P A R I S H H E A L T H N U R S I N G 4 2 6
K A T H I E O ’ D E L L
C O N C O R D I A C O L L E G E

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She would like to add some health focused programs for the congregation.
By doing a Congregational Assessment - long form she was able to identify areas of interest the congregation has about health information. These were distributed and collected at two worship services (Hickman, 2006).
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Data Collected from all assessment sources should be recorded in an organized and retrievable manner (Hickman, 2006).
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From the Data analysis she was able to identify the following health promotion topics: exercise, parenting, weight control, stress reduction, conflict resolution, and adolescent health.

Health Assessment Tool
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Her health assessment may include looking at the congregation as a whole and identifying its needs. The group will need to look at the average age of the congregation and speculate on what topics would best fit them. They could also do an interest survey to get the congregation involved with parish health nursing. The results of the survey may indicate what type of parish nursing the congregation is looking for.
Evidence Based Practice
 Mary needs to remember that current nursing is based off of evidence based practice. Practice based on the best available evidence, patient preferences, and clinical judgment.
Evidence based practice will require her to research practices through nursing journals, research articles, and online databases.

What health promotion topics were identified
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Population of the
Congregation
Because the rate of return of the survey is below 60% of the congregation, the data may not be as representative of the whole congregation (Hickman,
2006). She may want to supplement this survey with a mailed survey.

1 .
T H E C O M M U N I T Y P R E V E N T I V E S E R V I C E S T A S K F O R C E
N O T E D R E C O M M E N D A T I O N S T O I N C R E A S E P H Y S I C A L
A C T I V I T Y I N C O M M U N I T I E S , 2 0 0 2 .
2 .
R E C O M M E N D E D C O M M U N I T Y S T R A T E G I E S A N D
M E A S U R E M E N T S T O P R E V E N T O B E S I T Y I N T H E U N I T E D
S T A T E S : I M P L E M E N T A T I O N A N D M E A S U R E M E N T G U I D E ,
( K E E N E R , G O O D M A N , L O W R Y , Z A R O , & K E T T E L K H A N ,
2 0 0 9 ) .

The Community Preventive Services Task Force noted recommendations to increase physical activity in communities, 2002.
W A L K F O R J E S U S
S O C I A L S U P P O R T I N T E R V E N T I O N S F O C U S O N C H A N G I N G
P H Y S I C A L A C T I V I T Y B E H A V I O R T H R O U G H B U I L D I N G ,
S T R E N G T H E N I N G , A N D M A I N T A I N I N G S O C I A L
N E T W O R K S T H A T P R O V I D E S U P P O R T I V E
R E L A T I O N S H I P S F O R B E H A V I O R C H A N G E ( E . G . , S E T T I N G
U P A B U D D Y S Y S T E M , M A K I N G C O N T R A C T S W I T H
O T H E R S T O C O M P L E T E S P E C I F I E D L E V E L S O F P H Y S I C A L
A C T I V I T Y , O R S E T T I N G U P W A L K I N G G R O U P S O R O T H E R
G R O U P S T O P R O V I D E F R I E N D S H I P A N D S U P P O R T ) (
C O M M U N I T Y P R E V E N T I V E S E R V I C E S T A S K F O R C E ,
2 0 0 2 ) .

Recommended community strategies and measurements to prevent obesity in the United States:
Implementation and measurement guide, (Keener,
Goodman, Lowry, Zaro, & Kettel Khan, 2009).
LET’S GET COOKING
T H E D I E T A R Y G U I D E L I N E S F O R
A M E R I C A N S , 2 0 1 0 A R E T H E B E S T
S C I E N C E - B A S E D A D V I C E O N H O W T O
E A T F O R H E A L T H . T H E G U I D E L I N E S
E N C O U R A G E A L L A M E R I C A N S T O E A T
A H E A L T H Y D I E T A N D B E P H Y S I C A L L Y
A C T I V E ( U S D A , 2 0 1 1 ) .

Readiness for enhanced
Spiritual well being
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Some of the interventions that would be helpful are:
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Spiritual books, magazines, and devotions about exercise and eating heathy.
She may have to make sure the environment is safe for all participants.
She needs to make sure the participants feel comfortable expressing their spiritual needs.
Imbalanced Nutrition: more than the body requirements related to caloric intake exceeding energy expenditure.
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The congregation overall economics. Will they have funds to eat healthy.
Educational background of the participants. What reading level are they ate.
Transportation to and from events, the grocery store, and church.

• In the bible Jesus and many of the disciples walked to preach to other communities.
• There were no cars or other means of transportation and this could be the start of an evangelism of faith in walking for Jesus.
• Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability.
• Among adults and older adults, physical activity can lower the risk of; early death, Coronary heart disease, Stroke,
High blood pressure, Type 2 diabetes, Breast and colon cancer, falls, and Depression (US Department of Health and Human Services, 2008).

The fellowship and laughter among the participants is immeasurable yet research shows that these too aid in general physical and mental health (Krueger, 2009).
• The Parish health nurse would need to have the ministry staff involved and kick off the campaign with the Sunday School Children and possibly if there is a school at a school event.
• She would need access to a walking path and time to set up a committee to help plan a kickoff event.
• Her resources may include bottles of water and poster signs.
• She would also need informational pamphlets that highlight the event and possibly some sort of awards for the end of the event.
• As the event nears she would have volunteers organize a sign-up sheet and recruit from various members of the church.
• She could do presentations a committee meetings and board meetings with sign-up sheets available.
• She could encourage whole family participations and the formation of teams.
• The walk could be divided into separate lengths depending on abilities and each would be identified by poster signs.
• Along the way could be posted bible verses about walking for Jesus and works that he did during his time with us.
• Some of the posters could have information on what exercise does for the body adding humor to the posters helps urge participants along the way.

• The Parish health nurse would need a few resources to start educating her congregation on healthy living.
• She would need written educational materials that are current and up to date on healthy eating lifestyle.
• The resources need to identify what eating healthy means.
• The parish health nurse can implement the program first through Sunday school presentation and then by doing a healthy snack for Sunday school and before and after church services.
• She can provide educational materials at the healthy snack event.
• She then can encourage the congregation to do a healthy lifestyle cookbook and receive healthy recipes from the congregation and through the USDA web site.
• She could integrate faith into the campaign by asking for the congregation to also submit any bible passages that relate to food or eating.
• Compiling the cookbook and sharing it with those who would like a copy along with healthy eating tips would be a way to reach those who need help choosing healthy recipes.
• She can implement a produce (garden vegetable ) sharing program.
• She can identify the local food bank and what healthy food choices they offer.

Let’s Get Cooking
The Guidelines encourage all Americans to eat a healthy diet and be physically active (USDA, 2011).
• She can even start a cooking club like Let’s get Cooking
(ttp://www.letsgetcooking.org.uk/associate).
• When asked what they had enjoyed most about the club, the comments suggest that the benefits might include developing self-confidence, as well as learning how enjoyable and rewarding cooking can be (Carter, 2010).
• The cooking club can be as easy as sharing recipes, to meeting once a month and cooking a meal in a home, or start a healthy eating blog page on the church web site that can include sharing healthy recipes.

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Mary will need to meet with the Parish staff to present the congregation needs that she identified in her assessment and the ideas for interventions.
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Her budget for the two programs needs to be itemized out.
She needs to have dates and times of when she wants to start the programs and to what length of time they will run.
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These may coordinate with Health Observances and Recognition Days
Calendar (Hickman, 2006).
She needs to identify resources she will need.
She also needs to identify in what way she will generate participation.
Finally she needs to ask the Parish staff to prayfully consider her recommendations and program plans with a prayer of thanksgiving to God and his graciousness for the opportunity to serve his people .

• Mary then need to reach out to the volunteers she has already on staff.
• Meeting with her volunteers she can present the ideas to them and the approval of the Parish staff.
• She can then divide the task at hand with the volunteers.
• She needs to focus on the individual gifts each volunteer brings to the table and match them up with a task.
• After identifying and dividing up task together the volunteers and Mary can set a time table to what will happen first and goals that need to be met.
• During this time the committee will identify how they would like to measure the success of the program.

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Using Healthy People 2020 as a planning guide for program development.
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Books, water bottles, posters, reward gifts, bulletins, thank you gifts.

• She can evaluate the plan by the number of participants and the impact it had made on those who participated.
• She can have an evaluation form to fill out about the participants experience and if they would participate again.
• She may have a drop box for those who want more information on healthy eating topics
• She could create a blog or web site for access by the congregations to express their ideas and needs for further education.

The Foundation of Parish Nursing is above all Christ centered passionate care
(Schnorr, 2014)
While health promotion for this congregation is focused on the assessment tool that identified exercise, and eating healthy the parish health nurse has included spiritual guidance throughout each phase. The Parish health nurse needs to continue to assess and address the topics and needs of the congregation.
As time changes so may these needs change. Her confidence in the new programs will be a benefit not only to herself but the congregation she serves. She needs to trust in the Lord that he will guide her.
Do not be afraid or terrified because of them, for the
Lord your God goes with you, he will never leave you nor forsake you. Deuteronomy 31:6 (NIV Bible, 1991)

REFERENCES
Carter, W. (2010). Let's Get Cooking -- a national network of healthy cooking clubs. Nutrition Bulletin, 35(1), 57-59. doi:10.1111/j.1467-3010.2009.01804.x
Community Preventive Services Task Force. Recommendations to increase physical activity in communities. Am J Prev Med
[Internet]. 2002 May [cited 2013 Feb 5];22 (4S):67-72. Available from http://www.thecommunityguide.org/pa/pa-ajpmrecs.pd
Hickman, J. S. , (2006). Philosophical and Theoretical Foundations of Faith Community
Holy Bible, (1991). Life Application Study Bible, New international Version. Grand Rapids, MI: Tyndale House Publishers.
Nursing. M. Zuccarini, & B. Gentzler Editor, Faith Community Nursing. Philadelphia, PA: Lippincott Williams & Wilkins.
Keener, D., Goodman, K., Lowry, A., Zaro, S., & Kettel Khan, L. (2009).
Recommended community strategies and measurements to prevent obesity in the United States: Implementation and measurement guide. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.thecommunityguide.org/index.html
Krueger, J. (2009). Faith based community: women's exercise program. Parish Nurse Perspectives, 8(4), 11
Schnorr, M. (2014). Health Ministry, Training Webinars, The Lutheran Church Missouri Synod. 2.7.14.lcms.org/health retrieved 11/2/2014
Schmidt, N. A. & Brown, J. M. (2012). Identifying Research Questions. In A. Clerkin (Eds.) Evidence-Based Practice For
Nurses. (pp. 78-80) Jones Bartlett Learning
USDA Publication number: Home and Garden Bulletin No. 232-CP HHS Publication number: HHS-ODPHP-2010-01-DGA-B
June 2011. http://www.choosemyplate.gov/foodgroups/downloads/MyPlate/DG2010Brochure.pdf
US Department of Health and Human Services (HHS), Office of Disease Prevention and Health Promotion. Physical activity guidelines advisory committee report, 2008. Washington: HHS, 2008.