HCS 245 Week 5 Health Promotion and Wellness Programs Example

From Treating Stiff Knees to Walking Them Out: A City Parks Department Brings an Evidence-Based Arthritis Walking Program to Four Senior Centers

[Student Name]

University of Phoenix

HCS/245: Introduction to Health and Disease

Week 5 Assignment

[Instructor Name]

[Date]

The parks department, its centers and its figures are composites written for a model paper; prevalence and program results come from the sources listed.

At a composite city's largest senior center, a survey of 212 regular visitors found that 71 said joint pain kept them out of the exercise classes. Most had osteoarthritis in the knees or hips, and many had been told by their doctors to stay active without being told how. The city's parks and recreation department, which runs four senior centers, asked its wellness coordinator to propose a program. This paper explains the health promotion perspective behind the proposal, the evidence for the program chosen and what running it will require.

Two Ways of Seeing Arthritis

Under a medical model, arthritis is a disease of the joints to be diagnosed and treated. Care centers on pain relievers, anti-inflammatory drugs, injections and, eventually, joint replacement. These services matter, but they are delivered in clinics and hospitals and depend on the patient coming to them.

The Health Promotion View

In its Ottawa charter, the World Health Organization (1986) described health promotion as the process of enabling people to increase control over their health, and called for supportive environments and community action alongside health services. Applied to arthritis, this view asks what people can do each day to keep moving, and what settings make that easier.

How Common Arthritis Is

Fallon et al. (2023), using national survey data from 2019 to 2021, estimated that 21.2% of U.S. adults, about 53.2 million people, had diagnosed arthritis. Prevalence was higher in women than in men, and adults aged 45 and older accounted for 88.3% of adults with the condition. About half of adults aged 65 and older with conditions such as heart disease, diabetes or chronic lung disease also had arthritis.

Why This Trend Matters to Services

As the population ages, more people will live with arthritis and with other chronic conditions alongside it. Clinics alone cannot supply the daily activity those people need. Community settings such as senior centers, parks and libraries are where regular activity can happen.

What Activity Guidelines Say

Piercy et al. (2018), summarizing the federal Physical Activity Guidelines, reported that adults gain substantial benefits from at least 150 minutes a week of moderate activity, that some activity is better than none, and that adults with chronic conditions should be as active as their abilities allow. Walking is the most accessible way for most older adults with arthritis to begin.

The Program Chosen

The Arthritis Foundation's Walk With Ease program runs six weeks. Participants walk three times a week, building toward 30 minutes, and learn about pain management, pacing and stretching. It can be run as an instructor-led group or done alone with a guidebook.

Evidence for the Program

Callahan et al. (2011) evaluated 462 adults with self-reported arthritis who chose either the group format or the self-directed format. After six weeks, both groups showed improvements in pain, fatigue, stiffness, disability, strength, balance and walking pace, with modest to moderate effect sizes, and no adverse events were reported. At one year, some benefits remained, particularly among the self-directed walkers. The study was observational without a control group, so the size of the effects should be read cautiously.

Why the Parks Department

The department already owns the centers, walking paths at two parks and an indoor track at a recreation center for winter. Its staff know the visitors by name. A clinic would need to recruit these people; the department already sees them weekly. Its buildings are also on bus lines and have accessible restrooms and parking, details that decide whether an older adult with sore knees attends a program at all.

Partners

A regional hospital's physical therapy department will train leaders and accept referrals for anyone whose pain worsens. Two primary care practices will hand out program cards. The local Area Agency on Aging will list the program in its directory and help with transport for visitors who cannot drive.

Leaders and Schedule

Eight staff members and volunteers will be trained as leaders. Each center will run two six-week groups a year, spring and fall, meeting Monday, Wednesday and Friday mornings. Visitors who prefer to walk alone will receive the guidebook and a weekly phone check.

Costs

The main costs are leader training, guidebooks for participants, pedometers and part of the coordinator's time: about $14,500 in the first year. A state healthy aging grant will cover $9,000, and the department's recreation budget the rest. Participants pay nothing.

Reaching Those Most Affected

Men made up only a quarter of the survey respondents with joint pain but are less likely to join group classes. The department will offer one group at a hardware store's parking lot walking loop on Saturday mornings and invite men through a veterans' organization.

Safety

Leaders will ask participants about recent falls, chest pain and joint replacements, and refer anyone with new symptoms to the physical therapy partner before starting. Groups walk on level surfaces at first. Leaders carry a phone and a first aid kit, and each center posts the route and the nearest bench on a card so walkers who tire can rest and rejoin the group on its way back. On hot days, the indoor track replaces the outdoor loop.

Measures

Sign-ups and completion of at least 12 of 18 sessions. Self-rated pain and stiffness on a zero-to-ten scale at weeks one and six. A timed 50-foot walk at weeks one and six. A three-month follow-up call asking whether participants still walk at least three times a week.

What Could Go Wrong

The largest risk is dropout in the second and third weeks, when soreness from new activity can be mistaken for worsening arthritis. Leaders will explain in the first session that some muscle soreness is expected and will call anyone who misses two sessions in a row. A second risk is that the groups fill with visitors who were already active, leaving out the people with the most pain; the coordinator will reserve half the places for visitors who reported joint pain in the survey.

Links to Medical Care

The program does not replace clinicians. Participants are encouraged to share their results with their doctors, and the primary care partners receive a summary of the group's outcomes each season.

Conclusion

A medical model treats arthritis once it brings a person to a clinic. A health promotion model builds the daily habits that keep people moving and places them where people already are. National data show the size of the need, the walking program has published results in both formats, and the parks department has the settings and relationships to deliver it. With partners, a modest budget and clear measures, the program turns a common chronic disease into a reason to walk rather than to stay home.

References

Callahan, L. F., Shreffler, J. H., Altpeter, M., Schoster, B., Hootman, J., Houenou, L. O., Martin, K. R., & Schwartz, T. A. (2011). Evaluation of group and self-directed formats of the Arthritis Foundation's Walk With Ease Program. Arthritis Care & Research, 63(8), 1098-1107. https://doi.org/10.1002/acr.20490

Fallon, E. A., Boring, M. A., Foster, A. L., Stowe, E. W., Lites, T. D., Odom, E. L., & Seth, P. (2023). Prevalence of diagnosed arthritis: United States, 2019-2021. MMWR. Morbidity and Mortality Weekly Report, 72(41), 1101-1107. https://doi.org/10.15585/mmwr.mm7241a1

Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020-2028. https://doi.org/10.1001/jama.2018.14854

World Health Organization. (1986). Ottawa charter for health promotion. https://www.who.int/publications/i/item/WH-1987