Health Issues

1.This case scenario represents Alice and her son Travis. The first health issue this family can be the morbid obesity. Alice weighs over 200 lb, and is morbidly obese and along with that her son is also overweight and is on the doorstep of obesity. The second health issue of the family is the extremely sedentary lifestyle that they follow. The third health issue of the family is the lack of any health promotional behaviors; the family does not feel the need to adapt any healthy living strategy or a regular fitness regime. The fourth health issue with the case is the depression and loneliness that propel her to binge eating, especially fried food; despite being repeatedly instructed by the gynecologist, Alice does not recognize the need for change in the life style. Lastly, the fifth health issue that has been discovered includes lack of any health literacy

2.The first strategy for the family should be a standard physical exercise regime for both the mother and the child. It has to be understood that for a family that has never been introduced to the concept of physical exercise or any fitness program, the regimen for this family should begin with light and least tiresome exercises and slowly build their tolerance towards heavier  and tiring exercises (Hawkes et al., 2015).

The second strategy should focus on a strict diet plan based on low fat and high protein and energy to help both the mother and the child control their weight and get ahead of the morbid obesity.

The third strategy is to enhance the positive health awareness of the family, which can be attempted with the help of the different group and one to one counseling sessions that will benefit the patient with understanding the impact of obesity and how it can  complicate her pregnancy along with the health of her unborn child (Gillman & Ludwig, 2013).

The fourth strategy can be to refer the patient to a maternal and child health nurse so that Alice can focus on the health issues of her son Travis and the unborn child; how to reduce their weight and keep them healthy (Blomberg, 2013).

3.Primary prevention strategy: 

Primary prevention is a measure that stops a disease or health adversity before it can manifest. In this case the morbid obesity puts the family at risk for diabetes and cardiovascular diseases. The two strategies to prevent the onset are:

• Strict diet plan to be followed that is rich in fiber, protein and antioxidants will help maintain the blood sugar.
• Regular and frequent monitoring the blood sugar levels to recognize the early signs of the disease (Lutsiv et al., 2015).

Strategies to Improve Health

Secondary prevention: 

The secondary prevention is associated with reducing the impact of the disease that has already manifested. Here the family exhibit signs of morbid obesity indicating the fact that the secondary prevention strategies must focus on the reducing the impacts of that condition.

• A very common aftermath of obesity is the cardiac complications, having a low fat diet and regular exercising will help reduce the possibility of the obesity leading to cardiac complications (Hawkes et al., 2015).
• Frequent and periodic blood cholesterol monitoring will help reduce the risk of arterial blockage.

Tertiary prevention: 

Tertiary prevention softens the impacts of the disease that will have lasting effects. As the family has been dealing with obesity, there are two lasting effects: body image alteration and social isolation.

• Psychosocial intervention like counseling or CBT will help the family get a positive understanding of body image change and obesity.
• For the social isolation for appearance ad sedentary lifestyle, group therapies and workshops can help the patient as well (Gillman & Ludwig, 2013).  

4.The most impactful model that can be used in this context is the theory of reasoned action coined by Ajzen and Fishbane (Ajzen, 2012). This model attempts to change health behavior based on the reasoned action of the patients. This theory is based on human behavior facilitated by attitude, intention and perceptions. Along with that, for implementing any planned change in her behavior and attitude towards health, her perception and idea of a healthy lifestyle requires to be changed based on reasoned action. In this case, Alice lacked better understanding of a healthier lifestyle. However, with reasonable facts and figures, her attitude and perception of health can be altered or improved. This change in perception can in turn help her take responsible and reasonable actions regarding her family’s and her own health.

5.Among the 4 overarching goals, the first goal, “Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death” can relate to the family’s condition effectively. Morbid obesity not only decreases the quality of life but can also lead to many preventable diseases like type 2 diabetes, cardiac diseases, renal diseases and hypertension. According to the second goal, “Achieve health equity, eliminate disparities, and improve the health of all groups”, Alice should be treated equally and her health needs should be prioritized without any disparity (Asian, 2014). According to the third goal, “Create social and physical environments that promote good health for all”, the psychosocial and physical impact of obesity should be identified and empowering ideologies regarding her body image should be identified. According to the fourth goal, “Promote quality of life, healthy development, and healthy behaviors across all life stages”, it is again a highly applicable goal for Alice and her family. It has to be understood that it is crucial for her to identify the need for healthy behavior and healthy development, and continue acting on the mentioned behaviors to promote a quality and healthy life for herself and her children (Asian, 2014). 

References: 

Ajzen, I. (2012). Martin Fishbein’s legacy: The reasoned action approach. The Annals of the American Academy of Political and Social Science, 640(1), 11-27.

Asian, P. I. (2014). HEALTHY PEOPLE 2020. Community/Public Health Nursing Practice-E-Book: Health for Families and Populations, 41, 192.

Blomberg, M. (2013). Maternal obesity, mode of delivery, and neonatal outcome. Obstetrics & Gynecology, 122(1), 50-55.

Gillman, M. W., & Ludwig, D. S. (2013). How early should obesity prevention start?. New England Journal of Medicine, 369(23), 2173-2175.

Hawkes, C., Smith, T. G., Jewell, J., Wardle, J., Hammond, R. A., Friel, S., … & Kain, J. (2015). Smart food policies for obesity prevention. The Lancet, 385(9985), 2410-2421.

Lutsiv, O., Mah, J., Beyene, J., & McDonald, S. D. (2015). The effects of morbid obesity on maternal and neonatal health outcomes: a systematic review and meta?analyses. Obesity reviews, 16(7), 531-546.