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COMMUNITY PROJECT
OBESITY IN THE
HOMELESS
Sania A. BeckfordBoston College: William F. Connell School of NursingKeys to Inclusive Leadership in Nursing (KILN)Wednesday April 20, 2011
Oh the
Irony…
OBJECTIVESBy the end of this presentation, you will…
1. Discuss the effects of nutrition on long-term health in the population served at the Barbara McInnis House
2. Identify social disparities that places the population served at the Barbara McInnis at risk for obesity
3. Describe nursing roles and interventions to promote healthy weight & maintain good nutrition habits in the population served at the Barbara McInnis House
THE BARBARA MCINNIS HOUSEBOSTON HEALTHCARE FOR THE HOMELESS PROGRAM (BHCHP)
Boston.com; www.bhchp.org
Location: South End of Boston Established: 1984 as a pilot program funded by The Robert Wood Johnson Foundation (RWJ) &
the Pew Charitable Trusts (PCT)Mission: to provide or assure access to the highest quality health care for all homeless men,
women and children in the greater Boston areaSpecialized Services: clinics (suboxone, outpatient, transgender), dental, pharmacy, respite,
diabetes collaborative, outreach (HIV team, Street team, family team, racetrack)
MENTORSHIPPooja Bhalla
Registered Nurse (RN) Associate director of Clinical Operations 13 years at the Barbara McInnis House Multiple roles
Student nurse Clinical resource nurse Case manager
Community Project Topic Background Discussion
initiatives to control obesity of patients obesity was an issue in this population
lack of education, resources, finances Plan
list of preventative steps promote/ maintain healthy weight &
nutrition habits cost-effective & practical nfdl.k12.wi.us
PUBLIC HEALTH ISSUE: OBESITY
Food insecurity linked to poverty
Nutritional deficiencies Malnutrition
Obesity epidemic in USA Results from the 2007–2008
National Health and Nutrition Examination Survey (NHANES) 34.2% of U.S. adults aged 20
years and over are overweight 33.8% are obese 5.7% are extremely obese
(Ogden & Carroll, 2010) “the nature of nutritional risk
faced by low-income families in the US appears to be shifting from food insecurity to obesity”
(Surgeon Call, 2001; Schwarz et al.,2007)
Past Present
www.cdc.gov
FACTS & FIGURES
Poverty Homeless Low education level Underemployed/ Unemployed Family Structure
Single female head of household
Multiple morbidities Cardiovascular
Hypertension Foot ulcers Amputations
Diabetes Mellitus Mental Illness Substance Abuse
Nutritional deficiencies Malnutrition =↓ health
Illiteracy Poor management of illness/
disease status ↑ use of Emergency Room ↑ healthcare costs
Accessibility Homeless = No means for
preparing or storing food No $ = Binge on junk food
Limited hours & funding of food banks
Morbidity = ↓ activity level no job
Risk Factors Implications
NURSING ROLE PREVENTION Primary Prevention
Educate Cultural & Developmentally appropriate Learning Styles auditory, visual, kinesthetic
Assess Barriers language, access, literacy rate
Secondary Prevention Health Screenings
BMI < 24 Blood Pressure Glucose
Hemoglobin A 1 C < 7%
Tertiary Prevention Rehabilitation Long-term medication
COMMUNITY HEALTH PROJECT GOAL:
To control obesity in the population served by the Barbara McInnis House. Population: low-income and homeless individuals with co-
morbidities who utilizes services at the Barbara McInnis House
Task 1: Create a library of resources to inform the community about
signs/symptoms of illnesses Influenza Noravirus
Task 2: Create a brochure/ pamphlet educating about cost-effective
ways to control weight translated in various languages (e.g. Spanish, etc).
KNOW YOUR
NUMBERS
Normal Ranges
Blood Pressure: 120/80 mm Hg
Blood Glucose: 70-110 mg/dl
Cholesterol levels: <200 mg/dl
Body Mass Index (BMI)
Normal: 19-24.9
Overweight: 25.0- 29.9
Obese: >30www.harvardpilgrim.org
Weight Management Tips Be Active
Use the stairs Go for a walk, run, etc Be active for at least
30 to 60 minutes per day 60 minutes/ 3-5x per week
Do passive range-of-motion
Choose healthy options Avoid fried food Avoid alcoholic beverages Limit sugar and salt intake Choose a variety of whole grain products Choose foods from the Food Pyramid Choose FRUITS & VEGETABLES Stay hydrated DRINK WATER
Portion control Small, frequent meals Meals should be size of fist
COMMUNITY HEALTH PROJECT (CONT’D)
REFERENCES Boston Health Care for the Homeless Program. (2010). Barbara
McInnis House- Boston Health Care for the Homeless Program. Retrieved from www.bhchp.org
Ogden, C., & Carroll, M. (2010). Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1976–1980 Through 2007–2008. Retrieved from http://www.cdc.gov/nchs/fastats/overwt.htm
Schwarz, K., Garrett, B., Hampsey, J. & Thompson, D. (2007). High Prevalence of Overweight and Obesity in Homeless Baltimore Children and Their Caregivers: A Pilot Study. Medscape General Medicine, 9(1): 48. Retrieved from http://www.medscape.com/viewarticle/551711
Stanhope, M., & Lancaster, J. (2010) Foundations of nursing in the community: Community-oriented practice, (3rd e.d.). St: Louis, MO: Mosby Elsevier.
Surgeon General. (2001). The Surgeon General's Call to Action To Prevent and Decrease Overweigth and Obesity. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD.