Interventions for Obesity Prevention in hildren and Adolescents - Research Paper Example

Interventions for Obesity Prevention Introduction There has been increased attention to the problem of childhood obesity in the American society especially since the n umber of obese children in 1st to 12 grades has been increasing at an alarming rate in recent years. Data provided by the Centre for Disease Control and Prevention (CDC) indicates the number of overweight children of age six to eleven has doubled since 1980 with those of adolescents tripling over the same period. Current situation points to dire need for interventions as ten percent of children aged two to five and 16 percent of those aged 6-19 are already overweight (Ogden, Carroll, Kit and Flegal , 2012). Intervention programs aimed at obesity prevention for children and adolescents should be a national priority in order to have a healthy nation in future. There is considerable increase in health risk for children and adolescent who are obese or overweight as they are in danger of suffering from diseases such as, hyperlipidemia, type 2 diabetes, asthma and hypertension (Reilly et al., 2003). When children and adolescents with both type 1 diabetes and type 2 diabetes are compared, youth suffering from the later face increased health complications such as nephropathy and cardiovascular disease associated with diabetes (Eppens et al., 2006). Obesity also results in behavioral and mental issues for the affected children with studies indicating adolescents also experience psychological consequences such including low self-esteem and depression (Reilly et al., 2003). Obesity for children in 1st to 12 grades is a problem that is widespread as it cuts across all social, economic and racial classes. Based on the available data, obesity affects even children from the minority groups that include Native Americans, African-Americans as well as Hispanics in addition to low-income groups. According to Ogden, Carroll, Kit and Flegal (2012), the prevalence of obesity for children from African American (24 percent) and Hispanic backgrounds (21 percent) is higher compared to those from white ethnic background (14 percent). The problem of childhood obesity has led to concerted efforts by stakeholders in education and other welfare organizations to identify the childhood obesity causal factors, the consequence on overall wellbeing of the children as well as the necessary mechanisms to arrest the situation. The consequence of increased interest into the problem of obesity in children and adolescents attending 1st to 12 grades has led to the identification of several contributing factors that have been blamed for the trend. According to Ebbeling, Pawlak, and Ludwig, (2002), lack of physical activity is the main contributors to childhood obesity especially since other factors such as watching television and playing computer and video games encourage sedentary lifestyle for the children. The study conducted in South Carolina revealed that obese children had a lifestyle with reduced rate of physical activity in their daily routine compared to those who are not obese. Sedentary lifestyle encouraged by television viewership is a matter of concern for children of these ages as it also increases the consumption of junk food during their viewership period. Additionally, advertisements run on television increases preference to unhealthy diets given that American children are exposed to fast food, soft drinks as well as sugary sweets and cereals (Ebbeling, Pawlak, and Ludwig, 2002; Schwartz, Marlene and Puhl, 2003). Eating habits promoted by parents also have considerable implications on the weight of the children especially since it has become common to have both parents spending more time working that bringing up their children. These changes have enhanced predisposition to obesity by for instance encouraging eating in restaurants and children being left with more free time for television. Additionally, parents who spent increased quality time and offer social support to their children increases the children’s interest to take part in physical activities. Therefore, children who are neglected or depressed are at a significantly higher risk of being obese due to the absence of quality time with parents to offer them social support (Ebbeling, Pawlak, and Ludwig, 2002). Having identified the problems faced by obese children and adolescents in 1st to 12 grades, it is necessary that successful interventions should be provided to remedy the situation. The following sections of the research paper reviews existing interventions to determine the effectiveness of school based programs in reducing the risk of obesity and obesity for children and adolescents in 1st to 12 grades. Focus on school-based interventions to obesity in 1st to 12 grades children and adolescent is informed by the fact that the setting provides “intensive contact with children during their formative years” (Treu, Hinson and Walker, 2011, p. 242). School-based interventions takes advantage of presence of students from different backgrounds in the catchment area to measure variable such as nutritional knowledge, involvement in physical activities, waist circumference, fitness level, nutritional habits, BMI percentile and percentage body fat in pre- and post-intervention intervals (Greening, Harrell, Low and Fielder, 2011; Myers et al., 2014; King et al., 2014). The school-based interventions are also effective in reducing obesity and potential risks due to emphasis on behavior, attitude and knowledge change for the sampled children and adolescents (Caballero et al., 2003). 2) Review paper 1: Devault, N., Kennedy, T., Hermann, J., Mwavita, M., Rask, P. & Jaworsky, A. (2009). Its all about kids: Preventing overweight in elementary school children in Tulsa. J Am. Diet. Assoc., 109, 680-687. Devault et al (2009) used the outcomes measurement study to perform an appraisal of the impact of It’s All About Kids nutrition component. The component was made up of six weekly 30-minute classroom lessons on attitudes, knowledge and behaviors associated to nutrition. Through these lessons, the researchers wanted to find out the implication of learning curriculum topics such as portion sizes, food labels, lower-fat food choices and decision-making on food choice for the sampled group. Devault et al (2009) sampled fourth-grade students for their study due to the literacy level of the children as they could read the survey. Fourth-grade students can also sustain attention span of up to 30 minutes in addition to the fact that validated questionnaires were already available for such children. The researchers divided the sampled children into two groups with the comparison group having 69 students made up of 28 males and mean age of 9.9 years and range of 9.2 to 11.7 years. The second group labeled intervention group had 71 students with 40 of them males and mean age of 10.1 years at pretest with a range of 9.1 to 11.4 years. The It’s All About Kids nutrition component focused on proactive activities to improve student achievement levels with one person teaching all the six lessons. The six lessons were taught for six weeks each week based on a specific topic. The research by Devault et al (2009) was successful in improving knowledge attitudes and behaviors related to nutrition for the fourth-graders. Results after the study indicated the group of students sampled for intervention demonstrated increased knowledge of which foods contain more fat and demonstrated positive attitudes about food choice based on consumption of healthful and lower-fat options. Another positive outcome for the research is that the It’s All About Kids program did not result in sampled children experiencing increased worry about overweight or put more efforts towards losing weight through unhealthful means. The It’s All About Kids program used by Devault et al (2009) was an important component in the success of the study since the program highlighted major areas that should be addressed for the problem of childhood obesity to be mitigated. The program included a scale for measuring areas such as food choice, physical activities, knowledge on nutrition curriculum, food self-efficacy, concept of body image, attempted weight loss, and healthy body perception. While the study comprehensively covered areas concerning childhood obesity based on the perception of the children, the authors also ensured success of the study by focusing on behavioral and mental perceptions of the children about their weight situation. Devault et al (2009) focused on the fourth-graders from ten schools to improve the accuracy of the findings as they represent children with a small range in age differences as opposed to conducting the study based on children from 1st to 12 grades. However, the researchers also failed to have a balanced representation in terms of race given that majority of those sampled were from minority including African American (52%), Native American (9%) and Hispanic (24%) students which means those from White majority represented 24% of the sampled students. 3) Review paper 2: Coleman, K., Tiller, L., Heath, E., Ownar, S., Milliken, G. & Dzewaltowski, D. (2005). Prevention of the epidemic increase in child risk of overweight in low income schools. Arch Peadiatr. Med., 159, 217-224. The purpose of Coleman et al (2005) was to make an evaluation of the impact of Child and Adolescent Trial for Cardiovascular Health (CATCH) on children from low-income elementary schools. The authors note the prevalence rate of childhood obesity in Hispanic children was higher than that of any other ethnic groups. Therefore, the study focused on the Hispanic students to evaluate the effectiveness of CATCH. Coleman et al (2005) primarily sampled students from Hispanic ethnic group. The researchers sampled 896 third grade children for this study with 473 schools (224 girls and 249 boys) being used for comparison. Students in intervention were from 423 CATCH schools where 199 girls and 224 boys were sampled with 97 percent of the total number of sampled students was from Hispanic ethnic background. However, follow up was conducted for the children into their fourth and fifth grades while aerobic fitness was tested up to the sixth grade. The design for this study involved the use of untreated, matched control group that was used to compare with the intervention group used for dependent pretest and posttests of the samples. The study conducted by Coleman et al (2005) based on El Paso CATCH elementary schools revealed a number of issues based on the methods used to collect data. Based on the outcome from the study, students from both the control schools and CATCH schools had had a risk of being overweight. However, the rate of increase by percentage of risk of overweight was higher in control schools for both girls and boys compared to the results acquired from CATCH schools. The percentage risk of overweight for girls in control schools ranged 26 percent from third to 39 percent for fifth grades while for 30-32 percent was recorded for girls in CATCH schools. Boys in control schools had an increase in risk of overweight ranging from 40-49 percent while those from CATCH schools of ranged from 40-41 percent, therefore, the rate for CATCH schools (2% for girls and 1% for boys) was lower than in control schools (13% for girls and 9% for boys). The El Paso CATCH study conducted by Coleman et al (2005) was successful based on the region sampled. Since the national CATCH study was uniformly implemented in all the schools (Springer et al., 2012), it did not respond to the differences generated in American society by ethnic and socio-economic diversity. The El Paso CATCH study focused on a community with majority Hispanic students who were also characterized as low-income earners. The program was therefore implemented to respond to such social differences for accuracy of the study. Given that schools that were sampled for the study received financial assistance to facilitate implementation of the program, there were possibilities that the control schools may not cooperate since they did not need to implement any of the program. However, to ensure cooperation during the period of the study, control schools were given 1000 dollars annually. 4) Review paper 3: Whittemore, R., Chao, A., Jang, M., Jeon, S., Liptack, T., Popick, R. & Grey, M. (2013). Implementation of school-based internet obesity prevention program for adolescents. J Nutr. Educ. Beh., 45, 586-594. Same as above (write about a-f) Whittemore et al (2013) sought to make an evaluation of the effectiveness of HEALTH[e]TEEN program implemented in three public high schools in Connecticut. HEALTH[e]TEEN is an effective program in assessing the impact of technology in creating interventions against obesity. The program relies on the internet to provide information on differences in student participation and satisfaction based on differences created by school, gender, age, and race/ethnicity of the sampled students. Whittemore et al (2013) sampled 384 adolescents from three high schools in Connecticut with eight teachers assisting in the implementation of the program. The students were sampled from diverse ethnic backgrounds, different ages and sex. The intervention program design used by Whittemore et al (2013) is based on HEALTH[e]TEEN. The program that uses web-based educational program that aims at providing alternative approach in reduction of overweight problem especially based on its contribution to type-2 diabetes in at-risk teens. The students were taught about the dietary impact of their food choices on health in order to create a deeper understanding of nutrition. The program was implemented in two phases with one section undertaking the program as program as homework while the other as class work. The outcome of Whittemore et al (2013) evaluation of HEALTH[e]TEEN program implemented as either homework or classwork produced varied results in levels of satisfaction and participation. The recorded level of satisfaction was 3.6 out of an overall mean of 5 while participation was 83 percent lessons completed indicating a high level of student involvement during the period of program implementation. Students exposed to the program as lessons in class recorded higher (P ≤ .001) satisfaction and participation than those in schools implemented as homework (< .001). There were also gender differences in satisfaction and participation with girls (at P = .02) recording higher values than (boys p= .03). There were no differences in satisfaction based on age (P = .03) although the result for younger students indicated higher participation compared with older students. The study conducted by Whittemore et al (2013) was successful because of the approach taken by the researchers. Adolescents are attracted to technological devices, which made it easy to sustain the attention of sampled students during the implementation period. While research has indicated both Internet obesity prevention program and traditional classroom education have important contributions to make in reducing obesity, internet obesity prevention program has been found to be of greater assistance to children and adolescent dealing with selected health behaviors (Casazza and Ciccazzo, 2007; Cook et al., 2014). The researchers addressed generalization by sampling students from diverse backgrounds. Sampling children based on different gender, age, and ethnicity from different schools improved the accuracy in data collection and obtained results. 5) Conclusion The foregoing research paper has analysis application of school based interventions for obesity prevention in children and adolescent from 1st to 12 grades. The studies were found to be effective based on approaches taken, which focuses on the children for answers to the problem. Having interventions that covers aspects related to areas such as nutritional knowledge, involvement in physical activities, waist circumference, fitness level, nutritional habits, BMI percentile and percentage body fat in pre- and post-intervention intervals is important in tackling the risks for obesity and obesity for those affected. Although best applicable intervention in a national scale are those that samples children and adolescents from diverse backgrounds, it also important to have interventions that cover specific ethnic group such as Coleman et al (2005) that used samples from children of Hispanic background. This approach provides for interventions that are specifically prepared for the targeted group based on unique characteristics such as social-economic and environmental factors. As seen from the study conducted by Whittemore et al (2013) schools provide the best environment for the adolescent and children to gain the necessary knowledge, attitude and behavior to reduce the problem of obesity. However, combining both school and home based interventions might have greater impacts in the lives of concerned children as it will ensure both teachers and parents combine their efforts in addressing the problem. 6) References Caballero, B., Clay, T., Davis, S. M., Ethelbah, B., Rock, B. H., Lohman, T., ... & Stevens, J. (2003). Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren. The American journal of clinical nutrition, 78(5), 1030-1038. Casazza, K, Ciccazzo M. (2007). The method of delivery of nutrition and physical activity information may play a role in eliciting behavior changes in adolescents. Eat Behav, 8(1):73–82. Coleman, K., Tiller, L., Heath, E., Ownar, S., Milliken, G. & Dzewaltowski, D. (2005). Prevention of the epidemic increase in child risk of overweight in low income schools. Arch Peadiatr. Med., 159, 217-224. Cook, T. L., De Bourdeaudhuij, I., Maes, L., Haerens, L., Grammatikaki, E., Widhalm, K., ... & Manios, Y. (2014). Moderators of the Effectiveness of a Web‐Based Tailored Intervention Promoting Physical Activity in Adolescents: The HELENA Activ‐O‐Meter. Journal of School Health, 84(4), 256-266. Devault, N., Kennedy, T., Hermann, J., Mwavita, M., Rask, P. & Jaworsky, A. (2009). Its all about kids: Preventing overweight in elementary school children in Tulsa. J Am. Diet. Assoc., 109, 680-687. Ebbeling, C. B., Pawlak, D. B. & Ludwig, D. S. (2002). Childhood obesity: public-health crisis, common sense cure. The Lancet 360(9331), 473-482. Eppens, M. C., Craig, M. E., Cusumano, J., Hing, S., Chan, A. K., Howard, N. J., ... & Donaghue, K. C. (2006). Prevalence of diabetes complications in adolescents with type 2 compared with type 1 diabetes. 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