Are childhood obesity and test scores related - Essay Example

Jacksonville Department of Health, Physical Education and Recreation Are Child Obesity and Test Scores related AnAssignment Submitted for HPE 508 Research in Health and Physical Education Professor: Dr. Glaucio Scremin by YOUR NAME Table of Contents Introduction 3 Basic Background 3 Statement of the Problem 5 Research Hypotheses 5 Operational Definitions 6 Limitations 7 Significance of the Study 7 Literature Review 8 Key Considerations for Child Obesity 8 Obesity and Academic Connection 10 Economic Consequences of child obesity and its potential influence on test scores 11 Possibility of Reverse Correlation 12 Child Obesity Medication for Academic Performance 13 Summary 14 Method 15 Participants 15 Instruments 16 Procedures 17 Design and Analysis 18 References 22 Introduction Basic Background Child Obesity has become a chronic problem in our society today - one that has far reaching negative consequences and has acquired epidemic proportions in the 21st century. Following child obesity statistics are quite disturbing which provide the justifications for the amount of research and various measures that are underway to tackle this problem. According to the Centre for Disease Control and Prevention (CDCP), the number of overweight children between the age of 6 and 11 rose from 4 percent to 17 percent - more than quadrupled - between 1971 and 2006. Almost 20 percent of U.S. children will be categorized as obese (see operational definition of obese further in this document) by 2010, according to the Department of Health and Human Services In 2008, the proportion of overweight and obese children in United States was 32% and had stopped climbing (Patty Neighmond, NPR). In 2004, according to the Centre for Disease Control and Prevention, 65% of adults are obese. And, there is a 70-80% chance that an obese child will turn out an obese adult. Such high proportions of obese children are especially more worrying because of the various types of health issues that it has been found to be causing. The health problems that have a high chance of occurrence due to obesity are of a wide variety such as - emotional problems, psychological problems, diabetes, high blood pressure, heart disease, sleep problems, cancer and other such chronic diseases. Obesity during adolescence has also been found to lead to increase mortality rates during adulthood. The various categories of diseases which obese children are at risk of suffering are endocrine, gastrointestinal, muscular, cardiovascular, respiratory, neurological, psychological, dermatological, etc. Considering the high percentage of obesity occurrence among children and the severe probable consequence, there has been a significant amount of research conducted to find out the possible causes of the obesity in children as well as various measures needed to bring down the proportion of obese and overweight children. Various researches and surveys (Child Obesity Survey by Kaiser Family Foundation and The Future of Children, Volume 1, 2006) have found the following to be some of the causes of obesity and overweight in children - 1. Dietary Causes - eating fatty foods, frequent eating in restaurants, irregular food habits, high intake of fast foods, soft drink consumption and such are found to be dietary causes of obesity 2. Sedentary Lifestyle - Physical inactivity of children is one of the serious causes leading to obesity in children. The reasons for physical activities are mainly due to doing stationary activities like playing video games, watching TV, etc. 3. Genetics - in some cases, either or both of the parents being obese, have led to the child being obese as well. 4. Home Environment - status, social class and racial background which have different home environments are also found to be causative factors for child obesity. 5. Developmental Factors - a child's growth pattern or weight-length ratio during the initial months after birth or factors such as breast feeding have been found to have some correlation with the probability of child being obese in later years. 6. Medical Illness - some types of illnesses such as Cushing's Syndrome or Hypothyroidism have been found to lead to obesity. 7. Psychological - obese children have been seen to suffer from psychological or emotional problems like depression and low self esteem as well as are often targets of teasing by peers. The other way round is also sometime true - meaning, depression can sometime lead to overeating habits causing obesity among children. Statement of the Problem The key problem statement here would be - "to ascertain and find out if there exists a correlation between obesity and test scores in children". The relation between obesity and test scores needs to be ascertained in both ways in being the action and reaction to each other. Obesity can lead to lower scores at the same time high scores could possibly be mean a sedentary lifestyle due to greater time spent studying and hence leading to obesity. Research Hypotheses "There is a correlation between child obesity and his/her test scores" This is the research hypothesis statement which the proposed research will try to test and possibly draw sufficient meaningful conclusions. Operational Definitions As per the Centre for Disease Control and Prevention (CDCP), Body Mass Index (BMI) - "Body mass index (BMI) is a practical measure used to determine overweight and obesity. BMI is a measure of weight in relation to height that is used to determine weight status. BMI can be calculated using either English or metric units. BMI is the most widely accepted method used to screen for overweight and obesity in children and adolescents. For children and adolescents (aged 2-19 years), the BMI value is plotted on the CDC growth charts to determine the corresponding BMI-for-age percentile." Overweight - "Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile." Obesity - "Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex." Also to quote CDCP - "These definitions are based on the 2000 CDC Growth Charts for the United States and expert committee. A child's weight status is determined based on an age and sex specific percentile for BMI rather than by the BMI categories used for adults. Classifications of overweight and obesity for children and adolescents are age and sex specific because children's body composition varies as they age and varies between boys and girls." Limitations Although this study would try to ascertain the statistical correlation between child obesity and their test scores, other causative factors which may possibly affect obesity and test scores will not be researched in depth. This is because the central focus of this study is obesity and its relation to test scores. Hence, the results of this study would have limited ability to conclusively comment on dependence of one with another for obesity and test scores. Significance of the Study As stated above, physical inactivity has been found to be one of the top two reasons as the cause of obesity in children. Yet, there seems to be not enough focus on terms of policies and mandates which would ensure increased physical activity of children. In fact, the "No Child Left Behind" Act (NCLB), introduced by President Bush in 2001, which places additional emphasis on test scores for reading and math, has been frequently said to be one of the chief caused of current strains on physical education (P.E.). The findings of this study would be able to provide information on relation between obesity and test scores. In case, anyone of them is found to be the cause of other, this relationship can provide good basis for further studies into the measures that need to be adopted in order to control obesity as well as maintain good test scores. Literature Review Key Considerations for Child Obesity While considering Child Obesity and Test Scores, it is also important to consider other factors which may affect or have influence on Child Obesity because they may in turn themselves have some relation with either the Test Scores OR may be having a joint correlation with Test Scores in addition to Child Obesity. These related factors will provide important information which may be useful while designing the research and provide subjective or supportive inputs to deduce conclusions from the findings of the research. "Child Obesity Fact Sheet" published by Action for Healthy Kids in 2005 on their website provides a very objective and well covered observations on Child Obesity. For the purpose of the literature review on this topic, this publication would be majorly referred to since all the relevant facts related to childhood obesity have been succinctly stated. The factsheet consists of the following heads on the topic of Child Obesity - Prevalence & Trends Minority Populations Contributing Factors Health Consequences Academic Consequences and Economic Consequences An important fact provided at the start is that - "Poor diet and inadequate physical activity are the second leading cause of death in the United States and together account for 300,000 deaths annually". Obesity being the second leading cause of death and the fact that a large proportion of children are obese calls for measures to control obesity during childhood itself, thereby, reducing the mortality due to obesity. The factsheet states that obesity is more prevalent among children of minority populations as compared to white American children. In the age group of 6 to 11, the proportion of overweight and obese children is as follows - Indian Americans boys (30%), Mexican American boys (26.5%), African American boys (17%) and American Non Hispanic White boys (14%). Among girls, African American girls (22.8%) are overweight than Non Hispanic White girls (13.1%). Also, the factsheet interestingly observes that the percentage of overweight children according to their race changes with age groups. In grades 9 to 12, the prevalence of obese students proportions are following - Hispanic youth (21.7% males, 11.8% females), African Americans (19.5% males, 15.6% females) and white students (16.2% males, 7.8% females). Prima facie the reason for the observation of this variation in proportion of overweight children could be the cultural backgrounds, practices and eating habits of the race or culture of the family these children. This observation that obesity proportion changes as per children age group compels to think if a similar observation may be possible with respect the test scores of obese and overweight children. Thus, during initial stages of research opinions must be sought and high level facts should be collected to check if any trend is seen in the test scores as per age groups of overweight children. Obesity and Academic Connection Various research studies as well as day to day observations have led to an observation that overweight children score lesser than their normal weight fellow students. However, the "Childhood Obesity Factsheet" makes an important point in noting that - it is difficult to draw definitive conclusions with regards to the relationship between weight and achievement because of multiple variables that need to be controlled while examining this relationship. Even then, the following trends of this link are seen through numerous studies - "Severely overweight children and adolescents (those above the 95th percentile for weight) were four times more likely to report "impaired school functioning"." "Severely overweight inner city school children tended to have abnormal scores on the Child Behavior Checklist, and were twice as likely to be placed in special education or a remedial class setting." "Overweight kindergartners had significantly lower math and reading test scores at the beginning of the year than did their non-overweight peers, and these lower scores continued into first grade." Thus, these observations from various studies provide us with a sufficient justification to assume that some correlation does exist between child obesity and test score and formulate a positive hypothesis for research testing purposes. However, it is also important to keep in mind other controlling and influencing factors for the test scores. One of the points that come to mind is less or almost no literature available to indicate how has been the performance of overweight children when they have grown up into adults. While the low test scores of children at school level is definitely a cause for concern, but these test scores are not the ultimate measure of performance. If the same obese child who scored less in school due to obesity, turns out to be a good performer on growing up, then maybe that would reduce the worries of parents of overweight children. Since, preliminary research conducted at the time of this research proposal, did not provide any matter on this topic, it may be worth to broach this question during the focused group discussions or expert interviews. Economic Consequences of child obesity and its potential influence on test scores The economic consequences are not often obvious when trying to relate child obesity and other affected factors. The Child Obesity Factsheet brings out the economic consequences in terms of school costs, obesity related hospital costs and national health expenditure on adult obesity. In line with the increase in proportion of overweight children, the annual hospital expenditure on obese children increased from $35 Mn in 1981 to $ 127 Mn in 1999 while the annual hospital expenditure on obese adults ranges from $98-129 Bn annually. But, more important than these economic figures is the noted finding that - "Severely overweight children miss four times as much school as normal-weight kids." Apart from the fact that, this would cost a large school district like Los Angeles about $15 Mn annually, the occurrence of child missing school will also be an influencing factor on the child's learning and consequently his/her academic performance and test scores. Possibility of Reverse Correlation While most of the research studies conducted have indicated that obesity could lead to degradation of academic performance of students, there is not much literature available to ascertain if the reverse could also be true. Meaning - could high performance or better test scores of students could be due to sedentary lifestyle adopted for higher amount of studies. This could lead to reduced physical activity consequently giving rise to overweight and obesity among children. It would be interesting to consider this condition while conducting research to find out correlation between test scores and obesity such that high test scores would mean a sedentary lifestyle leading to obesity. As stated earlier, the NCLB act which puts a premium on high math and reading scores is already said to be putting a burden on children and reducing the scope for physical activity. Hence, while conducting this research for relation between test scores and obesity, it is also important to analyze if high test scores indicate lesser physical activity and hence higher obesity. Child Obesity Medication for Academic Performance There have been attempts to separate the two issues - child obesity and test scores in order to address them separately. One of the important developments in this field is the medication for obesity and also for high academic performance. While there are a host of obesity medicines recommended for adults, there are only a few which have been suggested to be used in case of children. No medications have been approved for children. However, for adolescents, Orlistat (12+ year's age) and Sibutramine (16+ year's age) may be useful in managing moderate obesity (Journal of Pediatric Gastroenterology and Nutrition, 2008). They work by altering brain chemistry, reducing appetite and preventing absorption of fats by the intestines. Similarly, there have been a host of medicines which are being used to enhance academic performance in children - not just obese or overweight children, but all children in general. Medicines for memory enhancements which can enable students to remember their lessons are used to a good extent. Also, apart from medication, there are numerous memory enhancement activities and techniques which have also been promoted and found useful. This is also true in case of overweight children and will be another important point to be covered at the relevant place in our research study. Summary The literature review for child obesity and test scores' relationship brings out several important elements and factors related to this topic which need to be addressed during our research study. These points need to be further discussed through the focused group discussions and expert interviews to validate their relevance. Once validated, these points will influence the research design - the survey questions, the information collection, the data analysis for correlation, etc. In summary, some of the key points discussed include - proven relation between obesity and test score through previous studies, child obesity and its impact on performance during adulthood, economic consequences which point towards higher absenteeism in school by obese children, possibility of reverse correlation and child obesity/memory enhancement medication. Method Participants The participants of this study - the sample population - are multiple segments of people related to the problem of child obesity and test scores. Sampling method used to select samples across all segments would be Random Sampling and Snowball Sampling. The primary target segment for this research is the affected group under discussion - the children. For the purpose of this study, obese and overweight children between the age group of 6 and 11 will be part of this study and will be contacted for responses to some of the questions needed to be answered. The next affected segment is the parents of the children, who would also be administered structured questioning in order to understand the habits, behavior and experiences related to obesity and test scores of their children. Thus, parents of obese and overweight children between the age of 6 and 11 will be participating in this study. Further, the next parties associated with this issue are the teachers - of the subjects like math, reading and physical education. They would provide inputs and perspectives on their observations on behavioral and lifestyle patterns of children which could provide information on relationship between obesity and test scores. This study would also need participation from groups and segments that are knowledgeable in the area of child obesity. Initially, students of the course "Research in Physical and Health Education" would be part of the focused group discussions to bring out key elements that need to be part of the study. In addition to this group, the study would also try to take opinions from experts in the field of child obesity. Instruments Secondary Research The study would take references from secondary research which would involve observations, findings or key inputs from articles, websites, books, etc. which would help in formulating important observations, questions and supporting arguments for the hypothesis testing. Primary Research Surveys, interviews, discussions, etc. conducted by any individuals, groups or organizations would also form a key source of inputs for this research on obesity and test scores relationship. Focused Group Discussion As stated earlier, a focused group discussion would be conducted among the students of this course, which would help in bringing out key aspects related to obesity and tests scores. The points and elements, discovered at this early stage, would help to ensure that no important issues are missed out while formulating the survey and interview questionnaires. Survey This research instrument would be the main instrument used to collect primary data and information from students, parents and teachers for the purpose of this research study. One survey questionnaire for each segment (in all three questionnaires) would be designed and used to conduct this survey. Interviews (Delphi Method) Structured interviews would be conducted of experts and people knowledgeable in the area of child obesity and test scores. The responses received would be considered while deriving observations and conclusions for relationships between test performance and obesity. This method of deriving conclusions through expert opinion is called as the Delphi Method. Procedures The first step in this study would be to conduct a focused group discussion among a group of students of this present course. The objective of the discussion would be to bring out key elements that need to be considered while designing the research questions. The discussion would be moderated by the owners of this research study and the key points would be noted down by an observer which can be later used as inputs. The next step would be to conduct primary and secondary research to collect references, inferences and observations made by different individuals, groups or organizations. A list of such observations with specific references to their sources will be drawn out and kept as records. Using the inputs received from focused group discussions, primary and secondary research, questionnaires will be prepared for the survey and interviews. There will be three survey questionnaires - one each for students, teachers and parents - and one questionnaire for structured interviews. Responses to the survey questionnaires will be collected by administering the questionnaires to the sample population in person or by inviting responses through emails. Interviews of experts and knowledgeable people will be conducted in person or on phone using the interview questionnaire. Responses received from the survey and interviews would be recorded in an excel sheet which would be structured so as to help in data analysis. Data will be analyzed in this excel sheet to find out any key trends or correlations seen which may be useful in testing the research hypothesis and drawing conclusions. All the information collected through primary and secondary research, observations from the data analyzed from survey and interviews and conclusions drawn from them will then be consolidated into a research report and published. Design and Analysis Sampling The main type of sampling followed in this research will be Random Sampling. Respondents from each segment will be chosen randomly and asked for responses in a manner suitable to them through either personal meeting, over phone or over email. In certain cases, the respondents may be asked to refer the research team to other potential respondents they may know. This form of sampling is Snow Ball sampling. Thus, this form of sampling would also be used to a certain extent. Questionnaire In all four questionnaires would be designed - three for survey sample segments of children, parents and teachers; and one for the structured interviews with experts and related stakeholders. The survey questionnaire would contain mostly closed ended questions as this makes it less stressful for respondents to respond to and takes lesser time to fill up. Hence, it is essential to design the questions carefully using the information and observations collected through primary research, secondary research and focused group discussions. The broad aim of the questionnaire would be to collect the respondent background, information relation to child BMI and test scores, opinions about the relationship between BMI and test scores, any changes that have been seen in the test scores in case there has been a significant change in the child BMI and so on. Various types of questions and scales of measurements would be used in this questionnaire. The interview questionnaire will have structured sequential questions which would be mostly open ended, trying to probe the respondents to find their opinions on this topic and their observations in this field which will provide inputs on obesity, test scores and their relationship. Results Analysis The data and information collected through the survey and interviews would be entered into an excel sheet. Columns would represent questions, rows would represent each respondent and each intersecting cell would represent the response of that particular respondent to that particular question. This would help to analyze the responses statistically. Some of the representations that the results from surveys and interviews would try to project are - Average test scores of children within particular range of BMI Change of test scores of children corresponding to change in their BMI Proportion of parents and teachers of the opinion that there is a correlation between test scores and BMI. Proportion of experts who are of the opinion that there is a correlation between test scores and BMI And some more such representations which would provide some relationships between test scores and obesity among children Apart from the results represented from the data and information collected from surveys and interview, the results report would also present a summary some of the observations from primary and secondary research as well as some subjective observations (in any) that the research team may have discovered during course of research. References 1. Ogden CL, Carroll MD, Flegal KM (May 2008). "High body mass index for age among US children and adolescents, 2003-2006". JAMA 299 (20): 2401-5. http://jama.ama-assn.org/cgi/content/abstract/299/20/2401 2. Ogden CL, Carroll MD, Flegal KM (2008). "High Body Mass Index for Age Among US Children and Adolescents, 2003-2006". JAMA 229 (20): 2401-2405. http://jama.ama-assn.org/cgi/content/abstract/299/20/2401. 3. Patti Neighmond, NPR, Morning Edition (May 2008). "U.S. Childhood Obesity Rates Level Off". http://www.npr.org/templates/story/story.phpstoryId=90880182 4. Mark Fainaru-Wada, ESPN (March 2009) "Critical mass crisis: child obesity". http://sports.espn.go.com/espn/otl/news/storyid=4015831 5. Kaiser Family Foundation (March 2004). "Survey on Childhood Obesity - Summary Document and Chartpack" 6. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH (November 1992). "Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935". The New England journal of medicine 327 (19): 1350-5 7. www.uptodate.com. http://www.uptodate.com/online/content/topic.dotopicKey=pedigast/13911#25 8. Patricia M. Anderson and Kristin F. Butcher. The Future of Children - VOLUME 16 NUMBER 1 SPRING 2006. "Childhood Obesity: Trends and Potential Causes" 9. www.ActionForHealthyKids.org. "Child Obesity Factsheet". 10. Thomas P. DiNapoli, State Comptroller (October 2008). "Preventing and Reducing Childhood Obesity in New York" 11. www.activelivingresearch.org. (Feb 2005). "Designing to Reduce Childhood Obesity" 12. "Obesity and facts". An analysis of data from the Health Survey for England 2003 by Social Issues Research Centre (Feb 2005). 13. "Obesity in Children and Adolescents". Journal of Pediatric Gastroenterology and Nutrition, 2008. http://www.naspghan.org/user-assets/Documents/pdf/WG%20Reports%202008/obesity.pdf Read More