final group project nurs 340 portfolio · D } v } µ v Ç ^ d á c \ a ] á ^ ` ^ ] d e \ ï á á...

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Nurs 340 Ferris State University Adrian Duke Walker Van Wagoner Lisa Zwerk Jessica House

Transcript of final group project nurs 340 portfolio · D } v } µ v Ç ^ d á c \ a ] á ^ ` ^ ] d e \ ï á á...

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Nurs 340Ferris State University

Adrian DukeWalker Van Wagoner

Lisa ZwerkJessica House

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Mason County

Figure 2: Map of Michigan Highlighting Mason County [Digital image]. (2002, September 29). From: https://en.wikipedia.org/wiki/Mason_County,_Michigan

Figure 1 CF Map-Mason County [Digital image]. (n.d.). from http://www.midnr.com/Publications/pdfs/ForestsLandWater/Commercial_Forest/mason.htm

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Mason County Population 28,705 Total area of 1,242 square miles As long ago as the 1890’s Mason County has been a

magnet for summer tourists Today, thousands of vacationers visit each year for the

beaches along the Lake Michigan coastline Mason County has both an aging, and rural

population-both vulnerable populations at risk for health disparity. (Historical Society, 2016)

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Presentation Overview Reviewing and analyzing community health data specific to

Mason County Performing a community assessment Identify current community resources Develop a nursing diagnosis and problem statement

regarding health related opportunities in Mason County Develop a SMART goal for improving outcomes within the

community Evaluate effectiveness of intervention

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Data Comparison

Mason County US Benchmarks

Poverty 16.3% Persons with disability (< 65

yrs.) 12.1% Persons w/o health insurance

(<65yr.) 11.1%

Poverty 13.5% Persons with disability (<65

yrs.) 8.5% Persons w/o health insurance

(<65 yr) 10.5%

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Data ComparisonMason County US Benchmark

Children in poverty: 28% Teen births: 10.9% Cancer rate: 289.1 per

100,000 Childhood obesity: 19.8%

Children in Poverty: 23% Teen births: 10% Cancer rate: 185.9 per 100,000 Childhood obesity: 13%

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Analyzing Data Mason County has a higher than average (by U.S. average) rates of

persons in poverty, teen births, childhood obesity, lack of insurance and economic disparity.

The aforementioned groups, all of which are found in a higher proportion in Mason county, are vulnerable populations / groups. Vulnerable populations are more prone to negative health outcomes; often these conditions potentiate and worsen the situation for those involved (Harkness & DeMarco, 2012, 335)

Lack of activity contributes to the abnormally high childhood obesity rates in the county (Hill, Mullins & Warner, 2012, 63)

Inability to pay for insurance is by far the largest factor in county residents’ ability to obtain insurance (Hill, Mullins & Warner, 2012, 82)

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Factors Contributing to Differences Lack of opportunity

Limited access to gainful employment is a significant limiting factor contributing to an abnormally high poverty rate and is one of the greatest concerns of county citizens (Hill, Mullins & Warner, 2012, 52)

Mason county is a rural area Rural areas, by their very nature, predispose residents to a public

health challenge including social inequalities and health disparities (Harkness & DeMarco, 2012, 336)

Remote location The largest nearby metropolitan area (Muskegon, MI) is 60 miles

away, thereby creating a physical barrier in access to larger markets

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Factors Contributing to Differences Currently the District 10 Health Department seeks to

address some of the aforementioned concerns by focusing programing on:

Colorectal, cervical and mammogram cancer screenings Worksite wellness screenings Family planning Adolescent health service programming

Increased interventions from a community public health level would be most appropriate to address the health issues where Mason county falls below the national average (Harkness & DeMarco, 2012).

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Current Resources Existing agencies that are likely partners within Mason

County Spectrum Health: Regional healthcare provider within local

area. Michigan Works! one-stop service center: Provide services to

assist in job searches. FiveCAP, Inc: Community Action Agency that provides public

and private resources to motivate impoverished residents to achieve economic and social independence.

Michigan Department of Health and Human Services : Provide assistance programs to include healthcare coverage, cash assistance, child care, and emergency relief.

Mason County Council on Aging: Services for senior citizens

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Community Strengths Strengths of community indicating likelihood of

successfully addressing problem Health care services Religious beliefs Political events Educational institutions Environmental conservation Parks and recreational activities Public transportation

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Nursing DiagnosisIneffective coping: related to limited access of health care and limited resources for gaining stable employment and preventative care.

Contributing factors: Lack of transportation and financial resources prevents

people from Mason County to receive optimal healthcare and stable employment.

Lack of social support within the community Deficient knowledge on how to manage a financial crisis No healthcare insurance or the means to acquire it to pay

medical expenses

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Figure 3 Poverty: District Health Department # 10. (2015). Health profile chartbook 2015 Mason County. Retrieved from https://dhd10.org/images/Mason_Chartbook_2015.pdf

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Figure 4 Health Care Access: District Health Department # 10. (2015). Health profile chartbook 2015 Mason County. Retrieved from https://dhd10.org/images/Mason_Chartbook_2015.pdf

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Community-Focused Nursing DiagnosisRisk for cancer, heart disease, teen pregnancy, and obesity

Disciplines involved in addressing this problem Healthcare providers Nutritionist Public health nurses Community health education programs

What community groups could be resources in addressing the issue? Community Health Center Spectrum Health Michigan Department of Health and Human Services Mason County Public Health Department Area Agency on Aging (Ackley & Ladwig, 2008)

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Problem statement: Mason County has a rate of childhood obesity far higher than the national average. Our group will discuss this in greater depth and present solutions for

improvement including the use of locally available resources. Specific population based health risk

Sedentary Lifestyle Everyone within the population is at risk of sedentary lifestyle People with medical issues Genetic predisposition Smokers (Harkness & DeMarco, 2012)

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Factors and Indicators Causative factors that can be measured and changed to decrease the incidence

of the identified problem A SMART goal is a measurable objective, using a nutritionist to assist a

family suffering with obesity by planning weekly meals Periodic weight measurements Calorie measurement Genetics Medical reasons (diabetic, smoking, heart disease hypothyroid etc…)

What indicators should change if the intervention is successfully carried out? Reduced obesity Lower cardiovascular disease Reduce diabetes Reduce high blood pressure (Oz & Roizen, 2015)

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Problem Review:Mason County has a rate of childhood obesity higher than the national average (Hill, Mullins & Warner, 2012, 63) As public health nurses, we can suggest community

wide interventions for helping improve the child obesity rates in Mason County.

Using the Health Department as the primary outlet and community partners, explicit permission would not necessarily be needed for carrying out the following problem-focused interventions proposed

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Prevention InterventionsPrimary Interventions Secondary Interventions Measures to help children with healthy weights maintain them (Hillier, Pedley, and Summerbell, 2011)

Healthy eating/Nutritional education Reduction in sedentary behaviors Increase and encourage physical activity Encourage physical activity – it is estimated

that children should receive at least 60 minutes of physical activity each day.

Utilize schools for educational purposes for healthy nutritional choices – Most children are enrolled in school. (Martinac, 2015)

Designed to detect obesity and treat at early stages. Offer free screenings with

nutritional consults. Encourage primary care follow up

and continuous re-evaluation. Monitor activity levels and plan

activity based outings focusing on those families in the county with higher obesity rates.

Encourage schools to offer scholarships for low income students. (Martinac, 2015)

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Socio-Ecological Model of Change Consistent evidence

shows that implementing multiple changes at various levels of the Social-Ecological Model is effective in improving eating and physical activity behaviors (DHHS, 2015).

Figure 6: Socio-Ecological Change: http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/change/pdf/changeactionguide.pdf

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SMART GoalSpecific, Measurable, Attainable, Realistic and Timely

Reduce the childhood obesity rate in Mason County to below

the national average levels within the next 10 years.

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Evaluation Evaluation of interventions and educational efforts

would be measured by the statistics given related to obesity rates and monitoring trends for childhood obesity for the next 10 years.

Education and primary prevention is KEY!

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Conclusion Recognizing the large percentage of children with obesity in

Mason County, our goal is to increase the activity level of the residents in this county, particularly children.

Acknowledging the barriers to this rural community, we hope to leverage existing resources including schools to help promote awareness and provide education to help decrease childhood obesity.

Over the course of 10 years, by educating and networking with local agencies, we hope to achieve our goal of overall reduction in childhood obesity compared to the national average.

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ReferencesAckley. B. J. & Ladwig, G. B. (2008). Nursing Diagnosis Handbook

An Evidence-Based Guide to Planning Care. (8th ed). St Louis, MO: Elsevier

Collection of the Mason County Historical Society. (2016). From http://www.pureludington.com/documents/Ludington_MI_History.pdf

Harkness, G. & DeMarco (2012). Community and public health nursing practice: Evidence for practice. Philadelphia, PA: Wolters Kluwer/Lippincott, Williams & Wilkins

Historical Society, Mason County. (2016). From: http://www.pureludington.com/documents/Ludington_MI_Historypdf

Hill, M., Mullins, M., & Warner, L. (2012, August). Mason county and northern oceana county behavioral risk factor survey

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References continuedHillier, F., Pedley, C. and Summerbell, C. (2011) Evidence base for

primary prevention of obesity in children and adolescents, 54(3), pp. 259–264. doi: 10.1007/s00103-010-1227-4

Martinac, P. (2015) Solutions for obesity in America. From: http://www.livestrong.com/article/342134-solutions-for-obesity-in-america/

Mason County Michigan. (2016). Other agencies. From: http://www.masoncounty.net/other-agencies/

Oz, M. C., & Roizen, M. F. (2015). RealAge. Sharecare. Retrieved from https://www.share care.com/static/realage-sharecare

U.S. Department of Health and Human Services (DHHS) and U.S. Department of Agriculture (UDSA) (December 2015). 2015–2020 Dietary Guidelines for Americans. 8th Edition. From: http://health.gov/dietaryguidelines/2015/guidelines/.


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