The Causes of Childhood Obesity in Saudis and Extent of Parents` Awareness of the Lifestyle - Research Proposal Example

Contents 1.0 Introduction 1.1 Background information………………………………………………………………………3 1.2 Statement of the problem………………………………….…………………………………..3 2.0 Aim and Objective……………………………………………………………………………. 2.1 Aim …………………………………...………………………………………………………5 2.4. Objectives…………………………………………………………………………………….5 3.0. Literature Review…………………………………………………………………………. …6 3.1. Summary of literature review………………………………………………………….……..9 4.0 METHODOLOGY 4.1 Study design…………………………………………………………………………………..8 4.2 Population / sampling…………………………………………………………………………9 4.3. Personnel…………………………………………………………………………………….10 4.4. Data collection…………………………………..…………………………………………..11 4.5 Questionnaire Part one…………………………………………………………………………………..11 Part two…………………………………………………………………………………..12 Part three…………………………………………………………………………………12 4.6 DATA ANALYSIS…………………………………………………………………………..13 4.7. Validity, Reliability and Rigour…………………………………………………...………...13 4.8. Limitation. …….………………...…………………………………………………………..14 4.9 Ethical consideration……………………..……………………………………………….....14 5.0. Conclusion…………………………………………………………………………………..15 9.0. References…………………………………………………………………………………… 10.0 Appendix……………………………………………………………………………………. The Causes of Childhood Obesity in Saudis and Extent of Parents` Awareness of the Lifestyle 1.0 Introduction 1.2 Background information Childhood obesity is a medical condition whereby the child becomes overweight due to accumulations of fats in the body. Obese child’s weight is not proportional to the height according to the Body Mass Index (BMI). Childhood obesity has turned out to be one of the most challenging problems in the 21st century. It has been considered to be a worldwide problem since it increases morbidity and mortality of the child (Abramovitz, 2004). Obesity may have harmful effect on all parts of the Childs body system. For instance, obesity has been known to cause considerable health challenges in the heart, muscles, kidneys, respiratory system, sleep, hormones controlling blood sugar and finally the digestive system (Chapman, 2010).Globally, it is estimated that at least 43 million children who are likely to be under the age of five years are practically obese which is an escalating rate compared to the previous statistics. The problem affects both the rich and the poor, but the poor are the most affected. Out of the 43 million preschool children who are affected by the obesity, 35 million come from developing countries and this affirms that poverty is a contributing factor to obesity (Barbour, 2011). 1.2 Statement of the problem Obesity in Saudi Arabia has been on escalating day in day out taking into concern that dietary consideration is highly valued in the country. According to Daghri in (2007), Saudi Arabia was ranked 29th by the Forbes list as one of the fattest countries in the world. Research postulates indicates that two thirds of the populations are obese and they have exceeded the threshold of the accepted BMI Mylett, T. (2c010).In cases of health adults their BMI should range 20 and 25. Once the BMI has been evaluated individuals can determine their weight ranges. For instance: Under 18.5 - you are very underweight and possibly malnourished. 18.5 to 24.9 - you have a healthy weight range for young and middle-aged adults. 25.0 to 29.9 - you are overweight Over 30 - you are obese Chen, Z. (2013). Childhood obesity should be taken into account and appropriate actions should be taken in an effort to control the escalating disaster. For example, if two thirds of Saudi population is obese, it means that children are the most affected due to availability food in plenty, and therefore, it is paramount to formulate ways and means to alleviate the situation. Obese children are unhealthy, which means that it is not practically possible to formulate efficient citizens Haslam, D. W., & Witterst, G. (2009).The problem of obesity should be solved in order to create an obesity free country. Obesity culminates top health complications which can be avoided if the society practices healthy eating and physical exercise. Preventing and managing obesity is much easier compared to providing medical attention to the comorbidities of obese patients. Obesity culminates to mental retardation and this translates economic retardation Al-Shahrani & Al-Khaldi (2013). Controlling obesity means creating a healthy and productive nation, therefore, it is inevitable to apply all measures in pursuant of the goal. 2.0 Aim and Objectives 2.1 Aim This proposal aims to know to identify the reasons behind the increase the prevalence of childhood obesity in Saudi Arabia and to assess parents` awareness of the impact of lifestyle changes on childhood obesity. Health promotion program will be prepared to preparation the community needs. 2.2. Objectives 1. To review previous studies that assessed childhood obesity in Saudi Arabia 2. To find out the changes in the society that contributed to childhood obesity 3. To assess parents’ knowledge about healthy and healthy dietary habits lifestyle through previous studies 4. To compare our results collected through questionnaire survey with previously published data in Saud. 3.0. Literature Review Childhood obesity is a global challenge affecting both the developed and developing countries particularly Saudi Arabia (Amin, 2008). The causes of this phenomenon are multiple, but the lifestyle is the main contributing factor. Childhood obesity has continued to be a challenge that should be solved with immediate effect in attempt to deter health complications involved. Considering the escalating levels of the disorder, it is a critical time for all stakeholders to work in unison to achieve a solution for the epidemic (Resnik and Shampoo, 2003), recent research postulates that out of all Saudi children, 23% of them are obese and these results are not appealing at all. In year 2010, WHO (World Health Organization) affirmed that at least 42 million children who under five years are affected by obesity. Obesity is a contributing factor to most non communicable diseases (NCDs) and it is projected that, by year 2020, most of the deaths occurring in developing countries especially Saudi Arabia will be attributed to the non-communicable diseases (Amin, 2008). In the Kingdom of Saudi Arabia, childhood obesity has been studied severally through a cross sectional approach and several cities have been covered. However, it is quite difficult to get the actual and reliable national data since it is not possible to get accurate data about rates and trends to be followed (Amin, 2008).However, a conclusion based on systematic reviews and published information adds up to the information that is available. El-Hazmi 2002 conducted the national Cross-Sectional study from year 1994-1998 in five provinces of Saudi Arabia and children between 1-18 years were included. Cole’s standards were practically used in the definition of overweight and obesity Swain, J., Heyman, B. & Gillman, M., 1998.The degree of overweight was actually affirmed as 10.68% and 12.7% for boys and girls, respectively. Mouzan asserted that there is a slight increase in obesity among children who are aged five to 18 years (Beseler, 2008). ISD overweight was 15.7% and prevalence of obesity ISD was 6%. Although the previous reviews provided a prevalence of overweight from 11.69 to 23.1% and that of obesity to be 6.3 to 11.3% for the children of school age in Saudi Arabia. The prevalence has continued to grow continuously for the six years since 1998 (Al-Shahrani& Al-Khaldi, 2013). The prevalence of overweight in the local surveys is indicated in the following discussion. Riyadh: Alshammari (2001). And colleagues conducted a cross-sectional study in 2001 and all people who are aged between 6-17 years were encouraged to participate. In this area, overweight in children was defined according to the NHANES criteria. The rate of overweight in the children was found out to be 10.5% and that of obesity was found out to be 8.7%. The comparison of the studies conducted in 2005 and 1988 has proved a significant increase in BMI from the 3.4% to the 24.5%.. According to Al-Khaldi, Y. (2013).study on males aged 12-20 years who were collected from the government schools. Overweight children parameter was chosen according to Iwata, F., Okada, T., & Harada, K. (2000). The Eastern province is one of the areas where the prevalence of obesity is high especially among children and adolescents. In this province and other areas of Saudi Arabia, it was observed that obesity is more prevalent among females than males (Barbour, 2011). However, there are some studies that concluded the opposite whereby males are more overweight than females. It should be noted that lifestyle is the most import contributing factor towards obesity and overweight. Urbanization in the Middle Eastern countries is among the social inequalities which contribute to wrong food choice hence contributing to obesity. Inefficient knowledge of health food choices and lack of good physical activities have maximally contributed to the disorder Greenway, J. (2008, May 1). 3.1 SUMMARY OF LITERATURE REVIEW Saudi Arabia is one of the leading countries in overweight and obesity. The mode of living, urbanization and social norms has played a huge role towards enhancing it. There are serious consequences related to obesity and infertility and health complications are inclusive. In effort to reduce the impact; measures should be taken to reduce the disease and create a healthy nation Iwata, F., Okada, T., & Harada, K. (2000). 4.0 METHODOLOGY 4.1 Study design In an effort to get accurate and concise information, efficient research design should be adopted. Cross-section design is the best approach to the task since it implies taking samples from the field and making conclusions from the data obtained from the sample. The study design adopted here is cross-sectional and it is more reliable and objective considering the directives and objectives to be followed Reilly, J. J. (2010).Measuring the magnitude of obesity is quite difficult, but through the cross sectional method it can be easily expressed into percentage or ration making it less complex. Cross section research design describes relationships in terms of cause and effect especially in high controlled environment. Taking the case of the study, it is possible to describe the cause and affect relationship of the research problem (obesity) and describe them relatively and precisely Wolin, K. Y., & Petrelli, J. M. (2009). The study design can easily test hypothesis and theories to ascertain whether they are right. Taking the case of the research problem, it is possible to formulate a declarative hypothesis which postulates” obesity is caused by feeding and lifestyle”. It’s possible to test the hypothesis through conducting research and affirming whether the hypothesis is real or vague. Moreover, the study affirms that the “sample used” is an actual representation of the real population. What the “sample says” is believed to be the fact. For instance, the sample taken from Riyadh is used as an actual representation of Saudi Arabia and therefore, backing up the design. In many cases of research, subjectivity is a main issue but using research design will ensure that subjectivity of the researcher is limited. For instance, taking the case of the research problem, the reader will not detect any cases of subjectivity since the design tends to limit it as much as possible. The obtained data will expressed in form of percentage and this will show the rate at which the children are affected. Following the above approach substantial results will be obtained concerning the causes of obesity and the impact it has on the society (Gearity, 2011). The questionnaires will be used to ascertain behavior and attitude of parents towards obesity. Quantitative methods will ensure a high level of reliability of the data that will be gathered. On the other hand, qualitative research will ensure that the information given will be based on depth information hence turning out to be real and authentic information, which is reliable. 4.2 Population / sampling Mention to the samples that have been selected in previous research and talk about random sample will be used in this research in Riyadh only, where the researches need plenty of time, high budget and qualified staff to cover all Kingdom`s regions (Almalki, FitzGerald, & Clark, 2011). Parents, who have children between 5 to 15 years old, will participate in this study because the psychological and behavioral change at this age (Sarwer & Dilks, 2012). The Random samples will be collected in Riyadh region and then generalizations will be made. The estimated sample is around 300 children, who will undergo obesity test. The test will involve several tests, which will determine whether a child is obese or not. Moreover, there will be some additional information which will be filled by the parents of the child that will help in determining the causes of obesity (El-Hazmi, 2002). The parents will be required to fill out some information which will give basic information on the lifestyle of the family. The information retrieved from the sample will determine the quality of the research and therefore it`s crucial to exhaust crucial information from the parent. It is worth noting that the sample age is around 5-15 years and parents will be needed to answer most of the questions needed to determine the causes of the disorder since the children might not have good grip of what the researchers want to investigate. 4.3. Personnel The personnel who will be used in the reach must meet particular criteria in pursuit of effective research. First, the individuals must have relevant communication skills which will be instrumental in filling the questionnaires Raj; M. (2010).Communication skills entail good PR-public relations since variety of people will require making the task effective. Moreover, the individuals must be versed with data collection and analysis skills since they will be fundamental in the whole exercise. Therefore, individuals who have special interest in research are the most efficient (Dillon, 2007). The skill of writing is also valuable in the exercise. People who have specialized skills in writing will tend to perform better compared to those who lack such skills. Finally, upon incorporating such an individual in the research, it will be easy to come up with quality research which gives clear and articulate figures and causes. 4.4. Data collection Data collection will take two months, through various methods of data collection; in this case it will involve taking a subset of the people and later using collected data to generalize the attributes of those people. For instance, it would be easy to take samples of individuals. Sample study is a minor representation of the greater group and it is the most appropriate method in this case. However, in addition to the sample survey questionnaires and interviews will be pivotal here. The parents will be required to fill out some information concerning their feeding habits since it will give information why things happen as they appear. The questionnaires to be used are open ended and they touch on the feeding habits since they are the main contributing factors. This information will be useful in determining whether economic status is a determining factor when it comes to the development of obesity (Abramovitz, 2004). Key question here should be based on economic, status, feeding habits and location. Therefore, after data collection will be important in making the right move towards solving the challenge (Khalid, 2008). 4.5 Questionnaire (Appendix 1) Part one As posited earlier, the first part of the questionnaire will be based on the social-economic and the level of education amongst parents. The level of education and the socio-economic factors will determine the type of food and lifestyle adopted by the family. Moreover, socio-economic factors also contribute to obesity in both cases, where healthy food is usually more expensive than unhealthy food subsequently the monthly family income effect the quality of food consumption (Sturm & Datar, 2011) Parents will be in a position to provide children with everything and this will not only make the children fat and clumsy, but they will tend to develop obesity. Therefore, social economic status is a contributing factor to obesity in all dimensions. Research shows that Riyadh is actually populated by the average people and that’s why it is possible to find many cases of obesity in the area Wang, Y., & Beydoun, M. A. (2009).There are average in terms of education and economic status and that’s it is possible to find many cases of obesity in the area. Part two Second part of the questionnaire should handle the nutrition aspect, whereby the parents are supposed to reveal their main diet. The diet will tell the nutritional value of the food and that is what will determine whether the children suffer obesity as a result of diet. The questionnaire should be able to show whether the child engages in physical exercise Metcalf, T., & Metcalf, G. (2008). Physical exercises are known to decrease the fats in the body and through that the child cannot become obese. However, failure to exercise the body cause increased fats in the body which in turn increases obesity. Part three Parents opinion to maintain their influence on their children from obesity or are there external influences that prevent the spread of obesity. 4.6 DATA ANALYSIS Data processing and analysis will include both quantitatively and use descriptive statistics (Moule & Hek, 2011) the information will be carefully scrutinized and examined to determine its relevance to the topic. Information collected will be analyzed using SPSS. Appendix will be also added to support the main ideas. 4.7 Validity, Reliability and Rigour Validity refers to the extent in which a concept, conclusion or measurement is accurate and corresponds to the real world. The data that will be provided in the research will be valid taking into account that all methods and procedures outlined are accurate (Beseler, 2008).The validity of data is critical since it guides users on what to do in special cases. When the data is valid, the conclusions made are real and in the case of Arabian data, it will be possible to validate every numerical data through findings that will be given out (Thirby, R. C., & Randall, J etal, 2002). Reliability refers to the ability of a system to perform as it is required. Talking of reliability the proposal is reliable and if implemented properly, it is going to produce good results. More also, the information that will be produced through research will also be reliable since the techniques and strategies employed are also worth. Hebebrand, J. (2008). Rigour is an attribute of research whereby it is described as high quality or low quality. When something is rigorous, it is said to be of high quality Al-Khaldi, Y. (2013). Considering the research that is undertaken, we can comfortably affirm that the proposal is rigorous and it is going to produce excellent results if it is followed to the letter. Moreover, the accuracy in analysis and data collection will add to the rigorous of the information. 4.8 LIMITATION One strong limitation is that parents may not be honest when filling out the questionnaires and this will end up distorting the information. Distorted information will ultimately lead to false conclusions. Second, acquisition of specialized workforce is expensive and in the long run, the specialists may not find it worth (Dillon, 2007). Lastly, parents may also restrict their children to undergo the task on the assumption that they may be blamed for the situation. 4.9 Ethical Considerations Informed consent It is imperative in this research that potential participants are able to provide voluntary, informed and comprehending consent. Information must be provided to the participants and must include purpose, methods, demands and possible outcomes of the research project. A record must also be kept by the researcher to confirm that potential participants were given sufficient information to make an informed choice and participants must also be aware that they may withdraw from the study at any time without penalty (Booth & Booth, 1994) Anonymity Anonymity has to be guaranteed. There also needs to be some justification of the study in terms of the benefit to its participants and the community at large. The justification is that this research is likely to be of benefit to the general public and may lead to a more effective education programmes for parents and children in Saudi Arabia Kingdom of Saudi Arabia. (2013). Confidentiality This research seeks to ensure confidentiality in all stages of the project. However, it must also be said that there may be times when there is a need to breach confidentiality (Swain, Heyman & Gillman, 1998). For instance, this could occur if authorities were to subpoena research notes in order to investigate an act of crime in which the participant may be implicated. It is imperative, therefore, that the researcher specifies the circumstances where confidentiality may be breached prior to engaging in the interview process. Should such issues arise, then advices will be sought from the supervisors or different members of the staff who might be suggested by the supervisor (GenoVive and Delta, 2013). 5.0 CONCLUSION In conclusion, it should be noted that obesity is a national disaster and measures should be taken to ensure that it is solved. Research has postulated that living style and feeding habits are some of the most contributing factors to the disorder. Hilden is eating much junk and they do not exercise and this makes them fat and lazy. Moreover, there is health complications associated with the disease, and they include some of the cardiovascular diseases. Mental problems and infertility can also be caused by the obesity and, therefore, it is important to try and control it. Preventing and controlling the disorder should not be one way rather it should be a common task whereby all people are involved. Saudi Arabia being a developing country, initiatives should be enhanced since the obese people are the future leaders, which should not be the case. The proposal seeks to fulfill the ultimate goal of investigating the causes of obesity and upon full realization; remedies will be offered which will be pivotal in the prevention. References Abramovitz, M. (2004). Obesity. San Diego, Calif.: Lucent Books. Al-Khaldi, Y. (2013). The birth of a new twin in Saudi Arabia. Saudi Journal of Obesity, 1(1), 1. Almalki, M., FitzGerald, G., & Clark, M. (2011). Health care system in Saudi Arabia: an overview. Eastern Mediterranean Health Journal, 17(10). Al-Shahrani, A., & Al-Khaldi, Y. (2013). Obesity among diabetic and hypertensive patients in Aseer region, Saudi Arabia. Saudi Journal of Obesity, 1(1), 14. Amin, T. A. (2008). Overweight and obesity and their association with dietary habits, and socio demographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia.(Original Article). Indian Journal of Community Medicine, 3, 14. Barbour, S. (2011). Obesity. Farmington Hills, MI: Green haven Press. Booth, T. & Booth, W., (1994). 'The Use of Depth Interviewing with Vulnerable Subjects: Lessons from a Research Study of Parents with Learning Difficulties', Social Science and Medicine, 39:3, 415-24. Chapman, R. (2010). Culture wars an encyclopedia of issues, viewpoints, and voices. Armonk, N.Y.: M.E. Sharpe. Chen, Z. (2013). Obesity Prevention: The Impact of Local Health Departments. Health Services Research, 3, 14. Daghri, N. M. (2007). Serum leptin and its relation to anthropometric measures of obesity in pre-diabetic Saudis. (Original investigation)(Clinical report). Cardiovascular Diabetology, 2, 19. Dillon, E. (2007). Obesity. Farmington Hills, MI: Green haven Press. El-Hazmi, M. A. (2002). A Comparative Study of Prevalence of Overweight and Obesity in Children in Different Provinces of Saudi Arabia. Journal of Tropical Pediatrics, 48(3), 172-177. Gearity, B. T. (2011, September 1). Case Closed: An Earnest Review of Gagnon's Case Study as Research Method. The Qualitative Report, 3, 12. GenoVive and Delta Marketing Company Joins Force to Combat the Rising Obesity Rate in the Kingdom of Saudi Arabia. (2013). Marketing Weekly News, 3, 23. Haslam, D. W., & Witterst, G. (2009). Obesity. Abingdon: Health Press.. Hebebrand, J. (2008). Welcome to OBESITY FACTS, the Official Journal of the European Association for the Study of Obesity (EASO)!. Obesity Facts, 1(1), 4-5. Khalid, M. E. (2008). Is High-Altitude Environment a Risk Factor for Childhood Overweight and Obesity in Saudi Arabia?. Wilderness and Environmental Medicine, 19(3), 157. Metcalf, T., & Metcalf, G. (2008). Obesity. Detroit: Thomson / Gale. Moule, P., & Hek, G. (2011). Making sense of research: an introduction for health and social care practitioners. Sage. Mylett, T. (2c010). Safety Culture: Conceptual Considerations and Research Method. International Journal of Employment Studies, 2, 12. Sarwer, D. B., & Dilks, R. J. (2012). Invited commentary: Childhood and adolescent obesity: Psychological and behavioral issues in weight loss treatment. Journal of youth and adolescence, 41(1), 98-104. Sturm, R., & Datar, A. (2011). Regional price differences and food consumption frequency among elementary school children. Public health, 125(3), 136-141. Swain, J., Heyman, B. & Gillman, M., 1998. 'Public Research, Private Concerns: ethical issues in the use of open ended interviews with people who have learning difficulties', Disability and Society, 13:1, 21-36. Thirby, R. C., & Randall, J. (2002). A Genetic "Obesity Risk Index" for Patients with Morbid Obesity. Obesity Surgery, 12(1), 25-29. Wang, Y., & Beydoun, M. A. (2009). Meat Consumption Is Associated With Obesity And Central Obesity Among US Adults. International Journal of Obesity, 33(6), 621-628. Wolin, K. Y., & Petrelli, J. M. (2009). Obesity. Santa Barbara, Calif.: Greenwood Press. Beseler, L. (2008). Obesity, children. Boca Raton: BarCharts, Inc. Greenway, J. (2008, May 1). Childhood obesity: bringing children's rights discourse to public health policy. (PROFESSIONAL). Community Practitioner, 3, 23. Iwata, F., Okada, T., & Harada, K. (2000). Assessment of obesity in children. International Journal of Obesity, 24(11), 1542-1542. Riyadh: Alshammari (2001). The prevalence of overweight in the local surveys Raj, M. (2010, November 1). Obesity in children & adolescents.(Report). Indian Journal of Medical Research, 2, 12. Reilly, J. J. (2010). Evidence-based obesity prevention in children. Obesity Research & Clinical Practice, 4, S87. Appendix SWANSEA UNIVERSITY College of Human and Health Science MSc Public Health and Health Promotion SHGM38 Date Dear Participant: My name is Areej Bahammam and I am a master’s student at Swansea University. For my dissertation, I am examining the causes of childhood obesity in Saudis and extent of parents` awareness of the lifestyle. I am inviting you to participate in this research study by completing the attached questionnaire. Completing the questionnaire will require approximately 30 minutes. If you choose to participate in this project, please answer all questions and return the completed questionnaires promptly. Please note that your response is private and confidential. You will not be identified in any data or reports. Survey responses will not be linked with other records. Participation in this survey is highly valued, but voluntary. You are free to withdraw at any time. We will protect your anonymity and the confidentiality of your response to the fullest possible extent within the limits of the law. If you have any questions about this survey or would like further information, please contact my Module leader DR. John Gammon at j.gammon@swansea.ac.uk Sincerely, Areej Bahammam a.s.bahammam.683294@swansea.ac.uk Questioner First Part: Biography 1. Optional Name ……………………………………………. Contact Number………………….. 2. Sex: 3. Education/ Qualification 4. Family Income for couple 4.1. Up to 4999RS 4.2. 5000- 9999 RS 4.3 10000- 14999RS 4.4 More than 15000 5. Family weight history 6. Number of Family members: ………. 7. Number of children between 5 to 15 years old........ Second Part: Personal Attitude Nutrition Question Always Often Sometime Rarely Never 8. I provide Breakfast for my family everyday 9. I interested of school meal 10. I present fruits and vegetables daily 11. I follow healthy diet at home. 12. I prepare healthy snack at home 13. We eat chocolate and candy every day. 14. We eat fast food weakly 15. I discuss my children about healthy food 16. I am sure to provide nutrition meals incomplete element 17. We watch T.V during a meal Physical Activity Question Always Often Sometime Rarely Never 18. All family exercise physical activity more than 3 times a week. 19. My children spend more than 2 hours front T.V or computer games. 20. My children practice specific sport regularly. 21. I park my car away and walk. Third Part: Personal Opinion Your Opinion Strongly Agree Agree Neither agree nor disagree Disagree Strongly disagree 22. Parents are primarily responsible for children health 23. Schools offer services to reduce childhood obesity 24. There are many health promotion program in childhood obesity 25. Health services percent childhood obesity programs. 26. Children`s gyms are available 27. The community interested in childhood obesity Read More