Running head: REALAGE HEALTH PROMOTION PAPER

REALAGE Health Promotion Paper

Julie Z. Sullivan
Ferris State University

REALAGE HEALTH PROMOTION PAPER

Abstract
The RealAge test is a comprehensive personalized tool used to assess the overall wellness of an
individual. It is also a tool used to identify positive and negative aspects of a persons current
health profile and to assist with identifying areas where a person may want to focus on achieving
an improved health status. This health promotion paper is based on information gleaned from
the RealAge test for a member of this class whom we will refer to as L. L is a 41.5 year old
female with a RealAge score that reflects she has the health of a person 4 years younger than her
real chronological age. In this paper Ls scores will be summarized and a proposed program for
improving her long term health status will be presented.

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REALAGE Health Promotion Paper

L is a 41.5 year old Caucasian female. According to the REALAGE evaluation her health
is better than would be expected for a person of her age. This may be due to a combination of
factors including her genetics and the efforts she has put into maintaining good health. L worked
with this author to help establish two goals for improving her health: increasing the frequency of
her exercising and improving her hydration. L understands that even though her health is good at
this time there are always things we can do to maintain and improve our health, and prevent
chronic diseases from developing as we age. Carter says that, It is postulated that exercise
introduced to inactive individuals may slow or halt many of the changes associated with aging
(2000).
RealAge Results
The RealAge test is used to assess the overall wellness of an individual. It also identifies
positive and negative aspects of a persons current health profile. While Ls chronological age is
is 41.5 years her RealAge score reflects that she has the health of a person 4 years younger than
her age. The test begins with a health screening that includes five specific areas including health,
feelings, diet, fitness, and ending with My RealAge.
Health
The health section is the area that pertains to the measurements of an individual such as
blood pressure, height, weight, waist measurement, and cholesterol levels. Also included are
questions related to how many hours per night of sleep the individual is getting and if she or he
has needed to use medications to aid in sleeping. The health assessment also wanted to know if
the participant felt they were in good health in contrast to people their own age. On the positive
side L is 5 feet 4 inches in height, 132 pounds, and with a waist measurement of 29 inches she

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feels that she is healthy compared to others her age. She also was aware of her cholesterol levels
and her blood pressure, and feels she has great genetics when it comes to her cholesterol and
family history. Her parents are still living and are healthy without noting any health concerns
that could be hereditary, including heart disease. L has never been a smoker nor has she been
exposed to second hand smoke. She is current with her mammograms and gynecological
appointments. A negative fact is that L stated she had been sunburned between 5 and 9 times in
her life, she sleeps seven hours per night but uses a sleep medication nearly every night in order
to sleep. Also, she was under the care of a physician for asthma as a child, which has been under
control as an adult. L states she only flosses her teeth three times per week.
Feelings
L has two children, ages 20 and 13 years, and she also has a dog and a cat that live at her
home. Her parents have never been divorced and she has had a long marriage herself that
includes a healthy happy sex life. L has a large family of siblings and many friends, and coworkers that are supportive of her and she feels she can confide in them. L states she feels that
she is in control at home and has a positive attitude in regards to the future and how she is
treated. She expects good things to happen to her and is easy going and doesnt get stressed out
easily. Occasionally she participates in social functions outside of work. She has a moderate
amount of stress related to financial concerns, is working a fulltime job and a second job, and she
is a student.
Diet
L eats breakfast five days out of the week and she includes four servings of whole grains
in her daily intake. Also, she eats one serving of fruit per day, four servings of vegetables, and
one to five servings of low-fat or nonfat milk per week. She only consumes two servings per
week of processed foods. She consumes three servings of meat per week including red meat,
chicken, and processed meats. On the negative side she only eats one or fewer servings of

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legumes per week, 2-4 servings of nuts, and no soy products. We also noted that she doesnt eat
any servings of fish per week but does take Omega 3 supplements, vitamin D, and a
multivitamin. L states she isnt interested in staying informed with the latest nutritional news,
and guidelines.
Fitness
In this section L has revealed that exercise is the most important aspect of her life that she
would like to change. Positives factors are that she walks at a moderate speed without any heavy
lifting at work and she spends less than 25% of her time watching television. She currently
attempts to exercise two times each week for thirty minutes per session; however, she reports
that she is somewhat inconsistent with this. Some negative aspects in this area are that she
spends less than 30 minutes weekly doing strength training exercises, no time increasing her
flexibility, and suffers from knee stiffness after exercise.
Ls RealAge
In this section of the Real Age test practical recommendations are given to improve
overall health. L has inherited good genes from her parents, but it is advisable that she include
foods in her diet that will help her slow down the aging process. Even great genetics only
account for a third of our health; the rest is what you do to maintain yourself. L needs to protect
her joints since she is already having some stiffness. On the positive side, she has a great weight
BMI of 22.6, and her waist is 29 inches. Also she has good cholesterol levels, but her HDL could
be higher which can be elevated with exercise. She is sleeping the recommended seven hours per
night but she is taking over the counter medications to sleep on a regular basis. Creating a sleep
routine, decreasing stress and anxiety, and exercising can combat a sleep issue. The RealAge
evaluation recommended that she avoid taking aspirin since she doesnt have a genetic history of
cardiac disease. L should definitely be wearing sun screen on a daily basis. It would also be
helpful for her to reapply sunscreen throughout the day using a good quantity of a product

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containing a SPF greater than 30. L should perform self-skin assessments regularly, looking for
anything out of the ordinary, and develop rituals to take care of her skin.
Planning and Interventions
While there are many potential areas for L to improve, during an interview she indicated
that the two areas she would be most interested in improving were increasing her frequency of
exercising and the amount of water that she drinks on any given day. These two areas seemed
consistent with some of the needs she identified in her RealAge test. They also have value to her
personally and she felt that she had a good chance of being successful in reaching these goals.
Planning and Intervention Number One
L has expressed that exercise is the number one component of her life that she would like
to change. Exercise is something that each of us as an individual can change or improve if we
choose to. The fact that L recognizes she needs to spend more time exercising and she wants to
make changes is half the battle for becoming successful in this area. Exercise in general has three
main components: cardiovascular, strength training, and flexibility. Each of these is important
and helps improve our health in different ways. L occasionally will spend time strength training
but currently spends no time on flexibility exercises. She has voiced her belief that she is better
at focusing on learning one exercise at a time, and doesnt have time for all three disciplines of
exercise, so she desires to focus on cardiovascular exercise at this time. The United States
Department of Health and Human Services Healthy People 2020 states Regular physical
activity can improve the health and quality of life of Americans of all ages, regardless of the
presence of a chronic disease or disability. Physical activity can lower the risk of an early death,
coronary heart disease, a stroke, high blood pressure, type 2 diabetes, colon and breast cancers,
falls, and depression (2013). As L ages it will become increasingly important that she has a
regular exercise routine. Some key benefits of exercise as we age are: reducing the risk of falls,

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maintaining our functional abilities, decreasing the risk of fractures, decreasing the risk of having
medical problems, and maintaining a sense of health and well-being, all of these will help to save
money in the long run (Carter & ODriscoll, 2000).
So how much exercise does a person need to be healthy? According to the Center for
Disease Control (CDC) adults aged 18 to 64 need 2 hours and 30 minutes (150 minutes) of
moderate-intensity aerobic activity, such a brisk walking, every week, and two days of musclestrengthening activities that work all major muscle groups, including legs, hips, back, chest,
shoulder and arms each week as well (2013). Moderate intensity activity means that you are
able to increase your heart rate and will start sweating. A person exercising at moderate-intensity
can still talk to someone but would be unable to sing a song. We note that this is the minimal
amount of exercise that the CDC recommends. If a person choses to spend more time exercising
than the minimal amount greater health benefits would occur (2013).
Goal for Area of Risk Number One
L will walk on the treadmill at a 4.0 mile per hour pace for 60 minutes five days per week for the
next three months. Her proper target heart rate goal is to be working at 60% to 80% of her 220,
minus her age (Klieman, 2006). For L this would mean 60% to 80% of 220 41.5 To check she
will have to feel for her pulse for 15 seconds and multiply by 4 to get her heart rate.
Planning and Intervention Number Two
During our interview, L indicated that she drinks less than three eight ounce glasses of
water each day. Maintaining proper hydration is very important even without the addition of
exercise on the body. Roger Zoorob, in his article entitled Sports Nutrition Needs Before,
During and After Exercise points out that maintaining proper hydration by drinking water
during exercise has the largest beneficial effect on performance of any single nutritional
intervention (2013). Another important area for L that she has expressed a desire to improve
upon is drinking more water during the day. L has even stated she often feels dehydrated and
doesnt drink very much especially at work. Mentes has recommended that an average adult

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should drink 1.5 to 2 liters of fluid a day, divided equally throughout the day and the best fluid to
drink is water. Other beverages that are popular can have added sugar, calories, and actually add
to an individuals dehydration (2006). If L increases her exercise she should also increase her
water intake, and hydrate before, during, and after exercise. L will be taught some signs to look
for to evaluate if she is adequately hydrated such as urine color (which should be light in color),
moist mucous membranes, and supple hydrated skin. Since L has a difficult time drinking water
at work, she will carry a water bottle that she can sip on at her work station, while she is charting
and at lunch and break times.
Goal for Area of Risk Number Two
L will drink 66 ounces of water every day for three months; this is half of her body
weight in ounces. She will use a water bottle with ounce measurement indicated on the bottle to
help her keep track of her daily consumption.
Transtheorectical Model and Two Wellness Diagnosis
Transtheorectical Model
The transtheorectical model involves a series of progressive steps that are made in order
for a person to have lasting changes in behaviors, and also they help to assess a persons
readiness to make new changes in their lives. The five stages are as follows: precontemplation,
contemplation, planning or preparation, action, and maintenance (Pender, 2011).
Currently L is in the planning or preparation stage where she seriously wants to make a
change to her exercise routine, and has already taken some steps to exercise two days per week.
L has made an effort to learn more about exercise, the availability of local gyms, and what these
gyms have to offer. Also, she had expressed a desire to be more self-motivated and take control
of her wellness. L has a keen awareness of how exercise can benefit her overall health in many
ways. She has had some success with her current exercise routine and feels empowered by her
discipline and desire to do more for her health. L is disciplined enough to find alternative ways to
exercise if she is unable to make it to a facility; she will walk outside or on a treadmill at her

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home. From past experiences she realizes it will take discipline and will be challenging to change
behaviors and make them a habit.
Penders Health Promotion Model
L is not currently facing any known health concern or crisis. Since Penders health
promotion theory isnt based on any fear or threat of illness, and isnt focused on a negative
outcome, it would seem to be a good fit for L at this time. L isnt deciding to increase her
exercise or fluid intake because she has an active disease process, nor did L state that she was
fearful of her current or future health status, but she did reveal that as a nurse she is cognizant
that her health is important and she can improve how she takes care of herself. L has had
previous positive experiences with exercise in the past, and is motivated by her desire to get into
better shape and to stay healthy for her own sake. She would also like to develop positive health
practices in order to be a good role model for her children. Since L has had positive experience
with modifying her behaviors in the past she believes she will be successful in increasing the
frequency and duration of exercise and her fluid intake in the future.
During our interview she wasnt under any false illusions that these changes were going
to be easy. She recognized that making long-term changes in these areas will require
commitment. L noted that some of her potential barriers included that she currently works third
shift and this is draining on her energy level; also she has children, a husband, and other
responsibilities that require her time. L also works-out at her home on a treadmill, which needs
maintenance from time to time and could periodically be unusable. While an alternative to
working out on her treadmill might be walking outside, we note that the weather can be
unpredictable and this can become a barrier to maintaining this discipline.
We also discussed the demands of having a family. While the potential for a family to be
an obstacle to exercise seems obvious in terms of time spent caring for others, there is also the
positive possibility that her husband could help with her children while she takes the time to

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exercise. Options for exercise could be joining a gym, recreational center, church or community
center that offers classes to stay motivated. L could find a friend or group to walk with, and
divide the exercise into 10-15 minutes blocks of time instead of trying to do it all at once. L
could also wear a pedometer at work to evaluate how many steps she is getting in during a shift,
and she could walk on her breaks and lunch periods if her work environment permits.
Two wellness diagnoses for her area of focus
According to Klieman a health-seeking behavior is defined as Active seeking (by a
person in stable health) of ways to alter personal health habits or the environment in order to
move toward a higher level of health (2006). L has clearly made a decision and has taken
action to improve her aerobic activity. The current health status for L is good; she has healthy
genetics with no evidence of cardiovascular disease, diabetes, or hypertension. As well, her
cholesterol, blood pressure, weight, and BMI are all within normal limits. She has never been a
smoker but does have stress with working two jobs, raising children, going to school, and being a
nurse. Interventions would include working with L to develop a plan for exercise that takes her
individual needs and goals into account. We would take into account the goals set for walking
five times per week for 60 minutes, with 5 to 10 minutes for cool down and stretching. L will be
taught how to monitor her own pulse to determine if she reaches a desired heart rate range, at 60
to 80% she would subtract her age from 220 which is a pulse of 179. The intention would be to
increase her consistency of walking within the target zone of moderate-intensity for the greatest
health benefit.
Evaluation and Reflection
Evaluation
Over the past few weeks during the evaluation process L has indicated that she has been
able to make a few positive changes. L has been able to exercise three days per week for the past
few weeks, and recognizes that she doesnt have to do all the activity at one time. L exercises
after she wakes up at 4:00 p.m. since she works the night shift. She also has been splitting the

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exercise time and doing 30 minutes after she wakes up and 30 minutes after she is finished
working. L will invest in a pedometer so that she can evaluate how much walking she does while
at work. The weekends are a good time for her to exercise with her husband and daughter,
especially while the weather is nice so she can be outside, which she enjoys. She will purchase a
few free weights and a video on how to properly lift weights, and start incorporating a few
techniques at a time into her exercise routine, After L has mastered these skills she has expressed
the desire to learn yoga possibly by watching a video at home to start. L has purchased a large
water bottle and will keep this at her work station to enable easy access to clean, fresh drinking
water. L will drink a large glass of water with each meal, and one before and after exercise. L
also recognizes that by increasing her fruit and vegetable intake she will be increasing her fluid
intake as well. L states that she is pleased with her progress and her success has encouraged her
to continue, she also has enjoyed changing her exercise routines to prevent boredom and by
including family members, friends, and the occasional piece of equipment that has been
motivating and fun.
Reflection
As I reflect on the progress that has been made in just a short time, I feel that L has made
some positive steps. My concern for L is that she maintains her motivation to continue her
progress, and feels encouraged to continue her program when the times get tough and the
newness has worn off. I have come to understand that no matter how hard I would like for L to
be successful at making lifelong health style changes, the desire and responsibility to change
belongs to L. I see the nurses role as coming beside an individual and supporting and
encouraging them in all the ways that are helpful to become successful, but then stepping back
and allowing them to make the new skill their own. I think one of the most important processes
for L was to encourage her own autonomy. According to Johnson autonomy support, or

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bolstering individual autonomy, is crucial to self-motivation and self-regulation (2007). I feel

that L has the confidence, motivation, and resources in place to accomplish her goals and make
lifelong changes to increase and sustain a healthy lifestyle.

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References
Carter, N. & ODriscoll. M. L. (2000, February). Life begins at forty! Should the route to
promoting exercise in elderly people also start in their forties? Physiotherapy, 86(2), 8593.
Healthy People 2020 US Department of Health and Human Services (HHS), Office of Disease
Prevention and Health Promotion. 2008 Physical activity guidelines for Americans.
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http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=33
Johnson, V. D. (2007). Promoting behavior change: making healthy choices in wellness and
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Klieman, L. (2006). Cardiovascular disease risk reduction in older adults. Journal of
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Pender, N. J., Murdaugh, C. L. & Parsons, M. A. (2011) Health promotion in nursing practice (6th
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Sharecare, Inc. (2010-2014). RealAge Test. Retrieved from:
https://www.sharecare.com/assessements/realagetest/completed?recs
Zoorob, R. & OHara, H. (2013) Sports nutrition needs before, during, and after exercise.
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