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Health Promotion: Childhood and Teen Obesity Joanne OngNURS 370

The ProblemBirmingham, Alabama has a high prevalence of obesity. The high school lunch program serves typical southern cuisine, which is not very healthy for the students. Having a school sports program is not sufficient to solve the problem. According to letsmove.gov, childhood and teen obesity is increasing in the U.S. and it is becoming a concern due to its potential risk of: CVD, DM II, asthma, sleep apnea and social discrimination (Obama, 2010). Solving the problem is not a one-man mission; we are all in this together. In this study, Michelle Obamas plan, Lets Move will also be utilized.

Learning Needs AssessmentAssess how the students learn best: hearing, reading, writing, doing/acting, etc. Learn about the students needs (as appropriate) through informal conversations, structured interviews, questionnaires, tests and through observation (Kohlbry, 2015). Welcome any questions since that is the best time to teach (Kohlbry, 2015). Interview teachers and other staff. Find out what they want to know and what they need to aid in the nurses health promotion plan.First step is to gather data. Find out what the students know about obesity, healthy eating, and the importance of physical activity. Assess the baseline or their routine. Individualize the assessment if possible.

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Health Promotion ModelThe Health Promotion Model chosen for this teaching plan is The Health Belief Model (HBM). The students will learn what obesity exposes them from (illnesses as threat), and the benefits of exercise and a healthy, balanced diet.The Health Belief Model

Perceived threat: developing type II diabetes early on in life, heart disease, social discrimination, sleep apnea, asthmaPerceived susceptibility: Been inactive for quite awhile, not eating healthy, choosing a high fat, high sodium, high sugar foodsPerceived severity: Unable to walk up a flight of stairs, SOB with activity, being bullied for physical appearance, unable to have quality sleep at night, unable to concentrate during classPerceived benefits: more energy, maintain healthy weight, increase concentration during class, less risk on developing diseases, increase self-esteemPerceived barriers: takes time, gets too tired easily, lack of motivation, not enough resources/supplies in school, not available in school, expensive

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Health Promotion and Education PlanGOAL: At the end of the education plan, the students will learn the importance of physical activity in their daily routine and students will also be able to identify healthy foods.

OUTCOMES: Students will exercise at least 20-40 minutes per day. 2. Students will eat 2-3 servings of fruits and/or vegetables per day. 3. Students will have an average BMI of less than 25 kg/m2.

Goal may be attained in a few weeks.Outcomes 1 and 2 may be measured weekly or monthlyOutcome 3 is more long-term and may be measured in a year or so

The Task Force recommendations focus on the five pillars of the First Ladys Lets Move! initiative:Creating a healthy start for childrenEmpowering parents and caregiversProviding healthy food in schoolsImproving access to healthy, affordable foodsIncreasing physical activity

For more information regarding Michelle Obamas plan, Lets Move!, go to letsmove.gov.

Lets move new school meals include:More whole grains, fruits, and vegetables; low-fat milk dairy products; and less sodium and fat.The right portion. Menus are planned for grades K-5, 6-8 and 9-12 and will demonstrate to your child the right size portions.Additional funding will be made available to schools that meet the new standards. Schools will be reimbursed an additional 6 cents for each lunch they serve in accordance with the new standards.

Lets move! recommendations for physical activity for kids and teens (thats anyone between 6 and 17 years), your goals are:You need to be active 60 minutes a day, at least 5 days a week, for 6 out of 8 weeks. As an alternative, you can count your daily activity steps using a pedometer (girls goal: 11,000; boys goal: 13,000).

Lets Move! aims to increase opportunities for kids to be physically active, both in and out of school and to create new opportunities for families to move together.

Active Families: Engage in physical activity each day : a total of 60 minutes for children, 30 minutes for adults

Active Schools: A variety of opportunities are available for schools to add more physical activity into the school day, including additional physical education classes, beforeand afterschool programs, recess, and opening school facilities for student and family recreation in the late afternoon and evening.

Active Communities: Mayors and community leaders can promote physical fitness by working to increase safe routes for kids to walk and ride to school; by revitalizing parks, playgrounds, and community centers; and by providing fun and affordable sports and fitness programs.5

Research and Evidence Teaching plan would include:

Encourage physical activity of 20-40 minutes per day. Studies show after 13 weeks, 20 or 40 min/day of aerobic training improved fitness and demonstrated dose-response benefits for insulin resistance and general and visceral adiposity in sedentary overweight or obese children, regardless of sex or race (Davis et al., 2012).

A healthy, balanced diet combined with physical activity every day is proven to be effective in weight loss and metabolic profile improvement and greater improvements in HDL cholesterol, fasting glucose and fasting insulin over 6 months (Ho et al., 2013).

Students will learn to identify junk foods and avoid them as much as possible. For example, sugar-sweetened drinks. A study conducted by Ebbeling et al. showed that in overweight and obese adolescents who regularly consumed sugar-sweetened beverages (control group), a 1-year intervention was designed to decrease consumption of sugar-sweetened beverages (experimental group) resulted in a smaller increase in BMI than the control group (Ebbeling et al., 2012).

EvaluationIn order to measure effectiveness of the plan it would take some time to determine it.Establish a schedule for periodic review of the planFor outcomes #1 (physical activity) and #2 (eating healthy foods), this could be measured weekly or monthly. However, measuring the effectiveness of outcome #3 (average BMI of less than 25 kg/m2.) may take a year or so. The long-term goal is for students to be able to incorporate healthy habits such as physical activity and eating healthy foods into their daily routine consistently.

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ConclusionExercise combined with healthy eating, and maintaining the behavior will definitely yield desired results. It is important that the behaviors are carried out in the community and at home. Get the whole family involved.Get teachers and school staff involved. Make it fun, be creative. For example, make it a competition. Provide incentives as appropriate.

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ReferenceDaddario, D. (2007). A review of the use of the health belief model for weight management. MEDSURG Nursing, 16(6), 363-366 4p.Davis, C. L., Pollock, N. K., Waller, J. L., Allison, J. D., Dennis, B. A., Bassali, R., ... & Gower, B. A. (2012). Exercise dose and diabetes risk in overweight and obese children: a randomized controlled trial. JAMA, 308(11), 1103-1112.Ebbeling, C. B., Feldman, H. A., Chomitz, V. R., Antonelli, T. A., Gortmaker, S. L., Osganian, S. K., & Ludwig, D. S. (2012). A randomized trial of sugar-sweetened beverages and adolescent body weight. New England Journal of Medicine, 367(15), 1407-1416.Ho, M., Garnett, S. P., Baur, L. A., Burrows, T., Stewart, L., Neve, M., & Collins, C. (2013). Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA pediatrics, 167(8), Kohlbry, P. (2015). Assessment of the Learner: Determinants of Learning. Needs Assessment for Health Promotion. [PowerPoint slides]. Retrieved from https://csusm.instructure.com/courses/101/pages/module-3-assessment-and-health-promotion?module_item_id=6368Obama, M. (2010). Get Active. Lets Move: Americas Move to Raise a Healthier Generation of kids. Retrieved from http://www.letsmove.gov/get-activeObama, M. (2010). Healthy Schools. Lets Move: Americas Move to Raise a Healthier Generation of kids. Retrieved from http://www.letsmove.gov/healthy-schools