Prevalence of childhood obesity is increasing worldwide, with researchers and health care providers citing lifestyle change, economic conditions and dietary compositions as the main causes (Cheung, Cunningham, Narayan & Kramer, 2016). The issue is a major health concern due to the health implication that obesity on the children in their current age or in future. Obesity affects children of all ages in the United States, with studies showing that 16.9% of children are obese across all age groups (Cheung, Cunningham, Narayan & Kramer, 2016). Prevalence is highest in younger children of between two and five years with the highest rates observed in adolescents of fourteen to nineteen years. Cases of obesity in early years most go on into the adult years. These cases have undesirable medical effects such as chronic diseases as well as adverse economic costs in medical expenses. Consequently, undermining obesity cases in children offers the benefits of improved health care for people of all ages.
Ideal, lifestyle behaviors linked to obesity are cultivated in family settings. Childhood obesity mainly occurs in low-income families in the US (GreenMills, Davison, Gordon, Li & Jurkowski, 2013). Hence, childhood obesity is mainly a factor of parental attitudes, the impact of parenting skills on the children, their knowledge on the issue and other obesity-related factors. Therefore, parents must recognize that their child or children are overnight before applying appropriate interventions to control the situation. Additionally, the child’s awareness and behavioral influence play a significant role in the success of obesity reduction intervention. Reducing obesity requires the incorporation of family-based interventions that alter the attitudes and perceptions of parents of obese children. This paper develops a health advocacy campaign for preventing obesity in children by basing interventions on the three crucial areas of family awareness, medical practitioner’s input and the child’s behavioral impact.
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Rationale for the Health Advocacy Campaign
Advocacy involves individuals, groups of people or institution with a common agenda drumming up support, promoting or striving to influence the opinions, attitudes, and perceptions of people about a certain issue or policy. Advocacy involves different levels of individuals, societal units or professionals affected by the issue of with the potential to significantly affect the desired outcome of the advocacy process. In the case of child advocacy in the US, family units hold the greatest degree of influence on the outcome of the advocacy campaign. Additionally, health care professionals and the children are better placed to influence obesity prevalence rates in the US. In the current age of technological advancement backed with scientific research, avenues or carrying out the campaign abound. These include social media, mass media, and direct contact with communities.
The negative psychological, social and long-term health effects of obesity are preventable by eliminating the obesity issue itself. The aforementioned influence of childhood obesity on the adult obesity issue proves that chronic diseases and high medical costs associated with these diseases can be prevented by creating awareness on the issue. Such are the adverse effects of obesity that a significant percentage of obese develop these chronic diseases or the greatest chance of developing them. Hence, measures to prevent childhood obesity are not only beneficial in the short-term but also provide a reprieve for those affected in the years to come. The benefits of advocacy against childhood obesity are bidirectional, implying that interventions will not only have health benefits on the children but also provide psychological benefits such as a boost in self-esteem and general empowerment of the children on the issue. Obesity in the US mostly affects children from low-income families, thus contributing to the health care disparities between classes in the country (GreenMills, Davison, Gordon, Li & Jurkowski, 2013). Interventions to prevent obesity are welcomed since they will assist in bridging the gap in health care between the rich and the poor.
Mostly, the outcome of advocacy programs has a ripple effect in society. The success of this campaign will lead to significant reductions in the number of children and also prevent new cases of obesity in children. Such positive outcomes can act as motivation for different age groups such as in youth and adults and facilitate the launch of campaigns and lifestyle changes that will improve the health of the population. Inadvertently, children who take part in the campaign to become empowered to deal with other health issues affecting children either in school or in their community. This can also work to reduce stigma and improve the well-being of obese children as they recover.
Family Awareness Health Advocacy
Children spend a significant amount of their lives in family settings rights from birth until their teenage year. Family morals, values, and behaviors are instilled in this at this crucial period of their lives. Therefore, family settings provide a potent avenue for either instilling positive behavioral characteristics that lead to healthy lifestyles or weak characteristics that eventually lead to obesity. Creating awareness among these families about the dangers of childhood obesity as well as aiding in the development of values that prevent obesity is a vital step in dealing with the issue. The perception of parents on their children’s weight status plays a key role in the success of health advocacy campaigns against obesity. Failure by a parent to acknowledge that his or her child is obese is a major hindrance to the engagement process for families (GreenMills, Davison, Gordon, Li & Jurkowski, 2013). Such parents need to be equipped with knowledge about obesity and the dangers that obesity poses on their child’s health either in present or in future. Family engagement in intervention planning positively contributes to the relevance of the plan while at the same time increases the receptivity of the campaign in the familial context.
Child’s Dietary Intake Awareness
Dietary factors such as consumption of fast foods, high sugar intake, snacks and large portion sizes are known to contribute to obesity in children. These factors are determined by the family setting of the child, where the chances of these dietary risk factors increase where the parent fails to pay close attention to their intake. Fast foods contain high calorific values with minimal nutritional content. Children living in families with both working parents have a high intake of these fast foods due to the limited time that parents have of preparing food, thus opting for cheap fast foods. Sugary foods and drinks to contribute to weight issues in children by causing gradual but steady weight gain over the years (Sahoo et al., 2015). Most parents lack this knowledge and view these sugary drinks, especially juices, as healthy foods. Excessive intake of snack foods is linked with weight issues due to their high calorific value. Again, families where snacks intake is not considered a risk in developing obesity place their children at risk of developing this condition.
Developing a health advocacy campaign with a focus on these dietary risk factors is crucial in assisting these families to carefully assess the nutritional value of the foods that their children take. Hence an advocacy program for the family must focus on empowering parents to change the calorific value of the foods to curb the weight issues associated with these unhealthy foods. Families, where both parents are working, should be encouraged to create time to prepare suitable foods for their children and eliminate the option of fast foods. Proper planning in nutrition intake will encourage packaging of nutritious foods as snacks for their children. Surprisingly, most families are unaware of the health effects of sugary foods and drinks. Owing to the gradual onset of the health effects of sugary foods, the repercussions of their intake is often ignored by parents. Thus, equipping these families with the rightful knowledge on the benefits of avoiding these foods positively contributes to the health of their children. Portion sizes are given least consideration by parents or nannies while feeding children. Large portions have the effect of increasing the calorific intake beyond the body requirements in children. This in effect causes excessive body weight especially in toddlers who cannot naturally feed themselves. Although the weight may be viewed as a sign of good health, the problem may persist later in life as the child grows. Therefore, the advocacy campaign must provide portion size versus child age information to educate parents on methods of avoiding obesity in children from a young age.
Family Factors
Family practices and values majorly contribute to obesity in children. These practices include mealtimes and certain routines like jogs and allocation of time for socialization (Butler, 2015). Socializing allows children to learn from their parents, resulting in the cultivation of good value and creation of stable mental wellness. Children between the ages of thirteen and eighteen are especially vulnerable to psychological stress which results in eating disorders and obesity (Cheung, Cunningham, Narayan & Kramer, 2016). Thus, encouraging family socialization prevents psychological stress in teenagers hence controlling cases of obesity brought about by stress. Investing time in healthy routines like jogging, walks, and playing encourages children to exercise which in turn helps to keep their bodies fit. The role of families, both through dietary intake and instilling of values in children is crucial in the campaign against childhood obesity. Incorporating these familial contributions while drafting advocacy programs will have a bearing on the success of the campaign.
Parenting
Parenting, in a dichotomized context from the family aspect, calls for consideration while developing a health advocacy campaign for preventing obesity in children. Parents have the closest contact with children from a young age, therefore placing them in an enviable position to discern the needs of the child. The advocacy campaign must, therefore, utilize this parenting aspect to encourage both parents and children to create a strong bond that facilitates the parent’s ability to understand the health requirements of the child. Obesity mainly results from reckless parenting where one or both patents fails to consider the health needs of the child especially relating to intake of foods. However, when the parent is well equipped with the prerequisite knowledge on the types of foods that are harmful to the child’s health, they are in an excellent position to direct the child on the foods that they should take and at the right intervals.
Parental attitude, concerns, and knowledge are significant factors in assessing parental role in childhood obesity. The campaign should instill a sense of concern and responsibility for the child’s health in the parents. The first step in instilling this mentality is informing the parents of the detrimental health effects that obesity has on their children. This knowledge will aid in devising measures that prevent obesity as well as applying appropriate interventions for losing weight in obese children. Additionally, parents who are aware of the economic costs of the condition through chronic diseases will strive to ensure healthy lifestyles for their children.
Focus on Behavioral Impact
Behavioral influences on childhood obesity, both physical and psychological, were investigated by GreenMills, Davison, Gordon, Li & Jurkowski (2013) with results indicating that interventions focusing on physical activity and mental wellness can help to solve the obesity problem in children. This multifaceted approach to the problem extensively explored the physical aspect of the problem and determined that interventions majoring on facilitating physical activity in children with obesity in the absence of psychological factors were efficient in solving the problem (GreenMills, Davison, Gordon, Li & Jurkowski, 2013).
Physical Activity
A child’s physical activity facilitates improvements in strength and agility while at the same time enhancing coordination, posture, balance, and flexibility. Conversely, obesity suppresses these physical attributes hence adversely affecting the fitness of the child. Physical activity is therefore vital in improving these attributes while at the same time preventing weight gain which leads to obesity. Advocacy campaigns can directly address these beneficial aspects of physical activity directly to the children or direct them to parents who then facilitate the activities in children.
Unsurprisingly, the negative effects of technology are majorly to blame for the dwindling time that children spend on physical activity. This shift in hobbies and interests is due to the advent of new media, video gaming and numerous television programs for children. While technology is a factor in this undesirable shift from a health promotion perspective, the primary responsibility for this inactivity resulting in high cases of obesity is on the parents and the children. The advocacy campaign must, therefore, encourage physical activity in children by designing fun programs that can easily be embraced by children. Furthermore, parents should be encouraged to ensure that their children strike a good balance between outside play and screen time.
Psychological Factors
The relationship between mental health and obesity has not been exhaustively explained by researchers but key factors such as emotional issues, anxiety, body dissatisfaction, and self-esteem are known to contribute to obesity in children. Developing advocacy programs with consideration for these psychological factors will introduce a dimension that is largely ignored when addressing the obesity problem in children. An efficient advocacy campaign must be developed with an understanding of how these factors lead to obesity. Depression and anxiety lead to eating disturbances especially in children approaching the teenage years. Surprisingly, most parents and guardians are oblivious of the fact that children in this age bracket are as much vulnerable to stress as their teenage counterparts. Resultantly, signs of stress are largely ignored leading to unhealthy eating habits that have the potential to lead to oppression. Although the problem may not affect a majority of the stressed children, addressing the stress problem in children has the capability of curbing the increasing number of obese children between the ages of 1forteen and nineteen (Cheung, Cunningham, Narayan & Kramer, 2016).
Obesity has the potential to affect the self-esteem of a child. In a study comparing the self-esteem of obese children with normal children, it was found that the obese children ranked lower than their normal counterparts in the same environment (Sahoo et al., 2015. However, the problem is not unidirectional since the obese children are likely to have low self-esteem while at the same time stress resulting from low esteem may lead to eating disturbances thus obesity. Additionally, obese children are highly vulnerable to self-esteem issues that that leaves them a precarious position for developing low self-esteem or stress issues. Health advocates for must, therefore, ensure that such children are guarded against developing low self-esteem before embarking on intervention plans to help them recover from the condition.
The erroneous westernized ideology of beauty residing in thinness has inadvertently caught up with adolescent children. Cases of body dissatisfaction are high in both adolescent boys and girls increasing the potential for their perceived weaknesses leading to obesity. Girls with slightly larger bodies are perceived as being less attractive, leading to frustration and the possibility of leading disorders that might cause obesity. Boys, on the other hand, are likely to be dissatisfied with their small bodies which then result in abnormal eating habits that lead to obesity. Advocacy for the prevention of obesity with a focus on body satisfaction should outline the importance of self-acceptance to the children together with the dangers of holding erroneous beliefs about their bodies or those of their colleagues. The children also need to be educated on the dangers of above normal body weight before being presented with intervention measures that not only correct the obesity problem but also assist in the development of the right mentality about their bodies. Emotional instability in children is greatly misunderstood by teachers and parents, often confused with the changes that children go through as they grow. However, emotional instability is can potentially result in a myriad of health and emotional conditions including obesity. Advocacy must aim to provide adequate education to parents and guardians about the potential sign of emotional instability such as frequent and excessive eating. These abnormal eating habits are easily noticeable and can be corrected before they have detrimental effects on the health of the child. A psychological approach to health advocacy is commendable given the extra dimension to add to the campaign. Furthermore, it approaches the childhood advocacy issue from the perspective of the subject hence offers a solution that the child can easily identify with in every aspect, therefore, allowing for easier adoption.
Health Care Provider’s Input
Harnessing the skills, knowledge, and position of health care providers in the health advocacy campaign for the prevention of childhood obesity is developing interventions that prevent obesity from the unborn child to the late stages of childhood. Traditionally pediatric providers diagnose and treat childhood obesity in clinical settings but other health care providers are also well placed to offer professional advice of healthy lifestyles, dietary intake and offer a psychological approach to the problem (Duplessis, 2014). Hence, the development of an effective advocacy campaign must involve health care providers who are in close contact with children and their parents to provide diagnosis, prevention, and treatment.
Prevention strategies for obesity begin with the unborn child. Practitioners are better placed to apply predictors of childhood obesity such as genetic factors, social and environmental predictors to offers advice to expectant mothers. Excessive maternal weight and smoking during pregnancy are also likely to cause obesity in childhood. This knowledge together with the ability to advise parents on the most effective nutrition can play a huge role in the success of the campaign. Furthermore, providers are conversant with teaching tools for children which help in the prevention of the condition.
Importantly, providers have the capability to offer accurate assessments of obese children using various tools such as the Body Mass Index (BMI) or the widely accepted WHO standards (Duplessis, 2014). Such assessment allows the provider to offer professional advice or interventions that aid in improving the condition of obese children. An assessment of parent awareness and knowledge of the condition is also necessary given that the parent is better placed to understand the child’s situation. Additionally, the provider’s intervention strategies will be facilitated by the parent. The parental assessment then provides the basis for educating both the parent and the child on measures to prevent deterioration of the condition and management of the condition until full recovery is achieved. Interventions offered by the provider such as goal setting can aid in hastening the child’s recovery process. Certainly, health care providers have a colossal role to play in developing a successful health advocacy campaign for preventing obesity in children.
Challenges in Health Advocacy
The development process for a health advocacy campaign for preventing obesity in children must take into full consideration the challenges that are likely to be encountered in the advocacy process. Challenges inherent in such health advocacy processes include lack of financial and social support, improper timelines for implementing the programs and failure to meet the goals and objectives of the advocacy.
Health advocacies done either in small settings or on large scale require financial support to recruit and train facilitators, reach out to other stakeholders and the target group. Funding is also required for research or obtaining permission to use existing research on obesity in the US. Placing messages on mass media requires financing as well as obtaining the support of health care providers to facilitate the process. Volunteers or other parties who will take part in the process also require training on strategies for achieving the goals of the campaign. Without a proper financial backing, the campaign is likely to stall midway of ultimately fail due to unavailability of resources to facilitate its completion. Therefore, planning and budgeting must take into account all these factors and come up with an appropriate budget source of funds. Social support on the other involves the willingness of the target group and other facilitators like health care providers affect the suggest changes or implement programs in the advocacy campaign respectively. Failure by any of these group to play their role will ultimately lead to failure of the campaign.
Timelines for the campaign involve the planning process before the actual commencement which involves activities such as training and formulation of programs to the end where assessment of goals and objectives is made. Proper timelines are necessary to keep the whole process on schedule. However, obstacles at any of the stages affect the others to such an extent that derailment of the whole process can occur if proper action is not taken immediately. The likelihood of the coordination process going wrong is existent which poses a major challenge in the development stage, therefore allowances must be provided and guards placed for any eventualities. Importantly, the advocacy campaign has its goals either as the process is going or at the end. The goals need to be realistic and verifiable at any given stage. In this case, the goal is to prevent cases of childhood obesity in the US. Statistical data will be available to ascertain if the campaign was successful. A major challenge arises if the goals are not met, therefore the development process should put in place measures that will ensure the goals are met.
Conclusion
Surprisingly, the childhood obesity problem in the US has not been granted the amount of attention it deserves. A rise in these cases in recent years was due to the erosion of family values in some situation, ignorance by parents and teachers, lack of sufficient support for the children and health care providers. An effective health advocacy campaign with an emphasis on the key areas leading to childhood obesity will aid in preventing the problem in the US. The input of parents, teachers, providers and the overall society is required for the campaign to become successful. Considering the health effects of childhood obesity and the economic cost, the success of the health advocacy campaign for the prevention of childhood obesity is a high stake undertaking that should result in success.
References
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