Table of Contents
Adult obesity rates vary among the US states from 20.7% in Colorado to 34.9% in Mississippi (Niggel et al., 2013, p. 565). However, this problem is a great concern for general community-wide health condition. While the issue relates to numerous health-based consequences, its scope is not limited to people’s health. To be more precise, obesity in adults also has detrimental effects on an individual’s life within social, cultural and economic domains and leads to large expenditures from both personal and national standpoints. Moreover, the trends of increase in adult obesity continue. Based on the information by the Centers of Disease Control and Prevention (CDC) (2015), since the 2000s, this indicator has grown by 10% at least, with different correlations throughout the states. It has occurred regardless of the fact that the US has enacted numerous laws and regulations in the field during the past decade (Niggel et al., 2013). Therefore, the paper overviews this acute problem from the nursing perspective and provides a well-reasoned way to addressing the issue in a comprehensive manner.
Due to the fact that obesity is not a solely medical, but a more complex problem, there is a need to position this concept as a relevant issue within the social dimension. The task of the nurse in this case is to develop an appropriate framework and thoroughly justify it with arguments and supporting evidence. Although obesity is a disease that may occur in the populations of different age groups, targeting adults will allow the nurse to refer to other age population segments. In particular, changing lifestyles of adults will be likely to result in indirect modifications of the lifestyles and habits of their children, parents, relatives and friends. The only factor that should be taken into account is communicating this message in a proper way in order to avoid stigmatizing people who are obese. At the same time, the centerpiece of the proposal is linked to the currently common practice of “healthy eating and active living” (CDC, 2015). The difference embodied in an updated practice is related to a comprehensive approach towards both positioning of the issue and engagement of the as many stakeholders as possible. The role of the nurse in this respect can be regarded as versatile, including preventive education of the target audience, assistance in dealing with related chronic diseases, and care about obese people, to list but a few. Therefore, planning and implementation of a well-reasoned solution to this ageless and relevant to any person problem can become a great way to enhance the community health and nursing practice as a whole.
A2. Problem Investigation
The issue of obesity incorporates a number of important characteristics making this health concern a multifaceted problem. From a numerical standpoint, each year, expenditures for the medical care related to the indicated problem range from $147 to $210 billion in the US alone, which are $1.4 billion more than those of ordinary patients (Niggel et al., 2013, p. 565). Apart from the cost-related aspects, this process involves several factors that negatively affect physical and mental health as well as the social position. In accordance with the statistic, “35.7% of adults, or almost 79 million, and 16.9% of youth were obese in 2009-2010” (Niggel et al., 2013, p. 565). While youths will become adults very soon, this correlation will be more imbalanced if the issue is not addressed appropriately. From the medical perspective, obese persons have “a higher risk of many chronic diseases, premature death, reduced quality of life, and social stigma” (Niggel et al., 2013, p. 565). Such health concern is ranked as one of the leading causes of preventable deaths due to severe consequences the overweight can cause in individuals. In particular, heart diseases and strokes, certain types of cancer, and type 2 diabetes are listed among the most significant obesity-mediated health complications (CDC, 2015).
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Moreover, the consequences of this disease are a great challenge for the population from a psychological perspective. For instance, Puhl, Peterson and Luedicke (2013) have found that “as obesity rates have increased, so has bias and prejudice against obese persons” (p. 774). The greatest concern may be linked to media’s promotion of skinny and well-shaped male and female images as standards of beauty. As soon as the person’s image is beyond the scope of this norm, an individual is likely to be criticized and stigmatized. Owing to the majorly flawed lifestyles, little physical activity and improper eating habits of the target audience, the situation may only get worse. Anxiety and depression can become additional negative consequences that will result in more detrimental effects to human health and well-being. Therefore, obesity is a complex health concern with numerous complications that can appear in the patient in the long run.
Obesity is an issue that can be discovered even before it even occurs. In particular, the scholars have identified a number of early markers which may be regarded as background evidence of the future problem. These early markers of adult obesity involve probable and possible ones. On the one hand, “maternal mass body index, childhood growth patterns,” such as “early rapid growth and early adiposity rebound,” childhood obesity and father’s employment” are considered as probable indicators of future manifestations of obesity development (Brisbois, Farmer, & McCargar, 2012, p. 347). On the other hand, possible markers relate to “maternal smoking” and “maternal mass gain during pregnancy” (Brisbois et al., 2012, p. 347). It follows that this health condition is determined not only by the lifestyle specificities, but also by genetic predisposition of the individual. Moreover, if the latter reason is an evident characteristic of the person, then inadequate eating habits, such as fast food consumption or unhealthy diet, along with sedentary work conditions and the lack of physical exercise, will contribute to the worsening of the health condition greatly. Continuous leisure time spent in front of a television set or computer and little sleep are other factors contributing to this process. Hence, the person without proper health education and with inactive or unhealthy lifestyle can become obese based on the above early markers.
A4. Proposition for a Solution
The theorists and practitioners in the field have proposed numerous solutions to resolve the analyzed problem. For instance, the ways to address the issue can be listed as “physical activity, fruit and vegetable intake, portion sizes and sugar-sweetened beverage consumption,” and “empowerment regarding modifying the body weight” among others (Puhl et al., 2013, p. 774). Moreover, media resources and businesses in the sphere thoroughly speculate on the consciousness and helplessness of the obese people and earn immense amounts of money by proposing revolutionary diets or products in order to fight obesity. Of course, no one-fits-all approach can be an equally acceptable and successful solution. What is more, each obesity-related situation should be addressed on an individual basis.
At the same time, whereas adult individuals are conscious personalities with well-framed and mature ideologies, there is a need to address this issue in a systematic manner. In this way, an anti-obesity campaign should be made a crucial and integral part of human lifestyles and cultures. In this respect, it is also relevant to refer to the best practices in the field. For instance, community officials and worksites can be targeted in order to reshape the community-wide lifestyle in terms of compliance with healthy cultural standards as a norm of daily life, as proposed by Mississippi authorities (Lubbell, 2012). This state tries to reshape the culture of bringing ham when visiting friends and relatives and learning healthy eating with the engagement of churches. Moreover, South Dakota has even launched a Facebook-based campaign which reminds people to eat more fruit and vegetables. As a result, the proposed alternative solution will not be limited to a worksite, a hospital, a church or other community formation, but will combine all places of socialization for individuals. This leadership vision of the solution will target all adult individuals rather than obese persons and will be aimed at both fighting and preventing obesity based on the fact that this problem may concern any adult person. Moreover, it is necessary to note that the campaign is to be implemented as large-scale and engaging officials and professionals of different ranks and levels along with ordinary employees or unemployed adults. For example, when a firm is welcomed to participate, the project will equally involve both the top manager and an ordinary clerk. In this way, it will be possible to change the entire community’s culture rather than the lifestyle of a single individual who faces this health-related dilemma and is doomed to fight it on one’s own.
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Therefore, the action plan of anti-obesity campaign can be outlined as follows:
- The project should be planned for implementation in a single locality on the grounds of holistic involvement of all city-wide facilities and institutions. This approach is justified and quite possible to be implemented. One of the main points for providing a rationale for the employers and their engagement is promotion of their worksites as caring about their staff as an implication of social responsibility. What is more, healthier lifestyles for the employees is the way to reduce the number of missed work days due to diseases.
- Involvement of the leadership of businesses and organizations is a must. This approach is a good way to ensure better participation of adults in the project. Moreover, it will be possible to emphasize the positioning of the campaign as changing the lifestyle rather than fighting obesity to avoid stigmatizing and developing inferiority complex in obese adults.
- Conveying the central message of the introduced intervention program as a positive life change is critical for success. The reason is the potential harmful effects of the obese condition on human emotional well-being and psychological self-determination. Being obese is a psychological trauma already, which leads to sufficient stigmatization of the individual’s consciousness. These findings were confirmed by the previous researchers, such as Puhl et al. (2013), with negative consequences of programs based on obesity-related messages. In contrast, the campaigns with a more holistic approach based on the healthy lifestyle were effective and had positive impacts on obese and not obese persons.
- The program itself will be multi-component. On the one hand, the project will focus on health education of the population providing it with ample information about the severity of the problem and a vital role of change. On the other hand, it will involve a practical domain manifested with healthy meals initiatives, culinary trainings, physical exercising at workplace, and weekend activities in the parks.
- Additionally, the emphasis will be put on the additional benefit for people willing to get assistance on an individual basis, such as a consultation with a nutritionist, therapist or trainer among other specialists. This decision does not depend on the worksite visits of the practitioners and trainings on obesity versus healthy lifestyle will be held.
- Moreover, businesses will be welcome to organize workplace wellness programs on the basis of competition with the rivals. The best wellness program can be rewarded by the authorities.
- An emphasis will be put on food retailers with a request to propose healthy menus for the customers and offer culinary trainings on preparation of the healthy food.
- After the intervention and evaluation of the obtained results the extent of the program may be further expanded based on the results of monitoring of the process and adjustments in the proposed strategy.
A5. Recommended Resources
Undoubtedly, the proposed solution requires time and cost investments. The funding will be based on the assistance of the local government as well as the through donation of local businesses. It will comprise of at least $100,000. However, there will be an opportunity to increase the financial sourcing of the project during the implementation based on charity, so the funding may be flexible. The rationale beyond this approach will be reasonable to obtain this budget. Specifically, the city officials are legally abiding to promote anti-obesity policies. On a similar note, the employers are abided by the law and may get a possibility to have decreased levels of employee absenteeism due to their improved health. Moreover, the current business trend of corporate social responsibility will be an additional argument for the companies to participate in the project as both donators and implementers.
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The budget will be redistributed per tasks in the aforementioned scenario. First, the trainings will be held at a workplace basis, hence participation will be free of charge. Simultaneously, the actions requiring the large-scale participant’s involvement may require renting a hall of large capacity. Second, although partnerships with professionals are planned as voluntary, some may require payments. Third, the funding will be necessary for the implementers and coordinators of the project in order to plan, monitor and adjust the strategy when necessary.
The project timeline and duration are complex. On the one hand, planning and scheduling activities, addressing authorities and recruiting participants will require time. This process may take up to two-three months, whereas the target area in the entire location. Moreover, the essence of the program and its timeline have to be explained to reach the whole target audience. Therefore, the intervention is planned on a year-wide basis. On the other hand, obesity cannot be fought once and forgotten forever. Hence, it will be just an initial stage of implementation, while further phases will be undertaken in the next years and the program will be launched on a permanent basis.
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A range of key stakeholders and partners to be involved is sufficient. Primary stakeholders to be considered should include authorities and governing bodies of city area in terms of regulation and management as well as workplace environment and opportunities. As it has been previously explained, their role is vital for ensuring the development of a large-scale and holistic project with the potential of reframing the existing culture. Apart from thorough engagement of the public, partnerships with different professionals in the healthcare sector should be considered. Undoubtedly, the analyzed phenomenon is large-scale. Hence, addressing the issue by nurses as single actors will be fragmented and even seemingly untrustworthy. In this respect, there is a necessity to engage other professionals in the field, such as nutritionists and therapists among others. The promotion of healthy lifestyle should be grounded on reasonable and evidence-based explanations from the practical experience in order to be credible and convincing. Since an individual approach to the healthy needs of the target population has been indicated, recruitment of other professionals will be made in the process per identified health-related requests of the population. Moreover, a physical activity part has to be implemented by professional trainers and instructors. Additionally, healthy eating will be impossible without the change in the eating habits. Hence, food retail professionals are other critical stakeholders. Finally, promotion is also necessary for the large-scale participation of the residents. Thus, media involvement will be needed.
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The task of the nurse as an initiator of the project and its main inspirer will be to contact all the vital stakeholders and convince them of the rightfulness of the proposed solution supported by the well-reasoned rationale. Therefore, proper positioning and conveying of the mission and vision of the problem and its solution will be critical for the successful achievement of the anticipated outcomes, namely, healthier adult community. As a result, after the discussion of the solution with the management and authorities, it will be necessary to communicate the intent to the larger audience – the staff. While it is too time-consuming to convey the message in person, the nurse may convince the above stakeholders to hold on-work sessions with their staff members in departments offering a possibility to express their ideas in this regard and even propose their own supplementary solutions. In this light, the individual solution can be expanded to the community-driven approach, which implies more responsibility and engagement of the community.
The step-by-step process of implementation will allow no opportunity of omission at any of the stages. The evaluation of the target audience with respect to obesity-related problems will be based on the data provided by hospitals. Further, planning of the key activities will follow. Next, the recruitment of participants, an implementation team and key stakeholders will be held. Further, the implementation stage will come. Finally, the results of the program will be evaluated on the basis of online self-assessment of the participants and surveys conducted by nursing practitioners.
The discussion concerns an extremely topical and acute problem of obesity targeting adult population. During the process of investigation, the author has managed to fulfill the roles of a scientist, a detective and a manager of the healing environment at the same time. From the viewpoint of the scientist, substantial evidence has been collected on the grounds of the contemporary academic literature review showing the severity and seriousness of the explored problem and the best solutions available. From the position of the detective, the author has identified key stakeholders and partners to be referred to in the process of implementation of the proposed solution. In terms of being the manager, the issue that concerns everyone without exceptions has been established. Moreover, a well-reasoned rationale for thorough engagement of different representatives of the public in order to implement the change strategy has been introduced. It provides a holistic transformation of the lifestyle and culture of the adults rather than targeting and stigmatizing the vulnerable population.