Running head: PERSONAL HEALTH ASSESSMENT AND PROMOTION

An Assessment of Personal Health and Plan for Health Promotion Melissa B. Scholtens Ferris State University

PERSONAL HEALTH ASSESSMENT AND PROMOTION

Abstract This paper addresses the importance of taking evaluation of an individuals own health beliefs, ascertaining what the results yielded and putting into motion a plan to address a concerning component relating to health and engaging in a process to promote health. Weight loss and proper nutrition were tracked using online logs for food intake, activity/exercise, and daily step counts with progress towards goal noted weekly.

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An Assessment of Personal Health and Plan for Health Promotion The rationale for this paper is to explore the authors personal health beliefs and the implications of such beliefs on her state of health and being. After reflection on the results of the Health Beliefs Survey (Appendix A) it was clear that health was something that she believed is under her own control, with only a small factor of health being controlled by chance or others. Through use of evaluative tools, information from a study conducted and published by the Journal of the Academy of Nutrition and Dietetics, and information tracking logs a personal health plan was developed. Empowerment is a process through which individuals gain mastery over their lives, (Pender, 2011) this statement is as dynamic as it is simple; recognition relating to the health belief survey combined with education from the information gained from journaling and tracking added to the learning and insight from the Journal of the Academy of Nutrition and Dietetics equals the empowerment she needed to gain control and mastery over her health. To begin this overall health assessment and prior to making a health promotion plan the author completed a Health Beliefs Survey (HBS). The HBS was a survey that consisted of eighteen questions designed to assess an individuals view on important health-related issues (Ursuy 2012). The survey results were broken down into three different categories including: internal, chance and powerful-others. After completion of the HBS the author was not surprised when tallying the results. The results indicated that more so than the mean, she believed that health was under personal control, and significantly less than the normative mean she believed that health is left to chance and powerful-others. The results of the HBS are fairly congruent with her personal beliefs, for the most part she believes that she has a significant amount of

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control over her own health, although she must admit that there are obvious illnesses that occur that are not within her ability to avoid or overcome based on her own interventions. Since the author has concluded that a significant proportion of health is within her control, she chose two areas to focus on: weight loss and weight maintenance as well as a healthy nutritional diet. Eating a healthy and nutritionally sound diet is paramount to losing weight and maintaining a healthy weight. Monitoring of weight, physical activity and food and water consumption have been found to be effective for weight loss maintenance as published in Journal of the Academy of Nutrition and Dietetics (Akers, 2012). Maintaining a healthy weight reduces your chance of hypertension, type II diabetes, musculoskeletal pain and injuries, as well an increased selfesteem. Assessment Tools Since the goal of this health promotion was to lose weight and maintain a healthy and nutritionally sound diet, the author chose 3 tools for goal assessment. More than one month ago she joined Weight Watchers Online and started on their weight loss plan. This plan is based on gender, age, height, weight and if you are a nursing mother or not. After this information is entered you are given a number which is the number of points that you can consume in a day, plus a bonus amount of points that can be used at any point during the week in addition to your daily points. The goal of this plan is after the first 2 weeks to lose 1-2 pounds a week until you reach your desired goal. With Weight Watchers online she had instant access via the computer or smart phone to the points value of any food and most of the foods off the menu at major food chains. This easy access allowed her to track each and every piece of food that she ate and at the same time forced her to in the moment take into account the number of points a food is valued and make a decision of whether or not to eat the food. Weight Watchers Online allows

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the input of an entire dietary intake to monitor food consumption and keep account of the point value for each food (Appendix B). The second tool was chosen was the utilization of an activity tracker. Weight Watchers Online offers an activity tracker in addition to the food log. Once again within Weight Watchers, everything from food and activity is broken down into a points system. Tracking activity creates points that can be used in exchange for eating more food. In addition to the tracking of food and diet, activity was also tracked daily using an activity log (Appendix C). The third tool that the author utilized was the use of a pedometer. Through a program called Walking Spree the author was able to wear a pedometer and track normal activity steps as well as aerobic activity steps and see the progress on a table (Appendix D). The author chose to utilize the food log and activity tracker from Weight Watchers (WW) as part of the Weight Watchers Plan. Prior to joining WW she researched and spoke with her physician about losing weight and learned that WW was not only healthy, it was successful. According to U.S. News & World Report, Weight Watchers was ranked number 1 best weight loss diet in 2012 (Haupt,2012). Transtheoretical Model The transtheoretical model is an integrative framework to describe how individuals progress toward adopting and maintaining behavior change (Pender, 2011). Associated with the transtheoretical model there are five different stages including: precontemplation, contemplation, planning or preparation, action and maintenance. Precontempation occurred for the author about one year ago, deep down she knew that changes needed to be made in her life to attain better health, but actually making that change was still more than six months away. Contemplation happened one day when she was looking through pictures and caught sight of what she looked like in the eye of the camera. Seeing herself how the rest of the world viewed her was eye

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opening, it was then that she knew that she needed to begin planning to engage in eating a more healthy diet and getting more exercise to affect change not only in her body, but her health as well. For the author, contemplation, planning and action occurred almost simultaneously. From realization that something needed to be done, to choosing a course of action and then following through with implementation of that action the time frame was about one week. Action is the stage that the author currently finds herself navigating and finding success. Her plan, preparation and subsequent action have been in place for 6 weeks and she is actively participating in weekly exercise and a healthful diet. Having traversed the stages from not exhibiting readiness to make a change and adopt a healthy lifestyle by eating a balanced diet, to thinking about the need to make a change and add exercise and healthful food options, to making a plan to follow for exercise and better food choices to finally taking action to participate in actively in making these changes the author has found success using the transtheoretical model. Wellness-oriented Nursing Diagnosis Health seeking behaviors related to absence of aerobic exercise as a risk factor for coronary artery disease is most in alignment with the authors current state of being (Sparks & Taylor, 2010). The definition of this nursing diagnosis is active seeking of ways to alter personal health habits or the environment in order to move toward a higher level of health (Sparks & Taylor, 2010), and this is exactly the place where the author finds herself, actively pursuing changes in her diet and exercise regimen to move towards a higher level of health. Through completion of an assessment related to the authors current health and motivation to make lifestyle changes and recognition that there was a need to make changes, she understood the need to seek a higher level of wellness and gain control and autonomy regarding

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health practices. The authors goal was two-fold; to eat a more healthful diet and increase physical and aerobic activity and to develop a plan to meet both of these desired outcomes. By implementing a food tracking log and exercise activity log, step tracking and consultation with weight watchers regarding healthy food options and daily goal food intake the author was able to put into action the behavior changes necessary to improve health. Health Promotion Plan and Personal Goals After discussing weight loss goals with her physician the author embarked on her journey to lowering her weight, eating a more healthful diet and adding exercise to her lifestyle. With the assistance and guidance of Weight Watchers, the author chose a goal weight of 180 pounds which calculates to a body mass index or BMI of 25. The goal for the author was to lose 1-2 pounds per week and maintain and exercise program of working out or fast walking for at least 30 minutes 3-4 times per week. In addition to the weight loss, the author tracked food intake and exercise daily which was kept in a log via www.weightwatchers.com. The author implemented this plan 6 weeks ago and has stayed close to her set goals with the occasional deviation in either diet or exercise, but not both at the same time. Weight Watchers builds into their recommended dietary intake and bonus number of points, this allows for the occasional splurge without impact on the waste line. Through tracking of food and exercise the author was held accountable for her eating and exercising decisions with the results showing in the scale at the end of each week. Since implementing this program the author has reduced her weight by 15 pounds and decreased her BMI by 2.1 which is roughly a little more than 7% (Appendix E).

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The authors overall goal is to be healthier, however she has placed numbers on this goal for measurement purposes. Her goal is to attain a BMI of under 25 which would place her in the healthy weight measurement, while doing this her goal is to continue with 3 times per week exercise and increase the length of exercise from 30 minutes to 45 minutes by 12 weeks as well as maintenance of at least 5,000 to 10,000 steps per day. Conclusion Through use of the Health Beliefs Survey (Appendix A) and self- assessment that author was able to ascertain that overall she felt that her health and wellness as well as the ability to affect change were within in her own power. Evaluating her change based on the transtheoretical model she was able to see the various stages of change that she worked through and understand that change is a process that occurs over time and that change is possible. By taking notice of all of the food that she consumed daily in addition to the exercise that did or did not happen, the author was able to recognize where changes needed to occur and implement them before the effect was detrimental. The authors overall goal was to increase healthy eating and add a regular exercise program to her weekly routine; she has been successful on both of these endeavors and hopes to take what she has learned forward with her for a brighter and lighter future.

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References Akers, J. D., Cornett, R. A., Savla, J. S., Davy, K. P., & Davy, B. M. (2012). Daily SelfMonitoring of Body Weight, Step Count, Fruit/Vegetable Intake, and Water Consumption: A Feasible and Effective Long-Term Weight Loss Maintenance Approach. Journal of the Academy of Nutrition and Dietetics, 112 (5), 385-392. doi:10.1016/j.jand.2012.01.022 Haupt, Angela. (2012). Health Buzz: U.S. News Ranks the Best Diets for 2012. US News and World Report. Retrieved from http://health.usnews.com/bestdiet/articles/2012/01/04/health-buzz-us-news-ranks-the-best-diets-for-2012 Pender, N. J., Murdaugh, C. L. & Parsons, M. A. (2011). Health Promotion in Nursing Practice (6th ed.). Upper Saddle River, NJ: Prentice-Hall. Sparks, S., & Taylor, C. (2010). Nursing diagnosis reference manual (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Ursuy, P. (2012). NURS 310 Class Syllabus. Weight Watchers (2012). Retrieved from weightwatchers.com.

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Appendix A

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Appendix B

PointsPlus Tracker entries Tuesday, June 12, 2012 Morning 2 item(s) Eggo Homestyle Waffles 1 cup(s) black coffee Subtotal Midday 2 Tbsp Light Done Right Creamy french style dressing 1/8 cup(s) Shredded Colby & Monterey Jack Cheese 2 cup(s) tossed salad without dressing 27 cracker(s) Crackers Cheez-It 2 serving(s) Dots Gumdrops, Assorted Fruit Flavored Subtotal Evening 8 oz grilled chicken breast fillet(s) 1 serving(s) Broccoli Florets (plain) 1 medium corn on the cob 7 0 2 2 1 0 4 7 14 5 0 5

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1 Cheesy Potatoes Subtotal Anytime No entries for this meal time. Subtotal Food PointsPlus values total used Food PointsPlus values remaining Activity No entries for activity. Activity PointsPlus values earned Check off these important items daily: Liquids Milk & Milk Products

6 15

0 34 3

Fruit & vegetables

Multivitamin/Mineral

Healthy Oil

Activity

Notes Today I felt like I succeeded, with the exception of the Dots candy. Bought them for my kids and before I knew it had consumed 2 servingsaghhhh. Did get on the treadmill and get some exercise and the rest of the days food was healthy

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and I stayed within my points range. Overall, a good day!

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Appendix C

Activity 8914 Pedometer Steps 30 min housework, moderate effort 30 min Walking (>3.0 mph [20 min mile] and <5.0 mph [12 min mile] on level surface) 6 3 3

Activity PointsPlus values earned 12

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Appendix D

June 17th, 2012

Summary Total Steps Total Aerobic Steps Total Number Of Minutes of Aerobic Steps Total Distance Walked Average steps/day Average Aerobic steps/day Total Days at 10,000 Steps Activity Nutrition/Calorie 33840 2566 24 22.30 4834 367 0 Body Snapshot

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Appendix E

BMI at the start of this program on 5/1/12:

Your Body Mass Index

The Height you entered is 5 feet, 10 inches. The Weight you entered is 245 pounds.

Your Calculated BMI is: 35.1

BMI currently on 6/15/12:

Your Body Mass Index

The Height you entered is 5 feet, 10 inches. The Weight you entered is 230 pounds.

Your Calculated BMI is: 33.0 (Calculations for BMI from http://www.nhlbisupport.com/bmi/)