RUA Presentation
Obesity and Community
Assessment on Sunnyside, Houston Tx
Marlyse Manyaka Ekwe, Yesenia Gomez, Vivian Gutierrez, Abigail Morales, Vanessa Myers, Yamileth Ortez, Laquita Sanders, Nattamon Raksasap
Chamberlain University
NR 442: Community Health
Professor Lightfoot
June 19, 2022
Introduction
What is obesity?
Obesity is defined as abnormal or excessive accumulation of fat which might present a risk to one’s health.
According to the Center of Disease Control and Prevention, obesity is a serious chronic disease, and the prevalence of obesity continues to increase in the United States. Obesity is common, serious, and costly. This epidemic is putting many American families in a difficulty position, affecting overall health, health care costs, and productivity.
The houstonstateofhealth.com in 2019 Sunnyside had a percentage of 46.6% of adults who were overweight and obese.
Overweight and obesity among adults in Sunnyside is higher than the city of Houston by 30.3% and 28% respectively and among African American than Hispanics and Whites.
People choose what to eat based on a variety of considerations—health goals, tastes developed in childhood or later in life, food prices, income available to spend on food, and the need for convenience. During this powerpoint we will discuss the community assessment, aggregate, health diagnoses, plan, interventions, and finally the evaluation for the priority diagnosis.
Community Assessment
Geographic Area and Target Population
There are approximately 17,751 residents
Median age 32 years old
47.41%: Males
52.59%: Females
Obese persons in this area are our target demographic.
Vivian- There are 17,751 residents in Sunnyside, with a median age of 32. Of this, 47.41% are males and 52.59% are females. US-born citizens make up 87.07% of the resident pool in Sunnyside, while non-US-born citizens account for 2.21%. Additionally, 10.71% of the population is represented by non-citizens.
A total of 13,685 people in Sunnyside currently live in the same house as they did last year.
Community Resources
Sunnyside Multi-Service Center Community Garden
Teaches aggregates about vegetables grown in the garden.
Aggregates plant, water and harvest from their community garden.
Builds community sustainability and food independence.
Expands knowledge of food, culture and ways to prevent food waste.
Independence creates a desire to harvest and prepare fresh fruits and vegetables.
LaQuita S- Growing your own vegetables provides a more diverse and healthy diet. The community that gardens together will have food forever. The knowledge Aggregates that live within the community that have limited access to Fresh fruits and vegetables at a reasonable price are allowed to break the mold and expand by growing food that continue to replenish itself at a cheaper price than buying the produce . There are Food stores and Marts Owned privately within the neighborhood that prices are higher when compared to the closest Chain grocery store (Fiesta). The idea is “that what you grow is what you will eat”, Encourages Increased intake of vegetables and fruits.
Community Resources
Promote healthy living in neighborhoods
Partnership with local vendors to provide healthier options.
Health Team conducts an assessment of the communities needs.
Leadership Training, Healthy resources, Fitness goals and COVID-19 support
.
LaQuita S- The goal off CAN DO Houston is to promote healthy living lifestyle in communities by providing each community specific solutions to promote healthy living and quality of Life. The community needs are assessed by Dr. Gor and his healthcare team, after the assessment the team meets with group leaders to assess what they felt Sunnyside needed to improve health within their community. The committee worked with community leaders to provide leadership and advocacy training. Fitness programs for the will be implemented in a safe environment based on the communities resources. The goal to provide healthy resources for the lifespan of the aggregate living in 77051 Zip code is to meet the individual where they are in their own community by training Leaders to advocate for their environmental health, providing fitness options that are interesting to the aggregates such as Zumba, Line dancing and Cardio classes.
Community Resources
Factors for low-income communities.
Greater chance for these items to be included in the diet.
Food desert communities have a significant barrier in accessing healthful foods.
Increased Knowledge of fruits and vegetables.
LaQuita S-Can Do Houston is an ideal partner for the Sunnyside area as the organization partnered with a local produce partner to deliver fresh fruits and vegetables to transform a corner store into one that provides healthier options that are comparably priced, of good quality along with knowledge of how to eat or cook fruits with fruits and vegetables. The produce is delivered weekly and aggregates are able to purchase fruits and vegetables using SNAP benefits. Since July 2014, CAN DO has expanded to 10 corner stores in 2 communities (Sunnyside and North Pasadena). To Increase knowledge of community aggregates there is also on-site cooking demonstrations and sampling for fruits and vegetables.
Windshield Survey
Ethnicity
75%: African American
21%: Hispanic
2%: White
1%: Asian
Religion
A wide variety of denominations are available.
St Francis Xavier Church
Real Truth Seventh-day Adventist Church
Vivian- Obesity in America has been a growing concern. That concern is multiplied in communities like Sunnyside, where contributing factors such as income and access to quality education and food has directly impacted the aggregates opportunity for healthier living. Health disparities along with unsafe places to be physically active influences the individual chances of living a healthy lifestyle.
Windshield Survey
Health and Social Services
Cullen Family Practice (Family, Pediatrics and Weight Loss)
FCHC Center Family Medicine
Poindexter Dental
Sunnyside Health Center
Vivian- According to a survey done in 2019. Chronic health problems are a concern for Sunnyside. More over a third of those polled said they or someone in their family had been diagnosed with high blood pressure, and a fifth said they had arthritis or diabetes (Olin, 2019). Individuals living in food deserts may be at a higher risk of diet-related diseases like obesity, diabetes, and cardiovascular disease if they don't have access to healthy foods.
Windshield Survey
Grocery Stores
Vivian- Sunnyside is one of the Houston area’s largest food deserts, defined as an area with few options available for residents to purchase fresh fruits and vegetables. Accompanied by the fact that Sunnyside is a predominantly lower-income neighborhood. As seen above there are not many options for grocery stores available with fresh fruits and vegetables.
Windshield Survey Results
In 2019 the obesity rate in Sunnyside was 47.2%
Vivian- Due to Sunnyside being one of the largest food deserts in Houston, lacking access to stores that sell affordable nutritious foods it causes the obesity rate to be high. In 2019 the obesity rate was 47.2%.
Aggregate Population
Aggregate population:
African-American
Age vulnerability
Nearly half (48%) were between 20 and 64 years of age, and 18% were 65 or older
Chronic Disease
Obesity
Heart disease
Cancer
Vanessa:
As we explored through Sunnyside, Tx the majority of the population were african-american aged 20 -early 60s. There we were able to see the lack of resources available to the people to live a healthy lifestyle. People appeared to have different restraints when it came to mobility which can increase their risk of obesity, sedentary lifestyle, and other medical concerns. With the lack of nearby grocery stores but with high amounts of corner stores it limited the residents to make unhealthy decisions. Ultimately increases the residents for risk of obesity, heart diseases, and diabetes. () There were a few noted bus stops in the area and a few people standing outside the corner stores
Identifies gatekeepers or key informants who will assist the community health nurse in gaining access to the population of interest
Key informants that would assist the community health nurse in gaining access to the population of interest would be local businesses, schools, and community centers.
Aggregate population is based on three or more elements or risks that impose a negative impact on the health of the community, identified in the community assessment.
Community Health Diagnoses
Imbalanced Nutrition
Sedentary Lifestyle
Deficient knowledge
Imbalanced nutrition: more than body requirements related to food intake that exceeds body needs as evidence by weight over optimum body weight.
Sedentary lifestyle related to lack of interest, motivation and/or resources as evidences by lack of physical exercise
Deficient knowledge regarding self-care related to lack of interest in learning and/or lack of recall as evidence by visualization of obesity and nutritional habit.
Yesenia
Community Health Diagnoses
Community Wellness Diagnosis
Faulty feeding habits related to poor food sources as evidence by lack of available grocery stores with healthy food choices.
Yesenia: The reason for these nursing diagnosis are due to the lack of not having big box stores like Walmart, Kroger and HEB. While gathering information for this project I noticed that there was five conner stores on Scott Street which obviously they don’t carry a variety of products that are healthy. There was a T & P seafood market, Jack in a box, and Seafood, burgers and pork chop and more restaurant. The neighborhood had a Sunnyside food store and a Z Mart store. The interesting thing about these stores were that their signs were only advertising beer, wine, cigar, soda, chips, and cigarettes. The restaurants mentioned above promoted great food and great prices. You buy we fry was a catch phrase of one of the restaurants promoted to the public.
When coming to the conclusions for my diagnoses I also notice the amount of traffic there was at these stores, and how many bus stops there were as well. The closest grocery store was approximately about 3.5-6 miles. Although, they had the option to travel to these grocery stores they chose what was more convenient for them.
Abigail will explain these diagnoses in further details.
Plan for Priority Diagnoses
Imbalanced nutrition related to obesity as evidenced by 47.2% of the population being obsese is the priority diagnosis in the Sunnyside community.
Short term goal is promoting health by making healthier foods more accessible to the community and patient education of healthy food choices with physical activity.
Long term goal is expanding the role of health care and accessibility to health care services to promote obesity prevention and tertiary care.
Abigail Morales
Short term
Short term goal is promoting health by making healthier foods more accessible to the community and patient education of healthy food choices and physical activity
Specific: Goal is to encourage healthier eating within the community by making healthier foods more available and affordable to the community and promoting education of clients within the community about obesity to encourage clients to make lifestyle changes.
Measurable: Measurable goal is to first education clients in the community by having meetings in the local area, posting flyers in local stores/schools and promoting education of obesity on local social media outlets.
Attainable: This goal is attainable with the help of other community leadership and members wanting better outcomes for the community.
Realistic: This goal is realistic that it is possible to education the fellow community as much as possible.
Timed: This goal can be achieved in a timely manner of a couple of months.
Long term goal
Long term goal is expanding the role of health care and accessibility to health care services to promote obesity prevention and tertiary prevention care.
Specific: The goal is to make health care offices, providers, and services more available more affordable to the community to provide preventive care and maintenance care to the target community.
Measurable: Measurable goal is to gather information of the community and calculate the need in the community. After assessing the need in the community and gathering information needed taking this information to the mayor of the city and see what steps we can take to further expand healthcare in the community.
Attainable: This goal is attainable with the help the mayor and state to encourage expansion of healthcare need in Sunnyside Texas.
Realistic: This goal is realistic, may need more encouragement of city council and state to be able to place this goal in motion.
Timed: This goal may take longer than 6 months to be able to gather approval and funding from the state or even private lenders to make this goal achievable.
Both plans are community oriented because we are using information based on the community of Sunnyside and seeing the need in this community. The short-term goal is involving the community directly in providing free patient education about obesity and the tools needed to make small lifestyle changes that turned into big lifestyle changes to reduce obesity. The long-term goal is involving the community by gather information directly from the community and seeing not very many health care offices available in the community.
Both plans advance the knowledge of members in the community by informing them of what we seen within our windshield survey, goals for the communities to change the disparities and how we can help the community for better outcomes within the Sunnyside community.
References: Houston Public Health (2019) Sunnyside Neighborhood. Houston Public Health Data Portal :: Indicators :: Adults Who Are Obese :: Neighborhood : Sunnyside (houstonstateofhealth.com)
Intervention for Priority Diagnosis
Appropriate interventions and community efforts to reverse the obesity in the community focus on:
Identify cultural & dietary preference (planning/intervention)
Supporting healthy eating
Active living in a variety of settings
Use different strategies & efforts to build a good foundation
about nutrition
Healthy food environment: salad bars to schools
(image by CDC.gov)
Natthamon (Ying) Raksasap
Identify cultural and dietary preference (critical fact to understand the community and community preferences).
Supporting healthy eating: education and teaching in the meeting or fairs.
Active living in a variety of settings - nurses advocate for social changes that promote healthy lifestyles and prevent obesity and create safe communities that support physical activity: advocate for creating environments for walking/biking, school and youth programs, individual support, equitable and inclusive access (distributive)
Use different strategies and efforts to build a good foundation about nutrition: school, food, and service: school nurse educate about food pyramids, nurses offer strategies for decreasing caloric intake and increasing physical activity.
Healthy food environment: salad bars to schools is a program that state and national leaders promote and sponsor (CDC) to help school children eat more fruits and vegetables by provided in a self-serve salad bar, which the children to develop a good eating habits early in life and promotes wellness throughout their lives (CDC). School and community nurses support and implement or create a program that improve overall community health.
Community strategies key point:
Promote the availability of affordable healthy food and beverages
Support healthy food and beverage choices
Encourage breastfeeding
Encourage physical activity or limit sedentary activity among children and youth
Create safe communities that support physical activity
Encourage communities to organize for change
Create safe communities that support physical activity
(CDC, 2021)
Intervention for Priority Diagnosis (cont…)
Interventions include from a range of strategies:
Using mass media
General information dissemination
Electronic information dissemination
Public forums
Always prepare for unexpected problem:
Bad weather
Transportation problems
Poor attendance
(McEwen, 2019)
(Images by google)
Natthamon (Ying) Raksasap
Beside some of the interventions and example that we have discussed in previous slide; we are going to discuss other key important and consideration, and things that we should consider during the intervention process.
the methods and ways to promotes a range of strategies:
Strategies that nurses can use to provide and educate a healthy diet and living include:
mass media: public service announcements, radio, television, billboards
general information dissemination: pamphlets, DVDs, CDs, posters
electronic information dissemination: websites, blogs, tweets, video stream
public forums: town meetings, focus groups, discussion groups.
Implementation should follow the initial plan, the nurse should always prepare for unforeseen or unexpected problems (e.g., bad weather, transportation problems, poor attendance, or competing events). (Nies, 2019)
Evaluation for Priority Diagnosis
Client Involvement
Ask the client what the daily meal plan looks like
Inquire from the client what physical activity they love doing.
Provide the client with myPlate resources and allow them make their choices
Inquire from the client what their motivation is.
Marlyse
By inquiring from the client what they love to eat will help the nurse incorporate some of the clients favorite meals in the preferable meal plan to encourage a balance nutrition.
By allowing clients make their food choices from the resources provided to them, encourage them to follow the plan
Know what motivates the client to what to make these preferred changes
Evaluation for Priority Diagnosis
Measures to Meet Attainable Goals
Use of questionnaires/interview
Lifestyle behavior and preferences
Create health fairs
Local social media.
Windshield survey
Observe the healthy lifestyle of the community
Marlyse
The use of questionnaires/interviews is to ask about the lifestyle and preference of the people in regards to healthy living.
Doing a windshield survey is to observe how the community lifestyle is when is coming having accessibility to those things that will help promote a lifestyle change
Creating health fairs is way of educating the community on the importance of having a balance nutrition and providing them with resources. Also this a forum to provide the community with the different resources they have available that will help them make good decision.
Evaluation for Priority Diagnosis
Outcome Criteria
Increase community knowledge on the level of balance nutrition, diet change, and obesity.
Encourage the people in the community to keep a journal to track their progress and keep setting goals.
Provide resources that will help the community make a better choice when it comes to healthy living
Marlyse Increase community knowledge on the level of balance nutrition, diet change, and obesity.
Encourage the people in the community to keep a journal to track their progress and keep setting goals
Provide resources that will help the community make a better choice when it comes to health living. Encourage follow up appointments with the health care provider.
Reference
Ackley, B., & Ladwig, G. (2021). Nursing Diagnosis Handbook, 12Th Edition Revised Reprint With 2021-2023. (12th ed.). Mosby.
CAN DO! Houston. (n.d.). OUR COMMUNITY-DRIVEN INITIATIVES. Http://Www.Candohouston.Org/. Retrieved June 9, 2022, from http://www.candohouston.org/
Center for Disease Control and Prevention (2022), Overweight & Community Efforts. https://www.cdc.gov/obesity/strategies/community.html\
City of Houston Health Department. (n.d.). Sunnyside Multi-Service Center. Http://Www.Houstontx.Gov/Health/Community/Sunnyside.Html. Retrieved June 9, 2022, from http://www.houstontx.gov/health/Community/Sunnyside.html
References
Ma, X., Sharpe, P. A., Bell, B. A., Liu, J., White, K., & Liese, A. D. (2018). Food Acquisition and Shopping Patterns among Residents of Low-Income and Low-Access Communities in South Carolina. Journal of the Academy of Nutrition and Dietetics, 118(10), 1844–1854. https://doi.org/10.1016/j.jand.2018.04.017
Rural Health Information Hub (2021-2022), how can rural communities address obesity.. https://www.ruralhealthinfo.org/toolkits/obesity/5/communities/how-can-rural-communities-address-obesity
Sunnyside, TX Household Income, Population & Demographics | Point2. (2022). Point2. https://www.point2homes.com/US/Neighborhood/TX/Houston/Sunnyside-Demographics.html
Nies, M. A., & McEwen, M. (2019). Community/public health nursing: Promoting the health of populations (7th ed.). Saunders.
Sutherland. (2013). Ethnicity and health in america series: Obesity in the African-American community. American Psychological Association. Retrieved June 17, 2022, from https://www.apa.org/pi/oema/resources/ethnicity-health/african-american/obesity
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