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Case Study: John Doe

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Julian Pisczak

on 29 April 2014

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Transcript of Case Study: John Doe

Case Study: John Doe
KINS 6700
Julian Pisczak

Married; 2 children
2 sisters, 1 autistic brother
Many friends around the community and neighborhood
Good job environment/well liked by co-workers
Both family and friends are supportive and encourage behavior change
Limited PA (no structured program)
Eats fast food quite regularly for lunch, has home cooked meals for dinner
Enjoys meeting up with friends to eat and drink on the weekends
3 Theories for Nutrition
1. Theory of Planned Behavior (TPB)
planning ahead will make eating healthier easier than having to make a decision on the spot
won't be pressured by co-workers to get fast food if he brings his lunch already made beforehand
has strong intention to change behavior and improve diet
2. Transtheoretical Model (TTM)
"preparation" stage
wife has similar goals to reduce weight (support)
use motivation to improve QOL to promote behavior change
3. Health Belief Model (HBM)
use the perceived benefits of improved diet on health
use his wife as a cue to action as a strategy to initiate behavior
Nutrition Plan
Obtain information about serving sizes, what foods to eat, how often, etc.
Limit alcohol consumption
Increase water intake while decreasing Soda and sugary beverage intake
Decrease the amount of fast food and make small substitutions for each meal
Continue to make substitutions for better options at every meal
Engage in meal preparation to have healthier food readily available
Limit fast food to 1-2 times a week
Continue to increase water intake and limit alcohol and soda intake
Emotional Health Status
No anxiety or depression
Sleep challenges come from sleep apnea, but none from emotional stress
Sleep apnea causing lowered sleep quality
High stress job
Autistic brother, requiring a lot of care and attention
Constantly feels tired
Health Status: Physical
52 years old
6'1" 275 lbs. (BMI = 36.3) OBESE!!
Has PAD (stents implanted in lower right leg)
Sleep Apnea (uses mask to sleep)
Doesn't take any medications
Occasional knee pain and bodily aches
Exteremely active when younger, limited physical activity now
Enjoys yardwork and mowing the lawn
Lifestyle constraints & Lifestage
Middle-aged adult; may limit some ability of activity
Works full-time manufacturing jet-engines (standing/walking 10 hour shifts)
Works in an open warehouse with tons of space
Financially secure with health insurance and work benefits
Lives in a neighborhood and community with parks and gyms available
Current diseases and orthopedic state may limit PA ability
3 Theories for PA
1. Transtheoretical Model (TTM)
"contemplation" stage
acknowledges he needs more PA and knows risks assoc. with being sedentary
can help John balance the pros and cons of changing his behavior
re-evaluate himself and relate how PA will help John reach his goals
2. Self-Determination Theory (SDT)
John has the needs for relatedness, competence, and autonomy
Find activities that meet at least 1 of these basic needs
Find a motivation that will promote behavior for reasons of pleasure and fun
3. Health Belief Model (HBM)
John has a current disease and has a desire to get healthy
He understands that inactivity can reduce his QOL and lead to other chronic disease
Since John was highly active when younger, has the self-efficacy for success with behavior change
Movement Plan
Obtain 10 min. of PA each day (continue current PA with yardwork)
3-5 days/week; preferably most days
Focus on aerobic activities (walking, jogging, biking)
Break up sedentary time any way possible
Trying to increase EE
Add 5 min. of PA each week to build up to the daily recommendations
3-5 days/week; preferably most days
Focus on large muscle aerobic activities (walking, jogging, biking)
Look to incorporate bodyweight exercises
Find a reasonable gym to begin including resistance training
Theory NOT chosen for PA
1. Self-Efficacy Theory
John has the knowledge that he is capable of performing the PA
has experiences with success already from his past with PA
Theory NOT used for Nutrition
1. Relapse Prevention
If John is using the 3 previous theories there won't be any risky situations to be in
There isn't any sign of alcohol abuse or compulsive behavior towards fast food and junk food
John's desire to improve his behavior outweighs the occurrence of constant setbacks
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