6030 Assessment 4; IMPLEMENTATION PLAN DESIGN
Implementation Plan Design
October 16, 2021
Implementation Plan Design
Part 1: Management and Leadership
Strategies for Leading, Managing, and Implementing Professional Nursing Practices
The project proposes community-based approaches in schools and at home to address the problem of adolescent obesity among school-going children and adolescents in a Pediatric Outpatient hospital that treats toddlers to 18 years old. The intervention entails strategic approaches such as healthy eating, physical activity habits, improved community obesity awareness to manage and prevent adolescent obesity. This intervention will involve several participants, some of which come from outside the healthcare settings, thereby requiring an interprofessional collaboration to facilitate the process of delivering the intervention. When the interprofessional teams work together in this professional practice, healthcare outcomes will significantly improve (Sangaleti et a., 2017). The interdisciplinary team responsible for the delivery of the objectives proposed in this intervention incorporate facility nurses, nutritionists, physiotherapists, and school representatives.
According to Bell et al. (2018) coordination, communication, and collaboration are vital during when implementing the intervention across the diverse disciplines regardless of the variance in professional norms, skills, and specialized languages that exist within the interprofessional teams. The team aspects allow the establishment of positive relationships among team members, promoting continuity of care and enhanced patient outcomes (Hustoft et a., 2019).
When implementing the intervention, the interprofessional team will must explore and deliberate on the existing research regarding the most desirable foods, physical activity, lifestyle adjustments, awareness about obesity, and changing the environment to suit weight management goals. This team will also review the current evidence that supports the effectiveness of the intervention in preventing and managing adolescent obesity.
The interdisciplinary team members will be assigned roles for which they are qualified and specialize in making sure that the intervention is delivered optimally. Further, the interdisciplinary team will have to agree on how they will evaluate the success of the approaches to determine whether the intervention affects weight management to deal with the issue of adolescent obesity. In this case, things like monthly weigh-ins will showcase whether one has been gaining, or losing, or maintaining weight. To deliver the intervention, the interprofessional team will employ the Self-Regulated Behavioral Change (SRBC) framework to help children and adolescents manage their weights. When applying the SRBC model, the interprofessional team members should begin by reflecting and assist the study participants to reflect on opposing weight management objectives like the desire to consume sweetened food products and the need for maintaining a healthy body weight (Keller et al., 2019).
Once the interprofessional team acquires such information, they can guide the participating to select an appropriate strategic approach to address the competing desires contributing to adolescent obesity. After implementing the strategic approaches, participants will require directions on evaluating, maintaining, and controlling the temptations. In the awareness or education section of the intervention, the interprofessional team will have to prepare printed training materials that can be easily comprehended by children and adolescents, as well as their parents. The main strategic approaches for delivering the proposed intervention are: interacting with adolescents and children, with obesity, providing education about measures to manage their weights, and guide them through the entire intervention process.
ALSO READ: Nursing Essay Writing Help
The Implications of Change
The proposed intervention targets toddlers to 18 years, old children and adolescents. Notably, children and adolescents are at high risk of obesity because of the decreased physical activity, making obesity prevention and management an important issue that must be solved to prevent future health complications and conditions like diabetes and cardiovascular problems (Sommer & Twig, 2018). In children and adolescents, the main factors that cause obesity are a sedentary lifestyle and reduced or inadequate physical activity. The main implication includes instilling behavioral modifications in children, adolescents, and their parents and awareness about the impact of unhealthy meals that can lead to obesity. The adolescents will be expected to shift their eating habits from eating unhealthy foods, like sweetened food products, junk foods, and high calorie-rich meals, to eating healthy foods that entail whole grains, fruits, and greens. Again, children are expected to establish the capability to choose healthy food products, with proper information regarding the effects of unhealthy food products.
This intervention is also expected to change adolescents' and childrens' point of view of sedentary lifestyles like watching television for extended periods and playing computer games that require them to sit for extended hours. Instead, children and adolescents are anticipated to adopt appropriate physical activity as a way body weight reduction. Further, parents and the community are also expected to create a healthy environment where the sale of unhealthy foods is discouraged and consuming healthy foods is encouraged, including having proper infrastructures that promote physical activity. Such lifestyle modifications will have significant impact on children, adolescents, and their parents or guardians. It is important to note that parents or guardians are the individuals mostly involved in food preparation for the children and adolescents. The parents and guardians need to adjust their food choices and lifestyle to support their children's goals in managing their weight.
“Part 2: Delivery and Technology”
Appropriate Delivery Methods to Implement the Intervention
The proposed intervention will be delivered in a Pediatric Outpatient facility setting that treats toddlers to 18 years, old adolescents. In this setting, the interdisciplinary team will interact directly with participants to initiate the change. This intervention may constitute a community health education that employs a multiplicity. Teaching methods include lectures, demonstrations, practicing what is taught, field visits and trips, or readiness to adopt the change (Mahaffey, 2018). This intervention will employ the first three methods, that is, lecture, demonstrations, and practice. The school nurse will work with parents and the facility’s nurses to identify the children and adolescents that qualify to be included in the project. The selection of obese adolescents and children will be grounded on the standard definitions of obesity, as stated by Skinner et al. (2018), “overweight as ≥85th percentile for age‐ and sex‐specific BMI; class I obesity as ≥95th percentile; class II obesity as ≥120 of the 95th percentile, or BMI ≥35; and class III obesity as ≥140% of the 95th percentile, or BMI ≥40.” Informed consent will be acquired from the parents or guardians of the selected adolescents and children before participating in the project. The intervention team will provide lectures to children, adolescents, and their parents on the causes and impacts of obesity. The participants (children and adolescents) will be required to reflect on their individual opposing goals. Further, the nutritionists and physiotherapists will teach the participants appropriate measures of managing their weights through appropriate dieting and adequate physical activity. Typically, printed materials stuck on walls will accompany these lectures, and they will show the causes, impacts, and how obesity can be managed. Further, the interprofessional team will illustrate what encompasses a healthy meal and appropriate physical activity. In the practicing step, the facility’s nurses, nutritionists, and physiotherapists will assist the participants in choosing healthy foods, performing adequate physical activities, adjusting their lifestyles, modify the environment. The proposed intervention will comprise four sessions per week. these sessions will be marked by weigh-ins, diet and activities review, evaluation of progress and behaviors, deliberation of problems encountered during the implementation, solving problems, and goal-setting sessions. At the end of every session, participants will be given the opportunity to ask questions that will require responses from the project team. The children and adolescents will then participate in training sports, fun game competitions, and suitable fitness exercises.
The Current and Emerging Technological Options
Various technological equipment can provide alternative ways of delivery. The first emerging technology is videoconferencing. Even though constant face-to-face meetings effectively manage weight, they tend to be inconvenient for healthcare practitioners. Videoconferencing will ensure virtual meetings and eliminate the demand for healthcare professionals managing the intervention to be present at the points where the intervention is taking place (Forman et al., 2016). The participants will receive weight management education via videoconferencing in their classrooms or homes. The other emerging technology is the use of exergames that combines physical exercise with fun games, making physical activity more appealing for students. The components of exergames like virtual reality and augmented reality establish an illusion of interaction with the virtual world, motivating children to participate. Most important, text messages can be utilized to provide personalized feedback to parents and their children on goal attain, reminders, and tips on weight loss, and the children and adolescents can utilize mobile phones to ask personal questions concerning their body weight (Kozak et al., 2017).
“Part 3: Stakeholders, Policy, and Regulations”
Analysis of Stakeholders and Regulatory Implications
The stakeholders in this project include government institutions like the Center for Disease Control and Prevention (CDC), adolescents and children and their parents, healthcare practitioners, teachers, and school administrators. In the US, schools are directed to ensure that students eat healthy foods through lunch programs. The “Healthy Hunger-Free Kids Act (HHFKA) of 2010” recommend that school lunch programs should increase the portions of whole grains, fruits, and vegetables and limit calory intake (Hecht et al., 2020). As a result, schools can also act as facilitators and help children and adolescents select healthy food choices. Additionally, the CDC encourages the parents or guardians to participate in their children’s healthy eating habits by doing away with calorie-rich temptations, decrease the sedentary hours, advocate for appropriate physical activities, cut on sweetened food products, and offer adequate whole grain meals, fruits, and vegetables, including awareness about the effects of unhealthy foods (CDC, 2021). In this intervention, the major stakeholders are the children and adolescents and their parents, schools, and the community.
Existing or New Policy Considerations
This project will involve school-going children and adolescents. Since the participants are adolescents and children with little knowledge about infringement of their rights, informed consent will be obtained from the parents of the selected participants before the intervention can be applied. This intervention will consider the policy that requires the protection of patients’ health information as required by The Health Insurance Portability and Accountability Act of 1996 (HIPAA) (HIPAA, 2021). Again, when reporting the intervention, the names of the participants and their families be made confidential, and only authorized persons who will close the deal with the participants will be allowed access. Since this project requires human participants, the Institutional Review Board’s (IRB) approval must be sought.
“Part 4: Timeline”
This proposed intervention will run for four continuous months. Managing obesity comprises weight loss, healthy eating habits, lifestyle changes, knowledge about obesity awareness, and environmental modifications. All these concepts will entail behavioral changes, which may take some time to achieve. Again, since children and adolescents have minimal self-regulation capabilities, they might experience challenges while sustaining the newly instilled habits. For example, children and adolescents often face the temptation of consuming snacks, sugary food products, and junk foods often work against weight management goals. This intervention will entail four weeks of training and physical activity, preceded by two months of maintaining weight.
References
Bell, S. T., Brown, S. G., Colaneri, A., & Outland, N. (2018). Team composition and the ABCs of teamwork. American Psychologist, 73(4), 349.
Centers for Disease Control and Prevention. (2021). Help Children Maintain Healthy Weight. https://www.cdc.gov/healthyweight/children/.
Forman, E. M., Evans, B. C., Flack, D., & Goldstein, S. P. (2016). Could technology help us tackle the obesity crisis?
Hecht, A. A., Pollack Porter, K. M., & Turner, L. (2020). Impact of the Community Eligibility Provision of the Healthy, Hunger-Free Kids Act on student nutrition, behavior, and academic outcomes: 2011–2019. American journal of public health, 110(9), 1405-1410.
HIPAA. (2021). Official 2021 HIPAA Compliance Checklist. Retrieved 16 October 2021, from https://www.hipaajournal.com/hipaa-compliance-checklist/.
Hustoft, M., Biringer, E., Gjesdal, S., Moen, V. P., Aβmus, J., & Hetlevik, Ø. (2019). The effect of team collaboration and continuity of care on health and disability among rehabilitation patients: a longitudinal survey-based study from western Norway. Quality of Life Research, 28(10), 2773-2785.
Keller, A., Eisen, C., & Hanss, D. (2019). Lessons learned from applications of the stage model of self-regulated behavioral change: A review. Frontiers in psychology, 10, 1091.
Kozak, A. T., Buscemi, J., Hawkins, M. A., Wang, M. L., Breland, J. Y., Ross, K. M., & Kommu, A. (2017). Technology-based interventions for weight management: current randomized controlled trial evidence and future directions. Journal of behavioral medicine, 40(1), 99-111.
Mahaffey, A. L. (2018). Interfacing virtual and face-to-face teaching methods in an undergraduate human physiology course for health professions students. Advances in physiology education, 42(3), 477-481.
Sangaleti, C., Schveitzer, M. C., Peduzzi, M., Zoboli, E. L. C. P., & Soares, C. B. (2017). Experiences and shared meaning of teamwork and interprofessional collaboration among health care professionals in primary health care settings: a systematic review. JBI Evidence Synthesis, 15(11), 2723-2788.
Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3).
Sommer, A., & Twig, G. (2018). The impact of childhood and adolescent obesity on cardiovascular risk in adulthood: a systematic review. Current diabetes reports, 18(10), 1-6.
