1

Pediatric ObesityMonica Castro, Claudia Chandler & Jennifer Hanks

2

Assessment

Interventions

Values

Preventions + Promotions

1

2

3

4

3

AssessmentChronosystem

The Past 1862 1945 1970 1977 2001 2005

Hunters + Gatherers

Department of Aggriculture

Post WW II

Federal Trade Commission deems cereal commercials as “deceiving”

“My Pyramid” replaces Food Pyramid

Earl Butz Secretary of Department of Agriculture

No Child Left Behind Act

4

Microsystem

Self Esteem Physical Health

Future Health Risks

5

Meso System• Unhealthy School lunches• Vending machines at school• Discontinuation of nutrition classes• Discontinuation of physical education • Behavioral problems at school• Poor grades• Drop out rates

6

Macro System• No child left behind• “Better for you” campaign• USDA regulations• Department of Agriculture• Government supported advertisements

7

Exo-System• Local farmers• Influx on health care system• Media

Risk FactorsFor pediatric obesity

Stress

SES

Lack of Access toParks/Activities

Genetics

Lack of Access to healthy foods

9

Protective Factors• Resilience• Humor• Comradely among similar peers• Desire for change• Ability to make life-long changes

10

Assessment

Interventions

Values

Preventions + Promotions

1

2

3

4

11

Interventions

‣ Social

• Health care providers should embrace and develop social media tools as part of a healthy weight plan to combat childhood obesity.

• MyfitnessPal, Nike Run etc.

The primary goal of pediatric obesity interventions is to empower the child and family

12

Interventions

‣ Organizational + Community

• A systematic review of childhood obesity prevention programs found that community-based intervention programs that incorporate schools and focus on both diet and physical activity are more effective at preventing obesity in children.

Focusing on the community is especially important for children since they generally have little or no control over their environment

13

School Based InterventionsHomework around nutrition and fitness, fliers from home to school around nutrition and local recourses for sports, nutrition, activities and other school and community activities.

14

Interventions

‣ Small Group and Individual

• The most difficult aspect of this kind intervention is convincing the primary caregiver their child is obese.

• 6 tips for caregivers…

‣ Often difficult to address one on one - it is the ethical responsibility of medical practitioners

15

Six Steps to Change…Once Primary Caregiver (Mom) is convinced her child/family has a problem with excess weight

1

2

3

4

Review the journal with the mother and explain how the foods they often think are healthy are actually not.

Eliminate pre made meals such as fast food and frozen dinners.

Have meal times, not just snacks available all day long.

Get rid of computers in kid’s rooms and have a communal computer. 5

Encourage Mom to keep a food journal.

The primary caregivers should be an example of an active lifestyle.6

16

Assessment

Values

Interventions

Preventions + Promotions

1

2

3

4

17

Preventions + Promotions

‣ Primary

• Develop and incorporate more educational components about proper nutrition, the importance of regular exercise, and the dangers of tobacco, alcohol and other drugs into existing systems of information communication.

• Education and legislation about a proper diet are paramount in preventing pediatric obesity.

• Regular exams and screening tests to monitor risk factors for illness such as BMI calculations, food journals, questionnaires and literature in doctor’s offices and school health offices about a healthy height and weight ratio.

• Controlling known hazardous junk food at home and at school.

Primary prevention measures include activities that help avoid a given health care problem

18

Preventions + Promotions

‣ Secondary

• Research shows these method’s don’t work as well.

• Examples of suggested interventions and preventions include targeting preschool institutions, schools and after-school activities as a setting for influencing already poor diet and physical activity.

Secondary prevention would identify and treat asymptomatic children who have already developed or are developing risk factors for obesity

19

Preventions + Promotions

‣ Universal

• Suggestions for universal preventative measures include modification of policies to reduce exposure to environmental causes of obesity for example regulating food marketing, regulating laws around food labels and approaching city planners to assure every citizen has access to healthy, low cost natural foods.

Universal interventions target general population groups without reference to those at particular risk

20

Preventions + Promotions

‣ Selective

• High risk prevention strategies have been poorly tested and no confirmed beneficial effects. In this case, Intervention and secondary prevention would be the best choice.

Selective programs target those at higher than average risk for any problem

21

Preventions + Promotions

‣ Indicated

• In this case the use of social media such as nutritional or exercise application programs would be beneficial for treating this population. Using social media would also lessen individual stigma as there is not a face-to-face component and a child interested in these apps would be able to use them on their own in private or with minimal help from a parent.

Indicated programs target those already using or engaged in other high-risk behaviors to prevent severe problems

22

Healthy City for Kids

23

Healthy City for Kids

24

AssessmentUse this area to provide an optional section subtitle or explanation

InterventionsHighlight the current section if using agenda slides as section breaks

ValuesUse this area to provide an optional section subtitle or explanation

Preventions + PromotionsUse this area to provide an optional section subtitle or explanation

1

2

3

4

25

Personal Values

‣ Self Determination

• Programs developed within the school system from an early start to emphasize the importance of accepting and tolerating differences amongst peers. Promoting determination within children to have accepting attitudes.

• School groups as well as community groups that involve the family as a whole to develop and or acknowledge strengths from within to have self-determination for healthy living.

26

Personal Values

‣ Caring and Compassion

• With help from individuals who have dealt with weight problems (obesity to be specific) using them in community support groups to talk about different ways of showing love (besides food) and the importance of children developing healthy coping strategies (avoiding emotional eating).

• Promoting self-validation.

27

Personal Values‣ Health

• Helping children with obesity develop inner-strength in order to build up self-esteem.

• With mass Internet use with children today developing an online support group for children so that they feel as though they have a healthy safe outlet to express their body concerns. Monitored through school systems.

28

Respect for DiversityCommunity programs where children and adults who are dealing with obesity can emphasize the untruth in in many of the stereotypes they as a community have to encounter.

29

Relational Values

‣ Participating + Collaboration

• Collaboration between all involved child/parent and doctor needs to be put in place, in order to develop a plan in overall healthy living. Should be a team effort on all counts so that all parties are motivated.

30

Collective Values

‣ Support for Community Structure

• No cost community healthy cooking classes for parents and children.

• Community support groups with professionals that help parents on how to approach weight topics with children.

31

Collective Values

‣ Social Justice and Accountability

• Improvement on better access to healthy foods within communities, especially lower income communities.

• Accesses to educational class (again more within lower income communities) that teach parents what children shouldn’t eat too much of along with giving parents healthy alternatives to give their children.