Promoting Healthy Lifestyle Program - Essay Example

Project and Evaluation Plan Promoting healthy lifestyle program: Obese women in the indigenous community in Australia Table of Contents Contents Contents 2 List of Terms & Abbreviations ACHP - Australian Centre for Health Promotion BMI - Body Mass Index AIHPN - Australian Indigenous Health Promotion Network CHF – Children’s Health Funds NSW – New South Wales WHA – Women’s Health Advocate 1. Introduction 1.1 Agency Women’s Health Advocates1 or WHA is an agency providing health-education materials about nutrition, physical activity, and weight management for women in rural communities. These include providing health educational materials to obese women and their family who are members of Australia’s indigenous community. 1.2 Target Group The specific target group of this project are overweight or obese women in Australia’s indigenous community. Since this project believes that health lifestyle promotion for obese women is more effective if excess weight gain is prevented during childhood, the secondary target group are young female family members. 1.3 Project Outline WHA develops and supports a small network of programs and working with other government agencies to facilitate and realized their mission in the remote areas of New South Wales and Queensland where more than half of Australia’s Indigenous population lives. The 2004-2005 survey of National Aboriginal and Torres Strait Islander suggest that obesity for children, men, and women is increasing in the Indigenous community. Data shows that 57% (Aboriginal) and 61% (Islanders) of the overall population are obese and most of them are women from age 15 and older (Thomson, 2006, p.2). For the above reason, WHA was asked to work on a project that would reduce the obesity problem in the target population. WHA intends to create two teams that would cover both locations at the same time. They will work with the local media and other key stakeholders to ensure that health messages reach the target population as well as monitoring the progress effectively. Budget for the staff will provided by Australian Centre for Health Promotion and the Australian Indigenous Health Promotion Network. These include infrastructure and financial support for the following WHA personnel: 20 Full-time health promotion workers Staff development and training including basic language course Development and distribution of health promotion materials Independent evaluators 1.4 Project Team The overall Team Manager selected from WHA’s roster of experienced health promotion workers will head the project. He will be also responsible for coordinating with ACHP, the WHA Board of Directors, and the AIHPN. Second to the rank are the two project Team Leaders who will lead their respective team in NSW and Queensland. 2. Background 2.1 Target Group Prevalence of overweight and obesity in Australia is widespread in children and adults (2010, p.117). Moreover, in a study conducted about heights and weights for Indigenous and non-Indigenous adults aged 18 years and over, the prevalence of obesity is higher among Indigenous adults. Most Aboriginal and Torres Strait Islanders are overweight while women are becoming obese. Particularly in remote or rural areas, overweight and obesity problems by 5% from 1995 to 2001 and to about 10 percent in 2005. In a recent study conducted in 2009 of Aboriginal and Torres Strait Islander, women from 15 to 34 years of age in North Queensland had central obesity (Wahlquist 2011, p.39). According to Johnson & Stoskopf (2010), Aboriginal and Torres Strait Islanders die younger than other Australians do while the gap between indigenous and non-indigenous health levels is significant and alarming. For instance, the indigenous community’s hospitalization for dialysis is 17 times more that non-indigenous Australians. Similarly, the rate for endocrine, nutritional, and metabolic diseases is four times higher than non-indigenous (p.199). Indigenous Australian women are more likely to be overweight or obese and in fact, in year 2004 alone, obesity rate among them doubled from 8% to 20% (Reynolds 2004, p.206). 2.2 Needs and Issues Obesity is highest among the indigenous population particularly in regions with low socioeconomic conditions (Ostman 2004, p.42). According to Goyen (2004), the health of indigenous Australians is one of the biggest health problems in Australia today since their death rates are much higher and illnesses such as cardiovascular disease, hypertension, respiratory, diabetes, and others are widespread in these communities. More importantly, they have higher incidence of obesity due to financial constraints leading to poor nutrition (p.20). Indigenous people are mostly socioeconomically disadvantage thus having the worst health among Australians. They have greater rates of unemployment, lower education levels, and have lower life expectancies (Cockerham 2004, p.437). Psychosocial pathways such as stress, social support, social cohesion, social affiliations, and early emotional development and social status increase the effects of these socioeconomic factors (Pairman et al, p.778). Consequently, indigenous women in particular are becoming increasingly vulnerable to obesity-related health problems such as android obesity leading to non-insulin dependent diabetes, hypertension, and coronary heart disease (O’Connor & Kovacs 2003, p.81). In summary, issues involving obesity and the target group are as follows: Poor social and economic conditions brought about by unemployment Low education levels Lack of knowledge about health and benefits of healthy diet Too much reliance on external support and welfare 2.3 Assets and strengths The Australian Indigenous community diets and health were optimal until they were colonized. They have excellent physical strength, stamina, quick, and agile since hunter-gatherers are usually fit, lean, and do not suffer from any diet-related chronic disease. The nutrient-dense diet of hunter-gatherer enables them to have nutritional body requirements to prevent diabetes (Dunning 2006, p.272). However, when these people abandoned their hunter-gatherer way of life and adopted a westernized way of living, their health level suffers considerably. Study shows that absence of knowledge, money, and healthy food choices often lead the indigenous eat more unhealthy food rich in carbohydrates, fat, and alcohol. In contrast, reverting to traditional hunter-gatherer life and diets improved their pre-diabetic metabolism (McMichael 1993, p.93). Development programs to facilitate nutritious and healthy eating among indigenous people has been shown to be very successful in North American thus development of similar programs for Australia’s indigenous community are likely to reduce the incidence of obesity and subsequent diabetes. The success factors of this program are convenience, education, reliability, motivation, feedback and fun thus to be considered in planning and implementing future programs (Fletcher 1994, p.44). 2.4 Rationale of the Project The prevalence of obesity among women in the indigenous community and its subsequent serious health effects provide the strong rationale for the development of specific, culturally appropriate project to intervene and modify the indigenous present lifestyle. The rationale for this project is based on the following: Obesity is a preventable condition (Hammaker & Tomlinson 2010, p.221) Sedentary lifestyle is responsible for obesity and subsequent health problems thus encouraging indigenous people revert to traditional foods, healthy eating, and exercise is a logical approach (Stidsen 2007, p.58). Reducing prevalence of obesity generally requires stabilizing population weight levels and this will be more effective if excess weight gain is prevented from childhood onward through awareness of the importance of healthy diet and physical activity (O’Dea & Eriksen 2010, p.348). The capacity of women in indigenous community to handle their Therefore, the project intend to: Promote of healthy diet and exercise through distribution of informational and educational materials Encourage the community particularly women to be vigilant about their weight at safe level Make it clear the serious consequences of obesity through Identify local resources and empower women about their health and well-being 3. Project Plan 3.1 Project Aim The aim of this project is reduce the prevalence of obesity of women in Australia’s indigenous community by promoting healthy lifestyle, diet, and exercise. These include health promotion for young female members of the community who are vulnerable to obesity in their older age. The long-term outcome of this aim is significant reduction of obesity and its health implications in the near future. 3.2 Objectives and Strategies/Activities The objectives and strategies have been carefully studied to ensure that they are clear, easy to understand, monitor, and evaluate. The purpose is to enable other projects to replicate the initiative in similar future endeavour. 3.2.1 First Objective and Strategies Develop an effective relationship between agencies involved in community building and health promotion in Australia’s Indigenous population. The strategies include: Creation of WHA Board of Directors to review, implements, monitors, and evaluates the progress of the project. Select community development workers particularly those that are well experienced in the area of health promotion, familiar with culture and language of the indigenous, and objective in their approach to community services. Create a separate team for New South Wales and Queensland’s indigenous community Select a Team Manager to handle and monitor both teams’ needs and progress Select Team Leaders for NSW and Queensland working group that will be responsible for direct implementation and coordination. The above strategies were developed in line with the need and issues of the target group. The partnership with the Australian Centre for Health Promotion and the Australian Indigenous Health Promotion Network is to ensure availability of knowledge, infrastructure, and financial support for the program. As with previous health promotion and disease prevention programs in cooperation with researchers, consumers, and representatives of the food industry (Ostman 2004, p.42), partnership with ACHP and AIHPN can make the same cooperation possible. Moreover, successful programs about obesity in Australia, United States, Singapore, and others often include several components working together such as doctors and nurses in primary care, family, school, and leaders of the community who ACHP and AIHPN can easily identify and contacted for the purpose. 3.2.2 Second Objective Educate entire WHA members and staff about the needs of the target group and issues involved in project implementation. The strategies therefore should include: Presentation of facts about obesity and related problems in the indigenous community to WHA members and staff using statistical data and previous program experiences. Discussing the goals and objectives of the project Clarifying the role of each members and staff in the project including ethical and cultural issues involved in the actual health promotion. Discussing the strength and limitations of the project Discussing the levels of expectations and performance indicators The rationale for these strategies is based on the idea that well-informed stakeholders in a project intended for long-term outcomes are an advantage. This is because full understanding of the project as well as the nature of intervention can effectively boost staff caring and compassionate attitude toward obese participants (Goldstein 2005, p.353). 3.2.3 Third Objective Develop appropriate health promotion materials that can effectively encourage indigenous women and children to take on a healthy lifestyle To achieve this objective, the strategies will need the full cooperation of all stakeholders particularly members that will be assigned to research and progress monitoring. The works for this objective include: Research and analysis of various literatures about obesity and its serious health consequences. Analysis and evaluation of previous health promotion programs and extraction of best practices Determine program requirements and evaluate availability of sources Planning and design of informational materials The rationale for these strategies were taken from studies suggesting that obesity prevention through educational materials about healthy diet and weight gain prevention is more effective than obesity treatment (Crawford et al. 2010, p.216). Therefore, promotional materials must be well design and appropriate to the target group. 3.2.4 Fourth Objective Educate and encourage women of indigenous community to engage in healthy diet and lifestyle. Strategies for this objective are as follows: Coordinate program to local stakeholders and develop informational campaign suited in specific indigenous community. Conduct preliminary meeting with members of the community and determine procedures to avoid ethical and cultural issues such as discrimination and women’s rights. The rationale for these strategies is associated with the third objective since well-designed educational materials will be useless if no coordination have done on those that will be affected by the program. 3.2.5 Fifth Objective Empower women of the indigenous community to monitor their progress and use their knowledge and resources to sustain a healthy lifestyle. Strategies required to achieve this objective include: Educate and encourage women and children of the indigenous community to participate actively in healthy lifestyle and monitor their own progress. Ensure sustainability of health lifestyle by providing women with access information and knowledge of available support for their needs. Empowerment is always an important component of community development thus the program must ensure that the target group is empowered and able to access and use local resources to achieve the long-term goals of the project (Garde 2010, p.166). 3.3 Performance indicators Reduction of obesity is the long-term goal of this project thus medium term changes should reflect the following outcomes. Women and children have sufficient access to healthy foods Increased physical activity and exercise Lower occurrence of obesity related diseases Reduced weight for most women The details of this output indicators can be found in the Service Delivery Plan in Appendix 1. 3.4 Timeline and Implementation Plan There are four major activities in this project as shown in Table 1 below and the Gantt Chart provided in Appendix 2. Activities Specific Work Required Time Allocated 1. Establishment of project needs and requirements Research on obesity and serious health consequences Determination of project requirements and available resources Creation of WHA Board of Directors Select community development workers services. Selection of team members for New South Wales and Queensland Selection of Team Manager and Team Leaders November 21 to December 19,2011 2. Development and Implementation of the project Presentation of facts about obesity and related problems in the indigenous community to WHA members and staff. Clarifying goals and expectations Establishing the role of each members and staff Identifying strength and limitations of the project Establishing expectation and performance levels Planning & design of informational materials Coordinate program to local stakeholders Conduct preliminary meeting with the community December 26 to January 23, 2012 3. Monitoring and Adjustment Educate and encourage women and children to be active and monitor their own progress. Provide access information and knowledge of available support for their needs. February 1 to March 1, 2012 4. Evaluation of the project Conduct project evaluation Findings and recommendations Plan and take course of action September 3 to October 29, 2012 3.5 Ethical Issues Australia’s Equal Opportunity Act 1984 provided remedies on issues concerning discrimination on the grounds of sex, marital status, pregnancy, race, religious conviction, and others. However, Australia’s department of social justice policy does not yet provide for discrimination against those who are obese (Haynes 1998, p.71). It is thus a challenge to develop and implement programs that are both scientific and culturally sensitive to ethical community concerns. Since obesity has no guiding law, it is very important to develop and implement interventions that address the problem in an atmosphere of respect and collaboration (Trimble & Fisher 2006, p.151). Informed Consent The most appropriate move in this case is securing informed consent from those that will be affected by the project. This strategy is very important in terms of ethics and legal issues since women of the indigenous community are not obliged by law to slim down and measure their success using weighing scales, tape measure or BMI (Monaghan 2008, p.187). Confidentiality There is no risk in confidentiality of the participants since the project is a health promotion or informational campaign that does require personal data or public presentation of individuals. Respect As mentioned earlier, the project should work in an environment of respect and collaboration thus its information materials as well as those who would disseminate this information respect the cultural diversity of the indigenous. 3.6 Monitoring and Evaluation Plan Since both ACHP and AIHPN is funding and providing infrastructure for this project, it is the responsibility of WHA to inform them about the progress and outcome of the program for obese women in the indigenous community. For this reason, WHA will conduct impact evaluation to determine the outcome achieved. The WHA Board of Directors will act as an assessment body who will decide on the information gathered from quantitative and qualitative data collection. Data collection includes interviews, open-ended surveys, observation, and statistical data based on output indicators. The key questions for this evaluation are as follows: Is the project being implemented according to agreed plan and procedures? Are there any flaws or areas not covered by the program? What is the level of outcome and achievement during the evaluation? Is there any improvement from previous outcome? Is the beneficiary satisfied with the way the project is implemented? What are the issues? Is the project sustainable based on current information and trend? Are the benefits proportionate to the cost of the project? Are there any changes to be made on the program? What are they? Monitoring is an on-going process thus, data collection will continue on a monthly basis to ensure currency of data for evaluation and assessment of the WHA Board. The information will be distributed to all stakeholders particularly the funding body who made this project possible. 4. Appendices 4.1 Appendix 1 WHA Project - Service Delivery Plan Aim: To reduce prevalence of women obesity in the indigenous population Objective Strategies Performance Indicators Establishment of project needs and requirements Research on obesity and serious health consequences Determination of project requirements and available resources Creation of WHA Board of Directors Select community development workers services. Selection of team members for New South Wales and Queensland Selection of Team Manager and Team Leaders Documented information about obesity and associated disease List of complete requirements and resources WHA Board established 20 workers/Team manager/Team leaders selected Development and Implementation of the project Presentation of facts about obesity and related problems in the indigenous community to WHA members and staff. Clarifying goals and expectations Establishing the role of each members and staff Identifying strength and limitations of the project Establishing expectation and performance levels Planning & design of informational materials Coordinate program to local stakeholders Conduct preliminary meeting with the community Meeting is conducted and informational materials designed Monitoring and Adjustment Educate and encourage women and children to be active and monitor their own progress. Provide access information and knowledge of available support for their needs. -Number of participants - Reduce prevalence of obesity - Use of information for self-management Evaluation of the project Conduct project evaluation Findings and recommendations Plan and take course of action Results are presented to the WHA board Recommendations are made and action taken 4.2 Appendix 2 Activities Month/Year 11/11 12/11 1/12 2/12 3/12 4/12 5/12 6/12 7/12 8/12 9/12 10/12 Establishment of project needs and requirements Development and Implementation of the project Monitoring and Adjustment Evaluation of the project 5. 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