Developing a Coordinated School Health Approach to Child Obesity Prevention Essay

excogitationObesity is now become an epidemic among condition going adolescent adolescence in authentic countries. The prevalence rate of childishness fleshiness is comfortably high in build uped countries. Similarly, prevalence rate of obesity is potpourri magnitude in developing countries too (James 2004). It is estimated that there argon 250 million large pear-shaped deal live world vast (Seidell 1999). Obesity is associated with m either chronic sicknesss like hypertension, heart diseases, diabetes type 2 and even cause targetcer. So, development prevalence of obesity cerebrates increase global burden of chronic diseases which indirectly affects the status of global economy. Obesity caused virtually 9% of summate annual medical expenditure in the US in 1998 (Finkelstein, Fiebelkorn and Wang 2003). check to Ogden et al. (2006), 19% of children aged 6 to 11 years ar obese and 18% are overw 8 in the US. Given the grand multitude of devastating wellness, social and economic consequences of obesity, the continuing escalating rates of childhood obesity, non least among rural dwellers in the USA, is a great public wellness concern. Consequently, lot of attention has been paid to the need for impressive cakes computer designs. Of such programs is fetching with Wellness platform in Appalachia- a rural area in the US. Based on the evaluation report of the architectural plan by Schetzina et al (2009), this paper reviews activities, nestle, framework and theories of the programme. Winning with Wellness ProgrammeThe shoal-establish wellness programme Winning with Wellness was introduced as a archetype project in an elementary discipline in rural Appalachia as a vogue to push wellnessy eating and sensible body process for elementary instill children (Schetzina et al. 2009). The programme was based upon the coordinated trail wellness (CSH) accession that was developed in 1988 (TN Gov 2010). The aim of the pilot progra mme was to prevent obesity which is a major problem, particularly in rural areas in the US (Schetzina et al. 2009). The programme was supported financially by community collation and it was implemented together with the groom based programme in Tennessee (TN Gov 2010). at that place are eight variant components to improve the modus vivendi of students and their families wellness bringing up wellness go counselling, psychological and social services nutrition physical education develop supply wellness sizable instruct environment, and student, parents and community involvement (CDC 2008). The school authority established indoor and outdoor take the airing trails to enhance physical action among students. Teachers trustworthy a training to guide the students properly in such physical activity. A proper nutrition service to promote wellnessy eating among students was installed such that a registered dietician was assigned to develop Go, Slow and Whoa programme which cate gorized the foods according to their nutritionary value and conscious the school food service coordinator to supply light diets. Teachers were responsible to set up schooling about the Go, slow and Whoa to students to improve their intimacy about nutritional value of the food and this kind of lesson enable a student to divulge wellnessy and un healthy diet. aim administration also encouraged parents to answer their children to choose the healthy diet during lunch in school or at shell. Besides students, this health furtherance intervention also advocated teachers and staffs to cut a healthy life by increasing physical solve and taking healthy diet. A counselling and psychological service was lendable to develop personalized skill among the students about physical apply and participating lifestyle. This health forwarding intervention maintained all kind of good issues such as consent were fall uponn from both students and parents to participate into this pilot proj ect (Schetzina et al. 2009). Third and fourth graders participated in the programme, in total 114 children. formAs stated before in the evaluation report by Schetzina et al. (2009) Winning with Wellness Programme was based on the Co-ordinated School wellness (CSH) model. The latter was based on the traditional three-component model, where a school health program is defined in name of health instruction, health services, and a healthful environment. This model was expanded and eight essential components were suggested nutrition services, health education, physical, education, school health services, counselling and psychological services, healthy school environment, health promotional material for school staff and participation of community. Diane Allensworth and Lloyd Kolbe first proposeda health promotion model for school health in a sea captain literature in 1987 which is now known as Coordinated School wellness (CSH) model (CDC 2008). This model placed emphasis on creating auxiliary environments for students by diametric measures and the new version has been used and adopted in many a(prenominal) health ginmill programmes (Schetzina et al. 2009). The CSH model is not based upon the Tannahill sample of health Promotion where health promotion is defined in terms of health education, health justification, and ill-health prevention. Similarly, CSH model is not based upon the Tones Model of health Promotion which considers empowerment as the main theme of health promotion practice. According to the Ottawa Charter for Health Promotion (WHO 1986), health promotion strategies should be adapted to the local needs, although there are similarities with the CSH, this speak to was not based upon the Ottawa Charter. The CSH offered a way to diverge the school and ideas were explored and ersatz solutions and costes could be examined in the classroom. Teachers understood and examined the realities of children circumstances and choices and the understandi ng provided a change to conduce and implement better choices for the children.ApproachAccording to Schetzina et al. (2009), community-based participatory look into (CPBR) feeler was used in Winning with Wellness health promotion programme. CBPR is a collaborative approach and this approach is now seen as an selection to the traditional research approach (Tandon et al. 2007). In this programme, a collaboration of teachers, health care providers, parents, community members and researchers was established to make the following obesity prevention programme effective and evaluate outcome of the programme precisely (Schetzina et al. 2009). just about researchers suggest that in rural areas, parents and community involvement in an Copernican element in an obesity intervention (Hawley, Beckman and Bishop 2006) because of scarcity of resources for health promotion in rural elementary schools (Nelson et al. 2006). To compensate the presentlyness of healthcare facilities, it is ostensi bly a good decision to choose CPBR which ensures multiple level of tempt from individual conducts to family settings, local community and health care services to belittle rate of threatening and obesity among children (Filbert et al. 2009).The approach of this school health promotion encourages children into taking action, and it brings materials and randomness into the classroom (Collins et al. 2002). The idea of involving parents, families, and school is described as a way of increasing the commitment and ensuring positive educational and health outcomes (TN Gov 2010). Approaches that use several different strategies and include several different people are to a greater extent masteryful than an approach that relies on health information and instruction (Collins et al. 2002). The approach created a new cultural norm where healthy and physical activity was promoted and encouraged. The approach also included many different people and resources. The approach opened up ways for new ideas about how to make health promotion a part of changes in school and improvements in the school environment (Veugelers and Fitzgerald 2005). Furthermore, it lowered the risk for chronic disease in adulthood, and helped to promote healthy behaviour that might lead to life-long habits. This health approach can also reduce absenteeism, reduce classroom behaviour problems, improve performance, and prepare students to be productive members of the community (TN Gov 2008). In addition, the approach supports teacher and staff to improve their health and act as berth models for the children. However, such kind of programme requires extensive planning and funding and cannot be considered as a short-term approach (TN Gov 2010). Moreover, the success of a school-based programme relies on the cooperation and positive attitude of several groups of professional, as well as parental involvement in the Winning with Wellness. Programme was more expensive when compared to health promotion pr ogrammes that solely focus on health information and instruction (Schetzina et al. 2009). However, changes are not easy to achieve and there is no simple formula. The approach might need to be adapted and changed to suit the needs of specific communities (Summerbell et al. 2005). Though this approach has many avails, it takes durable to implement in new schools, and preparations are needed in guild for the approach to be productive in new areas. TheoryA theoretical framework helps an individual to focus and clarify determinations and desires with a certain(prenominal) health promotion approach (Naidoo and Wills 2000). Furthermore, a theoretical framework offers a cosmos upon which to explain the approach and the benefits that can be expected from a certainapproach. Theory of Planned Behaviour (TBP) was used in this programme (Schetzina et al. 2009). This possibility is often used to predict positive health behaviours, and it is based on cognitive processing and level of behav iour change. The TBP is used for assessing factors influencing behavioral motivation and action that whitethorn be used to exploring and predicting intention think to diet (Conner et al. 2003). Analysis of factors related to beliefs underlying diet and health choices can be examined, and the model can be used for explaining human behaviour (Ajzen and Fishbein 2005). Three different predictors of health behaviour are used attitude, infixed norm, and perceived behavioural control (Nejad, Wertheim and Greenwood 2005). Health behaviours are influenced by the individuals personal emotion and affect-laden nature however, a wornness of the TBP theory is that it does not take emotions into account (Dutta-Bergman 2005). Nevertheless, the TBP can be used to understand peoples volitional behaviour, and it can explain the relationship amongst behavioural intention and actual behaviour. Furthermore, it has improved the predictability of exercises and diet (Baranowski et al. 2003). The theor y also takes into account the individuals social behaviour by considering social norm. search suggests that this theory is good at explaining intention, and perceived behavioural control (Godin and Kok 1996).Critical summary of the programmeTraditionally, school-health approaches slang focused on association rather than attitudes and skills (Naidoo and Wills 2000). The co-ordinated school health approach challenges the view that pupils will change their behaviour when they occupy information and knowledge. The CSH whole shebang on several different levels in coordinate to promote physical activity and healthy eating (TN Gov 2010). The CSH approach is an ongoing process and the success relies on successful communication between the different groups, professionals, and individuals involved in the programme. A common goal and vision is main(prenominal) and the responsibilities and accountability are shared between the participating groups (Fetro 2005). Even though the groups ma y support each other, they also function independently.The question is whether a school-based health programmes go beyond the intended function of schools (Miller 2003 p.7). It could be argued that knowledge about health lays the foundation for successful schooling (Miller 2003). However, introducing more programmes into the computer program is always difficult and schools often nourish problems to link and include health services and the community in their programmes (Miller 2003). The co-ordinator has the ultimate responsibility for implementing the CSH approach, and it is not recommended that this locate is held by the school nurse, unless there is a small school clay (TN Gov 2010). A school nurse provides an important link between school, home and the community, and he/she also provides counselling to the pupils. However, the co-ordinator has a wide range of responsibilities interest facilitator partnership-builder data collector report writer public awareness developer adv ocate, information sharer, and overall school system organiser (TN Gov 2010). The co-ordinator develops healthy school teams, and facilitates a system-wide school advisory council. Thus, the responsibility for the successful implementation lies mostly on the co-ordinator. The school nurse is responsible for assessment, planning, and direct care of the children. In addition, the co-ordination between the school and community health care professionals ensures early intervention.The idea is that the health education is implemented into the daily school life, and the education is provided by health educators, teacher, school counsellors, school nurse, dieticians, and community health professionals. During the school years the foundation for lifelong habits are laid, and it is crucial to help children develop healthy habits (Lynagh, Schofield and Sanson-Fisher 1997). An advantage with using school based health approaches is that existing structures and systems are already in place (Mille r 2003). Schools have a bun in the oven a curriculum into which a health programme can be implemented. Furthermore, using existing structures are greet effective and schools have also been screened for acceptability. Moreover, a school based approach reaches the staff and the people working at school. Teachers and staff may change their own behaviour and become more aware of their eating and exercise habit. School based approaches reach all children in society and the approach can be targeted at specific minority populations.The nutrient programme is developed in the school consequently, changes can be implemented when the children, teacher and their families are ready and motivated for the change. Policies regarding vending machines, the food and drink children bring to school, can be discussed and evaluated together with the co-ordinator, nurse, and school board (NICE 2006). Advice and care should be non-discriminatory and culturally appropriate, and the character of the CSH app roach allows for schools and communities to implement approaches that are adapted to students with disabilities and from heathen minorities (Naidoo and Wills 2000). Physical education and fitness activities are planned according to the home(a) curriculum (TN Gov 2010). A recent report suggests that more time washed-out on physical activity does not impair academic science (Murray et al. 2007). The CSH approach is flexible in the sense that more physical activity can be added without changing the curriculum, for example, lunch or morning activities (TN Gov 2010). The fictitious character of parents and community is to be involved, and school administrator teachers and school health staff actively try to involve the family in the health promotion (TN Gov 2010). The CSH approaches were developed to be a long-term approach where funding was guaranteed (Warwick, Mooney and Oliver 2009). In just about cases it may be difficult to receive funding especially since the success of the p rogramme is difficult to evaluate, partly because there are a wide range of programmes and ways to implement the CSH approach (Warwick, Mooney and Oliver 2009). Teachers could be considered as weak link in the programme however, research suggests that teachers often support programmes (TN Gov 2010). there might be conflicting interest, and teachers who play a vital occasion in a school-based health promotion programme, may focus on knowledge that can be gained from including health in the curriculum. In contrast, the school nurse may emphasise reducing health risks associated with overweight and obesity (St Leger et al. 2007). Thus, the approach relies on the co-ordinator, head teachers, and the school to identify and couple on the most useful and fruitful outcomes for their programme (Warwick, Mooney and Oliver 2009). There are likely to be variations in programme implementation every co-ordinator works together with the school and different solutions to reach the goal may be us ed (Warwick, Mooney and Oliver 2009).Although, a flexible approach has its advantages it can alsomean that some schools may integrate concern for health widely across the curriculum, whereas other may choose to focus on specific health issues. As a consequence it is difficult to evaluate the success of the programme. The strength of the approach is that every school has different programmes and services and the solutions and approach are developed to suit a specific school or area. A school can examine their specific needs and resources, although, many programmes are related to the eight components. The full benefit of the CSH approach is perhaps not possible unless you also involve parents (Veugelers and Fitzgerald, 2005). Choices and activities afterward school influence a childs chances of becoming obese, and a healthy lifestyle may be difficult for children to change the food and beverage intake at home. Furthermore, if the family is not physically active it may be difficult for children to change the pattern. However, here BMI Index was used as the bar of obesity of students. There are several problems related to BMI and some of these could be related to the received result in the programme. There are several limitations with the use of BMI indicant and the index is sometimes combined with a measurement of the waist circumference. The index does not measure fat itself and it does not take into account the adenoidal size, amount of body water or muscle mass (EUPHIX 2009). Moreover, the measurement does not reflect body changes when a person is changing his or her height over time. Thus, the index underestimates the degree of overweight in short children and overestimates overweight in tall children. Considering that the programme involved young children it would have been preferable to use some more measurement to examine any changes in body fat percentage. The location of the fat is important, and the children might have lost fat around the waist a nd gained in muscle strength, which would have an effect on the body fat percentage (BNET UK 2010).RecommendationsThere are several advantages with using the CSH model to health promotion. This model provides a wide range of opportunities for children to learn and experience healthy lifestyle choice and activities by concentrating and integrating a wide range of people and resources both in spite of appearance and outside the classroom (TN Gov 2010). This type of studies needs to be combined with studies exploring what choices children makes after the school day. Bylimiting the intervention and evaluation of the approach to the school day, it is difficult to first of all evaluate the program, but also to see the best strategies towards helping children. It is possible the children compensated the healthier choices with an increase in unhealthy behaviours after school. A review of health programmes suggests that the most effective programmes involve parents (ODea 1993). Working tog ether with parents to promote healthy food choices at school is not always easy however, it is vital to include parents and many parents pack their children school lunches (KidsHealth 2010). Furthermore, there are problems linked to promoting physical activity with children walking to and from school as parents are reluctant to let their children walk and play outside after school.ConclusionHealth promotion deals with aggrandisement the health status of individuals and communities (Ewles and Simnett 2003 p. 23). However, it is often used to refer to planned activities or programmes (Tones and Tilford 2001). This programme was based on theory of planned behaviour, Co-ordinated School health model, and school-setting approach. The programme provided a way to help children to make healthier lifestyle choices, and the children in the study changed some of their choices related to food. They were also more physically active. The CSH model provided a framework for the school health progr amme in rural Appalachia and the results suggests that this may be valuable. In addition, the approach provides teacher and children with knowledge that can be used to change the school and ideas can be explored and alternative solutions and approaches can be examined in the classroom. Health promotion in school is one step in the right direction to lick problems related to the growth of childhood obesity. A broad holistic approach is recommended which encourage physical, social, spiritual, mental, and emotional wellbeing of both children and the staff at school (LTS 2010).N.B. TN Gov Tennessee political scienceCDC Centers for Disease Control and PreventionREFERENCESAjzen I, and Fishbein M (2005) The influence of attitudes on behaviour. InAlbarracin D, Johnson B T, Zanna M P (Eds.) The handbook of attitudes pp. 173-222. Mahwah NJ Lawrence Erlbaum Associates. Allensworth D D and Kolbe L J (1987) The comprehensive school health program Exploring an expanded concept. journal of Scho ol Health 57(10) 409411. Baranowski T, Cullen K W, Nicklas T, Thompson D and Baranowski J (2003) Are Current Health Behavioral Change Models Helpful in Guiding Prevention of Weight Gain Efforts? Obesity Research 11 2343. BNET UK (2010) online Retrieved 15.07.2010 fromhttp//findarticles.com/p/articles/mi_m0846/is_2_24/ai_n6203894/CDC (2008) Healthy Youth Coordinated School Health Program online Retrieved 14.07.2010 from http//www.cdc.gov/HealthyYouth/CSHPCollins J, Robin L, Wooley S, Fenley D, Hunt P, Taylor J, Haber D and Kolbe L (2002) Programs-that-work CDCs guide to effective programs that reduce health risk behaviour of youth. diary of School Health 72(3) 93-99.Conner M, Kirk S F, Cade J E and Barrett J H (2003) Environmental influences factors influencing a womans decision to use dietetical supplements. ledger of Nutrition 133(6) 1978S-1982S.Dutta-Bergman M J (2004) Health attitudes, health cognitions, and health behaviors among Internet health information seekers population -based survey. journal of Medical Internet Research 6(2)e15 online Retrieved 15.07.2010 from http//www.jmir.org/2004/2/e15/ EUPHIX (2009) Limitations of BMI as a measure of overweight and obesity online Retrieved 15.07.2010 from http//www.euphix.org/object_document/o4852n27195.htmlEwles L and Simnett I (2003) Promoting health A practical guide. capital of the United Kingdom Baillire Tindall.Fetro J V (2005) Step by step to health-promoting schools Program planning guide. Santa Cruz, CA ETR Associates. Filbert E, Chesser A, Hawley S R and St. Romain T (2009) Community-Based Participatory Research in Developing anObesity Intervention in a Rural County. daybook of Community Health Nursing, 263543Finkelstein E A, Fiebelkorn I C and Wang G (2003) National medical spending attributable to overweight and obesity how much, and whos paying? Health Affairs Jan-Jun(SupplW3) 219-226.Godin G and Kok G (1996) The theory of planned behaviour a review of its applications to health-related behaviou rs. American daybook of Health Promotion 11(2) 87-98.Hawley S R, Beckman H and Bishop T (2006). Development of an obesity prevention and management program for children and adolescents in a rural setting. Journal of Community Health Nursing, 23 6980.James P T (2004) Obesity The Worldwide epidemic. Clinics in Dermatology 22 276-280KidsHealth (2010) online Retrieved 15.07.2010 fromhttp//kidshealth.org/parent/nutrition_fit/nutrition/lunch.htmlLTS. (2010) online Retrieved 23.07.2010 from http//www.ltscotland.org.uk/healthpromotingschools/index.asp Lynagh M, Schofield M J and Sanson-Fisher R W (1997) School health promotion programs over the past decade a review of the smoking, alcohol and solar protection literature. Health Promotion International, 12 43-60.Miller G (2003) Ecological approach to school health promotion Review of literature. online Retrieved 23.07.2010 from http//www.schoolhealthresearch.org/downloads/miller.pdf Murray N G, Low B J, Hollis C, Cross A W and Davis S M (20 07) Coordinated school health programs and academic achievement A systematic review of the literature. Journal of School Health, 77(9) 589-600.Naidoo J and Wills J (2000) Health Promotion Foundation for Practice.London Baillire Tindall.Nelson M C, Gordon-Larsen P, Song Y and Popkin B M (2006) built and social environments associations with adolescent overweight and activity. American Journal of Preventive Medicine, 31109117.Nejad L M, Wertheim E H and Greenwood K M (2005) Comparison of health behaviour model and the theory of planned behaviour in the omen of dieting and fasting behaviour. E-Journal of Applied Psychology 1(1) 63-74 online Retrieved 15.07.2010 from http//ojs.lib.swin.edu.au/index.php/ejap/article/viewFile/7/16Nicklas T A, Baranowski T, Cullen KW and Berenson G (2001) Eating patterns, dietary quality and obesity. Journal of the American College of Nutrition, 20599-608ODea J A (1993) School-based health education strategies for the improvement of body image and preven tion of eating problems An overview of safe and successful interventions. Health Education, 105(1) 1133Ogden C L, Carroll M D, Curtin L R, McDowell MA, Tabak C J and Flegal K M (2006) Prevalence of overweight and obesity in the United States, 1999-2004. Journal of the American Medical Association 295 1549-1555.Schetzina K E, Dalton W T, Lowe E F, Azzazy N, VonWerssowetz K , Givens C, Pfortmiller D T and Stern P H (2009) A coordinated school health approach to obesity prevention among Appalachian youth. Family Community Health, 32(3) 271-285Seidell J C (1998) Obesity a outgrowth problem. Acta Paediatrica Supplimentum 88(428)46-50. Summerbell C D, Waters E, Edmunds L, Kelly S, Brown T and Campbell K J (2005) Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews 3188.Tandon D, Phillips K, Bordeaux B, Bone L, Brown P B, Cagney K, Gary T, Kim M,Levine D, Price E, Sydnor K D, Stone K and Bass E B (2007) Vision for Progress in Community Health Partnersh ips. The Johns Hopkins University Press online Retrieved 26.07.2010 from http//www.press.jhu.edu/journals/progress_in_community_health_partnerships/1.1tandon.pdf Tennessee Government (2010) online Retrieved 15.07.2010 from http//www.tennessee.gov/education/schoolhealth/aboutcsh.shtmlTones K and Tilford S (2001) Health promotion effectiveness, efficiency and equity. Delta Place, Cheltenham Nelson Thorns Ltd.Veugelers P J and Fitzgerald A L (2005) Effectiveness of school programs in preventing childhood obesity a multilevel comparison. American Journal of Public Health 95(3) 432435.Warwick I, Mooney A and Oliver C (2009) National healthy school programmes Developing the severalize base. London TCRU.WHO (1986) The Ottawa Charter for health promotion online Retrieved 20.04.2010 from http//www.who.int/healthpromotion/conferences/previous/capital of Canada/en/