The Effects of a Health Promotion Program on Rural, West Virginia Adults
Family & Community Health
This health promotion project is a 12-week program for adults in a rural West Virginia community with a BMI of 25 or greater. The goals of this project was to facilitate learning through modules focusing on activity and nutrition, increase knowledge of healthy activity and nutrition, and improve weight and BMI. Each 12-week session provided evidenced-based information regarding obesity, physical activity, and nutrition. Participants completed pre-and post-program and one-month follow-up
... uestionnaire. Results were compared for changes in activity, nutrition, and BMI. The program resulted in positive changes: increase in activity and nutritional consumption and a decrease in BMI. Overweight, obesity, and inactivity are by no means a new concept. The United States has been making efforts to address these epidemics for years, but despite efforts, they continue to rise. 1 According to Cromartie, Parker, Breneman, and Nulph, 2 Americans living in rural areas face significant challenges in healthcare and could benefit from health promotion programs that focus on prevention, health, and lifestyle. The rural population in the U.S. is comprised of nearly 50 million citizens, 17 percent of the total population. Healthy People 2020 places critical importance on creating social environments that promote health and healthy behaviors in a community setting. 3 Partnering with community institutions such as a faith-based organization for health promotion is more successful in gaining acceptance, contacting target populations, and sustaining the program. 4 This health promotion project focused on the ongoing epidemic of weight, obesity, and inactivity that is plaguing the United States, more specifically West Virginia, and what influence a health promotion program rendered. This project answers the question: In adults with a basal metabolic index (BMI) of 25 or greater who live in a rural West Virginia community, how does a health promotion program affect BMI, weight, physical activity, and nutritional choices as compared to their BMI, weight, physical activity, and nutritional choices prior to the health promotion program over a 12-week period? Project Aims The DNP Project encompassed an evidence based, structured, 12-week health promotion program. The program began and ended with an assessment of participants' knowledge and understanding of health and a healthy lifestyle, including physical activity 4 level and good nutrition. In addition, age, sex, height, weight, and BMI calculations were collected from each participant. The goals of the project were to facilitate learning through wellness modules focusing on physical activity and nutrition, increase knowledge of healthy physical activity and nutrition, and to improve weight and BMI. Project Overview The population participating in this project was adults 25 years of age or older with a BMI of at least 25 who reside in a rural West Virginia community. The intervention was a 12-week health promotion program with the goals to facilitate learning and increase knowledge related to physical activity and nutrition. The program compared pre-and postintervention measurements of participants' weight, BMI, exercise/eating logs, and response to the Patient-centered Assessment and Counseling for Exercise (PACE) and Godin-Leisure Exercise Questionnaire. With a goal to improve weight and BMI, the expected project outcome was a decrease in BMI and weight and an increase in physical activity and making nutritious choices among participants. Relevance to Nursing The need for community-based nursing continues to grow, as demonstrated by increases in the numbers of parish nurses and community and faith-based programs. The project served as an example of one way in which nurses can reach out to and collaborate with the leaders of faith-based institutions to plan, develop, implement, and evaluate health promotion programs. REVIEW OF LITERATURE A comprehensive, systematic literature review was conducted on the effectiveness of health promotion programs for obese adults, focusing on physical activity and nutrition. The following 5 databases were used to conduct the exhaustive systematic literature review: OVID, Medline (PubMed), Elton B. Stephens Company (EBSCO), ProQuest, and LexisNexis. Capella University's Summon system was used to search keywords to retrieve evidence-based studies. Keyword searches included: obesity, West Virginia, health, programs, 12-week, faith-based facility, and promotion. Search terms were then paired to search two to six word phrases to narrow the search to keep concepts for this project. Phrase pairing included: faith-based health promotion programs, obesity in West Virginia, health promotion programs, 12-week health promotion programs, health promotion in West Virginia, 12-week obesity health promotion programs, and faith-based obesity health promotion programs. With all searches there was a total of 6,252 matches. After analysis of all articles many were found to either be repeated or were not relevant. Articles were then critiqued for relevance, validity, evidence, method, and limitations. Articles selected were identified as fundamental to this project in decreasing weight and BMI while increasing physical activity and nutritional consumption over a 12-week period. After careful analysis, 13 articles met inclusion criteria. Inclusion criteria applied to this exhaustive search included: peer-reviewed scholarly articles, clinical relevance, publication in or after 2010, adult studies, and health promotion programs based on obesity. Exclusion criteria applied to this exhaustive search included: non peerreviewed scholarly articles, clinical irrelevance, publications before 2010, adolescent and child studies, and health promotion programs not based on obesity. SYNTHESIS OF LITERATURE Problem and Treatment Overweight and obesity are the most prevalent but preventable chronic disorders in the United States. Obesity has become the most prevalent risk factor for conditions such as 2013;1(8):203-280. 8. Nordtvedt M, Chapman L. Health promotion in faith-based institutions and communities. Am J Health Promot. 2011;25(4):1-8. 9. Whisenant D, Cortes C, Hill J. Is faith-based health promotion effective? Results from two programs. J Christ Nurs. 2014;31(3):188-193. 10. Duru O, Sarkisian C, Leng M, Mangione C. Sisters in motion: A randomized controlled trial of a faith-based physical activity intervention.