1. BY:ERENDIRA VILLAGOMEZ HEALTH IMPROVEMENT PLAN

2. TABLE OF CONTENTS Tab1 2 3: Client Overview Health history interview Background analysis of client Tab 4 : Health Research Summary of article #1 w/ full APA citation Article #1 Summary of article #2 w/ full APA citation Article #2 Summary of article #3 w/ full APA citation Article #4 Summary of article #2 w/ full APA citation Tab 5 6 7 8 : Intervention Plan Theory of health behavior 4week SMART Goal and Documentation plan Tab 9 10 : Progress reports and final analysis Week 1-2 Results and analysis of success Client feedback form Personal/professional analysis of project Tab 11: Appendices Documentation

3. CLIENT OVERVIEW Gender: Female Age: 21 Education: 2 years of college Profession: Waiter and receptionist Family Situation: Lives with parents and is attending college. Chief Complaints: Juvenile Rheumatoid arthritis

4. BACKGROUND ANALYSIS Weight: 115 lb. Height: 5’5” ft. Adult Illnesses: Rheumatoid Arthritis Family Health History: Diabetes Modes of Relaxing: Exercising

5. RESEARCH Two test were performed to predict erosive disease. After two years the results showed RA patients were comparable. The Journal of Bone & Joint Surgery | Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty AN END-RESULT STUDY USING A NEW METHOD OF RESULT EVALUATION. (n.d.). The Journal of Bone & Joint Surgery | Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty AN END-RESULT STUDY USING A NEW METHOD OF RESULT EVALUATION. Retrieved May 19, 2014, from http://jbjs.org/article.aspx?articleid=15158 http://jbjs.org/article.aspx?articleid=15158 In 1945 through 1965 in 38 patients with hip arthritis, had factures of the acetabulum or dislocations of the hip. They had mold arthroplasties performed at massachusetts general hospital. 16 were rated good or excellent.. (n.d.).. Retrieved May 19, 2014, from http://onlinelibrary.wiley.com/doi/10.1002/1529- 0131(200001)43:1%3C155::AID-ANR20%3E3.0.CO;2-3/fullhttp://onlinelibrary.wiley.com/doi/10.1002/1529- 0131(200001)43:1%3C155::AID-ANR20%3E3.0.CO;2-3/full This article talks about a patients with advanced RA. The medication she is taking is not healing her and the medication is very strong. She has low vitamin D, this increases the risk of autoimmune diseases including RA Rheumatoid arthritis yields to the power of nutritional medicine. (n.d.). NaturalNews. Retrieved May 19, 2014, from http://www.naturalnews.com/036189_rheumatoid_arthritis_nutritional_therapy_medicine.html http://www.naturalnews.com/036189_rheumatoid_arthritis_nutritional_therapy_medicine.html Auto immune diseases causes the immune system to attack healthy tissue. Dietary therapy can reduce RA symptoms. This eliminates every possible food trigger for arthritis for example beef, eggs, wheat, oranges, milk, peanuts, malt and soy. How gluten causes rheumatoid arthritis. (n.d.). NaturalNews. Retrieved May 19, 2014, from http://www.naturalnews.com/035075_gluten_intolerance_rheumatoid_arthritis.html

6. TARGET BEHAVIOR Become more physically active. Eat healthier to reduce symptoms of RA.

7. THEORY (HBM) High Perceived Susceptibility: Higher risk of getting any health disease caused by lack of physical activity. The symptoms or arthritis will be stronger. Low Perceived Severity: Doesn't have any health problems because of lack of physical activity. She is still skinny even with a bad diet. Perceived Barriers: Arthritis limits her physical ability, she has bad eating habits. She is lactose intolerant. She is also a stress eater. High Self-Efficacy: Is getting a college degree, not over weight, support from family and friends, makes bank.

8. THEORY (CONT.…) Changing her diet Will help reduce the arthritis symptoms. Increased Perceived Severity: The arthritis symptoms will not be reduced and she will continue to have severe joint pain. Finding ways to be more physical and eat healthier : Keep track of how active you are, run a mile 4 times a week in the afternoon. Avoid eating or reduce the intake of beef, milk, oranges, eggs, wheat, peanuts and soy. Raise Perceived Benefits: She will become stronger physically and run a mile in 10 minutes or less. Work out with people who motivate you: Work out with athletic people. Use exercise to release stress: Use exercise to release stress from full time job and school.

9. SMART GOAL 4 weeks Charlie will be capable of running a 10 minute mile. She will follow through with this by running 4 times a week. Use exercise as a coping mechanism to deal with your stressful eating habits. Tell Charlie about the health risks of having bad eating habits and how it will affect her physically as well. Slowly get Charlie to change by running 2 miles Mondays and Tuesdays and 1 mile Thursdays and Fridays. This will make running almost a daily habit. On the weekends since she wont be exercising she needs to record her what she is eating. Absolutely no beef, eggs, wheat, oranges, milk, peanuts, malt and soy. This will reduce the symptoms of arthritis and allow her to exercise with less joint pain. The pattern will continue until it becomes a lifestyle We will be using a calendar to help track the progress

10. RESULTS  Charlie started out at an 18minute mile run, then after a week dropped to a 12minute run =, and finally is now at a 10 minute run.  Changing Charlie's eating habits helped her reduce the arthritis symptoms such as persistent joint swelling, pain, and stiffness that typically is worse in the morning or after a nap. Intermittent fever, loss of appetite, weight loss, anemia, or a blotchy rash on a child's arms and legs. Reducing these symptoms has made it easier for her to be physically active.  Overall Charlie followed through with her smart goals and is still improving.

11. PERSONAL / PROFESSIONAL ANALYSIS Using the health behavior theory helped point of the negatives and the consequences of not accomplishing the smart goals. Using the Health Belief Model to explain the client’s health problem was the easiest. Using the articles was for part of the intervention was the most helpful part. This gave us the idea of changing her diet which would result in helping her arthritis.

12. CHART MondayTuesdayWednesdayThursdayFridaySaturdaySunday 2 miles 1 mile2 miles Eating restriction 2 miles 1 mile2 miles Eating restriction 2 miles 1 mile2 miles Eating restriction 2 miles 1 mile2 miles Eating restriction

13. REFERENCES The Journal of Bone & Joint Surgery | Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty AN END-RESULT STUDY USING A NEW METHOD OF RESULT EVALUATION. (n.d.). The Journal of Bone & Joint Surgery | Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty AN END-RESULT STUDY USING A NEW METHOD OF RESULT EVALUATION. Retrieved May 19, 2014, from http://jbjs.org/article.aspx?articleid=15158http://jbjs.org/article.aspx?articleid=15158. (n.d.).. Retrieved May 19, 2014, from http://onlinelibrary.wiley.com/doi/10.1002/1529- 0131(200001)43:1%3C155::AID-ANR20%3E3.0.CO;2-3/fullhttp://onlinelibrary.wiley.com/doi/10.1002/1529- 0131(200001)43:1%3C155::AID-ANR20%3E3.0.CO;2-3/full Rheumatoid arthritis yields to the power of nutritional medicine. (n.d.). NaturalNews. Retrieved May 19, 2014, from http://www.naturalnews.com/036189_rheumatoid_arthritis_nutritional_therapy_medicine.html http://www.naturalnews.com/036189_rheumatoid_arthritis_nutritional_therapy_medicine.html How gluten causes rheumatoid arthritis. (n.d.). NaturalNews. Retrieved May 19, 2014, from http://www.naturalnews.com/035075_gluten_intolerance_rheumatoid_arthritis.html