Community Health and Population Focused Nursing Field Experience

The identified community health diagnosis discovered during my windshield survey for Manatee County, Florida is an increased risk for obesity for adults and older adults related to poor nutrition, availability of fast food and lack of physical activity demonstrated by an above average obesity rate in Manatee County by assessing available data, nutritional and activity related resources and services.

Currently the adult obesity rate is 28.4% which is an increase from 18.4% in the year 2000. My target population will be adults aged 26-44 with an average obesity rate of 29.0% and adults aged 45-64 with an average obesity rate of 34.0% (“State Briefs,” n.d.).  While these numbers are slightly lower than the national average of 39.8% recorded by the CDC (“Adult Obesity Facts | Overweight & Obesity | CDC,” 2018), they are higher than the average in the State of Florida of 26% (“Manatee County, Florida,” n.d.).

Health Inequity/Disparity

My focus area of the City of Bradenton Florida resides in the Western most portion of Manatee County. Settled in 1842, it consists of 14.44 square miles. Bradenton is considered a “seasonal area” with a large influx of retired part-time residents during the winter months. In addition to this seasonal increase in population, it is also home to a large number of un-documented (illegal) immigrant residents. The documented population of Manatee County is approximately 385,500 residents (“U.S. Census Bureau QuickFacts,” n.d.-b). The population of the City of Bradenton is roughly 56,500 (“U.S. Census Bureau QuickFacts,” n.d.-a). Some sources are reporting as many as 25,000 undocumented residents are also residing in The City of Bradenton (“The Social Contract A Report from Florida – The bad news is that almost all the news is bad,” n.d.). 

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The median income of Bradenton is $41,093. It is reported that 76.4% of residents are white, 19.3% are Black or African American and 16.3% are Hispanic. It is also reported that 17.3% of the population is living below the poverty line (“U.S. Census Bureau QuickFacts,” n.d.-a). These figures do not include either the seasonal or undocumented population.

Obesity is linked to several health conditions such as heart disease, stroke and diabetes. It is also shown to be more prevalent in certain groups. Hispanics and non-Hispanic blacks are the groups most affected by obesity according the CDC’s latest information (“Adult Obesity Facts | Overweight & Obesity | CDC,” 2018). Middle aged people are also affected more by obesity than other age groups. Our large number of un-documented residents do not have the same capability to access available resources. When we take into consideration the ease and availability of, and the low cost of fast food/junk food the chances of making poor nutrition choices increases. Sedentary lifestyle and lack of activity are also contributing factors to the increased obesity rates that we are seeing.

Primary community and Prevention Resources

In spite of the numerous resources that are available in The City of Bradenton, obesity continues to be a major issue.

Bradenton is home to several Farmers Markets that provide a wide variety of fresh fruits and vegetables, organic products and fresh meats. The “Red Barn” has a minimum of five fresh produce stands, many that cater to the Hispanic population. There are 10 supermarkets or grocery stores ranging from higher end Fresh Markets and Publix to more discount stores such as Bravo, Aldi and Save – A – Lots. Some stores such as Bravo are ethnically based and provide a wider variety of ethnic food choices.

 In addition to the availability of fresh healthy foods, Bradenton is home to several opportunities for physical activity. Numerous gyms and fitness centers are located throughout the city with fees ranging from $10 a month at Crunch or Planet Fitness to $25 a month at the County operated GT Bray Recreational facility to $50 a month at LA Fitness. For those who cannot afford a gym membership the City of Bradenton also offers 16 free community parks located throughout the city. These range from standard parks with children’s playgrounds and sports courts, to skate parks and also include several nature preserves and walking trails.

Traditional programs such as EBT/SNAP (food stamps) and WIC are available for lower income families seeking assistance. For those with emergent needs, there are 2 soup kitchens and 2 food banks as well. The Manatee County food bank offers emergency resources, a mobile produce pantry and participates in a program that feeds school aged children in the summer months called “Sack Summer Hunger”.

The Free Public Library also has a wealth of information on healthy lifestyles. Books on healthy eating, weight control, diets, physical activity and overall wellness are available. They also periodically offer healthy cooking classes and yoga classes. Online information and classes are also available to the public for free when accessed through the library.

Underlying Causes

There are several underlying causes that may attribute to increased obesity. We have touched upon how access to available resources such as EBT/SNAP and WIC could be a problem for a large portion of Bradenton’s un-documented population. This could also affect those with limited transportation as they would not be able to get to the local Department of Health offices. People who do not have the resources to obtain internet access would be affected as well, as much of the information provided is found and needs to be filled out online. The availability and low cost of non-nutritious junk and fast food makes poor food choices easy to make. Our culture of sedentary lifestyles also contributes to increased obesity. 

Evidence-Based Practice/(B2a) Identification of Data

Healthy People 2020 states that health status can be directly related to diet and body weight. Heart disease, high blood pressure, type II diabetes and stroke are just a few diseases that are associated with obesity (“Nutrition and Weight Status | Healthy People 2020,” n.d.). I was surprised to find that the State of Florida is 35^th in the nation with a 28.4% obesity rate for adults. This has more than doubled since 1990 when the rate was 11.4% (“State Briefs,” n.d.). In addition to the health risks associated with obesity, we must take into consideration economic factors, loss of productivity, and premature disability and mortality that are linked to obesity. The Center for Disease Control reports that the estimated care cost on a national level to treat and provide care for obesity related illness exceeds 147 billion dollars (“Adult Obesity Facts | Overweight & Obesity | CDC,” 2018).

Social Media Campaign Objective

I would like my social media campaign to focus on using online goal setting, group chats, and monitoring tools to promote healthier diet choices and life style changes for adults in my community.

Social Marketing Interventions

The first social marketing intervention that I would like to create would be a community based Facebook Group that promotes healthy diet choices. It would include resources to healthy recipes, places to purchase fresh fruits and vegetables, restaurants providing healthy food options and provide a group forum for people to communicate their ideas and share their successful healthy diet changes. The second would be a YouTube video showing simple and everyday ways that people can increase their activity levels to help promote a healthy lifestyle.

Description of Social Media Platform

The social media platforms that I would like to use are Facebook and YouTube. These two platforms are of particular interest for several reasons. They both reach a large number of people in our target population. They are an effective and inexpensive way to provide information to the public regardless of age, race or economic status. The can be accessed on multiple devices, and can be viewed at all hours of the day so that scheduling is not an issue. They fit into our society’s modern age of utilizing electronics in most facets of everyday life.

Benefits of Social Media Platform

The benefits of using social media outlets such as Facebook and YouTube include vast amount of people that will have access to the information that we would like to provide. Facebook posts and YouTube videos can be shared across the Community, the State and the Nation. The low cost and maintenance of the information provided is another benefit. Once the framework for the Community group is created, updating dating information can be done on an as needed basis. New or updated information can be added with a few clicks of a button. Settings can be made public or private so that the person managing the group can monitor the participants and discussions. YouTube videos are easy to create and upload. YouTube also offers “channels” that allow people to search by topic. Including the video on a health and wellness channel would increase exposure. The YouTube video can be marketed on its own, or could also be used in conjunction with Facebook and be shared with our target population using multiple media outlets. 

Benefit to Target Population

The benefits to the target population include a free, simple and easy way to access new information on healthy diet, food choices and healthy lifestyles. This can prompt new ideas, excitement and motivate a person to make a healthy life style change. The formats that we have chosen also allow a sense of group participation for those who choose to participate in the discussion forums on Facebook or allow privacy for those who wish to receive the information on a more individual basis. Our formats also allow for the information to be accessed at a person’s leisure thus increasing the chances that it would be viewed by our target population.

Best Practices for Social Media

Best practices associated with our social media campaign include setting realistic goals. Information should be honest and true. Our campaign should be brief, to the point and be specific to our target population. Too much information or non-essential data can clutter our message and lose the interest of our target audience. Including color and interesting design will help to catch people’s attention and help to draw them into viewing our material. Time is important to people, so an honest, to the point and visually appealing message is our goal (“5 Best Practices for Effective Social Media Marketing in 2018,” n.d.).

Stakeholder Roles and Responsibilities

I would be the ultimate stakeholder for this social media campaign. The responsibility of creating, maintaining, updating and monitoring would fall with me. Should the campaign take off and grow, I could delegate some of these roles to others should they wish to participate in a greater role at a later date.

Potential Public and Private Partnerships

There is the opportunity for many local partnerships. These include local farmers markets or fresh markets for produce availability, restaurants for healthy recipes, employers for healthy lifestyle incentives, local gyms or recreational programs for activity incentives. This would be win/win situation as the information that they could provide would enhance our campaign and the businesses would receive exposure.

Timeline

This campaign could potentially start within a week. Creating the Facebook page would be relatively quick and easy and is at no cost. The YouTube video could be prepared within a day and be published. Getting the information out to the public should be a quick process. Our goal would be to get the information shared with as many people as possible. Our initial target would be members of local community groups, local high school and college alumni groups, senior groups and recreational groups. As the campaign progresses we could attract more businesses for their contributions to enhance our offerings.

Evaluation

I would take advantage of many online tools that are available to evaluate the effectiveness of the campaign. There are many free survey sites such as surveymonkey.com, zoho.com and surveyhero.com that allow for custom surveys to be created. Many have ready to use templates available to guide the process. This will show us where we are doing well, and the areas that could use improvement. We can also track the number of views of both the Facebook page and YouTube video, this would give us an idea of how many people each form of media is reaching. Both formats also allow for comments or posts that will be monitored for feedback, allowing us to address individual comments directly.

Cost of Implementing the Campaign

One the best things about using social media for this campaign is that for the most part, it is either low cost or free. Both platforms that we have chosen are free to use. At this time both Facebook and YouTube are only charging for companies to place ads. Since we are not planning on using this format of advertising, our costs would remain zero. This is also a bonus for our business contributors who will receive free exposure for their services or products.

Reflection on Social Media Marketing

Our campaign would promote a healthier population by providing free and easy to access education in a fun and modern way. In today’s technology savvy world, using social media is smart and effective method to reach a large number of people. The more people that we can reach with our campaign, the better chance we have at helping people to make healthy life choices that will ultimately help to create a healthier population as a whole.  

Reflection on Future Nursing Practice

By participating in this campaign, we as nurses have touched upon another avenue to provide patient education. Being aware that there are these types of social media available allows us to recommend using this format for patients that prefer this form of communication. Explanation and demonstration are great ways to provide information. Giving patients resources that they can use once on their own gives them the opportunity to continue the education process at their own time and pace. 

References

• 5 Best Practices for Effective Social Media Marketing in 2018. (n.d.). Retrieved December 11, 2018, from https://www.business2community.com/social-media/5-best-practices-effective-social-media-marketing-2018-02010960
• Adult Obesity Facts | Overweight & Obesity | CDC. (2018, August 14). Retrieved November 7, 2018, from https://www.cdc.gov/obesity/data/adult.html
• Manatee County, Florida. (n.d.). Retrieved October 18, 2018, from http://www.countyhealthrankings.org/app
• Nutrition and Weight Status | Healthy People 2020. (n.d.). Retrieved December 11, 2018, from https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status
• State Briefs. (n.d.). Retrieved November 7, 2018, from https://stateofobesity.org/states/
• The Social Contract A Report from Florida – The bad news is that almost all the news is bad. (n.d.). Retrieved October 29, 2018, from https://www.thesocialcontract.com/artman2/publish/tsc_21_4/tsc_21_4_gemma_printer.shtml
• U.S. Census Bureau QuickFacts: Bradenton city, Florida. (n.d.-a). Retrieved October 30, 2018, from https://www.census.gov/quickfacts/fact/table/bradentoncityflorida/PST045217
• U.S. Census Bureau QuickFacts: Manatee County, Florida. (n.d.-b). Retrieved October 29, 2018, from https://www.census.gov/quickfacts/manateecountyflorida