RCHC Community Project Abstracts

Back to subject search page or search by preceptor site 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. Avoiding Unintentional Doping Violations Project Date: 4/28/2008 The problem addressed in this project was the possibility of a volunteer physician at the 2008 Olympic Trials causing an unintentional doping violation in an elite athlete/patient, by unknowingly prescribing a medication containing an agent prohibited by anti-doping regulations. The proposed solution was the creation of a concise educational report, detailing the appropriate prescribing practices for elite competitive athletes, and warning them of the often-prescribed medications which may cause positive drug screen results. This was accomplished by researching the anti-doping policies, practices, and requirements of US Track and Field and the International Olympic Committee, and the US Anti-Doping Agency and World Anti-Doping Agency. Research was also done to determine the medications most likely to cause unintentional doping violations. The result was a concise report, intended to be distributed to the physician volunteers for the Olympic Trials. True assessment of the success of the project would require follow up surveys of the physicians after the conclusion of the competition. “WI I ” TA S T I C : T H E I N T ROD U C T ION OF A NOV E L V I D EO G A M E CON SOL E I N TO A N U R S I N G HOM E Project Date: 12/31/2007 For nursing homes, the maintenance of physical activity is often an important, if not primary goal of day to day activities. It is commonly believed that lack of physical exercise will lead to exacerbation of co-morbid conditions and general overall decline. In many commercial nursing homes, this is primarily accomplished through group exercise as well as formal physical and occupational therapy.; each of these approaches has their limitations. The purpose of this project was to provide a qualitative analysis of the introduction of a novel video game console concept developed by Nintendo called the “Wii.” This console is unique in that it is one of the first to be introduced into the mass market that implements the use of physical interactive technology into game play. This task was accomplished through two general introductory sessions and two case study sessions with nursing home patients. Qualitative observations and analysis are reported with recommendations for follow studies that could be performed using a quantitative approach. An analysis of barriers to regular exercise and implementation of a patient handout in Philomath, OR. Project Date: 9/10/2007 Benefits of exercise and increased physical activity are well documented. Despite this, many patients of Philomath Family Medicine (PFM) do not engage in regular exercise. At PFM the barriers preventing patients from engaging in regular exercise were assessed by interviewing multiple physicians within the practice, a local expert, and by patient survey. During observation of physician-patient discussions, physicians often lacked the time to thoroughly explore patients’ reasons for inactivity. A patient handout was created to stimulate self-reflection and provide education and motivation for how to overcome personal barriers. Cycling in Florence, Oregon Project Date: 8/6/2007 Cycling is an excellent form of exercise, with physical, mental and environmental benefits. Many of the most common causes of morbidity and mortality have improved outcomes in patients who exercise on a regular basis. Florence, Oregon is a small, coastal town with an older retirement population. Many people in Florence suffer from chronic diseases that could be improved with exercise. This study attempted to identify the current perceptions of, barriers to, and support for cycling among older adult chronic disease management patients in the family practice clinic in Florence. Additionally, an environmental survey of Florence’s cycling amenities was done, revealing a mostly flat, small town with low traffic streets and well maintained multi-use paths. There is also a full service cycling shop with an owner dedicated to promoting cycling in Florence. Most barriers to and negative perceptions of cycling identified in this project would be combated by cycling education and skills training in either group or one-on-one setting. This process was started with a resource book created for this project including safety information, local and online resources, local maps, a biking activity, and copies of several articles with evidence for the benefits of cycling in older adult populations. 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. Increasing Exercise in Reedsport. Project Date: 7/2/2007 Exercise can help prevent and improve many chronic conditions. Reedsport, a small town on the Oregon coast, offers an incredible venue for an active lifestyle – there are lakes, rivers, sand dunes, beaches, pools, gyms and great trails for walking. Family practice physicians at Dunes Family Health Care (DFHC) in Reedsport spend a considerable amount of time counseling patients on the benefits of exercise. Despite the encouragement of the healthcare community and the favorable environment for physical activity, many of the patients at DFHC struggle to incorporate exercise into their daily routine. To help address these issues, I created www.reedsportwalks.com - an interactive, self-sustaining, online forum to help the Reedsport community lead a healthy, active life. The site contains information regarding the importance of exercise, how to start exercising by setting reasonable goals, and how to overcome barriers like chronic pain and time constraints. There is also a comprehensive list of exercise ideas specific to Reedsport including a walking map of the surrounding area and schedules for the pool and local gyms. The site was set up as a google group, making it easy to access, self-sustainable, and interactive. Ideas on how to expand the site include: publishing a page on specific exercise ideas for kids and teens, organizing a community fitness event or weekly walking group, or expanding the site to include healthy options for eating out in Reedsport. Treatment of the prediabetic patient in a primary care practice. Study of the current practices of managing prediabetic patients in Philomath, OR Project Date: 4/30/2007 Diabetes is a serious medical condition affecting 20.8 million children and adults in the United States, or 7% of the population. The diagnosis of diabetes has far reaching consequences including adverse effects on a patient’s kidneys, heart, eyes and nerves. There is growing evidence that a pre-diabetic states exists before the development of diabetes and that individuals in this state have the opportunity to prevent the disease through lifestyle changes in their diet and exercise regimens. The purpose of this project is to identify the prevalence of a population at high risk for diabetes, to assess current methods of diabetes prevention through interviews with family practice doctors and to develop effective patient education materials, which will help to teach patients methods to modify their risk for developing the disease. Education will be focused on lifestyle modifications with the goal of preventing the development of type 2 diabetes. Future projects may assess the effectiveness of these materials by long term follow up of the identified patient population and their propensity for developing diabetes. "Exercise by Prescription" Project Date: 3/19/2007 A routine of exercise and physical activity has been shown to decrease morbidity in patients suffering from things such as heart disease, cerebrovascular disease, hypertension and osteoporosis. Physical Inactivity however has been correlated with many external factors beyond the patients’ control. This study attempts to identify key barriers to physical activity in a rural population, specifically among the elderly. The design was the questioning of patients over 50 who came to Klamath Family Practice, and the Merle West Medical Center in Klamath Falls Oregon. Each patient who was being seen as a follow up for hypertension, Diabetes, or was having a complete physical exam was questioned on the primary reason that they did not perform a routine form of physical activity and or exercise. 2 different focus groups of 10 and 12 senior citizens at Klamath Senior Center & Center for Aging were also questioned about the same issue. This study found that the major barriers included weather in Klamath, safety and motivation along with other barriers. Whereas there was a great deal of emphasis on the importance of physical activity, the barriers to those activities were not being addressed by physicians and/or residents. In fact it was rare that a consultation was held at all to discuss physical activity for many patients who would obviously benefit. Therefore my intervention sought to decrease the burden of those same barriers in an effort to motivate the patients to seek out the recommended amount of physical activity set forth by “Healthy People 2010.” This included but was not limited to, making trail maps for walking and jogging, convincing local fitness centers and rentals shops to give discounts to patients mentioning “exercise by prescription” from their doctor. Such a sheet of information and incentives give the physicians in office, something to have in hand in order to have a worthwhile discussion about exercise with patients and to hopefully further impact preventive care in Klamath Falls. No More Excuses Project Date: 3/19/2007 Type II Diabetes and Obesity are increasing in incidence at an alarming rate. It has been well established that diet and exercise is the treatment of choice for obesity and type II diabetes. This study attempted to identify the effectiveness of treating and managing type II diabetics with diet and exercise. The design was to document each diabetic patient seen over a 5-week period, the date they were diagnosed with diabetes, their BMI and HbA1C at diagnosis and their current BMI and HbA1C as well as the medications used to treat their diabetes. When able, patients were questioned as to reasons why they chose to not exercise. These values were put into a chart from which came the results: How many patients have managed to successfully treat his or her diabetes with diet and exercise alone. Finally, a pamphlet was made to help aid providers in educating patients on the benefits of increasing physical activity through little effort on behalf of the patient. Physical Activity in Harney County, Oregon: Attitudes toward, Self-Assessment of, and Barriers to a Physically Active Lifestyle Project Date: 3/19/2007 Obesity and physical inactivity are quickly becoming major causes of morbidity and mortality in the United States. Rates of obesity and physical inactivity are increasing in the US every year. Citizens of rural communities have higher rates of obesity and physical inactivity than the overall population of the US. In order for small rural communities to take action against this slip into a culture of inactivity and obesity, they must identify trends, needs, and strengths within their communities. My project 1) assesses perceptions of and behaviors that affect health and physical activity, 2) identifies barriers to increased physical activity, and 3) solicits possible governmental/community solutions that can help citizens become more physically active. In order to elicit this information, I conducted interviews with a number of Harney County citizens, including health care staff, patients attending a health care facility, and local citizens in community spaces. I also surveyed patients attending High Desert Medical Center on the topics mentioned above. Surveys and Interviews indicated a number of trends. Citizens had a high personal value for health and physical activity, and had overall high average self-assessed levels of health and physical activity (especially high in the young). There was a slight fall off in self-assessed health and physical activity with increasing age, as well as a large decrease in at-home (as opposed to work/school-related) physical activity levels with increasing age. Walking, gardening, ranch work, bicycling, running, and swimming were the most commonly mentioned physical activities that citizens currently engage in. Swimming, walking, yoga/taichi, gardening, and bicycling were the most commonly mentioned activities that citizens would like to participate in. The most commonly mentioned barriers to physical activity were not having enough time, not having enough money, lack of year round facilities, lack of facilities appropriate to their activity of choice, medical conditions that prohibited their participation in an activity of choice. Most ideas submitted by patients were related to increasing availability of indoor facilities, increasing child-care availability at exercise facilities, and increasing hours of operation of facilities. Environmental Factors which Contribute to Obesity in Rural Communities: A Case Study of Coos Bay, Oregon Project Date: 10/16/2006 Studies suggest that the obesity epidemic disproportionately affects rural areas. However, it is difficult for people to change habits which contribute to obesity. Although patient education and counseling is an important step in changing behavior, even those patients who are aware of their condition and the necessary changes that need to be made to improve their health are unable to accomplish weight loss. Past efforts at changing behavior in Coos Bay have focused on counseling in the clinic setting, and are often ineffective due to time constraints and inability to exert influence over behavior outside of the clinic setting. Educational materials made available to rural physicians are un- or under-utilized. However, there are other methods for changing behavior. Studies show that the environment affects physical activity levels and obesity levels in a community. Environmental factors of rural communities like Coos Bay present unique challenges to successful weight loss when compared to larger cities like Portland. The main goal of this project was to study environmental factors of Coos Bay which may contribute to high rates of obesity and differ from those of more urban environments. This has important implications for the health of rural communities, and suggests that the health of a community can be substantially improved in an equitable manner by environmental modification. Increasing awareness of opportunities for social interactions and physical activity for senior residents of Philomath, OR Project Date: 9/11/2006 Numerous studies have demonstrated the benefits of maintaining social interactions and engaging in physical activity for elderly people. These include an increased sense of independence, improvements in quality of life and general functioning, an increase in measures of mental health functioning, as well as lower rates of obesity, diabetes, osteoarthritis and cardiovascular disease. I sought to catalog resources in the community for opportunities for social interaction and physical activity and to overcome the barriers of cost and transportation to encourage utilization of these resources. I then designed a large color poster to encourage awareness of local opportunities, printed 30 smaller color handouts for seniors to take home, and compiled an informational binder to be housed in the waiting room at Philomath Family Medicine. Choosing the Path Less Traveled: Walking for Health in Reedsport, Oregon Project Date: 7/3/2006 This paper introduces the concept of the “walkable” community and discusses opportunities for incorporating exercise into the daily routines of residents in the Reedsport, Winchester Bay, and Gardiner area. Past community health efforts and student research projects have reiterated the importance of health promotion in this population. Interviews with local residents and a literature search revealed the need for a more extensive list and map of pedestrian routes in the area to highlight a variety of walking and jogging options close to home. A survey of the Dunes Family Health Care clinicians demonstrated that exercise is important to medical providers, and a patient survey identified the need for better outreach to make health handouts available at multiple locations in the area. The final product is an easily reproducible brochure of walking and jogging trails in the Reedsport, Winchester Bay, and Gardiner area. 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. Increasing the Awareness of the Scope of Diabetes Mellitus in Klamath Falls, Oregon. Project Date: 1/2/2006 Approximately 7% of the United States population carries the diagnosis of diabetes, and it is estimated that about 33-50% of the diabetic population remains undiagnosed. 41 million more people are diagnosable as glucose intolerant. Considering the well-known complications of the disease – retinopathy, nephropathy, neuropathy and heart disease – and the fact that these complications can be prevented from both developing and progressing, as was proven in the Diabetes Control and Complications Trial, it is imperative that physicians are sensitive to the risk factors, lab tests, and the symptoms of DM. The ADA currently has recommendations for screening based on risk factors, and specific numbers for fasting plasma glucose and oral glucose tolerance test levels for a diagnosis. But the altered metabolism of neurons that leads to neuropathy begins at a blood sugar level of ~160, which is a diagnosis of glucose intolerance with the OGTT. With this result, insurance companies will not pay for routine diabetic care, such as a yearly dilated eye exam. It is thought that neuropathy and retinopathy begin 10 and 7 years before the diagnosis of type 2 diabetes occurs. Therefore, serious preventable complications are occurring long before patients are diagnosed, if they are diagnosed at all. To help with diagnosis, it might be beneficial to do a symptom screening, which is not currently offered by the ADA. The earliest symptom patients are aware of tends to be peripheral neuropathy, but there are others including blurry vision, polydipsia and polyuria, chronic infections, and impotence. The goal of this project was to offer a history-based checklist for symptoms that raise the suspicion of diabetes. Mental Health Care Resources in Linn County Project Date: 1/2/2006 Mental healthcare delivery everywhere is being provided to greater extents by primary care physicians than ever before, especially in rural settings where community mental health resources are lacking. This report assesses the prevalence and disease burden of mental illness in the U.S. overall, and in our rural communities like Linn County. Second, it discusses barriers to mental health care in rural settings. Next, it poses possible solutions to rural disparities in mental health care. Finally I discuss my project. The goal of this project was to examine the need for mental health services in Linn County, identify mental health resources in Linn County, and formulate a consolidated list of local mental health resources including their areas of expertise for use by local health care providers and community members. Employee Wellness At The Corvallis Clinic Project Date: 3/21/2005 Philomath Family Medicine is part of the Corvallis Clinic which employs 570 people in 3 clinics. Over the past year, several employees have mentioned their interest in company-sponsored fitness programs and activities. Many people working at the Corvallis Clinic feel that obesity is a major problem among employees in their organization. While informal walking groups and weight loss support groups exist, there is no explicit program in place to help employees maintain their health. This project was created to explore the possibility of creating a wellness program for Corvallis Clinic employees. This project focused on three things: 1) Assessing a local wellness program already in place at Samaritan Health Services (not affiliated with the Corvallis Clinic) 2) Gathering information on interest, ideas, and feasibility of a wellness program for the Corvallis Clinic 3) Making recommendations for a wellness program at the Corvallis Clinic Physical Activity in Children and Adolescents in Ontario, OR Project Date: 1/3/2005 Obesity has become a major health concern in the United States over the past several decades. When attacking this overwhelming problem, two areas are often targeted in order to keep obesity at bay: nutrition and physical activity. Despite their equal importance in a healthy lifestyle, physical activity is often overlooked in favor of nutrition, hence the popularity of fad diets and the current anti-carbohydrate campaign. Unfortunately, these trends are often short-lived and allow for little long-term success. For significant and more permanent change, patient education is an absolute necessity. At the Treasure Valley Pediatric Clinic in Ontario, Oregon, the primary method of patient education came in the form of a handout, whether the health issue was constipation, acne, or nutrition. Glaringly absent from this selection of handouts was any information regarding physical activity and exercise. The aim of this project was to evaluate the level of physical activity in the community, particularly with children and adolescents, and then create a patient handout that would provide education regarding ways to improve current fitness levels. Ultimately, the level of physical activity was found to be inadequate among children and adolescents in Ontario, Oregon; therefore, a kid-friendly brochure was produced and distributed at the pediatric clinic with the hope that early education could lead to a lifetime of healthy habits. Pedometers as Motivational Tools to Increase Physical Activity in Philomath Oregon Project Date: 9/13/2004 Physical inactivity has been identified as one of the top contributors to obesity. Combined with poor nutrition, it is the second highest preventable cause of mortality. In preliminary studies, pedometers have been shown to be a potential motivational tool to increase physical activity. The purpose of this study is to investigate the effects of a 7-day, pedometer-based lifestyle physical activity intervention. Participants were 10 patients from Philomath Family Clinic who volunteered to participate in the study. Participants’ perceived physical activity and actual physical activity was measured through questionnaires and by wearing a pedometer while doing typical activities. Questionnaires also examined patients’ motivation, environmental barriers, and knowledge of exercise. After completion of the 7-day trial, participants are asked to reflect on their activity level and their experience with the pedometer. Results indicate participants averaged 14,754 steps per day. Preliminary, findings from this study demonstrate that pedometers encourage most participants to want to increase their activity level. Fighting Childhood Obesity with Physical Education Project Date: 9/13/2004 Obesity is a growing problem in all age groups, but particularly alarming are the growing numbers of overweight children. The rural community of Burns, Oregon has not escaped this dilemma. Many attempts to address this problem have been made, but the community has yet to incorporate an important resource: physical education. Recent studies have shown that by enhancing physical education class, especially at the elementary level, dramatic differences can be made in a child’s weight. The purpose of this project is to evaluate the current PE and nutrition programs at Slater Elementary School in Burns, and make suggestions for increasing their effectiveness. This will be done by suggesting means to increase funding and support, and through making a parent handout on easy ways to keep their child’s diet healthy. Exercise in the Elderly in Benton County Project Date: 8/9/2004 Exercise in the elderly (>65 yo) has tremendous benefits for cardiovascular disease, diabetes, osteoporosis, osteoarthritis, neuropsychological health, and cancer. Philomath presented a challenge in mobilizing elderly for exercise with few facilities for exercise. The first part of this project was to discover if people were exercising and were they exercising enough. Secondly, to discover the types of exercise people were doing and their motivation to exercise. Lastly, with that data, mobilize the population to exercise. A survey was used at Fitness over 50 and philomath Family medicine to look at amount of exercise, motivation for exercise, types of exercise and barriers to exercise. The owner of Fitness over 50 was interviewed to understand his unique model and meeting attended at city hall to learn about a future Senior Center. The exercise group averaged 3.9 days of exercise a week at 53.4 minutes a day and the Philomath group averaged 3.3 days a week at 35.9 minutes a day. This data suggests that the population not exercising doesn't come to the physician's office frquently for annual checkups. Therefore in oder to reach the population, prevention has to extend beyond the clinic. With the data an exercise "prescription" was formulated to hand out to patients. Are the Diet and Exercise Habits of Middle & High School Students in Coos County Influenced by the School Environment? Project Date: 5/10/2004 The school environment has been shown to be a powerful determinant of child and adolescent diet and exercise habits. However, facets of school environment’s are believed to be unconducive to, as well as not fostering or promoting, healthy diet and exercise habits among students. In an effort to see whether the diet and exercise habits of students in Coos County School District are influenced by their school environment, 448 middle and high school students were surveyed. Specifically, their intake of fast food, candy and carbonated beverages, as well as their participation in school PE, or other physical activity was queried. They were also asked their responses to hypothetical situations where the school environment was modified, such as if vending machines were removed from campus, if they were not allowed to leave campus for lunch, or if PE were a required class. The results of the survey show that the school environment does indeed influence students’ diet and exercise habits. Furthermore, a majority of students indicated that they would relish changes to their school environment that would help foster healthier diet and exercise habits among them. The Ontario Aquatic and Fitness Center Project Date: 5/10/2004 Intro: The Ontario Aquatic and Fitness Center offers opportunities for people of Malheur County to swim, lift weights, or participate in water aerobics. After arriving in Ontario, it was mentioned that funding for the center was in jeopardy. After talking with my preceptor, individuals at the center, and other local health care professionals, I decided to create a usage survey for the facility to try to help determine who was using the center and for what specific reasons. Materials/Methods: A simple survey was designed asking for age, city of residence, average number of visits to the center in a month, and the main reason for the visit to the center. Five options were listed to select from for the main reason for the trip to the center. Results: 67.4% of the respondents used the center for water aerobics, which was indicated as their main form of exercise. Average age of this group was 67, with an average number of monthly visits of 12.3. The next largest group (18.4%) used the center for its gym, which was the main place they worked out. Average age was 39.6, with average monthly visits being 15.7. The remaining groups were those using the center for water aerobics, which was not their main form of exercise (10.2%), for physical therapy (2.0%), and for recreational swim (2.0%). Conclusions/Discussion: The results of the survey indicated that the center was utilized mainly by the geriatric population for water aerobics, which was their main form of exercise. The gym was used as a main work out facility by another large group, who tended to be of a younger generation. Average number of visits per month by each group was impressive. Given the benefits of exercise in several medical conditions, such as hypertension, diabetes, and osteoporosis, the center is serving a beneficial role in the health and well-being of many of Malheur county’s residents, particularly the elderly. The Utility of Written Information for the Rural Family Practice Patient Project Date: 1/5/2004 As health technology becomes increasingly complicated and patient appointment times become shorter, written information for patients in the form of handouts and brochures has become more popular. This study sought to determine how many patients received this type of education, whether it was useful, what they liked or disliked about it, and how many used the Internet as a resource. A questionnaire was designed and distributed to all patients with appointments at the Scappoose Family Health Clinic for a three-week period. Compilation and analysis of the results revealed that approximately 80% of patients have received written information, all of which read at least some of it. Nearly all found the information at least somewhat useful, half kept the handout for future reference, and approximately 75% said they would like to receive written information in the future. Finally, approximately half of patients used the Internet as a resource for health information and would like to receive Internet sites from their health care providers. The results of this study are similar to those found in recent literature. Written handouts are helpful for patients, and most would like to receive information in this format in the future. Reasons centered around taking control of one’s own health, making informed decisions, and wanting to know accurate, updated information about their health. PHYSICAL ACTIVITY AND HEALTH IN SCAPPOOSE, OREGON: Identification of Perceived Barriers to Being Physically Active and Development of a Patient Handout on the Benefits of Regular Exercise Project Date: 9/29/2003 The prevalence of obesity is increasing and continues to be a national problem. Although the benefits of weight control and physical activity are well documented in the primary prevention of many chronic diseases, most Americans do not participate in regular amounts of physical activity at recommended levels. This study attempted to identify the perceived barriers to being physically active in an OHSU family practice clinic located in the community of Scappoose, Oregon. Development and administration of a patient survey during a one-week period was the primary source of data used to identify the barriers to physical activity. Additional information was collected by direct observation of preceptors counseling patients on the topic of exercise throughout the six-week rotation. The goal was to create a patient handout that could be used during office visits to supplement counseling on the benefits of exercise and expose the common myths limiting participation. 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 Exercise For Residents Of Reedsport, Oregon The Importance Of and Opportunities For. Project Date: 8/12/2002 The obesity trend in the United States of America is on the rise. In Oregon, the number of overweight and obese rose from 55% in 1998 to 57% in 2002. Obesity has been proven to be associated with an increased incidence of heart disease, stroke, diabetes, high blood pressure, osteoarthritis, and some cancers. During my rural rotation at Dunes Family Health Clinic as a third year medical student in Reedsport, OR, I calculated the BMI on 53 of the patients I saw in clinic and found that 87.3% of the patients I saw were overweight or obese. Because obesity and lack of exercise are often coexisting conditions, I created a patient pamphlet which includes information on reasons why to exercise regularly, how to start a exercise program, and ideas for exercise in the Reedsport area. Back to subject search page or search by preceptor site