The Effects of Parents and Childhood Obesity - Essay Example

? ASSIGNMENT COVER SHEET Electronic or manual Form: SSC-115-06-08 UNIT HST 2122 Health Research Methodology (PRINT CLEARLY) XINTONG HAN FAMILY NAME FIRST NAME STUDENT ID. NO. 10134284 NAME OF LECTURER (PRINT CLEARLY) Dr Stacey Waters  DUE DATE 28/04/2011 Topic of assignment The Effects of Parents and Childhood Obesity Group or tutorial (if applicable) ????? Course E70_Bachlor of Health Science Campus JO I certify that the attached assignment is my own work and that any material drawn from other sources has been acknowledged. Copyright in assignments remains my property. I grant permission to the University to make copies of assignments for assessment, review and/or record keeping purposes. I note that the University reserves the right to check my assignment for plagiarism. Should the reproduction of all or part of an assignment be required by the University for any purpose other than those mentioned above, appropriate authorisation will be sought from me on the relevant form. OFFICE USE ONLY If handing in an assignment in a paper or other physical form, sign here to indicate that you have read this form, filled it in completely and that you certify as above. Signature XINTONG?HAN?? Date 28/04/2011 OR, if submitting this paper electronically as per instructions for the unit, place an ‘X’ in the box below to indicate that you have read this form and filled it in completely and that you certify as above. Please include this page in/with your submission. Any electronic responses to this submission will be sent to your ECU email address. Agreement XINTONG?HAN Date 28/04/2011 PROCEDURES AND PENALTIES ON LATE ASSIGNMENTS (University Rule 39) ? A student who wishes to defer the submission of an assignment must apply to the lecturer in charge of the relevant unit or course for an extension of the time within which to submit the assignment. (39.1) ? Where an extension is sought for the submission of an assignment the application must : bein writing - preferably before the due date; and set out the grounds on which deferral is sought.( see39.2) ? Assignments submitted after the normal or extended date without approval shall incur a penalty of loss of marks. (see 39.5) ACADEMIC MISCONDUCT (University Rule 40) All forms of cheating, plagiarism or collusion are regarded seriously and could result in penalties including loss of marks, exclusion from the unit or cancellation of enrolment. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ASSIGNMENT RECEIPT To be completed by the student if the receipt is required UNIT ????? NAME OF STUDENT ????? STUDENT ID. NO. ????? NAME OF LECTURER ????? RECEIVED BY Topic of assignment ????? DATE RECEIVED The Effects of Parents and Childhood Obesity Introduction With the development of the economy, the number of overweight and obesity children are increasing dramatically in many countries (Schmidt, p. 3, 2008), and this is becoming an important health issue of children (Schmidt, p. 3, 2008). In the past ten years, the number of overweight and obese children has actually tripled, especially in developed countries (Lobstein & Rrelu, 2003, p. 195). In Australia, twenty percent of children are overweight (Wake et al., 2007, p.1044). Population data shows the amount of overweight children increased dramatically, and that this increase has even been seen among four-year old children (Vaska, 2004, p.353). The above concerns are significant concerns because childhood obesity can lead to many diseases, such as diabetes, high blood pressure. It is a disease which is linked with various activities including increased screen time, lack of enough physical activities, and the increase in fast food consumption. Parents have a crucial role in the childhood obesity phenomenon. After all, they supply children with food resource; and they educate and affect their children’s food thinking and appetites. Others however do not consider the role of parents in children’s eating habits as significant, claiming that it is in the end, in the hands of the child. With these contrasting considerations, this research now seeks to establish the link between families and childhood obesity. Literature Review According to the World Health Organization, childhood overweight and obesity has risen significantly over the past few years. They actually consider it one of the most serious health challenges of the current century (WHO, 2011). It is a global issue and is affecting both developed and developing nations of the world. The prevalence of this disease has grown at alarming rates. Global figures reveal that in 2010, the number of overweight children below five reached about 42 million (WHO, 2011). About 35 million of these are living in developing nations. These are alarming prevalence rates because obese children often grow up to be obese adults who are at greater risk for developing cardiovascular diseases, diabetes, and other chronic care illnesses (WHO, 2011). Various studies on the childhood obesity have been carried out by other researchers. This study shall consider some of the studies which have evaluated the role of parents in childhood obesity. In a study Lindsay, et.al. (2006), the authors evaluated how parents can help their children develop healthy eating habits. Their study was able to establish that it is important for parents to understand that their roles in preventing childhood obesity change as the child moves through his development stages. The authors further emphasized that researchers and policymakers must also use such information to establish effective remedies and educational programs which would resolve childhood obesity where it starts at home. This study was able to establish that parents play a crucial role in managing their children’s diet and in eventually preventing obesity. In an article by Golan, et.al., (2006) the authors set out to evaluate the efficacy of treating childhood obesity through family-based interventions, focusing on parents alone and on parents and their obese children together. The study revealed that a larger reduction in food stimuli in the home was seen in the parents-only group. These results suggest that reducing the child’s participation in the health-centred programme may benefit the child in his weight loss and promote a healthier lifestyle for these children. This study implies that parents may sometimes enable their children too much in partaking of food which are not healthy to them. This then contributes to their obesity. In a 2007 paper by Clark, et.al., the authors set out to evaluate how parents’ child-feeding behaviours impact on child weight. The study revealed that parents use a wide range of child-feeding behaviours like monitoring, pressure to eat and restriction. The restriction of children’s eating has often been associated with child’s weight increase. This study revealed that parents may unconsciously cause excess weight gain in their children’s childhood through their inappropriate feeding behaviours. In a major way therefore, parents do impact greatly on their children’s eating habits and future weight gain. In a paper by Johansen, et.al., (2006, p. 431) the authors set out to evaluate the impact of “mothers’ and fathers’ eating behaviours, child feeding practices, and BMI on percentage body fat and BMI of their children”. The study covered about 400 parents who completed the Three-Factor Eating Questionnaire and Child-Feeding Questionnaire. Their BMI was also computed, along with their children’s BMI and percentage fat. The study revealed that about 140 mothers and 68 fathers completed the study. Their children’s weight was seen as linked to mother’s BMI, not to their father’s BMI. Girls had higher BMIs if any of their parents were overweight as children and most of the girls and boys were likely to be overweight if their mothers believed them to have risky health habits. Girls with fathers who were more controlling had higher percentage in their fat (Johansen, 2006). In effect, this study indicated that mothers seem to have more influence on their children’s weight; they are also more likely to be concerned about their children’s weight and eating habits. In short, this study was able to establish the importance of both parents being on the same page in raising their children and in managing their children’s eating habits. The studies above indicate a major link between parents’ behaviour and habits and childhood obesity. These studies indicate that parents may contribute largely to the prevalence of childhood obesity. This study would therefore now consider a more in depth assessment of this issue. Specific health research question and sub-questions This study seeks to establish whether or not parents have an impact on their children’s eating habits. It specifically seeks to answer the following questions: 1. Do parents’ food choices influence children’s food resource? 2. Do parents’ eating behaviour influence children’s eating behaviours? Dependent and Independent variables Parents’ as a provider and Models Each family has a different eating mode. Children’s thoughts about food are associated with their parents’ thoughts. As food providers and models, parents are the agents who would develop knowledge and affect their children’s food choice. Parents’ Model Parents are the model of their children regarding to eating behaviour. Through the observation, children can learn the eating behaviour from others in the eating environment (Savage, Fisher & Birch, p. 28, 2007). Sub-question_ Parents under different cultures: According to Sealy (p. 8, 2010), the food choosing habits of parents and children are associated with cultural based eating habits, food can be easily to accept and minimum preparing time is required (Sealy, p. 8, 2010). Parents’ behaviour and childhood obesity Traditional feeding methods are feeding frequently, cooking special designed food, supporting preferred food for infant or children and encourage children eat as much as possible; which methods are more or less compulsion(Savage, Fisher & Birch, p. 28, 2007) . Parents’ feeding practice, especially restrictive feeding practice, plays a vital role in developing children’s food practice, intake patterns, diet quality, growth and weight status (Savage, Fisher & Birch, p. 28, 2007). Children eating response has a definite link with the parental authoritarian feeding style whereas children eating response is less activity link with responsiveness. Parents’ eating behaviour affect the children’s eating habit, which reflect in the children food potion size or times of eating vegetable and fruit, acceptance of wasting food and consuming extra food (Spurrier et al., p. 6, 2008). Significance of the research question Children, especially 0-12 years old, depend on their parents to provide their food entirely. In effect, parents’ eating behaviour definitely affects children’s eating habits. Children and parents’ eating habits are quite similar, this is because they live together and parents affect children’s choice of food. Parents are more likely to prepare food based on their habits. Some types of the food, meat, fruit are fixed or appear more frequently than others and this often affects children habits and choosing food awareness. Cross-cultural reasons influence parents’ food choice as well. This behaviour is really dependent on different food patterns in different cultures. Although parental feeding styles are different, most parents have a same goal, and this is to increase the possibility of children eating some specific food, such as fruits and vegetables. They are aware that they have to intervene in their children’s eating habits before they become overweight or obese; however, the feeding styles should be applied in a highly restricted and controlling approach. Besides their feeding styles, genetic problems also affect children store more fat and less reduce fat, which link with children gaining weight. That is also the families’ own influence. Definition of Concepts Treat. Reward method which encourages kids to eating more or healthy food. Obesity. It is a BMI or body mass index of more than 30 kg/m2 BMI. Stands for Body Mass Index. It is computed with the formula weight in kg/ height in meters2 Ethics The four ethical principles are: respect for autonomy, beneficence, non-maleficence, and justice. The principle of autonomy refers to a person’s right to self-determination or the right to decide for himself, without any pressure or undue influence the means and methods of his care (Jacob, et.al., 2010). It generally refers to the act of respecting the decisions of autonomous individuals, allowing them to make informed decisions. A person’s right to beneficence is about balancing the positive impact of treatment against its costs and risks and after making such ascertainment, making decisions which would impact positively on the patient (Cullity, 2007). Non-maleficence refers to avoiding harm from befalling a person. In effect, a health professional must first, ‘do not harm’ (Fulda and Lykens, 2006). All his actions and interventions must not harm the patient, and if they do, such harm must be inconsequential and must not outweigh the benefits of treatment. Finally, justice is about giving a person his due (Beauchamp, 2008). It is about the process of allocating benefits, risks, and its costs justly. In applying these ethical principles to this research, it is appropriate to inform the respondents of the research being undertaken, its purpose, and his participation needed in the research (Korobkin, 2006). After explaining thoroughly the details of the research process, he would also be reassured of the confidentiality of the research gathering process and that his name and identity would not be revealed to anyone before, during, and after the research (Korobkin, 2006). After explaining such circumstances, his consent shall be sought. Those agreeing to be respondents shall be asked to sign a consent form read and written in a language of his understanding. Those refusing to be respondents shall not be pressured or convinced further to be respondents. In applying the principle of beneficence, I would need to weigh the positive impact of the research and interview process against its risks and costs on the respondent (Korobkin, 2006). In this case, I would have to try my best to minimize the negative impact of the research/interview on the respondent. In applying the principle of non-maleficence, I would have to prevent any harm from befalling my research respondents during the research and interview process (Watson, 2008). I would try my best to be sensitive during the interview process and to minimize the negative impact of the questions posed on the respondent. Finally, I would have to identify all the vulnerable groups who may be affected by my research. My actions would have to be equitable and fair to them (Beauchamp and Childress, 2001). Sampling This study shall apply stratified random sampling. It shall cover parents of children aged 5 to 18 years studying in the (please insert possible school here______) School. The number of students enrolled in the school shall be determined from school records. One student would represent one parental unit. After the total number of parents shall have been established, the Slovin’s formula (N/1+Ne2; N referring to the total population; e referring to the margin of error with a 95% confidence level) shall be applied to determine the sample population for this study. After the sample population is determined, the respondents shall be chosen. First, all parent’s names (or primary caregiver’s names – mother or father or legal guardian) shall be listed. Second, using a table of random numbers, a number shall be chosen at random (by closing eyes and pointing at the Table of Random numbers). Third, such number shall be the starting point for the first sample to be chosen from the list. Fourth, names of parents chosen shall be set aside, and more numbers from the Table of Random numbers shall be chosen until finally, the number of sample respondents shall have been completed. An additional 50 respondents shall also be chosen from the list of parents applying simple random sampling to cover possible unreturned or invalid questionnaires. Random sampling method is the best means of availing of respondents because it helps ensure the reliability of the study (Babbie, 2010). It also gives every person the population a chance to be chosen as respondents. In other words, there is a reduced bias in the choosing of respondents in random sampling (Black, 2009). It may be a more tedious method of selecting respondents however, its random processes helps increase the reliability of the research process and of the study as a whole. Pilot Study This paper seeks to answer whether or not parents have an impact on their children’s eating habits. It seeks to specifically answer the following questions: 1. Do parents’ food choices influence children’s food resource? 2. Do parents’ eating behaviour influence children’s eating behaviours? The study revealed that based on the computed BMI (from height and weight) of the children is mostly in the overweight category. It also revealed that for one respondent, it is the parent who decides what foods to include in the grocery list. For two of the respondents, their children are often the ones who choose which foods to include in the grocery list. Their grocery list includes mostly red meats, breads, chicken, junk foods, cereals, and dairy. Vegetables and fruits are not common purchases. The study also revealed that everyone eats the same food served from the grocery list and therefore, the children eat the same foods which the parents also eat. The respondents also indicated that they cannot influence their children to eat the same foods that they do. When parents make the effort to eat healthy foods, they have trouble convincing their children to eat the same. The families eat mostly in the living room in front of the television sets where they watch TV while eating their meals. The children cannot seem to be compelled to eat in the dining room as they have already gotten used to eating in front of the TV. The children also snack on junk foods between meals, very much like their parents. The parents do try to advice their children to eat nutritious and healthy foods however, their children do not seem to want to listen to their advice. In the end, they eat what they want. The parents believe that they can influence their children’s eating habits if they lay down firm rules on what and where they all eat. Based on the above results, this pilot study indicates that parents have an impact on their parent’s eating habits. Specifically, it indicates that parents’ food choices influence children’s food resource. It also indicates that parents’ eating behaviours influence children’s eating behaviours. Based on the above pilot study, I established that there was a need for me to improve the questions I posed in order to establish specific measures and assessments of parents impact on children’s eating habits. It is also possible to include ranges for the answers – from always to never. This would help determine specific qualities of parents’ answers. Research Design The research design I would apply would be the quantitative research method. This design would apply statistical methods to establish trends and patterns in the questions raised. This method studies the models, theories and generalizations. It uses experimental control and manipulates variables. It assists in the collection of empirical data and establishes an accurate and comprehensive evaluation of results. Questionnaire Design A good questionnaire is one which relies on usage and research goals (Food and Agriculture Organization, n.d). For exploratory questionnaires, a good questionnaire would be one which does not use a formal questionnaire. In effect, in asking a student which subjects she has enrolled in college, using formal questionnaires may interfere with the data gathering process. It may prevent the evaluation of the student’s views and perceptions. A good exploratory questionnaire can instead include a brief guide, a listing of ten main open-ended queries with the specific prompts included under each question (FAO, n.d). In testing and quantifying hypotheses, a formal standardized questionnaire may be applied (FAO, n.d). It is characterized by specific wording and order in order to ensure that each question is answered by the respondent. Each question is also explained and defined to ensure that the respondents would answer and treat each question consistently (FAO, n.d). The response is prescribed and formatted in order to ensure easy and speedy completion of questionnaire. In general, a good questionnaire is also one which helps fulfil the research objectives. The questions asked must help answer the research issues raised and must help meet the research goals (FAO, n.d). A good questionnaire must also make it easy for respondents to provide the information and for the interviewer to note down the answer; it must also be designed in a way which makes analysis possible. The questionnaire must also help direct and focus the interview process with the questions arranged to keep the respondent interested (FAO, n.d). I have integrated these suggestions in the questionnaire by first ensuring that each question raised is related to the research aims and objectives. I have also made sure that the questions are interesting, are easily answerable, and can undergo analysis. I have also provided explanation for each question raised in order to ensure that the respondents have a consistent understanding of the questions. Results Table 1: Demographics: Age of Respondents Age Range Frequency Below 18 18-27 28-37 38-47 48-57 58-67 Total Table 2: Gender Gender Frequency Male Female Total Table 3: Relationship to child Relationship To child Frequency Mother Father Legal guardian Total Table 4: Results by research questions: BMI BMI Frequency Underweight Normal Overweight Obese Table 5: Decides on what to include in grocery list Whether or not parent decides on what to include in grocery list Frequency Yes No Total Table 6: usual items in grocery list Items Frequency Vegetables Fruits Red Meats Breads Dairy Chicken Fish Junk Food Cereals Total Table 7: Eat same food served from grocery list Eat same food served Frequency Yes No Total Table 8: Eat same food as parents? Eat same food as parents Frequency Yes No Total Table 9: Influence children to eat same foods as parents Influence children to eat same foods Frequency Yes No Total Table 10: Eat dinner at table Eat dinner at table Frequency Yes No Total Table 11: Compel children to eat at dinner table Compel children to eat at dinner table Frequency Yes No Total Table 12: Snack on junk foods Snack on junk foods Frequency Yes No Total Table 13: Children snack on junk foods Children snack on junk foods Frequency Yes No Total Table 14: Advice children eat healthy foods Advice children to eat healthy foods Frequency Yes No Total Table 15: Improving eating habits of family Improving eating habits of family Frequency Yes No Total Table 16: Can positively on children eating habits Positively influence children eating habits Frequency Yes No Total Reference Babbie, E. (2010). Autonomy and Informed Consent in Nontherapeutic Biomedical Research; Sydney: Cengage Learning Beauchamp, T. (2008). Distributive Justice. Beachamp.org. Retrieved 18 May 2011 from http://129.11.3.26/entries/justice-distributive/ Beauchamp, T. & Childress, J. (2001) Principles of Biomedical Ethics, 5th Ed, Oxford University Press, Oxford. Birch, J., J. “Preschool Children’s Preferences and Consumption Patterns,” Journal of Nutrition Education 11 (1979): 189-192; Black, K. (2009). Business Statistics: Contemporary Decision Making. New Jersey: John Wiley and Sons Bouchard, C. (2009). Childhood obesity: are genetic differences involved? Am J Clin Nutr, 89, 1494S-1501S. Clark, H., R., Goyder, E., Bissell, P., Blank, L., & Peter, J. (2007). How do parents’ child-feeding behviours influence child weight? Implications for childhood obesity policy. Journal of Public Health, 29 (2), 132-141. Cook, T., Rutishauser, I., & Seelig, M. (2001). Comparable data on food and nutrient intake and physical measurements from the 1983, 1985 and 1995 national nutrition surveys Commonwealth Department of Health and Aged Care: Canberra Cowart, B., J. “Development of Taste Perception in Humans: Sensitivity and Preference throughout the Life Span,” Psychological Bulletin 90, no. 1 (1981): 43-73; Cullity, G. (2007). Beneficence. Principles of Health Care Ethics, Second Edition. Massachusetts: Lippincott Fisher, J., O., & Birch, L., L. “Restricting Access to a Palatable Food Affects Children’s Behavioral Response, Food Selection and Intake,” American Journal of Clinical Nutrition 69 (1999):1264-1272. Food and Agriculture Organization (n.d). Chapter 4: Questionnaire Design. Retrieved 18 May 2011 from http://www.fao.org/docrep/W3241E/w3241e05.htm Fulda, K. & Lykens, K. (2006). Ethical issues in predictive genetic testing: a public health perspective. J Med Ethics, volume 32(3): pp. 143–147. Gibson, E., L., & Wardle, J. “Energy Density Predicts Preferencesfor Fruit and Vegetables in 4-Year-Old Children,” Appetite 41(2003): 97-98. Gibson E.,L., Wardle J., & Watts CJ. (1998). Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children. Appetite, 31(2):205–28. Golan, M., Kaufman, V., & Shahara, D. (2006). Childhood obesity treatment: targeting parents exclusively v. parents and children. British Journal of Nutrition, volume 95: pp. 108-1015 Jacob, S., Decker, D., Hartshorne, T. (2010). Ethics and Law for School Psychologists. New Jersey: John Wiley and Sons Johannsen, D., Johannsen, N., Specker, B. (2006). Influence of Parents’ Eating Behaviors and Child Feeding Practices on Children’s Weight Status. Obesity, volume 14(3), pp. 431-439. Korobkin, R. (2006). Autonomy and Informed Consent in Nontherapeutic Biomedical Research. 54 UCLA L. Rev. 605. Lee, Y. , & Birch, L., L. “Diet Quality, Nutrient Intake, Weight Status, and Feeding Environments of Girls Meeting or Exceeding the American Academy of Pediatrics Recommendations for Total Dietary Fat,” Pediatrics 54, no. 3 (2002): 179-186. Lindsay, A., Sussner, K., Kim, J., Gortmaker, S. (2006). The Role of Parents in Preventing Childhood Obesity. The Future of Children, volume 16(1), pp. 169-186 Lobstein T., & Frelut M.L. (2003). Prevalence of overweight among children in Europe. Obes Rev, 4(4), 195-200. McCaffree J. (2003).Childhood eating patterns: the roles parents play. Am J Diet Assoc, 103(12):1587. National Health and Medical Research Council [NHMRC], n.d.: Food for Health; Dietary Guidelines for Children and Adolescents Canberra, Commonwealth of Australia; 2003. Savage, J., S., Fisher, J., O., & Birch L., L. (2007). Parental Influence on Eating Behavior: Conception to Adolescence. JOURNAL OF Law, MEDICINE & ETHICS. 22-34. Sealy, Y., M., (2010). Parents’ Food Choices: Obesity Among Minority Parents and Children. Journal of Community Health Nursing, 27, 1-11. Schmidt, H. (2008). Childhood obesity and parental responsibilities. HASTING CENTER REPORT, 3. Spurrier, N., J., Magarey, A., A., Golley, R., Curnow, F., & Sawyer, M., G, (2008). Relationships between the home environment and physical activity and dietary patterns of preschool children: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 5(31), 1-12. Vaska VL., & Volkmer R. (2004). Increasing prevalence of obesity in South Australian 4-year-olds:1995–2002. Journal of Paediatrics and Child Health, 40, 353-355. Wake M., Hardy P., Canterford L., Sawyer M., & Carlin J.B. (2007). Overweight, obesity and girth of Australian preschoolers: prevalence and socio-economic correlates. Int J Obes, 31, 1044-51. World Health Organization (2011). Childhood overweight and obesity. Retrieved 18 May 2011 from http://www.who.int/dietphysicalactivity/childhood/en/ Wilson G., & Wood K. (2004).The influence of children on parental purchases during supermarket shopping. Int J Consumer Stud, 28(4):329–36 Appendix A: Questionnaire Demographics Age____ Gender____ Relationship to child___________ Questionnaire Proper 1. What is your child’s weight and height? 2. Are you the one who decides what to include in your grocery list? Yes___No____ a. If not, who decides? Please indicate who decides______________ 3. What are the usual items you include in your grocery list? Please check items below: a. Vegetables b. Fruits c. Red Meats d. Breads e. Dairy f. Chicken g. Fish h. Junk Food i. Cereals 4. Does everyone eat the same food served from your grocery list? Yes____No____ a. If they do not, what do they eat? __________ 5. Do your children eat the same foods you do? Yes____No____ a. If they do not, what do they eat?__________ 6. Can you influence your children to eat the same foods you do? Yes____No____ a. If you cannot, who influences their food choices? _________ 7. Do you all eat at the dining table? Yes____No____ a. If not, where do you eat? ___________ 8. Can you compel your children to eat at the dining table? Yes____No_____ 9. Do you snack on junk foods between meals? Yes____No_____ 10. Do your children snack on junk foods between meals? Yes____No_____ 11. Do you advice your children to eat healthy nutritious foods? Yes____No____ a. If you do, do they listen to you? Yes____No____ 12. Have you tried improving your eating habits as a family? Yes____No____ a. Has it worked for the better? Yes____No_____ 13. Do you believe that you can impact positively on your children’s eating habits? Yes____No_____ Read More