Sustaining Healthy Habits in North Carolina - Research Proposal Example

? number) Sustaining Healthy Habits in North Carolina: Involving Stakeholders in Constructing Programs Designed to Combat Childhood Obesity Introduction In the U.S., childhood obesity is now a national priority, thanks to the Healthy People 2010 developed by the U.S. Department of Health and Human Services (HHS). However, despite the provisions for reducing the proportion of children and adolescents who are obese or overweight, the obesity prevalence is in fact, increasing (United States - Mexico Border Health Commission 3). What is causing this increase? Perhaps it is the fact that public perception about obesity has not changed over the years. Statistics on obesity. In the past 20 years, obesity in the U.S. has ballooned and national estimates show that about 33.8% American adults are obese (Centers for Disease Control and Prevention). Meanwhile, about 17% or 12.5 million children and adolescents aged 2 to 19 years are obese. 2010 estimates show that no state had prevalence below 20%, and North Carolina had 27.8% which is one of the highest in the country. If trends will continue, half of the U.S. population (both adults and children) will be obese by 2030. Daily Mail reports: “Obesity is fast replacing tobacco as the single most important preventable cause of chronic non-communicable diseases, and will add an extra 7.8 million cases of diabetes, 6.8million cases of heart disease and stroke, and 539,000 cases of cancer in the U.S. within the next two decades” (The Daily Mail). If the issue is not addressed, U.S. budget for health will be affected, as the government will need to allot additional 2.6% on its overall healthcare bill to support citizens suffering from obesity-related diseases. Risk and contributing factors. Researches show that the consumption of “cheap, tasty, energy-dense food” as well as the distribution and marketing of unhealthy food and drinks have contributed to what experts now call as the “obesity epidemic”. Lack of physical activity during childhood is also cited as contributing factor. Meanwhile, in a 2009 study about obesity in the U.S.-Mexico Border it was mentioned that obesity is related to low socioeconomic status (poverty and low educational levels), and increased sedentary lifestyle (United States - Mexico Border Health Commission 1). While Americans have heard the warnings and threats of obesity, many choose to treat the issue with equanimity, ignoring the messages and disregarding public affairs entirely. For some, obesity has become a salient issue but the information they receive has become diluted as the media, and now the internet, provides various solutions. Many households fail to make sense of the problem, especially when suggested solutions seem to create greater burden for their families. Many people wish to lose weight simply to avoid the stigma of being overweight, but the health and psychoemotional benefits of maintaining appropriate weight are mostly ignored. Those who wish to provide healthier alternatives for their children’s nutrition rely on the government to provide meal assistance. Obesity as a social problem that requires a multifaceted approach. Yet, obesity is not just a problem of the government, it is in fact, a social problem. The government has already instituted policies to that promote healthy eating and physical activity in school, but it is still the parents’ responsibility to ensure that new habits picked up from school is encouraged at home. Without parent assistance in obesity control and prevention, government efforts are temporary, if not fruitless. It is this author’s contention that parent involvement in obesity control and prevention should be encouraged through seminars and workshops. Moreover, the government policy must include provisions for stakeholders to design programs dealing with obesity. Parents, teachers and perhaps the children themselves, must be given government support in their effort to reconstruct obesity programs. Purpose of Research This proposal is designed to show that the government will benefit more if they allow stakeholders to reconstruct obesity control and prevention programs in North Carolina. Through this approach, the government can get an accurate picture on the different enabling factors and barriers to the success of obesity programs. By empowering the community to create solutions to the obesity epidemic, the government can ensure accountability and cooperation among parents, teachers and school administrators to uphold healthy lifestyle change for their wards. This new methodology will also ensure greater support for public policy and more efficient implementation of obesity prevention and control programs. This research includes citations from different studies that highlight on parent involvement in preventing and controlling obesity. Moreover, it aims to review some of the programs on obesity which are currently being implemented in North Carolina. Through this review, one will get an overall picture of the role that parents have in different obesity programs, and . Moreover, a comparison on research recommendations for parent involvement and actual roles parents have in public policy will be conducted. Then, this research will tackle how much support public policy is receiving from the public, in general, and summarize its implications to program implementation. Discussion Parents and their role in obesity prevention. There is increasing proof parents play a huge role in preventing obesity in childhood. Because poor eating habits and sedentary lifestyles are established during childhood, parents play the role of educating children about health and helping them weigh their options when it comes to diet and exercise. There are studies showing that “weight regulation effects are improved if atleast one parent is included with the child in treatment” (Gill 372). This is because parents become a model fos their children’s lifestyles – their attitudes, eating and exercise habits and support for active lifestyle are often mirrored by their children. The involvement of parents in managing weight problems of their children leads to higher success because of the “increased social support and reduction in the feeling of isolation [of the child]” (372). Meanwhile in another study conducted by Bobbie Berkowitz and Mayleyse Borchard shows that a family-based, health-centered approach to reducing childhood obesity was more effective than child-only approaches. Immediate results showed 29% mean weight reduction for children who had parent involved in the intervention (Berkowitz and Borchard). Meanwhile, long term success of childhood interventions involved one parent as an active participant. In a 2006 study, Ana C. Lindsay, Katarina M. Sussner, Juhee Kim, and Steven Gortmaker analyzed the role of parenting in preventing obesity and developing children’s food and activity related behavior. According to Lindsay et al., parents play a critical role at home at preventing childhood obesity since they are present in all stages of a child’s development. Yet this study shows that it is not enough for parents to know what causes childhood obesity, they must also have the commitment to ensure that their children will have a healthy lifestyle. Intervention must not only start in the years when the child is already exhibiting excessive weight, but rather, it should start from gestation and infancy. For example, parents often encourage babies to empty a bottle of formula milk when in fact this contains concentrated energy and nutrients. Such occurrence could lead to the infant’s unability to develop reliable food intake which could continue on when the child is of school age. Parents are responsible for developing the right behaviors at home, but the study shows that there is also a right way to do it. Inherent with addressing obesity is the need for parenting skills and the eradication of social issues such as poverty. “Children develop their food habits through exposure and repeated experience (Lindsay et al. 171) so parents have to feed their children with good food in order to hone their desire to eat healthy. “Good food” isn’t only about choosing vegetable over pizza, but also about ensuring that these vegetables do not contain harmful chemicals. Healthy food means unprocessed, organically produced, non-GMO food. Typically, healthy food is more expensive because they are not mass-produced and they require specific cultivation techniques. With an increasingly volatile economy, a problem that comes up is: how will a parent serve healthier alternatives if they cost more than the commercially available ones? Healthy school lunch is a solution, but for many school concessionaires, providing healthy options is costly and the money allotted by federal and state funding is not enough. The American Heart Association (AHA) and American Stroke Association (ASA) also released its own policy recommendations for preventing childhood obesity. In this paper, they said, “Parents are important role models and largely responsible for physical activity opportunities, the type of food presented to young children, the portion sizes offered, and the emotional context in which food is eaten” (American Heart Association and American Stroke Association 3). In this context, AHA and ASA are advocating for greater link between child care settings and families in order to counteract media messages and disseminate strategies outlined by the state and other credible health institutions so that they reach their intended audience. AHA and ASA suggests that health care systems can provide parents with the information they need to make the right decisions, but again, this brings up the question of the parents’ capability to provide their children with healthier alternatives. In a report published by the National Institutes of Health confirmed that there are multiple factors to a child’s behaviors towards food and activity. It recognized the epidemic as “cross cutting” wherein low socioeconomic status and minority issues, among other problems have to be addressed side by side with weight monitoring. Moreover, it the working paper proposed recommendation for future research to unearth new knowledge to deal with childhood obesity and prevention. How did the North Carolina government and NGOs respond with the increasing need for a multifaceted approach to obesity? The next section outlines some of the programs enacted in the previous years. Parental roles for each program is also summarized. Programs dealing with obesity control and prevention. Even Start is a block grant that encourages with community leaders to partner with the State Depart become partners in engaging parents to pursue obesity prevention in the home. Its main purpose is to improve literacy in low-income families but it has programs which incorporates health and nutrition campaigns (The Finance Project 35). In North Carolina, an Even Start funded program, the Greene County Lucy Hart Hill Family Literacy Program has partnered with the North Carolina Cooperative Extension Services to provide parents the opportunity to participate in programs that will help them make healthy food choices for their families. The Out for Lunch program was designed for Food Stamp families who feel that their only way to eat healthy is through government assistance. This program stressed on economics and nutrition and program components helped empower families to make healthier food choices. Parent were taught how to plan menus, to budget food expenses as well food safety. Parent who have children in preschool were involved in cooking activities and the “Read Me A Story” curriculum which helped them “identify and choose more fruits, prepare nutritious, appealing foods on a limited budget; and handle food to prevent food-borne illnesses” (The Finance Project 36). This project has allowed greater parent involvement and addressed some of the issues raised in the previous chapter. The problem with it, however, is that project components were designed by the implementing organizations and did not involve parents in its development phase. It did not recognize the ‘best practices’ used by the parents in the community and it did not make use of the community resources. Hence, at the end of the funding of the project, the program stopped and new parents were no longer benefitted. Parents were treated as passive recipients of the program and the bigger picture of the need to provide healthy food to younger children was not stressed. Eat Smart Move More (ESMM) Movement is North Carolina’s plan to prevent overweight, obesity and other weight-related chronic diseases. It builds up pioneers many of the state’s programs for healthy eating and increased physical activities. They have offer programs and tools for various sectors of the community and engages each one to become a partner in preventing and controlling obesity. It provides grants to communities who wish to advance the ESMM goals and objectives. Like the Even Start program, it recognizes that obesity is now a social issue and that the problem cannot be resolved by eating healthy and moving more. Instead, it considers the child’s individual factors, the behavioral setting, the sectors that influence healthy decisions and social norms and values which affect public perception about obesity. It creates a cooperative environment for individuals/parents, and the community/school. Some of the programs under ESMM includes parent educational campaign, establishment of support networks for families, creation of programs that facilitate behavioral changes to help people incorporate healthy choices in their daily routine, improved access to community gardens and farmer’s markets, etc. The ESMM is really the ideal plan, if only it could be properly implemented. The question is, is it being implemented properly? Unfortunately, the program does not include key indicators, so there really is no monitor its progress. Doing so will cost the state a few more millions which could be used for the operation of the programs themselves. Conclusion and Recommendation Obesity prevention and control should be a collaboration between the different stakeholders. It should be community led, meaning, the project is designed by the community and is funded by the government. In this approach, the community draws on its experience and resources in the creation of programs that will benefit its residents. It considers the unique position of all involved citizens so that every plan is unique to the community. State-wide plans are okay in that they provide a guideline for the design, but it should be left to the community to decide which stategy works best based on their unique situations. Some communities may already have community gardens and farmer’s markets but they need more parent education seminars. Others may have need for behavioral and parenting seminar in order for them to handle teenagers and the youth. It should fall upon the community to determine which strategies to employ and how they can implement it. This way, it will be the community leaders and their people who will determine key indicators of their success, as well as determine new areas for improvement. And because the community is able to connect programs with their unique situation, resistance against new approaches are minimal and the state does not need to employ specialists to help the community deal with their own problem. Through this approach, the state can guarantee that stakeholders will be responsible for their own results. Works Cited American Heart Association, and American Stroke Association. “Policy Recommendations for Obesity Prevention and Health Promotion in Child Care Settings.” Heart.Org. Web. 22 Nov 2011. Berkowitz, Bobbie, and Marleyse Borchard. “Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing.” The Online Journal of Issues in Nursing 14.1 (2009) : n. pag. Centers for Disease Control and Prevention. “U.S. Obesity Trends.” Overweight and Obesity 2011. Web. 18 Nov 2011. Gill, Timothy P. “Key Issues in the Prevention of Obesity.” British Medical Bulletin 53.2 (1997) : 359-388. Print. Lindsay, Ana C. et al. “The Role of Parents in Preventing Childhood Obesitity.” Childhood Obesity 16.1 (2006) : 169-186. Print. The Daily Mail. “Half of U.S. Population Will Be Obese by 2030 Experts Predict As The Number Could Swell to 164 Million Americans.” Mail Online News 26 Aug 2011. The Finance Project. Supporting Childhood Obesity Prevention Programs with Federal Funds. 2004. United States - Mexico Border Health Commission. Childhood Obesity and the U.S. - Mexico Border. 2009.  Read More