Reducing Obesity in Rural Eastern North Carolina

My capstone project was inspired by clinical rotations I had in rural communities and by the Service Learning Trip I took in spring 2011 to Tyrrell County, NC. I experienced firsthand how obesity is affecting people in rural communities and how the lack of resources hinders their efforts to fight obesity. Last semester in the Evidence Based Practice II course, my PICO question was whether having free health fairs in small towns better than providing patient education materials at local medical clinics at increasing physical activity to reduce obesity. EBP II Evidence Table

From my literature review, I found that patient education was a major factor in reducing obesity through lifestyle modification. I became very interested in finding real solutions to the obesity epidemic that is affecting so many communities in our state. I decided upon an educational module with the target audience of therapists in Wayne and Sampson counties (where I had two of my clinical rotations). There are three products within my capstone project: power point presentation to clinicians, obesity resource booklet for clinicians, and patient handout.

• Power Point Presentation: This presentation will be given on April 17^th, 2012 at Wayne Memorial Hospital and April 18^th, 2012 at Sampson Regional Medical Center. Presentation highlights include: defining obesity, prevention, treatment, management, and local obesity resources. My goal in giving these two presentations is to educate clinicians how to effectively treat patients who are overweight or obese. I plan to emphasize physical therapists as a “first line of defense” for obese treatment and prevention. Obesity in Sampson County Obesity in Wayne County

• Obesity Resource Booklet: I created two resource booklets to keep at each hospital for clinicians to use as needed in the future. The booklet is divided into three sections: physical activity, nutrition, and outcome measures. The exercise section includes specific recommendations from ACSM and the CDC as well as exercise logs that therapists can make copies of for patients. There is also information on how to motivate the overweight and obese patient so they adhere to their exercise program. Finally, there is information and resources specific to each county (wellness facilities, public parks, and public programs). The nutrition section also includes specific recommendations from the CDC and ChooseMyPlate.Gov. Additionally there are specific diet plans and recipes for therapists to make copies of for their patients as needed. Three outcome measures are included in the outcome measure section: Healthy Eating Index-2005, Impact of Weight on Quality of Life-Lite, and International Physical Activity Questionnaire. Each outcome measure has a sheet with the background information, psychometric properties, clinical relevance, and relevance to the obese patient. My purpose for including these outcome measures was to make therapists aware of available measures for use with appropriate patients.

• Patient Handout:  I created educational handouts for clinicians to give to overweight or obese patients as they see appropriate. Patient handout materials were made at a 2^nd grade reading level after discussing the patient population with a committee member (who works as a clinician in Sampson County). After conducting a health literacy review and listening to the voicethread about patient materials, I included simple terminology and appropriate images. Highlights of the brochure include starting an exercise program, proper nutrition, and local resources. Patient Handout-Sampson CountyPatient Handout-Wayne County

The evaluation component of my capstone will consist of a self evaluation form and presentation evaluation form, both of which I created specific to my capstone. Staff (PTs, PTAs, OTs, OTAs) at both hospitals will complete the evaluation form after I give the presentation. I will report the results of this evaluation after I give the presentations next week. Evaluation of Capstone Presentation

Thank you for visiting my capstone website! I will upload pictures from my presentations after I give them next week.

*Update: I presented my capstone at both hospitals and received excellent feedback from both locations. Numerous physical therapists told me how relevant the topic was and they plan to talk to patients about their weight in the future. Out of 21 evaluation forms, I received “excellent” remarks for all 5 questions on all 21 forms.