HLTH 4300 Week 1 Personal Risk Narrative Example

Janelle's Seven-Day Baseline, September 7-13: A Personal Risk Narrative Set Against the Physical Activity Guidelines, in Her Hours Rather Than the Nation's Averages

Student Name

Walden University

HLTH 4300: Personal Health and Wellness

Instructor Name

Month Day, Year

Janelle's Seven-Day Baseline, September 7-13: A Personal Risk Narrative Set Against the Physical Activity Guidelines, in Her Hours Rather Than the Nation's Averages

Who This Narrative Describes

Janelle is a composite 41-year-old freight dispatcher used throughout this course to show how national guidance applies to one life. She works four ten-hour day shifts a week, Monday through Thursday, from 7 a.m. to 5 p.m., mostly seated at a dispatch board with two 15-minute breaks and a 30-minute lunch she usually eats at her desk. She drives 35 minutes each way. She has a 9-year-old son who spends weekday evenings with her mother until about 6:30 p.m. At 52, her father had a heart attack.

This narrative records one baseline week, Monday, September 7, through Sunday, September 13, and sets it beside the Physical Activity Guidelines for Americans. It describes her week in her terms: the hours she actually has, the steps her phone recorded and the minutes of activity that met the guidelines' definition.

Her Family History in Context

A parent's early heart attack is a meaningful risk marker. In the Framingham Offspring Study, middle-aged adults with at least one parent who had premature cardiovascular disease, defined as onset before 55 in a father or 65 in a mother, had higher odds of a cardiovascular event over eight years; after adjustment for other risk factors, the odds ratio was 2.0 for men and 1.7 for women, though the estimate for women was less precise (Lloyd-Jones et al., 2004). Janelle's father's heart attack at 52 meets that definition. She cannot change her family history, which is why the factors she can change, including activity and sitting time, matter more for her than for someone without it.

The Baseline Week

On her four workdays, Janelle took about 4,000 steps a day, had no bouts of moderate activity and sat for roughly 13 to 13.5 hours, counting work, driving and evenings. On her three days off, she moved more: a 20-minute walk with her son on Friday and 45 minutes of yard work on Saturday.

Table 1

Janelle's Baseline Week, September 7-13

Steps come from the phone's health app; moderate minutes are from her notes, counting brisk walking or yard work that left her breathing harder; sitting is estimated from her schedule.

Set Beside the Guidelines

The federal activity guidelines ask adults for a weekly total in the range of 150 to 300 moderate minutes, with vigorous effort counting double, plus strength work on two or more days, and they tell adults to move more and sit less (Piercy et al., 2018).

In Janelle's terms, the 150-minute minimum means about 22 minutes a day if spread across all seven days, or 38 minutes on each of her four days off-shift and none on workdays, or some mix. Her baseline week provided 65 minutes, all on days off, which is 85 minutes short of the minimum. She did no muscle-strengthening activity.

Steps give a second view. Research on step counts suggests that 30 minutes of moderate walking adds roughly 3,000 to 4,000 steps to a day (Tudor-Locke et al., 2011). Janelle's workdays, at about 4,000 steps, contained little beyond the walking needed to get through the shift. In a national study of adults aged 40 and older, people taking 8,000 steps a day had about half the risk of dying during follow-up of people taking 4,000 (Saint-Maurice et al., 2020). Her workday step counts sit near the lower of those two figures.

Sitting

The guidelines' advice to sit less matters especially for Janelle, whose job and commute keep her seated most of the day. A pooled analysis of more than one million adults found that high sitting time was associated with higher mortality among people with low physical activity, but that the association was not seen among the most active people, those doing more than 35.5 MET-hours of activity a week (Ekelund et al., 2016). Janelle cannot easily stand at a dispatch board, but the finding suggests that adding activity elsewhere in her week could offset some of the risk her seated job carries.

What the Baseline Shows

The baseline locates Janelle's gap precisely. It is not on her days off, when she already moves more, but on her four workdays, which contain no activity bouts and the most sitting. Her available time on workdays is narrow: she leaves home at 6:25 a.m., returns at about 5:40 p.m. and has an hour before her son comes home. That hour is where any change on workdays would have to fit.

What Janelle Said About the Week

At the end of the baseline week, Janelle wrote three sentences in her notes. She was surprised that her workdays were so similar: the step counts for Monday through Thursday were within 500 of each other. She had assumed her job kept her moving, because she often walked to the printer and to the break room, but those trips added up to little. And she noticed that her days off were not especially active either; the Saturday yard work was a seasonal chore, not a habit. These observations matter for planning because they come from her own reading of her own record, which is more likely to produce a plan she will follow than a gap pointed out by someone else.

Limits of This Baseline

One week may not be typical. September weather is mild, and her schedule had no overtime or night shifts that week. Steps from a phone carried in a pocket miss movement when the phone sits on a desk, and moderate minutes from her notes depend on her judgment of effort. Sitting time is estimated from her schedule, not measured. Later assignments in this course examine these measurement problems directly.

Conclusion

In her baseline week, Janelle did 65 minutes of moderate activity, all on days off, against a guideline minimum of 150, and sat for about 13 hours on each workday. Her family history makes the gap more consequential. Translated into her schedule, the guidelines point to her workday evenings, the hour between arriving home and her son's return, as the place where change has the most room.

References

Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., Bauman, A., & Lee, I.-M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302-1310. https://doi.org/10.1016/S0140-6736(16)30370-1

Lloyd-Jones, D. M., Nam, B.-H., D'Agostino, R. B., Sr., Levy, D., Murabito, J. M., Wang, T. J., Wilson, P. W. F., & O'Donnell, C. J. (2004). Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults: A prospective study of parents and offspring. JAMA, 291(18), 2204-2211. https://doi.org/10.1001/jama.291.18.2204

Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020-2028. https://doi.org/10.1001/jama.2018.14854

Saint-Maurice, P. F., Troiano, R. P., Bassett, D. R., Graubard, B. I., Carlson, S. A., Shiroma, E. J., Fulton, J. E., & Matthews, C. E. (2020). Association of daily step count and step intensity with mortality among US adults. JAMA, 323(12), 1151-1160. https://doi.org/10.1001/jama.2020.1382

Tudor-Locke, C., Craig, C. L., Brown, W. J., Clemes, S. A., De Cocker, K., Giles-Corti, B., Hatano, Y., Inoue, S., Matsudo, S. M., Mutrie, N., Oppert, J.-M., Rowe, D. A., Schmidt, M. D., Schofield, G. M., Spence, J. C., Teixeira, P. J., Tully, M. A., & Blair, S. N. (2011). How many steps/day are enough? For adults. International Journal of Behavioral Nutrition and Physical Activity, 8, Article 79. https://doi.org/10.1186/1479-5868-8-79