Assigment .apa seven . all instructions attached.

Attemptfeedback.docx

Attempt feedback

Strengths (What Was Met)

You clearly identified obesity as a major public health concern and supported your introduction with global, national, and local data, which strengthens the significance of the problem. The inclusion of Miami-Dade County context aligns well with the assignment expectations.

You appropriately identified a vulnerable population (low-income adults, particularly Hispanic and minority populations in Miami-Dade County) and discussed key contributing factors such as socioeconomic disparities, environmental influences, and access to healthcare and healthy foods.

You included evidence-based risk factors supported by scholarly sources (e.g., food environment, neighborhood vulnerability), demonstrating a solid understanding of social determinants of health.

The literature review incorporates scholarly sources and includes discussion of strengths and limitations, which meets the expectation for evaluating evidence-based interventions.

You selected Pender’s Health Promotion Model, which is appropriate for addressing behavior change related to obesity, and you demonstrated understanding of its key constructs (e.g., perceived benefits, barriers, self-efficacy).

The reference list includes credible, scholarly, and mostly current sources, and there is alignment between in-text citations and the reference list.

Not Met / Requires Full Development for Week 8 Final Submission

The proposed health promotion program is not fully developed or clearly described. While general goals are mentioned (nutrition education and physical activity), the paper lacks:

Clear description of specific intervention components

Details on implementation (who, where, how, frequency, delivery method)

Clear structure of the program

For Week 8, the intervention must be fully operationalized and clearly detailed.

The measurable outcomes are underdeveloped and not fully aligned with assignment expectations. While knowledge and activity improvements are mentioned, the outcomes:

Lack specific measurable targets (e.g., percentage increase, defined metrics)

Do not clearly define how they will be measured

Are not fully written in SMART format

These must be significantly strengthened.

The vulnerable population section, while strong conceptually, lacks consistent citation support throughout. Some claims regarding socioeconomic and environmental barriers are not directly supported with references and require additional scholarly evidence.

The literature review does not fully meet structural expectations. The assignment requires:

At least two clearly separated article summaries (one paragraph each)

Followed by a 2–3 paragraph critical evaluation of all sources

While content is present, the structure is not clearly organized in this format and needs to be revised for clarity and alignment.

The evaluation of literature is limited in depth. While strengths and limitations are mentioned:

There is insufficient comparison across studies

Limited discussion of generalizability and applicability to your specific population

Minimal identification of gaps in the literature

This section needs stronger graduate-level synthesis and critique.

The application of the theoretical framework is partially developed but not fully operationalized. While Pender’s Health Promotion Model is explained:

The connection between model constructs and specific program activities is not consistently clear

Some examples are vague and need stronger linkage to intervention design

For Week 8, explicitly align each component of your intervention with elements of the model.

There are APA and scholarly writing issues that need revision:

Some sentences lack clarity and contain grammatical inconsistencies

Formatting inconsistencies in citations and references

Writing should be refined for clarity, conciseness, and academic tone

Proposalpart1-Copy.docx

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Health Promotion Program Proposal: Addressing Adult Obesity in Miami-Dade County, Florida

Alex De Cardenas

Florida National University

Health Promotion & Role Development in Adv. Nursing Practice

Dr. Nora Hernandez-Pupo

March 28, 2026

Health Promotion Program Proposal: Addressing Adult Obesity in Miami-Dade County, Florida

Adult obesity constitutes a substantial public health issue that impacts individuals on global, national, and local scales, heightening the risk of chronic conditions including cardiovascular disease, type 2 diabetes, and hypertension. The World Health Organization reports that global obesity rates have nearly tripled since 1975, with over 1 billion individuals today affected by obesity (World Health Organization, 2024). Between August 2021 and August 2023, the prevalence of obesity among adults in the United States was 40.3%, signifying a chronic and extensive health issue (Centers for Disease Control and Prevention [CDC], 2023). Miami-Dade County's obesity rates are notably high, particularly among disadvantaged populations, thereby necessitating targeted health promotion efforts. This proposed program will specifically address alterable lifestyle choices by improving nutritional understanding, promoting healthier dietary options, and increasing physical activity levels among adults in Miami-Dade County. The expected outcomes are both pragmatic and measurable: over an eight-week period, participants will demonstrate increased knowledge of healthy foods and higher weekly physical activity levels, as determined by pre- and post-intervention evaluations.

The population at risk in this proposal are low Income adults who live in Miami-Dade County, especially Hispanic and minorities that struggle with higher rates of obesity. This population is vulnerable because of socioeconomic disadvantages, environmental exposure and access to health stimulating resources. Lower socioeconomic status has been shown to be associated with barriers that affect nutrition such as limited availability of healthy and affordable foods and access to preventive healthcare services, both of which can lead to unhealthy dietary patterns and higher risk for obesity. This is coupled with structural inequities that impact minority communities and requires a focused effort for appropriate health promotion strategies to be established emphasizing cultural competence.

The vulnerability of this population is deeply influenced by environmental factors. Pineda et al. (2024) conducted a systematic review and meta-analysis concluded that outlet density of fast-food restaurants and the accessibility of essential fresh food retailers are significantly positively correlated with rising prevalence of obesity. People living in these environments tend to eat energy-dense, nutrient-poor foods, which put them at increased risk for obesity and other chronic diseases. These findings underscore the role of the built food environment in shaping dietary behaviors and, in turn, contributing to health disparities.

Furthermore, social vulnerability at the neighborhood level has been found to impact obesity outcomes substantially. Research conducted by Aris et al. (2022) found evidence that children residing in neighborhoods with higher levels of social vulnerability and lower access to opportunity had significantly steeper trajectories of body mass index (BMI; kg/m2) and greater risk for obesity over the same time. Although this analysis is done in children, the results are very relevant as early-life exposure to disadvantaged environments can retain adulthood and mediate obesity risk over the longer term. Combined, these socioeconomic and environmental risk factors underscore the need for a comprehensive, community-based health promotion program that targets both behavioral and structural determinants of obesity.

The interventions related to these approaches are largely evidence-based and target the environmental and lifestyle macro-determinants of health that can lead to obesity. Pineda et al. (2024) Systematic review and meta-analysis of food environments and obesity outcomes. The study determined that greater access to healthy food opportunities such as a wider variety of fresh produce and less access to fast-food restaurants impacted obesity rates positively. This research bolsters the evidence for broad environmental and policy approaches to reducing obesity, including access to healthy foods and community nutrition programs. One of the major strengths of this study is that it is a comprehensive synthesis of several studies which enhances evidence reliability. On the other hand, environmental interventions require structural changes on various scales and thus may not achieve immediate changes in individuals' behavior.

Similarly, Aris et al. (2022) discussed how social vulnerability and neighborhood conditions affected obesity trajectories and that exposure to a disadvantaged settings increase the risk of developing obesity over time. While observational, this study adds substantial evidence to support community-based programs that address social determinants of health such as providing health education, social support, and culturally tailored programming. A major strength was the longitudinal design enabling long-term trend analysis and further evidence of the critical importance of early and sustained interventions. The limitation of the work is that it includes child populations only, therefore limiting direct generalizability to adult populations, although the findings are applicable to understanding long-term obesity risk.

Despite the incoherent nature of these interventions, the literature indicates that successful obesity prevention or treatment programs need both environmental and behavioral components. One of the major strengths across evidence is that multi-component strategies, which included improving access to healthy foods, promoting physical activity and addressing social determinants of health were consistently identified as important. However, a major limitation is that these studies are based on observational data and not an experimental design that limits causal inference. Moreover, scaling-up environmental strategies to develop community-centered changes is fraught with practical difficulties .

In addition, heterogeneity in outcomes measured and dependence on self-reported data may induce bias and restrict the evaluation of persistence of efficacy. Despite these limitations, the existing literature provides solid evidence that culturally sensitive and community-based programs, using a combined approach for education, promotion of environmental awareness and behavioral change strategies should be developed. The results of this study also directly inform the health promotion program being proposed through its highlighting of practical, accessible, and sustainable approaches for vulnerable populations.

This proposal is framed by Pender’s Health Promotion Model, a theory focused on understanding and encouraging healthy behaviors aligned with individual characteristics and behavior-specific cognitions as well as interpersonal influences. The belief that certain key constructs of perceived benefits, perceived barriers, self-efficacy and action commitment had important implications for sustainable behavior change was highlighted in this model. The Health Promotion Model is particularly applicable to the issue of obesity due to its emphasis on modifiable lifestyle behaviors such as nutrition and physical activity, as well as underlying motivational factors that impact long-term adherence (Turner & Reed, 2023).

This model, as guided by evidence on how best to improve health-related behaviors and prevent chronic disease, has been shown to be effective in leading interventions. Sadeghi et al. (2022) showed a positive effect of an educational program based on Pender’s Health Promotion Model on healthy lifestyle behaviors of reproductive age women. The research study noted that knowledge gain, self-efficacy support and perceived barrier consideration were integral to the adoption of positive health behaviors. This study has one key strength: its intervention-based design, which allows for direct evidence of the model’s effectiveness in real-world settings. A limitation is that the study population did consist solely of women, which challenges generalizability to broader adult populations.

In applying this model to the proposed program, perceived barriers to establishing a fruit and vegetable garden or home gym space ( which are limited access to healthy foods, no knowledge of how/ where/ when as well take care of a garden) is overcome through the schedule of classes. Educational sessions will be included to increase perceived benefits of healthy diet and exercise, whereas group-based activities will provide interpersonal support and motivation. Furthermore, setting goals fosters self-efficacy by breaking down behavior changes into manageable steps and allowing individuals to track their progress. Incorporating Pender's Health Promotion Model, the proposed intervention offers a systematic, evidence-based methodology to facilitate meaningful and sustainable lifestyle modifications among a susceptible demographic.

References

Aris, I. M., Perng, W., Dabelea, D., Padula, A. M., Alshawabkeh, A., Vélez-Vega, C. M., Aschner, J. L., Camargo, C. A., Jr, Sussman, T. J., Dunlop, A. L., Elliott, A. J., Ferrara, A., Zhu, Y., Joseph, C. L. M., Singh, A. M., Hartert, T., Cacho, F., Karagas, M. R., North-Reid, T., Lester, B. M., … Program Collaborators for Environmental Influences on Child Health Outcomes (2022). Associations of Neighborhood Opportunity and Social Vulnerability With Trajectories of Childhood Body Mass Index and Obesity Among US Children. JAMA network open, 5(12), e2247957. https://doi.org/10.1001/jamanetworkopen.2022.47957

Centers for Disease Control and Prevention. (2024a, May 14). Adult obesity facts. CDC. https://www.cdc.gov/obesity/adult-obesity-facts/index.html

Pineda, E., Stockton, J., Scholes, S., Lassale, C., & Mindell, J. S. (2024). Food environment and obesity: a systematic review and meta-analysis. BMJ nutrition, prevention & health, 7(1), 204–211. https://doi.org/10.1136/bmjnph-2023-000663

Sadeghi, R., Arefi, Z., Shojaeizadeh, D., & Shaahmadi, F. (2022). The Impact of Educational Intervention Based on Pender's Health Promotion Model on Healthy Lifestyle in Women of Reproductive Age in Iran. Journal of lifestyle medicine, 12(2), 83–88. https://doi.org/10.15280/jlm.2022.12.2.83

Turner, A. R., & Reed, S. M. (2023). Theory Analysis: The Health Promotion Model and Motivation in Physical Activity. Research and theory for nursing practice, RTNP-2022-0085.R1. Advance online publication. https://doi.org/10.1891/RTNP-2022-0085

World Health Organization. (2025, May 7). Obesity and Overweight. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight