Obesity is a major health issue in the United States

QUESTION

Lorrie is 16 years old and 75 pounds overweight. Her father is a school bus driver who was recently diagnosed with type 2 diabetes and cardiovascular disease. Her mother works for a sewing company. She is overweight with high LDL levels. She is taking two antihypertensive medications at present time. At a recent health science fair at Lorrie’s school, a student-led screening clinic documented Lorrie’s blood pressure at 140/92 mm Hg. The family immigrated from Honduras 5 years ago and they do not have health insurance.

During health science fair, the following data was recorded: 55% of the students with BMI 25.0 to <30 and 15% of the students with BMI 30.0 or higher.

Consider yourself a community health nurse.

1. Is obesity a major health issue in the United States?
2. According to the National Health and Nutrition Examination Survey (NCHS, CDC; BRFSS, 2012), how is obesity defined?
3. What is your role as a community nurse?
4. What risk factors should be explored for Lorrie’s family for cardiovascular disease? Mention social determinants of health in this case. Incorporate the concepts of health promotion and risk reduction.
5. Would you apply any of the behavioral change models to address health promotion and risk reduction in this case (theoretical frameworks of behavioral change / models discussed on Chapter 5 of textbook). Describe your selection.
6. Public health nurses use statistics to demonstrate the need for obesity program development and community interventions. According to the most recent CDC data: What data were identified about obesity in children and adults?
7. Is there a necessity of planning a community nursing intervention? How will you do that? Will you implement it alone or in collaboration/teamwork? Will you look for funding? How?
8. If you decide to conduct a community intervention. How would you evaluate the community-level intervention(s)?
9. Will you use social marketing to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society. Which resources will you use?
10. Mention references that support any of the above (1 through 9) (mention at least 4 peer-reviewed articles).

ANSWER

Obesity is a major health issue in the United States, with significant implications for individuals’ health and the overall healthcare system. According to the National Health and Nutrition Examination Survey (NCHS, CDC; BRFSS, 2012), obesity is defined as having a body mass index (BMI) equal to or greater than 30.0. It is measured by calculating an individual’s weight in relation to their height.

As a community health nurse, my role is to promote and improve the health of the community through various interventions. In Lorrie’s case, my primary focus would be on health promotion and risk reduction strategies for her and her family. Considering her family history and risk factors for cardiovascular disease, it is crucial to explore additional risk factors such as tobacco use, physical inactivity, unhealthy diet, and psychosocial factors. Furthermore, social determinants of health, such as access to healthcare, education, and socio-economic status, should be considered in developing appropriate interventions.

To address health promotion and risk reduction, I would apply the transtheoretical model of behavioral change. This model recognizes that individuals go through stages of change when modifying their behaviors. By assessing Lorrie and her family’s readiness for change, I can tailor interventions accordingly. The model’s stages include precontemplation, contemplation, preparation, action, and maintenance. Through this framework, I can provide education, counseling, and support to help Lorrie and her family adopt healthier lifestyles and reduce their cardiovascular risk factors.

According to the most recent CDC data, the prevalence of obesity in children and adults remains alarmingly high. In children aged 2-19, the prevalence of obesity is approximately 18.5%, affecting nearly 13.7 million children. In adults, the prevalence of obesity is even higher, with approximately 42.4% of adults affected. These statistics highlight the urgent need for obesity program development and community interventions to address this growing public health concern.

Planning a community nursing intervention would involve collaboration and teamwork with various stakeholders, including community members, local organizations, and healthcare providers. Engaging community members and seeking their input and involvement is crucial for the intervention’s success. Funding can be sought through grants, partnerships with local organizations, or leveraging existing resources within the community.

To evaluate the community-level intervention(s), I would use a combination of qualitative and quantitative methods. This could include assessing changes in BMI and other health indicators, conducting surveys or interviews to gather feedback from community members, and monitoring the implementation and effectiveness of the intervention over time. Continuous evaluation and feedback from the community would guide adjustments and improvements to the intervention.

Social marketing strategies can be employed to change health behaviors and beliefs, social or cultural norms, and community standards. Utilizing various resources such as educational campaigns, social media platforms, community events, and partnerships with local media outlets can help disseminate health messages and promote behavior change.

References:
1. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA, 311(8), 806-814.
2. Bray, G. A., Kim, K. K., & Wilding, J. P. (2017). Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity Reviews, 18(7), 715-723.
3. Williams, E. P., Mesidor, M., Winters, K., Dubbert, P. M., & Wyatt, S. B. (2015). Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current Obesity Reports, 4(3), 363-370.
4. Shubair, M. M., & McCauley, L. (2020). Obesity and mental health: A scoping review of evidence and practice. Clinical Obesity, 10(5), e12411.