Prevention of Obesity in School Children

¶ … Focus Group Results to Inform Preschool Childhood Obesity Prevention Programming and Developing a Coordinated School Health Approach to Child Obesity Prevention in Rural Appalachia: Results of Focus Groups with Teachers, Parents and Students

These research projects, conducted by McGarvey et. al (2006) and Schetzina et. al (2009) respectively, use focus groups to promote healthy weight and improved health status in children. The McGarvey study recruited volunteers from WIC clinics in Northern Virginia, while the Schetzina study used a local elementary school in northeast Tennessee as entry points for their intervention models. The aims of both studies was to enhance the community knowledge base about the negative effects of unhealthy eating habits as well as promote the health effects of physical activity and to mitigate the current epidemic of childhood obesity.

Discussion

The McGarvey et. al (2006) intervention employed Social Cognitive theory and Self-efficacy theory as the theoretical framework for their study. Social Cognition theory holds that personal attributes, social-environment factors and personal factors all can contribute to or impede individual health behavior change. Self-efficacy describes one's perceived ability to act to make changes. The Schetzina et. al (2009) intervention was modeled on the Centers for Disease Control and Prevention Coordinated School Health (CSH) Program and included a community-based participatory research approach to address the health needs specific to the target population.

The McGarvey et. al (2006) study involved a total of 24 current or former WIC clients and 1 Vietnamese mother who was not yet a WIC client. All participants were women except for one White man. Focus groups were conducted with low income African-American, white non-Hispanic, Hispanic, and Vietnamese parents to collect cross-cultural perspectives on: infant and child feeding practices, childhood overweight, healthy dietary intake, physical activity and inactivity, and infant feeding information sources. A content analysis of the data yielded three main themes common to all four groups: 1) lack of awareness of the relationship between increased physical activity and health, 2) the use of food to influence behavior, and 3) the loss of parental control over feeding when a child starts child care or school, and 4) revealed perspectives on age appropriate food, infant satiety, overweight and information sources that were specific to each group. The study found that interventions that enhance parent self-efficacy and build on themes that are specific to ethnic groups toward preventing childhood obesity are needed. Additionally there is a need for culturally appropriate information for governmental nutrition programs that is in the client's own language and takes into account ethnic differences in beliefs and traditions.

The Schetzina et. al (2009) focus group consisted of teachers, parents and fourth grade students. The CSH model included 8 components: nutrition services, physical education, health services, health education, counseling/psychological/social services, family/community involvement, health promotion for staff, and healthy school environment. Results revealed that these community stakeholders were concerned about the problem of child obesity and supported the idea of their school doing more to improve the diet and physical activity of its students. All groups thought that foods and drinks consumed by students at school should be healthier and that they should have more opportunities for physical activity. Additionally, limitations of the school environment, academic pressures, and lack of parental support were cited as potential barriers to making such changes. Parents were most concerned that their children were not getting enough to eat and they and the teachers were not in favor of body mass index screening at the school. Parents were in favor of increasing physical activity during school and thought that parent volunteers should help students select foods in the cafeteria. Students cited examples of how diet and physical activity affect their health and school performance, and thought that they should have more physical education time and recess.