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Health Promotion Proposal, Part 2

Adult Obesity

Student’s Name: Yulexis Moreda

Institution: Florida National University

Instructor: Nora Hernandez Pupo

Course: Health Promotion & Role Development in Adv. Nursing Practice

Date: October 15, 2025

HEALTH PROMOTION PROGRAM PROPOSAL

Introduction

Based on the aforementioned evidence-based point, this proposal proposes a multicomponent community-based lifestyle intervention that will be used to improve the obesity and overweight conditions of urban, low-income, 35–60-year-old adults. Healthy Living for Life (HLL) is the name of the program, which is a health promotion initiative that includes dietary changes, physical activity, and theoretical counselling. Through at-risk, culturally sensitive, and nurse-led interventions that are easily accessible and feasible to implement in urban community-based settings, HLL aims to promote weight loss and a healthier lifestyle.

The stages of the program

Phase 1 (Months 1–3: Preparation and Enrollment): The recruitment will be conducted by the advanced practice nurse (APN) within this period to recruit via neighborhood clinics, community centers, and places of worship.  The baseline assessments based on validated instruments will be conducted to record blood pressure, weight, BMI, waist circumference, dietary and physical activity habits.  Besides getting culturally relevant educational content on the subject of physical activity and nutrition, the participants will be oriented on the expectations and the organization of the program.

Phase 2 (Months 4–12: Active Intervention): Weekly 90-minute group sessions involving behavioural counselling, instruction, and supervised physical exercise will be part of this stage. Each session will consist of 30 minutes of moderate physical activity (dance classes, walking clubs, resistance training), 30 minutes of group counselling using motivational interviewing and problem-solving techniques, and 30 minutes of nutrition education. 

Phase 3 (Months 13–18: Maintenance and Follow-up): To sustain lifestyle changes, the participants will change their monthly group meetings and continue virtual coaching.  Biometric checks carried out by the nurse practitioner after every three months will be used to assess the progress and pinpoint the barriers, whereas peer mentors, who are trained community volunteers, will be available to provide support throughout the process.

Resources and Personnel

Some of the resources that are needed when implementing the HLL program include a multidisciplinary team and community infrastructure.  The team will consist of two community health workers, a certified fitness instructor, a registered dietitian, and a nurse practitioner (program lead).  The job description of the nurse practitioner will involve clinical examination, behavioral counselling, health education, and coordination.  Physical resources may include access to a community center where they can hold weekly meetings, exercise equipment (e.g., resistance bands and mats), written materials, and online tools e.g., an SMS system or smartphone app, where participants who do not have smartphones can access the sessions.  The relationships with the local farmers' markets will enable access to lower-cost produce.

With the way it aligns with the nursing competencies in community partnership, preventing chronic diseases, and promoting health, there is a high probability that this intervention can be implemented by an advanced practice nurse.  Some of the skills advanced-role nurses possess are patient education, motivational interviewing, and holistic care, which are essential to facilitate long-term behavior change.  The digital tools, coupled with community-based support in the form of the intervention, make it cheaper and more accessible, and it is scalable to similar urban populations.

Intended Outcomes

The SMART goal for this intervention is: Within 1.5 years, according to validated biometric and behavioural measures, at least half of the low-income urban adults (35-60 years of age) will lose 5 percent of their initial body weight and show improved eating and physical exercise patterns.

  The exact intended outcomes are the following:

Weight Loss: By month 18, the participants will have lost a measurable average of 5 percent of their initial weight.

Physical Activity: By the program conclusion, 70 percent of the participants will have engaged in at least 150 minutes of moderate-intensity physical activity each week.

Improved Dietary Intake: By the end of the 12th month, the participants will record taking an additional two servings of fruits and vegetables in a day, and a reduction of sugar-sweetened drinks by half, continuing the same up to month 18.

Improved Self-Efficacy and Knowledge: Using a validated behavioural self-efficacy scale, participants will show increased self-efficacy scores in relation to weight management.

Decreased Clinical Risk Factors: Participants will show decreased blood pressure, fasting glucose levels, and waist circumference, all of which point to a lower risk of cardiometabolic disease.

These results are in line with the SMART framework because they are time-bound within 18 months, relevant to lowering the risks associated with obesity, measurable using validated tools, specific to quantifiable behavioural and biometric goals, and achievable based on previous research.

Evaluation Plan

Focus groups and participant interviews will be used for qualitative evaluation in order to gauge opinions regarding the program's value, obstacles faced, and contentment with the nurse-led approach. To assess viability and acceptability, attendance data, digital platform engagement levels, and retention rates will also be monitored. Pre- and post-intervention outcomes will be compared using paired t-tests and descriptive statistics, and qualitative responses will be subjected to thematic analysis (Golan et al., 2022). After every cycle of data collection, the advanced practice nurse will create evaluation reports with the help of a research assistant to direct continued program enhancement.

The program will incorporate a follow-up evaluation at 24 months (six months after completion) to make sure the evaluation accurately reflects effectiveness in the real world. The sustainability of the results more especially, the maintenance of weight loss and lifestyle changes, will be ascertained by this prolonged evaluation (Golan et al., 2022). The findings of this follow-up will be shared with local public health departments and community partners to promote funding or integration into long-term community health programs.

Barriers and Challenges

There are several possible obstacles to successful program implementation of the Healthy Living for Life. The first is economic and environmental, where program members from low-income inner-city neighborhoods might not have frequent access to healthy foods, safe places to exercise, or available time to get to sessions due to work or caregiving responsibilities. In an effort to offset such hindrances, the program shall launch collaborations with local food banks and farmers' markets to disperse produce vouchers and begin group-based exercises in public areas or schools in the evening hours (Gooey et al., 2022). Evening and weekend session provisions will further suit diverse work timetables.

The second major hindrance pertains to digital disparity and computer illiteracy. While adding a mobile or SMS element increases scalability, participants who have lower access to the internet or smartphones may be excluded (Anazco et al., 2024).

In addition, financial constraints may become an obstacle to ongoing program activity and staff assistance. The nurse practitioner will apply for grant funds from local public health authorities, community benefit programs of hospitals, and philanthropic organizations to offset expenses (Miranda-Peñarroya et al., 2022). In partnership with schools of nursing or universities, there would also be research grants and student volunteers to assist in data delivery and collection. Sustainability in the long run will depend on integrating the HLL program into such community health systems, such as federally qualified health centers, where nurse practitioners already practice within preventive care models (Gooey et al., 2022).

Finally, cultural and language diversity among participants could affect understanding and engagement. To prevent this, materials will be culturally adapted and translated into commonly used local languages, and cultural competency training will be offered to the staff to guarantee respect and inclusivity in honoring participants' beliefs and food and body image issues (Gooey et al., 2022).

In conclusion, This intervention plan offers a potential, evidence-based, nurse-led approach to reducing adult obesity in urban low-income residents. Healthy Living for Life is in a position to significantly impact the fight against obesity and enhance the health of vulnerable adults by fusing the strength of behavioural science with the reach of community-based nursing practice. While the Social Ecological Model is applied to ensure that the intervention addresses both individual behaviour and environmental determinants of health, digital support tools are used to increase engagement and scalability.

References

Anazco, D., Espinosa, M. A., Cifuentes, L., Kassmeyer, B., Schmidt, T. M., Fansa, S., Campos, A., Tama, E., Harmsen, W. S., Hurtado, M. D., Hensrud, D. D., & Acosta, A. (2024). Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity. Obesity Pillars, 12, 100133–100133. https://doi.org/10.1016/j.obpill.2024.100133

Golan, M., Tzabari, D., & Mozeikov, M. (2022). The Impact of Delivering School-Based Wellness Programs for Emerging Adult Facilitators—A Quasi-Controlled Clinical Trial. International Journal of Environmental Research and Public Health, 19(7), 4278. https://doi.org/10.3390/ijerph19074278

Gooey, M., Bacus, C., Ramachandran |, D., Piya, M., & Baur, L. (2022). Health service approaches to providing care for people who seek treatment for obesity: identifying challenges and ways forward. Public Health Research & Practice, 32(3). https://doi.org/10.17061/phrp3232228

Miranda-Peñarroya, G., Vallejo-Gracia, M., Ruiz-León, A.-M., Saenger-Ruiz, F., Sorio-Fuentes, R., Izquierdo-Pulido, M., & Farran-Codina, A. (2022). Development and Validation of a Short Questionnaire on Dietary and Physical Activity Habits for Patients Submitted to Bariatric Endoscopic Therapies. Obesity Surgery, 32(1), 142–151. https://doi.org/10.1007/s11695-021-05754-7