Plan of Action

Childhood obesity has more than tripled in American adolescents in the past decade. Nearly 32% of American children are overweight or obese.

The intervention I would like to implement relates to my environmental determinant. I would like to execute an intervention in schools removing vending machines and adding more nutritious foods to lunch meals. Kids spend 2/3 of their day in school and I believe they should be served nutritious foods as some of their only options. “School-based efforts have been oriented towards prevention, targeting all students in selected classes to avoid stigmatization of obese children. Planet Health is an interdisciplinary curriculum that aims to decrease dietary fat consumption, increase consumption of fruits and vegetables, promote physical activity, and limit television time.” (Ebbling, Pawlak, Ludwig, 2002)

A barrier for this would definitely be the cost. It’s expensive to change the school food system to be mostly nutritional food options. There really isn’t a way to change the cost, but this type of intervention would be effective in the long run, so the cost is worth it.

Another obstacle is a social barrier. Families might have a problem not having the option of buying sweet or salty snack in a vending machine or being able to have their children buy a soda in the lunch line. Some parents might view it as “taking away their rights.” But, I think if children get in the habit of eating healthy, the urge to have sugary foods will decrease over time.

In order for this plan to work, the stakeholders need to be involved. (Strength in numbers.) I think the biggest contributor to this issue could be the health insurance companies. They could contribute by backing the public health officials that implement this intervention. I don’t think it will be an issue getting insurance companies on board with this idea because it essentially is beneficial to them in the long run, because they won’t have to pay for children who have type two diabetes.

You could see how effective this intervention is by checking school cafeterias monthly profit history to see how many kids are still buying lunch compared to before. This way of doing this is easier then running an actual test because it is cost effective and not time consuming. Doing an intervention like this, I expect outcomes to be lower than before, but overtime I think kids will start buying their lunches at school again out of convenience.

Work Cited:

Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (n.d.). Retrieved fromhttp://www.sciencedirect.com/science/article/pii/S0140673602096782 

Childhood Obesity Interventions

Problem Statement:

Childhood obesity has more than tripled in American adolescents in the past decade. Nearly 32% of American children are overweight or obese.

“Over the last 50 years, obesity has been increasing at an alarming rate and is now recognized by leading government health authorities, such as the Centers for Disease Control (CDC) and National Institutes of Health (NIH), as a disease. In the United States alone, obesity affects more than 60 million individuals and is considered the second leading cause of preventable death. “ (Allergan, 2005)

One potential intervention could be a family-based intervention. The International Journal Behavioral Nutrition and Physical Activity did a particular study focusing on parent engagement, this study utilized community-based research to develop and test a family-centered intervention for low-income families with preschool-aged children enrolled in Head Start. (Davison, 2013) Some of the intervention components included: 1) educating parents by sending home letters sent home to families reporting child body mass index, 2) a communication campaign to raise parents’ awareness of their child’s weight status, 3) encouraging family engaged activities, and 4) a 6-week parent-led program to strengthen parents’ communication skills, conflict resolution, resource-related empowerment for healthy lifestyles, social networks, and media literacy. (Davison, 2013) I believe family education is one of the best ways to conquer childhood obesity, especially considering kids look up to their parents as role models. The results from this intervention compared with pre intervention, children at post intervention exhibited significant improvements in their rate of obesity, light physical activity, daily TV viewing, and dietary intake.

Another effective intervention could be going straight for the diet of children. One way to decrease the prevalence of childhood obesity would be cutting back/eliminating carbonated and sugary beverages. The BMJ did a study where they discouraged the consumption of “fizzy” drinks with positive affirmation of a balanced healthy diet. They believed the children would respond best to a simple, uncomplicated message so they were told that by decreasing sugar consumption they would improve overall wellbeing and that by reducing the consumption of diet carbonated drinks they would benefit dental health. (BMJ, 2004) A school based educational program aimed at reducing the consumption of carbonated drinks to prevent excessive weight gain in children aged 7-11 year olds would be effective. At the end of a 12-month study, the BMJ was able to conclude both the intervention group and the control group showed a significant increase in consumption of water, in part related to the promotion of drinking water during school to “improve concentration.” (BMJ, 2013)

Also, an intervention that could be implemented is a campaign that limits the amount of fast food commercials viewed on children networks. Fast foods are one of the most advertised products on television and children are often the targeted market. In Sweden, television advertising to children less than 12 years of age has not been permitted since commercial television began over a decade ago. Norway, Denmark, Austria, Ireland, Australia, and Greece also have some restrictions on television advertising to young children. (Dehghan, 2005) I think this is an excellent way to limit the prevalence of obesity in America, considering it’s already had some positive results in these other countries.

In conclusion, there are so many interventions that can be tried and tested, but health officials can give parents and children as much education as possible, the true change that’s going to be made is in the person’s behavior.

Word Cited:

Dehghan, Mahshid. "Childhood Obesity, Prevalence and Prevention." Nutrition Journal. N.p., 2 Sept. 2005. Web. 20 Apr. 2013.

Janet, James. "Preventing Childhood Obesity by Reducing Consumption of Carbonated Drinks: Cluster Randomised Controlled Trial." Ncbi. N.p., 22 May 2004. Web. 19 Apr. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC416601/>.

Stakeholders of Childhood Obesity

Problem Statement:

Childhood obesity has more than tripled in American adolescents in the past decade. Nearly 32% of American children are overweight or obese.

Stakeholders are persons, organizations, or other groups that share a stake in the issue. These are the people who are affect by the problem or the solution of the outcome. For childhood obesity, the most obvious stakeholder would be the children who are or potentially obese, but stakeholders who have to deal with the problem could potentially be organizations who promote clean health or insurance companies. Also, physicians and public health officials who have to deal with the affects of obesity on the society are stakeholders.

One intervention that could be done would be a family-based intervention. “Family intervention is implemented on the premise that parental support, family functioning, and home environment are important determinants of treatment outcomes.” (Ebbling, Pawlak, Ludwig, 2002) “For instance, one study reported that children who received dietary counseling, encouragement to exercise, and family therapy for 14–18 months had a smaller increase in BMI than controls, who received no treatment, though drop-out rate was substantial. (Ebbling, Pawlak, Ludwig, 2002)

Another intervention that could be very successful is a school intervention. Kids spend 2/3 of their day in school and I believe they should be served nutritious foods as some of their only options. “School-based efforts have been oriented towards prevention, targeting all students in selected classes to avoid stigmatization of obese children. Planet Health is an interdisciplinary curriculum that aims to decrease dietary fat consumption, increase consumption of fruits and vegetables, promote physical activity, and limit television time.” (Ebbling, Pawlak, Ludwig, 2002) “It is increasingly recognized that sugar-sweetened beverage consumption contributes to childhood obesity. Most states have adopted laws that regulate the availability of sugar-sweetened beverages in school settings. However, such policies have encountered resistance from consumer and parent groups, as well as the beverage industry.” (Mello, Pomeranz, Moran, 2007) If children aren’t given the option to have sugary beverages, then it’s possible that they will stop drinking them in other aspects of their lives as well.

Interventions that take affirmative action are the interventions that get the job done. Mayor Bloomberg just banned the sale of soda in places like movie theaters in New York and people are complaining and arguing that it’s unethical to make a ban like that. But, if he doesn’t try to stop the prevalence of obesity, who will? Educating people on the negative affects of the unhealthy foods consumed can be effective, but in order for a healthy diet to be implemented day in and day out, society has to change their behavior.

Work Cited:

Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (n.d.). Retrieved from http://www.sciencedirect.com/science/article/pii/S0140673602096782

Hassler, P. (n.d.). Retrieved from http://www.childrensdefense.org/policy-priorities/childrens-health/child-nutrition/childhood-obesity.html

Mello, M. (2008, April). The interplay of public health law and industry self-regulation: The case of sugar-sweetened beverage sales in schools. Retrieved from http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2006.107680

Key Determinants of Childhood Obesity

Childhood obesity has more than tripled in American adolescents in the past decade. Nearly 32% of American children are overweight or obese.

Biological Determinants

Biological determinants refer to a person’s physical, anatomic, or medical reasons a problem should occur. For childhood obesity, a lot of times it is hereditary in the child’s genes. Children whose parents are overweight or obese are at higher risk for becoming obese themselves. “A study in the Journal of Pediatrics, for instance, found five independent risk factors for childhood overweight. The main risk factor was parental weight.” (Yale, 2013) Nearly 80% of obese 10- to 14-year-olds with an obese parent will be obese as adults.

Social and Cultural Determinants

The American Heart Association estimates that one out of every three American children between the ages of 2 and 19 is obese. Some cultural challenges related to childhood obesity are the poor and ethnic. “For example, ethnic minorities often find women with fuller figures more attractive than thin women. In some cultures girls are not encouraged to exercise as much as boys. Girls receive the message that a fuller figure is a sign of good eating and good health. Recommended diets for obese children seldom include traditional foods that ethnic minorities like and eat on a regular basis.” (Margolis, 2013) Some cultural statistics include:

31.9% of all white male children are obese.

29.5% of all white female children are obese.

30.8% African-American male children are obese.

39.2% African-American female children are obese.

40.8% Mexican-American male children are obese.

35.0% Mexican-American female children are obese.

(Margolis 2013)

Besides cultural determinants, there are also social determinants including socioeconomic status and peer influences. Children who are raised in a lower social class are more likely to eat improperly than a child who has money to spend on healthier choices. Also, if a child hangs around other kids who eat poorly, the poor eating habits will influence the child leading to obesity.

Environmental Determinants

Family in the home environment can influence the behaviors of children and teens associated to calorie consumption and physical activity. Parents are role models for their children who are likely to develop habits similar to their parents. Habits, and beliefs about food selection and how to spend family leisure time are significant factors to make a healthy relationship with food. Some research also shows that extensive viewing of television can cause obesity in children.

Even in schools, kids are being served food that is not healthy and nutritious as even an option. “Students have access to sugar drinks and less healthy foods at school throughout the day from vending machines and school canteens and at fundraising events, school parties, and sporting events.” (CDC, 2012) Advertisements also play a role because the technology era has truly taken over this generations lives and advertisements have become a social norm. “Nearly half of U.S. middle and high schools allow advertising of less healthy foods, which impacts students' ability to make healthy food choices. In addition, foods high in total calories, sugars, salt, and fat, and low in nutrients are highly advertised and marketed through media targeted to children and adolescents, while advertising for healthier foods is almost nonexistent in comparison.” (CDC, 2012)

Economic Determinants

Economic determinants refer to issues with money on individual or community level. Lower income families already have a hard time making it by, but worrying about healthy foods for their kids is just the cherry on top for them. For poor families living in cities, it’s very hard to find a local grocery store because there are so many corner carry-outs and convenience stores that just serve greasy and fried foods.

Work Cited:

Yale medical group. (2013). Retrieved from            

 http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW001880

Margolis, R. (2011). Cultural factors of obesity in children. Retrieved from                   http://www.livestrong.com/article/357840-cultural-factors-of-obesity-in-children/

CDC. (2012, April 27). Centers for disease control and prevention. Retrieved from             http://www.cdc.gov/obesity/childhood/problem.html

Anderson, P., Butcher, K., & Levine, P. (2011). Economic perspectives on childhood obesity. Retrieved from      

http://qa.chicagofed.org/digital_assets/publications/economic_perspectives/2003/3qeppart3.pdf

            

Obesity Indicators

Childhood obesity has more than tripled in American adolescents in the past decade. Nearly 32% of American children are overweight or obese.

            Obesity has rapidly increased in children ages 1-18 and is continuing to grow. One’s body weight is measured as a BMI, which means body mass index and also depends on the person’s height, not just their weight. In general, being “overweight” is measured at a BMI of 25-29.9 and being “obese” is measured at a BMI greater than 30. Of the large population of adolescents, 80% of children who are considered overweight or obese are ages 10 to 15. Obesity is a huge problem within itself, but it also can lead to greater issues like, heart disease, diabetes, high blood pressure, high cholesterol, etc. Through active surveillance, it’s clear that child obesity is an epidemic. The USDA notes the on energy intake, energy expenditure, and "energy balance," who eat more "empty calories" and expend fewer calories through physical activity are more likely to be obese than other children.

            There really is a wide array of direct indicators for why obesity is so prevalent in our modern society. “Many kids are spending less time exercising and more time in front of the TV, computer, or video-game console. And today's busy families have fewer free moments to prepare nutritious, home-cooked meals.” From fast food to electronics, quick and easy is the reality for many people. The technology era has more than taken over our social lives, but now has taken over our ability to maintain a healthy diet for the children. Another potential direct indicator could be the media. While kids are sitting down watching TV, they experience dozens of commercials about fried and greasy foods that are psychologically designed to make you want to have them.

            In contrast, indirect indicators do not directly measure the problem, but instead measure related factors. Some factors that can help contribute to the obesity are the change in children's environment over the past three decades to distraught the energy balance equation. In particular, the USDA examines changes in the food market in schools and childcare settings, and in the role of parents—paying attention to the timing of these changes. In supermarkets and in some, not all, school cafeteria foods, the healthy foods are priced higher than the sweet and salty snacks. These types of underlying factors can also lead to obesity.

            Both indirect and direct indicators can be widely varied as well as their significance to contributing to obesity. The USDA’s statistics are reliable because they preformed control studies over a period time to gain the data. But, statistics showing sample size studies can’t always be accurate because they can be biased based on certain parts f the region, race, culture, etc. 

Work Cited:

http://www.childrensdefense.org/policy-priorities/childrens-health/child-nutrition/childhood-obesity.html

http://www.vaxa.com/childhood-obesity-statistics.cfm