Introduction

Public health is of paramount importance for ensuring that communities have appropriate access to health care and receive sufficient attention from care providers at various levels. While nurses offer direct services to people in need, ARNPs should be more focused on improving neighborhoods and assisting underserved families. The goal of this paper is to examine the case of a teenage female and her grandmother, who need help in overcoming obesity while living in a disadvantaged area. Furthermore, the paper discusses primary and secondary interventions that can be implemented by an ARNP as well as additional resources.

Problem Identification: Risks

In this case, it is possible to single out a range of risk factors that can lead a person to wrong choices, such as disregarding health problems, the onset of psychological issues, and criminal activity. First, a 15-yer-old girl suffers from obesity since her body mass index (BMI) is 40: it is considered that a person is obese when her or his BMI is higher than 30. Second, this health problem is complicated by the fact that the girl has no pediatrician, while the only caregiver is her grandmother. This means that the patient faces a lack of attention and behavioral examples, taking into account that she has never seen her father. Third, the suggestion of the nurse who wanted to talk about dieting and exercising with the parents seems to meet barriers. The area the family lives in is unsafe, which is an environmental risk factor.

Primary and Secondary Levels of Intervention

Primary prevention implies that diseases can be addressed before they occur by means of changing behaviors and avoiding exposure to hazards. In this case, the team of nurses that is to be led by the ARNP should employ the strategy of educating patients. Namely, the plan for increasing awareness of the teenage girl and her grandmother should be developed (Seburg, Olson-Bullis, Bredeson, Hayes, & Sherwood, 2015).

It is important to make it clear that nutrition plays one of the key roles in reducing one’s weight. A diet plan with preferred products and drinks needs to be composed and, most critically, explained to the family since they should understand the value of this intervention. Exercising is another area that is to be discussed with the family, which is especially important as outdoor activities are not safe (Seburg et al., 2015). The opportunities for group exercising or visiting special sports facilities can be identified.

Another intervention that can be considered by the ARNP is the review and analysis of the area the family lives in with regard to public health. The emotional and psychological risks related to this neighborhood should be revealed to design corresponding interventions, thus improving the safety and contributing to the possibility of doing sports near one’s home (Molina et al., 2017). By referring to the County Health Department, it seems to be important to discuss building a new sports facility. As a result, these interventions would help in altering unhealthy behaviors and preventing associated disorders, such as cardiovascular issues, misconduct, and personality problems. The collaboration between different team members along with the involvement of local organizations is likely to lead to the best outcomes possible.

Secondary prevention is beneficial to facilitate the disease and general tension of the situation in the given case. According to Hoelscher et al. (2015), childhood obesity prevention requires a family-centered approach, where weekly sessions son the role of nutrition and exercising are essential. In addition, the guided active play and interactive skill development sessions were proved to be beneficial as evidence-based secondary prevention interventions. The group activity can be offered in case it is possible to engage the extended family with uncles, aunts, cousins, et cetera, which would promote socialization of the girl (Jurkowski, Lawson, Mills, Wilner, & Davison, 2014). In other words, such an approach would be useful to show the patient that she is not alone with her problems.

Evidence-based cooking classes and receipts can be provided separately to the grandmother, and the easier version – to the patient. More to the point, the work of the ARNP should be directed towards liking this family with the community resources, including churches, social services, and non-health-related community services. Booklets and brochures about the options presented in the County can serve as an impetus for changing their lifestyles. In general, the efforts of the team should be focused on preventing complications associated with a lack of parents, excessive weight, and a medically underserved status.

Additional Resources

The ecomap offered in the case study allows considering the use of a variety of resources that should be individualized to the needs of the girl. School and friends compose, perhaps, the most promising resource since teenagers are strongly dependent on public opinion and feel better when they have friends (Brown, Halvorson, Cohen, Lazorick, & Skelton, 2015). The team should assess the relationships between the girl and her classmates to understand the directions for development. Among other factors of community, one can identify non-health-related community services, such as volunteering, participation in various events, or visiting music lessons.

The local groups should be contacted by the prevention team to learn about community services for teenagers and older adults. The grandmother should also be engaged in the community services to give help others or receive it from other people.

Social services and utility services compose another source for enhancing the health and overall well-being of the girl. Considering that she has no insurance, health care access becomes critical, and public utilities can be used for exercising. The low income of this family also limits their opportunities for recovery, while social services can help them with food, housing, and coping with other social struggles (Morgan et al., 2016). As for a church as a way to facilitate emotional tension, this option should be suggested with caution. Before advising it, the nurses should make sure that the family is religious and that the recommended church meets their needs.

Conclusion

To conclude, this paper discussed the case of a teenage girl and her grandmother, facing such problems as the child’s obesity, low income, a lack of insurance, and an unsafe area of living. Education regarding the importance of nutrition and exercising as well as the collaboration with the County Health Department were proposed as primary prevention interventions. Furthermore, guided activities, cooking lessons, and extended family meetings composed secondary prevention opportunities. Additional aid was discussed in terms of community resources, including social and utility services, school and friends, and church. It is expected that a set of the suggested evidence-based interventions would help the family to enhance their lifestyles.

References

Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015). Addressing childhood obesity: Opportunities for prevention. Pediatric Clinics, 62(5), 1241-1261.

Hoelscher, D. M., Butte, N. F., Barlow, S., Vandewater, E. A., Sharma, S. V., Huang, T.,… Oluyomi, A. O. (2015). Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Childhood Obesity, 11(1), 71-91.

Jurkowski, J. M., Lawson, H. A., Mills, L. L. G., Wilner III, P. G., & Davison, K. K. (2014). The empowerment of low-income parents engaged in a childhood obesity intervention. Family & Community Health, 37(2), 104-118.

Molina, Y., Glassgow, A. E., Kim, S. J., Berrios, N. M., Pauls, H., Watson, K. S.,… Calhoun, E. A. (2017). Patient navigation in medically underserved areas study design: A trial with implications for efficacy, effect modification, and full continuum assessment. Contemporary Clinical Trials, 53, 29-35.

Morgan, P. J., Jones, R. A., Collins, C. E., Hesketh, K. D., Young, M. D., Burrows, T. L.,… Brennan, L. (2016). Practicalities and research considerations for conducting childhood obesity prevention interventions with families. Children, 3(4), 24-40.

Seburg, E. M., Olson-Bullis, B. A., Bredeson, D. M., Hayes, M. G., & Sherwood, N. E. (2015). A review of primary care-based childhood obesity prevention and treatment interventions. Current Obesity Reports, 4(2), 157-173.