Community Health Nursing Diagnosis Statement
Community Health Nursing Diagnosis Statement
A. Community Health Field Experience Time-log
(see attached document)
B. Community Health Nursing Diagnosis Statement: Obesity
Increased risk for obesity among school aged children (3 years old to 18 years old) in New Market, Alabama related to poor nutritional intake and decreased physical activity as demonstrated by an increased BMI and high poverty rate in the community which affects the ability to obtain adequate nutrition.
B1. Health Concerns Linked to Target Population – Health Inequity/Disparity
My field experience topic of childhood obesity prevention and target population was completed in New Market, Alabama. New Market is a small, rural town of Madison County, located in the northern part of the state. New Market was founded in the early 1800s and is approximately 17.5 square miles (Huntsvilleal.gov, 2019) with a current population of around 1.31k people. The median age of citizens is 43.5 years old and, 28.1% of the New Market population is less than 20 years old. Alabama has the sixth highest adult obesity rate in the nation and the ninth highest obesity rate for youth ages 10 to 17. (State of Childhood Obesity, 2019). Overweight people in New Market make up 35.1% of the population as compared to 34.4% of the state of Alabama’s population. The Low-income preschool obesity rate for this rural area is also higher at 14.1% as compared to the state’s 13.5%. (City-Data, 2019). The average household income is less than the average US income at approximately $50,057 per year. It is estimated that 16.1% of households in New Market, live below the poverty line, which is also more than the national average. (Data USA, 2019). Despite the provision already in place, Madison County has a 16% food insecurity. (County Health Rankings, 2019). As the demographic information of the New Market community reveals, there is a great cause for concern of the New Market citizen’s health and knowledge of how to become healthier individuals for themselves and their children.
Obesity is measured by BMI (Body Mass Index) a calculation between a child’s age/weight/height. That percentage number is then compared in a chart. The children who fall in the 85th to 94th percentile are considered overweight and those who fall into the greater than or equal to the 95th percentile are labeled obese. Obese children are more likely to continue being obese into adulthood and obesity can cause many health-related problems, for example: cardiovascular disease, diabetes, respiratory problems, joint strain/pain and even some cancers. (CDC, 2019). It is possible that obesity can be prevented if we educate about the importance of a balanced diet, make nutritious foods available and encourage an active lifestyle for the whole family.
B1a. Primary Community & Prevention Resources
In my field experience, I found several quality resources and programs already in place to encourage a healthier lifestyle and prevent obesity. Unfortunately, the majority of resources are more readily available to Huntsville (the city in Madison County), approximately a 30-minute drive from the rural town of New Market. In the city of Huntsville, Mayor Tommy Battle was quoted to say, “Huntsville can no longer afford to ignore the impact that obesity has on the quality of our lives and our health care spending”. (City of Hsv., 2019). The Mayor has encouraged and endorsed several great programs to improving the health of the citizens. He has links to: Scale Back Alabama, Free Saturday workout classes in the local parks, the Double Helix Dash 5K walk/run, The Mayor’s Bike Ride, Fitness in the Park in May, Walking Challenges, Nutrition classes and a Healthy Huntsville Calendar available on his webpage. (City of Hsv., 2019). In the city, there are seven YMCA facilities, numerous fitness centers, several free parks with walking/hiking trails and playgrounds for those who want to be active outdoors.
Also, in the city of Huntsville, there are many nutrition resources. The Dept. of Public Health is located in Hsv. and they assist low-income families with signing up for WIC and SNAP (formerly known as food stamps). They also offer a variety of classes on obesity prevention, breastfeeding, nutrition, including the importance of nutrition for children. Huntsville has twenty-four listed places of food resources (food bank, food pantry, soup kitchen and food distribution center). (211 Connect AL, 2019). The city also has 2 large Farmer’s Markets that accept the government SNAP vouchers for payment. There are hospital owned Wellness Centers that offer free healthy eating & nutrition classes by Registered Dietitians in the city.
In the rural New Market Community, there are 30-45-minute school fitness programs available for students during the school day. The past couple of years the elementary school has sponsored a Boosterthon Fun Run fundraiser that encourages students to raise money for the school and increase physical activity at the same time. The PE Teacher in the elementary school teaches a heart-related component appropriate for each grade level. He also completes a fitness test (strength, endurance, CV endurance & flexibility) on students 2nd grade through 6th grade. There is one Recreation Center in New Market where children can sign up and play organized sports such as: T-ball, baseball, softball, basketball (girls & boys) and volleyball. New Market has one 250-acre community park with walking/running trails, a fishpond, campsite, playground, soccer fields, picnic areas and Olympic size pool. There is one fitness gym in New Market and 2 gyms in close proximity, memberships are required.
In the local public-school healthy meals are offered to students with state guidelines. According the New Market School Cafeteria Manager, 45% of the student body are free and reduced. One of the local churches sponsors a Snack Bag program that gives fifty-two of the elementary school students a weekly bag filled with a variety of food items to take home and eat over the weekend and school breaks. New Market has one food bank located in the United Methodist Church Fellowship Hall. Those in need have to call and make an appointment during the week. The only shopping store with food items located in New Market is the Dollar General, which offers mostly packaged and processed items. Three grocery store chains are located right outside of New Market for families to purchase quality groceries, meats and produce. There are two Farmers Markets that offer a small selection of produce, meats and cheese, one accepts government voucher for payment and the other does not.
B1b. Underlying Causes
Childhood obesity is a complex problem and be caused from several different problems. It is possible that the major causes of childhood obesity in New Market are from the lack of physical activity. Students in public school are required to have at least 30 to 45 minutes of physical exercise in the school day. For many children, that is the only physical activity they get in a day. There may be different barriers to their lack of physical activity outside of school. It could be caused from: busy schedules, parents who work late, parents who work multiple jobs, little to no safe places to play outside close to home, lack of desire or more interest in electronic entertainment options. Another possible underlying cause is the higher poverty rate. Parents may not be able to afford the higher prices of fresh fruits and vegetables. Some parents are required to work multiple jobs and do not have extra to plan and make healthy meals. Many of the food options given in the free Snack Bags/Food Banks are processed & packaged food items which have lesser nutritional value along with a higher sugar & sodium content. Lack of physical activity and poor nutrition can lead to obesity in all ages. I believe we are seeing the same in the school age children of New Market.
B2. Evidence-Based Practice
In 2014 a research was published about a group of children in a rural area of mid-Alabama considered the Black Belt. Studies suggested that weight gain and the eating behaviors of children could be closely related to their environments. The students in the study and those who live in this area are primarily African American. 613 students were studied to find the relationship between their weight and community food environments using multi-level models. Results found that the children’s weight and weight gain was influenced by their environment. The type of nutrition they had available was unhealthy, fast food, cheap. convenient and lacking in nutritional value. The findings also suggested there is a need for policymakers to improve they type food available and given to low-income and minority families. The study also suggested that children who live in environments that offer healthier food options have a lower change of becoming overweight and obese than those living in poverty. (Li, 2014).
B2a. Identification of Data
Alabama has been known as one of the top obese states in the U.S. The Robert Wood Johnson Foundation released data this year and Alabama continues to have an obesity rate of 16.1% in children between 10-17, that is higher than the national obesity rate of 15.3%. (Walker, 2019). This knowledge along with overweight people in New Market make up 35.1% of the population as compared to 34.4% of the state of Alabama’s population. The Low-income preschool obesity rate for this rural area is also higher at 14.1% as compared to the state’s 13.5%. (City-Data, 2019). The average household income is less than the average US income at approximately $50,057 per year. It is estimated that 16.1% of households in New Market, live below the poverty line, which is also more than the national average. (Data USA, 2019). Despite the provision already in place, Madison County has a 16% food insecurity. (County Health Rankings, 2019). The New Market. Elementary OSR PreK program is funded by a grant that requires the students to have a screening of their height, weight and BMI (with parent permission). In my field experience interview with the PreK Teacher, this year’s data showed that of the 36 students, only 63% of them were within a healthy & normal BMI range. All of the collected data on our New Market community indicates, there is a great cause for concern of the New Market citizen’s health and knowledge of how to become healthier individuals for themselves and their children.
C1. Social Media Campaign Objective
My social media campaign is to educate and prevent childhood obesity in New Market’s school-age children (ages 3 to 18 years old) and create a healthier lifestyle for them as evidenced by lowering the BMI of this age group of children in New Market, Alabama.
C2. Social Marketing Interventions
I would use Instagram and Facebook as two specific population focused social marketing interventions for my media campaign of educating against obesity and encouraging a healthier lifestyle. On Instagram, I would create a public account specifically designed to interest school-aged children or parents of school-age children. On this account, I would post weekly short “how to” videos of easy & healthy meal ideas that children would like. On Facebook, I would start a 5-Song Exercise Challenge geared towards school-aged children and their families. Each person would make a post of a photo/video indicating their 5 songs selected, including this hashtag “#5songs2MoveU” and tag others as a challenge to them to also pick 5 songs, exercise and challenge others to do the same. With the average song being 3 minutes long, this would encourage an extra approximately 15 minutes of fun exercise.
C3. Description of Social Media Platform
My social media platforms would help support education on healthier meals and encourage exercise for school-aged children and their families. Both Instagram and Facebook would be a way to reach out and communicate with the New Market community children and families. Almost everyone has at least one electronic device in the home and they can create an account, if they do not already have one. For smaller children, the parents could create an account and include the children to view the Instagram videos and post photos of their exercise session/challenge on Facebook. Children cannot feasibly make the necessary changes to their own diets and adaptation to exercise, so involving their parents would be a positive effect in the campaign.
During the school day, older students are allowed to use computers and ipads, they could access these accounts at school. Many teachers of younger children create a classroom accounts and could involve the entire class in both of these social media campaigns to encourage those students who might not have access to electronics or internet at home.
C3a. Benefits of Social Media Platform
Instagram and Facebook are both user friendly and an easy way to promote education to children and families on ways to eat healthier, exercise and prevent obesity. Most people already use and know how to use both. Instagram and Facebook are accessible with internet connection anytime and all-the-time. These two forms of social media would be the fastest way to reach out to a wide variety of ages with the least amount of effort. They both have the ability for people to post about positive movements towards eating healthier and exercising more regularly, all the while making it look fun and inspiring others to join in. Both have the capability to post messages, attach friends/family to a post, add photos and share a video for an audience. The capability of using videos is great for learning how to do something you didn’t already know.
C4. Benefit to Target Population
There would be many benefits to my target population with this social media platform of healthy snack/meal tips on Instagram and a 5-Song Exercise Challenge on Facebook. One is that it is widely accessible to the New Market community and beyond. It would be fun and easy way to adapt to a healthier lifestyle and reverse the obesity problem that our community and Alabama is known for. Children and families would learn about better food choices ideas and how to prepare nutritious snacks/meals with ease. They might be introduced to a new food they were afraid to try before. They would learn new recipes and hopefully acquire a desire for more nutritious food choices. My social media platform is geared towards school-age children and could help promote a positive way for families to spend time together. Exercise and eating healthier are easier to modify when your friends/family are doing the same. Participants would benefit from seeing that they are not alone in making changes towards eating healthier and exercising regularly. Also, participants would see steady fitness improvements by making a few changes to their diet and adding an extra 15 minutes of physical activity each day.
D. Best Practices for Social Media
