Childhood Obesity Summary of Public Health Program Capstone Project

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Childhood Obesity

Summary of Public Health Program Plan and Purposes of Evaluation

Obesity is a growing problem in the United States for both children and adults. Over the past 30 years, obesity has more than doubled among U.S. children ages 2 to 5 and nearly tripled among young people over the age of 6 (Obesity, 2011, NIH). Low-income and minority children are statistically more likely to suffer this condition: although the reasons for this are complex and difficult to determine, a lack of access to healthy, affordable food and places to exercise as well as cultural factors such as chronic food insecurity are implicated as factors. On a personal level, obesity can have devastating psychological and physical consequences for the individual; on a social level, an increase in obesity means that healthcare costs for the chronic conditions associated with obesity, including diabetes and heart disease. Obese children are more likely to become obese adults and the earlier children have weight problems, the longer their health problems will be a burden to themselves and to others.

The title of my program will be: "Healthy communities: Building health from the ground up." Until recently, most intervention programs have focused on changing students' lunches and exercise habits in school as a way of lowering BMI. However, this ignores the important influence the home can have on children's eating habits. Children who are not supported by their family in their healthy eating habits may still bring unhealthy foods to school, snack on unhealthy foods after school, and be served high-fat, high-sugar foods at home. The program will attempt to create a proactive strategy of change that reeducates the entire family and works with the family to create an eating strategy that is affordable and feasible.

Given the importance of early intervention, middle school children at two local inner-city public schools with a high percentage of obese children will be the focus of the program. Both children and their parents will participate in the program. The mission will be to create a 'healthy household' for both children and parents. Stakeholders include the participants (children and adults); the community as a whole and also the entire United States, given the need to reduce obesity in high-risk populations. Problems may arise given that lifestyle changes are inevitably difficult to orchestrate and economic problems as well as typical dieter's cravings must be dealt with -- even families that want to eat healthy may struggle because they are unable to afford certain foods. Working with families' budgets as well as nutritional education is essential.

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Reference

Obesity. (20111). National Institutes of Health. Retrieved from:

http://www.nih.gov/about/discovery/allages/obesity.htm

Week 2: Program Evaluation Plan -- Goals and Objectives, Evaluation Design, and Types of Evaluation

Because weight loss is usually a slow process, and for children obesity reduction may involve waiting until the child 'grows into' his or her weight rather than actually loses weight, tracking the success of this obesity program solely by weight loss is inherently problematic. Instead, a more useful strategy for short-term goal-setting is to track the changes made by different families involved in the program. Program leaders will set goals regarding agreed-upon changes in the family's eating habits and grocery buying, and the ability of families to meet these goals (such as including a green vegetable at every meal time, switching to lower-fat dairy products, using fruit instead of desserts as treats) will be counted as part of the success rate of the program. Each goal will be given a point value. In the long-term, it is reasonable to track reduction in BMI for children and adults as a sign of program success. The ideal impact in the long-term is a meaningful reduction in BMI.

To evaluate the program requires comparing the student-participants to a control group of demographically similar students whose families did not undergo the intervention. The control group would be comparable in terms of age and socioeconomic status. On a longitudinal basis, the control group and the experimental group would be regularly compared at annual intervals in terms of their BMI and family eating habits (Evaluation design, 2013, The World Bank). This would be called a quasi-experimental design, given that to obtain permission and to ensure logistical feasibility, the experimental group would be selected by design rather than randomized as would the control group, but there would be sufficient similarity between the two groups to ensure a meaningful comparison. Studying people in such a fashion can be difficult, however, given that families are functioning 'in the field' of life, not under controlled circumstances in a laboratory. Additionally, there is always the question that while 'an intervention' may work, because there was no intervention at all in the control group, the intervention may merely be 'better than nothing' and not necessarily the most optimal expenditure of finite resources.

Another evaluation method which could be deployed is a non-experimental, qualitative design in which the program participants could offer their input about the efficacy of the program in the form of interviews. They could discuss they perceived the intervention changed lifestyle, perceptions of food, and overall health......

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