Essay Instructions: Health Promotion Across the Lifespan:
ESTELLA CASE STUDY (Chapter 11, page 260)
Instructions Complete the following exercises using the case study (obesity / over weight: Estella) from your textbook (faxed to you). Be prepared to discuss your findings in class.
Include the question with each of your answers. Answers must be in complete sentences and at least one to two paragraphs long.
1) Which models of Health are most applicable to Estella and his family? And Why?
2) Which Healthy People 2020 (website) Objectives are of greatest importance to Estella's family?
3) What effect do the leading Health Indicators have upon the family?
4) What preventative measures could be performed at the following levels?
5) Correlate each preventative measure to the appropriate healthy people 2020 objectives and leading health indicator (web site).
6) What cultural aspects should be considered when discussing healthy eating habits with estella and her family?
7) How do Estella's health practices influence other family members?
Excerpt From Essay:
Essay Instructions: >Business Proposal: You have been crowned the 2007 Miss Nigeria in America (MNIA) and you have chosen a platform you would undertake during your reign. MNIA, Inc. has tasked you to write a proposal on your platform that you will present to different NGOs, Grant Agencies and to the Board Members of MNIA, Inc. The budget for your proposal/plan is $10,000
>Describe in essay format the following topics (1-4):
1.Name of platform and reason why you chose to undertake it:
High Blood Pressure Awareness
**If chosen as the next Miss Nigeria in America, I would undertake “High Blood Pressure Awareness” as my platform. High-blood pressure otherwise known as hypertension is a major health problem in the United States and especially among West Africans. Not only are the risks higher, but so is the likelihood of developing it at a younger age and its severity. In order to deal with this problem, people must know the risk factors and if they do have hypertension, that they lower their blood pressure.
Many of those who have high blood pressure do not know it. This is a uniquely silent disease. There are no symptoms until it is too late; unfortunately my grandmother and my aunt fell victim to the silent killer. This challenge can be met by raising awareness in Nigerian communities and empowering them to be responsible for their health. Because high blood pressure is silent and can be treated effectively, early detection and awareness is important. Given that high blood pressure runs in my family, I have a strong personal commitment, involvement, and conviction to promote widespread awareness about high blood pressure.
2. Steps you would take to promote this platform to Nigerians/Nigerians in Diaspora
Some suggestions I had includes build visibility, but this is NOT limited. **I’m open to suggestions
The goal is to promote the fact that HBP can be prevented and controlled; people just need to be aware and willing to get checked every now and then to ensure they are within a healthy range
B. Since I live in NYC; I thought to have a statewide awareness program
C. Work to assure blood pressure screening and follow-up services for state employees
D. Promote school health programs that maintain or enhance physical education classes and offer healthful foods in cafeterias
and vending machines.
E. Provide blood pressure screening programs focused on high-risk groups; Nigerians/Nigerians in Diaspora
F. Work with health care organizations like, American Heart Association, NIH
G. Monthly Screenings available for Nigerian Organziations; provide incentives. Discount for this high-risk group with hospitals?
H. Get people involved/organizations involved: http://hp2010.nhlbihin.net/nhbpep_kit/prior.htm
3. Advice you would give the named agencies above on ways to implement your platform program.
Below are some ideas, but not limited to
A. Work with your local American Heart Association
B. Free Clinics—please include the fact that I volunteered with the Ithaca Free Clinic in Ithaca, NY. I created a hypertension brochure to hand out to patients to educate them. Also, I was trained to read patient vitals and use the automated blood pressure machine to measure patients blood pressure levels
4. Detailed/Realistic Budget outlining total cost on undertaking this platform
This must be specific (i.e. in order to promote school health care; it will cost $X because research indicates…) In terms of the layout; the budget section does not count as a “page”. This will be included as a separate page and attached at the end of the proposal.
***So, 8 pages will focus on Topics 1-3 and the 9th page will focus on topic 4--budget.
Charts, tables etc, if used do not count as a page. Please put in the appendix section of the report if necessary.
>Tone of the Proposal:
Passionate—maybe open up with the major reason why I chose this topic. It runs in my family; I lost my aunt, grandmother, and my mom has it now. So, it’s a bit personal as well. Another suggestion may be to follow up with startling statistics to really grab the reader’s attention. This must be consistent throughout the essay/proposal b/c it’s 8 pages long.
>Quotes: Yes! This may help keep the reader engaged
1. Personal history/experience with HBP
2. Directly answer 1-4 above
3. Relate/Direct proposal with the target audience of Nigerians/Nigerians in America
4. Mention the Miss Nigeria in America Oranization
5. Mention that “as the 2007 Miss Nigeria in America, I will” or something to this extent
>Additional Information I think may help or to provide guidance:
Improving Control of High Blood Pressure in Wisconsin
Wisconsin’s Cardiovascular Health Program collaborated with a statewide group of 20 HMOs and health systems, as well as other public and private health organizations, to increase the percentage of patients who have their high blood pressure controlled. Participating HMOs represented 84 percent of patients enrolled in HMOs in the state in 2000 and more than 98 percent of those enrolled in 2001 (nearly 1.5 million people). The Cardiovascular Health Program asked that the 20 participating health plans with commercial enrollees collect data on measures of cardiovascular health. Based on these data, health plans made quality improvements in blood pressure control. Among participating health plans, the percentage of patients who had their high blood pressure controlled increased from 48 percent to 58 percent—a 21 percent relative increase. http://dhfs.wisconsin.gov/Health/cardiovascular/index.htm
Promote physical activity and healthy eating habits. “Programs aimed at increasing physical activity and promoting a healthy diet are effective in lowering blood pressure and could delay or prevent the onset of high blood pressure.”
Promote early identification of high blood pressure. “High blood pressure is a well-known risk factor for heart disease and stroke that can be prevented. Early intervention through detection and treatment is a fundamental strategy for public health.”
Develop community programs. “Successful community programs should be convenient for your population and conducted in a culturally sensitive manner. Programs should be targeted to those populations who are most likely to develop high blood pressure and those with limited access to health care.”
Promote access to the health care system for all. “Less than half of your constituents diagnosed with high blood pressure have it under control. Lack of access to health care providers and medical care will lead to uncontrolled high blood pressure.”
Encourage quality improvement efforts in the health care setting. “Systems that support providers and patients in following established guidelines are needed. Quality improvement programs in the primary care, specialty care and hospital settings can transform the care that is provided to patients with high blood pressure.” Resources: Washington State Department of Health Web site— http://www.doh.wa.gov/. “The Health of Washington State High Blood Pressure”: Available at http://www.doh.wa.gov/HWS/doc/CD/CD_HBP.doc
Excerpt From Essay:
Essay Instructions: a three parargraph format paper:
paragraph 1: intro and summary of article
paragraph 2: reflection of article (what did i find most interesting)
paragraph 3: professional recommedations for to a middle school staff and classroom implematation
Adolescent Growth and Development
Author: Angela Huebner, Assistant Professor and Extension Specialist, Family and Child Development, Virginia Tech
Publication Number 350-850, posted March 2000
Adolescence is a time of many transitions both for teens and their families. To ensure that teens and adults navigate these transitions successfully, it is important for both to understand what is happening to the teen physically, cognitively, and socially; how these transitions affect teens; what adults can do; and what support resources are available. As you read the following information, keep in mind that while all teens develop, they don't all follow the same timeline.
The following is the article from website: http://www.ext.vt.edu/pubs/family/350-850/350-850.html
I. Physical Development
What Is It?
During the teen years, adolescents experience changes in their physical development at a rate of speed unparalleled since infancy. Physical development includes:
Rapid gains in height and weight. During a one-year growth spurt, boys and girls can gain an average of 4.1 inches and 3.5 inches in height respectively. This spurt typically occurs two years earlier for girls than for boys. Weight gain results from increased muscle development in boys and body fat in girls.
Development of secondary sex characteristics. During puberty, changing hormonal levels play a role in activating the development of secondary sex characteristics. These include: (1) growth of pubic hair; (2) menarche (first menstrual period for girls) or penis growth (for boys); (3) voice changes (for boys); (4) growth of underarm hair; (5) facial hair growth (for boys); and (6) increased production of oil, increased sweat gland activity, and the beginning of acne.
Continued brain development. Recent research suggests that teens' brains are not completely developed until late in adolescence. Specifically, studies suggest that the connections between neurons affecting emotional, physical and mental abilities are incomplete. This could explain why some teens seem to be inconsistent in controlling their emotions, impulses, and judgments.
How Do These Changes Affect Teens?
Teens frequently sleep longer. Research suggests that teens actually need more sleep to allow their bodies to conduct the internal work required for such rapid growth. On average, teens need about 9 1/2 hours of sleep a night.
Teens may be more clumsy because of growth spurts. If it seems to you that teens' bodies are all arms and legs then your perception is correct. During this phase of development, body parts don't all grow at the same rate. This can lead to clumsiness as the teen tries to cope with limbs that seem to have grown overnight. Teens can appear gangly and uncoordinated.
Teenage girls may become overly sensitive about their weight. This concern arises because of the rapid weight gain associated with puberty. Sixty percent of adolescent girls report that they are trying to lose weight. A small percentage of adolescent girls (1-3%) become so obsessed with their weight that they develop severe eating disorders such as anorexia nervosa or bulimia. Anorexia nervosa refers to starvation; bulimia refers to binge eating and vomiting.
Teens may be concerned because they are not physically developing at the same rate as their peers. Teens may be more developed than their peers ("early-maturers") or less developed than their peers ("late-maturers"). Being out of developmental "step" with peers is a concern to adolescents because most just want to fit in. Early maturation affects boys and girls differently. Research suggests that early maturing boys tend to be more popular with peers and hold more leadership positions. Adults often assume that early maturing boys are cognitively mature as well. This assumption can lead to false expectations about a young person's ability to take on increased responsibility. Because of their physical appearance, early maturing girls are more likely to experience pressure to become involved in dating relationships with older boys before they are emotionally ready. Early maturing girls tend to suffer more from depression, eating disorders, and anxiety.
Teens may feel awkward about demonstrating affection to the opposite sex parent. As they develop physically, teens are beginning to rethink their interactions with the opposite sex. An adolescent girl who used to hug and kiss her dad when he returned home from work may now shy away. A boy who used to kiss his mother good night may now wave to her on his way up the stairs.
Teens may ask more direct questions about sex. At this stage, adolescents are trying to figure out their sexual values. Teens often equate intimacy with sex. Rather than exploring a deep emotional attachment first, teens tend to assume that if they engage in the physical act, the emotional attachment will follow. They may ask questions about how to abstain without becoming embarrassed or about how they will know when the time is right. They may also have specific questions about methods of birth control and protection from sexually transmitted diseases.
What Can You Do?
Knowledge about what changes and behaviors during adolescence are normal can go a long way in helping both teens and adults manage the transition successfully. There are also some specific things adults can do to be supportive:
Don't criticize or compare the teens to others. Teens are already acutely self-conscious about the way they look. They don't need you to point it out to them.
Encourage teens to get enough sleep. Realize they may need an extra boost in getting out of bed for school. Try to be understanding when teens want to sleep until noon on Saturday.
Encourage and model healthy eating habits. Keep plenty of nutritious foods in the house. Remember that teens need to take in more calories to fuel their growth. Monitor eating habits accordingly.
Encourage and model physical activity. Exercise will help teens burn excess energy, strengthen developing muscles, and sleep better at night. It may also help teens become more comfortable in their changing bodies.
Provide honest answers to teens about sex. Teens are in search of knowledge on this subject. If adults do not provide accurate information, teens are forced to rely on their peers or other potentially inaccurate sources. Unfortunately, such erroneous information is often to blame when teens make poor decisions.
Be understanding of their need for physical space. Do not take it personally if your teen is not as physically affectionate as he or she was in the past. Do not force your teen to hug or kiss relatives or family friends. Maintain communication, but respect teens' need to withdraw.
Be patient with excessive grooming habits. Teens often spend large amounts of time grooming themselves and obsessing over skin care products. Often, this behavior merely reflects teens' attempts to maintain some sense of control over their rapidly changing bodies.
II. Cognitive Development:
What Is It?
Most adults recognize that teens have better thinking skills than younger youth. These advances in thinking can be divided into several areas:
Developing advanced reasoning skills. Advanced reasoning skills include the ability to think about multiple options and possibilities. It includes a more logical thought process and the ability to think about things hypothetically. It involves asking and answering the question, "what if...?".
Developing abstract thinking skills. Abstract thinking means thinking about things that cannot be seen, heard, or touched. Examples include things like faith, trust, beliefs and spirituality.
Developing the ability to think about thinking in a process known as "meta-cognition." Meta-cognition allows individuals to think about how they feel and what they are thinking. It involves being able to think about how one is perceived by others. It can also be used to develop strategies, also known as mnemonic devices, for improving learning. Remembering the notes on the lines of a music staff (e, g, b, d, and f) through the phrase "every good boy does fine" is an example of such a mnemonic device.
How Do These Changes Affect Teens?
Teens demonstrate a heightened level of self-consciousness. Teens tend to believe that everyone is as concerned with their thoughts and behaviors as they are. This leads teens to believe that they have an "imaginary audience" of people who are always watching them.
Teens tend to believe that no one else has ever experienced similar feelings and emotions. They may become overly dramatic in describing things that are upsetting to them. They may say things like "You'll never understand," or "My life is ruined!"
Teens tend to exhibit the "it can't happen to me" syndrome also known as a "personal fable." This belief causes teens to take unnecessary risks like drinking and driving ("I won't crash this car"), having unprotected sex (I can't possibly get pregnant), or smoking (I can't possibly get cancer").
Teens tend to become very cause-oriented. Their activism is related to the ability to think about abstract concepts. After reading about cruelty to animals a teen may become a vegetarian and a member of "People for the Ethical Treatment of Animals" (P.E.T.A.). Another teen may become active in "Green Peace" or "Save the Whales" campaigns.
Teens tend to exhibit a "justice" orientation. They are quick to point out inconsistencies between adults' words and their actions. They have difficulty seeing shades of gray. They see little room for error.
What Can You Do?
Don't take it personally when teens discount your experience. Try to empathize with and listen to their concerns. Enlist the help of a slightly older sibling or friend to give good advice to the teen if needed.
Get teens involved in discussing their behavioral rules and consequences. Teens should take a more active role in determining how they should behave. Their advanced reasoning skills make it easier for them to generate realistic consequences for their actions. Listen to their ideas!
Provide opportunities for teens to participate in controlled risky behavior. Get teens involved in properly supervised extreme sports, such as parachuting, or rock climbing. Such activities will allow teens opportunities to play out their "it can't happen to me" mentality in an environment that won't be deadly if they fail.
Provide opportunities for teens to get involved in community service. Teens want to become active in things that have deeper meaning. Suggest they volunteer at a homeless shelter, walk dogs for the animal shelter, or take meals to the elderly. Talk with them about their experiences.
Talk to teens about their views and be open to discussing your own. Find out what they think about news stories on television or in the paper; ask them about their political and spiritual beliefs. Teens are already thinking about these things so give them a non-threatening forum for discussing them.
Try to build a genuine relationship with your teen. Let them know what you were like as a teen. Talk to them about your mistakes and vulnerabilities. Try to understand their feelings and express yours so you can be understood.
III. Psycho-Social Development
What Is It?
There are five recognized psychosocial issues that teens deal with during their adolescent years. These include:
Establishing an identity. This has been called one of the most important tasks of adolescents. The question of "who am I" is not one that teens think about at a conscious level. Instead, over the course of the adolescent years, teens begin to integrate the opinions of influential others (e.g. parents, other caring adults, friends, etc.) into their own likes and dislikes. The eventual outcome is people who have a clear sense of their values and beliefs, occupational goals, and relationship expectations. People with secure identities know where they fit (or where they don't want to fit) in their world.
Establishing autonomy. Some people assume that autonomy refers to becoming completely independent from others. They equate it with teen "rebellion." Rather than severing relationships, however, establishing autonomy during the teen years really means becoming an independent and self-governing person within relationships. Autonomous teens have gained the ability to make and follow through with their own decisions, live by their own set of principles of right and wrong, and have become less emotionally dependent on parents. Autonomy is a necessary achievement if the teen is to become self-sufficient in society.
Establishing intimacy. Many people, including teens, equate intimacy with sex. In fact, intimacy and sex are not the same. Intimacy is usually first learned within the context of same-sex friendships, then utilized in romantic relationships. Intimacy refers to close relationships in which people are open, honest, caring and trusting. Friendships provide the first setting in which young people can practice their social skills with those who are their equals. It is with friends that teens learn how to begin, maintain, and terminate relationships, practice social skills, and become intimate.
Becoming comfortable with one's sexuality. The teen years mark the first time that young people are both physically mature enough to reproduce and cognitively advanced enough to think about it. Given this, the teen years are the prime time for the development of sexuality. How teens are educated about and exposed to sexuality will largely determine whether or not they develop a healthy sexual identity. More than half of most high school students report being sexually active. Many experts agree that the mixed messages teens receive about sexuality contribute to problems such as teen pregnancy and sexually transmitted diseases.
Achievement. Our society tends to foster and value attitudes of competition and success. Because of cognitive advances, the teen years are a time when young people can begin to see the relationship between their current abilities and plans and their future vocational aspirations. They need to figure out what their achievement preferences are-what they are currently good at and areas in which they are willing to strive for success.
How Do These Changes Affect Teens?
Teens begin to spend more time with their friends than their families. It is within friendship groups that teens can develop and practice social skills. Teens are quick to point out to each other which behaviors are acceptable and which are not. It is important to remember that even though teens are spending increased amounts of time with their friends, they still tend to conform to parental ideals when it comes to decisions about values, education, and long-term plans.
Teens may have more questions about sexuality. They may ask about adults' values and beliefs. They may ask how you knew it was time to have sex or why you waited.
Teens may begin to keep a journal. Part of achieving identity is thinking about one's thoughts and feelings. Teens often begin journaling as a way of working through how they feel.
When they are in their rooms, teens may begin to lock their bedroom doors. Locking doors is a way to establish privacy. As long as teens continue to interact with the family, locked doors are usually nothing to worry about.
Teens may become involved in multiple hobbies or clubs. In an attempt to find out what they are good at, teens may try many activities. Teens' interests also change quickly. Today they are into yoga, and tomorrow they are into soccer.
Teens may become elusive about where they are going or with whom. When asked what they'll be doing for the evening, teens typically reply with "nothing" or "hanging out." When asked whom they'll be with, teens reply, "just some friends."
Teens may become more argumentative. Teens may question adults' values and judgments. When teens don't get their way, they may say, "you just don't understand."
Teens may not want to be seen with parents in public. They may make parents drop them off a block from their friends' houses or from school.
Teens may begin to interact with parents as people. Even though they may not want to be seen with parents in public, teens may begin to view parents more as people. They may ask more questions about how a parent was when he or she was a teen. They may attempt to interact with adults more as equals.
What Can You Do?
Encourage involvement in multiple groups or activities both within school and after-school. Realize that teens are trying to gain a sense of achievement-a sense of being uniquely good at something. Don't get frustrated if they frequently change their minds. At the same time, encourage them to stick with a project or activity long enough to establish some skills.
Praise teens for their efforts as well as their abilities. This will help teens to stick with activities instead of giving up if they are not immediately successful.
Help teens explore career goals and options. Take teens to work so they can see what adults do. Set up opportunities for them to "job shadow" others. Ask them questions about their future career goals. Remember that figuring out what they don't want to do is just as important as figuring out what they like!
Give teens an opportunity to establish their behavioral guidelines and consequences. Allow teens to have input into curfew and other family rules. Their advanced cognitive skills coupled with their need for autonomy makes this a perfect time for them to provide suggestions and to demonstrate responsibility for their own behavior.
Establish rituals to mark significant passages. Few rituals in our modern society mark the passage of teens to adulthood. Have a mother-daughter luncheon when the daughter gets her first period. Have a father-son outing when the son begins to shave. Have a family celebration when the teen moves from junior high to high school. Celebrate the teen's first driver's license and his or her ability to vote.
Be aware of who your teens' friends are and what they are doing. Such parental monitoring should not end when youth enter their teen years. Despite teens' objections, make sure you know who their friends are and where they are going. Meet the parents of teens' friends. Provide fun things to do at home to encourage teens to "hang out" at your house so you'll know where they are and what they are doing.
Continue to provide a structured environment. Teens should be allowed to have more independence, but not enough to place them in jeopardy. Despite their complaints, teens rely on adults to provide them with the sense of safety and structure they need to deal effectively with all the psychosocial tasks of adolescents.
Brownlee, B. (1999). Inside the Teen Brain, U.S. News & World Report, August 9, 1999.
Center for Disease Control. (1997). Youth Risk Behavior Survey.
Hayward, C., Killen, J., Wilson, D., & Hammer, L. (1997). Psychiatric risk associated with early puberty in adolescent girls. Journal of the American Academy of Child & Adolescent Psychiatry, 36(2), 255-262.
Steinberg, L. (1999). Adolescence (5th Edition). McGraw-Hill.
Walsh, T., & Devlin, M. (1998). Eating Disorders: Progress and Problems. Science, 280, 1387-1390.
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