects. https://cdm.weber.edu/digital/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact archives@weber.edu. FAMILY MEDIA PLAN EDUCATION AND ACCESS 1 Carrie Hanni Family Media Plan Education and Access for Junior High Counselors to Support Students and Their Families by Carrie Hanni A project submitted in partial fulfillment of the requirements for the degree of DOCTOR OF NURSING PRACTICE Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, Utah Date December 16, 2022 Project Consultant: Glen Porter, M. Ed. _______________________________ ______________________________ Carrie Hanni DNP-FNP, BSN, RN Date _______________________________ _____________________________ DNP Project Faculty (Electronic Signature) Date _______________________________ ______________________________ Melissa NeVille Norton DNP, APRN, CPNP-PC, CNE Date Graduate Programs Director Cynthia Beynon, PhD, RN, CNE December 16, 2022 December 16, 2022 December 16, 2022 FAMILY MEDIA PLAN EDUCATION AND ACCESS 2 Table of Contents Abstract ........................................................................................................................................... 4 Implementation of Family Media Plans for the Mental Health of Junior High Students ............... 5 Background and Problem Statement ........................................................................................... 5 Diversity of Population and Project Site ..................................................................................... 6 Significance for Practice Reflective of Role-Specific Leadership ............................................. 6 Literature Review............................................................................................................................ 7 Search Methods ........................................................................................................................... 7 Adolescent Depression................................................................................................................ 8 Screening for Depression ........................................................................................................ 9 Adolescent Anxiety ..................................................................................................................... 9 Digital Technology ................................................................................................................... 10 Technology Management...................................................................................................... 12 Parents and Family Media Involvement ............................................................................... 12 Discussion ................................................................................................................................. 13 Implication for Practice............................................................................................................. 14 Framework .................................................................................................................................... 14 Project Plan ................................................................................................................................... 15 Project Design ........................................................................................................................... 16 Needs Assessment/Gap Analysis of Project Site and Population ............................................. 16 Cost Analysis and Sustainability of Project .............................................................................. 16 Project Outcomes ...................................................................................................................... 17 Consent Procedures and Ethical Considerations....................................................................... 17 Instruments to Measure Intervention Effectiveness .................................................................. 18 Project Implementation ................................................................................................................. 18 Project Intervention ................................................................................................................... 18 Project Timeline ........................................................................................................................ 19 Project Evaluation ......................................................................................................................... 19 Data Maintenance and Security ................................................................................................ 20 Data Collection and Analysis.................................................................................................... 20 Table 1 ...................................................................................................................................... 21 Findings..................................................................................................................................... 21 Strengths ............................................................................................................................... 22 Weaknesses ........................................................................................................................... 22 Discussion ..................................................................................................................................... 22 FAMILY MEDIA PLAN EDUCATION AND ACCESS 3 Translation of Evidence into Practice ....................................................................................... 23 Implications for Practice and Future Scholarship ..................................................................... 23 Sustainability......................................................................................................................... 24 Dissemination ....................................................................................................................... 24 Conclusion ................................................................................................................................ 24 References ..................................................................................................................................... 25 Appendix A ................................................................................................................................... 32 Appendix B ................................................................................................................................... 33 Appendix C ................................................................................................................................... 35 Appendix D ................................................................................................................................... 36 Appendix E ................................................................................................................................... 38 Appendix F.................................................................................................................................... 40 Appendix G ................................................................................................................................... 41 FAMILY MEDIA PLAN EDUCATION AND ACCESS 4 Abstract Purpose: Adolescent depression and anxiety rates are on the rise. Adolescents are at a higher risk for depression and anxiety as their daily screen time increases. National pediatric medical guidelines recommend that children and adolescents who utilize screened devices have a family media plan. The goal of this DNP project was to increase the knowledge of the school counselors at South Ogden Junior High regarding the correlation between adolescent mental health and screen time and provide them with family media plans as a mental health resource. Methodology: Participating junior high counselors completed a pre-and post-project survey to measure knowledge regarding the correlation between student depression, anxiety, and screen use. The counselor's familiarity with available resources to impact the student population was also assessed. Counselors were educated on the project tool and provided copies to utilize during the implementation period. The project's effectiveness was evaluated through a qualitative survey based on a Likert scale. Results: Project analysis demonstrated the intervention increased counselor knowledge of (1) the correlation between adolescent mental health and screen time and (2) available resources for utilization. Improvement in the counselors' comfort level with discussing the project topics and confidence in their ability to impact student and family screen use habits were also supported by project evaluation. Implications for practice: Counselor knowledge increased through the educational intervention and resources provided. Project findings support the continued use of family media plans. Other schools in the district may also benefit from utilizing the project tools and resources. Keywords: adolescent depression, adolescent anxiety, screen time, family media plans, adolescent screen time recommendations FAMILY MEDIA PLAN EDUCATION AND ACCESS 5 Implementation of Family Media Plans for the Mental Health of Junior High Students Research indicates that adolescents are at a higher risk for depression and anxiety as their daily screen time increases (Boers et al., 2019; Kim et al., 2020; Stiglic & Viner, 2019; Twenge & Campbell, 2018; Wang et al., 2019). Depression is the leading cause of disability-related health loss in adolescents worldwide (Law, 2017), and youth depression rates are rapidly rising in the United States. In 2020, an increase of 121,000 adolescents experienced a severe major depressive episode compared to 2019 (Mental Health America, n.d.). The American Academy of Pediatrics (AAP, 2017) and the American Academy of Child and Adolescent Psychiatry (AACAP, 2020) recommend that children and adolescents who utilize screened devices have a family media plan (FMP) in place to promote mental health. Adolescents and their parents can benefit from education and support to create FMPs for their homes. Counselors at South Ogden Junior High (SOJH) are in a position to offer this education and support. The creation, implementation, and utilization of FMPs can assist students and their families in addressing screen time behaviors and habits that could be connected to poor mental health outcomes (Canadian Paediatric Society, 2019). The primary purposes of this project are to 1) increase counselors' knowledge of the correlation between adolescent mental health and screen time and 2) provide a mental health resource counselors can utilize with students and their families. Background and Problem Statement Counselors and administrators at SOJH report increasing rates of reported student depression, anxiety, and disciplinary action associated with screen misuse (B. Prall, personal communication, February 6, 2021). These school employees expressed an interest in obtaining resources to offer parents when students receive disciplinary action related to screen misuse or FAMILY MEDIA PLAN EDUCATION AND ACCESS 6 presenting with depression and anxiety concerns. Literature reports that among depressed youth, only one-third are identified by their primary care providers and receive mental health care (Zuckerbrot et al., 2018). Thus, the school setting is an ideal site for project implementation to reach adolescents who are not recognized by their health care providers. National pediatric medical guidelines recommend that children and adolescents who utilize screened devices have an FMP in place (AAP, 2017; AACAP, 2020). Family media plans can bring student and parental attention to screen habits that carry potential mental health risks and take steps to mitigate the risks. Counselors at SOJH are in a position to offer education and support regarding FMPs for students and their families. Diversity of Population and Project Site School administrators, counselors, teachers, students, and student families will all benefit from the implementation of this project. Direct education and training will be provided to the four school counselors who will utilize the FMP tool to educate the students and their families. The four counselors involved in this project oversee the entire student population. South Ogden Junior High is located in the suburbs of Ogden, Utah, in Weber County. There are approximately 850 students in grades 7th-9th enrolled in the school. About 75% of the student population is White, and 17% is Hispanic (National Center for Education Statistics, 2020). Significance for Practice Reflective of Role-Specific Leadership Doctorate of Nursing Practice Family Nurse Practitioners (DNP-FNPs) support clinical prevention and population health outcomes that improve the nation's health (American Association of Colleges of Nursing [AACN], 2006). Proactive interventions can be directed toward individuals and families in community settings. Outcomes of this project include FAMILY MEDIA PLAN EDUCATION AND ACCESS 7 increased awareness of mental health disparities among adolescents, greater collaboration between healthcare professionals and educators, and improved community health. As the indirect population of this project, improved mental health for adolescents is the intended outcome following project implementation. Literature Review This literature review aims to establish evidence to support the implementation of appropriate interventions to address the rising rates of adolescent depression and anxiety related to the marked increase in screen time use. Providing evidence for the project implementation site is also needed. Primary themes from the literature review include: (a) prevalence and recent increase of adolescent depression and related consequences, (b) prevalence and increase of adolescent anxiety and related consequences, and (c) adolescent use of digital technology and technology management. Search Methods Search terms for this project included "adolescent depression", "adolescent anxiety", "adolescent digital technology use", "suicide", "depression screening", "screen time", "family media plans", "technology safety", "adolescent anxiety consequences", "adolescent depression consequences", "pediatric screen time recommendations", "depression screening in school", and "internet addiction". Databases used for article searches included Google Scholar, Stewart Library One Search, PubMed, EBSCO host, and Elsevier. Inclusion criteria included articles relating to children or adolescents. Articles older than ten years old were excluded from use. FAMILY MEDIA PLAN EDUCATION AND ACCESS 8 Adolescent Depression The American Psychological Association (APA; 2019) identifies major depressive disorder (MDD) as a mood disorder characterized by a depressed mood and loss of pleasure or interest in previously enjoyable activities, lasting at least two weeks. Depressive disorders can include symptoms of sadness or low mood, crying, loss of interest in previously enjoyed activities, decreased energy, and changes to sleeping and eating patterns. These changes must differ notably from earlier function levels and occur over two weeks. Depressive symptoms in adolescents can present as fatigue, irritability, anger, acting out negatively, and poor relationships (APA, 2019). Suicide is the third major cause of death among adolescents aged 10 to 19 in the U.S. and the leading cause of death of adolescents ages 10-17 in Utah (Lu, 2019; Utah Department of Health, Bureau of Health Promotion, 2022). Adolescents experiencing depression have more frequent and costly physical health problems, reduced school attendance, as well as increased risk for suicide (Mullarkey et al., 2019) and substance use (Cioffredi, 2021). In Utah, during the two years from 2019 to 2021, a 4.4% increase was seen in students in grades 8, 10, and 12 reporting feeling sad or hopeless, totaling 35.1%. Almost one-fifth of this student population reported seriously considering attempting suicide in the past 12 months (Utah Department of Health, Bureau of Health Promotion, 2022). More than half of adolescent suicide victims were reported to have a depressive disorder diagnosis at the time of their death (APA, 2019). Multiple studies confirm the association between adolescent depression and screen time use (Boers et al., 2019; Kremer et al., 2014; Maras et al., 2015). Monitoring the Future, a cross-sectional survey of 8th, 10th, and 12th-grade students (N=1,260,159), provided annual data on FAMILY MEDIA PLAN EDUCATION AND ACCESS 9 adolescent depressive symptoms. Since 2012, adolescent depressive symptoms have increased markedly for girls and steadily for boys (Lu, 2019; Keyes et al., 2019). Screening for Depression Clinical settings fail to adequately identify adolescents with depression (Zuckerbrot, 2018), so an alternative location to impact this vulnerable population is needed. Zuckerbrot (2018) explained that among depressed adolescents, only one-third are identified by their primary care providers and receive mental health care. Lu (2019) found that untreated adolescent depression may result in substantial adverse health and social consequences. These effects can compound into adulthood and result in life-long mental health struggles. Solutions to address adolescent digital technology use, depression, and anxiety can begin with screening in the school setting (Law, 2017). The United States Preventive Services Task Force (USPSTF) recommends screening for major depressive disorder (MDD) in children and adolescents aged 12 to 18 years (Siu, 2016). Sekhar et al. (2021) performed a national survey of parents (n=770), which found strong parental support for depression screening in schools to begin during middle school. Among those parents who responded to the survey, 93.2% wished to be informed if their child was screened positively for MDD. Adolescent Anxiety Nearly one third of all adolescents ages 13 to 18 will experience an anxiety disorder (McCarthy, 2019). Centers for Disease Control and Prevention (CDC) identifies several anxiety disorders adolescents may experience. These include separation anxiety typically experienced when adolescents are away from a parent or loved one. Phobias present as extreme fears of specific things or situations. Social anxiety is experienced when fear is felt in places with other people, including in school. General anxiety is a feeling of worry about the future or bad things FAMILY MEDIA PLAN EDUCATION AND ACCESS 10 happening. Severe anxiety can present as a panic disorder when sudden, unexpected, intense fear can elicit physical symptoms such as a pounding heart, difficulty breathing, vertigo, shaking, and sweating. Adolescents experiencing anxiety can also become irritable, angry, have difficulty sleeping, and frequently complain of fatigue, headaches, and stomach aches (CDC, 2021). Pediatric anxiety is associated with severe disability and has a high degree of persistence into adulthood (Ginsberg et al., 2018). A systematic review conducted by Lijster et al. (2018) indicated that adolescents with anxiety disorders experience a range of significant social and academic problems. The review identified that adolescents with anxiety disorders have lower social competence when compared to their less-anxious peers. Moreover, they report increased negative interpersonal relationships, higher incidences of loneliness, and victimization. Socially anxious or depressed adolescents communicate and self-disclose online more often with strangers (Canadian Paediatric Society, 2019). A longitudinal study of Chinese adolescents (n=1545) and a cross-sectional study of Iranian adolescents (n=1052) both reported significant correlation between adolescent internet addiction and anxiety (Li et al., 2019; Ostovar et al., 2016). Adolescents who spend four or more hours a day on screen time are three times more likely to be diagnosed with a generalized anxiety disorder (Kim et al., 2020). Ogders & Jensen (2020) reviewed multiple narrative reviews, meta-analyses, cohort studies, and assessment studies involving adolescent technology use and well-being and concluded that small associations exist between the two. Digital Technology Screen time is the amount of time spent using a device with a screen, including smartphones, tablets, gaming consoles, television, and computers (AACAP, 2020). The U.S. proportion of adolescents between the age of 13 and 17 who own a smartphone has reached 89%, FAMILY MEDIA PLAN EDUCATION AND ACCESS 11 which more than doubled over six years (Abi-Jaoude et al., 2020). The average teen checks their smartphone more than 80 times daily (Twenge, 2017). Widespread screen time use among adolescents includes social media, with 70% of teenagers accessing social media multiple times per day (Boers et al., 2019; Abi-Jaoude et al., 2020). Adolescents' higher levels of social media use are associated with increased anxiety and depression (Ghaemi, 2020; Woods & Scott, 2016). Parents or guardians of adolescents may be unaware of their children's screen time and device utilization. At least twenty-five percent of teens report their parents have little to no knowledge of their online activity (Rideout, 2015). Morris & Cravens (2017) suggest that interpersonal relationships are interrupted by digital technology use and termed this association "technoference." Technoference is associated with lower relationship satisfaction and poorer individual well-being (Morris & Cravens, 2017). Livingstone et al. (2011) identified bedroom culture after finding that 49% of European children aged nine to 16 used the Internet in their bedrooms, resulting in increased social isolation. Adolescent bedroom internet use is concerning because it is highly correlated with nighttime-specific social media use and linked to poor sleep quality, low self-esteem, and increased anxiety and depression (Woods & Scott, 2016). People of all ages have become increasingly involved in the digital world. Ekşi et al. (2020) found that technology use has increased exponentially and resulted in technology addiction. Internet addiction is a form of technology addiction. It has been defined as compulsive and excessive internet use, discomfort when deprived of the Internet, decreased relations with others due to internet use, and avoidance of specific problems and feelings. Smartphone addiction is described as the excessive use of a smartphone, phone use without taking breaks, feelings of emptiness without a smartphone, and concentration problems with one's daily work FAMILY MEDIA PLAN EDUCATION AND ACCESS 12 due to excessive use of a smartphone. Adolescents are at risk for internet and smartphone addiction (Ekşi et al., 2020; Young & Nabuco De Abreu, 2017). A significant correlation exists between the level of internet addiction and depression symptoms in adolescents (Banjanin et al., 2015). Puri and Sharma (2016) identified a correlation between increased internet usage and depression, social isolation, and loneliness amongst adolescents. Depressive states are highest in adolescents with three or more hours per day of digital technology usage (Ghaemi, 2020). Achieving a balance between necessary screen time and excessive screen time use will require solutions that engage adolescents and their families. Technology Management Sevil et al. (2019) researched the effects of multiple behavior change interventions on student healthy lifestyle measures in a school setting, including screen time. Their study showed significant improvement in sedentary screen time levels among the students who experienced tutorial action plans, healthy lifestyle project learning, and family involvement in extracurricular learning activities over one academic year. Abdel Magid et al. (2021) identified that schools influence adolescents' screen time use more than other factors in their neighborhoods. In 2010, a school-based curriculum titled Common Sense Education was initiated to teach students safe digital citizenship. Since its initiation, over 600,000 educators and 60,000 schools have utilized the program to support parents who look to schools for advice on parenting in this digital age (James et al., 2019). These results support educating adolescents about screen time use in the school setting. Parents and Family Media Involvement Padilla-Walker et al. (2020) examined parenting styles connected to media monitoring, their effects on decreasing adolescent media time, and the associated internalizing behaviors of FAMILY MEDIA PLAN EDUCATION AND ACCESS 13 depression and anxiety. They concluded that the only parenting style to accomplish this is autonomy-supportive restrictive monitoring, classified as restrictive or active media monitoring. The focus of this parenting style is that adolescents will benefit from rules, regulations, and guidance from parents about media use (2020). Symons et al. (2020) support parental monitoring of children's internet and social media use and refer to this behavior as parental media mediation. Parental mediation may include monitoring online behavior and imposing internet use rules, which generally reduces online risk exposure. Current AAP guidelines recommend family discussions about media use and developing an FMP to help address the increased prevalence of adolescent screen time use (2017). Creation of FMPs can be encouraged in the school setting for students who screen positively for depression, anxiety, or digital technology misuse. This intervention will require education for teachers, counselors, and parents on the importance of the media plans and how they can benefit each student. The AAP's FMP template addresses each family member's type and amount of media use (AAP, 2017). The formation of these plans should bring to parental attention areas where their child needs assistance or help in creating better screen time habits. Discussion Limitations of the literature on adolescent digital technology use, depression, and anxiety include lack of instrument validity/reliability, small sample sizes, and subjective data use. Most research related to these topics has resulted in correlational and associative relationships, not causality (Kim et al., 2020; Kremer et al., 2014; Odgers & Jensen, 2020). There is a general lack of quasi-experimental or experimental data related to this topic. Emerging studies on the effects of digital screen time have contributed data to a relatively new and unresearched topic related to adolescent depression and anxiety (Ginsburg et al., 2018; FAMILY MEDIA PLAN EDUCATION AND ACCESS 14 Maras et al., 2015). Strengths of the literature include many large representative sample sizes spanning many years in multiple settings. These studies provide important data for tracing adolescent depression and anxiety rate changes. These findings support the need for further research on this topic, particularly including intervention-based, objective, and longitudinal studies. Establishing cause and effect through experimental study designs would be profoundly beneficial. It is not adequate to substantiate the rising trends in adolescent depression and anxiety. Instead, future research and quality improvement projects must focus on identifying and implementing meaningful interventions to address the problem. Implication for Practice This project formation and implementation support quality and safety in nursing practice by aiding in the care of a vulnerable population. Research supports that modifying student and family digital use habits can reduce depressive and anxious symptoms in adolescents, thus resulting in healthier communities (AAP, 2019; Canadian Paediatric Society, 2019). A gap was identified in resources available to school counselors to address student depression and anxiety related to screen use. In this school where a need was identified, this project aims to increase the counselors' knowledge of the correlation between adolescent mental health and screen time and provide them with a mental health resource to share with students. Framework Kotter's change model provides the framework to guide this improvement project. The steps of this model include: (a) establish a sense of urgency, (b) create a guiding coalition, (c) develop a vision and strategy, (d) communicate the change vision, (e) empower broad-based FAMILY MEDIA PLAN EDUCATION AND ACCESS 15 action, (f) generate short term wins, (g) consolidate gains and produce more change, and (h) anchor new approaches in the culture (Finkelman, 2022). Urgency (a) was established in a meeting with the SOJH administration and counseling members as they expressed a need for assistance in addressing mental health concerns with their students. A guiding coalition (b) was created, including the school administration, counselors, and the faculty mentor. Working closely with the faculty mentor, a vision and strategy (c) for project implementation was outlined. The counselors' concerns and feedback were considered as project tools were idealized. Based on this feedback, communication of the change vision (d) occurred with the project consultant (counselor). Project training (e) was provided to SOJH counselors to ensure they were knowledgeable and ready to implement the screening tool and technology safety plans throughout the school year. This education was essential to ensure the counselors were prepared to act on the tools provided. Short-term wins (f) were assessed throughout the school year to further the use of project tools. Positive changes witnessed by the counselors were shared with other project participants to motivate continued change (g) with project tool implementation. Project tools were anchored (h) into the school culture and will be considered for district dissemination. District-wide utilization of the project tools will be made available for dissemination district-wide, allowing for greater outreach to adolescents in the Weber County area. Project Plan The project was implemented during the second semester of the 2021-2022 school year. Direct project goals were to increase counselors' knowledge of the correlation between adolescent mental health and screen time and provide them with a mental health resource. FAMILY MEDIA PLAN EDUCATION AND ACCESS 16 Indirect project goals included reducing adolescent depression and anxiety rates following FMP implementation. Project Design A quality improvement design was used for this project. It provided education and access to an FMP for counselors to distribute to their students. Implementation occurred over five months. Needs Assessment/Gap Analysis of Project Site and Population The direct project target population included the four counselors at SOJH. Indirect participants included the 7th-9th grade students the counselors had stewardship over, the students' parents, and school administration members. Key stakeholders included the members of the Weber School District administration, which necessitated approval from the Director of Curriculum and Assessment on all project interventions before project implementation. Counselors and administrators at SOJH have witnessed increased rates of reported student depression, anxiety, and disciplinary action following screen misuse (B. Prall, personal communication, February 6, 2021). Through the project implementation, the counselors at SOJH were offered the education to support the AAP (2017) recommendation that children and adolescents who utilize screened devices have a FMP. Cost Analysis and Sustainability of Project Project budgetary requirements were discussed with the counselors at SOJH and approved for the project implementation period. Included costs were: • One hundred printed copies of the FMP form cost $30 and were distributed evenly among the four counselors. The project author supplied the initial 100 copies. • SOJH will provide additional copies if required beyond the initial 100. FAMILY MEDIA PLAN EDUCATION AND ACCESS 17 The project's sustainability plan included recording the project implementation presentation to be shared and reviewed for future school years. Project Outcomes The project had two primary outcomes: • Secondary school counselors at SOJH will receive education regarding and access to FMPs during the second semester of the 2021-2022 school year. • Counselors will demonstrate increased knowledge of FMPs as a resource for students presenting with depression and anxiety related to screen use by the end of the 2021-2022 school year. Consent Procedures and Ethical Considerations Weber State University's Institutional Review Board (IRB) ruled this project did not need formal IRB approval because it met the requirements for quality improvement. The Director of Curriculum and Assessment for Weber School District also ruled that IRB approval was not required. In addition, the director approved all project documents, tools, and presentation materials for use at SOJH. Consent to participate in the project was obtained from all four SOJH counselors. Before project implementation, each SOJH counselor was sent a project participation agreement letter (see Appendix B). The letter explained the project's intended purpose, outlined the time commitment required of them to participate, and required their signature of agreement to be further involved in the project. This agreement form was a requirement from the district Director of Curriculum and Assessment for the counselors to participate in the project. FAMILY MEDIA PLAN EDUCATION AND ACCESS 18 Instruments to Measure Intervention Effectiveness The project's effectiveness was evaluated through a survey developed with Harvard guidelines and based on a Likert scale (see Appendix A). The survey was administered to the counselors before project implementation and at the end of the 2021-2022 school year, marking the project data collection conclusion. Survey results measured the difference in counselor knowledge and opinions regarding student depression, anxiety, and screen use. The number of FMPs distributed to students during the measurement period was also assessed to aid future project sustainability efforts. Project Implementation This project was implemented after all the counselors completed the pre-project survey. The counselors received education on project research findings and tools. They were supplied with copies of the FMP to use during the project implementation phase, which occurred during the second semester of the 2021-2022 school year. Project Intervention After the project participation agreement forms were signed, an appointment was created for the project implementation date. On that date, the counselors were administered the pre-media safety survey (see Appendix A) to measure their knowledge and opinions regarding student depression, anxiety, and screen use. This deliverable was integral to the project results because the same survey was used as the data source for project evaluation after the implementation period. A presentation outline (see Appendix C) was given to each counselor to summarize the expected learning objectives for the project teaching. The project teaching PowerPoint (see Appendix D) visually displayed research data and project outcomes to supplement verbal FAMILY MEDIA PLAN EDUCATION AND ACCESS 19 instruction. The PowerPoint also provided references for data support of educational topics. The counselors were able to learn how to create a FMP so they could guide their students in doing so. After the project teaching, the counselors received 100 copies of the FMP. Instructions were delivered to the counselors on accounting for additional copies made so that the number of FMPs distributed could be evaluated after the project. The FMP form (see Appendix E) included vital statistics regarding adolescent depression and anxiety, the stance from the AAP on FMP creation, and a Q.R. code to lead the student and their families to the AAP's website healthychildren.org where they could create their FMP. Lastly, the counselors completed a presentation feedback survey (see Appendix F) to evaluate their opinions of the project presentation. This survey addressed the topics presented and the delivery from the DNP-FNP student. The results of this survey were utilized to improve the project presentation for possible future use by SOJH or other secondary schools in the Weber School District. Project Timeline All project documents, tools, and presentation materials were created between September 2021 and November 2021. They were submitted for district approval before project implementation. Implementation took place in January 2022 (see Appendix G). Data collection was completed in May 2022. Project Evaluation The project was evaluated using pre- and post-media safety survey data, presentation evaluation data, qualitative counselor feedback, and FMP distribution. The knowledge and attitudes of the counselors related to FMPs as a resource for students presenting with depression and anxiety related to screen use was evaluated. The 13-item survey addressed the counselors' FAMILY MEDIA PLAN EDUCATION AND ACCESS 20 knowledge regarding the correlation between mental health and screen time, their ability to help students with the resources available, and their comfort level in discussing screen time and its resulting impacts on students and their families. Data Maintenance and Security Project surveys, results, and data were stored on a password-protected computer. Data from all project tools were kept anonymous due to the limited number of project participants to ensure the confidentiality of their responses. Paper copies of completed project tools were shredded after being uploaded to a secured computer. Data Collection and Analysis Paper pre- and post-surveys were administered to the counselors at SOJH during the initiation and conclusion of the project implementation period. The questions listed on the pre and post-surveys were identical for accurate project data analysis (see Appendix A). Survey results were compiled by hand and totaled by the DNP student. The counselors' knowledge of the correlation between adolescent mental health and screen time was assessed. Their opinion regarding available resources and their ability to impact student and family screen use was also evaluated. Their comfort level discussing mental health and screen time was assessed because the project tool required teaching and instruction from the counselors to the students and their families (see Table 1). FAMILY MEDIA PLAN EDUCATION AND ACCESS 21 Table 1 Results of pre-and post-survey questions Note: To see the complete survey, see Appendix A. Findings The survey results demonstrated increased counselor knowledge and attitudes towards adolescent mental health and screen time generally. The provided project resource improved counselor opinions on all survey questions. An increase was noted in counselor knowledge of the correlation between adolescent mental health and screen time, awareness of available resources, Strongly Disagree % Disagree % Neither % Agree % Strongly Agree % Pre Post Pre Post Pre Post Pre Post Pre Post Mental health and screen time correlation 0 0 0 0 0 0 75 0 25 100 Resources to identify depression 0 0 0 0 50 0 25 100 25 0 Resources to identify anxiety 0 0 0 0 50 0 25 75 25 25 Help students with depression 0 0 0 0 25 0 75 75 0 25 Help students with anxiety 0 0 0 0 25 0 75 50 0 50 Discussing screen time with students 0 0 0 0 25 0 50 25 25 75 Discussing screen time with parents 0 0 0 0 25 0 75 50 0 50 Discussing depression with students 0 0 0 0 25 0 50 50 25 50 Discussing depression with parents 0 0 0 0 25 0 50 50 25 50 Discussing anxiety with students 0 0 0 0 25 0 50 50 25 50 Discussing anxiety with parents 0 0 0 0 25 0 50 50 25 50 Counsel will affect behaviors 0 0 25 0 50 25 25 75 0 0 Counsel to parents affect behaviors 0 0 25 0 50 25 25 75 0 0 FAMILY MEDIA PLAN EDUCATION AND ACCESS 22 comfort level with discussing the project topics, and confidence in their ability to impact students and their families regarding their screen habits (see Table 1). Feedback from the project implementation presentation included a strong agreement that counselor time was well spent and that the DNP student was knowledgeable about the presentation topics. Written feedback included a suggestion to include a demonstration on how to navigate the AAP's webpage healthchildren.org to create an FMP during the presentation. During the implementation period, counselors utilized the FMP resource. An estimated 50 copies of the project tool were distributed. Strengths All counselors employed at SOJH participated in the project. The student population was divided between the counselors, so each student had an opportunity to be impacted by the project resources through their assigned counselor. The project implementation presentation and teaching provided all the necessary resources for the counselors to use the FMPs immediately. Weaknesses Potential improvements in the project design would include more participants and a more extended implementation period. The intervention could be further analyzed with increased participation at multiple schools within the district. Discussion Adolescent depression and anxiety rates are increasing, (Lu, 2019; Utah Department of Health, Bureau of Health Promotion, 2022; McCarthy, 2019) and a correlation between increased screen time and depression and anxiety symptoms has been corroborated (Boers et al., 2019; Kim et al., 2020; Stiglic & Viner, 2019; Twenge & Campbell, 2018; Wang et al., 2019). FAMILY MEDIA PLAN EDUCATION AND ACCESS 23 National pediatric medical guidelines recommend FMPs as a tool to help adolescents and their parents develop action plans to best support their overall health (AAP, 2017; AACAP, 2020). This quality improvement project was developed to increase the knowledge of secondary school counselors regarding the correlation between adolescent mental health and screen time and provide an FMP tool as a mental health resource. Current evidence supports the development of all project teaching material and the FMP tool. Implementing the project in the school setting increased counselor knowledge of the correlation between adolescent mental health and screen time. The project provided a mental health resource the counselors utilized with students and their families. Translation of Evidence into Practice It is vital to increase identification of adolescent depression and anxiety in the school setting. Efforts to address mental health in schools can help bridge the gap to connect to students most in need. School counselors and educators are crucial in impacting the adolescent mental health crisis. The project highlighted the positive impact school counselors can have on the mental health of their students through FMP education and dissemination. The counselors involved in the project reported that their opinions, knowledge, and comfort level in addressing student mental health concerns and screen time use were positively influenced by the project's teaching and tools. Implications for Practice and Future Scholarship Project findings support the continued use of FMPs. Implications for future practice include an extended implementation period and expansion to other secondary schools in the FAMILY MEDIA PLAN EDUCATION AND ACCESS 24 district. Recommendations for future scholarship include increased counselor training and demonstration on how to help students and their families create an FMP. Sustainability The counselors involved in the project expressed interest in the continued utilization of the project tool. The lead counselor kept a copy of all project education documents to review and share with the other counselors each school year. He also retained the remaining FMP copies to distribute to students after the implementation period was completed. The counselors plan to include the FMP tool with each mental health student support group they oversee. The school will cover the continued cost involved to print more FMP tools. Dissemination A school administrator at SOJH was reassigned to another junior high in the district for the 2022-2023 school year and requested the project teaching documents and FMP tool to implement at the new school. After the DNP project, the project paper with its included data was sent to the district director of curriculum and assessment to review for possible dissemination to other schools in the district. Project findings and implications will be shared with other nurse leaders in an academic setting. Conclusion Interventions are needed to address rising adolescent depression and anxiety rates. Project implementation demonstrated that the school setting is a viable location for such interventions. Secondary school counselors felt it was valuable to receive the project teaching regarding adolescent depression, anxiety, screen use rates, and how to help students and their families create FMPs. Nurse leaders can play a critical role in collaborating with educational professionals to support and impact this vulnerable population. FAMILY MEDIA PLAN EDUCATION AND ACCESS 25 References Abi-Jaoude, E., Treurnicht Naylor, K., & Pignatiello, A. (2020). Smartphones, social media use and youth mental health. Canadian Medical Association Journal, 192(6), 136-141. https://doi.org/10.1503/cmaj.190434 Abdel Magid, H. S., Milliren, C. E., Pettee Gabriel, K., & Nagata, J. M. (2021). Disentangling individual, school, and neighborhood effects on screen time among adolescents and young adults in the United States. Preventative Medicine, 142, 106357. https://doi.org/10.1016/j.ypmed.2020.106357 American Academy of Child and Adolescent Psychiatry. (2020). Screen time and children. Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/ Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx American Academy of Pediatrics. (2017). Use of media by school-age children and adolescents: A policy statement from the AAP. Retrieved from https://www.aafp.org/afp/2017/0701/ afp20170701p56.pdf American Association of Colleges of Nursing. (2006, October). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/DNP/DNP-Essentials American Psychological Association. (2019). Clinical practice guideline for the treatment of depression across three age cohorts. Retrieved from https://www.apa.org/depression- guideline/guideline.pdf Banjanin, N., Banjanin, N., Dimitrijevic, I., Pantic, I. (2015). Relationship between internet use FAMILY MEDIA PLAN EDUCATION AND ACCESS 26 and depression: Focus on physiological mood oscillations, social networking and online addictive behavior. Computers in Human Behavior, 43, 308-312. https://doi.org/10.1016/j.chb.2014.11.013 Boers, E., Afzali, M. H., Newton, N., & Conrod, P. (2019). Association of screen time and depression in adolescents. The Journal of the American Medical Association (JAMA) Pediatrics, 173(9), 853-859. https://doi.org/10.1001/jamapediatrics.2019.1759 Canadian Paediatric Society. (2019). Digital media: Promoting healthy screen use in school-aged children and adolescents. Paediatrics & Child Health, 24(6), 402-408. https://doi.org/10.1093/pch/pxz095 Centers for Disease Control and Prevention. (2021). Anxiety and depression in children. Retrieved from https://www.cdc.gov/childrensmentalhealth/depression.html Cioffredi, L., Kamon, J., & Turner, W. (2021) Effects of depression, anxiety and screen use on adolescent substance abuse. Preventive Medicine Reports, 22, 1-6. https://doi.org/10.1016/j.pmedr.2021.101362 Ekşi, F., Demirci, I., & Tanyeri, H. (2020). Problematic technology use and well-being in adolescence: The personal and relational effects of technology. The Turkish Journal on Addictions, 7(2), 107-121. https://doi.org/10.5152/ADDICTA.2020.19077 Finkelman, A. (2022). Quality improvement: A guide for integration in nursing (2nd ed.). Jones and Bartlett Learning. Ghaemi, S. N. (2020). Digital depression: A new disease of the millennium? Acta Psychiatrica Scandinavica, 141, 356-361. https://doi.org/10.1111/acps.13151 Ginsburg, G. S., Becker-Haimes, E. M., Keeton, C., Kendall, P. C., Iyengar, S., Sakolsky, D., Albano, A. M., Peris, T., Compton, S. N., & Piacentini, J. (2018). Results from the child/ FAMILY MEDIA PLAN EDUCATION AND ACCESS 27 adolescent anxiety multimodal extended long-term study (CAMELS): Primary anxiety outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 57(7), 471-480. https://doi.org/10.1016/j.jaac.2018.03.017 Keyes, K. M., Gary, D., O'Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among U.S. adolescents: Trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8), 987-996. https://doi.org/10.1007/s00127-019-01697-8 Kim, S., Favotto, L., Halladay, J., Wang, L., Boyle, M. H., & Georgiades, K. (2020). Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders. Social Psychiatry and Psychiatric Epidemiology, 55, 1469–1478. https://doi.org/10.1007/s00127-020-01833-9 Kremer, P., Elshaug, C., Leslie, E., Toumbourou, J. W., Patton, G., C., & Williams, J. (2014). Physical activity, leisure-time screen use and depression among children and young adolescents. Journal of Science and Medicine in Sport, 17(2), 183-187. https://doi.org/10.1016/j.jsams.2013.03.012 James, C., Weinstein, E., & Mendoza, K. (2019). Teaching digital citizens in today's world: Research and insights behind the Common Sense K–12 Digital Citizenship Curriculum. San Francisco, CA: Common Sense Media. Law, W. C., McClanahan, R., & Weismuller, P. C. (2017). Depression screening in the school setting: Identification of the depressed adolescent. NASN School Nurse, 32(6), 364-370. https://doi.org/10.1177/1942602X17726095 FAMILY MEDIA PLAN EDUCATION AND ACCESS 28 Li, G., Hou, G., Yang, D., Jian, H., Wang, W. (2019). Relationship between anxiety depression sex obesity an Internet addiction in Chinese adolescents: A short term longitudinal study. Addictive Behaviors, 90, 421-427. https://doi.org/10.1016/j.addbeh.2018.12.009 Lijster, J. M., Dieleman, G. C., Utens, E. M. W. J., Dierckx, B., Wierenga, M., Verhulst, F. C., & Legerstee, J. S. (2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108-117. https://doi.org/10.1016/j.jad.2018.01.008 Livingstone, S., Haddon, L., Görzig, A., & Ólafsson, K. (2011). Risks and safety on the Internet: The perspective of European children. Full Findings. LSE, London: E.U. Kids Online. Lu, W. (2019). Adolescent depression: National trends, risk factors, and healthcare disparities. American Journal of Health Behavior, 43(1), 181-194. https://doi.org/10.5993/ AJHB.43.1.15 Maras, D., Flament, M. F., Murray, M., Buchholz, A., Henderson, K. A., Obeid, N., & Goldfield, G. S. (2015). Screen time is associated with depression and anxiety in Canadian youth. Preventtive Medicine, 73, 133-138. https://doi.org/10.1016/j.ypmed.2015.01.029 McCarthy, C. (2019). Anxiety in teens is rising: What's going on? Retrieved November 11, 2021, from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Anxiety-Disorders.aspx Mental Health America. (n.d.). 2020 Mental health in America-Youth data. Retrieved July 10, 2021, from https://mhanational.org/issues/2020/mental-health-america-youth-data#three Morris, N., & Cravens Pickens, J.D. (2017). "I'm not a gadget": A grounded theory on unplugging. The American Journal of Family Therapy, 45(5), 264-282. https://doi.org/10.1080/01926187.2017.1365665 FAMILY MEDIA PLAN EDUCATION AND ACCESS 29 Mullarkey, M. C., Marchetti, I., & Beevers, C. G. (2019). Using network analysis to identify central symptoms of adolescent depression. Journal of Clinical Child and Adolescent Psychology, 48(4), 656-668. https://doi.org/10.1080/15374416.2018.1437735 National Center for Education Statistics. (2020). South Ogden Junior High. https://nces.ed.gov/ccd/schoolsearch/school_detail.asp?ID=490120000638 Odgers, C. L., & Jensen, M. R. (2020). Annual research review: Adolescent mental health in the digital age: Facts, fears, and future directions. The Journal of Child Psychology and Psychiatry, 61(3), 336-348. https://doi.org/10.1111/jcpp.13190 Ostovar, S., Allahyar, N., Aminpoor, H., Moafian, F., Binti Md Nor, M., & Griffiths, M. D. (2016). Internet addiction and its psychosocial risks (depression, anxiety, stress and loneliness) among Iranian adolescents and young adults: A structural equation model in a cross-sectional study. International Journal of Mental Health and Addiction, 14(3), 257-267. https://doi.org/10.1007/s11469-015-9628-0 Padilla-Walker, L. M., Stockdale, L. A., & McLean, R. D. (2020). Associations between parental media monitoring, media use, and internalizing symptoms during adolescence. Psychology of Popular Media, 9(4), 481-492. http://dx.doi.org/10.1037/ppm0000256 Puri, A., & Sharma, R. (2016). Internet usage, depression, social isolation and loneliness amongst adolescents. Indian Journal of Health and Wellbeing, 7(10), 996-1003. http://www.iahrw.com/index.php/home/journal_detail/19#list Rideout, V. (2015). The Common Sense census: Media use by tweens and teens. Retrieved from Common Sense Media website: https://www.commonsensemedia.org/sites/default /files/uploads/research/census_researchreport.pdf Sekhar, D.L., Gebremariam, A., Waxmonsky, J.G., Walker-Harding, L.R., Stuckey, H., Batra, FAMILY MEDIA PLAN EDUCATION AND ACCESS 30 E., Rosen, P., Kraschnewski, J.L., & Clark, S.J. (2021). Parent views on school-based depression screening: Findings from a national survey. Journal of Adolescent Health, 68(2), 403-406. https://doi.org/10.1016/j.jadohealth.2020.08.023 Sevil, J., Garcia-Gonzalez, L., Abos, A., Generelo, E., & Aibar, A. (2019). Can high schools be an effective setting to promote healthy lifestyles? Effects of a multiple behavior change intervention in adolescents. Journal of Adolescent Health, 64(4), 478-486. https://doi.org/10.1016/j.jadohealth.2018.09.027 Siu, A. (2016). Screening for depression in children and adolescents: U.S. preventive services task force recommendation statement. Pediatrics, 137(3), 1-8. https://doi.org/10.1542/peds.2015-4467 Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: A systematic review of reviews. BMJ Open, 9(1), e023191. https://doi.org/10.1136/bmjopen-2018-023191 Symons, K., Vanwesenbeeck, I., Walrave, M., Van Ouytsel, J., & Ponnet, K. (2020). Parents' concerns over internet use, their engagement in interaction restrictions, and adolescents' behavior on social networking sites. Youth & Society, 52(8), 1569-1581. https://doi.org/10.1177/0044118X19834769 Twenge, J. M., & Campbell, W.K. (2018). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventative Medicine Reports, 12, 271-283. https://doi.org/10.1016/ j.pmedr.2018.10.003 Utah Department of Health, Bureau of Health Promotion. (2022). 2021 Utah Adolescent Health Report. Salt Lake City, UT: Utah Department of Health. FAMILY MEDIA PLAN EDUCATION AND ACCESS 31 Wang, X., Li, Y., & Fan, H. (2019). The associations between screen time-based sedentary behavior and depression: A systematic review and meta-analysis. BMC Public Health, 19(1). http://dx.doi.org.hal.weber.edu:2200/10.1186/s12889-019-7904-9 Woods, H. C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51, 41-49. https://doi.org/10.1016/j.adolescence.2016.05.008 Young, K. S., & Nabuco De Abreu, C. (2017). Internet addiction in children and adolescents: Risk factors, assessment, and treatment. Springer Publishing Company. Zuckerbrot, R. A., Cheung, A., Jensen, P.S., Stein, R. E. K., & Laraque, D. (2018). Guidelines for adolescent depression in primary care (CLAD-PC): Part I. Practice preparation, identification, assessment, and initial management. Pediatrics, 141(3), 1-21. https://doi.org/10.1542/peds.2017-4081 FAMILY MEDIA PLAN EDUCATION AND ACCESS 32 Appendix A Media Safety Survey Directions: Please rate how much you agree or disagree with these statements. 1. There is a correlation between adolescent mental health and screen time use. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 2. There are resources available to help me identify students with depression. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 3. There are resources available to help me identify students with anxiety. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 4. I can help students with depression. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 5. I can help students with anxiety. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 6. I am comfortable discussing screen time use with students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 7. I am comfortable discussing screen time with parents or guardians of students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 8. I am comfortable discussing depression with students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 9. I am comfortable discussing depression with parents or guardians of students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 10. I am comfortable discussing anxiety with students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 11. I am comfortable discussing anxiety with parents or guardians of students. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 12. My counsel to students regarding screen time use will affect their behaviors. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 13. My counsel to the parents or guardians of students regarding screen time use will affect their behaviors. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree FAMILY MEDIA PLAN EDUCATION AND ACCESS 33 Appendix B South Ogden Junior High Counselor, My name is Carrie Hanni, and I am a Family Nurse Practitioner student at Weber State University. I am creating a quality improvement project to fulfill graduate requirements for my program. I have a great interest in the mental health of children and adolescents. I specifically have studied the correlation between screen use and adolescent depression and anxiety. I want to support counselors as they work with students who present with these concerns. You are invited to participate in this quality improvement project. Your involvement is entirely voluntary. I respect that your time is limited and valuable. Below is a simple outline of the time requirements to participate in the project: • Complete the pre-project implementation survey in mid-January 2022- 10 minutes • Attend my project presentation at SOJH, where I will share my research findings and the tool that can be offered to students and their families to help them navigate the challenges related to screen time and mental health- 20 minutes o You are invited to utilize the family media plan tool with your students and their parents during the second school semester as you deem helpful • Complete the post-project implementation survey at the end of May 2022- 10 minutes Project surveys will not contain any personal data. Survey results will be reviewed as an aggregate for my project paper at the end of my program. Information from this project will serve as a pilot for possible future use in other schools throughout the district. I want to thank you in advance for supporting my educational pursuits. If you would be willing to participate in this quality improvement project, please sign and date below. FAMILY MEDIA PLAN EDUCATION AND ACCESS 34 ____________________ _______________________ __________________ Name Signature Date FAMILY MEDIA PLAN EDUCATION AND ACCESS 35 Appendix C Family Media Plans to Support Students and Families Presentation Objectives: • Identify trends in adolescent mental health • Identify trends in adolescent screen time consumption • Identify correlations between screen time and mental health outcomes • Examine the use of family media plans to address student mental health outcomes • Identify the role counselors have in this quality improvement project Adolescent Mental Health • What has changed in the last decade? • What needs to change? Adolescent Screen Time Use • What has changed in the last decade? • What needs to change? Correlations • What does the research show? • What research is needed further? Family Media Plans • The power of making commitments • What behaviors do family media plans address? • How are mental health outcomes impacted? Counselors • Position of influence and impact FAMILY MEDIA PLAN EDUCATION AND ACCESS 36 Appendix D FAMILY MEDIA PLAN EDUCATION AND ACCESS 37 FAMILY MEDIA PLAN EDUCATION AND ACCESS 38 Appendix E FAMILY MEDIA PLAN EDUCATION AND ACCESS 39 FAMILY MEDIA PLAN EDUCATION AND ACCESS 40 Appendix F Directions: Please rate your level of agreement with the following statements about the presentation. 1. My time was well served by this presentation. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 2. I knew a lot about these topics before the presentation. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 3. I enjoyed this presentation. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 4. I learned new things that I can employ in my work. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 5. I left feeling like I wanted to learn more about the topics presented. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 6. The presenter delivered the material in a clear and structured manner. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 7. The presenter was knowledgeable about the topics and any related issues. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 8. The presenter answered questions effectively. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 9. The presenter was enthusiastic about the topic. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 10. The presenter was well organized and prepared. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 11. Do you have any comments, suggestions, or feedback on the presentation? FAMILY MEDIA PLAN EDUCATION AND ACCESS 41 Appendix G Task Completion Date Develop Family Media Plan 11/11/2021 Create Pre/Post Media Safety survey 11/11/2021 Project proposal presentation at Weber School District office 11/12/2021 Create Counselor Participation Agreement letter 11/22/2021 Submit application for district project approval 11/22/2021 Obtain project approval from Weber School District Curriculum Director 11/23/2021 Presentation Teaching Sheet and Presentation Feedback Form creation 11/24/2021 Obtain counselor agreement for project participation 1/10/2022 Finalize and rehearse Project PowerPoint 1/13/2022 Obtain 100 Family Media Plan copies to distribute following project presentation 1/13/2022 Project presentation and implementation at SOJH 1/14/2022