Health Belief Model to Combat Obesity in 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 among this age group currently stands at 18.5% (CDC, 2021). This is a clear indication that urgent action is needed to address the situation. According to the CDC (2021), obesity puts children at significant risk of poor health outcomes. Obesity can also result in various mental health and wellbeing issues. 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). Furthermore, there is evidence indicating that overweight and obesity in childhood are likely to persist into adulthood.

In adulthood, obesity has been closely linked to several leading causes of death (Kirch, 2008). These include, but are not limited to, certain kinds of cancer, stroke, heart disease, and diabetes. It therefore follows that there is strong motivation to implement strategies to reduce obesity rates across the nation. According to Kirch (2008), studies have linked obesity to a wide range of factors including lack of physical activity and poor food choices — specifically, the consumption of diets high in simple carbohydrates. As the author further notes, genetics have also been shown to play a role, effectively meaning that a child whose parents are obese is also more likely to be obese. All of 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 developing a program aimed at reducing obesity among school children. Models that could be considered include, but are not limited to, the health belief model, the transtheoretical model, the social ecological model, and social cognitive theory. This indicates that there is no single standard model routinely applied in behavioral change or health education and promotion efforts. In the present paper, the Health Belief Model is applied in efforts to address obesity among school children.

The Health Belief Model

According to Glanz, Rimer, and Viswanath (2015), the Health Belief Model (HBM) is one of the most widely used frameworks for understanding health behaviors. The authors define it 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, the model is well suited for helping us comprehend and chart viable intervention measures in the context of childhood obesity.

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 — for example, by joining an athletics club. More specifically, the education and awareness program will be firmly rooted in the HBM and will focus on bringing about behavioral change among school children aged between 6 and 11 years (grades 1 through 6). These programs will be incorporated into the school curriculum. The various components of the Health Belief Model are presented below in the form of a checklist that also incorporates ideas for implementation.

Empirical Support and Limitations of the HBM

According to Orji, Vassileva, and Mandryk (2012), the Health Belief Model has proven effective across multiple fronts since it was first conceptualized in the 1950s. As the authors note, "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 developing practical interventions to modify health-related behaviors. Hayden (2009) similarly affirms that various studies have indicated that the HBM remains one of the most viable approaches to establishing healthy behaviors, owing in large part to its focus on positive behavioral change at the individual level. It is on the basis of this available empirical support that the HBM was selected for the present program.

It is important, however, to acknowledge that a number of limitations have been identified in relation to the Health Belief Model. Two limitations are highlighted below, selected on the basis of their relevance to the present undertaking. They do not represent the full scope of limitations associated with the HBM in the broader literature.

1. The HBM largely ignores individuals' beliefs and attitudes and the impact these could have on health behavior implementation. In the present undertaking, the model fails to take into account the school children's existing beliefs and attitudes, which may well determine whether or not they embrace the recommended courses of action.

2. The HBM does not account for key economic or environmental factors that may undermine efforts to implement the recommended behaviors. In the present scenario, economic constraints could make it difficult for some school children to follow through on the two actions. For instance, limited family resources could place certain healthy food options out of reach for some households.

Conclusion

In the present undertaking, efforts were made to increase perceived susceptibility to obesity among school children. This was necessary given that, as noted in the introduction, obesity among school children is one of the most significant public health concerns today. Approximately 13 million school children in the U.S. are classified as obese — and this figure does not include children who are classified as overweight but not yet obese.

The perceived seriousness of obesity was also highlighted throughout the program. This was done to ensure that school children have a basis upon which to anchor their motivation to maintain a healthy body weight. If children do not consider the consequences of obesity to be serious enough, they are unlikely to embrace the two recommended courses of action: adopting a healthy diet and engaging in physical activities.

Third, efforts were made to decrease perceived barriers while simultaneously increasing the perceived benefits for school children. If children were to conduct a cost-benefit analysis, the goal was for the scales to tip in favor of embracing the two recommended behaviors in order to maintain a healthy body weight and avoid obesity. Finally, the need to provide cues to action was addressed to ensure that school children were not only encouraged but also regularly reminded of the importance of pursuing the recommended behaviors. Deliberate actions were also taken to strengthen the school children's self-efficacy throughout the program.

Bahar, S. (2013). Health Behavior: Emerging Research Perspectives. Springer Science & Business Media.

Centers for Disease Control and Prevention – CDC (2021). Childhood Obesity Facts. https://www.cdc.gov/obesity/data/childhood.html

Glanz, K., Rimer, B.K., & Viswanath, R.K. (2015). Health Behavior: Theory, Research, and Practice. John Wiley & Sons.

Hayden, J.A. (2009). Introduction to Health Behavior Theory. Jones & Bartlett Publishers.

Jelalian, E., & Steele, R.G. (2008). Handbook of Childhood and Adolescent Obesity. Springer Science & Business Media.

Kirch, W. (2008). Encyclopedia of Public Health. New York, NY: Springer.

Orji, R., Vassileva, J., & Mandryk, M. (2012). Towards an effective health interventions design: An extension of the Health Belief Model. J Public Health Inform., 4(3), 43–57.