Mecosta County The need for increased physical activity

Mecosta County The need for increased physical activity

Mecosta CountyThe need for increased physical activityMarylynnAdamski, Nathon Kelly, Dena Bailey, Katherine France& Marijo JohnsonAssessment Population in 2009 Michigan 9,969,727 Mecosta County 41,775

Leading cause of death 2008

Michigan Heart Disease 23.5 Mecosta county Heart Disease 25.2

Death by heart disease is much higher in Mecosta County than the State of Michigan

Assessment Obesity is the leading cause of Heart Disease

Obesity is Body Mass Index (BMI) > 30

Mecosta Obesity 26.2%Michigan Obesity 29.4%

Mecosta county has less people but they have almost same the obesity rate as the State of Michigan.

What group is most effectedObese adults had a higher prevalence of coronary heart disease, arthritis, high blood pressure, high cholesterol, asthma, stroke, heart attack, diabetes and inadequate sleep compared with non obese adults.Resources for physical activityMecosta County Parks 18 Golf courses Public 4Golf courses Private 3Fitness Centers/Gyms 4Walking/Biking/Hiking Trails 4

City of Big Rapids Recreation

50+ Exercise Tuesdays 1:00 Evergreen Community Building50+ Dance Tuesdays 1:00 Evergreen Community Building50+ Water Areobic Monday Wednesday & Friday 8:30am-9:30am and 10:00 am-11:00 am Ferris State University PoolResources contLETS WALK BIG RAPIDS - is a non-competitive walking program that offers exercise while spending quality time on Big Rapids parks and trails. Lets Walk Big Rapids is a free program for all ages. Walks are held in the Spring and Fall months.

Big Rapids Bike Club

CITY OF BIG RAPIDS RECREATION. (2010). Retrieved from: http://www.ci.big-rapids.mi.us/pdfs/Recreation_Programs_Offered.pdf6 Scope of Community Nursing PracticeCommunity health nurses will be taking care of clients who have the diseases associated with the lack of physical activity.It is a community wide problem.Community health nursing will work to get clients to increase physical activity. Community health nurses will inform various groups about what they can do to increase physical activity.Community Groups that can help promote physical activityChippewa Lake Lions ClubCommission on Aging and Senior Center Big Rapids Lions ClubsBarryton Lions Club

DiagnosisRisk for heart disease among adults related to lack of physical activity secondary to obesity

PlanPrimary Prevention:Must start at a young age.Emphasis on exercise and healthy eating habits.Establish healthy habits from a young age to reduce obesity later in life. Continued support of physical activity throughout life.Secondary Prevention:Establish a diet and exercise program.Screen for medical causes of obesity and treat.Primary Prevention - ChildrenThe first step in increasing physical activity and decreasing obesity is with children.The primary care physician (pcp) should be one of the greatest advocates for physical activity.Young et al. (2010) establish a need for pcps to advise parents on ways to increase physical activity and promote healthy eating habits.

Primary Prevention - AdultPCPs play an important role in promoting health and physical activity in normal weight adults.

Normal weight adults are least likely to receive education on healthy habits when they are the ones that would most benefit from it.

Nawal et al. (2007) found that on 2.6% of normal weight adults received primary prevention.Secondary PreventionFocus on addressing lack of physical activity and unhealthy eating habits.The PCP is the prime candidate for this but all healthcare workers should work to address lack of physical activity.Kirksick et al. (2010) found that even moderate decreases in caloric intake and moderate increases in physical activity can result in weight loss.OutcomesOutcomes will be measured using national and state data on obesity in adults and children in Mecosta county.

Self reported exercise and food journals will be utilized to monitor physical activity and caloric intake. These can be followed by the PCP.

PCPs will weigh and record BMI at all visits to monitor for changes and provide education at needed. InterventionsEncourage nutritious, satisfying meals.Teach about low-calorie, nutritious foods.Encourage exercise such as walking, jogging, aerobics, or swimming appropriate to age and physical condition.Provide teaching and pamphlets on cholesterol and hypertension.Encourage patient to take prescribed medications for cholesterol, hypertension and diabetes if needed.Teach the importance of medication compliance

Interventions, Cont.Encourage the use of food journals Teach children about nutritious snacks and mealsTeach parents the importance of physical activity for children

Factors Positively Associated with Adult Physical Activity Postsecondary educationHigher incomeEnjoyment of exerciseExpectation of benefitsBelief in ability to exercise (self-efficacy)History of activity in adulthoodSocial support from peers, family, or spouseAccess to and satisfaction with facilitiesEnjoyable scenerySafe neighborhoods(U.S. Department of Health and Human Services, Understanding physical activity)

Barriers to Increasing Physical ActivityAdvancing ageLow incomeLack of timeLow motivationRural residencyPerception of great effort needed for exerciseOverweight or obesityPerception of poor health Being disabled(U.S. Department of Health and Human Services, Understanding Physical Activity) EvaluationEvidence Based Practice has shown that by starting young, teaching and providing healthy foods to children can increase the amount of healthy food that children will eat. A 2-year randomized control trial of a school-based environmental intervention that increased the availability of lower-fat foods in cafeteria la carte areas indicated that sales of lower-fat foods increased among adolescents attending schools exposed to the intervention (Khan, Sobush, Keener, Goodman, Lowry, Kakietek, Zaro, 2009).

Teaching parents about the importance of physical activity and having children inrcrease the amount of physical activity does make a difference. Modifying school PE curricula was effective in increasing physical activity across racial, ethnic, and socioeconomic populations, among males and females, in elementary and high schools, and in urban and rural settings (Khan et al., 2009). Physical activity is known to reduce your risk of heart disease and obesity. The Center for Disease Control states Regular physical activity can also lower your blood pressure and improve your cholesterol levels (CDC, 2011).

EvaluationEducation, such as providing pamphlets on cholesterol and teaching on medication management proved to be an effective intervention in a study done by the CDC. Patient outcomes included a reduction in both weight gain and blood pressure.(CDC, 2010).

Interventions in community settings to promote physical activity have emerged as a critical piece of an overall strategy to increase physical activity in the United States (Zaza, Briss, & Harris, 2005, p. 81). EBP shows that these interventions can help to encourage and educate the people in the community to understand how important it is to be physically active and eat a healthy diet. Implementing these interventions can reduce the risk of heart disease and obesity. Other Interventions that are recommended by EBP are:

Making sure there is access to healthy foodRestrict the sales of less healthy foodProvided smaller portions in public venuesLower the amount of hours that are spent watching television and on the computer(Khan et al., 2009).

Policy DevelopmentPolicies to Enhance Physical ActivityIncreasing physical activity in adults requires both resources and motivation of the individual.

Mecosta County has several community infrastructures available but barriers may continue to exist.

Federal and State governments have demonstrated increased awareness of the need for increased physical activity by addressing physical activity goals in Healthy people 2020 and Healthy Michigan 2010. Policies to Enhance Physical Activity Increasing physical activity requires a consistent message from the media, government and educational systems.

Successful policies will include an assessment and plan to eliminate barriers.

Although the target group for this presentation is adults, research has demonstrated that developing physical activity habits at a young age is more likely to increase physical activity as an adult.

U.S. National Physical Activity Plancomprehensive set of policies, programs, and initiatives that aim to increase physical activity and create a national culture that supports physically active lifestyles, improve health, prevent disease and disability, and enhance quality of life

Vision: One day, all Americans will be physically active and they will live, work, and play in environments that facilitate regular physical activity.(National Physical Activity plan, 2010, para. 2-3)

Plan InitiativesBusiness and IndustryEducationIdentify evidence based practice and interventions in the workplaceEncourage business to increase physical activity opportunities in the workplaceProvide education to business owners on the positive effects of physical activityAssist with policy developmentProvide access and opportunity for high quality physical activity programs in schoolsDevelop state and district school policies and regulationsProvide access to physical activity programsDevelop partnerships with private sector to link opportunities in the school and community

Plan Initiatives (Continued)Health CareMass MediaMake physical activity a vital signEstablish physical activity as treatable and preventablePrevent and treat physical inactivityReduce disparities to access to physical activitiesInclude physical activity training in the education of health care professionalsAssist with local, state and institutional policy developmentEncourage partnerships to promote themes in physical activitySustain a mass media campaignDevelop mass media messagesIdentify funding for research to develop evidence related to the use of existing and emerging technologies for increasing physical activityPlan Initiatives (Continued)Parks, Recreation, Fitness and SportsPublic HealthPromote programs and facilities where people work, learn, live, play and worship Enhance the existing parks, recreation, fitness, and sports infrastructure Increase funding and resources for parks, recreation, fitness, and sports programs and facilities in areas of high need. Create, maintain, and leverage cross-sector partnerships and coalitions that implement effective strategies to promote physical activitypolicy development to elevate the priority of physical activity in public health practice, policy, and researchDisseminate tools and resources important to promoting physical activityPlan Initiatives (Continued)Transportation, Land Use and Community DesignVolunteer and Not for ProfitPrioritize resources and provide incentives to increase active transportation and other physical activity through community Increase connectivity and accessibility to essential community destinations to increase active transportation and other physical activityAdvocate to local, state and national decision makers for policies and system changes identified in the National Physical Activity PlanConduct outreach to non-profit groups members, volunteers, and constituents to change their own behaviors and advocate for policy and system changesNational Physical Activity Plan, 2010.Healthy Michigan 2010Initiatives to promote health and physical activity to ensure the wellness and productivity of the workforce200 Community Health employees worked to develop initiativesMichigan Healthy People 2010 included goals to increase physical activity in adults and adolescents.

(Surgeon General Report, 2004, p. 55)Community Physical Fitness Support GroupsMecosta County Medical Center: produced several community news letters with significant information on the benefits of increased physical activityMecosta Medical Center: Assists cardiac rehab patients with initiating a phase 1 and 2 rehab program which includes a physical fitness programMecosta County Youth Center: after school sports and activitiesMecosta County Area on Aging: fitness classes- A Matter of Balance, EnhanceFitness; also offer transportation to activitiesConclusionPhysical activity can decrease the incidence of obesity and therefore decrease the incident of heart disease. Mecosta County has a significant number of overweight individuals and may benefit from implementation of the initiatives represented in the U.S. National Physical Activity PlanEarly physical activity habits are more likely to carry on into adult life. This signifies the importance of early education and physical activity programs. ReferencesCenter for Disease Control. The Guide to Community Preventative Services. 2010. Retrieved from: http://www.thecommunityguide.org/obesity/Multicomponent.html

City of Big Rapids Recreation. (2010). Retrieved from: http://www.ci.big-rapids.mi.us/pdfs/Recreation_Programs_Offered.pdf

Department of Health and Human Services. Healthy people 2020. Retrieved from: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=33Kerksick, C., Wismann-Bunn, J., Fogt, D., Thomas, A., Taylor, L., Campbell, B., & ... Kreider, R. (2010). Changes in weight loss, body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women. Nutrition Journal, 959. Retrieved from EBSCOhost.

Khan, L. K. Sobush, K. Dana Keener, D. Goodman, K. Lowry, A.Kakietek, J. Zaro, S. Recommended community strategies and measurements to prevent obesity in the United States. Center for Disease Control and Prevention. 2009. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm

Leading causes of death, 2008 Mecosta County. (2011). In Michigan Department of Community Health. Retrieved from http://www.michigan.gov/mdch.

References cont.Lutfiyya, M., Nika, B., Ng, L., Tragos, C., Won, R., & Lipsky, M. (2008). Primary prevention of overweight and obesity: an analysis of national survey data. Journal Of General Internal Medicine, 23(6), 821-823. Retrieved from EBSCOhostMecosta County Clubs and Organizations Retrieved from: http://www.americantowns.com/mi/mecosta-county/organizations/clubs-and-organizations

Michigan Department of Community Health. (2009) Cardiovascular disease Retrieved from: http://www.michigan.gov/documents/mdch/09_HeartDis_198879_7.pdf

Michigan Department of Community Health. (2009) Overweight and Obesity in Michigan: Surveillance Report Series. Retrieved from: http://www.michigan.gov/documents/mdch/Obesity_chapter_283600_7.pdf

ReferencesMI Home Town Locator. (2011).Retrieved from http://michigan.hometownlocator.com/features/cultural,class,park,scfips,26107.cfm

Ralph, S., Taylor, C. (2008). Nursing diagnosis reference manual. (Seventh ed.) Lipponcott Williams & Wilkins, Ambler, PA.

U.S. National Physical Activity Plan. (2010). The plan. Retrieved from : http://www.physicalactivityplan.org/theplan.php

Wisdom, K. (2004, April 8). Healthy Michigan 2010. Retrieved from: http://www.michigan.gov/documents/Healthy_Michigan_2010_1_88117_7.pdf

Young, P., DeBry, S., Jackson, W., Metos, J., Joy, E., Templeman, M., & Norlin, C. (2010). Improving the prevention, early recognition, and treatment of pediatric obesity by primary care physicians. Clinical Pediatrics, 49(10), 964-969. Retrieved from EBSCOhost.

References cont.Zaza, S. Briss, P.A. Harris, K.W. The Guide to Community Preventive Services: What Works to Promote Health? Atlanta (GA): Oxford University Press;2005. 80-113.