“The future of healthcare lies in coaching- people helping people. And nurses are the key actors that are going to change the future of healthcare. Doing it in communities with nurses, coaching people to health, is where we all need to be.” -Mark Hyman, MD
Dr. Hyman- physician, author, and Advisory Board Member for the International Nurse Coach Association- is featured in a new documentary, Fed Up, exposing the powerful impact of the food industry on childhood obesity. Dr. Hyman’s insights come at a particularly important time both for families struggling with obesity as well as nurses who are looking for a more proactive role in patient’s lives.
In fact, the World Health Organization reports that childhood obesity is one of the most serious public health challenges of the 21st century. The WHO states that more than 42 million children under the age of five were overweight in 2010, and close to 35 million of these children live in developing countries. In the United States, more than one-third of adults and 17% of children are obese, and these numbers are not getting any better according to a JAMA study released earlier this year. And while there may be minimal progress in reducing childhood obesity rates amongst preschoolers, the number of extremely obese children, those who are most at risk for lifelong disease, has increased.
Overweight and obese children are likely to stay obese into adulthood and are more likely to develop diabetes and cardiovascular diseases at a younger age. This epidemic could cost as much as $19,000 per child in medical expenses over a lifetime. According to the report, these conditions, as well as their related diseases, are largely preventable.
Many physicians recognize the need for families to make lifestyle changes, and may even encourage their patients to increase physical activity and improve their diets. However, more is needed. If a physician recommends an increase in physical activity or changes in diet, the whole family needs support and ongoing guidance in making those changes. Nurses, and specifically Nurse Coaches, have the skills and expertise to effectively support families in making changes to reverse these escalating patterns of illness for a more sustainable future.
Working Through Barriers to Change
A Nurse Coach working with a family towards a healthier lifestyle could begin by asking open-ended questions about their lifestyle such as these:
- Can you tell me a little about your home environment?
- Imagine you and your family went for a walk near your home, what kinds of things would you see, hear and smell?
- Take me through a typical school day? What about the weekend?
- What is bedtime like at your house? How do you feel in the morning?
- Who are the people you typically see and talk to throughout the week?
- Tell me about a trip to the grocery store? What is that like for you?
- How would you describe your family’s attitude towards health?
- What does being healthy mean to you?
Using active listening skills, the Nurse Coach gathers information and insights about important issues such as access to fresh and local food, as well as underlying beliefs that may be driving unhealthy behaviors. Nurse coaches can then work in collaboration with the family to set realistic, attainable goals considering their individual circumstances. With the guidance and accountability of the Nurse Coach, families receive the support they need to make lasting changes. Group coaching for several families at once is also a powerful tool for creating healthy communities through the influence of social connections and support.
Organizations such as the National Institute for Children’s Health Quality encourage healthcare providers to include proactive choices, such as breastfeeding, as part of their 5-point Obesity Prevention Model. Nurse Coaches forming relationships with families in the early stages of life can provide the ongoing support to maintain healthy lifestyles.
Nurse Coaches Lead the Way
It is time to envision and take action towards a culture that promotes healthy lifestyles. Nurses have an opportunity to take the lead in transforming this epidemic of childhood obesity. Do you work with childhood obesity? Please share your thoughts in the comments below.