Posted: May 9th, 2022

Changing Behavior in Dieting and Physical Activity for Children at Risk of Obesity

Assignment 6
After a program has been created, it must be evaluated in order to determine its success. For this assignment, complete the following:
1. Incorporate the changes to address the feedback received.
a. Use the feedback from your instructor to address pertinent sections for errors or insufficiencies. Implementing this feedback will help you draft this assignment and your course project.
2. Discuss the program to be introduced to the selected population to address the specific public health problem or issue.
a. Assess population needs, assets, and capacities that affect communities’ health through epidemiological records and literature reviews. Explain activities and resources to be introduced and used for this program to change behaviors and health outcomes and why they are selected.
b. Describe the projected goals for the program.
c. Based on past studies and available data, analyze the projected expected effects of the program.
3. Identify the engaged stakeholders.
a. Describe those involved, those affected, and the primary intended users.
4. Gather credible evidence to substantiate the need for the program.
a. Identify past programs similar to the proposed program and the outcomes for those past programs.
b. Explain past study results and epidemiological data for similar programs implemented.
c. Justify conclusions on the past programs and provide lessons learned for implementing this program.
5. Analyze how data will be collected from program participants and other relevant stakeholders to determine program effectiveness.
a. Identify what instruments will be used to collect data, such as surveys, focus group interviews, or key informant interviews.
b. Determine who will analyze the data and how the data will be analyzed.
6. Propose policy recommendations.
a. Evaluate policies for their impact on public health and health equity. Discuss multiple dimensions of the policy-making process, including the roles of ethics and evidence.
b. Discuss dissemination and communication suggestions for the Assessment results both in writing and through oral presentation.
c. Explain how the results will be shared with key stakeholders and the community.
d. Identify how the results will inform future programs and how they can improve health outcomes.
View the scoring guide to ensure you fulfill all grading criteria.
Explain how motivation affects how well a student learns. Describe the methods you would use to get and keep students interested in learning, to get them actively involved in the process, to encourage good social interactions, and to create a supportive learning environment.
Additional Requirements
• Length: A minimum of 10–12 double-spaced pages, not including title and reference pages.
• Font: Arial, 12 point.
• References: Cite at least eight references from peer-reviewed journals.
• Format: Use current APA style and formatting.

FEEDBACK FROM PREVIOUS ASSIGNMENT:
Great program intervention paper with SMART objectives! When reading through your work, I could see a clear plan for your program intervention with SMART objectives. You have identified the intervention to be implemented, analyzing how it will be used and included SMART objectives. You designed a population-based policy, program, project or intervention based on best practices for your issues. SMART objectives are an essential public health tool for programming, policy, research and Assessment. I am very proud of the work you put into this assignment.

Content: Points made are great. Appropriate amount of detail to document the need to examine your public health issue. Well written/formatted, and your references all substantiate your supporting points.
Mechanics: Well written and nicely organized
Format: Thank you for including all the required information
Overall Comment: Great program intervention paper with SMART objectives!

Dr. E
Assignment 4
Changing Behavior in Dieting and Physical Activity for Children at Risk of Obesity
MPH 5900: Public Health Capstone

Changing how kids who are at risk of becoming overweight eat and move.
History of the trouble
In the United States, the problem of child obesity is quickly becoming a pandemic. This puts both children and teens at risk for diabetes and poor health in general. In the developed world, there are still a lot of children who are overweight (Karik & Kanekar, 2012). Statistics from the Center for Disease Control and Prevention show that over 14.7 million children and teens between the ages of 2 and 19 were obese between 2017 and 2021. This was for children between the ages of 2 and 19. There were 12.7% obese children between the ages of 2 and 5, and 20.7% obese children between the ages of 6 and 11. 22.2% of children and teens between the ages of 12 and 19 were obese. The CDC study also looked at children of different races and found that their rates of obesity were different. For example, the rate of occurrence was 16.6% among white children, 26.2% among Hispanic children, 24.8% among non-Hispanic black children, and 9% among non-Hispanic Asian children (CDC, n.d).
High blood pressure, high cholesterol, type 2 diabetes, asthma, sleep apnea, and other health problems, like joint pain, are all linked to obesity. This is why we need to do something about the problem of childhood obesity (Ogden et al., 2014). The above statistics show that there is a need to lower the number of overweight and obese children in the short and long term.
As an intervention, dieting changes how people act.
Poor nutrition leads to obesity, so a change in nutrition is the only way to stop kids from getting fat (Han et al., 2019). In the United States, a lot of kids are overweight or obese because the foods people eat are high in calories and carbs. The main reason why there are so many obese people in the developed world is that they eat a lot of processed sugary foods like cakes, candy, fast food, and soft drinks. According to De Miguel-Etayo (2013), there are many ways to treat childhood obesity. These include making changes to a child’s lifestyle, having surgery, and giving them medicine. Diet changes are the most effective of these three methods because they are the cheapest and easiest to use. De Miguel-Etayo et al. (2013) say that the goal of dietary treatment for childhood obesity should be to improve the proper growth and development of children by reducing the accumulation of excess fat and preventing the loss of lean body mass, improving self-esteem and well-being, and preventing the regaining of excess weight in the future.
Changing your diet is a behavior change intervention because eating poorly is a habit. Management protocols need to be set up in order to change this behavior. These management plans include things like family support, behavior changes, and changes in lifestyle, which may need the help of a multi-disciplinary team. Also, other studies support the use of dietary interventions along with other ways to help people change their behavior, like getting more exercise and using psychological interventions.
Brown et al. (2019) did a study to find out how effective a wide range of interventions were, such as diet and exercise. The researchers did a randomized controlled trial (RCT) with 153 studies, most of which came from the US or Europe. Thirteen of the studies were done in countries with high to middle incomes, such as Brazil, Mexico, Thailand, Turkey, and the border between the US and Mexico. Most of the results, or 16 RCTs, showed that changing what you eat and being more active together can lower your BMI. The results also showed that when diet or exercise alone were used, there was no significant change in the BMI of obese children. The two studies above show that changing a child’s diary is a good way to fight childhood obesity.
The intervention will use things from the community
As an intervention, changing people’s eating habits needs the help of community resources to work well. Facilities, community networks, schools, community centers, hospitals, and other health care facilities are all types of community resources. Warren et al. (2020) say that schools are an important part of changing how people eat. Schools teach students how important it is to eat well and stay healthy. Other community resources that can help change eating habits are community centers and community health organizations. These groups play a big role in teaching parents about the dangers of childhood obesity, how to diagnose it, and how to treat it (Verduci et al., 2022). Education is the most important way to stop kids from being overweight, and most of that education happens in schools. Community gardens and farms in both rural and urban areas are also very important in the fight against childhood obesity. Mohamed et al. (2018) say that the number of adults with heart disease and obesity has gone down in areas where community gardens and farms have been put in place. Food deserts, which are mostly in low-income areas, are the best places for community farms and gardens to work. This is one reason why Black and Hispanic children are more likely to be overweight than other children.
What the intervention consists of
The intervention will be a change in how people eat and how much they move around. Since childhood obesity affects kids between the ages of 2 and 19, the behavior change program must work with all of these kids. The intervention will have three parts: educating kids and parents, changing the way schools feed kids on an experimental basis, and starting a physical activity program for older kids. Other subcomponents will include changing the way people talk to each other, using psychological interventions like counseling, and using the media to promote healthy eating for kids in public eateries.
• Education and good communication: This part works with schools as community resources to change the way kids who go to school act. In the US, school lunches and other snacks make up a big part of what kids eat, so schools are the perfect place to start changing unhealthy eating habits. Children as young as two can learn in school about how to eat well. Schools can also encourage kids to eat well by changing their menus so that there are more servings of healthy foods than unhealthy foods. Dudley et al. (2015) did a systematic review of randomized controlled, quasi-experimental, and cluster-controlled trials to look at how school-based teaching interventions can be used to get kids to change their eating habits. The researchers only looked at four healthy eating outcomes in their systematic review. These were: eating more fruits and vegetables, eating less sugar (except for whole fruits), learning more about nutrition, and giving children smaller portions. The results showed that experiential learning strategies help kids change what they eat when they are at school. Most of the changes in sugar consumption and food preferences were caused by the cross-curricular approaches that were built into the interventions. The researchers came to the conclusion that using education to change behavior has a positive effect on how healthy kids act in elementary school. This intervention will be used because it changes behavior most effectively.
• Educating parents. Because kids spend a lot of time at home, eating habits at home are also a cause of the high rates of childhood obesity in the US. Dudley et al. (2015), for example, found that giving toddlers sugary solid foods instead of breast milk in the first six months is one of the main reasons why so many children are overweight. This part is important because parents are an important stakeholder in changing children’s diets because they are in charge of their nutrition.
• Changes should be made to school meal programs that are known to be the weakest link in the fight against childhood obesity. One way to reduce the number of obese children is to change school lunches so that they have more fruits and vegetables and less fast food, high-calorie foods, and sugary foods. Schools can add healthy foods to their menus and teach their students how to eat well. This part is very important because school lunch programs are a big part of what kids eat.
• Physical activity for kids: A study by Brown et al. (2019) found that adding physical activity to a change in eating habits is an effective way to reduce childhood obesity. Along with making changes to your diet, physical activity is a good way to lose weight, lower your risk of heart disease, and improve your child’s general health.
Assessment of the needs, assets, and abilities of the population that affect the health of the community
The intervention is for kids between the ages of 2 and 19 who are at risk of becoming overweight as kids. This group doesn’t have many needs when it comes to this intervention. The needs of the population include materials for learning and tools for working out. This group doesn’t have any assets that could help them change their behavior, and they don’t have the skills to do it on their own. This is why there needs to be support from the community and other support systems for this behavior change to be fully put into place.
How SMART goals will be used to help the program reach its goals
SMART goals will be used to make sure the program works well and is a success. When trying to change someone’s behavior, it’s important to have SMART goals because they help make it clear how the proposed interventions will help people reach their goals. Smart goals are clear, measurable, attainable, realistic, and set for the right time. Smart goals help the intervention go in the right direction, create a space for measuring and evaluating its progress, and set realistic goals that can be met with the resources available. The program will be a success if the following goals are met.
1. Specific and time-bound: Reduce the number of obese children in the United States by putting in place a program to change eating habits and get kids moving.
– Change kids’ eating habits through effective media communication – Teach elementary and high school students about healthy eating
2. able to be measured and possible
– Drop the number of obese children from 18.7% to less than 5% in the next five years. – Halve the number of children who eat sugar. – Double the number of fruits and vegetables that children eat at school and at home.
Attainable: Start a campaign to make people aware of childhood obesity in neighborhoods, churches, and schools, and teach parents how to deal with the problem.
Results you want
In general, the goals of this program are to reduce the number of overweight children and encourage healthy eating habits. Brown et al. (2019) used BMI as the main thing they were interested in when they did their study. Since BMI is the best way to measure weight loss or gain, it can also be used to measure how well the proposed interventions work. So, the goal should be for children who are obese or at risk of being obese to have a lower BMI, completely change their eating habits from eating unhealthy meals to eating healthy meals, become more active and spend less time sitting around. Also, the educational intervention tries to teach kids how to tell the difference between healthy and unhealthy foods, like fast food.
Assessment of how the program is going
Milestones will be set that must be reached after a certain amount of time so that the progress of the program can be tracked. The intervention program lasts for 18 months, which is long enough to change someone’s behavior completely and to measure the desired variables without taking into account other variables. More specifically, the progress of the program will be measured every three months, and so will the BMI of the children in the program. The goal is for the BMI to go down by small amounts about once every three months. Also, the kids’ progress in every physical activity they do will be tracked and measured. The program will be a success if the following things happen: – The children’s BMIs go down after the program is over – Unhealthy foods are taken off or cut down on the school lunch menus
– Children are able to be more active and move around more. – Children spend more time outside than inside.
How the intervention will be done
For this intervention to work, the patient needs to take part in it fully. Because the people who will be helped are kids, parents, guardians, community resources, and schools will need to be involved. The kids must take an active role in the program by eating the healthy foods suggested by the program, taking part in the exercises and activities, and giving feedback on how the program is going. So, the intervention needs the patients to be there, take part, and give feedback throughout the whole program.
The intervention will be done through meal plans at school and at home. First, the schools in the school district where the program will be used will be scoured for children who are at risk of becoming overweight. Then, a survey will be given to the parents of the children to find out who is willing to take part in the program. The parents of these children will then be invited to a seminar where they will learn how to help their children lose weight by making changes to their diets at home. The school administration will also be made aware of how to fight childhood obesity by changing school meal plans to include healthier options.
Another way to reach the audience will be through a bigger media campaign. Children will be reached through picture books that show healthy and unhealthy foods, while parents will be reached through mass media, social media, and brochures.
How important cultural competence is when sharing information about public health
Cultural competence is the ability to get along with people from other cultures, whether it’s for work or for fun. Cultural competence is very important when talking about public health, because public health messages are meant for a larger audience that includes people from many different cultures. Cultural competence has been named as one way to fix the problems with healthcare in the United States. At the moment, health care workers must be culturally competent because their patients come from many different backgrounds.
In this particular intervention, being culturally competent is important because different cultures have different ideas about what a healthy diet is and how food should be treated. In some cultures, for example, having a lot of extra weight is seen as a sign of health and happiness. In our culture, especially for women, being overweight is a source of shame, which can lead to low self-esteem and even stress.
Cultural awareness must be a part of this program intervention for it to work. The program will take into account the fact that some children come from cultures where certain foods are a staple. For example, there are a lot of obese Native Americans because they eat a lot of foods that are high in calories. Also, most Black and Hispanic children come from low-income areas where there aren’t many healthy options. In this case, the healthy diet plan will mostly be carried out through the school lunch program, since the kids won’t have access to a healthy diet at home.
The intervention has to be different for each family and each school. Some schools, for example, don’t have enough money for extracurricular classes, and some schools can’t make changes to their meal plans because they don’t have enough money. When putting the program into action, all of these things must be taken into account. Because of this, the intervention must be made to fit the children’s culture. In places where it is used, there must be a clause that says the document can be changed to meet the cultural and ethnic needs of the people who live there.
For this particular intervention, culture will play a role in how it is used, from how it is communicated to how it is carried out. For example, culture isn’t just about ethnic and traditional ways of doing things; it’s also about how people treat each other. In the US, for example, it is against the law to put kids through these kinds of programs without their parents’ permission. So, permission from the parents will be asked for first. Second, if some foods are part of a culture, this will be taken into account and accommodations will be made.

References
Disease Control and Prevention Center (n.d). Childhood Obesity Facts: The Number of Obese Children in the U.S.
Dudley, D. A., W. G. Cotton, and L. R. Peralta (2015). A systematic review and meta-analysis of teaching methods and strategies that help elementary school kids eat healthy foods. International Journal of Behavioral Nutrition and Physical Activity, 12(1), pp. 1-26.
Mohamed, W., Azlan, A., & Abd Talib, R. (2018). Findings from the FEAT program show that community gardening can help fight obesity. Current Research in Nutrition and Food Science Journal, 6(3), pages 700–710.
Warren, A.M., E.A. Frongillo, P.H. Nguyen, and P. (2020). Bangladesh spent more on key food groups after a nutrition intervention that focused on changing people’s behavior through communication and didn’t use any extra materials. Nutrition Journal, 150(5), 1284–1290. https://doi.org/10.1093/jn/nxz339
De Miguel-Etayo, P., Bueno, G., Garagorri, J. M., & Moreno, L. A. (2013). How to help children who are overweight. World review of nutrition and dietetics, 108, pp. 98–106. https://doi.org/10.1159/000351493
Brown, T., Moore, T. H., Hooper, L., Gao, Y., Zayegh, A., Ijaz, S., Elwenspoek, M., Foxen, S. C., Magee, L., O’Malley, C., Waters, E., and Summerbell, C. D. (2019). Interventions to keep kids from getting fat. The Cochrane database of systematic reviews, 7(7), CD001871. http://doi.org/10.1002/14651858.CD001871.pub4.
Han, J. C., Lawlor, D. A., & Kimm, S. Y. (2019). Too much fat in kids. The lancet, 375(9727), 1737-1748.
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. https://doi.org/10.1001/jama.2014.732
Verduci, E., Di Profio, E., Fiore, G., & Zuccotti, G. (2022). Integrated approaches to combatting childhood obesity. Annals of Nutrition and Metabolism, 1-12.
Karik, S., & Kanekar, A. (2012). Childhood obesity: a global public health crisis. Int J Prev Med, 3(1), 1-7.

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