Running head: HEALTH PROMOTION AND REAL AGE

Health Promotion and Real Age

Patricia Adams
Ferris State University

HEALTH PROMOTION AND REAL AGE

Health Promotion
Real Age refers to a persons physical age or the actual rate of aging, opposed to their
chronological age. Individuals perform Real Age tests through self-reporting. Responses to
health questions generate personalized results of Real Age (Roizen & Oz, 2010). This can be
used by individuals and health care workers to personalize wellness plans to promote healthy
lifestyle changes and positive health outcomes. Nurses can partner with individuals to develop
these plans using the nursing process as a guide. Thorough assessment and accurate nursing
diagnosis shape client-centered plans that potentially increases the overall well being of the
individual. Including client perception into the plan of action will help promote the adherence to
revised plans.
Assessment and Diagnosis
After completing the Real Age test, both positive and negative factors affected my
clients results. Positive factors influenced her overall health, making her Real Age 2.1 years
younger than her chronological age. Positive factors include the following: activity levels,
cholesterol ratio, sleep patterns and smoking status. Negative factors include the following:
body mass index (BMI) of 31.2, blood pressure, sunblock use and diet. Goals toward optimal
health were devised by review of both positive and negative factors and desired outcomes.
Thorough assessment is essential for wellness diagnosis and goals for improved health
outcomes. Readiness for change is an important part of the nursing assessment and is crucial to
making accurate nursing diagnosis as well as interventions. The transtheoretical model (TTM) is
made up of five different stages of behavior change: pre-contemplation, contemplation,
preparation, action and maintenance (Pender, 2011 p. 51). It is evident through my clients
current level of activity that she falls within the action stage, reporting that she has had increased
physical activity for less than six months but is motivated to include exercise as a way to
improve health.

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Personal factors, such as age and BMI, were reviewed along with psychological factors
such as motivation and perceived health status (Pender, 2011). A BMI of 31.2 is a major risk
factor for potential health problems. According to the Centers for Disease Control and
Prevention (2012), an adult with a BMI greater than 30 is considered obese (Centers for Disease
Control and Prevention, 2012). Tuah et al., explain that obesity can lead to hypertension,
diabetes, heart disease, osteoarthritis and even certain types of cancer (Tuah, 2011). Assessment
of my clients family history included all of the mentioned diseases, increasing her risk for
complications related to weight.
Self-perception of good health, with a BMI of 31.2, is another cause for concern. Ely,
Miller, & Dignan (2011), state that optimistic bias may interfere with health behavior
perceptions (Ely, Miller, & Dignan, 2011 p. 296). While my client states she feels healthy, she
has a negative concept of self, related to weight. While walking is already incorporated into her
weekly routine, adjustments to how she walks may increase benefits of walking, resulting in
healthier outcomes.
Body, mind and spiritual needs were used to develop measurable, achievable, wellness
goals. A higher level of functioning, improved health and prevention of disease were objectives
for the wellness plan. According to Pender, Murdaugh and Parsons, the best predictor of
behavior is the frequency of the same or a similar behavior in the past (Pender, 2011 p. 45).
Identification of desired outcomes include increased physical activity leading to weight loss,
better health and enhanced self-concept. This along with a her family history, the Taylor and
Sparks wellness diagnosis health-seeking behaviors related to hypertension as a risk factor for
CAD along with readiness for enhanced self concept were used for the development of smart
goals (Sparks & Taylor, 2010).
Planning and Intervention

HEALTH PROMOTION AND REAL AGE

Wellness diagnoses were developed based on the action stage of the TTM
readiness for change theory, family history, and motivation to improve health. Outcome
identification during the assessment phase helped create a wellness plan that included
interventions of increased physical activity, monitoring of blood pressure and an exercise journal
(see Appendix A). Changes to her exercise plan included increasing the pace and length of
walking for four weeks. Weekly journaling of progress, feelings while walking or about
walking, feelings related to self-concept and barriers encountered were included.
Exercise is one of the best ways to combat obesity. According to Smith, Griffin, and
Fitzpatrick (2011), regular exercise decreases the risk of obesity, hypertension, diabetes and
coronary artery disease. Using the TTM model, pros of the behavior need to outweigh the cons
as they relate to the stage of change. Smith, Griffin, and Fitspatrick (2011), convey that in the
action stage of this model, individuals perceive the pros of behavior change as outweighing the
cons (Smith, Griffin, & Fitzpatrick, 2011 p.94). My clents perception and motivation level are
consistent with this theory and indicate that an increase in the exercise effort expenditure will
help achieve desired goals. Walking 3 miles leisurely, three to four times per week, will increase
to moderate walking, 4-5 miles on three to four days per week. The increased effort of exercise
will lead to an increased caloric expenditure, weight loss, drop in blood pressure, positive
feelings of self perception and an overall increase in health and well-being.
Exercise journals are often used by individuals to stay on track. They assist individuals
in accountability to self, track progress, identify barriers and offer insight on fitness plan
modification. Review of the journal will assist me, as the health coach, to analyze information
and set new goals based on actual inteventions as well as percieved barriers.
Evaluation and Reflection
After four weeks of increased activity, my client has been successful at increasing her
overall activity level with only a few minor set backs. Original goals were reviewed and my

HEALTH PROMOTION AND REAL AGE

client met or exceeded the goal of brisk walking for 60-70 minutes three to four days per week.
The addition of upbeat, workout music increased her paced, allowing her to walk further in the
same amount of time. Journaling minimally one time per week kept her accountable for tracking
of exercise listed the barriers encountered and was useful tool in shaping future fitness goals.
Barriers encountered were lengthy work hours, shorter days, living in a rural community with
limited safe outdoor walking areas, especially with darkness, bad weather or a family crisis.
One of the negative Real Age factors was her blood pressure. After two weeks of
walking at an increased pace, it was back into the normal range. When the weather was bad, my
client opted to self modify her exercise intervention of walking to doing a fitness video. One of
the largest barriers to exercise for my client was length of work shift. She attempted to walk 1520 minutes during her breaks and do a core workout in the evening although on many days was
just too tired.
To reach out target objectives, decrease weight and improve the overall health of my
client, modification of the wellness plan was necessary. Several interventions were added based
the analysis of journal entries. By using data that tracked actual progress and habits, a new
wellness plan was put into place. To facilitate weight loss, this plan included the improved
walking plan, added strengthening and toning exercises routinely three times per week or more
as suggested by Dr. Oz (Roizen M. & Oz, 2010), walking for 15 minutes while on break at work,
and making some dietary changes. According to Tuah et al. (2011), combination of the TTM
stage, diet and physical activity led to significant outcomes (Tuah et al., 2011). Dietary changes
included limitation of red meat to two to three times per week, increasing fish to two times per
week, and making one meatless meal per week.
Journaling, along with having a peer coach, increased accountability to the wellness plan.
It helped my client stay on track of current progress and reach most fitness goals. Identifying

HEALTH PROMOTION AND REAL AGE

barriers helped in modification of the wellness plan to maintain consistency with objectives and
outcomes desired.
Real Age health is great way for individuals to understand how their current health status
is affected by their lifestyle, habits and health. Wellness plans and physical activity have a direct
relationship with Real Age results. Active individuals with healthy weights have Real Age
results younger than their chronological age. By actively improving health through lifestyle
changes, individuals can live healthier lives and prevent many potential diseases such as
hypertension, diabetes and coronary heart disease.

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References
Ely, G. E., Miller, K., & Dignan M. (2011). The disconnect between perceptions of health and
measures of health in a rural appalachian sample: Implications of public health social
workers. Social Work in Health Care, 50, 292-304. doi:10.1080/00981389.2010.534342.
Centers for Disease Control and Prevention. (2012). Overweight and Obesity. Retrieved from
http://www.cdc.gov/obesity/adult/defining.html.
Pender, N. M. (2011). Health Promotion in Nursing Practice (6th ed. ed.). Upper Saddle River,
NJ: Pearson Education.
Roizen M. & Oz, M. (2010). RealAge: Live life to the youngest. (Sharecare) Retrieved October
10, 2013, from Sharecare: www.realage.com.
Smith, D. W., Griffin, Q. and Fitzpatrick, J. (2011), Exercise and exercise intentions among
obese and overweight individuals. Journal of the American Academy of Nurse
Practitioners, 23: 92100. doi: 10.1111/j.1745-7599.2010.00582.x.
Sparks, S. & Taylor, C. (2010) Nursing diagnosis reference manual. New York, NY:
Lippincott & Williams.
Tuah, N., Amiel, C., Qureshi, S., Car, J., Kaur, B., & Majeed, A. (2011). Transtheoretical model
for dietary and physical exercise modification in weight loss management for overweight
and obese adults. Cochrane Database of Systematic Reviews, (10),
doi: 10.1002/14651858.CD008066.pub2.

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Appendix A
Exercise Journal
First Four Weeks September 7-28, 2013
9.3.13 BP 136/96
9.7.13. 8 mile hike camping. Included hills, constant pace. Yankee Springs/Deep Lake.
9.8.13. 3 mile hike Deep Lake
9.13.13 3 miles everyday unless work. BP 130/93
9.21.13 Walking four to five miles all week, alternating between Hastings River Walk and
Middleville Trail. 16-18 minute miles. Walked one mile each day at work. BP 117/78
9.28.13 walked 4 miles, jogged for a short distance
9.29.13 4 miles completed. Feeling more energetic after walking.
9.30.13 1.5 miles today, too busy, doctor apt. Getting discouraged with walking, as there has not
been a change to weight. BP 117/73
Exercise Journal After Evaluation of progress, revision of goals
10.1.13 6 mile walk ran 1 one mile of it. Read article on ways to burn fat faster. Started to listen
to music that increased my pace. 5-6 miles. BP 104.80
Arm exercises 10 min x 4 this wk.
Want to start lunges and squats after reading information gathered on share care website about
toning legs.
10.2.13 after 6 mi run/walk with 30 squats was very sore so walked leisurely in Hastings trail 3-4
miles. Beautiful weather, reviewed learning mod 6 during walk.
10.09.12 on track with walking. The Hastings River walk doing for 5 miles at a very brisk pace
four days a week, increased energy, feel like I am toning, enjoying music with walking. Feeling
more confident in self-image although have not noticed any difference in weight.
10.16.13 continued to walk 4 miles a day briskly up to 5 miles 4 to 5 days a week including
strengthening exercises and have been using music to keep the pace
October 20, 2013 invited a friend to walk we walked 5 miles together
Continue wanting on my days off of work approximately 4 miles on my days that I'm working I
am walking. I have started toning exercises. BP 110/83
10.24.13 Went to a class last Thursday 60 minutes of strength and Tone, did multiple squats
lunges abdominal work stairs for three-minute intervals rotating with abdominal and squat and
other exercises. Total of 40 minute walk today with friend, cool outside but sunny.
Had barriers last week with walking related family emergency/stress level high but got back on
track by confiding in a friend and was motivated to work out
10.26.13 Back on track this week walked at work 20 minutes. Toning, core abdominal and leg
workouts
10.28.13 Volunteered today at Pierce Cedar Creek Instituted for 3 hours and used the hiking trails
after. Hiked for 60 minutes on hilly ground to increase calories burned as noted in article on
burning fat faster.
Took the stairs at work several times, both up and down

HEALTH PROMOTION AND REAL AGE

Health Promotion Risk Reduction Paper -REALAGE
Total Possible Points
Points Earned
=250
Assessment
Real age test completed,
results interpreted and
discussed in paper;
summarize both positive
and negative
Area of risk focus
discussed in depth
One Wellness diagnosis for
area of focus; supported by
data and research ; EBP
Planning and Intervention
Rubric
One SMART obtainable
goals should be able to
measure progress
Interventions based on
EBP ~ includes one peer
reviewed journal article as
a reference for at the
minimum two interventions
Includes information re:
TTM and readiness for
change
Evaluation and Reflection
Evaluate partners progress
toward SMART goals.
Reflect on any changes
that are necessary in order
for partner to reach goals;
include references/support
for these changes
APA
APA format and references
cited properly; scholarly
writing; spelling and
grammar accurate;

25

25

25

25

25

24

Points Earned
25

25

25

25

25

24

25

Points Earned
23

25

25

50

42

Total Points Earned: 238

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