Strategies for Promoting Health or Managing Disease

Obesity

A website for Current Nursing touts a health promotion model as espoused by Nola J. Pender, a former professor of nursing at the University of Michigan. The model's focus is on three areas: 1) individual characteristics and experiences, 2) behavior-specific cognitions and affect, and 3) behavioral outcomes (Current Nursing, 2011). Additionally, the model touts the fact that each individual has unique personal characteristics and experiences that will affect their actions and their health. Employing the Pender health promotion model concerning obesity will necessarily entail understanding each individual's motivation for participating in the study, and gearing the study towards those motivations.

It might be a simple matter to understand the motivating factors an obese person will be feeling regarding participation in the study, but to prepare an individualized course of action for each individual would likely entail a lot more time and expense than developing a more broad based approach that will hopefully include the vast majority of experiences by those who are suffering from obesity and its effects.

A number of other studies have shown that the obesity problem is not a small one. One recent study found that "In the United States, childhood obesity is on the rise; the percentage of obese children aged 6 to 11 more than doubled in the past two decades, increasing from 6.5% in 1980 to 17.0% in 2006" (Li, Hooker, 2010, p. 97) while in England "the level of overweight and obesity for children aged 7 -- 11 was less than 10% in the mid-1970's but it exceeded 20% for girls and 15% for boys in 1998 (Lobstein, James, Cole, 2003) and in China the percentage of children aged 2 -- 6 who were obese increased from 1.5% in 1989 to 12.6% in 1997 (Luo, Ju, 2002).

The study will, therefore, attempt to discern the most educational and efficient manner in which to develop an educational diet and exercise program that will address the vast majority of individuals who are suffering from the effects of obesity, or at the very least, are categorized as being obese.

The study will also incorporate modeling which consists of the manner in which a nurse or educator seeks to understand the client's personal and unique model of his or her world, and role modeling which is the process in which the nurse or educator nurtures the individual with the objective of attaining and maintaining a positive and healthy lifestyle. According to the theory of role modeling; the patient understands and knows what works best for that individual and the nurse or educator works within the patient's personal guidelines.

Critical Factors

The critical factors facing the obese in today's society are the negative health effects that take place within their bodies. These negative health effects can be both physical and psychological in nature. The physical effects of obesity include; shortness of breath (asthma), hypertension, lowered fecundity, shorter life spans, higher disease contraction and overall poor health. Psychologically the person suffering from obesity will often times have a negative aspect regarding his or her own world, a depressive nature requiring medical treatment, or a perspective on life that affects the person's overall productive nature. Other critical factors can include the cost of the person's healthcare and the medicines employed to cope with the health effects of obesity.

A recent study determined that "one side effect of an aging population is an increase in the prevalence of obesity, metabolic disorders, and neurodegenerative orders, diseases that are likely to co-occur" (Aitlhadj, Avila, Benedetto, Aschner, Sturzenbaum, 2010, p. 20). It what the study found is true, another critical factor would be how obesity affects the onset of other diseases and health issues.

Study objectives

The study seeks to promote an enhanced level of healthy living for the study participants both individually, and as a group. It is hoped that the enhanced level of healthy living will influence not only the study participants but will also influence other individuals as well, including participant's friends, family and fellow students.

Additionally, the study seeks to document the results of the educational program and process as it is presented to the participants. Creating a program that could have lifestyle changing effects on the involved individuals is a complex and time consuming endeavor but one that could have long-lasting, positive influence on the individual suffering from obesity. The study seeks to create such a program while documenting the results in order to improve upon the program and present the improved product to additional members of society who might benefit from its inception.

Another objective of the study is to create a program that may be implemented in other schools and school systems across the United States; a program that entails healthy eating and regular exercise to combat the onslaught of overweight and obese students.

By focusing on the student population it is hoped that the study will generate interest and enthusiasm amongst other schools and institutions.

The study's main objective therefore is to create a program that can be implemented in an easy manner in a variety of situations, for any number of individuals. A recent 2011 study determined that the "worldwide increase in obesity is related to changes in eating patterns and reduced physical activity" (Siegrist, Hanssen, Lammel, Haller, Halle, 2011, p. 259) and a number of programs have been developed to address both problems. In the Siegrist et al. study the primary focus was to increase the number of days per week that the participants were active. The study defined activity as more than 60 minutes per day in which the student took part in physical activities. The study concluded that their "intervention can easily be integrated in the daily routine of schools and that it proves to be an effective means to increase the physical activity levels of children in school and at home" (p. 65). However, other studies have not been as optimistic and one evidence-based review conducted in 2008 showed that "reviews on school-based childhood obesity prevention programs have so far been unable to show clear evidence for the efficacy of intervention programs, limited by the small number of published studies and by methodological concerns" (Kropski, Keckly, Jensen, 2008). It is hoped, therefore that this particular study will provide additional data to overcome those concerns while at the same time addressing the diverse and specific needs of a student population that has become a much more weighted subject than in previous generations.

Diverse population

The specific needs of the student population which this study seeks to influence are very diverse based upon the melting pot concept which plays a large role in the nation's educational system.

Since the study is taking place using schools and students from a variety of areas, the disparities evidenced by those demographics should be examined. Disparities in income levels, family styles and home cultures are all relevant factors in providing a program that addresses such a personal item as being overweight or obese. A comprehensive intervention should take into consideration all those aspects and more. A recent study found that "many educational researchers charge that it takes a comprehensive school reform to raise student achievement levels" (Durden, 2008, p. 403) and that is true of this study as well; the study will have to take a comprehensive approach in order to raise student's level of awareness regarding the way in which they prepare and consume food, as well as the amount and types of exercise that can be undertaken to assist in losing or maintaining a healthy weight. Student needs will also be addressed by the study, including providing pertinent information in an easily understandable manner. An easily understandable manner may well entail providing charts and posters that use cartoon graphics with bright, eye-pleasing colors and information in both English and Spanish. The study will use as its model for assessment a number of comprehensive school reform approaches which should provide the study with a foundation that will allow for effective teaching and assessing tools in the educational arena. A comprehensive approach that follows the U.S. Department of Education's standards will include (but not be limited to) employing the following items: 1) proven strategies and methods for student learning that is based on scientific research and practices that have been successfully used in other schools, 2) identifying student needs through a vigorous assessment, 3) providing an opportunity for continuing development by teachers, 4) provides measurable goals, 5) is supported by staff and administrators, 6) provides an avenue for parent involvement, 7) and provides for assessment of the study's goals and objectives both before and after the instruction is completed (U.S. Department of Education, 2004)

Implementing the plan

The manner in which the study approaches the gathering of the data will necessarily have to be very circumspect, while at the same time being creative and fun in order to reach the students in an effective a manner as possible. The first step will be to conduct an assessment of the participant population. A number of schools chosen at random will receive surveys in the mail to distribute to their students. The surveys will measure the percentage of students perceived to have a problem with overweight or obesity issues. Once that percentage has been ascertained, the students will be given the opportunity to participate in regular sessions that will instruct them on the importance of a healthy diet and exercise.

Creativity will be a must when attempting to instruct students. Some of the creative strategies that will be employed during the study will include providing samples of different types of foods that the students might not be experiencing in their homes. Samples can come from a variety of cultures and hopefully will also be presented by different students. The students can then discuss with their peers not only how the foods are prepared but the nutritional values of the foods as well. Parents will be invited to participate as well by presenting to the students traditions and values and how the food they prepare for their families adhere to those traditions. In addition, exercises will be presented to the groups of students by volunteer instructors who understand the importance of a balanced approach to fitness.

It is hoped that using this interactive approach to food and exercise will increase the student's knowledge and awareness to the importance of the program, while at the same time keeping the educational environment one of learning and fun.

It is also important to remember that students who may be afflicted with obesity and overweight issues might also be experiencing psychological problems. A 2009 study determined that as obesity treatments become multidimensional in aspect "the need for attention to psychosocial factors and the involvement of mental health providers increases" (Davin, Taylor, 2009, p. 716). The study also determined that the providers of health services should have a comprehensive understanding of obesity's physical, psychological and social basis in order to ensure proper assessment and treatment. In a group setting the psychological aspects are certainly forefront, complement that environment with a student environment (especially young students), and the overall importance of the psychological influences grows even stronger.