Problem Identification
Anytown community is a small town located in the southern region of the U.S., and it has a population of 10,000 people with diverse ethnic and cultural inclinations. According to available assessment data, a family of four people in the community earns an average income of $31,012 per annum as opposed to the average state income of $47,542.
Moreover, about 60% of adult residents in the community are uninsured while their children are covered by the State Children’s Health Insurance Program (SCHIP). On the other hand, about 1300 residents have well-paying jobs while the rest of the community members are minimum wage earners.
Additionally, the health behavior assessment data regarding residents of the Anytown community shows that about 38% of the residents have good or very good health as opposed to 46% at the state level. Moreover, about 10% of the residents consume at least 5 servings of fruits and vegetables daily. On the other hand, about 54% of the residents carry out physical exercises for more than 30 minutes within one month compared to 68% at the state level.
Furthermore, 10% of the residents engage in physical exercises for more than 30 minutes per week compared to 30% at the state level. Certainly, approximately 35% of the residents smoke more than one pack per day compared to 22% at the state level. Conversely, 48% of the residents use smokeless tobacco compared to 35% of the state residents.
Further, the number of males and females consuming more than 2 and 1 drink/day respectively stands at 7% of the residents compared to 4% of the state’s population. Finally, the percentage of teen pregnancies in the community is 68.8% compared to 42% at the state level.
From the statistics, it is worth noting that a large percentage of residents of the Anytown community engage in behaviors, which can be described as major risk factors in the development of various chronic diseases such as cancer and cardiovascular diseases. However, the most notable behavior among most community members is poor nutrition and lack of physical activity. Consequently, there is the paramount need to promote healthy eating habits and physical activity among residents of the Anytown community as described in the preceding discussions.
Strengths and Competencies of the Community
Despite that most residents in the Anytown community are low-income earners, there are various reasons to believe that the community members and their leaders are hard workings. As a result, the community being the client in this program, there is the need to allow the community members to own and manage the program without the dominance of any professional decision-making processes. That is, each community member will be allowed to take control of the health intervention initiatives in place regardless of the prevailing environmental, economic, and socio-cultural health determinants (Leddy, 2006, p. 265).
Additionally, the existence of schools, industrial workplaces, restaurants, and other local health promotion organizations within the community will allow the program to run smoothly since these institutions will be used to provide the required support and health promotion avenues.
Conversely, the program will target both the school-age children and their parents because it is a fact that poor nutrition and lack of physical activity form very important risk factors in the development of health problems affecting the two groups. As a result, the program will be designed to intervene in unfavorable health behaviors of the community members at three stages namely health promotion, primary prevention, and secondary prevention (Macera, 2010).
At the stage of health promotion, the program aims at instilling healthy eating habits among the children and maintaining these habits as they grow. On the other hand, primary interventions entail identifying the population affected by various risk factors such as those with elevated blood sugar, alcoholism, and high blood pressure.
Subsequently, the affected groups are then given the skills, which can allow them to avoid the progress of the risk factors into disease stages by practicing active lifestyles and good eating habits. Lastly, the secondary interventions target those community members who are already suffering from various infections and chronic disorders by giving them information on how to manage their current health status and prevent further development of adverse effects (Macera, 2010).
Health Goals and Outcomes
The program aims at promoting good eating habits and increased participation in physical exercises among the residents of the Anytown community within a specified period. As a result, the program entails a nutrition and physical education approach targeting school children and community members to create a favorable environment for behavioral change.
The desired behavioral changes include encouraging energy balance; increasing physical activity; reducing incidences of overweight children and parents; and providing healthy foods in major food joints, schools, and workplaces (Contento, 2011).
Research studies show that these goals are feasible and thus, they can be achieved by delivering public advertisements through the print media and radio; encouraging schools, food stores, and restaurant owners to provide healthy foods besides labeling the food products sold or served; informing teachers, children, and parents on the significance and available ways of maintaining healthy eating habits and physical activity; and lastly, by giving various incentives to those showing positive behavioral change after a given period (Contento, 2011, pp. 131-133).
As a result, the community should participate in almost all phases of the program including designing, implementation, evaluation, identification of relevant data for program improvement, and maintenance of the change processes. Therefore, the program will involve parents, children, teachers, restaurant owners, grocery shops, local health departments, the media, transport agencies, non-governmental health providers, and state policymakers.
On the other hand, the desired outcomes regarding the program include there are a significant decrease in the body mass index (BMI) scores among the participants; availability of more fruits, whole grains, vegetables, and milk products with low fats at home, schools, workplaces, food stores, and restaurants; provision of menus reflecting compliance to various nutrition and state law guidelines; improvement of the eating habits and attitudes of school children, parents, teachers, restaurant staff, and food store service personnel; and enactment of state guidelines and regulations regarding food nutrition in schools and the community at large (Macera, 2010).
Accordingly, these outcomes can be measured through various statistical methods by subjecting a considerable number of community members to research procedures aimed at determining different health improvement determinants mentioned above.
Health Interventions for Behavior Change
To achieve the desired outcomes, there is the need to educate the participants at an individual level on the available strategies of promoting healthy eating habits and physical activity. Afterward, the community members should be divided into various groups, which should then form community-based networks aimed at incorporating additional community members into the program (Chiverton et al., 2003, p. 192).
This phenomenon is called environmental leadership, and it entails allowing the first patch in the nutrition and physical education program to be professionals such as teachers, chief cooks, some parents, and the top management in industries. This group will then graduate into environmental leaders who will help the program coordinators, in this case, nutrition and physical education nurses, to inform the rest of the community about the significance of healthy eating habits and physical activity (Chiverton et al., 2003).
On the other hand, the community-based interventions in this program are aimed at developing and instilling various skills, competencies, and health behaviors necessary for promoting healthy eating and physical exercise.
As a result, about the health behaviors identified among residents of the Anytown community, the community-based nutrition, and physical health nurses will form part of the coordinating team whose aim should be to encourage the community members to participate in designing, planning, implementing, evaluating, and maintaining the program (Chiverton et al., 2003).
Furthermore, the nurses will be involved in identifying target groups whose views regarding nutrition and physical education will be used to develop relevant strategies for the program. Subsequently, the identified subgroups and other state policy-makers will be educated on how to create favorable environments to enable other participants to achieve the desired goals.
With a favorable environment for behavior change in place, the coordinators will look at the possibility of promoting other social and environmental factors, which complement individual initiatives in the change process. Here, there is the need for the coordinators in conjunction with the community members and other state policy-makers to ensure that healthy food choices are available in homes, schools, food stores, restaurants, workplace cafeterias, and other public places (Macera, 2010).
Additionally, the coordinating team should encourage restaurants and food vending services to include food labels on the menus to provide for more healthy food choices. Moreover, the program will include the allocation of available community resources to the delivery of professional messages regarding nutrition and physical activity through churches, schools, grocery stores, media, health professionals, and other strategic places.
Finally, the program will involve the demonstration of basic healthy eating practices and physical activity procedures at schools, workplaces, and other recreational centers. Moreover, employers will be encouraged to provide favorable avenues and enough time for physical activities among the employees (Macera, 2010).
Incentives and Barriers to Change
Considering that a large percentage of the residents of the Anytown community are low-income earners, the first barrier to behavioral change will be the financial constraints. Here, it is expected that many families will be hesitant to implement the above-mentioned interventions because of their perceived inability to afford healthy foods and physical activity facilities or services. Conversely, most restaurant owners, food stores, and food vending service providers may be unwilling to stock-specific types of foods due to their low demand, and thus, this may be a major impediment.
Further, employers may fail to implement some of the recommended interventions due to a lack of space, time, and funds. Furthermore, the state policymakers may fail to enact the recommended nutrition guidelines and regulations for schools, food vendors, and restaurants due to the existence of other opposing federal provisions.
However, for the program to succeed there is the need to offer the community members various incentives such as physical activity facilities such as a gymnasium, which will be communally run and offer free or subsidized services to community members. Additionally, some members who would have demonstrated excellent improvement at the end of a specified period should be given free membership cards to attend various privately run physical activity centers and nutritional health organizations.
Conversely, some families with excellent health behavioral changes should be given shopping vouchers to enable them to obtain healthy foods for free within a given period. Furthermore, the low achievers should also be given a token of appreciation to encourage them to try harder.
The time frame for Behavior Change
The nutrition and physical education program will run for three years to achieve the overall program goals. This period is enough to allow various stakeholders to adjust their budgetary allocations and fit in various changes, which may require additional resources. On the other hand, the program goals will be evaluated every quarter in which case some short-term goals such as developing an individual health promotion plan for the community members and increased participation of the community members in physical activities will be analyzed.
This evaluative approach will allow the coordinators to collect relevant data to be used in identifying different aspects of the program, which may need improvement. Furthermore, the timeframe will allow those community members who would prefer a wait-and-see mode to learn from their neighbors about the positive benefits of the program such as the decreased number of hospital visits and improved health among others, which will be obvious to the whole community.
Maintenance Strategies
The program is bound to stall in case the coordinating and implementation teams run out of resources. On the other hand, the community members may also prefer to go back to their old ways in case they realize that the program interventions are eating into their budgets than expected. Furthermore, most people including partners may pull out of the program if the anticipated goals and outcomes are not realized within the timeframe.
As a result, there is the need to evaluate the program goals on an incremental basis to give room for improvements in cases where some interventions fail to work. Further, there is the need to seek additional partnerships from other community-based organizations and non-traditional partners such as food producers, transportation agencies, building designers, and trial coordinators.
Overall, there is the paramount need for the coordinators to introduce refresher classes regarding nutrition and physical education to the community members to remind them of the various aspects of the program as discussed earlier.
Reference list
Chiverton, P.A., Votava, K.M. & Tortoretti, D.M. (2003). The future role of nursing in health promotion. Am J Health Promot., 18(2), 192-194.
Contento, I.R. (2011). Nutrition education: Linking research, theory, and practice (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Leddy, S.K. (2006). Integrative Health promotion: Conceptual bases for nursing practice (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Macera, C.A. (2010). Promoting healthy eating and physical activity for a healthier nation. USA: Division of Nutrition and Physical Activity, Center for Disease Control and Prevention, CDC.