The proportion of school-age children in the US with obesity rose from 6% in 1980 to about 20% in 2012 (Ogden, Carroll, Kit, & Flegal, 2014). Obesity in school-age children has both immediate and lasting impacts on health and welfare. These include hypertension, cardiovascular diseases, heart diseases, stroke, osteoarthritis, type II diabetes, numerous kinds of cancers, and psychological and social challenges, for instance, poor self-worth and stigmatization (Cunningham, Kramer, & Narayan, 2014). Studies ascertain that school age children with obesity have a high likelihood of becoming obese grown-ups, and that the moment obesity gets established, it is hard to reverse with the help of available interventions.
The Social Cognitive Theory
The Social Cognitive Theory affirms that the people who believe they have the ability to carry out a given health-promotion task, consider that it will result in the desired medical benefit, and treasure the outcome, have a great probability of changing their conduct and succeeding in their endeavor. The major components of Social Cognitive Theory encompass efficacy anticipations: self-efficacy, which signifies the belief that one can successfully execute the conduct; outcome anticipations, an individual’s perception that the conduct will cause certain results; and outcome predictions, the significance one ascribes to the outcome (Plotnikoff, Costigan, Karunamuni, & Lubans, 2013). For instance, programs for the prevention and treatment of obesity amid school-age children in the US must assist them in developing confidence in the capacity to improve eating habits (self-efficacy), believing that the improvement of the eating habits will reduce the likelihood of being overweight (outcome anticipations), and perceiving the significance of maintaining an ideal weight (outcome predictions).
Concerns under the Social Cognitive Theory that could be beneficial in developing obesity interventions and prevention programs among school-age children in the US encompass the surroundings, behavioral ability, observational learning, and objective-setting. In this regard, the physical and social environments both at home and the school could be used to offer motivation, for or in opposition to, carrying out the set behavior. The physical setting may encompass the available foods at home and school or eating out.
The social setting might encompass friends, members of the family, peers, or community members (Plotnikoff et al., 2013). The way in which school-age children view the environment influences their likelihood of adopting certain behaviors. Observational learning is vital especially amid school age children as they observe their family members and peers undertake positive health approaches. On this note, reinforcements are beneficial and may encompass self-reinforcement, explicit support, and implicit backup such as in observing the eating habits of others.
The development of programs for school age children necessitates special deliberation. School age children are reliant on the influences of their parents and school. In this regard, parents and schools have to be crucial players in the development of any program. The main objective of successful obesity prevention programs is to foster positive lifestyle conducts through the empowerment and motivation of school age children to inculcate healthy nutrition and regular exercise and enhance this through activities within the environment. To achieve a successful intervention, eating habits and exercise patterns ought to be documented, but most significantly, the social and environmental forces of change have to be established through a solution-anchored, instead of a problem-based technique (Pulgaron, 2013).
Health Promoting Schools Program
The objective of the Health Promoting Schools (HPS) program is to enhance the significance of health initiatives that seek to prevent and manage obesity among school-age children (Wang & Stewart, 2013). Policies of the program encompass research to boost school health endeavors, create the ability to advocate for health initiatives in learning institutions, reinforce countrywide efforts for the prevention and treatment of obesity in school-age children, and generate networks and alliances amid schools. Schools should implement this program to reinforce their position as healthy environments for living and learning. Amid other functions, the HPS program should seek to boost a healthy setting, health awareness, school-community initiatives, dietary and food safety policies, opportunities for exercise and recreation, and strategies for counseling, social backing, and mental health advancement.
Implementation and Evaluation of the Program
In the execution of the HPS program, learning institutions ought to involve every stakeholder (for instance, health professionals, community leaders, educators, learners, and parents) in their endeavors to make the environment a healthy place. A reward approach ought to be created as a way of offering acknowledgment and awarding schools that are implementing the program effectively. A framework for accomplishment ought to be followed for successful adoption of the program (Wang & Stewart, 2013). This framework should contain checkpoints and factors that focus on the main areas of health promotion, which include school health approaches, physical environment, social setting, community affiliations, personal contribution, and medical services. A lot can be carried out through the implementation of the program to boost nutrition and physical exercise in an effort of preventing and managing obesity amid school-age children.
Under the HPS program, action ought to be undertaken to guarantee that the food given to the students is at all times healthy. On the concerns of personal health proficiencies, school curriculums ought to be created in a manner that boosts the knowledge of learners regarding obesity and associated health problems, encompassing proper nutrition, illness-prevention, regular exercise, and effective interventions. With respect to medical services provided to school age children, screening and other aspects of obesity prevention and intervention ought to be offered. The evaluation of the success of HPS programs ought to be done regularly (Hills, Dengel, & Lubans, 2015). This ought to be based on the rate of successful prevention and treatment of obesity in school-age children.
A wide pool of studies establishes that most of the health promotion programs in schools are successful, their effectiveness is more evident in older learners and girls, and increased awareness is significant. Another means of evaluating the program is the assessment of its adoption in the entire operations within the school such as incorporation of healthy meals in the canteen and increased physical activity among the students (Hills et al., 2015). If the program is effectively implemented in all schools in the US, it could go a long way to influencing not just health-associated endeavors amid the school-age children, but also the physical and social settings. For instance, with respect to the lunch provided, enhancement of physical activities, and facilitation of positive social ambiance.
Execution of the Activities and the Function of Advanced Practice Nursing
A successful HPS program should be anchored in the values of reinforcement, sustainability, collaboration, democracy, fairness, and proficiency. Moreover, the learners, school personnel, parents, advanced practice nurses, and other stakeholders ought to focus on a health promotion strategy that facilitates free will and everyone’s contribution. The school environment ought to reinforce health promotion initiatives and educational interventions as crucial components of the countrywide curriculum. Traditionally, the nursing movement in learning institutions has offered reinforcement to nursing-based health advancement endeavors.
Nevertheless, there is a great need for the advanced practice nurses in schools to either re-assess their tasks and practices or seek the adoption of comprehensive primary health care (Wright, Giger, Norris, & Suro, 2013). Advanced practice nurses ought to take Health Promoting Schools program as a chance of embracing evolving comprehensive initiatives of preventing and treating obesity in school-age children. Moreover, this should act as a way of progressing past a traditional dependence on a restricted health education approach.
Advanced practice nurses in schools should apply and boost their endeavors to center on the promotion of wellbeing, in conjunction with the ever-broadening community systems of social and health groups. This demands dedication of all advanced practice nurses and other stakeholders. Advanced practice nurses who operate in any environment, and not just learning institutions, ought to embark on the initiation and enhancement of fundamental health promotion efforts as clearly outlined in the HPS program.
For advanced practice nurses to be at the forefront in the contemporary heath promotion initiatives in schools, they have to employ essential approaches for effective prevention and treatment of obesity and its comorbidities (Wright et al., 2013). The realization of such an approach and development of effective social relations, unity, partnership, and contribution of all stakeholders will go a long way to reducing obesity in school-age children and its impact in the United States in the long-run while enhancing the health promotion responsibilities of advanced practice nurses. The Health Promoting Schools program is evidently a global platform and, therefore, necessitates an intensive nursing depiction and support past its present approach.
References
Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). Incidence of childhood obesity in the United States. New England Journal of Medicine, 370(5), 403-411.
Hills, A. P., Dengel, D. R., & Lubans, D. R. (2015). Supporting public health priorities: Recommendations for physical education and physical activity promotion in schools. Progress in Cardiovascular Diseases, 57(4), 368-374.
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Jama, 311(8), 806-814.
Plotnikoff, R. C., Costigan, S. A., Karunamuni, N., & Lubans, D. R. (2013). Social cognitive theories used to explain physical activity behavior in adolescents: A systematic review and meta-analysis. Preventive Medicine, 56(5), 245-253.
Pulgaron, E. R. (2013). Childhood obesity: A review of increased risk for physical and psychological comorbidities. Clinical Therapeutics, 35(1), 18-32.
Wang, D., & Stewart, D. (2013). The implementation and effectiveness of school-based nutrition promotion programs using a health-promoting schools approach: A systematic review. Public Health Nutrition, 16(6), 1082-1100.
Wright, K., Giger, J. N., Norris, K., & Suro, Z. (2013). Impact of a nurse-directed, coordinated school health program to enhance physical activity behaviors and reduce body mass index among minority children: A parallel-group, randomized control trial. International Journal of Nursing Studies, 50(6), 727-737.