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Health Educator Consultation Summary:

Overall the purpose for my visit is to address Sara Gs screening results. Sara G had all mildly abnormal
results with the exception of her High Density Lipoprotein (HDL) value. Before visiting Saras residence I will
complete a thorough review of her chart and information. I also will information on Appalachian culture
through various resources and by reading a book titled Cultural Sensitivity: a pocket guide for health
professional by Dr. Geri-Ann Galanti.
Sara indicated she had been fasting 10-12 hours before she completed her screening. Saras body mass
index (BMI) of 29 indicates she is overweight. Normal BMI ranges from 18.5 24.9. Her blood pressure
reading of 130/74 indicated she is pre-hypertensive. Blood pressure should normally be is less than 120/80
(less than 120 systolic AND less than 80 diastolic). Her total cholesterol value measured 202. Desirable
total cholesterol levels are less than 200. Saras low density lipoprotein (LDL) measured 101. Optimal levels
of LDL are less than 100. Her triglyceride level was 188. Normal triglyceride levels are less than 150. Sara
self-identified as borderline diabetic, her glucose level was 102. Normal glucose levels while fasting are less
than 100. Saras T-Score was -1.2. Normal ranges for t-score are 1.0 to -1.0.
After addressing each result individually, I will explain health implications related to abnormal values. It will
be important to highlight how these screening results translate to increased risk for chronic illnesses such
as heart disease and diabetes. As an elderly woman, who has completed menopause it will be important to
increase her knowledge on the role research shows menopause and loss of estrogen has on increasing her
risk for disease as well.
Utilizing the Health Belief Model as a tool, we will discuss how Sara perceives the severity and susceptibility
of her risk. I will also focus on her perception of the benefits and barriers to behavioral change. This will lead
into our discussion of goals and opportunities for change.
I will explain that lifestyle changes such as exercise and diet are important in improving her screening
values. Sara already exercises and considers herself more active than others her age. I will focus on this as
a strength for her and encourage she continue to exercise regularly but better understand her routine. We
will dialogue about potential barriers related to her continuing to exercise. Some barriers might be her age,
her pre-existing arthritis, transportation, etc. We will then explore potential solutions. She may find it helpful
if I provided additional exercise opportunities that could be beneficial in managing her arthritis as well as
improve her screening results such as arthritis group fitness classes at the YMCA near her home.
We will continue to dialogue about lifestyle changes and explore her current nutrition habits. Special
attention will be placed on increasing her vegetable intake and decreasing the amount of snack she
consumes. Further discussion would address additional changes she can make to improve her values.
Examples are shown below in the goals and objectives. Smoking will be important to address, but because
this consultation is the first and very informational I will ascertain where she is her desire to change this
behavior. Utilizing the Transtheoretical Model (TTM) as a reference, if she is in the contemplation or action
stages we will further discuss options for quitting. Potential cultural and/or personal barriers to lifestyle
changes would be addressed.
Lastly we will discuss the importance of a PCP as a key factor in preventing disease and early detection. I
would encourage and assist Sara in scheduling for an appointment with her PCP. Again using the Health
Belief Model as a tool I would explore some of Saras perceived barriers to not scheduling an appointment.
A dialogue about her personal and/or cultural barriers would be acknowledged and addressed. Potential
solutions will be discussed.
I will engage Sara in her teaching through a variety of methods, reinforce positive feedback, and allow her
to make the decisions regarding where she would like to begin with her goals and when. Concluding our

consultation a letter will be mailed summarizing our conversation with handouts to facilitate change will be
provided for her. Handouts on the following topics will be included:

Healthy eating: How to create a healthy plate using MyPlate

Exercise (will include recommendations, benefits, examples, and exercises for bone health)
Places for physical activity near her residence
Blood pressure

She will also be provided with my phone number for support if she needs to contact me before our follow up
date in two months. Based on our consultation, Sara will review the list of suggested goals and objectives
provided below. We will then modify or remove the goals and objectives as needed.

Health Educator, Goal Setting Planning

Name: Sara G
DOB: 4/12/45
Health Educator

Goal: Maintain annual and/or scheduled appointments with primary care provider.
A. Schedule a visit within the next 30 days to see a physician to complete physical exam and
scheduling of preventative services
Teaching strategies:
A. Didactic teaching and using examples of how physicians can detect diseases early if they are
familiar with your health.
B. Use research studies about the benefits of having a PCP
A. Teaching will be evaluated through verbal understanding and participants decision to make an


Goal: Reduce Blood Pressure

A. Keep a log of blood pressure readings twice per week
B. Establish an exercise program for 30 minutes per day x 5 days per week.
a. Moderate intensity exercise (examples include: walking, warm water aerobics, dancing)
b. Strengthening Exercises 2x per week, can be done during workout as apart of 30 minute
workout (light weight lifting at home or gym, own body weight or elastic bands)
c. Balance exercises (everyday, during stretching or as often as possible)
C. Reduce sodium intake
Teaching strategies:
A. Didactic teaching
B. Demonstrations
a. How to use a home blood pressure cuff
b. How to log blood pressure log B/P readings in booklet given to participant
c. Different types of exercises
d. How to read a nutrition label to identify foods high in sodium using food from her cabinet
C. Handouts
a. For review of demonstrations (B/P log, different exercises, and how to read a nutrition
level and I identify what is considered low in sodium)
A. Return demonstration for all demonstrations as stated above.
B. Verbalize understanding of how to reduce blood pressure through various objectives


Goal: Smoking cessation

A. Reduce amount of cigarettes smoked per day
B. Identify method for quitting (ie gum, patches, acupuncture, smoking cessation programs, etc.)
C. Identify a quit date and positive reinforcement (ie money jar that would have been spent on
cigarettes, etc.)
Teaching strategies:
A. Didactic teaching and reflective discussion
B. Demonstrations
a. How to reduce amount of cigarettes smoked per day using bags to separate number of
cigarettes per day based on agreed amount of participant
b. Model showing a normal and smokers lung, simulate breathing differences
C. Handouts
a. Methods to quit smoking and referral numbers to smoking cessation programs
b. Patient handout showing the effects of smoking and benefits for quitting
A. Patient verbalizes through reflective discussion motivations to quit based on experiences,
choices, etc. Patient also will reflect on and identify high risk times she smokes (ie before work,
while drinking alcohol, when she is stressed etc.)
B. Return demonstration of separating cigarettes
C. Patient identified method of quitting
D. Patient identified quit date
E. Patient identified positive reinforcements


Goal: Improve nutrition intake

A. Increase vegetables to at least 4 serving per day (emphasizes on low calorie, non-starchy
vegetables, and good sources of calcium such as dark green leafy vegetables.)
B. Decreasing snack consumption to 1-2 snacks per day, with emphasizes on small portions and
healthier options such as whole grain snacks, low in saturated fat, sodium and sugar
C. Identify and consume low and non-fat dairy products
Teaching strategies:
A. Didactic teaching
B. Demonstrations
a. Demonstrate how to read a nutrition label using food in her home
b. Model showing amount of fat in different dairy products (ie comparing whole milk, 2%,
1%, and fat free milk models with fat separated out)
c. Model showing examples of serving sizes of vegetables
d. Use Stop, Whoa, Go game to demonstration foods that you should avoid, choose
occasionally, and healthy options
C. Handouts
a. Handout on healthy food options including vegetables, healthy snacks, etc.
b. Handout on easy ways to learn to read a nutrition label

A. Return demonstrations
B. Ability to describe Stop, Whoa, Go foods to measure understanding
C. Verbalize understanding of nutrition through discussion