OCEANA COUNTY: OBESITY

By: Kelsey Agruda, Cassaundra Braden, Christine Demler, Jody Foster, Stefanie Lombard

OCEANA COUNTY
Located

in the middle of Michigans West shore line.

Photo Credit: Wikipedia.org

Population

of 26,523: 96% White, 0.7% Black, 1.4% American Indian/Alaska Native, 0.4% Asian, 14% Hispanic.

ASSESSMENT OF COMMUNITY
The

average income is 40,422 which is approximately $8,000 less than Michigans average. There is 83% of high school graduates but only 14.8% with a Bachelors degree or higher. Both of these are lower than Michigans percentage. The jobless rate is higher than Michigans average which results with 19.1% of the population below the poverty level.

ANALYSIS OF ASSESSMENT FINDINGS

The

majority of the population is persons between the ages of 18-65. High poverty jobless rates account for main reasons for the population being overweight and obese. This population cannot spend extra money to join fitness clubs and on proper foods. The leading causes of death are cancer and heart disease.

ANALYSIS CONT.
The

Michigan Department of Community Health reports that the population has an inadequate fruit and vegetable consumption.

COMMUNITY FOCUSED NURSING DIAGNOSIS: OCEANA COUNTY

Risk

for imbalanced nutrition greater than body requirements Among Oceana county residents Related to intake exceeding body needs and/ or decreased physical activity As demonstrated by obesity rate of 38.5%

DIAGNOSIS RELATED STATISTICS

Oceana County Michigan

Obesity
Overweight Diabetes Lack of physical activity Inadequate fruit and vegetable consumption

38.5%
40.5% 12.5% 26.8% 78.8%

35.6%
30.1% 9.3% 23.4% 78.2%

Binge drinking in the last month

No health insurance

19.4%

17.1%

17.6%

15.1%

SMART

Specific Measurable Appropriate/ Realistic Time

agreed upon

limited

GOAL #1

Oceana county residents will increase fruit and vegetable consumption to 2-4 servings/day of fruit and 3-5 servings/day of vegetables in order to decrease inadequate fruit and vegetable consumption to 70% by June 2014.

GOAL #2
Oceana

county residents will exercise 30-60 minutes per day in order to see lack of physical activity down to 16% by June 2014

EVIDENCE-BASED INTERVENTIONS

Modify diet Physical activity

EVIDENCE-BASED INTERVENTIONS:
MODIFYING DIET
Choosing

foods high in protein and low in

fat. Eating more fruits and vegetables. Eating leaner meats, including poultry and fish. Opt for smaller portions, use smaller table settings, take half of meal home when eating out.

EVIDENCE-BASED INTERVENTIONS:
PHYSICAL ACTIVITY
Attempt

for 30-60 minutes of activity each

day Find an activity that is enjoyable to you walking, biking, gardening, aerobics, etc. Use stairs when available, park in a far spot when going to the store Community-wide campaigns Enhance school-based physical education

ANALYSIS OF EVIDENCE BASED INTERVENTIONS: MODIFYING DIET

Eating too much or not being physically active enough will make you overweight. To maintain your weight, the calories you eat must equal the energy you burn. To lose weight, you must use more calories than you eat (NIH, 2013). Research has found that a diet high in fruits and vegetables can be an important part of a weightmanagement strategy (CDC, 2011). By using smaller dishes, bowls, and glasses, you will be eating and drinking less (NIH, 2013).

ANALYSIS OF EVIDENCE BASED INTERVENTIONS: PHYSICAL ACTIVITY

Physical activities (both daily activities and exercise) help tip the balance scale by increasing the calories you expend each day (CDC, 2011). According to the CDC (2011), the recommendation for community-wide campaigns is based on a review of 10 studies that suggest that these campaigns result in a median increase of about 4% in the percentage of people engaging in physical activity and a 16% increase in energy expenditure. If schools implement enhanced PE, students flexibility, muscular endurance, physical activity-related knowledge, and overall physical fitness are likely to improve (CDC, 2011).

OBESITY RESOURCES-WEIGHT WATCHERS

Philosophy: A healthy body results from a healthy lifestyle which means mental, emotional, and physical health. We help you on your journey by: Helping you make the positive changes required to lose weight. Guiding you to make positive behavioral changes in your life. Inspiring you with our belief in your power to succeed. Motivating you every step of the way Meeting every week First Congregational Church at Shelby 51 E 3rd St Shelby Mi 49455

OBESITY RESOURCES- TAKE OFF POUNDS SENSIBLY (TOPS)

TOPS mission is to support our members as they take off and keep off pounds sensibly. There are 3 meetings in the county 1. Unleashed building

55 S State St Hart Mi 49420 Tuesday 5:00/5:30 (weigh in/ meeting)

2. Mears Community Methodist Church

1990 Joy Street Mears Mi 49436 Tuesday 8:00/9:00 (weigh in/ meeting)

3. Shelby First congregational Church

51 E 3rd St Shelby Mi 49455

OUTSIDE THE COUNTY THERE ARE MORE

RESOURCES
Weight

Loss Classes Memorial Medical Center of West Michigan Ludington, Michigan 18.4 miles away from Hart, MI 49420 Weight Loss Classes Mercy General Health Partners Muskegon, Michigan 34.6 miles away from Hart, MI 49420

POLICY IMPLICATIONS OF OBESITY IN OCEANA COUNTY

Oceana

County as an employer does not have any specific policies implicated related to obesity. Keep Moving 30 minutes of Exercise at least 5x a Week is a program that has been setup to promote healthier lives in Oceana, County Michigan. The goal of Oceana County Government is to provide the foundation for a safe and healthy community.

SCHOOL POLICIES
School Policies Affecting Childhood Obesity in Michigan and Oceana County: Physical education requirements. Health education requirements. Limiting Access to Sugar-Sweetened Beverages (SSBs) SSBs are readily accessible in homes, schools, worksites, and communities. Limiting their availability and accessibility can decrease SSB consumption and increase the consumption of more healthful beverages.

EVALUATION

Desired outcomes:

Increase physical activity throughout community Modify diet to increase healthy food choices

Increasing physical activity is an anticipated gradual change, with levels of physical activity steadily increasing based on physical condition and endurance. Diet modification will have some immediate benefits, but will also be a continual process with an ultimate goal of achieving permanent lifestyle changes. Diet modification can also be influenced by other environmental and socioeconomic factors.

EVALUATION

Community evaluation of outcomes rely heavily on both qualitative, and quantitative results information.
For qualitative results, the community members must be honest and willing to participate in evaluation tools such as surveys and interviews. Quantitative results can be gathered from statistical reports, and physical assessments of the community. Existing tools can be utilized to measure certain outcomes.

EVALUATION

Short term
Community acceptance/adherence of health promotion programs, and effective methods of teaching through community survey/questionnaire. Partner with local farmers markets to create frequent a buyers club card that is free to join, and results in a discount or award when filled. This encourages the purchase of fresh produce, and helps low income families afford healthier options. Cards can track community involvement. Health program enrollment rates.

Long term

District Health Department #10: Annual report statistics for obesity and physical activity in Oceana county. Physical exams: BMI, diabetes, heart disease, and other obesity related factors. Interviews to assess overall satisfaction with healthcare programs School policies/updates. Assessments to evaluate the need for ongoing support to encourage long term adherence and lifestyle changes.

EVALUATION

Process evaluation:
Conduct community survey about how effective teaching was, and questionnaires related to community acceptance of interventions. Effectiveness of school policy implementation. Gives direct feedback regarding interventions and adherence to programs.

Outcome evaluation:

Measuring whether interventions were effective in creating behavioral changes within community. This can be measured with existing reports such as the District Health Department #10: Annual report statistics for obesity and physical activity in Oceana county. Also provides ability to cross-evaluate, and compare other counties in state. Other factors may also influences these changes.

Impact evaluation:

Long term lifestyle changes for community over generations. This type of measurement would take many years to be able to accurately evaluate community changes, and lifestyle adaptation.

REFERENCES

Centers for Disease Control and Prevention. (2011). Strategies to prevent obesity and other chronic diseases: the CDC guide to strategies to increase the consumption of fruits and vegetables. Atlanta, GA: U.S. Department of Health and Human Services. Retrieved from http://www.cdc.gov/obesity/downloads/fandv_2011_web_tag5 08.pdf Centers for Disease Control and Prevention. (2011). Healthy weight its not a diet, its a lifestyle. Retrieved from http://www.cdc.gov/healthyweight/calories/index.html Community health education nutrition education. (2013). Retrieved from http://dhd10.org/index.php/community-healtheducation

REFERENCES CONT.

Drewnowski, A. (2010). The cost of US foods as related to their nutritive value. American Journal of Clinical Nutrition, 92(5), 1181-1188. http://0dx.doi.org.libcat.ferris.edu/10.3945/ajcn.2010.29300 James, K. S. (2009). People who were obese tried diets but felt they needed ongoing support to empower them to make lifestyle changes. Evidenced Based Nursing, 12(3), 92. http://0-dx.doi.org.libcat.ferris.edu/10.1136/ebn.12.3.92 Live well. (2013). Retrieved from http://www.livewell4health.org/ Muecke, M.A. (1984) Community health diagnosis in nursing, Public Health Nursing, 1(1), 23-35

REFERENCES CONT.

National Institute of Diabetes and Digestive and Kidney Diseases. (2013). Weight-control information network. Retrieved from http://win.niddk.nih.gov/publications/just_enough.htm#f National Institutes of Health. (2013). Weight control. MedlinePlus: Trusted Health Information for You. Retrieved from http://www.nlm.nih.gov/medlineplus/weightcontrol.html Overweight and obesity. (2013). Retrieved from http://www.cdc.gov/obesity/stateprograms/highlights.htm Rademakers, J., Delnoij, D., & De Boer, D. (2011). Structure, process or outcome: which contributes most to patients overall assessment of healthcare quality? BMJ Quality & Safety, 20(2), 326-331. http://0dx.doi.org.libcat.ferris.edu/10.1136/bmjqs.2010.042358

REFERENCES CONT.

Statewide scan of childhood obesity programs, policies and resources in Michigan. (2013). Retrieved from http://www.michigan.gov/documents/mdch/EnvironmentalSca nExectivesSummaryReduced-244924-7.pdf The official website for the government of Oceana County, Michigan. (2013). Retrieved from http://www.oceana.mi.us/ TOPS, 2013. Retrieved from http://www.tops.org/TOPS/FindAMeeting.aspx Weight Watchers, 2013. History and philosophy, retrieved from http://www.weightwatchers.com/about/his/history.aspx