The Obesity Epidemic Finding Aid in Empowerment

Transcription

1 GET GET CONNECTED CONNECTED Internet Services The Obesity Epidemic Finding Aid in Empowerment Karen Gatliff-Holley, MSN, CNP-BC University of South Carolina, Aiken, Student Health Center DNP Student Georgia Southern University Office of Lamar Murray, MD., Rural Health Center GET IN TOUCH , W. GEORGIA AVENUE, 175 VANCOUVER BC, CA

2 What is Empowerment? 17 th Century- to authorize. Catalyst to social reform. Facilitate knowledge and self-care. Increase positive patient outcomes. Provider acts as patient advocate. Non-paternalistic viewpoint. When we want your opinion, we will give it to you! (AADE, 2012; American Heritage Dictionary, 2009; CDC, 2011; Robert Woods Foundation, 2011).

3 Literature Review v The United States spends more on health care than any other nation, (+2.6 trillion). v 60 million Americans (1 in 5) have inadequate access to care. v 1.7 million American deaths annually from chronic disease. v 80% could be reduced by behavioral and lifestyle changes. v Positive relationship between education and patient outcomes. v Knowledge alone cannot predict a positive outcome. v Patients recall half of all information given them. v To improve knowledge, education must be integrated into daily activities. v 82% of Americans own a cell phone capable of internet use. v Use of advanced technology increases self-efficacy and knowledge. v Research is limited regarding long-term chronic disease management and technology. (AADE, 2012; AHRQ, 2010; Ali, Faridi, Katz, Liberti, Northup, & Shuval, 2008; Angrisano, Farrell, Kocher, Laboissiere, & Parker, 2007; Arnold, Barbosa, Gruenberger, & Scwartz, 2011; CDC, 2010; CMS, 2010; Funnel et al., 2011; Garrett et al., 2005; Kim, Love, Shea, & Quistberg, 2004; Lenhart, 2010; Nelson, McFarland, & Reiber, 2007).

4 What s the Problem? Why is it so Hard to Lose Weight? q More than 1/3 or 35% of adults are obese with a BMI of 30 or above. q 17% of US children are in the 95 th percentile, meeting criteria for obesity. q 30% increase in 10 years. q Greater prevalence of chronic disease. (Caroll, Kit, Flegal, & Ogden, 2012; CDC, 2012; WHO, 2012). Factors Health Implications v Socioeconomic v Medical: thyroid, postmenopause, medications, inactivity, and diet. v Psychological: v Sleep Apnea v Type II DM v Heart Disease STRONG SERVERS SERVICE 00 SERVICE 01 FOR YOUR HOME OR BUSSINESS 1. Loss of Control/ Stress v CVA 2. Self-Esteem v Certain Cancers

5 The American Culture of Over-Eating We have a love/hate relationship with food-a part of our traditions. Behavior modification is the key to lifelong change (AADE, 2012).

6 _Traditional Medical Model v How People Should Behave How Did We Get Here? Why is the Problem Still Growing? v Assumptions Made from Theory Patient Behavioral Model_ v How People Actually Behave v React to Environment v Expectation of Rational Behavior v Manipulated by Psychology, Culture, Economics All great change in America begins at the dinner table, (Ronald Regan). Our dilemma is that we hate change and love it at the same time; what we really want is for things to remain the same and get better, (Sidney Harris). (BrainyQuote, 2012).

7 The University of South Carolina, Aiken-Empowering Change! Student Body Student Diversity v Rural community, 5 miles outside of Aiken. v Approximately 3,300 students-80% full-time, traditional. v 67% female & 33% male student population. Student Health Center v Provide comprehensive primary care. African Amer. Hispanic Other v Holistic approach staffed by LSW, APN s, RN s, and offsite collaborating MD specializing in Infectious Disease. Wellness Center v State of the art cardiac-rehab. facility. v Referrals for evaluations within a 25,000 sq. ft. fully equipped and staffed center.

8 University of South Carolina, Aiken Campus Student Health Center Collaboration v Exercise is Medicine : conditioning, weight loss, and chronic disease risk reduction. v Collaborative partnership allows for close medical supervision of other conditions. v SHC focuses on nutrition education, sleep hygiene, and other barriers to weight loss. v Technology aids comprehension and integration of knowledge into daily life. v Introduction of ShopWell application has been vital to mobile population. v Free nutrition application, designed to empower users to make healthier food choices. v Individualized profiles rate foods based on specific needs. v Food scores with corresponding red, yellow, or green sign..

9 Methodology DUEAT Research Project (Diabetics Utilizing Empowerment and Advanced Technology) Improving Self-Efficacy Skills and Nutrition Knowledge in the Rural Patient with Adult Type II Diabetes Utilizing Advanced Technology in Group Diabetic Teaching Health Outcomes were Measured by: 1. Michigan Diabetes Training Center Knowledge test 2. Diabetes Short Form Empowerment Scale 3. ShopWell Food Choice/Food Swap Logs Goals To improve the treatment, monitoring, and management of chronic disease by: a) promoting self-efficacy through increased dietary knowledge. b) improving health care outcomes by integrating knowledge into daily activities. Theory v Rogers Diffusion Theory-addressing the gap between disseminating research to evidenced based practice, as well as behavioral change. ShopWell v ShopWell follows IOM, FDA, ADA, and AADE national standards. v Designed by a team of dietitians, Stanford University statisticians and engineers providing regular updates. v Food is scored based on individual health needs. (ADA, 2012; AADE, 2012; FDA, 2012; Garcia, Green Hiatt, & Ottoson, 2009; Rogers, 2003; ShopWell, 2012)

10 Results (pre- post descrip4ve study design) DUEAT Research Project v SPSS evaluation of Michigan Diabetes Research Training Center Knowledge Preand Post-Test. v Likert Scale utilized with multiple linear regression analysis demonstrated a 52% increase from pre-test scores. v Use of ShopWell as an adjunct to traditional instruction demonstrated positive outcomes. v Mean average hemoglobin A1C 8.1%, with a maximum average of 12%. v All were referred to the study due to complicated disease states, comorbidities, and noncompliance. v Positive correlations were found with hemoglobin A1C and cholesterol. v Cholesterol level and age positively correlated with the job status of the participants. v Results hold promise for future collaborative research Knowledge Scores

11 v v v v v v v Collaborative Opportunities.. The DUEAT Research Project is in Phase 3 committee-publication is next step! I welcome all collaborative opportunities for future research-particularly in areas of advanced technology, adult, student, and rural populations. Karen Gatliff-Holley, MSN, CNP-BC; GA Southern DNP Student KEHolley@Comcast.net (706) Mila Padgett, Wellness Center Director; Holly Guy, Assistant Director Many collaborative research opportunities for Exercise is Medicine for student populations. milap@usca.edu hollyg@usca.edu (803) (803) Cindy Gelinas, LISW-CP Counseling Center & Disability Services Director; Interim Director of Student Health Center Unlimited research and collaborative opportunities. cindyg@usca.edu (803) or (803) Marci Harnischfeger, MS RD-Head Dietitian Brian Witlin, Co-Founder, and CEO Scott Golubock, Head of Engineering ShopWell is an Empowerment Application that can be specialized to meet your specific needs. marci@shopwell.com Thank You!

12 References Ali, A., Faridi, Z., Katz, D., Liberti, L., Northrup, V., & Shuval, K. (2008). Evaluating the impact of mobile telephone technology on type 2 diabetic patients self-management: the NICHE pilot study. Journal of Evaluation in Clinical Practice, 14(3): doi: /j x American Association of Diabetes Educators. (AADE). (2012). Professional resources. Retrieved from American Heritage Dictionary. (2009). Empowerment. (4 th Ed). New York, NY: Houghton Muffin Company. Angrisano, C., Farrell, P., Kocher, B., Laboissiere, M., & Parker, S. (2007). Accounting for cost of health care in the United States. San Francisco, CA: McKinsey Global Institute. Arnold, B., Barbosa, C., Gruenberger, J., & Schwartz, P. (2011). Considering the patient perspective of assessing the outcomes of diabetes lifestyle modification programs. What should we measure, and how? British Journal of Diabetes and Vascular Disease, 11(14): doi: BrainyQuote. (2012). Change quotes. Retrieved from Caroll, M., Kit, B., Flegal, K., & Ogden, C. (2012). Prevalence of obesity in the United States, NCHS data brief, (82). Hyattsville, MD: National Center for Health Statistics. Centers for Disease Control and Prevention. (CDC). (2012). BMI calculator for child and teen English versions. Retrieved from apps.nccd.cdc.gov/dnpabmi/ Center for Disease Control and Prevention (CDC). (2010). Chronic disease overview. Retrieved from overview/index.html Centers for Disease Control and Prevention. (CDC). (2011). National diabetes fact sheet. Accessible at: Funnell, M., Brown, T., Childs, B., Hass, L., Hosey, G., Jensen, B., Weiss, M. (2011). National standards for diabetes and selfmanagement education. Retrieved from Garcia, C., Green, L., Hiatt, R., & Ottoson, J. (2009). Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual Review of Public Health, 30( ). doi: /annurev.pubhealth Garrett, N., Hagman, C., Shalamar, S., Davern, M., Berger, M., Brunzell, C., & Malecha, K. (2005). The effectiveness of an interactive small group diabetes intervention in improving knowledge, feeling of control and behavior. Health Promotion Practice, Kim, S., Love, F., Quistberg, D., & Shea, J. (2004). Association of health literacy with self-management behavior in patients with diabetes. Diabetes Care, 27(12): Lenhart, K. (2010). Cell phones and American adults. Retrieved from National Institutes of Health. (NIH). (2010). Final review healthy people Nutrition and overweight. Retrieved from Nelson, K., McFarland, L., & Reiber, G. (2007). Factors influencing disease self-management among veterans with diabetes and poor glycemic control. Journal of Internal Medicine, 22: Robert Woods Foundation. (2011). Vulnerable populations. Retrieved from Rogers, M. (2003). Diffusion of innovations (5 th ed.). New York, NY: Free Press. ShopWell. (2012). About ShopWell. Retrieved from US Department of Health and Human Services. (HHS). (2012). Calculate your body mass index. Retrieved from