RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Public Perceptions Regarding Adult Obesity and Treatment Options in Gold Beach, OR Project Date: 9/7/2009 Obesity is a nationwide problem associated with many well-known effects on physical and emotional health. Gold Beach is a small, coastal community in the southern portion of Curry County, OR. It is not currently known what options exist regarding obesity in this rural area, and what local public perceptions are regarding both the problem of obesity and the treatment options available. This qualitative project was designed to explore regional views on obesity and therapies available both from patients and physicians in the area. These were conducted via personal interviews with many members of the community. In addition, a literature search was performed to explore evidence-based data available on other treatment options that have been explored. Results showed many areas of frustration with diet and exercise, as well as success with mainly surgical therapies. Interestingly, many behavioral and group therapies had not been tried in this smaller community. Based on the perceptions gathered from patients in Gold Beach, failures and successes reported, and the literature search performed, recommendations to help physicians and patients achieve weight loss outside of medical and surgical management were created. Burns's Biggest Loser: A real world program of education, increased physical activity and healthy food choices to lose weight. Project Date: 9/8/2008 There is an epidemic of obesity across the United States including small communities like Burns, Oregon. One method to counteract obesity includes increasing activity and decreasing food intake. Members of the community of Burns desired a program to lose weight that incorporated health diet advice and physical activity suggestions. They also wanted a program that was fun, motivating and offered social support in their efforts to lose weight. Thus, a program to lose weight was developed that centered around making healthy food choices with portion control, increasing daily physical activity using a team competition approach. Additionally, the participants were offered education on the risks of obesity and methods to recognize and counteract barriers to physical activity as well as education in goal setting. This comprehensive program was implemented and the participants were followed for the first week which resulted in an average weight loss of just less than two pounds per participant. Putting the brakes on diabetes in Eugene, Oregon by putting the facts in a patient's hands: Development of a handout incorporating diabetes risk assessment and prevention strategies. Project Date: 7/2/2007 Diabetes Mellitus has grown into one of the nation's largest health concerns for the new millennium. Because of its insidious effects on the arteries of many organs, diabetes has a significant morbidity and mortality. The cost of treating diabetes also has a significant impact on healthcare and the economy. Dr. Larry Hirons, a family physician in downtown Eugene, Oregon, has watched many of his patients develop diabetes. He is always counseling his patients concerning weight loss and exercise, but would like a more specific tool to help patients realize their risk for developing diabetes, why they do not want to become diabetic, and how they can avoid diabetes. The prevalence of obesity in patients presenting to Dr. Hirons was observed, as well as his interaction with patients motivating them to lose weight and avoid becoming diabetic. A literature search was performed to identify a tool for diabetes risk assessment as well as studies showing effective risk reduction strategies. A handout was designed using the information from the literature search and the effectiveness of this handout was assessed by patient and physician interviews. Weight loss interventions in Astoria, OR: development of a patient resource guide to connect patients with weight loss resources in the community. Project Date: 8/7/2006 With over 60% of Americans classified as overweight or obese, a significant portion of our population continues to share an elevated risk for obesity related conditions such as diabetes, hypertension, coronary artery disease, arthritis and sleep apnea. Through this project, I hoped to identify ways in which physicians could support their patients who are trying to lose weight. Exploring this question involved observing how my preceptor in Astoria discussed weight loss with her patients. I then created a list of simple, cost effective ways a family physician could support weight loss among a patient population. An interview was conducted with my preceptor and her practice partner to learn how willing they would be to implement various weight loss interventions. I spent one morning at Curves, a chain fitness center that offers circuit training and is attended mostly by women. Willing participants were interviewed regarding weight loss and how doctors could support weight loss efforts. Interviewees were also asked to evaluate how helpful it would be if their doctors implemented various specific weight loss interventions. Of the many interventions suggested, patients and doctors were most excited about the availability of a booklet that presented information on local resources for weight management. Therefore, the project culminated in the creation of "Health Knocks: A Resource Guide to Weight Management in Astoria, OR". This tool will help physicians to connect patients with weight loss resources n the community. Food For Your Heart: Socioeconomic status and the prevalence of chronic medical conditions Project Date: 2/13/2006 Diet and exercise are lifestyle components that have long been known as a means to non-pharmacologically manage chronic medical illnesses such as hypertension, diabetes mellitus and hyperlipidemia. However, there appears to be significant knowledge gaps among certain patients. There is a need for succinct and practical nutrition education geared towards a diverse patient population that includes those with limited incomes. This prompted the question regarding the association of socioeconomic status (SES) and the prevalence of chronic medical conditions. A chart review was done on 50 patients at the Scappoose clinic comparing the prevalence of HTN, DM and hyperlipidemia among patients with private insurance compared to patients with lower SES, as measured by participation in Medicaid programs (OHP, OMAP). The scope of this study was quite limited and did not demonstrate an association between SES and these chronic conditions. However, this research question can be better answered if a larger general population was studied and more specific SES parameters such as income data and level of education are used. Based on the information and knowledge gaps identified from patient interviews, an education brochure was created for distribution at the clinic that included dietary recommendations, practical diet tips and money-saving strategies. It will hopefully serve as a useful tool to counsel patients on more optimal diet management of their chronic diseases. Weight Loss Support Group Project Date: 3/21/2005 Obesity has become one of the most problematic medical conditions currently faced in the United States as well as Oregon. Obesity raises the risk of morbidity from several life threatening conditions, however that risk may be reduced with weight loss. The purpose of this study is to improve the effectiveness of treating obesity in the setting of the Rinehart Clinic in Wheeler, Oregon. Observation of a family practitioner and patient interviews were the primary sources of patient information about dieting effectiveness and patient resources. A diet plan which included educational materials was readily available in the clinic, but no further information or support source was identified in this community. Evidence exists that social support dramatically increases the amount of weight loss as well as the ability to keep weight off. Therefore, a weekly weight loss support group was established as a social support network for patients trying to lose weight. You Are What You Eat! Project Date: 9/13/2004 My community project was aimed at educating teen athletes about eating healthy diets to maximize their success in sports and to maintain their health. I picked this topic because all teens that want to play school sports must get a sports physical before they can participate in the sports. This allows physicians a good opportunity to educate the athletes before they start to train. The second reason that I decided to educate teens about a healthy diet is because it may be confusing for teens. I was also hoping to educate the teens about eating disorders so that they may recognize the signs and seek help if needed. Lastly, I wanted to educate teens about nutrition because for them, this is the time to develop proper eating habits that will serve as a foundation for healthy eating as an adult. I decided that the best way to educate teen athletes was by making an informative flyer that could easily be handed out at their sports physical. In this flyer, I provide information about main things to consider with respect to diet as an athlete, helpful eating habit hints, pre and post game eating tips, and eating disorder signs. I hope that this information will contribute to the success of teen athletes in developing healthy eating habits for the present time and for later on in life. Eating to lose fat in Coos County, OR Project Date: 7/7/2003 A low carbohydrate or Atkins diet has received much attention in the press recently, and has gained popularity among those battling excess weight. Coos Bay and North Bend, OR are no exception to the wave of popularity. They are also no stranger to the epidemic of obesity in this country, with a prevalence of obesity in Coos County of about 20%. The diet promotes weight loss through very low carbohydrate eating and fairly liberal consumption of protein and natural fats, without calorie restriction. It is thought to work by inducing lipolysis (and thus “burning fat”) as a result of so few carbohydrates to burn for fuel. Lipolysis leads to a state of ketosis which may be responsible for appetite suppression and loss of calories in the urine as ketones. At the Bay Clinic in Coos Bay, numerous patients were immediately identified who had tried this diet. In an effort to assess why the diet is so popular, how well it is working for people and the impact it has had on the community, a survey, several interviews and a current literature review were conducted. The results of the survey showed a relatively easy to follow diet plan and overall participant satisfaction. Most people had lost a significant amount of weight in 3-6 months. Most of these people had tried low fat diets before without lasting success. Numerous restaurants, health clubs and a nutrition consultant in town support the low carbohydrate approach to eating. There are a couple of stores in town that carry specifically low carbohydrate products. Finally, three recent studies have evaluated a low carbohydrate diet compared to a low fat diet to show more weight loss, longer adherence, and an absence of negative impact on lipid profiles for the low carbohydrate diet. From these data a patient and healthcare provider information sheet was designed to describe the diet, how it is done, answer some common questions and provide a list of resources for information on recent studies and relevant websites. Obesity Project Date: 12/30/2002 Obesity is a growing epidemic in the U.S. today. Currently obesity related diseases claim 300,000 lives yearly. If this trend continues, obesity will overtake smoking as the number one preventable killer of United States citizens. Obesity costs our health care system more than 330 billion dollars annually, which is approximately 12% of the national health care budget. It is an enormous problem. At the present there are no effective “quick fix” therapies for obesity. Drug therapy has been un-affective and gastric bypass is an option for very few. Good old-fashioned dietary control through lifestyle change and physical activity seem to be the most effective and long-lasting way to prevent and treat obesity. Because treatment is so difficult, the war on obesity begins with prevention. Children who are obese become adults who are obese. Obese six-year-olds become obese adults 50% of the time, while adult obesity rates from obese teens rise as high as 70-80%. Are we succeeding at preventing this obesity epidemic? Data suggests that primary care doctors are poor at screening for and treating the complications of obesity. Childhood obesity has nearly doubled since the 60’s and we are still not actively treating this epidemic. I set out to define the gravity of this problem in the West Salem Clinic. Both low-income and Hispanic populations are the populations with the greatest increase in childhood obesity in the last 15 years. The West Salem Clinic treats mostly low-income families and the majority of the patients are Hispanic. Providers at the clinic have noticed the problem for years and I set out to define the prevalence of childhood obesity in the West Salem Clinic and compare it to the U.S. population. After defining the prevalence of this at-risk population, I developed a detection and screening process to identify and treat obese and overweight children. I provided the providers of the clinic with a checklist of evidence-based guidelines for identifying the complications associated with childhood obesity. This detailed checklist includes prevalence data to convince providers of the importance of screening. I also made up a short checklist to be inserted in the chart if any child is ever identified as overweight on the BMI growth chart. Overweight is defined as a BMI >85 percentile for age and sex while obesity is >95 percentile. This checklist contains solid evidence-based screening tests that should be done on every overweight or obese child. Identifying and treating the medical complications associated with childhood obesity is responsible but the obesity itself must be treated to truly take care of your patients. Most physicians encourage diet and exercise but most folks are unresponsive to these vague suggestions. Diet and exercise is accomplished through lifestyle change. Lifestyle change is very difficult and it must be encouraged and followed in a gradual step-wise fashion to prevent failure and assure lo Back to subject search page or search by preceptor site