Introduction
Childhood obesity is a complex health problem that requires the involvement of multiple stakeholders to promote healthier lifestyles and achieve sustainable changes in individual behaviors. According to recent statistics, over twenty-five million U.S. children are obese (Schneider et al., 2013). These high rates indicate an urgent need for intervention because obesity increases the risks for children to develop life-long adverse health conditions.
Obese youth are prone to developing type 2 diabetes and usually have a shorter lifespan (Schneider et al., 2013). Due to the complex nature of this public health issue—as well as the genetic, behavioral, social, psychological, metabolic, and other factors contributing to its development—a health policy addressing childhood obesity should be large in scale, evidence-based, and well-coordinated. It should include various marketing techniques aimed to educate the target population and raise awareness of health risks, prevention measures, and available sources of support.
This paper will review two articles studying different advocacy campaigns: a community-based approach and a youth-led intervention for childhood obesity. The objectives and goals of each strategy will be evaluated, along with the factors contributing to successful implementation and positive outcomes. The findings of the literature review will be used to substantiate the design of an advocacy campaign.
Literature Review
Community-Wide Strategy
The advocacy campaign suggested by Schneider et al. (2013) is a strategy that strives to bring changes at the community level by modifying the local environment. The researchers claim that environmental factors have likely played an essential role in the recent rise of obesity in the United States because human genetics could not have changed so drastically over a period of just a few decades (Schneider et al., 2013).
Given the role of environmental factors, the creation of a supportive social environment is crucial to combating obesity. The proposed policy addresses such issues as access to healthy foods, the presence of recreational facilities, the development of physical activity programs, and so on. The researchers emphasize the role of schools in the promotion of healthier lifestyles in children, who spend much of their time in educational settings. The school-based intervention involves a health curriculum and education program designed by local physicians and community workers; encouragement for children to engage in physical activities (e.g., the construction of bike lanes and paths); and an improvement in the quality of food served to students.
Youth-Led Campaign
In their article, Frerichs, Sjolie, Curtis, Peterson, and Huang (2015) examine a youth-lead advocacy program drawing upon social network and community mobilization theories. Under the guidance of school and health leaders, teenagers in an Omaha high school administered a cafeteria food labeling and social marketing campaign; developed graphic posters and displayed them around the public school; and shared information through posts on social networks such as Facebook.
The major purpose of this advocacy initiative was to develop an awareness of health factors and risks for obesity, as well as the contents of food that children consume on a daily basis. At the end of the seven-week intervention, Frerichs et al. (2015) found significant improvements in children’s self-reported confidence to distinguish healthy foods from unhealthy ones. However, there were no significant positive changes in self-reported fruit and vegetable intake levels.
Attributes of Success
Research findings indicate strong links between individual behaviors and lifestyles and the overall environment at home, school, and the community at large (Schneider et al., 2013). According to Sahoo et al. (2015), all children learn, adopt behavioral norms, and model their own preferences based on their interactions with caregivers and peers. Thus, the availability of or repeated exposure to healthy foods, as well as parental eating habits, may significantly contribute to the development of healthier eating habits in children. Based on this evidence, the major attribute of success for community-based advocacy campaigns is their focus on the psychological and social cores of the problem, as well as on the capacity to influence large audiences.
As a form of community-based intervention, school-based, peer-led advocacy initiatives employ the principles of social cognitive theory, which emphasizes the interplay of individuals, their behaviors, and their environments. Moreover, the program discussed by Frerichs et al. (2015) integrated the elements of social network theory, according to which “influential individuals can affect the opinions and behaviors of many individuals quickly due to chains of social interconnections” (p. 434).
The social marketing of nutrition interventions administered by peers online has the potential to have a strong impact on the eating behavior of students, as well as their knowledge and attitudes, especially because teenagers tend to be more sensitive to the opinions and current behavioral trends of their peers. As Llauradó et al. (2015) state, peer-led interventions are more effective when implemented in school-based environments; within educational settings, they may lead to more positive outcomes than adult-led programs. However, in order to ensure greater efficiency, significant attention should be paid to the training of youth leaders, as they must be provided with sufficient information and support to overcome organizational and instructional challenges.
Plan for Health Advocacy Campaign
The research evidence suggests that the following prevention strategies show promise: school-based skill training, the development of obesity risk awareness in children, family and community education, the encouragement of physical activity within the community, the provision of access to healthy food, and the restriction of fast food availability (Schneider et al., 2013). However, these measures are usually localized. As the findings of the literature review demonstrate, current prevention programs and policies are primarily clinically focused or community-focused—meaning that they usually do not imply population-based approaches to intervention.
However, in order to ensure sustainable changes at both the public and individual level, childhood obesity interventions must address the largest possible audience and ideally target the entire nation. Thus, when developing the policy, there should be a focus on both the qualitative and quantitative aspects of prevention efforts. The policy should involve as many stakeholders, individuals, and communities as possible. Moreover, it should address causal and, at the same time, modifiable risk factors: environment, diet, physical activity, family, psychological determinants, and fast food consumption.
A comprehensive strategy for childhood obesity prevention will target both welfare promotion and risk reduction. Consistent with previous research data, the specific objectives of this national public policy should include community education, the promotion of a healthy diet and physical activity, the improvement of social support networks, and youth and family education. However, along with these target areas, it could be useful to address the psychological factors linked to obesity as well. Obesity negatively impacts individuals’ social and emotional well-being, as well as their overall quality of life.
Sahoo et al. (2015) state that adverse psycho-emotional conditions such as depression and anxiety “may be both a cause and a consequence of obesity” (p. 190). It is possible to assume that the psychological determinants of childhood obesity are interconnected with other social and cultural factors as well. Thus, the proposed advocacy campaign should strive to target all given areas of concern. For instance, it could be possible to address the issues associated with socialization and evaluate their links to obesity in children. Overall, it is important to keep in mind that if preventive measures are implemented independently of each other, their positive effects may be reduced; therefore, it is necessary to develop an integrated approach to fighting childhood obesity by targeting many areas of concern simultaneously.
References
Frerichs, L., Sjolie, S., Curtis, M., Peterson, M., & Huang, T. T. (2015). Process and outcomes from a youth-led campaign to address healthy eating in an urban high school. Journal of Primary Prevention, 36(6), 433-438. Web.
Schneider, C., Donohue, S., Crawford, P., Swanson, P., Spezzano, T., Martin, A.,… Nicholson, Y. (2013). Communitywide strategies key to preventing childhood obesity. California Agriculture, 67(1), 13-20. Web.
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187–192. Web.
Llauradó, E., Aceves-Martins, M., Tarro, L., Papell-Garcia, I., Puiggròs, F., Arola, L., … Giralt, M. (2015). A youth-led social marketing intervention to encourage healthy lifestyles, the EYTO (European Youth Tackling Obesity) project: A cluster randomised controlled trial in Catalonia, Spain. BMC Public Health, 15, 607. Web.