A Health Advocacy Campaign for Childhood Obesity - Research Paper Example

? A Health Advocacy Campaign for Childhood Obesity ID Number & Total Number of Words:3,006 Introduction Obesity is not only a serious health condition such as eating disorders but also a lifestyle problem that is visible within a person, family, and the society. Even though there has been a lot of studies conducted in the past which relates obesity with the abnormal food intake or poor diet (Styne, 2005), a genetic factor such as a metabolic disorder (Roth et al., 2004), or the leptin deficiency and the use of steroids (Link et al., 2004); the major causes of obesity is still uncertain because each individual has different capacity of burning calories (Jebb & Prentice, 1995). Aa a form of health prevention and nursing intervention strategy, the health advocacy campaign can be defined as the method of winning political assurance of supporting a particular health care program (Chapman, 2004; Christoffel, 2000). In most cases, the target audiences for a health advocacy campaign include not only the policy makers but also the small group of people who has the power to make decisions and can influence certain actions that can affect positive changes for the people (Hoover, 2012; Wallack, 2000, pp. 337 – 365). Considering the long-term health consequences of childhood obesity, this report will not only discuss the importance of developing effective health advocacy campaign against childhood obsity but also conduct an actual advocay campaign that will assist the nurses in winning the support of the government. Therefore, the actual report will be divided under three (3) major sections known as: (1) health advocacy campaign for obesity; (2) the legal considerations behind the development of a health advocacy campaign for obesity; and (3) the ethical considerations behind the development of a health advocacy campaign for obesity. Section 1 – Health Advocacy Campaign in Fighting Obesity Goal of Health Advocacy Campaign Program Based on the National Health and Nutrition Examination Survey, approximately 17.1% of the 3,958 children who participated in the research study were overweight and that 35% of children between the age brackets of 6 to 19 years old are seriously overweight (Ogden et al., 2006). To help these children avoid the long-term negative physiological and social consequences of childhood obesity, the main goal of the proposed advocacy campaign program is to encourage the political people to support the health promotion campaign against childhood obesity. Description of the Selected Population and Their Health Issues The target population for this particular health advocacy campaign program includes the obese children between the ages of 6 to 19 years old. In general, obesity is considered as a serious health problem because it can lead to negative effects related to a person’s physical health, emotional well-being, and psychosocial functioning (Tuthill et al., 2006; Linde et al., 2004; Goodman & Whitaker, 2002). Obese people can sometimes be strongly discriminated in academic and work environment. As part of not being socially accepted, people who extremely over weight would normally to go through a series of depression, low quality of life, and low levels of self-esteem (Frisco, Houle, & Martin, 2010; Kolotkin et al., 1995). With regards to being socially discriminated in academic and work environment, Viner and Cole (2005) explained that obese children who were able to successfully manage having a normal weight at the time they reach adulthood are less likely to become discriminated at work and in public areas whereas obese children who remained extremely overweight during their adulthood age are the ones who are highly affected by having poorer employment opportunities and negative social relationship outcomes. Aside from experiencing work and healthcare discrimination, the study of Carr and Friedman (2005) revealed that obese individuals are prone to interpersonal mistreatment and lower levels of self-acceptance purely because of their body weight and overall physical appearance. As a result, most of the obese individuals are suffering from emotional distress as compared with individuals who have normal weight (Mills & Andrianopoulos, 1993). Vision of the Health Advocacy Campaign Program By 2020, the vision of this health advocacy campaign program is to reverse the on-going trend of childhood obesity throughout the United States. This can be made possible by continuously promoting childhood obesity prevention not only within the community circle but also on a nationwide level. Approach to Health Advocacy Campaign Program To increase the effectiveness of health advocacy campaign program against childhood obesity, nurses should first identify all factors that will contribute to the overweight and obesity before coming up with the actual prevention strategies for childhood obesity (Berkowitz & Borchard, 2009; Friedman & Schwartz, 2008). By learning more about the factors that can add up to the child’s weight, the nurses will be able to think of the best solution on how they can effectively control and manage all factors that can contribute to weight gain. Nurses should also learn about the etiology behind obesity. In line with this, several studies have noted that as a type of chroninc health condition, the development of obesity is caused by genes and environmental factors such as the intake of excessive calories combined with sedentary lifestyle and low metabolic rate (Afridi & Khan, 2004; Weinsier et al., 1998). Therefore, one of the best intervention programs for obesity is health teachings and health promotion activities like encouraging people to join a fun-run or any sports that is designed to increase a person’s physical activity. After examining the significance of race and ethnicity on childhood obesity, several studies found out that mothers in Latin American prefer to have overweight children than a thinner one (Centeno, Basch & Zybert, 2003). Therefore, nurses should focus on educating the mothers in Latin America about the long-term health consequences of chilldhood obesity. After teaching them the adverse consequences of childhood obesity, the nurses can then focus on educating them on how to properly manage their food intake. It is equally important to encourage these children to have some physical exerices. Since most children are eating at home, Berkowitz and Borchard (2009) purposely focused the design of its health advocacy campaign against childhood obesity on the use of a “family-focused approach”. Childhood obesity starts with how parents are providing healthy foods for their children. Since parents can significantly affect the food preferences and lifestyle of each child, family perspective in community/public health nursing is considered essential in the development of effective health promotion intervention strategies. For example, lifestyle and sedentary behaviors like ‘playing computer game or watching TV while eating’ is highly associated with obesity (Utter, Scragg & Schaaf, 2006; Tremblay & Willms, 2003; Swinburn & Egger, 2002). Furthermore, binge eating or the habit of being unable to control over eating could lead to obesity. Due to the inability to control the amount of food they eat, individuals who have binge eating problems have frequent episodes of eating significantly large amount of food all at the same time (de Zwaan & Mitchell, 1992). Therefore, obese individuals tend to continuously eat even when they are already uncomfortably full. By using the family-focused approach as part of the health advocacy campaign, the nurses will be able to educate the mothers on how they should change the eating habits and nutritional intake of very young children. This particular advocacy strategy will also give the nurses the opportunity to promote a healthy lifestyle. Basically, this can be done by encouraging these children to increase their physical activities. Using this particular nursing intervention strategy, the nurses will be able to have more power in advocating for obesity prevention rather than cure. Some of the external factors that can contribute to weight gain are more difficult to control. This includes the presence of environmental stimuli such as fastfood advertisements on the television. Since television advertisements could easily attract and affect the food preferences of the children, food and advertising companies often target the children more than the adults (Magnus et al., 2009). This explains why most of the unhealthy food advertisements are using toys, colorful images, convincing music, and popular personalities as a way of effectively capture the attention of children to patronize unhealthy food products (Morley et al., 2008). In response to this kind of environmental stimuli, Friedman and Schwartz (2008) highlighted the need to control environmental factors such as this by designing, implementing, and enforcing a public health policy against these external stimulus. For example, the healthcare organization can work together with the government to design a public health policy that will require all schools to offer only nutrious foods to the students. Using this kind of public health policy, the government can make it illegal for schools to sell soda, foods with high-fat content, and other sweetened drinks to the students (Friedman & Schwartz, 2008). Furthermore, it is possible to design and implement a public health policy that will require all schools to promote physical activities while inside the school premises (Friedman & Schwartz, 2008). (See Table I – Summary of Health Advocacy Campaign against Chilldhood Obesity on page 7) Table I – Summary of Health Advocacy Campaign against Chilldhood Obesity Family-Centered Approach Public Health Policy Educate the parents about the importance of food nutrition; Educate the parents about the presence of external factors that can lead to obesity (i.e. junk food advertisements, binge eating habits, eating while watching tv, etc.) Encourage parents to increase the child’s physical activities by allowing them to join sports in schools, etc.; Encourage the parents to serve more fruits and vegetables at home; Limit the time wherein the child is allowed to watch tv. Source: Berkowitz & Borchard, 2009 Ban selling of non-nutrious foods in school cafeterias; Require offering nutritional and physical education; Mandate the monitoring of students’ BMI; Require school cafeterias to serve more fruits and vegetables; Ban the use of trans fat in food preparation; Encourage walk-to-school programs; Require the labeling of foods in school menus; Ban the advertisements of junk foods, etc.; Source: Friedman & Schwartz, 2008 Section 2 – The Legal Considerations behind the Development of a Health Advocacy Campaign In general, registered nurses are considered as a significant group that has a role not only in the development of health adovocacies but also in the development of public healthcare legislations, promoting health education, and protecting the “health, safety, and rights of the patients” (Milstead, 2011, pp. 46 – 47). Despite the significant increase in the number of nurses, this group of healthcare professionals are still very much inactive when it comes to legalizing a health advocacy campaign. To increase the nurses’ participation in the legalization of health advocacy campaigns, the nurses should know by heart all factors that can effectively convert a health advocacy plan into a part of the U.S. healthcare legislations. In general, there are several legal considerations that nurses should consider when developing a health advocacy campaign program for childhood obesity. First of all, the nurses should keep in mind that before a given health advocacy can be ratified into law, a nurse or a group of nurses should first submit a formal healthcare bill to the House of Senate (Milstead, 2011, pp. 50 – 51). After winning the approval of the standing health committee, the House of Senate will have to review and debate on the bill’s content before it reaches the presidential action and ratify the bill into a law (Milstead, 2011, pp. 51 – 52). Since the bill will have to be passed through a series of legal discussion, the nurses should keep in mind the importance of being able to persuade the legislators on why they should approve the bill. In line with this, the nurses should be clear about who the target population are, the main purpose or goal of the health advocacy campaign, the specific health advocacy campaign, and the rationale behind the need to pass the bill. Therefore, the nurses should be clear about the health benefits and socio-economic gains that can be earned out of passing the proposed health advocacy bill. Other than submitting a health advocacy bill to the House of Senate, the nurses should also keep in mind that the input of lobbyist is important behind the process of successfully passing the bill into law. In line with this, Milstead (2011, p. 53) identified the three (3) forms of lobbying as: (1) the professional lobbyist; (2) the grassroots leg; and (3) the political leg. As compared to a single registered nurse who wishes to submit a health advocacy bill to the House of Senate, a large group of healthcare professionals who are behind the submission of a health advocacy campaign has more power in terms of winning the lawmakers’ attention to review the bill. For this reason, nurses should keep in mind that they need to form a group of professional supporters each time they plan to make certain health advocacy plan legal. The most effective lobbying strategy is the grassroot (Milstead, 2011, p. 54). Basically, the grassroot lobbyists are group of people who has the expertise and knowledge behind the submitted bill. In the case of a health advocacy campaign, gathering a large group of nurses and doctors are usually much stronger and more effective in terms of convicing the Congress about their professional concerns behind the submitted bill. To increase the success rate of grassroot lobbyists, the nurses should focus more on organizing themselves and be more knowledgeable about the advocacy campaign they are fighting for. Lastly, one of the main concerns of the political leg is the issue on money (Milstead, 2011, p. 59). Given that the proposed health advocacy bill requires a large sum of money, then the chances wherein the legislation would approve the bill would be less. For this reason, it is important on the part of the nurses to be able to establish effective health advocacy plan that does not require too much financial support from the government. Section 3 – The Ethical Considerations behind the Development of a Health Advocacy Campaign Under provision 7 of the Nursing Code of Ethics, it was mentioned that part of the nurses’ duty is to actively involve themselves in the development of public health care policy (American Nurses Association, 2012). Therefore, each nurse should focus on advancing their existing knowledge and skills through continuous education and other related knowledge and skills development programs. When developing a health advocacy campaign against childhood obesity, it is ethical on the part of the nurses to make use of the Code of Ethics as a guide in continuously improving the standards of their professional practice as stipulated by the state and federal laws. Aside from activitly participating in the development of legislative means of promoting the public health, the provision 8(2) of the Nursing Code of Ethics mentioned that all nurses have a role and responsibility to the public in terms of educating them with necessary health promotion and health prevention strategies, and improve and encourage the people to live a healthy lifestyle (American Nurses Association, 2012). Therefore, nurses should exert an effort to reach out the community members whenever necessary. Nurses should establish a good nurse-patient relationship with the family. Likewise, it is part of the duty of the nurses to respect the human rights and dignity of other people when designing, developing, or implementing a health advocacy campaign for childhood obesity. For example, when conducting a family or population-based care, the nurses should always be sensitive towards the feelings of the family members as a whole. As part of delivering holistic care to patients, community nurses should observe the law of beneficence and nonmaleficence which means that health care professionals should focus on helping the family members prevent childhood obesity and avoid causing harm to the emotional, physical or psychological well-being of the family members (U.S. Department of Health and Human Services, 1992, p. 67). When conducting a first-time home visit to a prospective family, nurses should take it as a challenge to develop and maintain nurse-client relationship with the family. Furthermore, it will be easier on the part of the nurse to make the family members voluntarily participate in the development and implementation of health promotion intervention plan (Hitchcock, Schubert, & Thomas, 2003, p. 501). The nurses are not aware about the family’s eating habits and lifestyle. For this reason, the act of building the client’s trust will empower nurses to effective communicate and gather useful data directly from the family members. In response to the collective responsibility, the nurses should continuously develop and improve their professional accountability to the public. To do so, provision 9(2) of the Nursing Code of Ethics mentioned that all nurses are obliged to follow the guidelines written under the Code of Ethics for nurses, the standards of nursing practice, continuously upgrade their knwoeldge based on the latest research studies on nursing actions and guidelines, continuously improve or aim for higher learning in education, continuously seek for more certifications, and undergo a series of evaluation process to determine the efficiency and effectiveness of a proposed nursing action (American Nurses Association, 2012). Based on the social reform in nursing profession, nurses are given the choice of either to work by themselves as an individual or work collectively with other group of professional nurses (American Nurses Association, 2012). In most cases, nurses who work collectively with other professional nurses are the ones who can easily speak out their voices and actively help in shaing or reshaping the current legislations with regards to fighting childhood obesity throughout the United States. Since registered nurses who prefer to work alone can lose their opportunity to participate in social reforms, the Code of Ethics in the nursing profession will continuously serve as a reminder about their individual obligations and responsibility to the general public. Conclusion Because of the continuosly increasing number of childhood obesity in the United States, the nursing student decided to make a health advocacy campaign against childhood obesity. After analyzing how several scholarly articles presented their health advocacy program on childhood obesity, the nursing student was able to come up with a more effective health advocacy plan for this purpose. A health advocacy campaign against childhood obesity is possible either with the use of either a family-centered approach or the use of public health policy. As compared to public health policy, the family-centered approach is a better method in terms of allowing the nurses to establish a nurse-patient relationship with the family members. However, there are limitations with regards to the use of this approach. For instance, external factors like the management of a school cafeteria or the presence of television advertisements on unhealthy foods are few and most common examples that are beyond the control of the nurses. For this reason, the call for the development and implementation of a public health policy is necessary. An effective health advocacy campaign requires some legal and ethical considerations on the part of the nurses. Before nurses can convert a health advocacy bill into law, the nurses should lobby with other nurses before their voices can be heard by the House of Senate. To increase the chances of getting an approved bill, the nurses should learn how to effectively communicate their voices in the form of writing. References Afridi, A., & Khan, A. (2004). Prevalence and Etiology of Obesity - An Overview. Pakistan Journal of Nutrition, 3(1), 14-25. American Nurses Association. (2012). Code of Ethics for Nurses. Retrieved November 11, 2012, from: http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics.aspx Contento, I.R., Basch, C., & Zybert, P. (2003). Body image, weight, and food choices of Latina women and their young children. Journal of Nutritional Education Behavior, 35(5), 236-248. Berkowitz, B., & Borchard, M. (2009). 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