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Community Health Project on Diet

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Running head: Community Health Project 1

The Community Health Project and Proposed Intervention

Yvette Sanford Hall

Loyola University of New Orleans

Fall 2011

Community Health Project 2

This paper discusses the summary of the community health project carried out in the Eastern New Orleans Community in New Orleans, Louisiana, to encourage health promotion and disease prevention. This discussion includes a profile of Eastern New Orleans Community with its strengths and challenges as noted during the windshield survey conducted in the community. I will share with you a few problems identified in the community and plans proposed to address them. Also included will be a brief description of the aggregate group, a summary of the interventions, and practicum activities based on a health indicator chosen from Healthy People 2010. The theoretical framework or model that guided the interventions will be discussed.

Profile of Eastern New Orleans

The community identified throughout this paper is within eastern New Orleans area and its resident boundaries are Read Boulevard, Chef Menteur Highway, Dwyer Road, and Crowder Boulevard. Eastern New Orleans is a large section of the city of New Orleans, Louisiana. Developed from the 1960s onwards, it was originally marketed as “suburban-style living within the city limits,” and has much in common with the Algiers neighborhood of New Orleans. As of September 2011, the United States Postal Service reported 9,088 homes received mail in zip code 70127 (citydata.com 2009). There are numerous vacant lots where homes and businesses previously stood but were torn down and are now just green spaces. Post Katrina the Latino population in New Orleans metro spiked to 57%, 24% Mexican, 7% Cuban, 5% Puerto Rican, and 64% “others” (Greater New Orleans Community Data Center (GNOCDC). The GNOCDC reports of the full time year round workers in the metropolitan area 47% earn less than $35,000

Community Health Project 3 annually. 16% of adults greater then 25 have less than a high school diploma, and households with children under the age of 18 have decreased to 23% in Orleans Parish. According to the report authorized by Louisiana State Epidemiologist Dr. Raoult Ratard, there are no apparent increases in deaths or subsequently death rates in the Greater New Orleans area. The report looked at data from 2002 through 2006. Orleans Parish for the first six months of 2006, there was an excess of 21% with an average of 13.0 per 1,000 population versus 10.8 per 1,000 population for similar six month period for 2002-2005. The rates decreased afterwards in Orleans Parish to become similar to those of previous years (Mortality in the Greater New Orleans Area, Louisiana–Post Katrina (June 2007). Infant mortality rate was 13.0 per 1,000 births in Orleans Parish. Statewide leading causes of death in 2002 (death rate per 100,000) were Heart 237.7, Cancer 232.0, Stroke 69.4, Accidents 28.5, Diabetes 61.5 and Chronic Lower Respiratory 34.4 (Parish Health Profile 2005). Sexual transmitted diseases rates in Louisiana rank among the highest in the nation. The state holds the highest rate in the country for primary and secondary syphilis at 533 cases in 2007 of this total Orleans Parish had 117 cases. In 2007, the state rose to 2nd highest rate in country for gonorrhea at 11,137 cases of this total Orleans Parish had 1529 cases (Parish Health Profile 2005). New Orleans is a unique place for many reasons, namely its music, food, and diverse heritage of people. Eating unhealthy food is the main factor contributing to 17% obesity rate in youths in New Orleans area as reported by the Louisiana Department of Health and Hospitals. Numerous fast foods places, corner stores selling fired foods and sandwiches, donut shop with many pastries, one public park, sedentary lifestyles of community are reasons there is a need for healthier food choices and exercise.
Community Health Project 4

Strengths and challenges of the community As with most African American communities, the family unit working together to overcome adversities has been a strength. For many years we have had limited assets therefore, we have learned to improvise or be creative in dealing with daily obstacles. My community is faced with many issues that impact their health including decreased population, increased poverty, loss of job, increased rates of depression as it relates to stress, increase crime rate, and loss of inpatient facility. Smothering marsh fires triggering or aggravating respiratory condition of residents and polluting the air. The nearest emergency room is 20-30 minutes away from some residents, and this can be the difference between life and death. Effects of environmental impurities, a decrease in mental health service, slow rebuilding of homes, and limited health services are few challenges encountered by my community. There are several churches in my community Catholic, Lutheran, Presbyterian, nondenominational, and Protestant. There two elementary schools within the community, one private and the other public. There is an elementary, middle, and high school in areas outlining the Donna Villa Subdivision. Returning to live in the eastern New Orleans with the failing school system, no hospital service, limited or no retail stores makes it a struggle for some who want to return to the area. Mayor Mitchell Landrieu has announced the possible opening of the Pendleton Memorial Methodist Hospital under the direction of the Daughters of Charities later this year. There is an urgent care clinic near the hospital site, pediatric, and dentist offices are throughout the community with of couple of LSU clinics and a Tulane clinic also

Community Health Project 5 established in the eastern New Orleans community. There is little or no use of technology related to healthcare and addressing the health needs of the community.
Three Nursing Diagnoses Based on the evaluation of the collected data in my windshield survey, and other data sources areas of concern in my community are, 1) Alteration in Nutrition: More than Body Requirement, 2) Alteration in Health Maintenance: Related to decreases physical activity and 3) Alteration in Health Maintenance: Related to tobacco use.
Problem statement: Alteration in Nutrition: More Than Body Requirement
|Factors Contributing to the Problem and |Relationship of Factors |Data Supportive to Relationships |
|Outcomes | | |
|1. Unhealthy diet choices |1. Eating fast foods and diets high in fats |1. As reported by the Center for Disease |
| | |Control in 2010, 31% of Louisiana adults are |
| | |obese. Obesity has increased several health |
| | |conditions like diabetes, cardiac disease, or |
| | |cerebrovascular disease. |

Alteration in Health Maintenance: Decreased Physical Activity

|Factors Contributing to the Problem and |Relationship of Factors |Data Supportive to Relationships |
|Outcomes | | |
|1. Limited or no access to gym, park, or |1. Only one park and gym available in community|1. La Dept of Health and Hospitals report 28% |
|playground | |of La adults are not physically active |

Community Health Project 6

Alteration in Health Maintenance: Related to tobacco use

|Factors Contributing to the Problem and |Relationship of Factors |Data Supportive to Relationships |
|Outcomes | | |
|1. Tobacco use |1. People sitting out and walking streets |1. Tobacco use one of top five causes of death |
| |smoking cigarettes |in United States and 23.5% adults smoke |
| | |cigarettes every day or some days as reported |
| | |in Orleans Parish Health Profile 2005 |

Plan for addressing the Problems Identified

The members of the community will be given verbal information and provided printed material on the topics on the problems identified. The printed information will include excerpts from the Orleans Parish Health Profile 2005, Youth Risk Behavior Surveillance System 2009, CDC’s Division of Adolescent and School Health (DASH), and United States Department of Health and Human Services’ (HHS) Steps to a Healthier US regarding obesity, physical activity, and tobacco use. This information will serve as an aide in maintaining, promoting, and restoring health to members of the community. Awareness of the risk, and consequences of unhealthy eating, decreased or no activity, or tobacco use should motivate the community member to make better health choices.

The social learning theory was used in my practicum activities to teach my aggregate. This theory as defined by Stanhope and Lancaster (2006) states behavior is a function of an individual’s expectations about the value of an outcome. A group of cub scouts were presented with information on healthier food choices and exercises, to help promote and prevent diseases

Community Health Project 7

that may be caused by obesity and decreased physical activity. The risks and ill health of tobacco use were elaborated on more with the boy scouts.

Information about Boy Scout Troop 53/Cub Scout Pack 53

The McFarland Cub scouts and Boys Scouts are committed to providing a rewarding scouting experience for all members. Both the Pack and Troop participate in regular meetings held every Friday at Resurrection of our Lord Catholic Church’s cafeteria 9701 Hammond St. New Orleans, Louisiana 70127. They participate in a variety of activities including working on advancements, working on merit badges and activity pins, going on monthly weekend campouts, going to summer camp, high adventure camp, lower adventure camp, and having fun! The cubs age range from 7-11 and boys age range 12-17. Present for the activities were 15 cubs and 6 boys.

Interventions and Practicum Activities for Aggregate

The aggregate chosen for the practicum were the groups mentioned above Cub and Boy Scouts Troop 53. A few members of the group exhibited, and presented at risk factors for the behaviors, I saw during my windshield survey a problem with overweight. This was observed during a group meeting.

Teaching plan

Title: Healthy Food Choices and Exercise Build Strong Minds and Bodies

Program length: 1.5 hours

Purpose: To educate scouts on how wise diet choices and physical activity promote good health. Provide them with tools to prevent illness (es) associated with obesity and sedentary lifestyles.

Community Health Project 8

|Lerner Outcomes |Content Outline |Methodology |Time Frame |Evaluation |
| | | | | |
|1.Lerner will name the five |1. Give an example of what |1.Powerpoint presentation on|1. 20 minutes |1.Lerner stated the name of |
|food groups |item is included in each |the Food Pyramid; verbal | |five food groups |
| |group |explanation of what items | | |
| | |are in a specific food group| | |
| | |and serving amount for each;| | |
| | |reinforced with a handout | | |
| | |(Making Healthful Choices) | | |
| | |asking identification of | | |
| | |three of five foods that | | |
| | |make most healthy breakfast,| | |
| | |lunch, snack, and dinner | | |
| | |2. Lecture | | |
| | |3. Handouts | | |
| | |4. Discussion | | |
| | |5. Poster | | |
| | | | | |
| | | | | |

The cubs that answered questions correctly regarding meals choices were given a Frisbee, soft football, or paddle ball. All the scouts, parents and scoutmasters were offered a snack of

Community Health Project 9

turkey sandwiches on whole wheat bread, fresh fruits, and fresh vegetables and a drink with 25% less sugar. Each scout was given a folder with a copy of the food and activity pyramids, activities sheet on healthy food choices, the heart, and body coloring pages.

The group was instructed to exercise with moderate (walking briskly, dancing or bicycling), or vigorous (running/jogging, walking very fast or basketball) intensity for at least 60 minutes per day. A majority of scouts were running and playing with items won as prizes but each group as a 15- 30 minutes time slot set aside for exercise during meeting. Most of the scouts shared with me they did participate and a sport or regular physical activity. We also discuss deterring from playing video games for extended periods to avoid carpel tunnel.

The group was instructed on empty calories “junk foods” and avoiding or limiting fast foods. They were also instructed to help their parents with grocery shopping and pay attention to food labels. Avoid foods with large amounts of sugars, fats, or sodium content. This will help prevent being diagnosed with diseases like high blood pressure, diabetes, or heart problems.

Benefits, Gatekeepers, and Problems

The benefits of this program will be seen in the future, these young people can grow up to be healthy adults. The young will be equipped with knowledge to help their parents, and others they come in contact with regarding better lifestyle choices. The parents are in control of implementing and maintaining this plan. They purchase and prepare the foods. Anyone that follows the plan can benefit from it.

The gatekeepers of this group would be the parents and scout masters. A resource binder

Community Health Project 10

was left with scout masters along with poster and extra folders for scouts not at the meeting.

Unforeseen problems would be the parents not purchasing or preparing the foods and eating fast food. I did stress to parents in attendance to avoid or limit junk food. Currently, there is a move in schools nationwide to serve healthy school foods and promoting exercise fostered by the signing of the Hunger-Free Kids Act of 2010. To evaluate my plan I would need to revisit my aggregate in three months to get an idea of how much of the material was retained and practiced. I would expect 25% of scouts to have made some diet changes. The community health nurse role would be to educate and instruct parents and children on healthy choices and promoting more physical activity. Education is the main resource needed for this plan.

This presentation has made me take a closer look at my choices in my diet and considering joining a health club. The realization of it all is it is never too late to learn new things. This is especially good if the things being taught have positive effects. Healthier diet choices, exercise, and no tobacco use are cornerstones of a healthy lifestyle and this should be promoted and endorsed by everyone.

Community Health Project 11

References

Center for Disease Control (2011). United States Obesity Trends, 2011. Retrieved December 1, 2011, from http://www.cdc.gov

Custer, S. (2009). Healthy Corner Stores for Healthy New Orleans Neighborhoods. Retrieved December 2, 2011, from http://www.healthycornerstores.org

Donna Villa (Camelot) neighborhood in New Orleans, Louisiana, 70127 detailed profile. (2009). Retrieved October 26, 2011, from http://www.citydata.com

Greater New Orleans Community Data Center. (2011). Zip Code Population Indicators.

Retrieved November 5, 2011, from http://www.gnocdc.org

Louisiana Department of Health and Hospitals (2007). Mortality in the Greater New Orleans Area Louisiana-Post Katrina. Retrieved November 30, 2011, from http://www.dhh.louisiana.gov

Louisiana Department of Health and Hospitals (2005). Parish Health Profile 2005. Retrieved November 31, 2011, from http://www.dhh.louisiana.gov

North American Nursing Diagnosis Association (2007). Nursing Diagnosis: Definitions and Classifications 2007-2008. National International

President Obama Signs Health Hunger-Free Kids Act 2010. Retrieved November 9, 2011, from http://www.whitehouse.gov

Community Health Project 12

References (Continue)

Stanhope, M. & Lancaster, J. (2006). Foundations of Nursing in the Community: Community oriented practice (p.191-200). Mosby, Inc.

United States Department of Agriculture (2010). My Pyramid. Retrieved on November 7, 2011, from http://www.mypyramid.gov

United States Department of Health and Human Services (2010). Healthy People 2010. Retrieved on October 26, 2011, from http://www.healthypeople.gov

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