Long-Term TV Watching and Childhood Obesity - Research Paper Example

Running Head: PARENTAL CONTROL AND OBESITY Parental Controls and Restrictions Regarding Television Viewing And Obesity Research Question: What are the parental controls and restrictions regarding television viewing among students? Introduction The prevalence of childhood obesity has increased substantially over a single decade, and therefore, the epidemic cannot be blamed only on genetics (Gilman, 2010). It is not surprising that adolescent obesity is strongly predictive of increased long-term morbidity and mortality (Reilly et al., 2003). Moreover, in recent decades, research evidence has demonstrated a significant association between declining levels of physical activity in children, overall increases in children's body weights, and the incidence of obesity (Goran et al., 1999). The most widely accepted hypothesis for this association is that over time cultural changes and technological advances have resulted in less physical activity and promoted a gradually more sedentary lifestyle (Goran et al. 1999; Luepker, 1999). This mirrors what is occurring in the adult population and highlights the influence that parental physical activity behaviours have on the behaviours of children (Goran et al., 1999). Clearly, physical activity plays a critical role in the prevention and treatment of childhood obesity, leading some experts to suggest that if physical activity levels were increased that the epidemic of childhood obesity would diminish or even disappear (Luepker, 1999). Research has suggests the need for family-based interventions since families share genetic disposition as well as environments (Hill & Trowbridge, 1998). Accomplishing the task of combating childhood obesity will require that every family become committed to improving their children's physical activity habits. Research shows that parents play an important role in the health and well being of their children, and in shaping early eating and physical activity habits (Hill & Trowbridge, 1998). Parents can modify environmental cues and change their child's microenvironment and thus, help them to achieve a targeted behaviour. Direct parental encouragements to be active have been associated with higher levels of activity in young children (Haslam & Wittert, 2009). Moreover, children learn lifestyle behaviours from an early age and may be more flexible in their ability to change behaviours than adults. Many parents, however, lack knowledge about healthy lifestyle practices and/or fail to encourage or model these healthy behaviours for their children. Parents of overweight children also may tend to underestimate their child's weight and may not be as concerned about their child's physical inactivity. It is important to understand whether this lack of knowledge and/or modelling of healthy behaviours on the part of the parents are related to unhealthy practices among their children. According to Nicklas and Johnson (2004), health promotion interventions should be implemented at an age when a child is still impartial to change, which is typically prior to entrance into sixth grade. The role of the home environment is critical to prevent childhood obesity. Parents must provide a physically active environment for their children, and limit the amount of time spent in sedentary behaviours. Parental controls of television viewing can have many benefits. Research Questions The specific research question of this study is: What are the parental controls and restrictions regarding television viewing among students? Sub-questions for the study were: (a) Does the parental controls and restrictions that are being used by parents correlate with children's BMI; (b) Do parental controls differ according to the child's age? Literature Review Family Environment and Childhood Obesity The best way to significantly affect the prevalence of childhood obesity is to prevent it. Therefore, the issue of childhood obesity becomes a family affair. Families provide the primary environment for a healthy lifestyle and must provide a healthy foundation including healthy eating and physical activity behaviours. It has been well recognized that obese parents likely to have obese children (Davidson & Birch, 2002). Moreover, family members tend to prefer similar physical activity pursuits. Parents who are involved in physical activities are six times more likely to have children who are physically active when they are compared to their peers (Moore et al., 1991). Parents who are supportive of their children also enhance their child's activity level. Family interventions in treating and preventing obesity are vital because of the influence, particularly parental support and modelling, the family has on children's physical activity patterns (Strauss & Knight, 1999). Research has outlined strategies that can be used by communities and families to address the problem of obesity (Nicklas and Johnson, 2004). According to the National Service Framework for Children, Young People and Maternity Services, decreasing television viewing habits and other sedentary activities would help to reduce the prevalence of obesity (Department of Health, 2011).. National Service Framework for Children, Young People and Maternity Services also recommended that children must participate in moderate intensity physical activity daily for sixty minutes (Department of Health, 2011). Moderate intensity physical activity includes activities such as jump roping, playing tag, running, or brisk walking. Despite these recommendations many parents are not encouraging physical activity and discouraging sedentary behaviours. Strauss and Knight (1999) examined the relationship between the development of obesity in children and home environment. From their research, Strauss and Knight (1999) concluded that the home environment play a crucial role in the progress of childhood obesity. Moreover, children who had an overweight mother were four times more likely to become overweight than children whose mother was lean. This result was similar to other studies, however it is important to note that paternal obesity was not measured. A survey by the Kaiser Family Foundation (2004) revealed that more than half of all youth have a television in their bedroom. The increasing trend of placing a televisions and computers in children's bedrooms tends to decrease supervision by parents while increasing the amount of time children spend using the media. Increasing children's assess to television and computers also increases the total amount of time spent in sedentary activity at the expense of other physically active behaviours, thereby putting them at risk for obesity (Subrahmanyam, 2000). Furthermore, children who have a television in their bedroom are more likely to be overweight and spend more time watching television (Dennison, Erb & Jenkins, 2002). A study by Weicha, Sobol, Peterson, and Gortmaker (2001) aimed to identify household factors that could be altered to reduce television viewing among youth. The average television viewing time of their sample population was 3.35 hours per day. This was the first study to show independent associations of household factors that affect access to television. About one hour and forty minutes of total viewing per day was independently associated with three variables: having a television set in the bedroom, lack of parental limit setting on television time, and having few or no dinners involving sitting down with family. An additional seven minutes of viewing per day was associated with each additional television set outside of the youth's bedroom. Youth also spent an additional twenty minutes reading and completing homework if they did not have a television in the bedroom and if their parents set limits on television viewing. This study recognizes the household environment as an important factor in a potential social ecological framework for understanding and reducing television viewing among children. The importance of parental limit setting on television time is also emphasized. However, despite its importance many parents are not limiting television-viewing time. Research has pointed out that parental restriction has the potential to work as an intervention to obesity, however, majority of parents do not regulate televising viewing (Dietz & Gortmaker, 2001). Research also suggests that attempts to encourage physical activity must be a key to treat or prevent obesity. Epstein, Valoski, and Wing (1990) reported that when children are forced to decrease television viewing, their approach towards physical activity found to be more positive than when they are encouraged to enhance physical activity. Methodology and Procedures Study Design This study will utilize a descriptive research design to identify the parental controls and restrictions being used to monitor television viewing among children attending an elementary school. The descriptive design will not explore any causation but will attempt to establish the relationship between the study variables that may be effective in reducing childhood obesity. This study design is chosen because it fit the research questions of the study. The advantages of this study design is that it allows the researcher to have some flexibility in designing the questionnaire, it is less time consuming than observational studies, and it allows for a foundation of knowledge about the topic to be developed (Neutens & Robinson, 2009). Study Site and Population The study population will consist of parents of children attending an elementary school. The permission will be obtained from the school administration to use the school as the study site. Furthermore, school administration will be requested to provide a complete list of parent's names and mailing addresses. This study has selected elementary school children because they are in the process of forming their sedentary lifestyle practices, and controls regarding television viewing are extremely important. Inclusion & Exclusion Criteria The participant must be a parent or guardian of a child attending the elementary school. Parents who had more than one child attending the school will be asked to complete only one questionnaire. Sampling Procedures The sampling frame will be chosen from the list of classes at the elementary school using simple random sampling techniques. Once a specific classroom list with students' names will be obtained, numbers will be assigned to each name in order to protect the identity of the participant and to maintain confidentiality. Institutional Review Board An application will be filed with the Institutional Review Board (IRB) to request permission to conduct this study. The application will include a description of the study, design and methods, the survey instrument, the informed consent form, and all other documents necessary for IRB approval. Ethics Informed consent will be obtained from the study participants. The informed consent form will explain the purpose of the study and the procedures that will be used to collect the data. In addition, the risks and benefits will be explained to the participants. Participants will be informed that their participation in this study is completely voluntary and they can leave this study at any stage. There will be no monetary costs to the participants. Furthermore, to ensure the confidentiality of the participants the numbers will be assigned to each name in order to protect the identity. Instrumentation The questionnaire that will be used for this study will consist of a combination of open and closed-end items to facilitate completion and allow respondents to expand their answers. The instrument will be a combination of questions developed by the researcher based on the literature review, and the research questions. The questionnaire will measure parental controls and restrictions of television viewing, which is the focus of this research study. The questionnaire will focus on collecting information to analyze the main variables. The variables will include: parental controls to monitor television viewing, varying controls based on child's age BMI of child, and the specific regulation methods. Multiple forms of questions will be used to obtain the participants' responses. For example, closed ended questions will include dichotomous questions, multiple-choice questions (for demographic information), and rating questions (parent's recognition of television as a threat to their child's health). Open-ended questions will be used to determine what aspects of controls and restrictions are being used by parents to regulate their child's television viewing. Parents will also be asked to report their child's height and weight so that BMI could be calculated to determine if a correlation between BMI and parental controls and restrictions exists. Face validity of the instrument will be established by the researcher to ensure that the questions in the instrument correlate with the research questions. Content validity will be established by giving the instrument to the school principal to critique for content, linguistic and cultural relevance, and to ensure that all potential parental concerns should be represented. Pilot Test A pilot test of the study instrument will be conducted to assess the appropriateness of the instrument. The questionnaire will be administered to members of the school's Parent Teacher Association. They will assess the questionnaire for readability, format, directions, cultural sensitivity, and reliability. Feedback from the volunteers will help the researcher to test the instrument and determine if improvement is needed. Data Collection Procedures The research study packets will be distributed to the students at the end of the school day with instructions for them to deliver the packet to their parents. Each research study packet will include a cover letter, an informed consent form, and a return envelope. After completing the questionnaire, the parents will be requested to send it back to school administration. Data Analysis Procedures Descriptive statistics will be used to identify demographic characteristics of the sample including marital status, level of education, and critical variables regarding parental controls of television viewing. Measures of central tendency, including the mean and frequency, will be used to identify the most frequently occurring parental controls among the sample. Each child's height and weight will be used to calculate their BMI. Where appropriate a Chi-square test will also be used to explore associations between the selected variables. The data will be analyzed using the Statistical Package for Social Sciences [SPSS], because it is the most convenient and available to the researcher. Summary The purpose of this descriptive study is to explore parental controls regarding television viewing among elementary school students. The study population will consist of parents of students attending an elementary school. A questionnaire will be distributed to parents to address the research questions. Finally, descriptive statistics will be used to identify critical variables of parental controls and restrictions of television viewing. The statistical analysis through the use of frequency distributions and percentages will summarize the data. The Chi-Square test will be used to determine whether an association between parental control and restrictions and a child's BMI exist. References Davidson, K. K., & Birch, L. L. (2002). Childhood overweight: A contextual model and recommendations for future research. Obesity Reviews, 2, 159-171. Dennison, B., Erb, T., & Jenkins, P. (2002). Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics, (109),1028-1035. Department of Health (2011). Standard 1: Promoting Health and Well-being Identifying Needs and Intervening Early http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4865614. Dietz, W., & Gortmaker, S. (2001). Preventing obesity in children and adolescents. Annual Review of Public Health, 22, 337-353. Epstein, L., Valoski, L., & Wing, R. (1990). Ten-year follow-up of behavioral, family-based treatment for obese children. Journal of Medical Association, 264, 2519-2523. Gilman, L. (2010). Obesity: The Biography (Biographies of Disease). OUP Oxford. Goran, M., Reynolds, K. D., & Lindquist, C. H. (1999). Role of physical activity in the prevention of obesity in children. International Journal of Obesity, 23(Suppl. 3), S18­-S33. Haslam D., & Wittert, G., (2009). Fast Facts: Obesity. 1 edition. Health Press Limited. Hill, J., & Trowbridge, F. (1998). Childhood obesity: Future directions and research priorities. Pediatrics, 101, 570-574. Kaiser Family Foundation. (2004). The role of media in childhood obesity. Retrieved, from http://www.kff.org/entmedia/upload/The- Role-Of- Media-in-Childhood-Obesity.PDF Luepker, R. V. (1999). How physically active are American children and what can we do about it. International Journal of Obesity, 23(Suppl. 2), S12-S17. Moore, L., Lombardi, D., White, M., Campbell, J., Oliveria, S., & Ellison, R. (1991). Influence of parents' physical activity levels on young children. Journal of Pediatrics, 118,215-219. Neutens, J., & Rubinson, L. (2009). Research techniques for the health sciences. 4 edition. Benjamin Cummings. Nicklas, T., & Johnson, R. (2004). Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years. Journal of the Dietetic Association, 104, 660-667. Reilly, J. J., Methven, E., McDowell, S. C., Hacking, B., Alexander, D., Stewart, L. et al. (2003). Health consequences of obesity. Archives of Diseases of Childhood, 88, 748-752. Strauss, R., & Knight, J. (1999). Influence of the home environment on the development of obesity in children. Pediatrics, 103,85-93. Subrahmanyam, K. (2000). The impact of home computer use on children's activities and development. Future Child, 10(2), 123-144. Weicha, .T., Sobol, A., Peterson, K., & Gortmaker, S. (2001). Household television access: Associations with screen time, reading, and homework among youth. Ambulatory Pediatrics, 1, 244-251. Read More