Reducing Obesity and Improving Diet and Nutrition - Assignment Example

Health Promotion in Action FDH 200 Health Promotion Modules Chosen Area: Reducing Obesity and Improving Diet and Nutrition Section One Social CapitalReducing obesity and improving diet and nutrition Introduction In this activity, reducing obesity and improving diet and nutrition has been chosen as the area for writing my reports. This assignment will highlight the activities that take place in my area of practice. My area of practice is children health, and I am posted at a Children's Hospital Outpatient in the United Kingdom. I am currently being trained to become an assistant practitioner, and my future job will comprise of provision of health promotion to the patients while monitoring their clinical conditions in the clinical area. The objective of this assignment is to share thoughts and experiences within the group. Methodology Apart from active experience in the clinical area, this note will also contain references from literature available from asynchronous web search. Practical Experience It is to be recognised that whatever the condition the child presents for, the proportion of obese children is very high in the practice. Academic reading suggests childhood obesity has many ill effects. As a result, health promotion against obesity is one of the prime requirements. Since the most common cause of childhood obesity is nutritional, health promotion directed to promotion of healthy dietary habits and adequate nutrition remains the mainstay of health promotion activity (Veerman et al., 2007). The mothers are advised against intake of junk food, and children are advised for what is right about the foods that they take. If they are habituated to obesity promoting high-fat content food, the effects are also tutored to them (Davenport et al., 2006). Brief Report Counselling the children and their families to eat less and exercise more is the easiest idea to promote anti-obesity campaign among children. Practically, however, this may become time-consuming, frustrating, and difficult (Douglas et al., 2001). The parents and children must be informed that obese children are at risk of developing many of the adult obesity-associated comorbidities. When the BMI is above greater than 95th percentile, the prevalence of impaired glucose tolerance and systolic hypertension is higher. Evidence suggests that behavioural interventions and promotion of increased physical activities may reduce obesity in children. This would also include changes in food habits and nutrition (Bruce and Grove, 1994). The families and children alike must be aware that overweight or obesity results from an imbalance between energy intake and expenditure (Calnan, 1995). Dietary patterns, television and other sedentary activities, and an overall lack of physical activities play important roles. Based on these, this information is delivered to the parents through leaflets and audiovisual media. Information about different food groups are also shared with the children and the parents (Bubela et al., 1990). They are also provided with literature to carry home, so they can have active guidance. The importance of fruits and vegetables in diet are also highlighted. The importance of fibres in the diet is also highlighted. Changes This is the standard health promotion intervention that takes place in my work area. However, the results are not evident so easily (Anderson et al., 1995). The main reason in my opinion is that in most cases, the children are not given enough weightage. I would create separate customised health promotional cartoons that would promote nutrition and exercise for these children, so the message is driven in to their mind, and they can exercise choices in terms of food and exercise and physical activities (Naidoo and Wills, 2000). Section Two Working Together Activity 2 The objective of this part of the assignment is to identify collaborative relationship among professionals. The method that is used here is asynchronised discussion. In the unit, while promoting health among children against obesity, a customised care plan depending on the choices of the children is important. This customised care plan would involve education about the adverse effects of obesity, promotion of healthy dietary habits, promotion of nutritious diets, and promotion of suitable physical activities. This array of care plan in relation to health promotion cannot be achieved by a single health professional. Moreover, the encounter in the outpatient department is not the final one, and to be successful, it needs maintenance and reinforcement of health promotion. This is accomplished in our unit through a collaborative interprofessional team. The people involved in an interprofessional care are the pediatrician, pediatric health psychologist, pediatric dietician, the pediatric nurse, assistant practitioner, family, the child, the general practitioner, and the physical therapist. A suspect overweight or obese child undergoes a clinical examination by the pediatrician. Depending on the necessity of intervention and anthropometric measurement of the child, a pediatric health psychologist devises a plan for intervention (Bernier, 1992). This plan of intervention is further reinforced by the pediatric dietician. The pediatric nurse and the assistant then take over and implement the health promotion. The maintenance is mostly family's responsibility, but the child's awareness and motivation to change (Brownlea, 1987) can be further reiterated by the general practitioner. The physical therapist implements the physical exercise plan. The collective action that occurs in the case of an obese child's health promotion activity should be reviewed in order to assess its effectiveness. Certainly, the pediatrician detects the case and decides whether health promotion is necessary in any particular care. Since children vary in their food habits, choices regarding nutritious diets, exercise behaviour, every child is in need of a customised care plan where he is a part thereof (Brownlee-Duffeck et al., 1987). The necessity of intervention needs establishment of the diagnosis, and anthropometric measurements by the pediatrician can definitely assess the body mass index, based on which the obesity is defined. However, the health psychologist is in a better position to assess which promotional activity would suit best the need of a particular child (Cameron and Best, 1987). The success of the psychologist ultimately decides the effectiveness of the intervention. Based on the dietician's plan in collaboration with the child and family and indicated by the family culture, in the pathway provided by the health psychologist, the nurse and the assistant would better be able to deliver the promotion, which can be maintained by the GP (Arborelius and Osterberg, 1995) and the physical therapist may augment the plan by providing specific physical activity regimens which the child may agree to perform regularly, and the family may oversee this (Caraher, 1998). Section Three Evaluating Health promotion I had been involved in the health promotion activity of children with obesity. The objective of this assignment is to review the methods used to evaluate the practice. This assignment is to be used for asynchronised discussion. In this part of the assignment, the same health promotion activity on nutritional management, healthy dietary habits, and exercise promotion will be evaluated. Whatever means of evaluation are adopted perhaps the most important fact is that some attempt to measure outcome is made. Clearly, the effort involved in patient education can only be justified if it can be shown that there is a tangible benefit to these children. Thus there must be measurable outcomes which can be utilised to evaluate the effects of health promotion (Falvo, 1995). In practice, I have seen, patient education and health promotion have often been delivered without any particular form of evaluation. In this promotional activity, there had been use of written promotional materials, but seldom there had been any evaluation of resources (Frederikson and Bull, 1995). In the department, there were written and printed colourful brochures which had been developed as a result of great deal of time and effort. However, the language and images used in these brochures are often unread (Albert and Chadwick, 1992). So there may be a question whether these pamphlets were being used appropriately worth their values. The audiovisual media were excellent and were really friendly for the family and the children. However, they were designed in such a manner that these were time consuming, which almost practically make it impossible for the children to go through these (Arthur, 1995). Traditionally, measurement of impact of these resources on the target children would be best, but measurement of impact in a busy pediatric outpatient department is a far more difficult task. It appears that evaluation is required both in a research context to further develop patient education at a scientific level and also at a practice-based level by individual practitioners to complete the education process (French, 1997). If the target is a change in the behaviour of the children and the family, the measurement would comprise of the level of learning. We have a format of questionnaire where family and children are asked about their concepts on hazards of childhood obesity, the role of food habits in precipitating obesity, healthy food habits and nutritional changes that can bring about reduction in body fat, and exercise through yes/no questions. At the end of promotional session each child and accompanying family members are required to answer these questions (Luker and Kendrick, 1995). While this assesses the cognitive component of learning, the measurable objective goals in terms of skills gained or attitudes and perceptions which have been acquired or moderated may also be valuable outcomes of an educational programme. If the goals are relevant to the psychomotor or affective domains then the evaluation must be tailored appropriately to gauge this. This was also done through specially framed questions directed to the family member and the child. Reference List Albert, T. and Chadwick, S. (1992) How readable are practice leaflets, British Medical Journal, 305:1266-1268. Anderson, R.A., Funnell, M.M., Butler, P.M., Arnold, M.S., Fitzgerald, J.T. and Feste, C.C. (1995) Patient empowerment: results of a randomized controlled trial, Diabetes Care, 18(7): 943-949. Arborelius, E. and Osterberg, E. (1995) How do GPs discuss subjects other than illness, Patient Education and Counseling, 25:257-268. Arthur, V.A.M. (1995) Written patient information: a review of the literature, Journal of Advanced Nursing, 21:1081-1086. Bernier, M.J. (1992) Current perspectives: psychoeducation: subset or prototype of the health education model, Patient Education and Counseling, 19:125-127. Brownlea, A. (1987) Participation: myths, realities, and progress, Social Science and Medicine, 25(6);605-614. Brownlee-Duffeck, M., Peterson, L., Simonds, J.F., Goldstein, D., Kilo, C. and Hoette, S. (1987) The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus, Journal of Consulting and Clinical Psychology, 55(2):139-144. Bruce, S.L. and Grove, S.K. (1994) The effect of a coronary artery risk evaluation program on serum lipid values and cardiovascular risk levels, Applied Nursing Research, 7(2):67-74. Bubela, N., Galloway, S., McCay, E., McKibbon, A., Nagle, L., Pringle, D., Ross, E. and Shamain, J. (1990) Factors influencing patients' informational needs at time of hospital discharge, Patient Education and Counseling, 16:21-28. Calnan, M. (1995) The role of the general practitioner in health promotion in the UK: the case of coronary heart disease prevention, Patient Education and Counseling, 25:301-304. Cameron, R. and Best, A. (1987) Promoting adherence to health behaviour change interventions: recent findings from behavioural research, Patient Education and Counseling, 10:139-154. Caraher, M. (1998) Patient education and health promotion: clinical health promotion-the conceptual link, Patient Education and Counseling, 33: 49-58. Davenport, C., Mathers, J., and Parry, J., (2006). Use of health impact assessment in incorporating health considerations in decision making. J Epidemiol Community Health; 60: 196 - 201. Douglas, MJ., Conway, L., Gorman, D., Gavin, S., and Hanlon, P., (2001). Developing principles for health impact assessment. J. Public Health Med.; 23: 148 - 154. Falvo, D.R. (1995) Educational evaluation: what are the outcomes, Advances in Renal Replacement Therapy, 2(3):227-233. Frederikson, L.G. and Bull, P.E. (1995) Evaluation of a patient education leaflet designed to improve communication in medical consultations, Patient Education and Counseling, 25:51-57. French, B. (1997) British studies which measure patient outcome, 1990-1994, Journal of Advanced Nursing, 26:320-328. Luker, K. and Kendrick, M. (1995) Towards knowledge-based practice: an evaluation of a method of dissemination, International Journal of Nursing Studies, 32(1):59-67. Naidoo, J. and Wills, J.(2000) Health Promotion Foundations for Practice 2nd ed Bailliere Tindall. Veerman, JL., Mackenbach, JP., and Barendregt, JJ., (2007). Validity of predictions in health impact assessment. J Epidemiol Community Health; 61: 362 - 366. Read More