Health Improvement Plan

1. Health Improvement Plan Client Analysis – Hailey Cablao

2. Client Overview • Pseudonym: Kimmie • Age: 55 • Weight: 145 lbs • Height: 5’5” • Profession: Business Manager • Family Situation: Lives at home with husband and two kids • Goals and Major Complaints: Wants to lose ten pounds, stomach pain after eating certain foods

3. Overview of Health History • Child Illness: Chicken Pox (age 10), German Measles (around age 10) • Prescriptions: Omeprazol for Hiatal Hernia • Other: Family has a history of developing gastrointestinal problems • Brother and Mother – Diverticulitis • Grandfather – Colon Cancer • Father – Type Two Diabetes

4. Research • Article One – To help decrease the patient’s risk of developing cancer • This study was done in order to determine if an increased intake in red meat would increase a person’s chances of developing certain types of cancers. Research had been done before and had concluded that things like obesity and smoking could increase a person’s risk of developing lung cancer, esophageal cancer, etc. The results showed that those people who were in the highest quintile (5th percentile) had an increased risk of developing colorectal and lung cancer. The findings also supported the idea that increased intake of red meat can increase a person’s risk of getting esophageal and/or liver cancer. Despite this, many of the participants were ‘non-Hispanic White’ people, so there is room for speculation in the event that these findings may, also, be driven by genetic factors or lifestyle factors. • Leitzmann, M., Gail, M., Hollenback, A., Shatzkin, A., & Sinha, R. (2007, December 11). A Prospective Study of Red and Processed Meat Intake in Relation to Cancer Risk. <i></i>. Retrieved May 28, 2014, from http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040325 • Article Two – To Decrease the patient’s risk of developing type two diabetes • This study was conducted in order to decipher whether weight loss would help decrease the risk of patients developing type two diabetes. Although susceptibility to type two diabetes can be hereditary, many times it is developed because of lifestyle factors and/or excess weight. The intervention involved setting goals for target weight and minimum requirements for the daily amount of physical activity each person would aim to do. The patients had meetings in order to discuss success, diets, and activity plans over the course of three years. Many of the people who met their weight goal continued to keep the lost weight off. The study concluded that, in fact, the decrease in weight did help to decrease the risk of type two diabetes in the patients. • White, M., Lindström, J., Blaak, E., Eriksson, J., Feskens, E., Ilanne-Parikka, P., et al. (2013, February 25). Importance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes: Analysis of European Diabetes Prevention Study RCT. . Retrieved May 29, 2014, from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057143#abstract0

5. Research Cont. • Article Three – To inform the patient about type two diabetes and her risk for developing it • This article helps to solidify the fact that, to achieve a better lifestyle and prevent type two diabetes, people must have a healthy diet and participate regularly in physical activity. Like the article states, 80 – 90 percent of people with type two diabetes are obese. Since my patient’s family has had a pervious history of developing diabetes, she should be pushed to try and prevent that by eating right and getting, a minimum, of 30 minutes of physical activity every day. • A Codependent Relationship: Diabetes & Obesity. (n.d.). . Retrieved May 30, 2014, from http://www.diabeticcareservices.com/diabetes-education/diabetes-and-obesity • Article Four – To give the patient ideas on how to prevent type two diabetes by changing their diet • This article explains that making a change to your diet can significantly decrease your risk of developing type two diabetes. This article also explains how to change your diet to be one that is based off of carbohydrate. By controlling the amount of carbs you take in, you can control your blood sugar. This Article will help give my patient ideas on how to change her diet without sacrificing all of the foods that she loves. • A Healthy Type 2 Diabetes Diet. (n.d.). <i></i>. Retrieved May 29, 2014, from http://www.webmd.com/diabetes/guide/eating-right

6. Target Behavior • Weight Loss: • The patient hopes to lose ten pounds over the next three weeks.

7. Theory – HBM • High Perceived Susceptibility: The patient is highly at risk for developing type two diabetes, since her family has a history of the disease. • Moderate Perceived Severity: The patient knows that her family history puts her at risk, but has put off making any habit changes. She understands that continuing her current behavior will, also, put her more at risk for developing other conditions that are more serious. However, since she is not quite overweight, she has decided to wait to make any changes to her lifestyle. • Perceived Benefits: The patient knows that taking action will not only prevent her chances of developing diabetes, but improve her energy levels andquality of life as well. Despite the fact that it may be easier in the short to continue to eat an excess amount of sugars and fat, she understands that making this change will be better for her health in the future. • High Self-Efficacy: The patient is very willing to make change, however, she may need a few reminders in order to stay on track for the first week or so.

8. Smart Goal • Patient has set a goal to lose ten pounds over the next three weeks to hit her target weight of 135 lbs. She will do this by making changes to her diet, by eating more vegetables, salad, soup, etc. and cutting down on fat intake. In addition to this, she will spend more time getting exercise and physical activity in order to help her lose the weight and improve her lifestyle. This physical activity will include walking as well as horseback riding. She will measure success by how much weight she loses; she will know that she has achieved her goal when she has reached her set target weight.

9. Intervention Highlights • Patient has lost five pounds and is working to lose the rest of the weight on her own time, even after this project has finished.

10. Results • Patient continued to gradually lose weight after the first week of her behavior change • Patient has noticed a visible change in her energy levels since beginning the behavior change • Patient was very willing to take advice and make the change, so their improvement went well

11. Professional Analysis • By implementing the Health Belief Model, the behavior change went very smoothly, using the HBM helped give structure to this project and helped to guide the patient in the right direction in terms of making a positive change • Using the Health Belief Model worked the best in terms of explaining information and giving recommendations, and the patient responded well to it. • The hardest part of the intervention process was finding times for the patient to come in, often times, the patient would have outside conflicts and couldn’t come in as often as she needed to.

12. References • A Codependent Relationship: Diabetes & Obesity. (n.d.). . Retrieved May 30, 2014, from http://www.diabeticcareservices.com/diabetes-education/diabetes-and-obesity • A Healthy Type 2 Diabetes Diet. (n.d.). <i></i>. Retrieved May 29, 2014, from http://www.webmd.com/diabetes/guide/eating-right • Leitzmann, M., Gail, M., Hollenback, A., Shatzkin, A., & Sinha, R. (2007, December 11). A Prospective Study of Red and Processed Meat Intake in Relation to Cancer Risk. <i></i>. Retrieved May 28, 2014, from http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040325 • White, M., Lindström, J., Blaak, E., Eriksson, J., Feskens, E., Ilanne-Parikka, P., et al. (2013, February 25). Importance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes: Analysis of European Diabetes Prevention Study RCT. . Retrieved May 29, 2014, from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057143#abstract0