In children suffering from obesity, is the education of parent in healthy lifestyle for the children compared with medication treatment, increase the outcome and prevention of obesity.
Introduction and Background
The incidence of overweight and obesity among children have become a global concern that is associated with increased health complications. According to Karnik and Kanekar (2015), obesity is a chronic and multifactorial disease that results in increased morbidity and premature mortality across the globe. Prevention measures and treatment are important undertakings that have been prioritized in the health circles. The prevention measures such as lifestyle changes and treatment have a great role in the reduction of the obesity prevalence. Even with the critical roles played by the two undertakings, there are contentions on how each strategy leads to increased outcome and prevention of obesity (Ho et al., 2012). For instance, some systematic studies have shown that lifestyles are efficacious in weight loss; a case in point, a dietary review intervention by Ho et al. (2012) established a high degree of positive outcomes. There is a common saying that ‘prevention is better than cure’; however, this statement should not be considered exclusive, both the prevention and treatment play a great role in tackling the obesity problem. Therefore, the aim of the study is to find out whether the education of parent on a healthy lifestyle for the children compared with medication treatment, increase the outcome and prevention of obesity.
Obesity among children has been documented as one of the chronic diseases that have negative health implications. Across the globe, the incidence and prevalence rates of childhood obesity have been on the increase. Globally, it is projected that by 2030 one billion people will suffer from obesity. In European Countries such as the U.K., there is a projected increase of a 10% in obesity between 2010 and 2020 (Karnik & Kanekar, 2015). Similar trends are found in other developed nations and urban centers in the developing countries. These statistics are partly contributed by the huge number of obese children graduating with obesity to adulthood. Bearing in mind the negative health implication of obesity, there is the need to take measures to address the problem.
Significance of the study
Prevention of obesity requires a change that will ensure that people adopt lifestyles that guarantee long-term good health benefits. Rudolf (2016) added that treatment helps in reducing the negative implications of the disease, but it does not provide the long-term lifestyle changes that have been proven to be crucial in tackling the problem. In relation to the treatment of obesity, many studies have pointed out to the importance of family-based interventions as they result in behavioral changes that influence the entire family. On the other hand, treatment of obesity focuses on one child. Even though there are many studies on the way parents influence the eating habits of their children and the lifestyles in general, Ho et al. (2012) pointed that there lacks quality data on the effectiveness of the education programs.
Statement of the Problem
Some studies have shown that the attitude of the child towards healthy habits is related to those of the parents, this denotes the importance of socializations that takes place between the parent and the child. The socialization process represents a parental modeling process that should make the children repeat the behavior of their parents (Stand & Loth, 2011). In relation to the healthy lifestyles, Stand and Loth (2011) front the question “how significant is the role of parents in modeling and encouraging healthy behaviors to children in regards to weight management and preventing childhood obesity?” (p. 1302). The majority of parents recognize the benefits associated with healthy lifestyles and the dangers of sedentary lives; however, there are few indications that they have put the knowledge into practice (Ho et al., 2012). Therefore, the need to conduct a study to establish whether education of the parents compared to treatment increases the outcome and prevention of obesity among children.
Purpose of the Study
Education and counseling may have important roles in the primary prevention especially when pediatricians are actively involved in providing the right information to the parents about children’s growth and healthy lifestyle choices (Ho et al., 2012). It has also been argued that education alone has little or no effect on tackling behaviors that lead to obesity. This leaves policymakers on crossroads when it comes to choosing the best alternative to reduce the ever increasing incidence and prevalence of obesity among the children. It is also, rife that many factors influence the lifestyle choices for children. In spite of parents being socializing agents when it comes to health-related behaviors, peers and schools also have a significant impact. Therefore, this study will present adequate information on the impact parents’ education on lifestyle versus the treatment in order to have evidence base on the approach that is likely to result in long-term prevention of obesity. As such, the study findings can be used by health policy makers to formulate informed strategies aimed at curbing the obesity menace.
Research Questions
Research questions are important in this study as they will act as the guide to discovering the approach that can increase the outcome and prevention of obesity. Therefore, the research questions to be used in the study include:
- To what extent do parents influence the lifestyle choices of their children?
- To what degree does the treatment of obesity result in long-term prevention of obesity?
- Does the parents’ level of education and awareness of healthy lifestyle changes lead to improved nutrition practices at family level?
Hypotheses
- H1. Education of parents about a healthy lifestyle for their children increases the outcome and prevention of obesity compared to medication treatment.
- H1. Parents’ education on a healthy lifestyle change results in increased outcome in the prevention of obesity, and it is more sustainable compared to the treatment.
- H0. The education of parents on healthy lifestyles does not lead to increased outcome on the prevention of obesity among children.
Definition of Variables
As noted, obesity is a multifactorial disease; this signifies that different parameters can be used to study the prevention measures. In the current study, the main variables to be used for the study will include demography, health history of the child, parents’ awareness of health, and the treatment measures for obese children. In this case, demography will entail the age of the child, occupation of the parents and their education level. The health history of the child is the weight at birth, the feeding processes, and the dietary patterns. Finally, the parents’ awareness of health entails determining whether the parents of the selected children have knowledge about the importance of healthy eating, physical exercise, and other health promotion activities. The variables such as awareness level will be operationalized by designing a measuring tool to quantify the knowledge levels.
Prevention of Obesity in Children: Literature Review
Obesity in children is one of the major health problems affecting many communities. Stang and Loth (2011) indicate that the prevalence of obesity in young children has been on the rise within the past two decades. Scholars have been focusing on the major issues associated with obesity. For instance, some studies have argued that there is a relationship between increased calorie intake and obesity (Waters et al., 2014). Some factors such as human behaviors, genetic compositions, and environmental forces have also been associated with diabetes. Ho et al. (2012) argue that psychological, social, and physical health issues can result in childhood obesity. Within the past three decades, different communities have been on the frontline to identify new strategies that can deal with childhood obesity (Kruk, Kortekaas, Lucas, & Jager-Wittenaar, 2013). Many campaigns and societal programs have been put in place in an attempt to address the problem of childhood obesity in different populations. This literature review presents the major social actions and family-based interventions that have been in use to address the problem of obesity in children.
Background Information
Obesity is one of the risk factors for diseases such as cancer and diabetes. Obese children have higher chances of recording poor academic performance and well-being (Waters et al., 2014). Prevention of this condition has remained a priority for many healthcare institutions, governments, and international organizations. Many analysts have indicated clearly that governments, families, and communities can collaborate in order to deal with this health problem. The implementation of appropriate campaigns to deal with obesity is a common practice embraced by many communities (Rudolf, 2016). However, the current information is inadequate thus making it impossible for many families to address the problem of obesity.
Review of Literature
A number of interventions have been employed by different governments and societies to deal with obesity. A study by Ho et al. (2012) indicated that the use of home-based campaigns was critical towards supporting the nutritional needs of many children. Health-based programs also made it easier for more children below the age of fourteen to embrace the power of balanced diets. Similar studies have indicated that the use of carefully-designed programs to improve the nutritional intakes of many students. However, the use of such programs has been characterized by a number of challenges. For instance, obese children are usually discriminated and stigmatized thus being hard for them to support the campaigns (Karnik & Kanekar, 2015). This challenge was observed to explain why the problem of obesity continued to affect more people in the country.
Financial constraints have affected the success of many home-based campaigns. Many families lack the relevant finances and resources to support the campaigns. Consequently, most of the campaigns fail to support the diverse needs of more children (Ho et al. (2012). The inclusion of healthcare organizations was seen as a powerful strategy towards supporting such campaigns. However, lack of coordination in different communities was observed to affect the success of such programs.
The government has been collaborating with different agencies to address the issue of obesity in children (Karnik & Kanekar, 2015). Some of these agencies have been presenting various policies and campaigns to address the problem of obesity in different families. However, the government’s inability to offer safe environments for more children affects the success of such preventative programs. Bayles (2010) indicated that it was necessary for different healthcare organizations to be involved in each and every program. This approach can empower more parents to support the health needs of their children.
Campaigns focusing on physical exercises were found to support the health needs of many children (Bayles, 2010). Past studies have indicated that communities can provide new interventions and guidelines to ensure more children engage in a wide range of physical exercises. Sustainable measures and inclusion of physical exercises to deal with obesity were supported by many scholars (Rudolf, 2016). The practice was observed to make it easier for obese children to reduce weight and realize their goals. Bayles (2010) argued that parents could be equipped with the relevant skills and resources in order to support the needs of their children.
The use of healthy lifestyle programs can support the diverse needs of different children. Such programs can be supported, monitored, and implemented by parents. Pioneers of such campaigns indicate that parents should design powerful initiatives to ensure their children lead healthy lifestyles. A study by Bayles (2010) indicated that parents should be trained and guided in order to understand the health issues faced by their children. Such parents would possess the best competencies to guide and support to their respective children. A family-based approach towards dealing with the problem of obesity can deliver positive results and support the health needs of more children. Similar views have been presented by different authors. Karnik and Kanekar (2015) indicate that empowered or trained parents can find it easier to reshape the lifestyles and eating habits of their children.
Campaigns focusing on the feeding behaviors of children have been proposed in the recent past by many researchers. For instance, responsive feeding is a practice that has delivered positive results in many communities (Karnik & Kanekar, 2015). Families and learning institutions promoting positive mealtimes were observed to record reduced cases of obesity. Good eating behaviors can play a positive role towards dealing with the problem of obesity.
The role of practitioners and guardians is something that has not been ignored by previous researchers. For instance, nurse practitioners (NPs) have been found to offer useful tips towards dealing with the problem of obesity (Rudolf, 2016). Nutritionists can guide children and their families in order to engage in healthy eating habits. Families that seek the skills and views of different professionals find it easier to achieve their health goals. Children who are guided “to model appropriate lifestyle can reduce their weights within a short period” (Rudolf, 2016, p. 16).
Stang and Loth (2011) support the importance of balancing sleep and play. According to the scholars, parents and teachers should always encourage their children to engage in active play (Stang & Loth, 2011). Sedentary behaviors can be discouraged in an attempt to address this health problem. Children should be guided to sleep for eight hours (Stang & Loth, 2011). By so doing, the children will develop healthy bodies and eventually achieve their academic goals. Parents and guardians should collaborate with their children in order to achieve the best goals.
Rudolf (2016) indicates that governments should outline new policies to minimize cases of obesity. Effective government policies can guide different stakeholders, agencies, and healthcare practitioners to implement the most desirable programs. The intervention methods for obesity should also be sustainable. Most of the sustainable programs recorded within the past two decades have managed to address the problem of obesity (Kruk et al., 2013). This is the case because such projects encourage more children to engage in healthy behaviors. The campaigns should “be executed throughout the lifespan” (Rudolf, 2016, p. 24). This fact explains why children and adults should be engage in different exercises. Such physical exercises can make it easier for more children to have healthy bodies.
Rudolf (2016) proposes another model that is capable of dealing with obesity in children. The model outlines various practices that have the potential to deliver positive results. The first consideration is guiding every family to design an appropriate program characterized by healthy eating habits (Rudolf, 2016). The food materials consumed by children should be balanced and healthy. Relatives and parents can be trained in order to implement sustainable health promotion models (Stang & Loth, 2011). The support provided by parents can play a critical role towards dealing with the problem of obesity in children.
Implications for Future Research
The current literature outlines a wide range of practices that can address the problem of obesity in children. Most of the proposed campaigns have managed to deliver positive results (Stang & Loth, 2011). However, few studies have focused on the best approaches towards developing sustainable obesity prevention campaigns. Similarly, few researches have examined the role of parents towards preventing obesity. The practice of educating parents in order to support their children’s lifestyles has not received much attention (Kruk et al., 2013). That being the case, the proposed study will focus on the provision of health education to parents and guardians. The study will go further to examine how the newly-acquired skills can make it easier for more parents to address the problem of obesity in young children.
Methodology
The study is aimed at answering the questions that require the further quantification of results. Specifically, the identification of the degree, to which the choices of parents affect children as patients with obesity issues needs to be identified. Therefore, it will be reasonable to use a quantitative research design as the foundation for the study.
A quasi-experimental design has been selected as the foundation for the research methodology. To be more exact, a randomized controlled trial (RCT) will be used to conduct the research (Belenchia, Hillman, & Peterson, 2013). Children from low-income families will be the target population of the study. The inpatients of a local healthcare facility will be considered as the target population. The sample size required to carry out the research will equal approximately 80 people. Random probability sampling will be used as the sampling tool. The reasons for the choice include the necessity to maintain the research outcomes objective.
To make sure that the study follows the existing ethical standards and norms, all parents or legal guardians of the children that will be chosen for the study will be provided with a letter of informed consent. Thus, the potential participants will be notified about the goals of the study, the essential stages thereof, and the role that the children selected for the research will play in it. As a result, numerous misconceptions and conflicts will be avoided. Furthermore, it will be necessary to make sure that the personal data of the participants, including their health record, should not be disclosed to a third party. For this purpose, the use of an elaborate data management approach and the latest IT tools will be adopted to enhance information security.
Theoretical Framework
Among all factors that affect obesity, eating habits and lifestyle can be deemed as the ones that have the greatest effect on the development of the problem. Therefore, it is reasonable to suggest that changing the child’s behavior and habits as far as the physical activities and a diet are concerned is bound to lead to a more efficient weight control. In other words, it will be necessary to help the target audience develop an understanding of the effects that their behavior has on their health. For these purposes, Dorothea Orem’s Theory of Self-Care Deficit can be utilized (Ling, Anderson, & Ji, 2015).
Orem’s theory consists of three essential elements, i.e., the Self-Care Theory, The Theory of Self-Care Deficit, and the General Nursing Theory, which marries the two approaches identified above with the existing concepts of EBP in nursing (Queirós, Vidinha, & Filho, 2014). The theory suggests that shaping the behavior of the target audience and building their awareness of crucial aspects of self-care is essential to the patients’ well-being. Since the theory allows designing the strategy that will ostensibly help change children’s eating habits and level of engagement in physical activities, I can be viewed as an appropriate theoretical framework.
It could be argued that raising awareness in children is unlikely to have a significant effect since young people’s opinions are shaped by their parents’ and guardians’ viewpoints to a considerable extent. The argument above is quite legitimate – while children are capable of making decisions, they are easily influenced by their parents or guardians. Thus, it will be necessary to make sure that Orem’s theory is applied to children’s family members (primarily, parents or legal guardians) as well.
Extraneous Variables
One of the extraneous variables in this research is the effect of poverty on obesity. While the study seeks to examine the effect of parent education on obesity in children, poverty levels is likely to influence the outcomes of the study. While it generally believed that parents with low levels of education are much more likely to make poor dietary decisions, poor parents are as well likely to make similar decisions (Crosnoe, 2012). As such, when conducting a study in an area that is dominated by parents with low levels of education who are poor, it might be difficult to determine whether the identified cases of obesity are as a result of low education levels of the parents or due to poverty. There is a close relationship between poverty, low levels of education and poor eating habits. For any researcher conducting a research of this nature, it can be difficult to single out whether it is the low levels of education or poverty that is leading to the identified cases of obesity (Pickett, Kelly, Brunner, Lobstein & Wilkinson 2011). In addition, participants in such a study who are both poor and lowly education may not be in a position to single out the real cause of the identified phenomenon. Most of them are likely to relate it to poverty other than low education levels.
The second extraneous factor in this study is the individual characteristics of the children. Children from poor backgrounds are likely to supplement the food they take at home with outside eating. If the portion that these children get at home is not enough, they may tend to engage in binge eating when they find an opportunity to do so. These children are likely to eat too much in school or buy a lot of fast food when they get money. Such a practice is likely to be the leading cause of obesity in the study group and hence it will affect the results of the study.
Instruments: Description, Validity, and Reliability Estimates
The main research instrument that will be adopted in this study is interviews. The study subjects, who in this case are parents with low levels of education, will be engaged in a one on one interview with the researcher where they will be required to answer a number of research questions relating to obesity in their children. The validity and reliability of this research will be estimated through a test re-test method where similar questions will be asked to the same respondents at different times so as to identify and analyze any discrepancies that may arise.
Intervention
Intervention in this research will entail ensuring that only those who qualify as respondents are interviewed so as to prevent a situation where ineligible respondents are interviewed. The target respondents are those who have low levels of education and not necessarily the poor. As such, the main determining factor of those to take part in the research will be their education. Measure will be taken to ensure that only the poorly educated, whether poor or rich will be included in this study.
Data Collection Procedures
The data in this research will be collected in a number of ways. The researcher will make short notes from the responses given by the respondents. The researcher will as well take photographs of the obese children which will be used for reference later in the study.
Methodology: Data Analysis
The data collected form the table will be screened for redundancy and stored in spreadsheets for consequent descriptive and inferential analysis. Essentially, the data will be coded for ease of analysis. Descriptive analysis for the demographic variables will be processed in SPSS (v23) and presented in tables and graphs. The quantitative data will be analyzed for descriptive statistics such as measures of central tendency and the results presented in frequency tables, bar and line graphs as well as pie charts. These will include the age category of the children, parents’ occupation, healthy history, and birth weight as well as the feeding processes and dietary patterns. Demographic data will be described in terms of frequencies and percentages of the sample size of 80 children included in this study.
Cronbach’s alpha, a measure of reliability in the variable tested for causation of obesity in children will be used to assess the internal consistency of the variables. An α value of 0.7 is regarded as a considerable measure for the reliability of the tested (Pallant, 2007). Inferential statistics will include the correlation of the variables selected for the study. Correlation depicts reliability where its coefficients predict the strength of a relationship between given model variables.
According to Pallant (2007), the predicted strength should range between -1.00 and +1.00 for the correlation to be statistically significant at 95% confidence (P <0.05). The factor given by correlation analysis will provide the measure of the relationship of the variables such as the relationship between parent’s levels of education, obesity in children as well the relationship with extraneous variables such as the level of poverty. Content analysis will be used in the analysis of qualitative data from the interviews. Content analysis is a continuum of analysis that begins in the collection of raw data from the participants followed by descriptive summarized statements and the interpretation of the statement. It involves familiarization, identification of thematic framework, indexing, charting, mapping and results interpretation (Ritchie and Spencer, 1994). This analysis enables a researcher to mine rich data from interviews while complementing with observational notes made during the interviews.
References
Bayles, B. (2010). Perceptions of childhood obesity on the Texas-Mexico border. Public Health Nursing, 27(4), 320-328.
Belenchia, A. M., Hillman, A. K., & Peterson, L. S. (2013). Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. The American Journal of Clinical Nutrition, 97(4), 774-781. Web.
Ho, M., Garnett, P., Baur, L., Burrows, T., Stewart, L., & Collins, C. (2012). Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics, 130(6), 1-8.
Ho, M., Garnett, S. P., Baur, L., Burrows, T., Stewart, L., & Collins, C. (2012). Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics, 130(6), 1-8.
Karnik, S., & Kanekar, A. (2015). Childhood obesity: a global public health crisis. International Journal of Preventive Medicine, 3 (1), 1-7.
Karnik, S., & Kanekar, A. (2015). Childhood obesity: a global public health crisis. International Journal of Preventive Medicine, 3(1), 1-7.
Kersh, R., Stroup, D. F., & Taylor, W. C. (2011). Childhood obesity: a framework for policy approaches and ethical considerations. Preventing Chronic Disease, 8(5), 1-5.
Kruk, J., Kortekaas, F., Lucas, C., & Jager-Wittenaar, H. (2013). Obesity: a systematic review on parental involvement in long-term European childhood weight control interventions with a nutritional focus. Obesity Reviews, 14(9), 745-760.
Ling, J., Anderson, L. M., & Ji, H. (2015). Self-management training for Chinese obese children at risk for metabolic syndrome: Effectiveness and implications for school health. School Psychology International, 36(2), 189-206. Web.
Pallant, J.F., (2007).A step by step guide to data analysis using SPSS for windows: SPSS survival manual (3rdEd.). England: Open University Press.
Pickett, K., Kelly, S., Brunner, E., Lobstein, T., & Wilkinson, R. (2011). Wider Income Gaps, Queirós, P. J. P., Vidinha, T. S. D. S., & Filho, A. J. D. A. (2014). Self-care: Orem’s theoretical contribution to the Nursing discipline and profession. Revista de Enfermagem Referência, 4(3), 157-163. Web.
Ritchie, J. and Spencer, L. (1994). Qualitative data analysis for applied policy research. In Analysing Qualitative Data, pp. 173–194 [A Bryman and RG Burgess, editors]. London: Routledge
Rudolf, M. (2016). Tackling obesity through the healthy child program: a framework for action. Lancet.
Rudolf, M. (2016). Tackling obesity through the healthy child program: a framework for action. National Obesity Observatory, 1(1), 1-57.
Stang, J., & Loth, A. (2011). Parenting style and child feeding practices: potential mitigating factors in the etiology of childhood obesity. Journal of the American Dietetic Association, 111(9), 1301-1305.
Stang, J., & Loth, K. A. (2011). Parenting style and child feeding practices: potential mitigating factors in the etiology of childhood obesity. Journal of the American Dietetic Association, 111(9), 1301-1305.
Waters, E., de Silva-Sanigorski, A., Burford, B., Brown, T., Campbell, K., Gao, Y.,…Summerbell, C. (2014). Interventions for preventing obesity in children. Sao Paulo Medical Journal, 132(2), 128-129.
Wider Waistbands? An Ecological Study of Obesity and Income Inequality. Journal of Epidemiology and Community Health (1979-), 59(8), 670-674.