Using Health Behavior Models to Address Obesity among School Children The Health Belief Model

HEALTH BELIEF MODEL APPLICATION

Using Health Behavior Models to Address Obesity among School Children

Introduction

The number of overweight school children has significantly increased over the last few decades. Data from the Centers for Disease Control and Prevention – CDC (2021) indicates that approximately 13 million school children in the U.S. could be deemed obese. This essentially means that the prevalence of obesity at present among this age group happens to stand at 18.5% (CDC, 2021). To a large extent, this is a clear indication that something needs to be done urgently to salvage the situation. This is more so the case given that according to the CDC (2021), obesity puts children at significant risk of poor health. Obesity could also result in various other issues revolving around mental health and wellbeing. This is more so the case given that as Jelalian and Steele (2008) point out, “overweight children are more likely to be teased by their peers or to develop low self-esteem or body image problems” (p. 311). Further, there is evidence indicating that overweight and obesity in childhood is likely to be carried on to adulthood.

In adulthood, obesity has been closely linked to several leading causes of death (Kirch, 2008). These are inclusive of, but they are not limited to; certain kinds of cancer, stroke, heart disease, as well as diabetes. It therefore follows that we have all the motivation to implement strategies to reduce obesity rates across the nation. It would be prudent to note that according to Kirch (2008), studies have in the past linked obesity to a wide range of factors including, but not limited to; lack of physical activity and poor food choices (i.e. consumption of high simple carbohydrate diets). As the author further points out, genetics have also been shown to play a role – effectively meaning that a child or individual whose parents are obese is also likely to be obese. All these factors should be taken into consideration in efforts to address obesity among school children.

There are a wide range of theories that could be applied in the development of a program that aims to reign in obesity amongst school children. Models which could be taken into consideration are inclusive of, but they are not limited to; the health belief model, the transtheoretical model, the social ecological model, and the social cognitive theory. This indicates that to a large extent, there is no standard model routinely applied or deployed in behavioral change as well as health education and promotion efforts. In the present exercise, the health belief model will be taken into consideration in efforts to address obesity among school children.

The Health Belief Model

This particular model, according to Glanz, Rimer, and Viswanath (2015), happens to be one of the most utilized models in efforts to not only comprehend, but also understand health behaviors. Indeed, it has been defined by the authors as “one of the most widely recognized conceptual frameworks for creating healthy behaviors by focusing on positive behavioral change at the individual level” (Glanz, Rimer, and Viswanath, 2015, p. 211). For this reason, I am convinced that this particular model would come in handy in enabling us to better comprehend and chart the most viable intervention measures to be implemented on this front. In the present setting, the model will be used to promote education and awareness programs at school aimed at motivating school children to embrace better eating habits and participate in physical activities (i.e. by joining an athletics club). More specifically, the education and awareness program will be firmly rooted on the HBM model and will be focused on bringing about behavioral change among school children aged between 6 and 11 years, i.e. those in grade 1 to grade 6. The education and awareness programs will be incorporated into the curriculum. Towards this end, the various components of the Health Belief Model have been captured below in the form of a checklist that also incorporates ideas for implementation.

Implementation

In Brief

Issue: Obesity among School Children

Demographic Variables: School children aged 6 to 11 years

Course of Action: Education and awareness programs incorporated into the curriculum – with the key focus being to encourage school children to embrace better eating habits and participate in physical activities.

A: Construct: Perceived Severity

It is important to note that the probability that school children will embrace better eating habits and participate in physical activities will be determined by their understanding of the consequences of being obese. This is more so the case given that according to Bahar (2013), “perceived severity refers to the subjective assessment of the severity of a health problem and its potential consequences” (p. 377).

Educator Checklist:

There is need to see to it that the school children develop understanding of the seriousness of obesity and the impact it could have on their health and wellbeing. This could be accomplished by teaching the said children about the downsides of obesity.

Ideas for Implementation:

1. Start a discussion on what obesity is and what causes obesity. Ensure that there is a clear connection made between obesity and poor eating habits as well as lack of physical activities.

2. Ask school children to brainstorm 5 negative consequences of being obese

3. Share with the school children the effects that obesity has on the health and wellbeing of an individual. Explain more than 5 health effects of obesity. These could be inclusive of, but they are not limited to; certain kinds of cancer, stroke, heart disease, gallbladder disease, as well as diabetes.

4. Share with the school children the social as well as psychological effects of being obese, and how obesity could impact the social and mental health or wellbeing of an individual. Touch on issues relating to lower quality of life, social discrimination, etc.

5. Make the school children understand that childhood obesity predisposes them to obesity in adulthood and show a video of a person struggling with obesity and pointing out how the disease has negatively impacted their lives. There are plenty of documentaries of persons struggling with obesity.

6. Ask the school children to think of the consequences (for two minutes) highlighted. Follow-up discussion could in this case be a recap of the impact obesity has on our health and wellbeing.

B: Construct: Perceived Susceptibility

In this case, there is need to understand that the school children will only embrace a recommended course of action if they deem themselves to be at risk of suffering the consequences of being obese – as has already been highlighted above. According to Bahar (2013), “perceived susceptibility refers to subjective assessment of risk of developing a health problem” (p. 382).

Educator Checklist:

Assess whether the school children are able to correctly perceive their vulnerability to obesity.

Ideas for Implementation:

1. Get the school children to indicate in an index card their position (Yes or No) on whether or not they believe they could be obese. The school children do not have to indicate their names on the index cards.

2. Collect the index cards.

3. On the basis of the overall responses as contained in the index cards, ensure that the school children are able to make a connection between obesity and poor eating habits as well as failure to engage in physical activities.

C: Construct: Perceived Benefits

In this case, if the school children do not perceive the benefits that they are likely to derive from maintaining the ideal/normal body weight, they will not embrace healthy eating habits and engage in physical activities. As Hayden (2009) points out, “perceived benefits refer to an individual’s assessment of the value or efficacy of engaging in a health-promoting behavior to decrease risk of disease” (p. 66).

Educator Checklist:

Ensure that the various benefits of maintaining the normal body weight or lean body frame are presented in a clear and easy-to-understand manner.

Ideas for Implementation:

1. Describe the desired actions – i.e. adoption of a healthy diet and engagement in physical activities – in manner that is clear and easy to understand for the concerned age group.

2. Establish a connection between the desired actions, the maintenance of normal weight and optimal health.

3. Highlight the various benefits of optimal health. Highlights in this case could be inclusive of: avoidance of diseases, feeling good about oneself, appearing attractive, having more energy, etc.

D: Construct: Perceived Barriers

If the school children in this case are convinced that embracing the two options suggested (adoption of a healthy diet and engagement in physical activities) is going to be an uphill task, they are unlikely to take action towards decreasing their chances of being obese or making efforts to maintain the ideal body weight. In the words of Hayden (2009), “even if an individual perceives a health condition as threatening and believes that a particular action will effectively reduce the threat, barriers may prevent engagement in the health-promoting behavior” (p. 79).

Educator Checklist:

Ensure that the school children are capable of identifying barriers to action at a personal level. Also, seek to advance or extend the relevant support to ensure that the identified barriers are eliminated.

Ideas for Implementation:

1. Ask the school children to brainstorm the various difficulties or challenges that they think they are likely to encounter. Clearly identify and list the common barriers highlighted.

2. Discuss with the school children some of the most viable strategies to reign in the challenges identified.

3. Ensure that the school children have info on where they are to get support should they be in need of the same. Sources of support in this case could be inclusive of, but they are not limited to; parents, teachers in school, the PE instructor, etc.

4. It is necessary to ensure that support in this case is ongoing. Towards this end, there would be need for parental involvement. Institutional measures would also be set up so as to ensure that school children are given the relevant assistance as well as incentives every step of the way – with the focus in this case being the elimination of common barriers to the full embrace of the two courses of action suggested (i.e. adoption of a healthy diet and engagement in physical activities).

E: Cues to Action

This happens to be an addition that was made later on to the Health Belief Model components already highlighted above. Cues to action could, in basic terms, be defined as triggers that would come in handy in efforts to ensure that the school children in this case are prompted to partake in the recommended course of action so as to root out obesity. Bahar (2013) defines ‘cues to action’ as “the stimulus needed to trigger the decision-making process to accept a recommended health action” (p. 326).

Educator Checklist:

Ensure that the school children are provided with cues to action.

Ideas for Implementation:

1. From time to time, the learning institution should organize events (such as sporting events) that seek to further motivate or promote the call to action, i.e. in as far as engagement in physical activities is concerned.

2. Encourage parents to reinforce the message at home by, amongst other things, pointing out to their children the harms of poor food choices. Parents could also be encouraged to purchase texts and resources that aid their children in the further discovery of what comprises healthy eating habits.

3. Within the school grounds, posters could be placed in strategic points to serve as information sources as well as reminders of the need to embrace the courses of action discussed.

4. Avail to school children a number of innovative items - such as water flasks, school bags and handkerchiefs – containing reminders (visual) of the course of action discussed/highlighted.

F: Self-Efficacy

This, like cues to action, is yet another an addition that was made later on to the four Health Belief Model components. In this context, self-sufficiency has got to do with the perception that the school children have with regard to their ability or capability to embrace the course of actions highlighted (i.e. adoption of a healthy diet and engagement in physical activities) successfully. The relevance of this particular element cannot be overstated in this context owing to the fact that as Glanz, Rimer, and Viswanath (2015) observe, “a person’s faith in his ability to do something has an enormous impact on his actual ability to do it” (p. 97).

Educator Checklist:

Assess whether school children are confident about their ability to implement the courses of action discussed.

Ideas for Implementation:

1. Chart school children participation in extracurricular activities

2. Discuss with school children the various difficulties they may have encountered in attempts to implement the two courses of action highlighted

3. Take deliberate steps to reinforce or encourage behaviors that are consistent with the courses of action discussed.

Empirical Support for the Selected Model

In the final analysis, it would be prudent to note that according to Orji, Vassileva, and Mandryk (2012), the model selected in this case, i.e. the Health Belief Model (HBM), has proven effective on multiple fronts from the moment it was conceptualized – back in the 1950s. Indeed, as the author further points out, “HBM happens to be one of the most widely used and well-tested models for explaining and predicting health-related behavior” (p. 43). The model has been particularly effective in efforts to come up with practical interventions to modify behaviors that are health-related. Hayden (2009) is also categorical that various studies have indicated that HBM remains one of the most viable approaches in efforts to establish healthy behaviors. This, according to the author, is more so the case given that significant focus is apportioned to behavior changes that are positive at the individual level. It is on the basis of the available empirical support for HBM that the said model was selected.

It would, however, be prudent to note that a number of limitations have been identified in as far as the health belief model is concerned. A total of two limitations of the model will be highlighted below. The limitations have been selected on the basis of how applicable they are to the present undertaking. Thus, they are not the only limitations associated with the Health Belief Model in the wider sense.