Assessment & Planning
Gahanna started as 800 acres of land in 1849 (City of Gahanna, 2011). The land was named “Gahanna” by its founder; the name itself was derived from a Native American word meaning “three creeks coming into one” (City of Gahanna, 2011). In 1881, Gahanna merged with Bridgeport, which used to be its lifetime competitor: the merger put an end to their rivalry and set the stage for the rapid development of the Gahanna community (City of Gahanna, 2011). The present-day Gahanna has approximately 33,000 residents (U.S. Census Bureau, 2011). Of these, almost one-third (10,000) are under the age of 18 (U.S. Census Bureau, 2011). The elderly account for 8.7% of Gahanna residents (U.S. Census Bureau, 2011). Less than 2,500 children in Gahanna are under five years old (U.S. Census Bureau, 2011). The Gahanna community runs a well-developed system of health and medical care, which includes hospitals and medical offices, clinics and mental health facilities, nursing care homes, EMS, etc. Nevertheless, childhood obesity remains a significant issue in Gahanna: 13.3% of low-income preschool children display the symptoms of obesity, compared to 11.9% at the state level (City Data, 2011). This is one of the reasons why nursing professionals and community residents must engage in a collective effort and develop nursing interventions aimed to prevent obesity in children and reduce its negative effects on pediatric health.
Planning
Childhood obesity remains a serious issue in the Gahanna community. This is particularly the case of low-income preschool children, 13% of whom have the signs and symptoms of obesity or excessive body weight (City Data, 2011). NANDA diagnosis for childhood obesity in the Gahanna community looks as follows: Imbalanced nutrition more than body requirement related to excessive intake in relation to metabolic needs as evidenced by reported dysfunctional eating patterns and excessive body weight. The long-term goal is to improve community residents’ knowledge and awareness of resources available for preventing and reducing childhood obesity by fifteen percent, by January 1, 2012. Gahanna residents must be aware of the effects of childhood obesity on pediatric health. To meet this goal, health professionals from the Gahanna health center and community residents will have to collectively develop and implement a broad school-based education campaign, to ensure that children and their parents have a better awareness of resources available for preventing and reducing excess body weight in children. The program lasts three days and begins on May 15, 2011, and will represent the primary level of intervention. At the secondary level, parents with obese children will be invited to participate in physical activity classes. The current evidence base suggests that school-based programs are critical drivers of positive behavioral changes in children, which further track into adolescence and adulthood (Dietz & Gortmaker, 2001, p.346). Moreover, “parental involvement in obesity prevention and treatment programs is key to the development of a psychosocial environment that promotes healthy eating and physical activity among young people” (Story, 1999, p.S49).
Implementation
Education was used as the form of primary intervention against childhood obesity in the Gahanna community. Community residents and health professionals from the Gahanna health center played the role of key informants during the intervention. However, community resident involvement appeared to be the major barrier to program implementation, as not all community residents were aware of the childhood obesity problem in the Gahanna community and its effects on child and adolescent health. Gahanna community residents confess that they are happy at being part of the community and do not always see the need to participate in community- and school-based health interventions. The team of individuals involved in the project included health professionals from the Gahanna health center and community residents. The intervention resulted in two important unintended outcomes. First, community residents expressed willingness to develop similar programs relating to the problem of aging and Alzheimer’s in the Gahanna community. Second, parents of children with excessive body weight and obesity confessed that physical activity alone could not help their children to cope with obesity: they also needed nursing support to develop and pursue healthy diets and lifestyles. Overall, community residents were surprised to learn that childhood obesity was a serious problem in the Gahanna community and finally recognized the importance of school-based interventions to fight against and reduce the severity of obesity in Gahanna children.
Evaluation
School-based community projects have proved to be an effective measure of primary prevention against childhood obesity. Pre and post-test measures/ surveys were administered among 30 community residents, most of them low-income mothers of children with obesity and excess body mass. Tests/ surveys were administered at one of Gahanna’s schools, during the last session of the school-based program. The results of pre-test and post-test analyses suggest that primary intervention has significantly increased community residents’ awareness of the childhood obesity problem and their understanding of the resources available for treating and preventing obesity in children. Before the intervention, only 15 percent of parents with obese children could identify community resources for preventing and treating obesity; post-test measures showed a 50 percent increase in parents’ knowledge of community resources available for preventing and dealing with obesity and excess weight in children. Following the school-based intervention, 65 percent of parents could easily name two or more community resources for preventing and treating childhood obesity, compared with only 15 percent pre-test. Post-test results also showed that 89 percent of parents of children with obesity and excessive body weight recognized primary care physicians as the main source of relevant health information, compared with only 33 percent pre-test. These results indicate the vital importance of education and knowledge interventions in community settings. Simultaneously, the need to continue and implement broader education programs is obvious.
Discussion
The intervention turned out to be a relevant source of learning and knowledge for nursing students. The school-based program proved the value and importance of nursing interventions for treating the most complicated chronic health conditions. Childhood obesity is one of the most problematic factors of childhood health in the Gahanna community. Simultaneously, the effects and successes of the project suggest that similar frameworks could be used to address other community health issues, like aging and Alzheimer’s in elderly populations. The project alone cannot help to solve all pediatric health problems in the Gahanna community. Nurses need to follow up on obese children, to ensure that they are able to achieve the desired health outcomes. Nurses need to develop complex programs, to monitor the effects of education and physical exercise on children with excess body weight. This could be done through nurse short text messaging (Kim, Kim & Ahn, 2006). Telephone calls could become a relevant measure of follow-up for children with obesity and excess body mass (Wong et al, 2005). The project could be improved, by letting other informants participate in the intervention. For example, psychologists and dietary professionals could add to the current knowledge of childhood obesity and resources available for treating and preventing it. This project has far-reaching implications for nursing practices, as it proves the significance of primary nursing interventions and their positive effects on the health, life, and wellbeing of the Gahanna community residents.
References
City Data. (2011). Gahanna, Ohio. City Data. Web.
City of Gahanna. (2011). Community profile. City of Gahanna. Web.
Dietz, W.H. & Gortmaker, S.L. (2001). Preventing obesity in children and adolescents. Annual Review of Public Health, 22, 337-353.
Kim, H.S., Kim, N.C. & Ahn, S.H. (2006). Impact of a nurse short message service intervention for patients with diabetes. Journal of Nursing Care Quality, 21(3), 266-271.
Story, M. (1999). School-based approaches for preventing and treating obesity. International Journal of Obesity, 23(2), S43-S51.
U.S. Census Bureau. (2011). State & County quick facts: Gahanna (city) Ohio. U.S. Census Bureau. Web.
Wong, K.Y., Mok, M.P., Chan, T. & Tsang, M.W. (2005). Nurse follow-up of patients with diabetes: Randomized controlled trial. Journal of Advanced Nursing, 50(4), 391-402.