Health Promotion Programs in Schools - Case Study Example

Health Promotion Programmes in Schools to Prevent Saudi Arabia Community from Childhood Obesity Table of Contents Table of Contents 1 1.0Introduction 2 2.2 Health Promotion Programmes 6 1.2.1 Physical Activity Programmes 6 2.2.2 Physical Education Programmes 7 2.2.3 Health Screening Programmes 8 2.3 Health Promotion Programmes in Developed Countries 8 2.5 Effectiveness of School Health Programmes on Childhood Obesity 12 3.0 Conclusion 13 4.0 References 14 1.0 Introduction The current obesity epidemic is not a challenge restricted to a particular geographical region, but has become a worldwide concern. In the late 20th century, obesity was identified as a global health care problem which affected the wellbeing of the world’s population (Bagchi, 2011). Obesity among children is increasingly becoming a major problem in the recent past affecting children of both genders all over the world. The Gulf region is not an exemption as indicated by rising prevalence of obese and overweight among the Saudi children of both genders and in all age groups (Davies, Fitzgerald, & Mousouli, 2008). The high prevalence of childhood obesity in Saudi Arabia calls for the need to support health promotion programmes aiming at reducing obesity in the community, and especially among the children (Cash & Smolak, 2011). Health programmes such as physical activity, diet and nutrition are vital in reducing obesity in the community, as well as maintaining the recommended weight for age and height in the general population (Ferry, 2011). In addition, health education programmes create public awareness of the complications associated with obesity, and help change the eating habits of the community. The policy makers, ministry of education and the local government need to review educational programmes with the aim of promoting school health and reducing childhood obesity in Saudi Arabia This assignment will examine the roles of Saudi Government in coming up with health promotion schools, how to apply the health promotion programmes in Saudi Arabia in the context of developing countries. In addition, the paper will examine how school health promotion programmes can reduce childhood obesity. 2.1 Development of Health Promotion programmes in Saudi Arabia Reducing childhood obesity is a central issue for the Saudi Government that needs to be given the first priority and attention by the policymakers at all government levels (Ferry, 2011). Therefore, the government must intervene to make schools in Saudi health promotion schools. Schools are in control of many influential tools that act as key agents in reducing the high prevalence of the obesity crisis. They have mechanisms for offering health education and supporting health behaviours, and serve as an important gateway to reach the population at large (Cash & Smolak, 2011). Studies have illustrated that childhood obesity crisis has negative impacts for the country’s economy, public health systems, and the nation’s entire prosperity (Ferry, 2011). The epidemic is common in children and its consequences are not only reflected mentally and physically but also in academic performance. Thus, the Saudi Government has a great role to play in making Saudi schools health promotion schools. However, it is imperative to realize that schools cannot be left alone to address this concern. Nevertheless, the schools have a duty to team up with the government, local authorities, as well as the policy makers to come up with policies that could address the issue (Crawford, 2010). Therefore, the government and the ministry of education should concentrate on the consequences of childhood obesity and its long-term effects on the welfare of children. Studies indicate that obese children are likely to be hospitalized for more than two times per year and the associated cost is three times more, especially to non-insured children in Saudi Arabia (Tessmer, Hagen & Beecher, 2013). Therefore, it is evident that strategies to reduce childhood obesity require to be undertaken in multiple setting, as well as at all government levels. Hence, in order to make schools in Saudi Arabia health promotional schools the government should work together with various stakeholders to prevent the epidemic (OECD, 2013). The first component of making schools in Saudi health promotional schools is through formation of structures in the government that promote childhood obesity reduction frameworks and interventions (Poskitt& Edmunds, 2008). The structural components include leadership in schools, comprehensive health benefits for school children, provision of health funds for health promotion in schools, establishment of systems of non-communicable monitoring of disease, implementation of nutrition education in schools, as well as partnering with health care provision experts and policy makers to improve the effectiveness of health promotion programmes in schools (Moreno, Pigeot & Ahrens, 2011). The second aspect that the Saudi Government should consider in making schools health promotion schools is implementation of population-wide frameworks and programmes in schools. These are policies that assist in creating a favourable environment in schools that is inclined towards promotion of health diets and encouraging physical activity (Tessmer, Hagen & Beecher, 2013). Some of the policy tools that are supposed to be aligned with this aspect of inclusive childhood obesity reduction strategy are rules and regulations, supporting obesity campaigns, introduction of taxes, and subsidies for health care programmes in schools. The government should also monitor and implement policies on food environments and strive to make them effective (Cash & Smolak, 2011). Some of these frameworks would include imposing restrictions concerning sale of unhealthy foods to children, introduction of food subsidies, taxes and nutrition labelling. Hence, through putting these measures into place there would be reduced cases of obesity among young children in schools (Brewis, 2011). Therefore, the Saudi Government need to implement childhood obesity reduction and intervention framework policies, allocate the funds for nutrition and diet campaigns as well as monitoring the prevalence of obesity in the community (Cash & Smolak, 2011). Nonetheless, for these policies to be effectiveness, the government should impose restrictions on consumption of unhealthy foods within and out of the Saudi schools. Thus, consumption of safe foods in schools may lead to fewer cases associated with obesity (Poskitt & Edmunds, 2008). Similarly, the government should support and encourage physical activity in schools to help students lose excessive weight. Scientists have recommended that every young person requires spending 60 minutes of their time daily in moderate to vigorous physical exercise (Kazaks & Stern, 2013). Therefore, schools can provide various means through which the students can engage in daily exercises to reduce their weight given that children spend most of their time in schools. However, most schools in Saudi Arabia do not have adequate facilities that are required by the students to engage in daily exercises. Nonetheless, the Saudi Government needs to intervene in order to provide adequate and resourceful facilities and equipments that are necessary while participating in physical activities (Hollar, 2012). These facilities may include improving the conditions of playing fields, buying more land to reduce congestion in schools, as well as purchasing games equipments. Hence, he Saudi Government should provide adequate funds for schools in order to increase the capacity for engaging in daily physical exercises, in schools (O'Dea & Eriksen, 2010). Thus, this would promote school health and reduce childhood obesity in Saudi Arabia. Similarly, the policy makers, as well as the school administration should come up with policies that are meant to increase the student’s physical fitness and make them more active. One of the renowned strategies is recess that is believed to have cognitive and social advantage for young children to reinforce positive impacts on physical health. Supporting interscholastic, as well as intramural sports, supporting physical exercise breaks, offering accessible and secure walk-to-school route paths would lead to health promotion schools (Poskitt& Edmunds, 2008). Another component that the government should consider in the development of health promotion schools is supporting community-based interventions (World Health Organization, 2010). 2.2 Health Promotion Programmes So as to reduce medication and treatment costs incurred in an attempt to lessen the burden of the disease, the government should support schools to come up with programmes aimed at preventing the high prevalence of childhood obesity among the children (Ferry, 2011. It should collaborate with the ministry of education, sports, finance, as well as the ministry of health to establish health programmes in schools such as; physical activity programmes, physical education programmes, as well as programmes on Body-Mass Index screening (Birch et.al, 2011). 1.2.1 Physical Activity Programmes Physical activity programmes are important for prevention of childhood obesity. The physical activities enhance body metabolism leading to burning body fat calories with the aim of reducing weight (Hollar, 2012). Therefore, physical activity requires to be supported at home, within the community, and in schools. However, there has been a progress in Saudi Arabia to promote the physical activity programmes through involvement of paediatricians at school setting. (Freemark, 2010).The programme involves determining the amount of time spent by school children either at home, at school or at child care which involves unorganized sports, recreation and transportation. Parents should be encouraged on how to involve their children to be physically active when they are not participating in sports. This may involve; parents walking around and playing together with the children (Bundy & World Bank, 2011). Further, it should include participation in physical activities with the entire family. Therefore, the communities that are designed with biking trails and green spaces help provide families with the means to enjoy such active lifestyles (Lewin, 2009). 2.2.2 Physical Education Programmes Recently, the physical education (PE) classes used aerobics and sport-specific skill gaining in order to enhance fitness (Ferry, 2011). However, the approach does not meet the needs for all the students, especially those with physical disabilities and obesity. The PE curricula and guidelines should emphasize on attitudes, knowledge, behaviour and motor skills that are required to maintain and adopt long-term habits of physical activity (Birch et.al, 2011). The school based cross-sectional studies have illustrated correlation between the physical activity and lower BMI. Moreover, increase in PE instructions and guidelines may lead to reduction in BMI for overweight students. In SPARK (sports, play, and active recreation for kid’s curriculum) project, the aim is to increase the physical activity through modified PE and classroom-based teaching on skill and health fitness (Hollar, 2012). Establishing PE in South Arabia is vital in schools as a way of reducing childhood obesity. Studies suggest that the school based physical activity programmes may significantly enhance both short term and long term improvements in reducing obesity and academic outcome (Tessmer, Hagen & Beecher, 2013). Furthermore, a PLAY (promoting lifestyle activity for youth) programme aims at engaging in vigorous physical activity for an hour on a daily basis (Ferry, 2011). Physical activities should be beyond school time and during regular school hours outside the PE classes. This increases the levels of physical activities among children, mostly girls, during their school and non-school hours. 2.2.3 Health Screening Programmes These programmes are aimed at measuring the children’s BMI, the number which is calculated from a person’s weight and height. BMI is an indicator which is reliable in indicating the overweight people (Hollar, 2012). However, BMI does not directly measure the body fat. Studies have shown that it correlates to the direct measures of body fat such as, weighing under water and dual energy x-ray absorptiometry (DXA). Therefore, using health screening programme such as BMI can be considered as an option for the body measure (Coulston & Boushey, 2013). The aim of conducting BMI is not only for schools to identify the obese students or those who are at risk for becoming overweight, but also to create awareness to the families and community on the epidemic (Preedy, 2012). However, concerns in regard to compulsory use of BMI screening have risen. Many parents are upset when their children are termed as obese or overweight and will be a subject to bullying and harassment. Also, some parents suspect that collected obese data might be used by insurance agencies to deny coverage (Hollar, 2012). Thus, in instituting the BMI programme in health screening, the states must consider the confidentiality of results collected from the obese students in implementing an obesity surveillance programme. The BMI data results can inform the schools, as well as policy makers regarding the population of students that need intervention and the need to change lifestyle (Grossman& Mocan, 2011). 2.3 Health Promotion Programmes in Developed Countries Health programmes to reduce childhood obesity have been used successfully in developed countries such as South Carolina, Arkansas and Rhode Island. The obese reduction programmes were successful due to the use of one policy option to integrate the school nutrition, physical activity and education policies into local health and wellness policy (Liburd, 2010). The strategies placed physical activity and nutrition equally with school subjects and reading in terms of state budget allocation and funding. In nutrition education, the policies include the provision of comprehensive standards that are based on nutrition education integrated within the school curriculum (Preedy, 2012). The students were provided with healthy meals and their access to unhealthy competitive options of foods was limited. However, this did not limit the student’s choices on healthy food when outside the school setting (Heaton-Harris, 2009). A fifth grader recent nationwide study found that, banning high-calorie and sugary soft drinks led to only a 4 percent reduction in student consumption of these drinks (Gleason & United States, 2009). The American Dietetic Association (ADA) review of twelve rigorously evaluated school nutrition education programmes, found that nine of the schools produced positive effects. In addition, five of the schools had a significant impact on the children’s weight status. The researchers projected that the school programmes that did not correlate with the student’s positive impacts and the student’s eating habits were inadequate in exposing the students to the programme (Garcia et al, 2009). Therefore, the nutrition education programmes in school curriculum should aim at changing the obese students’ norms and views about eating health foods. Moreover, concrete health information and approaches, changing their personal values in supporting healthy lifestyles, and involving families in the process leads to success in reducing obesity among students. In South Carolina, the policy supported this type of integrated strategy of behavioural-directed education in the efforts of a sustainable prevention of childhood obesity in schools (Crawford, 2010). In order to access policy implementation within the school setting, several studies were carried out to measure the effectiveness of physical activity and health diet programmes (Tessmer, Hagen & Beecher, 2013). The results from the study established an evidence based policy that was needed to support the requirements for successful implementation of school health programmes. These studies were aimed at identifying the frameworks that support childhood obesity programmes as well as identifying the successful components in those programmes. The studies were conducted in China, USA, New Zealand, Australia, United Kingdom and Canada involving intervention programmes to reduce childhood obesity (Liburd, 2010). The interventions were developed and conducted in the elementary schools among childhood obese students. They targeted health behaviours aimed at increasing the physical activity, improve the nutrition behaviours and decrease the BMI. In addition, they also aimed at creating nutrition policies and plans in the schools, as well as reducing the amount of time students and families spend watching the TV (Moreno, Pigeot & Ahrens, 2011). The programmes demonstrated valuable results in reducing the BMI among children indicating a decrease in obesity. For example, the children who had vigorous physical activities within and out of the school had a significant drop in their BMI. The interventions also employed a behavioural theory that was used in the social ecological model, the normative influence theories of persuasion, behavioural choice theory, health belief model, protection motivation theory, social learning theory and social cognitive theory (Grossman& Mocan, 2011). The interventions also used the role models and self-esteem as components of the childhood obesity prevention programme. 2.4 Application of School-Based Programmes in Saudi Arabia Saudi Arabia can adopt a comprehensive and rigorous school wellness policy, to make it easier for the children to be physically active and choose healthy foods (Swinburn et al., 2009). The adopted policies will help transform the communities through the health departments that allocate budgets and funds for the school learning institutions. The nutrition directors supported by the school learning network (SLN) in the department of health, will help bring together different stakeholders to develop new policies to be approved by local school boards (O’Donohue & Draper, 2011). The school health-based programmes policy will define the practices that will be instituted in schools, to help reduce and prevent obesity among the children (Schneider, Pestronk, & Jarris, 2013). The programme will enhance intervention in Saudi Arabia schools, reducing the childhood obesity where the programme activities needs be coordinated by the nutrition directors. The programme will need principal investigators and evaluators to determine the effectiveness of obesity reduction programme among children (Ferry, 2011). The findings from the study will be disseminated both locally and nationally, so that future researchers of the policy development process can be easily reviewed. The policy will constitute school based programmes relating to nutrition education, physical education, use of BMI health screening programmes and physical activity programmes to enable prevent and reduce childhood obesity (Preedy, 2012). The policymakers and the school administrators need to get the obese students active. Supporting the schools internal sports between classes, enhancing breaks on physical activities during and between classes, and establishing accessible and safe walk to school route are opportunities that schools should successfully implement (Kaphingst & French, 2006). Besides, the policy makers need to acknowledge that these activities require the input staff and teachers. Therefore, the staff and teachers require provision with professional development for the school based programmes to successfully reduce and prevent childhood obesity (World Health Organization, 2010). 2.5 Effectiveness of School Health Programmes on Childhood Obesity Based on the finding from these intervention programmes to reduce obesity among children from developed countries, it is evident that the school health programmes were effectively implemented to achieve the desired results (Neumark-Sztainer, Story, Hannan, & Rex, 2003). The interventions emphasized the need to design a behavioural health intervention for the childhood populations in the measuring of the outcomes (Garcia et al, 2009). The participation of parents in school intervention policies helped to change the children’s behaviour and produced a positive outcome related to physical activity, diet and BMI. In addition, the interventions focusing on individual behaviour and nutritional policy reduced obesity significantly in the countries of study (Swinburn et al., 2009). Regarding the individual behaviour, it included family, classes of cooking, food training selection, and health education gathering on disorderly eating. In measuring the behaviours, the studies measured changes in time spent being physically active, intake of fruits and vegetables, and the reduction of time spent in watching TV (Cash & Smolak, 2011). The results indicated a significant change in the behaviours among the children, as positive results were reflected from the reduced BMI among the obese students. From the study, students with the school-based health eating programmes demonstrated a significant reduced overweight (Davies, Fitzgerald, & Mousouli, 2008). However, schools that provide healthy menu options are likely to have a substantial healthy body weights than children from schools without these programmes. The school-based health programmes focusing on inactive behaviour and encouraging self exercises are more effective than focusing on forced exercises, and reducing the food intake in order to prevent the already obese children from gaining more weight (Zahner et al., 2006). The recent efforts to prevent childhood obesity include the use of children’s school report cards to create awareness of their children’s weight problem (Bundy & World Bank, 2011). The health report cards are thought to help prevent obesity among children. A study in Boston found that, parents who received health and fitness cards acknowledged that their children were overweight better than those who did not receive a report card. Besides, parents who received the child’s health and fitness card were likely to plan for the weight-control activities for their overweight children (Ogden, 2011). 3.0 Conclusion Obesity is a lifestyle disease that has multiple causes. Childhood obesity has significant effects on children on both psychological and physical health. Besides, psychological disorders like depression occurs with increased frequency among obese children. Obese children are more likely to develop digestive and cardiovascular diseases as compared to those with normal weight. It is speculated that, both reduced physical activity and over consumption of calories lead to childhood obesity. Diet, nutritional education and increased physical activity are effective strategies to reduce childhood obesity at preschool institutions and home (Cash & Smolak, 2011). However, there is a need for further research to examine the most effective strategies of prevention, intervention, and treatment of obesity. 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