Obesity in Washington DC
Order Instructions:
Description
This is a continuation of the health promotion program proposal, part one, which you submitted in Unit 6. Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.
This paper below is a continuation of a previous paper you guys completed for me , and all what is require this week is to make corrections on the graded paper base on the comments of the prof and then respond to the following questions in 4 pages adding it as another section B to the revise paper. This section alone should contain a minimum of 4 pages. Follow the instructions below to complete this paper.
For this assignment add criteria 5-8 as detailed below: and label that section on your paper PART TWO
5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. Be certain to include a timeline
6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach
7. Provide a detailed plan for evaluation for each outcome
8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges.
Paper Requirements
• Your assignment should be 7-8 pages (excluding title page, references, and appendices)
• Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion.
References
Urban Institute (2010). Health police center. Vulnerable population. Retrieve from http://www.urban.org/health_policy/vulnerable_populations/
NOAA Coaster Services Center (2009). Linking people, information and technology. Introduction to conducting focus groups. Retrieve from http://www.csc.noaa.gov/digitalcoast/_/pdf/focus_groups.pdf
Eliot & Associates (2005). Guidelines for conducting a focus group. Retrieve from http://assessment.aas.duke.edu/documents/How_to_Conduct_a_Focus_Group.pdf
Dunn, L. (2014) Becker’s Hospital Review. 6 questions to evaluate population health initiatives. Retrieve from http://www.beckershospitalreview.com/healthcare-blog/6-questions-to-evaluate-population-health-initiatives.html
SAMPLE ANSWER
Obesity in Washington DC
Introduction
The health problem is obesity in Washington, District of Columbia. In the United States, obesity and overweight are today so prevalent considering that 66 percent of Americans are either obese or overweight. In Washington DC, the number of those who are obese exceeds those who are overweight. Obesity remains one of the main public health problems, and is even regarded as a long-standing epidemic by health officials. In 2012, the prevalence of obesity in District of Columbia was 21.9 percent(Trust for America’s Health & Robert Wood Johnson Foundation, 2014). In essence, Washington, D. C. is presently the 2nd least obese state countrywide. The purpose of this proposal is to address existing nursing knowledge related to health promotion of childhood obesity in Washington, D.C. A health promotion program is developed in this proposal to meet the need of obese children in Washington, D.C.
Vulnerable population and setting: the vulnerable population is children and the setting is schools and at homes. Currently, as regards childhood obesity in Washington, DC, and the current obesity rate is 21.4% and it ranks 3rd out of 51 states in the U.S. This rate is for 10 to 17 year old children (Trust for America’s Health & Robert Wood Johnson Foundation, 2014). In my proposed health promotion program, what I will specifically address is diet and lifestyle. I will seek to alter the diet of the 10-17 year olds and promote lifestyle changes by recommending healthier lifestyles such as exercising and doing physical activity.The proposed outcome is to reduce the rate of childhood obesity in Washington, D.C. to 12.5% or less within the next 12 months from the current 21.4%.
Risk factors for childhood obesity
The risk factors for childhood obesity include the following: (i) diet: consuming foods with high-calories like vending machine snacks and baked foods, is a key risk factor in addition to desserts, candy and soft drinks that have sugar (Pratt et al., 2013). (ii) Lack of physical exercise: in essence, a child who does not exercise has a higher chance of gaining weight since he/she does not burn calories by doing physical exercise. Playing video games and watching TV are some of the inactive leisure activities which contribute to this health problem (Voigt, Nicholls& Williams, 2014). (iii) Family history: a child is at a great risk of being obese if she/he comes from a family of overweight children. The child might also have a higher likelihood of becoming overweight particularly within an environment in which foods of high calorie are available all the time and doing physical activity is not encouraged. (iv) Psychological factors: it is notable that some children eat too much in order to deal with problems or cope with emotions for instance stress, or just to deal with boredom (Schaub, 2014). (v) Socio-economic factors:Pratt et al. (2013) stated that foodstuffs that will not spoil very fast, for instance cookies, crackers and frozen meals usually have a lot of fats and salts. These types of foods are typically less costly relative to healthier foods. They are also an easier option compared to healthier foods.
Literature Review – evidence-based interventions
Interventions for childhood obesity include the following: (i) weight-loss surgery: this procedure could be an effective and safe option for very obese children who have not been able to reduce their weight with the use of conventional methods of weight-loss. Nonetheless, just as with any sort of surgery, there are possible long-lasting complications as well as risks associated with weight-loss surgery (Schaub, 2014). This procedure is essential especially if the weight of the child poses a greater threat to his/her health compared to the possible risks of surgery. (ii) Healthy eating:parents are the people who purchase food, cook it and decide the place wherein the food would be eaten. Even small changes in diet could make a significant difference in the health of the child. Pratt et al. (2013) pointed out that vegetables and fruits should be chosen when purchasing groceries, sweetened beverages should be reduced, the number of times a child eats should be limited, the number of times the family eats out particularly at fast-food eateries should be limited, and appropriate portions of food should be served.
(iii) Doing physical activity: physical activity is an essential part of weight for children. This is primarily because it burns calories, builds strong muscles and bones, and assists the child to sleep well during the night. In essence, these kinds of habits established when the child is still young will help them to maintain healthy weight regardless of the social influences, hormonal alters, as well as rapid growth that usually result in overeating (Davison et al., 2013). (iv) Medications: the prescription medicine for weight loss available in the United States presently is orlistat/xenical. This drug is approved for children who are older than twelve years, and it serves to prevent fat absorption in the intestines. In case the child has a high level of cholesterol, it is recommended to provide him/her with a statin medication (Sung-chanet al., 2013).
Review of the strengths and weaknesses of the sources used
See Appendix 1
Implementation Plan
The proposed project would be carried out over a period of three months starting August 15, 2014 and ending October 25, 2014. The implementation will entail the following: (i) communicating with partners in my state to support the provision of much healthier and high-quality foods in schools; (ii) initiate promotional and marketing programs to encourage parents to get their children physically active. (iii) Recommending to policy makers to reduce advertising and marketing to children; and (iv) Providing resource opportunities and education for primary care providers and other healthcare practitioners to promote prevention of childhood obesity. The specific implementation plan table is included in Appendix 2.
Health promotion/disease prevention conceptual or theoretical model
The health promotion/disease prevention theoretical model applied is the Relapse Prevention theoretical model. As per this theoretical model, people who are starting regular physical activity as well as exercise programs may be helped by interventions which assist them to expect factors or barriers that could contribute to relapse. The key concepts of this theoretical model include lifestyle rebalancing, cognitive reframing, and skills training (Davison et al., 2013). Relapse Prevention theoretical model is applied in the implementation and evaluation of this proposal in that through training programs that would be offered to parents in Washington, D. C, parents would obtain the skills necessary to promote health and prevent obesity in their children and change their lifestyle. For instance, they will know which physical activities their children can do or which foods and beverages to avoid in order to stay healthy.
PART 2
In this second part of the proposal, a health promotion program is proposed using an evidence-based intervention found in the literature search to address the problem in the selected population/setting – childhood obesity in schools and at homes. An in-depth discussion of the specifics of the this intervention is provided which comprise resources necessary, those involved, as well as the feasibility for a nurse in an advanced role. The intended outcomes are described comprehensively concurrent with the SMART goal approach along with a detailed plan for evaluation of each outcome. Lastly, the potential challenges/barriers to implementing the proposed project in addition to strategies to address these barriers/challenges are thoroughly described.
- Health promotion program: lifestyle changes
The health promotion program for addressing the obesity in children is lifestyle changes, which basically includes encouraging (i) health eating; and (ii) doing physical activity and exercises in children.
- Resources necessary
The key resources include: (i) personnel, 6 people would be hired to help me implement this project; (ii) materials such as computers to prepare PowerPoint presentations to be used during training programs; (iii) time, this project will take 12 months to complete; and (v) money. This project proposal is estimated to cost $120,627 over the course of its implementation. This figure is broken down as shown in Appendix 3.
- People involved
To effectively address the problem of childhood obesity requires a multi-sectoral, sustained response that involves the general public, non-governmental and health professional sectors. It also includes visible leadership from ministers in Washington D.C. working together (Gollust, Niederdeppe& Barry, 2013). Nonetheless, the key people who would be involved include parents and caregivers in Washington, DC especially those with obese children. They will be involved by taking part in symposiums that my 6 colleagues and I will hold to educate them on appropriate diet and physical activity to prevent childhood obesity. In essence, caregivers and parents would be provided with nutrition education which will help develop and awareness of health eating habits and nutrition.
It is of note that caregivers and parents could help in preventing obesity in children simply by providing healthy snacks and meals, as well as daily physical activity (Rudolf, 2013). They will be encouraged to reduce sedentary activities of children by limiting amount of time that children play video games and watch TV. School heads in Washington D.C would be encouraged to increase the amount of time children engage in active play and to provide healthier foods.This strategy is essential considering that children spend a significant amount of their time in schools.
- Feasibility for a nurse in an advanced role
An advanced practice nurse would be required in order to provide preventative care, treatment, as well as management of obesity in children with the use of advanced diagnostic reasoning, clinical skills, and advanced therapeutic interventions. It is of note that an Advanced Practice Nurse assesses and documents progress of the patient towards achievement of anticipated outcomes and offers consultation to other healthcare providers in order to optimize the plan of care and effect system of change (Pearson, 2011). The Advanced Practice Nurse will be a Nurse Practitioner who will address the weight of the patient and encourage them to lose weight.
- Timeline
This program would be implemented over a period of 12 months. See the table showing timeline in Appendix 4.
- Intended Outcomes
The following are the intended outcomes of the health promotion program:
Intended Outcome 1: To reduce the overall rate of childhood obesity in Washington, D.C. to 12.5% or less within the next 12 months from the current 21.4%.
Intended Outcome 2: to increase the accessibility of nutritious foods and reduce the marketing, accessibility and availability of beverages and foods which are high in sugar, fat and/or sodium to children by February 2015.
Intended Outcome 3: To make physical and social environments in Washington, D.C. wherein children learn, play and live more supportive of healthy eating and physical activity by April 2015.
- Plan for evaluation of each outcome
Evaluating Intended Outcome 1: the first intended outcome would be evaluated by analyzing it to determine whether or not the overall rate of childhood obesity in Washington D.C has actually reduced to at least 12.5% by August 2015.
Evaluating Intended Outcome 2: analyzing to determine the extent with which beverages and foods high in sugar, fat and/or sodium are accessed, available to, and marketed to children in Washington, D.C by February 2015.
Evaluating Intended Outcome 3: ensuring that there are more physical and social environments in Washington, D.C in which children live, play and learn that are more supportive of healthy eating as well as physical activity by April 2015.
- Barriers to implementing the proposed project and strategies to address them
Resistance and lack of cooperation from some parents and schools: this project will entail suggesting to schools, as well as parents and caregivers to provide healthier, nutritious meals and physical activity to children. School heads and parents may resist this project citing high costs of foods which are more nutritious. Generally, more nutritious and healthier foods are more costly compared to less healthy foods such as cookies, crackers and frozen meals which usually have a lot of fats and salts. As such, some parents and schools may find healthier foods to be cost-prohibitive (Phillips, 2012). To address this barrier, I will inform them of the benefits of providing healthier foods and physical activity to children by informing that it is imperative in fighting the epidemic of childhood obesity.
Inadequate financial resources: this proposed project is estimated to cost a total of $120,627, which is a substantial amount and I cannot raise the whole of this amount by myself. Personally, I can only raise $2,043 leaving a huge deficit. I will overcome this challenge by seeking financial assistance from friends, family members, government and non-governmental agencies, as well as corporate and individual sponsors.
References
Davison, K. K., Jurkowski, J. M., Li, K., Kranz, S., & Lawson, H. A. (2013). A Childhood Obesity Intervention Developed by Families: Results from a Pilot Study. International Journal of Behavioral Nutrition and Physical Activity; 10: 3.
Gollust, S. E., Niederdeppe, J., & Barry, C. L. (2013).Framing the Consequences of Childhood Obesity to Increase Public Support for Obesity Prevention Policy.American Journal Of Public Health, 103(11), e96-e102. doi:10.2105/AJPH.2013.301271
Pearson, K. (2011). Starter Knowledge for Childhood Obesity: Tackling Childhood Obesity as a New Clinician. Advanced Healthcare Network.Available at http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Starter-Knowledge-for-Childhood-Obesity.aspx (Accessed August 1, 2014).
Phillips, F. (2012).Facing up to childhood obesity.Practice Nurse, 42(11), 14-17.
Pratt, C. A., Boyington, J., Esposito, L., Pemberton, V. L., Bonds, D., Kelley, M., & … Stevens, J. (2013). Childhood Obesity Prevention and Treatment Research (COPTR): Interventions addressing multiple influences in childhood and adolescent obesity. Contemporary Clinical Trials, 36(2), 406-413. doi:10.1016/j.cct.2013.08.010
Rudolf, M. (2013). Tackling Obesity Through the Healthy Child Programme: A Framework for Action. Leeds Community Healthcare.
Schaub, J. P. (2014). Childhood Obesity: Solutions to a Growing Problem. Integrative Weight Management, 123.doi:10.1007/978-1-4939-0548-5_9
Sung-Chan, P. P., Sung, Y. W., Zhao, X. X., &Brownson, R. C. (2013). Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obesity Reviews, 14(4), 265-278. doi:10.1111/obr.12000
Trust for America’s Health & Robert Wood Johnson Foundation. (2014). The State of Obesity: Washington, DC.Available at http://www.fasinfat.org/states/dc/ (Accessed July 20, 2014).
Voigt, K., Nicholls, S. G., & Williams, G. (2014).Childhood Obesity Interventions, Equity, and Social Justice.Oxford University Press. doi:10.1093/acprof:oso/9780199964482.003.0005
Appendix 1: Review of the strengths and weaknesses of the sources used
| Source | Strength | Weakness | |
| 1 | Davison, K. K., Jurkowski, J. M., Li, K., Kranz, S., & Lawson, H. A. (2013). A Childhood Obesity Intervention Developed by Families: Results from a Pilot Study. International Journal of Behavioral Nutrition and Physical Activity; 10: 3. | Source is up-to-date and relevant | Does not describe the causes or risk factors |
| 2 | Pratt, C. A., Boyington, J., Esposito, L., Pemberton, V. L., Bonds, D., Kelley, M., & Stevens, J. (2013). Childhood Obesity Prevention and Treatment Research (COPTR): Interventions addressing multiple influences in childhood and adolescent obesity. Contemporary Clinical Trials, 36(2), 406-413. doi:10.1016/j.cct.2013.08.010
|
Source is up-to-date.
Properly describes the interventions for childhood obesity It is research-based |
Does not describe pharmacological interventions |
| 3 | Schaub, J. P. (2014). Childhood Obesity: Solutions to a Growing Problem. Integrative Weight Management, 123. doi:10.1007/978-1-4939-0548-5_9 | Source is up-to-date and provides a clear description of the health problem along with apt interventions | Does not specify what policy makers can do to prevent the health problem |
| 4 | Sung-Chan, P. P., Sung, Y. W., Zhao, X. X., &Brownson, R. C. (2013). Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obesity Reviews, 14(4), 265-278. doi:10.1111/obr.12000 | Source is up-to-date
Is research-based |
Does not describe what schools can do to provide healthier meals for children |
| 5 | Voigt, K., Nicholls, S. G., & Williams, G. (2014). Childhood Obesity Interventions, Equity, and Social Justice. Oxford University Press. doi:10.1093/acprofoso/9780199964482.003.0005 | Source is up-to-date
Clearly describes the interventions for childhood obesity
|
Does not clearly describe the causes or risk factors |
Appendix 2: The implementation plan is as follows:
| Communication idea | Timeline | |
| 1 | Communicate with partners in Washington, DC about increasing meal reimbursement in order to support the provision of high-quality and much healthier foods in Washington DC schools | August 15, 2014 to August 22, 2014 |
| 2 | Begin and expand promotional and marketing programs to encourage parents in Washington DC to get their children physically active. | August 23, 2014 – August 30, 2014 |
| 3 | Encourage the increase of healthy and fresh foods in Washington, DC by supporting farmers markets in Washington DC through advising relevant authorities to create a farmer’s management network. | September 3, 2014 – September 10, 2014 |
| 4 | Create a statewide childhood obesity prevention social marketing campaign that will provide families in Washington DC tools and information for preventing childhood obesity. | September 11, 2014 – September 16, 2014 |
| 5 | Launch a healthy living challenge to the children of Washington DC that would incorporate obesity prevention social marketing campaign. | September 18, 2014 – September 28, 2014 |
| 6 | Recommend to policy makers in Washington DC to improve physical activity as well as nutrition policies within child care settings in Washington, DC. | October 2, 2014 – October 7, 2014 |
| 7 | Provide resource opportunities and education for primary care providers and other healthcare practitioners to promote prevention of childhood obesity. | October 10, 2014 – October 17, 2014 |
| 8 | Promote healthier environments in pre-school and school settings | October 18, 2014 – October 23, 2014 |
| 9 | Recommend policy makers to reduce advertising and marketing to children | October 24, 2014 – October 25, 2014 |
Appendix 3: budget for this project showing the financial resources required
| Budget Item | Cost ($) | |
| 1 | Recruiting 6 personnel who will help in the implementation each costing $ 2,105 per month for 12 months | $75,780.00 |
| 2 | Hiring conference room to train parents on ways to prevent obesity in their children costing $877 per month for 12 months | $10,524.00 |
| 3 | Materials such as flyers, brochures, magazines and handouts which contain text that encourage parents in Washington DC to ensure physical activity and healthy eating for their children | $905.00 |
| 4 | Running campaigns and promotional activities on radio and television in Washington, DC that encourage parents to ensure physical activity and healthy eating for their children | $33,418.00 |
| 5 | Total cost of project | $120,627.00 |
Appendix 4: Timeline
| Communication idea | Timeline | |
| 1 | Communicate with partners in Washington, DC about increasing meal reimbursement in order to support the provision of high-quality and much healthier foods in Washington DC schools | August 15, 2014 to October 22, 2014 |
| 2 | Begin and expand promotional and marketing programs to encourage parents in Washington DC to get their children physically active. | October 23, 2014 – December 30, 2014 |
| 3 | Encourage the increase of healthy and fresh foods in Washington, DC by supporting farmers markets in Washington DC through advising relevant authorities to create a farmer’s management network. | December 3, 2014 – February 10, 2015 |
| 4 | Create a statewide childhood obesity prevention social marketing campaign that will provide families in Washington DC tools and information for preventing childhood obesity. | February 11, 2015 – April 16, 2015 |
| 5 | Launch a healthy living challenge to the children of Washington DC that would incorporate obesity prevention social marketing campaign. | April 18, 2015 – May 28, 2015 |
| 6 | Recommend to policy makers in Washington DC to improve physical activity as well as nutrition policies within child care settings in Washington, DC. | May 6, 2015 – June 20, 2015 |
| 7 | Promote healthier environments in pre-school and school settings | June 18, 2015 – July 23, 2015 |
| 8 | Recommend policy makers to reduce advertising and marketing to children | July 24, 2015 – August 25, 2015 |
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