6104525_Anderson_N555C_Feb_Final Project - Part 1

Running head: NURSE SOCIAL MEDIA COORDINATOR POSITION1

Nurse Social Media Coordinator Position for Combating Childhood Obesity

Robert Anderson

American Sentinel University

NURSE SOCIAL MEDIA COORDINATOR POSITION2

Nurse Social Media Coordinator Position for Combating Childhood Obesity

Executive Summary

It is a fact that almost eight million American children between the ages of five and 19

are either overweight or obese (Rao, 2012). It is also a fact that a vast majority of American

children use social media as their primary source of communication (CHCMC, 2015). The

nursing community needs to take advantage of this opportunity to speak to adolescents in their

own language and establish a nurse-monitored Facebook Page specifically to combat childhood

obesity.

Overweight children are four times more likely to become obese adults (Rao, 2012). This

statistic raises the probability of these children getting one or more weight-related diseases like

diabetes, high blood pressure, high cholesterol, and coronary heart disease. Being obese will

shorten a child’s lifespan by an average of ten years and severely diminish their quality of life.

The significance of creating a nurse social media coordinator position is twofold. First, there are

the educational measures and health benefits that are brought to the affected children and their

families. Second, for the nursing profession, the position assumes more of a leadership role in

health prevention by using the latest information-sharing technology.

Over 95 percent of American children between the ages of five and 19 have access to the

Internet (Child Trends, 2013). Social media interactions, mainly Facebook, are how these

children identify themselves and perceive the outside world. For this generation, if it is not on the

Internet, it does not exist. By starting a Facebook Page, nurses can directly access an extensive

network of children struggling with weight issues.

The Facebook Page will be educational, supportive, interactive, and community-based.

Children and their parents can learn nutrition basics and how to make healthy food choices.


There will also be a resource list included for local support groups. Participants will learn the

importance of exercise for staying fit and healthy. All interactions will be nurse-monitored 24

hours a day, seven days a week to answer healthcare questions and offer assistance.

Obesity in America currently costs over three billion dollars a year in healthcare expenses

and that number is growing (Rowen, 2009). Every pound a person loses directly converts into

money saved by both the patient and the system. Since the primary focus of this project is

combating childhood obesity, success could conserve enormous healthcare resources for decades

to come.

The desired outcome of the project of creating a nurse social media coordinator position

for combating childhood obesity is to raise awareness and help as many participants as possible.

Facebook provides a real-time look at social media interactions. It is time for proven theories and

methods to be adapted to a new medium.

Project Details

For over 35 years, the number of American children ages five to 19 diagnosed as

overweight or obese has risen to epidemic proportions. Almost eight million children are

affected, and that figure will continue to grow, given current dietary trends and continually

sedentary lifestyle choices (Rao, 2012). American children have near-universal Internet access

and overwhelmingly participate in social media activities, namely posting and sharing on

Facebook (CHCMC, 2015). Utilizing this information, Facebook can become a powerful tool for

nurses in combating childhood obesity.

The creation of a new type of nursing position, social media coordinator, will be vital in

the endeavor for reaching overweight children. This nursing specialist will be responsible for

developing the Facebook Page content, training social media-adept nurses, and scheduling


continual monitoring. While many healthcare institutions already have a Facebook presence, this

project is specifically to focus on children and their families. The Page will offer diet and

exercise recommendations that meet accepted standards of practice with age-appropriate

comprehensive clarity. Peer and family-centered support systems and interactive content will

also be utilized to encourage participation to empower the children and reinforce positive

lifestyle health maintenance behaviors.

Background of Childhood Obesity and Significance of the Project

Historically, obesity was not commonplace and was considered to be a sign of wealth.

Medical records have shown an explosion of obesity diagnoses across all levels of the social

spectrum in the past 35 years. Lower income demographics, though, have provided a

preponderance of causes (Koehly & Loscalzo, 2009). The two leading causes of developing

obesity are excessive caloric intake and a lack of exercise. Individually, these are serious health

risks. The likelihood of obesity increases when both excessive caloric intake and a lack of

physical activity are combined.

The timeline is important in understanding the root determinate of childhood obesity

(Morgan, 2013). The dietary component can be traced to corn subsidies enacted by President

Richard Nixon in the early 1970’s. Initially used to boost the income of rural farmers by

standardizing grain prices, the program was well received. The rise of industrial-scale farming

led to abuses of the system and a glut of corn crops. To deal with an excess of corn, many food

manufacturers started using high-fructose corn syrup despite the relatively low cost of

conventional cane sugar (Morgan, 2013).

By the 1980’s, high-fructose corn syrup found its way into nearly every processed food

product from soups to sodas. The American diet quickly changed from home cooked,


nutrient-dense and portion controlled to calorie-laden, nutrient-poor fast food convenience.

Children fashion their eating habits after their parents. When the children of the 1980’s started

having offspring of their own, the effects of these poor dietary choices manifested itself into the

current childhood obesity epidemic.

The cause of inactivity can also trace its ascension to the 35-year timeline (Hensrud,

2011). Economic downturns and austerity measures initiated during the Reagan administration

had an immediate impact on education financing, particularly at the elementary and high school

levels. As a result, schools cut physical education classes and extra-curricular sports activities.

These classes and activities were the main opportunities for physical exercise for many children,

especially those from the lower income, inner city.

During the same period, there were many two-income households and single parents.

Children of these families became known as ‘latchkey kids’ (Hensrud, 2011). For safety

concerns, latchkey kids were instructed to stay indoors and not play freely outside with others.

The home entertainment industry took advantage of this growing market and an explosion of

video games, personal computers, and cell phone use was born.

The significance of this project is that all invested parties benefit from the inception of a

nurse social media coordinator position for combating childhood obesity. Patients and their

families receive quality health maintenance education, guidance for related decision-making

skills, and a strong support system using group activities. The healthcare system can conserve

resources and valuable time having a healthier populace. Finally, the nursing profession benefits

by taking enormous strides using modern technology and assuming a larger leadership role in

health promotion. Using social media to combat childhood obesity represents a paradigm shift in


how nurses communicate with their patients. Programs modeled after this innovation can address

a multitude of healthcare issues and positively influence future generations.

Theoretical Plan

The nursing theory, Roy’s Adaptation Model, was developed in 1976 by Sister Callista

Roy (Nursing Theory, 2013). In the context of nursing, adaptation transpires when people have a

positive response to the conscious awareness of a certain environment. In short, learning gives

rise to health-promoting behaviors. The nurse social media coordinator position adheres to this

model by meeting Roy’s four basic tenets. First, a person can be studied, and actions quantified.

Thanks to marketing, these statistics are available as part of the homepage format allowing

patients and the nurse social media coordinator to track participation. Second, obesity prevention

is a primary cause for a nursing action. Third, care is taken to respect the patient’s opinions and

values. Reaching out to children through social media is analogous to using a translator when

treating a non-English speaking patient. Without connection, there can be no understanding.

Finally, by adaptation, the patient can focus on other stimuli. A healthy child has more

opportunity to lead a rewarding life.

Roy’s Adaptation Model informed the planning of this project because it encourages

patient self-reliance guided by appropriate educational techniques (Sales, Smith, Curran &

Kochevar, 2006). By using Facebook as an outlet for health promotion, participants can actively

seek knowledge about real or potential health issues. Roy’s model stresses personal

responsibility to maintain one’s health through action. The mechanism of action is visiting the

project’s Facebook Page and participating in educational endeavors, enjoining family members,

and partaking in group activities.


Project’s Plan

Nurses must incorporate the use of emerging technology like social media into their

personal skill set if the nursing profession wishes to attain a leadership role in health promotion

(Wood, 2010). The position of nurse social media coordinator will focus on developing a

working understanding of the Internet, cellular technology, video conferencing, text messaging,

smartphones, and social media networking. Children are proficient in all of these activities and

use them as their preferred method of interacting with the world at large (Huston, 2013).

Conventional communication methods, classroom study, and television and radio are becoming

increasingly ineffective for children within the target demographic, ages five to 19. These

communication modes show no sign of returning to prominence. Proven useful content for

reducing the incidence of childhood obesity already exists. The nurse social media coordinator’s

task will be to formulate data into a Facebook-friendly format.

Starting a Facebook ‘Page’, the term social media utilizes, is a relatively simple process

that provides prompts for the initial set-up (Hussain, 2014). The first step is to create an account.

Second, choose a category from the pre-set menu. For this project, the category will be ‘Cause or

Community’. Naming the Page is important. There will be only one opportunity to change the

name or URL address. Third, the nurse social media coordinator must complete some basic

information about the organization. Included in this information will be a two or three sentence

description of the project and a link to the facility’s website. A logo or profile picture can be

added as a visual icon. Next, the Page can be added as a ‘Favorite’ in the navigation bar for easy

log-on access. At this point, the basic skeleton of the Page will be considered ‘live’ and will be

available to ‘Like’. The ‘Like’ action should be delayed until the content has been added to the

Page. The administration panel can be completed after selecting ‘Settings’. Information for this


panel includes a mission statement, notification options that allow network connections and a

section for designated colleagues to make changes to the Page. The next step is to populate the

Page with content in a multi-media format. It is here that the project invites Facebook users to

join, share, and be a part of a growing community. The final step is measuring the growth of the

network. Facebook already provides this step in an embedded metric format. The nurse social

media coordinator can ascertain this vital data by clicking on ‘Insights’. The ‘Likes’ tab shows

overall growth and losses. The ‘Reach’ tab shows the raw number of people the Page reaches

daily, including cross-referencing content effect. The ‘Visits’ tab gives a demographic of Page

visitors, and the ‘Overview’ tab gives a weekly summary of network traffic. The entire project

can be up and running in a matter of hours and effective within days.

A Facebook Page of this type, though technically an educational and health promotional

tool, can successfully adapt proven business advertising models within the Facebook community.

Using Facebook’s actuarial tables, a project Page of this size typically generates 6,000 ‘Likes’

through the initial free social plug-ins with 50 to 300 daily visits. Creating an ad for the Page will

cost between 27 cents and 57 cents per ‘Like’. Additionally, there is a ‘Promote’ button that can

reach 500 to 5,000 viewers costing five dollars to 30 dollars per use (Facebook, 2015). These

figures represent a significant cost-savings compared to conventional television, radio and print

advertising while gaining participation in the stated demographics.

Another ancillary benefit of using Facebook is the ability of the nurse social media

coordinator and other designated site monitors to receive and respond to participant’s queries in a

timely fashion. Children love to take photos. They will be able to post pictures of their meals and

have feedback as to the balance of the portion, estimated calories, and distribution of protein,

carbohydrates, and fats. Participants will also be able to share success stories. The Page can link


to local support groups as an adjunct to weight loss strategies, healthy weight maintenance, and

community health promotional events such as sponsored walkathons or bike rides for children.

Cost-Benefit Analysis

The creation of the nurse social media coordinator position for combating childhood

obesity, utilizing Facebook, is primarily an educational and health promotional venture.

Organizations wishing to undertake this project will assume the financial burden while reaping

little in actual monetary recompense. As such, the project should be classified as a community

service. The costs can be tax-exempted against the operational capital. See Appendix A for the

initial investment cost to implement the project.

Research data has concluded that childhood obesity has an economic impact on parents

and the healthcare system (Trasande, 2011). Yearly costs for a child with a healthy body mass

index (BMI) are about 175 dollars less than a BMI-classified, overweight child. Obese children

face an additional 220 dollars in yearly medical expenditures. These expenditures represent a

cost of almost three billion dollars to the healthcare system in outpatient visits, incremental

prescriptions drug costs, and emergency room visits. Including associated comorbidities, the

basic cost of obesity exponentially rises. This project, when taken in its entirety, is what

businesses term a ‘loss leader’, a significant initial investment that eventually produces an

overwhelming net gain.

Intervention Strategies

The two primary elemental causes of childhood obesity are excessive caloric intake and

lack of physical activity. Research has found that adolescent’s social networking use is linked

inextricably to both physical activity levels and eating behaviors (Koehly & Loscalzo, 2009).


While these actions are initiated by parenting, as children move into adolescence, social groups

begin to exert more influence over a child’s decision-making. Social networking can be an

important link in halting childhood obesity through a process known as communal coping.

Communal coping operates against known environmental and behavioral risks like

communicating known risk factors, a shared appraisal of overweight or obesity risk, and use of

cooperative strategies to adapt a healthy lifestyle. Interventions that address family systems

rather than the individual have a greater chance of success. These measures must be tailored to

the family structure. Community-based support systems will aid parents through social

connections. The children will use the peer network to encourage participating in more physical

activities.

Outcome Analysis

The project will utilize a qualitative approach to analyze the outcomes of this venture. A

qualitative approach is useful when complex issues are being addressed (Morse, Penrod &

Hupcey, 2000). The data provided by Facebook, coupled with periodic tracking surveys, are the

foundation for analysis. Performing these actions will identify which intervention strategies work

and which components require improvement.

With over 700 million registered users, Facebook provides an opportunity to reach a

sizeable audience. A host of celebrities and mega-corporations receive tens of millions of ‘Likes’

for their Page content. A Facebook Page is not a ‘set-and-forget’ proposition. To attract an

audience, the Page must have continual input in the form of posts. Posts are 250 words or less,

entered at least once a day, to be considered active and generate interest. Too much posting will

cause users to block the posts and unsubscribe to the Page. Photos will also be necessary to

create an emotional connection. For the healthcare site to be successful, it should reach over


30,000 Facebook users and have at least 3,000 users actively engaged. Continued rates of 15

percent to 25 percent in both metrics per month are necessary to justify expenses.

Implementation

The implementation of this project has previously been outlined in a step-by-step

methodology in the project’s planning section. A brief synopsis involves establishing a Facebook

presence, expanding a social network, monitoring the Facebook Page with registered nurses

familiar with accepted standards of practice, and periodically assessing the project’s

effectiveness. Implementation is part of the nursing process and is the point at which planning

becomes action (American Nurses Association, 2015).

An important element necessary prior to the implementation of this project is proper

training for the nurses involved. Training will focus on two main areas, childhood obesity, and

social media use. The team members will learn nutrition and exercise that is age-appropriate and

realistically achievable, using currently accepted standards of practice. These nurses will work

together under the leadership of the nurse social media coordinator to compile relevant content

for the Facebook Page. Negative feedback while monitoring the Page is rare, however, negative

comments may appear. Any negative feedback or bullying will immediately be addressed to

demonstrate in a rational, adult fashion why such comments can be hurtful to the individuals and

the Page. The comment can then be deleted. Participants will diligently observe every action on

the site that is performed by the nurse social media coordinator and designated monitors. The

Page will be designed to enforce positive participation. Correspondingly, all HIPAA regulations

must be followed, and any personal medical information will be removed immediately to be in

compliance with HIPAA standards.


QSEN Standard – Patient-centered Care

Patient-centered care is based on a profound respect for patients as unique living beings

and the moral obligation to treat them in those terms (Epstein & Street Jr, 2011). It is in this

manner that patients identify their position within the social community. They deserve to be

heard, listened to, respected, and take an active role in their healthcare. Although this project

strives to reach as many people as possible, essential elements are tailored to the individual. All

relevant factors such as family structure, heritage, and economic status are utilized for

individuals and their families to avoid generalizing.

QSEN Standard – Evidence-based Practice (EBP)

In contrast to patient-centered care, evidence-based practice (EBP) is more focused on

scientific research based on patient populations (Academy of Medical-Surgical Nurses, 2014).

EBP is the foundation upon which all nursing standards of practice are based. Through EBP,

clinical guidelines are created using high-quality findings of research that follow the scientific

method. An example of EBP in this project is information placed on the Facebook Page. The

information is broad-based and intended for a mass audience.

Recommendations for Personal Growth and Innovation in Nursing Practice

For nurses that are chosen to participate in this project, particularly the nurse social media

coordinator, this is an invaluable learning experience. The same can be said for the nursing

profession. The project of creating a nurse social media coordinator position for combating

childhood obesity represents an entirely new and unique form of communication between patient

and nurse. The communication will be continually evolving. Fortunately for the nurses

monitoring the Facebook Page, some ground rules have been set (Utengen, 2011). Unlike a

clinical setting, the nurse does not have a captive audience. Children using the Internet have


millions of options as to how to spend their time. Reaching the project’s target demographic,

children ages five to 19, requires a deft approach. Something as simple as the wrong picture on

the Page will turn people away. The monitored Page will be the voice of the users and thus entice

more users. It is the children who will ultimately determine the success or failure of the project

by their participation and assistance in expanding the Page’s social network. The Facebook

presence is just the beginning for the nurse social media coordinator’s networking. Success

hinges on utilizing other popular forms of social media such as Twitter or YouTube to engage,

enlighten, and entertain the target demographic who will in turn connect to their individual social

groups. There is an enormous growth opportunity for both the individual nurse and the nursing

profession.

Conclusion

Since 1980, the number of American children classified as overweight or obese has risen

to epidemic levels. Currently, around eight million children are affected, and many more are at

risk of becoming overweight. That figure will indeed grow given the increase in sedentary

lifestyle choices combined with poor dietary decisions. At the same time, 95 percent of

American children have access to the Internet and participate in social media activities. A well-

run Facebook Page can become a powerful tool in combating childhood obesity.

The project reflects on the feasibility of creating a unique nursing position. The new

position is a nurse social media coordinator for combating childhood obesity. To accomplish a

successful outcome, the nurse social media coordinator will begin by establishing a Facebook

Page and train nurses to staff and monitor the Page. The nurse social media coordinator will

provide content for the Page and actively engage participation by continually updating the

content and encouraging family and community support.


APPENDIX A

Project Investment Costs

Staff

1 – Nurse Social Media Coordinator $95,000/year salary This position represents a nurse educator responsible for staffing, training, and site content

5 – Registered Nurses – Part-time $200,000/year total Specialty-trained site monitors for @$24/hour each full-time coverage

1 – Information Technology (IT) Specialist $54,000/year salary

Hardware

2 – PC Computers $1,200/total @$600/each Monthly connection fees $40 to $100/month

6 – Smartphones $2,400/total @$400/each Monthly usage fees $40 to $100/month

FacebookAdvertising per ‘Like’ $2,700 to

$5,000/month @$0.27 to $0.57 each

Initial Total - $355,300 to $357,600 Monthly Total - $3,020 to $9,000


References

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6104525_Anderson_N555C_Feb_Final Project - Part 1

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