This paper discusses obesity in Florida. Obesity rates are high, with 36% of Florida adults overweight and 26.2% obese. Obesity increases risks for diseases like diabetes and heart disease. As a future nurse practitioner, the author plans to screen patients for obesity, discuss weight management, and work with communities to increase access to healthy foods and physical activity.

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Running head: OBESITY
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Running head: OBESITY
Obesity
Lauren Urquiza
Chamberlain University
NR503 Population Health, Epidemiology, & Statistical
Principles
January 2018
Obesity
Obesity is a chronic medical condition and a significant
health concern in the United States that is increasing
worldwide. More than one third of the adults in the U.S. are

2. obese. It is a leading cause of preventable illness and death
(Centers for Disease Control and Prevention [CDC], 2016). This
global epidemic is a leading concern for adults and for children
who are predisposed to becoming obese as adults. This paper
will discuss the significance of obesity in Florida, provide a
background of the disease, review current surveillance and
reporting methods, conduct a descriptive epidemiological
analysis, discuss diagnosis and screening for prevention tools,
develop an evidence based plan along with measureable
outcomes to address obesity as an advanced practice nurse, and
conclude with an overview of the main points presented.
Background and Significance
According to the CDC (2016), obesity is defined as
“weight that is higher than what is considered as a healthy
weight for a given height.” It involves excessive weight gain
and accumulation of fat. In order to determine obesity, Body
Mass Index or BMI is used to indirectly calculate a person’s
body fat and health risk based on weight in relation to height. A
BMI of 25.0 or above is considered overweight and 30.0 or
greater is considered obese. Athletes with a greater amount of
muscle mass may have a higher BMI even though they do not
have excess body fat. Waist circumference is also used as a tool
to diagnose obesity.
There are many causes that contribute to obesity, including
behavioral, genetic, hormonal, environmental, and social
factors. Increase in caloric intake, unhealthy eating habits,
decrease in physical activity, certain medications, age, lack of
sleep, quitting smoking, pregnancy, and certain medical
disorders can contribute to weight gain (Mayo Clinic, 2018).
Driving cars has replaced walking and riding bikes, technology
has replaced engaging in physical activity, and easy access to
cheaper foods has replaced nutritional importance. Most people
are aware when weight is gained. Obvious signs and symptoms
are tighter clothes, excess fat, and increased weight on a scale.
Being overweight or obese increases the risk for many health
diseases. Obesity may cause low endurance, breathing issues,

3. excessive sweating, and joint discomfort. It can also lead to
diabetes, gastroesophageal reflux disease, coronary heart
disease, hypertension, high cholesterol, stroke, depression, and
even certain types of cancer such as bowel, breast, and prostate
cancer (Mayo Clinic, 2018).
Below is a map that highlights the obesity prevalence
across the U.S. in 2016 according to the CDC. There is no
significant difference in overall prevalence between men and
women. The prevalence of women with a BMI > 35 is 18.3%
compared to 12.5% of men. The highest prevalence of obesity is
32% in the South, followed by 31.4% in the Midwest, 26.9% in
the Northeast, and 26% in the West. Globally, in 2016 more
than 1.9 billion (39%) adults were overweight and over 650
million (13%) were considered obese (WHO, 2017).
Current Surveillance Methods
A surveillance system is used to examine public health
issues and monitor long term trends, compare health, and
determine improving or worsening factors (CDC, 2016).
Behavioral Risk Factor Surveillance System (BRFSS) is one of
the largest continuously conducted on going telephone health
survey system in the world, completing more than 400,000
interviews yearly. BRFSS collects state data in all 50 states
from residents regarding health related risk behaviors, chronic
health conditions, and use of preventive services, which aids
targeting and building health promotion activities (CDC, 2016).
The National Health Interview Survey (NHIS) monitors the
health of the U.S. population through the collection and analysis
of data related to health topics. Data is collected through
personal household interviews. This data allows to tracks the
progress toward achieving national health objectives (CDC,
2016).
Descriptive Epidemiological Analysis
Florida has an estimated population of 20,271,272, and
approximately 160 million Americas are overweight or
obese.Florida is noted to have 36% of adults who are

4. overweight and 26.2% of adults who have obesity (CDC, 2016).
Locally, Pembroke Pines, Florida, has a prevalence of 24.8%
among adults greater than 18 years of age (CDC, 2016). Obesity
affects people of all ethnic and racial groups, all ages, and both
males and females. The highest rates of obesity are among the
non-Hispanic blacks (48.1%), followed by Hispanics (42.5%),
non-Hispanic whites (34.5%), and non-Hispanic Asians
(11.7%). Middle age adult’s, ages 40-59 (40.2%) are more at
risk, as well as older adults over 60 years of age (37%) (CDC,
2016).
In Florida, 38% of adults consume fruit less than one time
per day, and 20.8% of adults consume vegetables less than one
time per day. Approximately 50.2% of adults engage in at least
150 minutes of moderate physical activity per week (CDC,
2016). These alarming statistics may help create a prevention
plan by educating the community on the importance of
consuming more healthy foods to reduce the rate of obesity.
Screening and Diagnosis
Health care providers use BMI as a screening tool to
determine if one is underweight, healthy weight, overweight, or
obese. BMI is calculated by dividing a person’s weight in
kilograms by the person’s height in meters. A BMI of 18.5 is
underweight, 18.5-25.9 is healthy weight, 25.0-29-9 is
overweight, and 30.0 or above is considered obese. It is an easy
and inexpensive method of screening for obesity. The
sensitivity and specificity of BMI screening for men is
approximately 73.7% and 72.5% and for women 76.3% and
100% (Vasconcelos, Cordeiro, Rech, & Petroski, 2010).
Healthcare providers also take into consideration and assess
additional risk factor such as diet, physical activity, and family
history. Other more expensive screening methods that are used
are skinfold thickness measurements, underwater weighing,
dual-energy x-ray absorptiometry (DXA), and isotope dilution
(CDC, 2017).
In 2008, obesity related medical costs estimated $147
billion in the U.S.; about $1,429 more per obese persons than

5. healthy weight persons (Mennella & March, 2016). It is
recommended for health care providers to screen all adults for
obesity to identify at risk individuals for early intervention. For
patients with a BMI > 30, health care providers should
recommend intensive multi-component counseling, including
behavioral management activities, diet and nutrition
improvement, increasing daily physical activity, self
monitoring, and addressing strategies on how to maintain
lifestyle modification (Yao, 2013).
Plan of Action
As a future Family Nurse Practitioner (FNP), it is
important to recognize the negative health outcomes, morbidity,
mortality, and the costly healthcare costs associated with
obesity. It is important for healthcare professionals to initiate
evidence based practice strategies to treat and prevent obesity,
regardless of age. Given the high prevalence of obesity in the
U.S., this writer believes it is important to develop a rapport,
initiate a discussion, and recommend non-pharmacological
treatment goals about weight management with every patient.
“While research has shown that patients are more likely to try
and lose weight and to have a greater weight loss success if they
have been advised by their health care provider to lose weight,
research has also shown that only 27% to 42% of obese patients
seeking medical help are advised to lose weight” (American
Nurse Practitioner Foundation, 2013).
As a FNP, an example of a goal would be to work with
local government officials and community leaders to create
more farmers’ markets in different communities to advocate
healthy living. The lack of education within communities plays
a major role in the rising obesity rates. This writer would
discuss with patients about setting daily caloric restrictions,
maintaining portion control, and utilizing a daily food and
activity diary to improve weight loss goals. Patients would then
follow up during office visits to measure the outcomes. The 5
A’s is an evidence based approach to behavior change allowing
patients to collaborate with their provider. Providers would ask

6. about the patients health behaviors, assess patients readiness to
change, advise about risks and benefits, assist with goal setting,
and arrange follow ups to assess progress and reassess goals.
(American Nurse Practitioner Foundation, 2013). Also, this
writer would provide patients with community resources by
identifying different farmer market with nutrition assistance
programs, and different locations of local parks, pools, and
health food stores.
Conclusion
The obesity epidemic continues to rise and has proven to
be difficult to reverse. It is a complex public health issue and
has been one of the most difficult to overcome. This paper
discussed the significance of obesity in Florida, provided a
background of the disease, reviewed current surveillance and
reporting methods, conducted a descriptive epidemiological
analysis, discussed diagnosis and screening for prevention tools,
and developed an evidence-based plan along with measureable
outcomes to address obesity as an advanced practice nurse.
Obesity is a major public health issue, but by implementing the
right polices and strategies, the growing epidemic of obesity
can change. It takes a collaborative and comprehensive
approach involving governments, media, health care providers,
and individuals in reversing the U.S. obesity epidemic.

7. Reference
American Nurse Practitioner Foundation. (2013). Nurse
practitioners and the prevention and treatment of adult
obesity. Retrieved from
http://international.aanp.org/Content/docs/ObesityWhitePa
per.pdf
Centers for Disease Control and Prevention. (2017). About adult
BMI. Retrieved from
https://www.cdc.gov/healthyweight/assessing/bmi/adult_b
mi/index.html
Centers for Disease Control and Prevention. (2016). Overweight
and obesity. Retrieved from
https://www.cdc.gov/obesity/adult/defining.html
Centers for Disease Control and Prevention. (2016). 500 cities
project: Local data for better health 2014. Retrieved from
ftp://ftp.cdc.gov/pub/MAPBOOKS/FL_Pembroke%20Pines
_MB_508tag.pdf
Mayo Clinic. (2018). Obesity. Retrieved from
https://www.mayoclinic.org/diseases-
conditions/obesity/symptoms-causes/syc-20375742
Mennella, H. A., & March, P. P. (2016). Case management:
Obesity. CINAHL Nursing Guide.
Vasconcelos F. A., Cordeiro, B. A., Rech, C. R., & Petroski, E.
L. (2010). Sensitivity and specificity of body mass index
for the diagnosis of overweight/obesity in elderly. Retrieved
from http://www.ncbi.nlm.nih.gov/pubmed/21229211
World Health Organization. (2017). Obesity and overweight.
Retrieved from
http://www.who.int/mediacentre/factsheets/fs311/en/
Yao, A. (2013). Screening for and management of obesity in
adults: U.S. preventive services task force recommendation
statement: A policy review. Ann Med Surg, 2(1), 18-21.

8. Evaluation of Epidemiological Problem
Guidelines & Grading RubricPurpose
The purpose of this assignment is to
· Provide learners with the opportunity to integrate knowledge
and skills learned throughout this course
· Directly apply principles and knowledge learned in the course
to problem solving of population health problems in their own
geographic areas. Course Outcomes
This assignment enables the student to meet the following
course outcomes:
1. Define key terms in epidemiology, community health, and
population-based research.
2. Compare study designs used for obtaining population health
information from surveillance, observation, community, and
control trial based research.
3. Identify appropriate outcome measures and study designs
applicable to epidemiological subfields such as infectious
disease, chronic disease, environmental exposures, reproductive
health, and genetics.
4. Apply commonly used measures of health risk.
5. Examine current ethical/legal issues in epidemiology.
6. Identify important sources of epidemiological data.
7. Evaluate a public health problem in terms of magnitude,
person, time, and place.
Due Date: Sunday, 11:59 p.m. MT at the end of Week 6.
Total Points Possible: 150Requirements
This paper should clearly and comprehensively identify the
disease or population health problem chosen. The problem must
be an issue in your geographic area and a concern for the
population you will serve upon graduation with your degree.
The paper should be organized into the following sections:
1. Introduction with a clear presentation of the problem as well
as significance and a scholarly overview of the paper.

9. 2. Background of the disease including definition, description,
signs and symptoms, and current incidence and/or prevalence
statistics current state, local, and national statistics pertaining
to the disease. (Include a table of incidence or prevalence rates
by your geographic county, state, and national statistics.)
3. A review of current surveillance methods and any mandated
reporting or methods for reporting the disease for providers.
4. Conduct descriptive epidemiology analysis of the disease
including who is more frequently affected and characteristics of
the population that might help in creating a prevention plan.
Include costs (both financial and social) associated with the
disease or problem.
5. Review how the disease is diagnosed, current national
standards for screening or prevention, and pick one screening
test and review its sensitivity, specificity, positive predictive
value, cost and any current national guidelines for conducting
which patients to conduct this test on.
6. Provide a brief plan of how you will address this
epidemiological disease in your practice once you are finished
with school. Provide three actions you will take along with how
you will measure outcomes of your actions.
7. Conclude in a clear manner with a brief overview of key
points of the entire disease, Preparing the Paper
· Page length: 7-10 pages, excluding title/cover page
· APA format 6th edition
· Include references when necessary.
· Include at least one table to present information somewhere in
the paper. Directions and Grading Criteria
Category
Points
Possible
Points Earned
Comments
Scholarly Introduction (clear presentation of problem)
10

10. Background and significance of the disease (includes incidence
or prevalence statistics)
25
Current surveillance methods
25
Descriptive epidemiological analysis (includes characteristics of
the at-risk population and/or those affected by the disease and
costs of the disease)
25
Screening and diagnosis (includes review of current guidelines
for screening and diagnosis of the disease. In-depth review of
statistics one screening or diagnostic test provided)
25
Plan of action (includes at least three evidenced based actions,
supported by literature, that the student will take in their own
practice and how outcomes will be measured)
25
Conclusion
10
Mechanics of writing, APA
5

11. Total
150
Total Points earned =
A quality paper will meet or exceed all of the criteria
requirements.
Chamberlain College of Nursing NR503
Population Health, Epidemiology, & Statistical Principles
January 2018
Grading Rubric
Assignment Criteria
Exceptional
Outstanding or highest level of performance
Exceeds
Very good or high level of performance
Meets
Competent or satisfactory level of performance
Needs Improvement
Poor or failing level of performance
Developing
Unsatisfactory level of performance
Identification of the problem/concern
10 Points
9 Points
8 Points
4 Points
0 Points
Comprehensively identifies the problem/concern
Adequately identifies the problem/concern
Identification of problem/concern is limited
Identification of problem/concern is unclear.

12. Identification of problem/concern is absent
Background and significance of the disease (includes incidence
or prevalence statistics)
25 Points
22 Points
20 Points
10 Points
0 Points
Background is complete, presents risks, disease impact and
includes a review of incidence and prevalence of the disease
within the student’s local area, state, and nationally. Evidence
supports background.
Background is complete, presents risk, disease impact and at
least one set of incidence and prevalence statistics are presented
and supported by evidence.
Background missing one or more key points and at least one set
of incidence and prevalence statistics are presented. Lack of
evidence or limited presentation of the background.
Background missing more than one key point and at least one
set of incidence and prevalence statistics are presented, or there
is no supported evidence. Unclear conclusions or presentation.
Background and significance of the disease is not provided.
Current surveillance methods
25 Points
22 Points
20 Points
10 Points
0 Points
Current local, state, and national disease surveillance methods
are reviewed, currently gathered types of statistics, and
information on whether the disease is mandated for reporting,
supported by evidence
More than one local, state, and national disease surveillance
methods are reviewed, currently gathered types of statistics, and

13. information on whether the disease is mandated for reporting,
supported by evidence
One of either local, state, and national disease surveillance
methods are reviewed, currently gathered types of statistics, and
information on whether the disease is mandated for reporting,
supported by evidence
One of either local, state, and national disease surveillance
methods are reviewed, currently gathered types of statistics, or
only information on whether the disease is mandated for
reporting, or evidence is lacking to support this area. Unclear
conclusions or presentation.
Local, state, and national disease surveillance methods were not
discussed.
Descriptive epidemiological analysis (includes characteristics of
the at-risk population and/or those affected by the disease and
costs of the disease)
25 Points
22 Points
20 Points
10 Points
0 Points
Comprehensive review and analysis of descriptive
epidemiological points of the identified disease and population
most at risk, supported by scholarly evidence.
Adequate review with some analysis of descriptive
epidemiological points of the identified disease and population
most at risk supported by scholarly evidence.
Limited review and analysis of key descriptive epidemiological
points of the identified disease and at-risk population.
Minimal analysis of key descriptive epidemiological points of
the identified disease and at-risk population.
No analysis of key descriptive epidemiological points of the
identified disease and at-risk population is provided.
Screening and diagnosis (includes review of current guidelines
for screening and diagnosis of the disease. In-depth review of

14. statistics one screening or diagnostic test provided)
25 Points
22 Points
20 Points
10 Points
0 Points
Comprehensive review of current guidelines for screening,
diagnosis, and statistics related to validity, predictive value,
and reliability of screening tests is presented.
Adequate review of guidelines for screening, diagnosis, and
statistics related to validity, predictive value, and reliability of
screening tests is presented.
Limited review of guidelines for screening, diagnosis, and
statistics related to validity, predictive value, and reliability of
screening tests.
Minimal or unclear review of guidelines for screening,
diagnosis, and statistics related to validity, predictive value,
and reliability of screening tests.
Review of guidelines for screening, diagnosis, and statistics
related to validity, predictive value, and reliability of screening
tests not provided.
Plan of action (includes at least three evidenced based actions,
supported by literature, that the student will take in their own
practice and how outcomes will be measured)
25 Points
22 Points
20 Points
10 Points
0 Points
A comprehensive plan of action specific to the student’s
interests, the problem, and the geographic area is presented with
3 evidenced based actions that will be taken to address the
impact, outcomes, or prevalence of the disease.

15. An adequate, but not fully comprehensive, plan of action
specific to the student’s interests, the problem, and the
geographic area is presented with 3 evidenced based actions that
will be taken to address the impact, outcomes, or prevalence of
the disease.
A limited plan of action specific to the student’s interests, the
problem, and the geographic area is, outcomes, or prevalence of
the disease. Three actions are presented with limited or little
evidence.
Actions are minimal or unclear, or lack specificity to
geographic area, are not supported directly by evidence or are
not direct actions the student can take in practice.
Plan of action not provided.
Conclusion
10 Points
9 Points
8 Points
4 Points
0 Points
The conclusion thoroughly, clearly, succinctly, and logically
presents major points of the paper with clear direction for
action.
The conclusion adequately and logically presents major points
of the paper with clear direction for action, but lacks one major
point or is not succinct.
The conclusion is a limited review of key points of the paper, is
not succinct, or lacks one or more major points of the paper or
clear direction for action.
Conclusion is unclear or significantly limited in overview of the
paper.
Conclusion not provided.
Grammar, Spelling, APA
5 Points
4 Points
3 Points

16. 2 Points
0 Points
APA format, grammar, spelling, and/or punctuation are
accurate, or with zero to one errors.
Two to four errors in APA format, grammar, spelling, and
syntax noted.
Five to seven errors in APA format, grammar, spelling, and
syntax noted.
Eight to nine errors in APA format, grammar, spelling, and
syntax noted.
Post contains greater than ten errors in APA format, grammar,
spelling, and/or punctuation or repeatedly makes the same
errors after faculty feedback.
Total Points Possible = 150 points