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Obesity is a significant national public health crisis, affecting one-third of American adults. It is a complex and multifactorial disease that increases the risk of multiple chronic medical conditions including coronary heart disease, diabetes, and even leading to potential premature mortality. Moreover, increased health care utilization and escalating medical costs

Obesity is a significant national public health crisis, affecting one-third of American adults. It is a complex and multifactorial disease that increases the risk of multiple chronic medical conditions including coronary heart disease, diabetes, and even leading to potential premature mortality. Moreover, increased health care utilization and escalating medical costs associated with obesity treatment are overwhelming an already burdened health care system. Obesity is nondiscriminatory, affecting individuals from various demographic and socioeconomic backgrounds, even extending to our unique population of active duty military service members and veterans.

Despite mandatory physical fitness and body composition requirements, active duty service members continue to experience an increasing prevalence of obesity. The obesity epidemic has considerable implications for military readiness, accession, and retention. Limited studies have examined weight-loss interventions including self-paced and provider-led interventions among active duty military service members with varying degrees of success. The purpose of this evidence based doctoral project was to examine the effectiveness of a twelve-week group lifestyle intervention involving education regarding healthy diet, physical activity and behavior change recommendations on weight and body mass index (BMI). The study demonstrated no significant differences in initial and post intervention weight and BMI.

ContributorsMonti, Kimberly M. (Author) / Root, Lynda (Thesis advisor)
Created2020-05-06
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Description
Objective: Obesity is the fifth leading cause of global death and is preventable. It affects all body systems and causes major chronic illnesses such as diabetes, heart diseases, stroke, and some cancers. The goal of this transtheoretical stages of changes (TSOC) theory-based project are as follows: To educate the

Objective: Obesity is the fifth leading cause of global death and is preventable. It affects all body systems and causes major chronic illnesses such as diabetes, heart diseases, stroke, and some cancers. The goal of this transtheoretical stages of changes (TSOC) theory-based project are as follows: To educate the participants of the project to be aware of obesity and its complications; motivate them to use community resources, and improve their body mass indexes (BMI), waist circumference (WC), motivation, quality of life (QOL) and lifestyle. Methods: Twenty-three participants were recruited in a primary care clinic. Six participants dropped out during the project. All the randomly selected participants who met the criteria of obesity signed written informed consent and were provided a 4-digit code to maintain anonymity. Participants were motivated and educated using a handout, two pre-and post-project in-person nursing visits, and five telemedicine weekly nursing follow-ups visits. Pre- and post-surveys collected during in-person visits include data such as weight, BMI, WC, demographic data, comorbidities, lifestyle, motivation, QOL, TSOC, and utilization of community resources. Results: Descriptive analysis and paired t-test is done utilizing Intellectus statistics software to measure the outcome. The results show improvement in dietary choices, physical activity, motivation, QOL, use of community resources, decrease in BMI, and WC. In paired t tests, results show clinical and statistical significance in BMI, WC, MOT and clinical significance in QOL. There was increase in the revenue at the project site due to reimbursement of the services provided for the patients. Conclusion: The results are expected to develop practice change in preventing and treating obesity. More evidence-based projects and studies with large sample size are needed to develop improvement in the knowledge base of providers and current practice.
Created2022-04-28
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Description
The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese

The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese adolescents. Healthcare providers must continuously explore novel ways to empower teens to make healthy lifestyle changes. The Creating Opportunities for Personal Empowerment (COPE) Thinking, Emotions, Exercise, and Nutrition (TEEN) program was delivered to three adolescent participants in a primary care pediatric clinic in Southwest Arizona. The 15 sessions were provided weekly in the pediatrician’s office using the COPE TEEN manual. The participants completed the HABITS questionnaire and the Patient Health Questionnaire-9 (PHQ-9) before starting the program and after program cessation and kept confidential. The survey results were compared using descriptive analysis and paired t-tests to analyze the data collected. Due to a small sample size (n=3), statistical significance could not be calculated. However, clinical significance was found as evidenced by lower depression scores and improvement in healthy habits. A cognitive behavior skills-building program such as the COPE TEEN program has the potential to empower adolescents to make healthy decisions in life. These healthy choices lead to a long, happy life free from diseases caused by unhealthy choices. This program positively impacts the clinical care of adolescents who are overweight or obese by offering providers an alternative manner of educating adolescents.
Created2022-04-29
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Description

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnershi

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity. Effective interventions for addressing childhood obesity require community-specific information on

who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community. Based on comprehensive research, a series of reports are being prepared for each community to assist in planning effective interventions.

The main components of the study were:

• A household telephone survey of 1700 families with 3–18 year old children,

• De-identified heights and weights measured at public schools,

• Assessment of the food and physical activity environments using objective data.

This report presents the results from the household survey. Reports based on school body mass index (BMI) data and food and physical activity environment data are available at www.cshp.rutgers.edu/childhoodobesity.htm.

Created2010
The New Jersey Childhood Obesity Study: Food Environment Maps, Newark
Description

The maps in this chartbook describe the food environment in ewark in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.

• Food environment maps were created using geo-coded commercially

The maps in this chartbook describe the food environment in ewark in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.

• Food environment maps were created using geo-coded commercially available data of food outlets (InfoUSA, 2008 and Trade Dimensions, 2008) in Newark and in a 1 mile buffer area around Newark.

•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likelihood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.

• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.

• Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy foods in neighborhoods with different characteristics.

Data Sources: Info USA food outlet 2008 data

Trade Dimensions food outlet 2008 data

Census 2000 data

New Jersey Department of Education 2008-2009 data

Created2010-08
The New Jersey Childhood Obesity Study: Food Environment Maps, Trenton
Description

The maps in this chartbook describe the food environment in Trenton in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.

•Food environment maps were created using geo-coded commercially available

The maps in this chartbook describe the food environment in Trenton in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.

•Food environment maps were created using geo-coded commercially available data of food outlets (InfoUSA, 2008 and Trade Dimensions, 2008) in Trenton and in a 1 mile buffer area around Trenton.

•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likelihood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.

• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.

•Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy foods in neighborhoods with different characteristics.

 

Data Sources: Info USA food outlet 2008 data

Trade Dimensions food outlet 2008 data

Census 2000 data

New Jersey Department of Education 2008-2009 data

Created2010-08
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Description

This study answers the question, “In Adult Hispanic BMI ≥ 30 (P), how does development of a weight loss program that utilizes Motivational Interviewing (I) compared to counseling and educational materials only (C) affect weight loss over the period of three months (T).” There are limited published systematic reviews and

This study answers the question, “In Adult Hispanic BMI ≥ 30 (P), how does development of a weight loss program that utilizes Motivational Interviewing (I) compared to counseling and educational materials only (C) affect weight loss over the period of three months (T).” There are limited published systematic reviews and randomized control trials to evaluate the effectiveness of Motivational Interviewing (MI), in conjunction with diet and exercise to promote weight loss. Participants (n = 5) were Latino patients of a local community health care center who were overweight and medically at risk due to unhealthy lifestyles that were determined through a screening test.

The 4-week clinical pathway program used motivational interviewing in one-on-one sessions every other week, and implemented the “Your Heart, Your Life” curriculum the other weeks. One expected outcome included lower anthropometric measurement numbers of participants’ WL, BMI, WC, and BP. Another expected outcome was an increase in physical activity. Participants were also expected to earn a higher score on a post-test about nutrition and healthy living. A paired t-test and power analyses were used to assess its effectiveness.

Results indicated significant decrease in weight loss (t [5] = 3.68, p = .0211, Cohen’s dz=1.647). For heart healthy habits, there were significant increases all three categories: weight management (t [5] = - 3.36, p = .0211), cholesterol and fat (t [5] = - 3.138, p =.035, salt and sodium (t [5] = - 4.899, p = .008). In addition, there was an increase in knowledge (t [5] = - 4.000, p = .016). Every participant showed small gains. Future implications should include more participants, including males, a control group, innovative activities that help to motivate a community of learners and more flexibility in allotted time for interventions.

ContributorsLedesma, Nadia (Author) / Thrall, Charlotte (Thesis advisor)
Created2016-05-06
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Description

Purpose: This project examined the effectiveness of an online educational module on basic Motivational Interviewing (MI) techniques for Nurse Practitioners (NPs) providing obesity management to middle-aged women.

Background: Middle-aged women experience distinct physiological and psychosocial factors that contribute to weight gain and make obesity management especially challenging. The evidence supports the

Purpose: This project examined the effectiveness of an online educational module on basic Motivational Interviewing (MI) techniques for Nurse Practitioners (NPs) providing obesity management to middle-aged women.

Background: Middle-aged women experience distinct physiological and psychosocial factors that contribute to weight gain and make obesity management especially challenging. The evidence supports the use of motivational interviewing (MI) interventions as a highly effective approach to obesity management in combination with standard medical weight loss programs. Educating NPs that provide medical weight loss on basic MI counseling techniques is necessary to facilitate the use of this intervention.

Methods: NP providers at a group of seven medical weight loss clinics in the southwestern United States completed an online MI educational module that was developed for this project. The module content covered basic MI counseling techniques. MI knowledge was assessed using a 6-item pre/post-test. Participants completed an 8-item course evaluation to provide additional feedback.

Results: Ten of the 13 NPs eligible participated in the project. The overall response to the project was positive as demonstrated by high scores on the course evaluation. The average post-test knowledge scores increased after completion of the module, however no statistical significance was noted.

Conclusions: The basic MI education module was beneficial for NPs providing obesity management and future research should focus on developing standardized MI weight loss interventions.

ContributorsMarley, Abigail (Author)
Created2016-05-02
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Description

The maps in this chartbook describe the physical activity environment in Newark in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical activity facilities data

The maps in this chartbook describe the physical activity environment in Newark in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical activity facilities data from a commercial database (lnfoUSA, 2008), data from city departments, as well as information obtained from systematic web searches. The maps present data for the city of Newark and for a 1 mile buffer area around Newark.

• Physical activity centers include private and public facilities which offer physical activity opportunities for children 3-18 years of age.

• Physical activity environment maps are compared with Census 2000 data to visualize accessibility of physical activity opportunities in neighborhoods with different characteristics.

• Poverty level presented in this chartbook are based on the 2000 Federal Poverty Guidelines.

• Crime rates in Newark are presented at the census block group level as relative crime risk (CrimeRisk) obtained from a commercial data source (Applied Geographic Solutions, 2008). CrimeRisk - an index value derived from modeling the relationship between crime rates and demographics data - is expressed as the risk of crime occurring in a specific block group relative to the national average. For this chartbook, data on total CrimeRisk, which includes personal and property crimes, are reported.

Created2010