Appraisal of a Health Promotion Initiative - Essay Example

? Appraisal of a Health Promotion Initiative Number and Number Number of Words: 2,556 Introduction This report will identify and examine existing health promotion policies that aim to fight obesity among children and young adults. As part of going through the main discussion, the significance of planning, evaluation method and assessment in the success rate of health promotion will be tackled in relation to strategic ways on how we could make young individuals become more concern about their weight gain issues. One of the Suffolk County Council’s challenges towards healthy living is to launch a campaign to combat childhood obesity (Suffolk County Council, 2009, p. 2). In response to what really constitute a good health promotion in our local primary schools, this report will focus on identifying and critically review the health promotion initiatives of Suffolk County Council particularly with regards to its obesity fighting campaign. Relevant literature review will be gathered to determine how effective Suffolk’s health promotion campaign should be implemented. Right after critically appraising the health promotion intervention of Suffolk County Council in practice as compared to the gathered literature review, a list of recommendations will be provided in order to increase the assurance that children in Suffolk County are receiving effective health promotion intervention. Literature Review Basic Concept and Definition of Health and Health Promotion The World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being not merely the absence of disease” (Lucas and Lloyd, 2005, p. 6). To ensure that each person is in good health, the local Department of Health together with the WHO strongly promotes the importance of health promotion. The Ottawa Charter defined health promotion as “the process of enabling people to exert control over the determinants of health and thereby improve their health” (IUHPE, 2000, p. 2). The main purpose of health promotion is to provide effective health intervention each time there is a risk for a person to suffer from short- and/or long-term health detriments. It means that health promotion is about developing useful intervention that could effectively reduce or prevent situations wherein people are engaging in negative health behaviour (Green and Tones, 2010, p. 156). Instead, health promotion aims to convert negative health behaviours into positive ones. Established by WHO Regional Office in Europe back in January 1984, health promotion is considered “a mediating strategy between people and their environments by synthesizing personal choice and social health responsibility necessary to create a healthier future” (WHO, 1984). With regards to the importance of health promotion, the Tannahill model of health promotion is one of the most common health promotion model used to enable the health promotion developers develop useful and effective strategies that prevent the young individuals from becoming obese. In general, the Tannahill model of health promotion adopts the three overlapping spheres of activity known as: health education, tertiary protection, and disease prevention (McGee and Castledine, 2003, p. 119). These three overlapping spheres known as: health education, tertiary protection, and disease prevention works together in order to achieve the ultimate goal of fighting against the increasing number of young obesity throughout the United Kingdom. Although the use of the Tannahill model of health promotion is effective in terms of encouraging young individuals to consume more healthy foods, this model is limited in terms of taking into consideration other aspects of health that contributes to obesity. In most cases, other health aspects include those that are related to mental, psychological, environmental, and spiritual needs of a person. In response to the need to fight obesity among the young individuals in UK, the Health Promotion Agency publicly announced the need for the local primary schools to take initiative to support healthy eating within and outside the school premises (Public Health Agency, 2009). By closely monitoring the food essentials based on nutritional standards for school meals and drinks, the local primary schools could make it a habit to develop healthier food choices. Significance of Planning, Evaluation and Assessment in the Development of Health Promotion Programme Planning The main purpose of planning is “to ensure that a programme has the best possible likelihood of being successful… …even with the use of the least possible resources” (Issel, 2008, p. 4). It means that planning for health promotion programme designed for weight management should be SMART (i.e. specific, measurable, attainable, realistic, and within time-bound) (Waters, Seidell and Swinburn, 2010, p. 230). As a common knowledge, health is a holistic concept in the sense that it involves not only the physical, mental, developmental, and social aspects of each person but also their financial capabilities in life. With this in mind, the planner needs to be aware that for a person to be healthy, the health intervention plan should not only be able to address the health detriments associated with obesity (i.e. increased risk for heart diseases, type II diabetes, stroke, etc.) but also ensure that the health intervention plan will be able to help the target population enjoy the benefits of having a balanced the physical, mental, developmental, social, and financial capabilities when planning for an effective health promotion programme. It is equally important to plan the health promotion program in such a way that it could improve the target population’s well-being, social attitude, attitude and behaviour. Furthermore, planning should consider the need to innovate new intervention strategies that has never been addressed by any past intervention programmes (Issel, 2008, p. 5). Based on the ANGELO (Analysis Grid for Elements Linked to Obesity) process as presented by Waters, Seidell and Swinburn (2010, p. 229), planner should first analyze the demographics, socio-economic, health issues, and behavior of the target population with regards to proper nutrition and physical activities. Depending on the planner’s analysis with regards to the target population’s behavior, knowledge and skills, and other related environtal factors, the planner should then prioritize the importance of each health intervention plan based on what the planner perceives to be more effective and feasible. Eventually, the planner needs to list down health intervention plans that are specific, measurable, achievable, relevant, and time-bound before finalizing the action plan. Evaluation and Assessment Method The main purpose of evaluation and assessment is to measure the success of health promotion strategies. Over the years, different types of evaluation and assessment methods were developed to ensure that health promotion programmes are effective in terms of satisfying a list of expected health prevention outcomes. Issel (2008, p. 6) explained that the first evaluation and assessment of health promotion programme was conducted in a school even before the use of rational approaches to evaluation was developed. Today, the common evaluation and assessment tools which can be use in measuring the effectiveness of health promotion programs include the outcome-focused or utilization-focused approach. In general, outcome-focused measures the outcome of implementing a health promotion programme whereas the utilization-focused is a more preferred evaluation technique when there is a need to evaluate the needs and personal interests of the evaluators (Issel, 2008, pp. 7 – 8). Between these two evalation and assessment method, most evaluators are using the outcome-focused approach to evaluation (Lien et al., 2010; Stock, et al., 2007; Warren et al., 2003). The HEalth in Adolescents (HEIA) intervention programme aims to increase adolescents’ physical activity and consumption of fruits and vegetables while decreasing the screentime and consumption of sweetened beverages by providing the students with lessons on dietary behavior, allowing them to enjoy fruit-and-vegetable and physical activity breaks, the use of health promotion posters, etc. Using questionnaire, measuring the body, and the use of accelerometer in measuring the physical activity, Lien et al. (2010) conducted a 2-week test re-test on a cluster randomized controlled trial (controlled study in 25 schools with n=1014 and intervention programme in 12 schools with n=566) as a strategy used in evaluating the effectiveness of the HEalth in Adolescents (HEIA) intervention programme. Stock, et al. (2007) conducted a pilot study among the 4th to 7th grade students in 2 Canadian elementary schools (intervention programme with n=232 and control with n=151). The goal is to measure significant changes in the students’ nutrition, physical activity and healthy body image (i.e. 9-minute fitness run, body satisfaction, signs of disordered eating symptoms, knowledge on healthy lifestyle, behavior and attitude and the use of anthropometry which includes recording the students’ heart rate, blood pressure and BMI). Almost similar to the evaluation method of Stock, et al. (2007), conducted a research study which also focused on monitoring significant changes in the students’ growth, knowledge on nutrition, perception on diet and physical activities. The only difference between the evaluation method of Stock et al. (2007) and Warren et al. (2003) is that the study of Stock et al. (2007) was focused on evaluating and assessing the impact of school-based intervention whereas Warren et al. (2003) did not only evaluate the use of school-based intervention but also the use of family-based intervention plan among children between 5 to 7 years of age. Comparison between the Effectiveness of Health Promotion Initiatives of UK Government and the Health Promotion Strategies Used by Suffolk County Council Health promotion policies serves as a “formal decision by an executive agency which aims to solve certain problem through the deployment of specific resources and the establishment of specific sets of goals and objectives to be met within a specific time frame” (De Leeuw, 2007, p. 51). Health promotion policies normally provide the general public with a list of effective health interventions. Through proper legislation, health promotion policies can serve as a guide on how the local primary schools in UK could decide on how to alleviate the health consequences associated with the continuously increasing population of obesity among the young individuals. Over the past few years, public health policies are widely used to correct behavioural, socio-cultural, and environmental factors that promote less physical activities and excessive intake of high calorie foods (Government Office for Science, 2007; Nestle and Jacobson, 2000). To fight obesity, policymakers implemented an anti-obesity programme that makes use of an ‘upstream’ public health policy approach (Musingarimi, 2008). These policies are more focused on the implementation of nutritional standards in schools and controlling the students’ lifestyle through the use of health teaching and mass media intervention. School-based intervention targets a large population of young individuals. The local schools are made responsible to teach the students about the importance of proper nutrition, provide them with lessons on how to cook nutritious foods, develop their interests in sports, and give them with access to healthy foods (Musingarimi, 2008). Aside from stipulating the foods’ vitamins and mineral contents, the local primary schools are required to offer meals with “at least two portions of fruits and vegetables”1 (BBC News, 2006a, 2006b) For example: Initiated by the Scottish government, politicians in England are also strongly in support of the need to improve the nutritional quality and standards of school meals. In support of the need to provide free milk and healthy snacks to students between primaries 1 to 3 (The Scottish Government, 2008), there has been a legislation that was passed four years ago on banning junk foods within and outside the close vicinity of the local primary schools in England, Wales, North Ireland, and Scotland (BBC News Wales, 2011; Musingarimi, 2008, p. 24; BBC News, 2006b). On top of nutritional and physical intervention, the local schools in UK are required to regularly measure each of the primary school student’s height and weight (Clout, 2007). Despite a long list of health policies being implemented throughout the United Kingdom in response to the increasing number of obesity among children (i.e. banning of junk foods within and outside the school vicinity, provision of well-balanced nutritious foods to students, regularly monitoring students’ height and weight, etc.), the Suffolk County Council focused its health promotion initiatives in the improvements of quality in physical education and sports throughout the entire Suffolk schools. Suffolk Country Council strongly believes that “encouraging children and their families to lead healthier and more active lifestyles such as 1 hour exercise a day” can effectively fight childhood obesity (Suffolk County Council, 2009, p. 1). Despite the importance of assessment in health promotion initiatives, “less than a third of the primary schools shared records of pupils’ achievements in physical education” (Suffolk County Council, 2009, p. 5). Although increased in physical activity in the prevention of obesity among children, one of the weaknesses of Suffolk County Council’s health promotion initiative lies behind the fact that they fail to consider the significance and importance of controlling excessive intake of high calorie food. Since the Suffolk County Council’s health promotion initiative fails to take into consideration the significance of unhealthy food intake in fighting obesity among children, its health promotion strategies is less effective as compared to those of the UK government. Conclusion and Recommendation Suffolk County Council’s confront towards healthy living by fighting against childhood obesity and is unswerving with Ottawa charter for health promotion. It is one such measure among the string of many other health promotion programs laid down for this very purpose of betterment of health. Build Healthy Public Policy Suffolk County’s programme supports the idea of anti-obesity programs in young adults as a key to a healthy generation. Policy is made after considering the behavioural, socio cultural and environmental factors that discourage the physical activities and intake of high caloric food and after analysing the statistics of obesity victims frame works is laid down for the program. Create Supportive Environments Suffolk County’s programme supports school based intervention objectives and emphasize upon the need of proper nutritious diet and appropriate physical activities to improve the mental and physical heath of younger generation. Various Governmental and political sectors are also supporting healthy food in school theme. Strengthen Community Actions Suffolk County Council offers instructions of healthy and active life style not only to the children but also their families, are included in the circle to provide support to the program of healthy living and also their children. As family plays a major role in depicting a proper life style to a child. Develop Personal Skills The foundation of Suffolk’s action in preventing obesity is considered weak in the sense that it fails to focus on educating the public about the importance of proper diet and consequences of their food choices, whereas this area is very important. Reorient Health Services: Further research and intervention techniques are required in the area of controlling the use of junk food intake among children and young adults; this also includes teaching and training programs which will lead to change of attitudes. More data is crucial for the program. Among the factors that constitute a good health promotion programme include not only the need to have clear and well defined health promotion policies that are in accordance to the main objective of the programme but also conduct a careful planning, evaluation and assessment on each of the health promotion activities. Through careful planning, health promotion developers will be able to have the opportunity to prioritize the importance of each health intervention strategies and eventually come up with a final action plans that are specific, measurable, achievable, relevant, and within the specified time-bound. In general, the presence of health policy, planning, evaluation and assessment technique has its unique role in protecting the health and wellness of young individuals. Suffolk County Council’s health promotion initiative is useful in terms of enabling children in Suffolk schools burn more calories. However, this County failed to highlight the importance of well-balanced nutrition as compared to unhealthy foods (i.e. junk foods). For this reason, it is safe to conclude that the planning of Suffolk County Council’s health promotion strategies was at some point weak. Aside from weak planning, Suffolk County Council also admitted that only “less than a third of the primary schools shared records of pupils’ achievements in physical education” (Suffolk County Council, 2009, p. 5). Upon analyzing the health promotion strategies of Suffolk County Council, it is clear that that the absence of careful planning process makes its health promotion initiative less effective. Furthermore, failure to practice assessment and evaluation of physical education in Suffolk schools serve as a gap in terms of determining whether or not the schools’ initiative to fight against child obesity is effective. To increase the success rate of Suffolk County Council’s health promotion programme, this report highly recommends the need for the County to work together with other group of professionals (i.e. nutritionist, health promotion evaluators, school teachers, etc.). By doing so, Suffolk County will be able to design and develop a more effective health promotion campaign in fighting obesity among children. *** End *** References BBC News, 2006a, September 4. Chips down as school term starts. Pupils in England are being presented with healthier choices on the school dinner menu and in vending machines. Available at: [Accessed on 10 September 2011] BBC News, 2006b, May 19. Junk food banned in school meals. School dinners in England will be free from chocolate, crisps, fizzy drinks and "low-quality" meat from the autumn, the government has announced. Available at: [Accessed on 10 September 2011] BBC News Wales, 2011, January 7. Pupils 'ban' on buying food outside school suggested. 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