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Running head: GET HEALTHY 1

Get Healthy Clearwater!

Andrew S. Harriman

University of South Florida


Get Healthy Clearwater!

The purpose of this paper is to address the increasing rate of obesity in adults in

Clearwater, Florida. According to the Centers for Disease Control and Prevention ([CDC],

2017), more than 72 million adults in the United States (U.S.) are obese and not a single state has

an obesity rate less than 15% which is the national goal. This paper will highlight the extent of

this health trend in Pinellas County, Florida, and propose a program to combat this rising trend.

The proposal laid out in the following pages will follow a peer reviewed, evidence-based



Pinellas County, Florida is located in the middle of Floridas Gulf Coast and is made up

of twenty-four incorporated municipalities (Pinellas County Government, n.d.). Residents of this

area differ greatly in age and socioeconomic status. According to the U.S. Census Bureau (2016),

Pinellas County has the following demographics: 83% are Caucasian and 10.9% are African

American with Hispanics and Asians making up the remaining 6.1%. Clearwater is the county

seat and the second biggest city in Pinellas County with just over 114,000 full-time residents.

Approximately 72% of Clearwater is Caucasian while 16% are Hispanic and 12% are African


Currently, 26% of adults in Pinellas County are considered obese and 22% are considered

physically inactive, yet 100% of the population is considered to have access to community

centers, gyms, trails and other areas for physical fitness (University of Wisconsin, 2017).

Target Population

Obesity is a far greater public health concern than most people realize. It can lead to

serious health complications including Metabolic Syndrome, Type II diabetes, cancer, heart

disease, liver disease and respiratory issues (National Institutes of Health, 2017). Regular

physical activity and a well-balanced diet are important weapons in the fight against obesity.

The low-income population in Clearwater are particularly vulnerable to becoming obese.

A large portion of this demographic falls within the lowest bracket of the socioeconomic scale.

Many are also part of a large family which means a dollar must stretch even further than normal

in order to feed everyone. It is very difficult to provide a consistently healthy diet when one is

under such financial strain.

Healthy people 2020 Goals

According to the United States Department of Health and Human Services ([HHS],

2017), the Healthy People 2020 (HP 2020) goal for nutrition and weight status is to Promote

health and reduce chronic disease risk through the consumption of healthful diets and

achievement and maintenance of healthy body weights. The HP 2020 guidelines provide several

objectives to help guide communities on how to best implement these changes. These objectives

include developing policies at the state level that would provide incentives to food retailers that

encourage healthy food options; increase the number of Americans who have access to healthy

foods and reducing the number of adults who are obese (HHS, 2017).

Evidence Based Plan

Eat Smart, Move More North Carolina

In North Carolina, representatives from a number of organizations joined together to

form the Eat Smart, Move More North Carolina Leadership Team (ESMMNC). The team

includes organizations from the public and private sectors, health organizations and others. The

purpose of the ESMMNC (2013) is to promote increased opportunities for healthy eating and

physical activity wherever people live, learn, earn, play and pray.

This plan addresses six core behaviors to combat the high levels of obesity by


increased physical activity

increased consumption of fruits and vegetables

decreased consumption of sugar-sweetened beverages

reduced consumption of energy-dense foods

decreased television and screen time

increased breastfeeding initiation, duration, and exclusivity (ESMMNC, 2013)

While not every core behavior listed will apply to every member of the community, this plan can

be tailored to help anyone reduce their level of obesity.

Plan Effectiveness

One of the objectives of the ESMMNC program was that by January 1st of 2017 there

will be no increase in the percentage of [NC] adults, youth and children who are classified as

overweight or obese. Two of these objectives were met. The percentage of youth, ages 10 to 17,

who were overweight or obese decreased from 33.7% in 2007 to 30.1% by December of 2012.

The percentage of youth, ages 10 to 17, who are overweight decreased from 19.9% to 13.0% in

the same time frame. While this is a step in the right direction, not only was there was no

improvement in the obesity levels in adults, they incidence of adult obesity actually increased

during this time. (ESMMNC, p.19)



This program could be successfully adapted and implemented in Clearwater with the

cooperation of several agencies and departments. This would allow the fiscal, educational and

manpower requirements to be evenly distributed instead of a single agency shouldering the


Adjustments to Clearwaters version of the program should include recording height,

weight and body-mass index (BMI) measurements for all participants when they enroll in this

free program. This measurement was not included in the ESMMNC version but would provide

crucial baseline numbers that would help track the overall effectiveness of the program. Overall

success will be determined by the number of people with BMIs that have dropped below the

obesity level.

Level of Prevention

This program will mainly focus on the secondary prevention of obesity (Anderson &

McFarlane, 2015). Those that fall into this category are already obese but have not yet developed

any complications such as hypertension, type II diabetes, etc. as a result of being obese.

Initiation of Intervention

In order to reach the highest number of people from the target population, this program

should be integrated into various places around the community. These places should include the

city-run parks and recreation facilities and state health department clinics. Funding can be shared

by city, county and state budgets. Funding can also be obtained from private sources similar to

the John Rex Endowment. This endowment helps to ensure that children in Wake County, North

Carolina receive the support they need to live happy, healthy and active lives. Employees from

the respective government agencies will attend an orientation where they will be trained on how

to enroll people into the program and monitor their progress.


Method of Evaluation

Several pieces of data will be used to evaluate the progress of people who take part in this

program. Initial BMIs will be taken when the person enrolls in the program. Repeat BMI

measurements will be taken approximately every three weeks. Participants will also answer the

same short questionnaire every two weeks. This will include questions pertaining to the amount,

duration and intensity of physical activity over the previous two weeks and the amount and

frequency of fruit and vegetable intake over the same time period. These can all be used to help

establish whether the long term goal of decreasing the overall level of obesity in the community

has been met.


The ESMMNC (2013) committee recommended stronger reinforcement of healthy eating

habits in both the work place and schools (meetings, potlucks, barbecues, etc.) since healthy

choices and habits are rarely shared by the majority of attendees. A second recommendation was

to further expand their free fitness and yoga classes in throughout the community. These

recommendations should be taken into consideration for implementation in Clearwater.


Obesity is an ever growing health crisis in not only Clearwater but across the nation and

around the world. The health issues that stem from this preventable condition can be numerous

and far reaching. There is no silver bullet when it comes to reversing the alarming rise in

overall cases of obesity. Nonetheless, if more communities started to implement programs such

as this one, we could start to reverse this deadly trend and go on to lead long and healthy lives.


Anderson, E.T., & McFarlane, J.M. (2015). Community as partner: Theory and practice in

nursing. (7th ed.). Philadelphia: Wolters Kluwer Health.

Centers for Disease Control and Prevention. (2017). Adult Obesity. Retrieved from

Eat Smart, Move More North Carolina Leadership Team. (2013). North Carolinas

Plan to Address Obesity: Healthy Weight and Healthy Communities 20132020.

Eat Smart, Move More NC, Raleigh, NC.

National Institutes of Health. (2017). Overweight and obesity: Signs, symptoms, and

complications. National Heart, Lung, and Blood Institute. Retrieved from

Pinellas County Government. (n.d.). Municipalities/cities. Retrieved September 23, 2017, from

U.S. Census Bureau (2016). Quick Facts: Pinellas county, Florida. Retrieved September 22,

2017 from,


U.S. Department of Health and Human Services, Office of Disease Prevention and Health

Promotion. (2017). Nutrition and weight status. Retrieved from

University of Wisconsin Population Health Institute (2017). Pinellas County snapshot. Retrieved