Health Promotion Case Study

Patient: C. James – 66-year-old female (For this exercise, patient information has been fabricated.)

Assuming the patient has received all childhood immunizations the patient should receive the following vaccinations:

  • Influenza, once annually
  • If it has been more than 10 years, one Tdap booster
  • If not received at age 60, either first of two doses of Zoster Recombinant or one dose of Zoster Live for Shingles
  • Pneumococcal polysaccharide (PPSV23), one dose


Per USPSTF recommendations, the patient should be screened for:

  • Depression
  • Hypertension
  • BRCA Gene Screening: Ms. James’ mother had breast cancer
  • Hepatitis C Virus Infection: Ms. James is recommended as she was born in 1954
  • Colorectal cancer
  • Breast cancer every other year: Ms. James’ mother developed breast cancer at age 52.
  • Lung cancer: Ms. James has a 40 pack-year history and quit only 5 years ago
  • Osteoporosis: Ms. James is indicated as she is postmenopausal

Health Promotion/Disease Prevention Concerns

  • Injury Prevention
    • Traffic safety including wearing her helmet on bike rides
    • Swimming safety on the beach
    • Proper lifting techniques when using her home weights unsupervised

  • Diet
    • Ms. James’ BMI is currently 25.8, slightly over the normal weight range of 18.5-24.9.
    • Ms. James shows that she works to maintain a relatively healthy diet to keep herself in a caloric deficit. Her current diet shows a lot of fruits and vegetables along with small protein sources such as eggs, peanut butter, and a small protein over dinner. However, she admits that she tends to eat many salads and prepared foods from the supermarket that may lack some of the nutritional components of food necessary to maintain a healthy lifestyle (high protein, low fat, low sodium, etc.). Ms. James describes herself as having an addictive nature which has been characterized by severe weight fluctuations in the last 2.5 years, first losing 75 pounds then gaining 15 back.
    • It seems that Ms. James’ biggest hurdle involving her diet is being so fixated on maintaining a caloric deficit that she is often starving off hunger and falling into “joyless” relationship with food.
  • Outline a Dietary Plan – Incorporate Meal Prepping
    • Breakfast: Scrambled egg whites and whole wheat toast
      • This is the breakfast Ms. Jones currently enjoys and it is a wonderful source of protein and energy while remaining low calorie.

    • Lunch: Home-prepared spinach salad topped with berries and cheese and a piece of grilled chicken.
      • While this will have more calories than her current yogurt and fruit, there are more nutrients in this meal that will keep her fuller longer which can help her cut down on snacking impulses.

    • Dinner: A rotating meal-prepped vegetable, starch, and protein
      • Keeping different options on rotation keeps things fun in the kitchen by exploring different ways to prepare you food so you do not feel like you are always having the same thing. Be sure to limit intake of red meats as your protein but can be allowed once or twice per week. Balancing her plate with proteins, fiber, and carbohydrates is another way to help stay full and fight the urge to snack.

    • Snacking: Ms. James should continue to allow herself two pieces of dark chocolate (80 calories) as dessert. Staying within the product serving size limits will show her that she can have a healthy relationship with food that she enjoys.

  • Exercise
    • Currently Ms. James seems to be meeting the CDC guidelines of adequate exercise. By taking long brisk walks, riding her bike to do errands, swimming at the local beach during the season, and using free weights and resistance bands at home, she is ensuring to completely the aerobic activity and muscle-strengthen that is recommended.

    • If she feels she is not currently getting enough exercise, Ms. James can set specific goals for herself as a challenge to meet not just the recommendations but to do them at an effective, rigorous level.  

  • Harm Reduction
    • The harm reduction initiative that pertains to Ms. James is to continue safe sex education. Just because she is older does not mean she is unable to contract a STI when with her lesbian partner. Aside from that, being sober, quitting smoking, and keeping a healthy diet have mitigated many of the risky behaviors that affect most adults.  

Brief Intervention

  • Being sober for eight years, quitting smoking five years ago, and no indications of using illicit drugs, Ms. James’ daily behaviors do not trigger the need for a brief intervention.

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