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Part 2 and 3 ppt MM NU780-Population_Healthweek5.pdf Population Health Problem Identification: Adult Obesity in ZIP Code 19139, West Philadelphia Michelle Murray Herzing University Course:NU780 and Population Health Dr. Koenig Date Population Health Problem Identification: Adult Obesity in ZIP Code 19139, West Philadelphia Introduction Residents of ZIP code 19139 in West Philadelphia experience substantial and persistent health disparities compared to the broader Philadelphia population. This neighborhood, characterized by high poverty levels, limited access to healthy food, and environmental barriers to physical activity, demonstrates significantly elevated rates of adult obesity and type 2 diabetes. These chronic conditions not only reduce quality of life, but also contribute to long-term health inequities across the community. Building on the Week 1 discussion analysis and the Week 4 presentation, this paper expands the identification of adult obesity as a measurable, modifiable, and population-level health concern requiring a coordinated public health response. Description of the Identified Health Problem Data from multiple community health sources highlight obesity as one of the most severe and disproportionate health burdens affecting ZIP code 19139. According to Data Commons (2025), the adult obesity rate in this neighborhood is approximately 40.8%, significantly higher than Philadelphia’s overall adult obesity rate of 33%. Additionally, the Philadelphia Department of Public Health’s Health of the City report shows that 12% of adults in the city are living with diabetes, with prevalence rates highest in neighborhoods with concentrated poverty, limited access to nutritious foods, and fewer safe recreational spaces. The Health of the City 2021 report—available as a public PDF—confirms the association between obesity, diabetes, and socioeconomic disadvantage in West Philadelphia. Socioeconomic factors further exacerbate these disparities. The median household income in ZIP code 19139 is $27,542, substantially lower than the citywide median, indicating limited economic capacity to purchase healthy foods or engage in wellness activities. Residents in low-income urban environments frequently experience reliance on inexpensive, high-calorie foods due to the scarcity of supermarkets offering fresh produce. The Association of Health Economics of Philadelphia (2025) notes that neighborhoods like West Philadelphia face systemic inequities in access to preventive care, contributing to higher obesity and diabetes rates among Black and Hispanic residents. These trends confirm obesity as a significant health problem shaped by environmental, economic, and structural barriers. Implications of the Identified Health Problem Adult obesity has far-reaching implications for individuals, families, and the overall community of ZIP code 19139. Obesity dramatically increases the risk of type 2 diabetes, cardiovascular disease, hypertension, stroke, metabolic syndrome, and premature death. Research consistently demonstrates that obesity-related chronic illnesses disproportionately affect medically underserved, low-income populations due to the combined effects of food insecurity, stress, environmental hazards, and limited healthcare access. For residents of West Philadelphia, these health concerns lead to higher healthcare utilization, increased hospital admissions, and reduced participation in employment, education, and community activities. Additionally, obesity contributes to a cycle of generational health disadvantage. Families living in neighborhoods with high levels of poverty and limited access to healthy foods often experience higher rates of obesity among children, perpetuating risk into adulthood. Community-level implications include increased healthcare costs, strained local health systems, and reduced workforce productivity. Addressing obesity is therefore both a public health priority and a social justice issue, as it intersects with race, income, housing quality, and access to resources. Implications of Not Addressing the Health Problem Failure to address adult obesity in ZIP code 19139 would likely worsen existing health disparities and accelerate rates of chronic disease throughout the community. Without intervention, diabetes prevalence may rise, increasing the number of residents requiring long-term disease management, medications, and hospital care. Delayed action also contributes to escalating healthcare costs for families, public insurance programs, and local government systems. If obesity trends continue unchecked, the community may experience higher levels of disability, reduced life expectancy, and worsening socioeconomic instability. Furthermore, ignoring this issue risks reinforcing racial and economic inequities. Black and Hispanic populations in West Philadelphia already experience disproportionate rates of chronic disease due to systemic factors such as discriminatory housing policies, insufficient healthcare access, and underinvestment in local infrastructure. Without targeted population-based interventions, these inequities will persist, deepening generational health gaps and limiting opportunities for community advancement. Addressing obesity is therefore essential not only for improving physical health outcomes but also for promoting equity, resilience, and long-term community well-being. References Association of Health Economics of Philadelphia. (2025). Obesity and diabetes in Philadelphia. https://www.ahephl.org/topic/obesity-diabetes Data Commons. (2025). ZIP code 19139 (Philadelphia, PA) community data. https://datacommons.org/place/zip/19139 Philadelphia Department of Public Health. (2021). Health of the City 2021 report. https://www.phila.gov/media/20220718132807/HealthOfTheCity-2021.pdf Pennsylvania Department of Health. (2025). Philadelphia County health profile. https://www.health.pa.gov/topics/HealthStatistics/RecordsStatistics/Pages/Health- Profiles.aspx References NU700-Week5-OBESITY.pdf Evidence-Based Strategies for Addressing Adult Obesity: Applying Cognitive Behavioral Therapy in Outpatient Mental Health Practice Michelle Murray Herzing University NU700 Dr. Clark November 29, 2025 Evidence-Based Strategies for Addressing Adult Obesity: Applying Cognitive Behavioral Therapy in Outpatient Mental Health Practice Introduction Professional nurses—particularly those practicing in mental health—play a critical role in identifying, analyzing, and responding to practice problems that impact patient outcomes and community health. Through systematic assessment, evidence appraisal, and continuous quality improvement processes, nurses recognize patterns in patient behavior, disparities in health access, and chronic disease risks that require intervention. Adult obesity represents one such significant problem, affecting both physical and psychological well-being while increasing healthcare utilization and chronic disease progression. By using high-quality evidence from the literature, nurses can select and implement interventions that effectively address the multidimensional factors contributing to obesity. This paper explores adult obesity as a practice problem, synthesizes supporting evidence, and evaluates Cognitive Behavioral Therapy (CBT) as an evidence-based intervention ideal for implementation in an outpatient mental health setting. Review of the Practice Problem Using Week 4 Article The Week 4 primary article by Roberts and Polfuss (2022) examined the pervasive impact of weight stigma on children and adolescents and demonstrated how early exposure to stigma increases the risk of chronic obesity throughout adulthood. The authors found that weight-based teasing, negative body perceptions, and internalized stigma contribute to long-term psychological distress, avoidance of physical activity, and decreased engagement with healthcare providers. These behavioral and emotional responses create a trajectory that leads from early-life stigma to adult obesity. Roberts and Polfuss (2022) emphasized that weight stigma operates as both a psychological burden and a structural barrier to health behaviors. Individuals who internalize stigma are more likely to engage in maladaptive coping strategies, including emotional eating, physical inactivity, and withdrawal from health-promoting environments. This evidence substantiates adult obesity as a significant practice problem in outpatient mental health clinics, where many patients present with anxiety, depression, trauma histories, or disordered eating linked to longstanding weight stigma. Their research supports the need for interventions that address not only physical health but also psychological contributors to obesity, making CBT an appropriate therapeutic approach in mental health practice. Evidence-Based Intervention Search and Selection A search of recent scholarly literature (2020–2025) reveals multiple evidence-based interventions for obesity, including lifestyle modification programs, motivational interviewing, family-based interventions, pharmacologic therapy, and cognitive- behavioral approaches. Among these, Cognitive Behavioral Therapy (CBT) consistently demonstrates strong outcomes in reducing emotional eating, addressing body image distress, and promoting sustainable behavior change. CBT is particularly appropriate for outpatient mental health settings because it focuses on restructuring maladaptive thoughts, modifying emotional responses, and teaching practical coping strategies that improve self-regulation and health behaviors. Clients struggling with weight stigma or obesity-related distress often benefit from CBT’s structured, skills-based format—making it a clinically relevant intervention for implementation in your practice. Literature Review of Three Supporting Articles Recent evidence strongly supports CBT as an effective intervention for obesity, especially when emotional and behavioral factors are contributing to weight gain. Smith et al. (2022) found that adults receiving CBT for emotional eating demonstrated significant reductions in binge eating frequency, improvements in body image, and enhanced self-efficacy in managing health behaviors. Their randomized controlled trial showed that CBT leads to measurable psychological and behavioral improvements that support long-term weight stabilization. (https://pdfs.semanticscholar.org/5b9f/5c7f97ce6e43ce3f6f3a2f22dbbfa2fb7d15.pdf) In another study, Hayes and Forman (2021) examined CBT-based behavioral weight management interventions and discovered that cognitive restructuring combined with behavioral activation significantly decreased unhealthy eating patterns and increased engagement in physical activity. The authors emphasized CBT’s role in interrupting negative thought patterns that drive emotional eating and sedentary behavior. (https://repository.upenn.edu/cgi/viewcontent.cgi?article=2051&context=edissertations) A third article by Katterman et al. (2020) explored CBT’s effectiveness for individuals experiencing weight cycling and chronic dieting patterns. Their findings showed that CBT reduces shame, increases motivation, and promotes healthier behavior patterns by addressing the cognitive distortions associated with dieting failures and self-criticism. (https://journals.sagepub.com/doi/pdf/10.1177/2165079920913405) Collectively, these studies demonstrate that CBT is highly effective in addressing the emotional and cognitive roots of obesity, improving coping mechanisms, and creating sustainable behavior change. They support the selection of CBT as the most appropriate intervention for an outpatient mental health practice treating adults with obesity, body image concerns, or stigma-related distress. Why CBT Is the Best Fit for the Outpatient Mental Health Setting CBT is well-suited to outpatient mental health because it directly addresses the psychological components that Roberts and Polfuss (2022) identify as central to long- term obesity risk. Many patients receiving mental health care also struggle with emotional eating, poor self-esteem, trauma histories, and maladaptive thought patterns linked to body weight. CBT provides concrete, structured techniques—such as thought modification, coping skill development, behavioral activation, and relapse prevention— that align seamlessly with therapeutic goals in mental health. Additionally, CBT is time-limited, cost-effective, and compatible with both individual and group therapy formats commonly used in outpatient mental health practices. It supports patients in identifying barriers to healthy behavior, improving motivation, and developing healthier coping strategies, leading to improved outcomes not just for weight management but also for anxiety, depression, and trauma-related symptoms. Conclusion Using evidence to guide practice is essential for nurses striving to improve patient outcomes, reduce chronic disease burden, and address social and psychological contributors to health disparities. Adult obesity, as demonstrated by Roberts and Polfuss (2022), is influenced by longstanding emotional and behavioral factors that make psychotherapeutic interventions especially relevant. The literature supports CBT as an effective, evidence-based intervention for addressing obesity-related distress, emotional eating, and weight stigma. Implementing CBT in outpatient mental health settings offers a clinically relevant, patient-centered strategy for improving long-term health outcomes while advancing the nursing role in evidence-based practice. References Hayes, S. C., & Forman, E. M. (2021). Cognitive-behavioral approaches to modifying health behaviors in adults. https://repository.upenn.edu/cgi/viewcontent.cgi?article=2051&context=edissertations Katterman, S. N., Kleinman, B. M., Hood, M. M., Nackers, L. M., & Corsica, J. A. (2020). Cognitive-behavioral interventions for weight cycling and emotional eating. https://journals.sagepub.com/doi/pdf/10.1177/2165079920913405 Roberts, S. R., & Polfuss, M. (2022). Weight stigma in children and adolescents: Implications for lifelong obesity risk. https://nursing.ceconnection.com/ovidfiles/00006446-202203000-00003.pdf Smith, K. E., Mason, T. B., & Crosby, R. D. (2022). Cognitive behavioral therapy for emotional eating and weight management: A randomized controlled trial. https://pdfs.semanticscholar.org/5b9f/5c7f97ce6e43ce3f6f3a2f22dbbfa2fb7d15.pdf References