Nursing Assignment: School-Based Intervention Program in Reducing the Prevalence of Child Obesity

Question

Task: The aim of this nursing assignment is to conduct a literature review based on Childhood Obesity and consider how well the evidence addresses the question and the implications for clinical practice.

Answer

Introduction:
Childhood obesity, focused in the present scenario of nursing assignment, has been identified as one of the most commonly occurring and severe public health issues in the current era. It is known to impact most of the organ systems of the suffering child such as lungs, heart, bones, muscles, kidneys as well other associated parts. It has its chief impact on the regulation of hormones in the body whichoftenincreases the risk of diabetes. The condition of childhood obesity has been impacting the youth of the nation with an increased risk of remaining obese or overweight throughout adulthood (Nickel et al., 2021, p.p. 1). The continuation of the state of obesity often hampers and disrupts the ability to move to cause severedisability and sustain life-threatening illnesses. School-based interventions have been taking a greater step against childhood obesity and ensure reducing the prevalencerate of childhood obesity in students of pre-and middle school in the United States (Bustos et al., 2016, p.p 1217). One of the significant and considerateschool-based interventions was the Planet Health Program, which was a 2-yearschool-based program focusing on reducing the rising rate of obesity among the students belonging to middle school within the United States (Xu et al., 2020, p.p 2).

Thus, focusing on the current evidence on childhood obesity and the research questionhighlightedin assessment 1 part A, the following assessment will be carried out using literature evidence from different electronic databases. The literature review will help in assessing the current literature available on the condition of childhood obesity and the impact of a school-basedintervention in minimizing and controlling the prevalence of the condition.

Research question:
In school going children from 8–15-year-old, what is the impact of the school-based intervention program in reducing the prevalence of child obesity?

Literature analysis:
One of the reports of the National Health and Morbidity Survey (NHMS) 2017 highlighted the rising prevalence of overnutrition among the children of Malaysia ageing between 10 to 12 years. It was found that the rate of overnutrition within these children are much higher than the prevalence of undernutrition as the statistics show that 16.3 per cent of the children were obese while 17.4 percentage were suffering from obesity. Whereas the prevalence of undernutrition focuses on stunting among 7.8 per cent of the children and thinning among 6.7 percentage of the overall child population. According toTeo et al., (2019), the prevalence rate of overnutrition was near about 33.7 percentage among the children in primary school which was higher than those children who were in secondary school accounting for 28.5 percentage. The term malnutrition explains the condition of excessive, low intake or imbalance in the proper intake of nutrition and energy by an individual, where condition such as undernutrition and overnutrition occurs as a complex outcome of nutrition imbalance (Teo et al., 2019, p.p.1). Overnutrition is known to have a major impact on the health of the suffering individual as it promotes the condition of obesity along with other mental health complications such as depression, social withdrawal, and many more. It was found from the research that, there are several different nutrition-based school interventions functioning to support the children within the age group up to 8 years along with children suffering from obesity and overweight with better health. These programs focus on improving and enhancing the knowledge and understanding along with the regular practice of intaking proper nutrition to ensure better health along with physical activity (Teo et al., 2019, p.p. 2).

According to the World Health Organization, implementation of a significant school-based intervention or programmes to promote healthy eating, nutritional education as well as physical activity has a potential role in addressing the rising issue of overnutrition and obesity among school-going children (Weihrauch-Blüher et al., 2018, p.p. 263). It has been reported that the development and implementation of a standard for the meal that is to be provided to the students within the school premises should highlight the intake of whole grains and eliminate the sale and delivery of unhealthy high sugar and fat content food (Elinder et al., 2018, p.p 459). It is necessary that school premises must deliver foods that meet the national standard of food that is essential for school ging students in rode rot ensure healthy earrings and minimize the risk of obesity. Also, school-based interventions should not only focus on healthy eating but must ensure regular involvement of children in physical activity to main tin a healthy body mass index with reduced risk ofoverweight (Liu et al., 2019, p.p. 2). In the study carried out byHabib-Mourad et al., (2020), the aim was focused around to assess the significance of school-based intervention against childhood obesity conducted and provided by trained schoolteachers. The study was carried out with a comparison of the servicedeliveredby a non-professional school teacher and the service provided by a nutritionist. In the research trial, it was found that when the programme was delivered by the trained school teachers, the intake of healthy food in breakfast and meals were significantly increasing. The intake of crisps was also reduced, but it was found that intake of fruits and vegetables by the children increase as the nutritionist took an active part in the school based intervention. Though the study trial was unsuccessful in implanting and assessing change in the involvement of students in physical activity. From the research, it was found that school-based interventions have significance in promoting better health and healthy diet as teaches involves helps students link with the aim and protocol of the intervention. Increased number and consideration of students is sought towards intervention as teaches are associated with delivering healthy meals and other resources to these school students (Habib-Mourad et al., 2020, p.p. 2).

Evidence addressing research question:
The above-conducted literature analysis provided an insight into the current prevalence of childhood obesity as well as the implicating of school-based intervention against the rising issues. the above discussion provided an understanding and insight about the significance of school-based intervention in the case of childhood obesity and helped in addressing the research question developed in assessment 1 part A. The literature evinces in the researcharticlecarried out byMetgud, Hungund& Kulkarni, (2018),stated that change in dietarypractices and inactive routine has a potentialimpact on developing childhood obesity in children belonging to the age group 6 to 12. It has been found the World Health Organization has reported that body mass index is known to be one of the necessary indicators for the risingstate of overweight and obesity (Okely & Hammersley, 2018, p.p. 5). In such conditions, school-based interventions involvingmulticomponent have a significant role in managing the increasingbody mass index and recovery from the rising risk of obesity in school-going children. In the research finding it was found that involving a healthynutritional diet in school meals as well as regularphysicalactivity as school-based intervention significantlyreduces skinfoldthickness and manages body mass index (Metgud, Hungund& Kulkarni, 2018, p.p 146).

According to World Health Organization, it is necessary for children and adolescents to be provided with moderate-to-vigorous (MVPA) physicalactivity for 60min each day in order to manage and maintain a healthy body mass index and reduce the risk of obesity. In order to ensure daily physical activity along with a healthy diet, school-based interventions have a significant role to play as they have an aim to provide a healthy diet and physical activity, education, awareness as well as training to maintain the routine in their daily lifestyle within or out the school premises (Wright et al., 2016, p.p. 1078). Thus, it is recommended that to achieve health benefits and a healthy body mass index, it is necessary to initiate the implementation of school-based intervention with regular exercise and a healthy diet within school-going children as an intervention against obesity (Yuksel et al., 2020, p.p. 347).

Implications on nursing and midwifery practice:
The research and literaturefindings relating to school-based intervention programmes against the risingprevalenceof childhood obesityhas a significant role in nursing and midwifery practice. Nurses and midwiferyhave a significant role in providingawareness, education and assistance to children and their families suffering from obesity. These professionals can significantly play a necessary role in delivering school-based intervention against obesity by linking with the school authorities and social care providers to provide a healthy diet and necessary physical activity to children within the school premises (Heilok et al., 2021, p.p. 104008). Also, the evidence from the literaturereview may have a majorimplication on the role of the nurses and midwifery as they will understand the significance of the active participation of nurses in providing care and service to children with obesity. It is necessary that diet guidance and physical activity is promoted within the community to ensurethe delivery of service to every child (Gómez et al., 2018, p.p. 1531). Nurses can use the evidence and collaborate with the community care providers to provide obesity interventions to every child within the community. The nurses can use their skills and training and ensure better servicedelivery within the community to mitigate the rising issue of obesity (Tucker & Lanningham-Foster, 2015, p.p. 450). Thus, the evidence has a professional role in assisting nurses and midwives with their responsibility in delivering the proper professional guided school-based intervention.

Conclusion:
Thus, the literature analysis providedan in-depth insight into the rising issue of childhood obesity within the children between the age group 8 to 15 years within the premise of the United States. In order to conclude the literaturereview, it can be stated that school-based intervention has a significant role in minimizing the risk of obesityamong children. It was found from the review that school-basedinterventionsprovide children with an opportunity to seek better understanding, knowledgeas well as guidance about healthy eating and involvement in physicalactivity along with a healthy meal with whole grains. The assessment also helped in assessing the impact of school-basedintervention againstobesity as well as theresearchevidencehelpedinaddressing the research questions. It also helped in highlighting the significantimpact of the evidence in the role of nurses and midwifery practice the nursesand midwives can use this evidenceand support the children with better professionalservices to the children with obesity within the community.

References:
Bustos, N., Olivares, S., Leyton, B., Cano, M., &Albala, C. (2016). Impact of a school-based intervention on nutritional education and physical activity in primary public schools in Chile (KIND) programme study protocol: cluster randomised controlled trial. BMC public health, 16(1), 1217. https://doi.org/10.1186/s12889-016-3878-z Elinder, L. S., Patterson, E., Nyberg, G., & Norman, Å. (2018). A Healthy School Start Plus for prevention of childhood overweight and obesity in disadvantaged areas through parental support in the school setting - study protocol for a parallel group cluster randomised trial. BMC public health, 18(1), 459. https://doi.org/10.1186/s12889-018-5354-4

Gómez, S. F., Casas Esteve, R., Subirana, I., Serra-Majem, L., Fletas Torrent, M., Homs, C., Bawaked, R. A., Estrada, L., Fíto, M., &Schröder, H. (2018). Effect of a community-based childhood obesity intervention program on changes in anthropometric variables, incidence of obesity, and lifestyle choices in Spanish children aged 8 to 10 years.Nursing assignment European journal of pediatrics, 177(10), 1531–1539. https://doi.org/10.1007/s00431-018-3207-x

Habib-Mourad, C., Ghandour, L. A., Maliha, C., Awada, N., Dagher, M., & Hwalla, N. (2020). Impact of a one-year school-based teacher-implemented nutrition and physical activity intervention: main findings and future recommendations. BMC public health, 20(1), 1-7. Retrieved from: https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-020-8351-3.pdf

Heilok, C., Cobie, G., Melissa, D., Lisa, W., & Elizabeth, D. W. (2021). Nurse-led interventions in the prevention and treatment of overweight and obesity in infants, children and adolescents: a scoping review. International Journal of Nursing Studies, 104008.https://doi.org/10.1016/j.ijnurstu.2021.104008 Liu, Z., Xu, H. M., Wen, L. M., Peng, Y. Z., Lin, L. Z., Zhou, S., ... & Wang, H. J. (2019). A systematic review and meta-analysis of the overall effects of school-based obesity prevention interventions and effect differences by intervention components. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-12. Retrieved from: https://ijbnpa.biomedcentral.com/track/pdf/10.1186/s12966-019-0848-8.pdf

Metgud, D. C., Hungund, A. A., & Kulkarni, A. A. (2018). Effect of school-based intervention program for children with obesity: A randomized control trial. Indian Journal of Health Sciences and Biomedical Research (KLEU), 11(2), 146. Retrieved from: https://www.ijournalhs.org/temp/indianjhealthsci112146-2982047_081700.pdf

Nickel, N. C., Doupe, M., Enns, J. E., Brownell, M., Sarkar, J., Chateau, D., ... & Santos, R. (2021). Differential effects of a school?based obesity prevention program: A cluster randomized trial. Maternal & Child Nutrition, 17(1), e13009.https://doi.org/10.1111/mcn.13009

Okely, A. D., & Hammersley, M. L. (2018). School–home partnerships: the missing piece in obesity prevention?. The Lancet Child & Adolescent Health, 2(1), 5-6.https://doi.org/10.1016/S2352-4642(17)30154-2

Teo, C. H., Chin, Y. S., Lim, P. Y., Masrom, S. A. H., & Shariff, Z. M. (2019). School-based intervention that integrates nutrition education and supportive healthy school food environment among Malaysian primary school children: a study protocol. BMC public health, 19(1), 1-10. Retrieved from: https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7708-y.pdf Tucker, S., & Lanningham-Foster, L. M. (2015). Nurse-led school-based child obesity prevention. The Journal of School Nursing, 31(6), 450-466.10.1177/1059840515574002 Weihrauch-Blüher, S., Kromeyer-Hauschild, K., Graf, C., Widhalm, K., Korsten-Reck, U., Jödicke, B., ... & Wiegand, S. (2018). Current guidelines for obesity prevention in childhood and adolescence. Obesity facts, 11(3), 263-276.https://doi.org/10.1159/000486512

Wright, C. M., Duquesnay, P. J., Anzman-Frasca, S., Chomitz, V. R., Chui, K., Economos, C. D., Langevin, E. G., Nelson, M. E., &Sacheck, J. M. (2016). Study protocol: the Fueling Learning through Exercise (FLEX) study - a randomized controlled trial of the impact of school-based physical activity programs on children's physical activity, cognitive function, and academic achievement. BMC public health, 16(1), 1078. https://doi.org/10.1186/s12889-016-3719-0

Xu, H., Li, Y., Du, S., Zhang, Q., Liu, A., Sun, J., & Ma, G. (2020). Cost–utility and cost–benefit analyses of school-based obesity prevention program. BMC public health, 20(1), 1-7. Retrieved from: https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-020-09718-x.pdf

Yuksel, H. S., ?ahin, F. N., Maksimovic, N., Drid, P., & Bianco, A. (2020). School-based intervention programs for preventing obesity and promoting physical activity and fitness: A systematic review. International journal of environmental research and public health, 17(1), 347.https://doi.org/10.3390/ijerph17010347