1.0 Introduction
1.1 Overview of the condition
- An individual is regarded as obese if their body mass index exceeds 30. A body mass index of between 25 and 29.9 qualifies an individual to be regarded as overweight.
Daniels, S., Arnett, D., & Eckel, R. (2005;). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111 , 1999–2002.
- The majority of obesity incidences are as a result of an imbalance between the calories that an individual has ingested versus the calories that the individual expends.
Ogden, C., Carroll, M., Kit, B., & Flegal, K. (2012;). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. . Journal of the American Medical Association 307(5): , 483-490.
- Childhood obesity has become a national concern in the United States. Poor eating habits and little or no physical activity are known to be the main causes of obesity.
Daniels, S., Arnett, D., & Eckel, R. (2005;). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111 , 1999–2002.
- Childhood obesity results in problematic growth and development, high blood pressure, cardiac arrests, kidney problems and low self esteem.
CDC . (2007). The Obesity Epidemic and New York Students. Retrieved January 10, 2014, from Centers for Disease Control and Prevention:: Retrieved from <http://www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_new_york_obesity.pdf>
- There is also a 70% chance that an adolescent who is obese is likely to become an obese adult.
CDC . (2007). The Obesity Epidemic and New York Students. Retrieved January 10, 2014, from Centers for Disease Control and Prevention:: Retrieved from <http://www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_new_york_obesity.pdf>
1.2 Etiology
- Obesity is caused by a number of factors. The quality, quantity and frequency of food consumption are a major cause of obesity coupled with physical inactivity.
Dietz, W. (2004). Overweight in childhood and adolescence. . New England Journal of Medicine , 855-857.
- With the advent of technology, adolescents and children are spending most of their time indoors engaging in one or more technology related activity. Most children and adolescents in the USA driven to and from school hence they barely get a chance to engage in physical activity in form of a walk or running.
Ogden, C., Flegal, K., Carroll, M., & Johnson, C. ( 2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA , 1728–1732.
- Some individuals being more predisposed to becoming obese due to their genetic makeup. Environmental and societal influences shape an individual’s lifestyle choices making these factors one of the causes of obesity.
Dietz, W. (2004). Overweight in childhood and adolescence. . New England Journal of Medicine , 855-857.
- If an individual lives in an environment where the groceries are a rarity, he or she is likely to opt for whatever is available which may not always be healthy. Societal pressures such as the need to fit in could easily sway a child or an adolescent’s food choices.
S.Anderson. (2009 ). Prevalence of obesity among US preschool children in different racial and ethnic groups. . Arch Pediatr Adolesc Med , 163(4) , 344-348.
1.3 Disease burden
- Statistics indicate that as early as preschool, children are already contending with obesity with one out of eight preschoolers being obese. 19.6% of the children between the ages of 6 and 11 in the USA are obese.
CDC . (2007). The Obesity Epidemic and New York Students. Retrieved January 10, 2014, from Centers for Disease Control and Prevention:: Retrieved from <http://www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_new_york_obesity.pdf>
The number of children who are obese has doubled in the past 30 years. Among adolescents, current obesity rates are thrice what they were 30 years ago. New York has to contend with over 1.1 million people under the age of 18 who are obese.
CDC . (2007). The Obesity Epidemic and New York Students. Retrieved January 10, 2014, from Centers for Disease Control and Prevention:: Retrieved from <http://www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_new_york_obesity.pdf>
1.4 Risk factors
- Genetics can be a direct cause of obesity in cases where individuals are suffering from syndromes such as Bardet Biedl syndrome and Prader Willi Syndrome.
S.Anderson. (2009 ). Prevalence of obesity among US preschool children in different racial and ethnic groups. . Arch Pediatr Adolesc Med , 163(4) , 344-348.
- The interaction of outside factors such as eating habits and physical activity with genetics is the common causative agent of obesity.
Daniels, S., Arnett, D., & Eckel, R. (2005;). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111 , 1999–2002.
- Consumption of highly calorific foods while expending little or no energy puts one at risk of becoming obese. Schools across the USA have been criticized in the past for availing junk food at school canteens and providing meals that have little nutritional value to children hence increasing the prevalence of obesity in the count.
Daniels, S., Arnett, D., & Eckel, R. (2005;). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111 , 1999–2002.
2. 0 Background
- With 95% of the children in New York currently enrolled in school, most of the intervention measures target school going children.
Davison, K. K., Jurkowski, J. M., Li, K., & Lawson, S. K. (2013, ). A childhood obesity intervention developed by families for families: results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity 10(3)
- The National School Lunch and Breakfast program has been adopted in some schools in line with the nutritional guidelines recommended by the Department of Health and Human Services. This has however been met by non compliance particularly from the students with a 2007 survey revealing that students do not consume the recommended five portions of fruits on a daily basis.
Campbell, K., & Hesketh, K. (2007). Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obesity review , 327-338.
- Physical education is mandatory in most schools but most students do not participate. A survey carried out in 2007 revealed that 62% of the children in New York do not engage in the recommended physical activities while 87% do not participate in physical education in school.
Campbell, K., & Hesketh, K. (2007). Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obesity review , 327-338.
- Whilst this may look gloomy, CDC has actually found that child hood obesity rates in New York have dropped as a result of the implementation of these programs.
Campbell, K., & Hesketh, K. (2007). Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obesity review , 327-338.
- Buffalo, New York has not only adopted the aforementioned approaches but also adapted them in order to adequately address the problem. The Healthy Kids, Healthy Communities initiative is touted as being instrumental in encouraging more children to engage in physical activities.
E.Waters, Silva-Sanigorski, d., Hall, B., T.Brown, Campbell, K., Y.Gao, et al. (2011). Interventions for preventing obesity in children. Cochrane Data Base (12) , np.
- The initiative has resulted in the increase in the number of biking lanes, safe routes to school and play zones within the city. Further adaptation of the initiative can be done in order to ensure that lunches and breakfasts are provided by school administrations
E.Waters, Silva-Sanigorski, d., Hall, B., T.Brown, Campbell, K., Y.Gao, et al. (2011). Interventions for preventing obesity in children. Cochrane Data Base (12) , np.
3.0 Methods
3.1 Recruitment of participants
A community centered approach known as Stay and Play initiative will be developed in partnership with parents and teachers. The initiative will be pilot tested for a period of a year among a select group of students drawn from 12 schools in Buffalo city. The participants will be aged between 12 and 15 years. In line with the statistics which indicate the prevalence of child hood obesity is more pronounced among Hispanic and African American children, the study population will be made up of: 38% Hispanics, 29% African Americans, 15% Caucasians, 14% biracial children and 4% multiracial children. All children within the ages of 12 and 15 in the participating schools were eligible for participation. The participants were selected through systematic sampling.
3.2 Treatment of participants
The participants will have their weight and height measurements taken prior to the commencement of the study. They will then undergo a rigorous training in order to acquaint them with the details of the program. The participants will remain in school every day for two hours and play. The ones in the control group will be allowed to go home but will be required to document their activities after school.
3.3 Data collection
Multiple methods of assessments will be used to determine the outcome of participating in the Stay and Play program. Survey questions will be administered to the teachers while the participants will document their experiences. Focus groups will discuss the impact of having children engage in physical exercise after school.
3.4 Data analysis
The analysis of the data will be carried out using SPSS version 13.0. Mc Nemar’s test will be used in the comparison of differences in the participants who are obese while they were on other intervention programs and while they were participating in the Stay and Play program. Paired t-tests shall be used in comparing the pre and post intervention differences. The following measures will be considered: the child BMI, physical activity and attitudes.
3.5 Control of confounding factors
In order to control confounding variables such as the games that the participants engage in and the level of participation, the researcher will ensure that all the participants play the same set of games throughout the period of the study.
References
Campbell, K., & Hesketh, K. (2007). Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obesity review , 327-338.
Centre for Disease Control and Prevention. (1996.). Physical Activity and Health: A Report of the Surgeon General. Atlanta, Ga: : National Center for Chronic Disease and Prevention and Health Promotion;.
CDC . (2007). The Obesity Epidemic and New York Students. Retrieved January 10, 2014, from Centers for Disease Control and Prevention:: <http://www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_new_york_obesity.pdf>
Daniels, S., Arnett, D., & Eckel, R. (2005;). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111 , 1999–2002.
Davison, K. K., Jurkowski, J. M., Li, K., & Lawson, S. K. (2013, ). A childhood obesity intervention developed by families for families: results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity 10(3) .
Dietz, W. (2004). Overweight in childhood and adolescence. . New England Journal of Medicine , 855-857.
E.Waters, Silva-Sanigorski, d., Hall, B., T.Brown, Campbell, K., Y.Gao, et al. (2011). Interventions for preventing obesity in children. Cochrane Data Base (12) , np.
Ogden, C., Carroll, M., Kit, B., & Flegal, K. (2012;). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. . Journal of the American Medical Association 307(5): , 483-490.
Ogden, C., Flegal, K., Carroll, M., & Johnson, C. ( 2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA , 1728–1732.
S.Anderson. (2009 ). Prevalence of obesity among US preschool children in different racial and ethnic groups. . Arch Pediatr Adolesc Med , 163(4) , 344-348.
S.Daniels. (2006 ). The consequences of childhood overweight and obesity. Future Child , 47-67.
Wolf, A., & Colditz, G. (1998). Current estimates of the economic cost of obesity in the United States. Obesity Research 6(2) , 97–106.
