Running head: HEALTH ASSESSMENT AND PROMOTION PLAN

Health Assessment and Promotion Plan

Ken McIntyre Jr.
Ferris State University

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Abstract

The objective of this paper is to assess an individual clients health based on the RealAge selfadministered web-based assessment tool and develop a health promotion plan using the
information from the client along with the RealAge web-based assessment tool. The clients
health related strengths and weakness will be explored with the client to help define the clients
health related goals and resources to help obtain those objectives. The clients health related
behaviors, barriers to better health, and steps to better health will be explored in this paper.

Health Assessment & Promotion Plan

Health Assessment and Promotion Plan

At one point in our lives we all have been told to act our age. But what is our real age?
According to Whitbourne, Psychologists who study aging long ago dispensed with the value of
chronological age as a variable to use in research. For one thing, its not an independent
variable because it cant be experimentally manipulated (2012). In other words, chronological
age is arbitrary. Dr. Mehmet Oz agrees, and along with Dr. Mike Roize, has developed an online
assessment tool to help individuals determine their Real Age. According to the RealAge
website,
The RealAge test works by examining up to 125 factors related to a person's overall
health, including health, feelings, diet, and fitness. Questions range from how often
people eat fish versus red meat to exercise and sleep habits, asthma, smoking, aspirin use,
cancer history, parental longevity, and conditions such as high blood pressure and
diabetes (n.d.).
The RealAge is assessment tool is powered by the latest medical research and is
intended to help individuals create personalized tips and action plans to get healthier and grow
younger (ZoCo Productions, LLC, n.d.)! Although this assessment tool cannot replace sound
medical advice from the clients primary care provider (PCP), this tool can provide valuable
information that can be shared with the PCP that can be used to create a template for a healthier
lifestyle.
Assessment and Analysis
The client evaluated in this paper completed the RealAge assessment on February 4,
2016 which revealed a RealAge of 25.9 years old. See appendix A for the clients RealAge
test results. The clients chronological age is 27.9 years old. The client tests at two years

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younger than his chronological age. Using the information garnered from the RealAge test,
this paper will explore the clients health related strengths, weaknesses, and possible solutions to
improve the clients overall health.
Strengths
The client has many positive characteristics indicative of a healthy life-style, beginning
with a healthy weight. The client reports a waist size of 33 and a body mass index (BMI) of
22.78. This is a healthy weight for this client. Studies have shown that overweight or obese
people are at risk for many more health problems, including a higher risk for diabetes, heart
disease, and osteoarthritis. Overweight individuals are also put at a higher risk for liver disease
(Hoffman, J., et al., 2012). The client indicates getting an adequate amount of sleep. According
to the Division of Sleep Medicine at Harvard Medical School, Numerous studies have found
that insufficient sleep increases a person's risk of developing serious medical conditions,
including obesity, diabetes, and cardiovascular disease, and, Lack of adequate sleep over time
has been associated with a shortened lifespan (2008, para. 1).
The client also reports a healthy sex life, a strong social support network, and a positive
attitude with a sense of purpose. Sex boosts the immune system, lowers blood pressure, it is a
good form of exercise, lowers the risk for a heart attack, and eases stress (Robinson, 2013). The
client assessment discloses little or no financial problems and the client has a pet both of which
help reduce stress. In addition, the client assessment shows a routine of regular exercise, and
eating somewhat healthy, with the exception of occasionally indulging in junk food and not
covering the five basic food groups in his diet on a regular basis. Eating fish on a regular basis
and keeping red meat to a minimum is another positive aspect to the clients life-style, as is
eating fruit and avoiding too much sun.

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Weaknesses
A slightly elevated blood pressure and some slightly unhealthy eating habits are some
aspects of this clients health that can be addressed in order to promote a healthier lifestyle and
increase wellbeing. An elevated blood pressure and diet are the most concerning issues.
Complications of hypertension are aneurysms, kidney disease, cognitive changes, eye damage,
heart problems, stroke, and peripheral artery disease (National Heart, Lung, and Blood Institute,
2015-a). Known as the silent killer, in 2013, 30,770 deaths were attributed to essential
hypertension and hypertensive renal disease, and the disease accounted for 38.9 million
physician office visits, and 3.7 million hospital outpatient visits (Centers for Disease Control and
Prevention, 2013).
Hypertension, when left undiagnosed and untreated, is a chronic condition that can lead
to heart disease, stroke, and other diseases that can result in premature death (Kung & Xu, 2015).
Treatment for hypertension is based on whether you were diagnosed with primary or secondary
high blood pressure and if there is a suspected or known cause (National Heart, Lung, and Blood
Institute, 2015-b). Many times, changes in life-style such as diet and exercise can be effective in
reducing blood pressure. Although the RealAge test indicates the client smokes, the client
denies smoking (J.W., personal communication, 2016). This discrepancy concerning the clients
status as a smoker will offer the opportunity to provide smoking prevention information to the
client. Emphasis will be placed on health issues and costs associated with smoking, along with
the benefits of quitting smoking.
According to the Centers for Disease Control and Prevention (CDC), Cigarette smoking
causes more than 480,000 deaths each year in the United States and smoking can exacerbate the
effects of hypertension in addition to causing other problems such as emphysema, chronic

Health Assessment & Promotion Plan

bronchitis, and lung cancer (2015). Smoking is also an expensive habit. The average price for
one pack of cigarettes in Michigan is $8.00 (Fair Reporters, 2015). Smoking just one pack of
cigarettes each day would cost nearly $3,000.00 each year.
While many people find that breaking the habit of smoking is difficult, quitting smoking
is extremely beneficial. The CDC reports that one year after quitting smoking cuts
cardiovascular risks, and the risk for a heart attack drops sharply, within 2 to 5 years after
quitting smoking, the risk for stroke could fall to about the same as a nonsmoker, within 5 years
the risks for cancers of the mouth, throat, esophagus, and bladder drop by half, and ten years
after you quit smoking, your risk for lung cancer drops by half (2015).
Since there is a discrepancy between the clients RealAge assessment and the clients
communication to clarify the difference, the risk focus assessment will concentrate on the
clients diet instead of the possibility of the client being a smoker or the client contemplating
smoking.
Risk Focus Assessment
Diet
After consultation with the client, a healthy diet will be the focus. The client is not
overweight, exercises adequately and consistently, and is generally in very good health. The
client reports eating junk food, not eating breakfast, and not getting the recommended daily
servings of each food group as endorsed by the United States Department of Agriculture
(USDA).
The USDA recommends, for a client of this age and sex, to eat daily two cups of fruit, 3
cups of vegetables, seven ounces of grains, six ounces of protein, three cups of dairy, and no
more than 6 ounces of oils (2016).

Health Assessment & Promotion Plan

The American Heart Association also recommends a healthy diet, stating, A healthy diet
and lifestyle are your best weapons to fight cardiovascular disease (2015). As the client has an
elevated blood pressure, a healthy diet may be beneficial and aid in lowering the clients blood
pressure by reducing sodium, limiting caffeine and alcohol.
Wellness Diagnosis
Eating healthy can help reduce the risk for becoming overweight, lower blood pressure,
and mitigate the risk for cardiovascular disease. The client expresses an interest in eating
healthier, and together with this author, the client as chosen the health seeking behavior of eating
healthier related to (R/T) a risk of becoming overweight as increasing the risk factor for
hypertension (United States Department of Agriculture, 2016; American Heart Association,
2015).
Planning and Intervention
SMART Goal
The Specific, Measurable, Achievable, Realistic, and Time-bound (SMART) goal for this
client is to reduce the amount of calorie-dense, low nutritional value and fatty foods in favor of
grains, fruits, vegetables, lean-protein, and low-fat foods. The objective is to limit fast-food to
no more than two times each week and replace calorie-dense foods such as candy bars with
fruits, yogurt, or lean proteins. To start, one candy bar or similar snack item will be allowed
each day. Eating a healthy breakfast will also be included in this objective. This SMART Goal
will begin on March 1, 2016. See appendix B for Daily Food and Nutrition Log.
Interventions
It is important to establish the clients eating patterns so as to best address what foods are
missing from the clients diet, and to determine what unhealthy foods are being consumed and at

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what intervals. Increasing the clients awareness of what is being consumed can help reduce the
intake of unhealthy foods. In a study published in the American Journal of Preventive Medicine,
1,685 overweight or obese adults kept a food dairy, and those adults who kept a record of what
they ate at least six days a week lost about twice as much weight as those who kept food records
one day a week or less (Hitti, 2008). Although the client does not need to lose weight, the
concept of increasing awareness, and making yourself accountable increases the chances of
eating healthier by helping target areas for improvement (Hitti, 2008). See appendix B for
Daily Food and Nutrition Log tailored specifically for the client.
Another intervention is limiting the availability of unhealthy foods. According to a study
by Marteau, Hollands, & Fletcher, habits, or human behavior, is mostly controlled either
reflective behavior, where individuals contemplate and plan their actions, and automatic
behavior, where individuals respond to their surroundings in complex ways while their thoughts
are somewhere else (2012). It is thought some behaviors can be changed by altering the persons
environment (Marteau, Hollands, & Fletcher, 2012, p. 1493). To accomplish this intervention,
the client will refrain from purchasing undesirable food items for the home. In addition, the
client will, whenever possible, keep desirable snack items available.
It is important to determine the clients readiness to alter his lifestyle to accommodate a
healthier eating routine. Attempting an intervention when the client is not ready will most likely
result in failure of the intervention, and may prevent subsequent interventions from being
considered by the client. The transtheoretical model (TTM) addresses six stages of change using
principles and processes of change from across leading theories of psychotherapy and behavior
change, and defines behavior change as a process that unfolds over time and involves progress

Health Assessment & Promotion Plan

through a series of stages: precontemplation, contemplation, action, maintenance, and
termination (Prochaska, 2008, p. 845).
According to the transtheoretical model, I would place the client in the contemplation
stage, where the client is thinking about adapting a particular behavior. Pender, Murdaugh, &
Parsons wrote the contemplation stage is where, an individual is seriously thinking about
quitting or adopting a particular behavior in the next six months [aware of the problem and
intends to change] (2015, p. 41). The client is aware of his unhealthy eating habits, however,
since the client is not overweight and has minimal health issues, there has been no compelling
reason to alter his eating habits.

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References

American Heart Association. (2015, August). The American Heart Association's diet and
lifestyle recommendations. Retrieved February 16, 2016, from
http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/TheAmerican-Heart-Associations-Diet-and-LifestyleRecommendations_UCM_305855_Article.jsp#.VsP7WtC7aUk
Centers for Disease Control and Prevention. (2015, October 1). Health effects of cigarette
smoking. Retrieved February 14, 2016, from
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smokin
g/
Centers for Disease Control and Prevention. (2013, November 21). Hypertension.
Retrieved February 14, 2016, from http://www.cdc.gov/nchs/fastats/hypertension.htm
Fair Reporters. (2015, July 20). Prices of cigarettes by state. Retrieved February 14, 2016, from
http://fairreporters.net/health/prices-of-cigarettes-by-state/
Division of Sleep Medicine at Harvard Medical School. (2008, January 16). Sleep and health.
Retrieved February 7, 2016, from http://healthysleep.med.harvard.edu/need-sleep/whatsin-it-for-you/health
Hitti, M. (2008, July 8). Weight loss study: Keeping a food diary helps shed extra pounds.
Retrieved April 1, 2016, from http://www.webmd.com/diet/20080708/keeping-fooddiary-helps-lose-weight
Hoffman, J., Chaykin, D., Teale, S., In Heredia, P., In McGarrity, J., In McMillan, C., In Shaw,
B., ... Michael & Susan Dell Foundation. (2012, May 14). The weight of the nation. Part

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1: Consequences [Video file]. Retrieved from

http://theweightofthenation.hbo.com/films/main-films/Consequences
Kung, H-C., & Xu, J. (2015). Hypertension-related mortality in the United States, 20002013
(20151209). Retrieved from Department of Health and Human Services website:
http://www.cdc.gov/nchs/data/databriefs/db193.htm
Marteau, T. M., Hollands, G. J., & Fletcher, P. C. (2012). Changing human behavior to prevent
disease: The importance of targeting automatic processes. Science, 337(6101), 14921495. doi:10.1126/science.1226918
National Heart, Lung, and Blood Institute. (2015, September 10-a). What are the signs,
symptoms, and complications of high blood pressure? Retrieved February 14, 2016, from
http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/signs
National Heart, Lung, and Blood Institute. (2015, September 10-b). How is high blood pressure
treated? Retrieved February 14, 2016, from http://www.nhlbi.nih.gov/health/healthtopics/topics/hbp/treatment
Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health promotion in nursing practice
[Kindle] (7th ed.).
Prochaska, J. O. (2008). Decision making in the transtheoretical model of behavior change.
Medical Decision Making, 28(6), 845-849. doi:10.1177/0272989x08327068
United States Department of Agriculture. (2016, February 5). Dietary guidelines.
Retrieved February 16, 2016, from http://www.choosemyplate.gov/dietary-guidelines
Whitbourne, S. K. (2012, June 23). Whats your true age? Retrieved February 7, 2016, from
https://www.psychologytoday.com/blog/fulfillment-any-age/201206/what-s-your-trueage

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ZoCo Productions, LLC. (n.d.). RealAge. Retrieved February 7, 2016, from
https://auth.doctoroz.com/realage

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Appendix A

RealAge

25.9
Taken 02-04-16
Difference

2
Younger

The RealAge Test

Retake the TestUpdate my answers

Your Personalized Recommendations

Based on your RealAge Test, we have compiled some personalized recommendations for you to
help improve your lifestyle.

Health
Feelings
Diet
Fitness

Lower your blood pressure.

Make lifestyle changes to help control your blood pressure.
Because your blood pressure (BP) is slightly Expand

Keep watching your waist.

Nice numbers! Keep your numbers in the healthy zone.
Your healthy waist size of 33 and BMI of 22.78 help Expand

Get your cholesterol tested.

Get your cholesterol checked.
On the test, you estimated both your total cholesterol level and your HDL level Expand

Become a former smoker.

Not surprisingly, smoking makes your RealAge older. And not only do you age yourself with your
smoke, but you Expand

Stick with your sleep schedule.

Stick with your sleep schedule.
You may be getting the amount of nightly sleep that's right for you; but ifExpand

Keep passing on aspirin.

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Given your age and health history, not taking a daily aspirin is likely the right choice for you.
Here's why: Expand

Keep avoiding sunburns.

Keep up the good work avoiding sunburns! Stay vigilant about protecting your skin from ultraviolet
(UV) rays Expand

Take care of your ticker.

The early stages of heart disease are often symptomless, so routine checkups with your doctor are
important Expand

Stop putting off that check-up.

If you're like most men, you've probably skipped your last physical (or two). It's time to take control
of Expand

Protect your joints.

How old are your joints -- and what can you do to prevent future joint pain and damage? Get
personalized Expand

Appreciate your mate.

Kiss your spouse! Being happily married is good for your mental and physical health and helps make
your Expand

Keep having sex.

Yes! Orgasms don't just feel good -- they actually ARE good for you. Research suggests that men
who have two Expand

Stay in touch with friends.

Your social support network (family, friends, organized groups) is excellent. Stay in touch through emails, Expand

Keep on top of stress.

Keep a good handle on your stress level. Try relaxation techniques to minimize the internal damage
caused by Expand

Keep your finances in order.

Sounds like you have a good handle on your financial situation. Smart planning now can help secure
a stress- Expand

Keep stress in check.

A year without any major life-disrupting events is a good year, in terms of stress. Keep in mind,
though, Expand

Stay positive.
Keep cultivating positive emotions to keep the blues away.
Here's why: The benefits of good feelings don't Expand

Maintain your sense of purpose.

Keep feeling good about what you've done in the past and what you hope to do in the future. Having
a sense of Expand

Hug your dog.

Woof, woof! Throw your dog a bone, and take the quiz to find out how you and your pet can stay
healthy Expand

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Pet your cat.

Purrfect! Curl up with your kitty and take the quiz to find out how you and your pet can stay
healthy Expand

Have a healthy morning meal.

Eat breakfast every morning -- and make sure it's healthy.
Here's why: Having a healthy morning meal is the Expand

Eat more grains.

Make whole grains a bigger part of your diet by eating at least six servings a day of wholegrain bread, Expand

Keep reaching for fruit.

By eating two to four pieces of whole fruit a day, you've made yourself younger. Way to go!
Here's why: Expand

Vary your veggies.

Fill your plate with colorful veggies -- have at least five servings every day.
Here's why: Think of veggies Expand

Eat more nuts.

Enjoy a handful of nuts on most days.
Here's why: They're a tasty and satisfying way to keep your heart Expand

Go easy on the junk food.

Kick nutritional felons -- also known as junk foods -- out of your diet.
Here's why: They're stealing the Expand

Keep red meat to a minimum.

Give yourself four stars for not eating much red meat. It makes good health sense and helps
you stay young.
Expand

Stay hooked on fish.

Keep eating at least one serving of fish (or another good source of omega-3s) per week.
You make fish a Expand

Start taking D.
Start taking vitamin D. This "live longer" supernutrient will help make you younger.
Here's why: Running Expand

Expand your diet.

You're not covering the five basic food groups (grains, vegetables, fruit, low-fat dairy products and
protein) Expand

Keep up the cardio.

Keep up the cardio.
You spend 1665 minutes per week doing cardio/aerobic exercises and activities, and it's Expand

Keep on stepping.
Walk on!

Health Assessment & Promotion Plan

By spending 1605 minutes per week walking, you're helping your body stay young.
Here's why: In Expand

Tighten and tone.

Ready, set, tone! Carve out at least 30 minutes each week for exercises that build muscle
strength and Expand

Keep up your flexibility exercises.

Keep building flexibility.
Here's why: Your muscles are meant to be stretched -- to move, expand and contract. Expand

Create a workout that works for you.

Build a better-body plan that fits your likes, needs, and abilities.
Some people work out to lose weight. Expand

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Appendix B

Daily Food and Nutrition Log

Time

Date

Total

/ / /16
0000-0400

0400-0800

0800-1200

1200-1600

1600-2000

Goal

2000-2400

Fruits

cups

Vegetables

cups

Grains

oz.

Proteins

oz.

Dairy

cups

Oils

tsp.

Snacks

Recommended daily intake:

Fruits 2 cups daily
Vegetables 3 cups daily
Grains 7 oz. daily
Proteins 6 oz. daily
Dairy 3 cups daily
Oils 6 teaspoons daily

NOTES:

Over/Under
Goal