Reducing the Prevalence of Obesity in Children, Adolescents, and Young Adults Proposal

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Project Statement

This project aims at reducing the prevalence of obesity in children, adolescents and young adults aged between 6-19 years. This goal will be attained by developing health promotion interventions that revolve around cultural, social, political and economic factors as well as applying health promotion theories, processes, and skills in the promotion of good health practices.

This project is part of a broader one-year community-based initiative in building the capacity of the community to promote good health practices among children, adolescents, and young adults aged between 6-19 years to reduce cases of obesity. The project is a partnership between Griffith University and Be Active and Eat Well program, funded by the Healthy Local Government Scheme. This project will be commencing in May 2011 and has received a budget of $20, 000.

Project Scope

Purpose

As a result of this project, we expect to see:

  • Adoption of good healthy nutritional practices among children, adolescents and young adults.
  • Children, adolescents and young adults taking physical exercise.
  • Reduced cases of overweight children, adolescents and young adults.
  • Reduced cases of diabetes, cardiac arrests, and heart diseases caused by obesity.

Key Performance Indicators

  • Improved quality of life.
  • Reduced unhealthy weight gain.
  • Reduced prevalence of weight and obesity.

Benefits:

  • Achievement of the project purpose should contribute to the following benefits:
  • Reduced cases of diabetes, cardiac arrests, and heart diseases caused by obesity.
  • Reduced cases of deaths due to obesity.
  • Ability to move around comfortably in the physical environment.

Constraints

  • Human resource availability for physical exercise.
  • Resources available for providing a proper diet.

Risk Factors

  • The appointed working group members may not take their roles of ensuring good diet and physical exercise are taken as planned.
  • In cases whereby the cause of obesity is inheritance, there could be no change even after the interventions.
  • Other stakeholders may be unwilling to cooperate.

Project Rationale

Obesity has been identified as the most common nutritional disorder that affects many teenagers and young adults between the ages of 6-19 years (Johnson et al, 2002). The rising cases of children, adolescents, and young adults with obesity have made it to be termed as a national health epidemic in many countries (Agras, 2001). A study by the Centres for Disease Control and Prevention (CDC) indicates that the prevalence of obesity in children and adolescents has increased at a steady rate over the years where current statistics show that 15 percent of young children and teenagers aged between the years of 6 to19 are obese and overweight. Flegal et al (2001) also note that, obesity in children and adolescents has continued to increase over the years in both developing and developed countries with most paediatricians citing it as a worldwide epidemic.

According to Borodulin et al (2008), the increasing cases of obesity are majorly due to poor nutrition. Haines and Neumark-Sztainer’s Work (2006) indicates that the aetiology of obesity is mostly related to environmental factors such as the dietary patterns of most teenagers, their level of physical activity and the rate of their metabolism. Hills & Kings ( 2007) also explains that a study conducted recently in the United States revealed that the rates of physical activity amongst adolescents have declined over the recent years which have had a direct impact on the escalating cases of obesity in the country. Other researchers argue that obesity is greatly influenced by social media and television as many young children and adolescents are frequently exposed to television and social media (Brownson et al, 2005).

Some of the complications that arise as a result of obesity include myocardial infarctions, deep vein thrombosis and pulmonary embolism, which lead to heart problems, carpal tunnel syndrome, migraines and multiple sclerosis, which cause neurological defects in the person suffering from the nutritional disorder, hypoventilation syndromes, asthma and sleep apnea which are respiratory problems, as well as erectile dysfunction, chronic renal failure and urinary incontinence, which affect the reproductive organs of an individual. Individuals who are overweight also have a higher risk of suffering from gall bladder disease and kidney failure because of the accumulation of fats in the major arteries of the body (Peters et al, 2003). Health consequences that are caused by an accumulation of fats include obstructive sleep apnea, osteoarthritis diabetes, cancer, cardiovascular diseases and liver diseases (Shoelson et al, 2007). Obesity also leads to conditions such as metabolic syndrome, high blood pressure and high blood cholesterol levels in the body (Sturm, 2007). At the same time, obesity leads to low levels of self-esteem and self-confidence. Caplan (1993) notes that, “teenagers who are obese are usually aware of the social and psychological aspects and not the ramitifications of their morbidity.”

The prevalence of obesity in the target population mostly depends on the measurement of certain factors such as the age, height and weight of the children (Ebbelling et al, 2002). Studies reveal that a person with a BMI of 30 to 35 kg/m2 has a reduced life expectancy of between 2 to 4 years while a person with a body mass index that is above 40kg/m2 has a reduced life expectancy of ten years (Kushner, 2007). Other measurements on obesity include: energy intake levels which are measured by an individual’s dietary records and their macronutrient composition, the energy expenditure measured by the physical activity level and heart rate of an individual (WHO, 2000).

According to Withrow and Alter (2011), the cost of obesity on a country’s total health care expenditure is estimated to be between 0.7 to 2.8 percent of the country’s health care costs. People who suffer from obesity have health care costs that are 30 percent more than those of their counterparts who have a normal body mass index. (Bray, 2004).

The prevalence of obesity can be reduced by good health practices and use of social interventions. Good health practices may include taking a proper diet and doing physical exercise (Hills & King, 2007). For the social interventions, there is need to give children, adolescents and young adults who are obese statistics of obesity cases (Caplan, 1993). This will improve their self esteem as they will gain confidence that they are not socially unfit. It’s also important to make this group know that its not there fault hat they are obese, but it’s a trend in the society. In our case, we shall work closely with local community based prevention programs to ensure that there is improved knowledge, skills, practices and beliefs about obesity.

Objectives

Promoting of good health practises among children, adolescents and young adults aged between 6-19 years so as to reduce cases of obesity.

By the end of the project we will have:

  • Collaborated with the relevant community based centers to improved knowledge, skills and beliefs about obesity.
  • Collaborated with the relevant community based centers so as to promote healthy eating habits.
  • Increased physical activities among children, adolescents and young adults.
  • Reduced unhealthy weight gain among children, adolescents and young adults.

Strategies

  • Health promotion interventions will be carried out by selecting a group of children, adolescents and young adults from the various community based centers, and ensuring that they acquire the right information, skills and attitude towards obesity before introducing a proper diet and supervised physical activities to them.
  • Conduct review of available theoretical frameworks and interviews on health promotion interventions.
  • Select a group of obese children, adolescents and young adults from Community based Obesity Prevention Centers.
  • Appoint a working group to aid in implementing the project.
  • Ensure that the selected group of obese children, adolescents and adults acquires the right knowledge, attitude and skills about obesity.
  • Introduce a proper diet and physical activities to the selected group, monitored by the working group.

Partners

  • School of Public Health, Griffith University
  • Be Active and Eat Well.

Other Stakeholders

  • Cambridge Healthy Living for kids.
  • Project APPLE.
  • Good for Life.

Time table

Key Milestones during Implementation Phase

Milestone NoMilestone DescriptionCommencement DateCompletion Date
1Conduct review of available theoretical frameworks and interviews on health promotion interventions.1stJuly 201110thJuly 2011
2Select a group of obese children, adolescents and young adults from Community based Obesity Prevention Centers.10thJuly 201115thJuly 2011
3Appoint a working group to aid in implementing the project.16thJuly 201117thJuly 2011
4Ensure that the selected group of obese children, adolescents and adults acquires the right information, attitude and skills about obesity.18thJuly 201130thJuly 2011
5Introduce a proper diet and physical activities to the selected group, monitored by the working group.1stAugust 201123th October 2011
6Make a follow up after three months from implementation date24thOctober

Project Management

The project as a whole has an advisory group to advice on the implementation. There is an assigned chair of the group who is also a member of the project management group. The chair takes overall responsibility of conducting and reporting of the project.

Roles and responsibilities

Project roleName/sOrganizationResponsibilities
ChairMercedes SepulvedaBe Active and Eat Well.
  • Overall responsibility for conduct and reporting of the project.
Member of project management groupMichael LeverittCambridge Healthy living for kids
  • Develop detailed plan for the project objectives
  • Oversee implementation of processes to progress objective
  • Advise on and review reports and materials prepared for objective
Member of project management groupLynn TurnerProject APPLE
Member of project management groupBec MorrisonGood for Life
Member of project management groupFazil RostamGood for Life
Member of project management groupKylie GilmoreProject APPLE
Member of project management groupLouis OberleuterBe Active and Eat Well.

Higher Authority

Key project decision pointsHigher authority for approval/sign-off
Approval of project planProject advisory group
Release of project fundsProject management group
Pre-implementation reviewProject management group
Status reportsHealthy Local Government Scheme
Significant variations to project planHealthy Local Government Scheme
Approval to progress to finalisation phase
(final status report)
Project management group
Project completion reportHealthy Local Government Scheme

Budget

No. Of days in the monthJulyAugustSeptemberOctoberTotal
31313031123
Total week (17), (16×7=112 days)31313020112
Days in the month as a percentage of total27.7%27.7%26.8%17.9%100%
Project office Total weeks 16,(16×7=56)31313020112
Days in the month as a percentage of total27.7%27.7%26.8%17.9%100%
Nurse
Total weeks, 3 (3×7=21)
2121
Days in the month as a percentage of total100%100%
Working group
Total weeks 12 (11×7=77)
31301677
Days in the month as a percentage of total40.2%38.9%21.9%100%

Administration salary

Project Manager10, 34210, 34210,0086,67237,364.
Total administration salary10, 34210, 34210,0086,67237, 364

Nursing salary

Nurse3, 3503,350
Total nursing salary3,3503,350

Working group salary

Monitor of physical activities2100175021005950
Cook2100175021005950
Total42003500420011900

Food staff cost

Flour1035103510109204000
Rice345034503420298013300
Vegetables and fruits14501450138011205400
Meat1115111510009404170
Total705070506810596026870
Total Labour budget1369217542135081087255614
Total non labour budget705070506810596026870
Total budget2074224592203181683282484

Project evaluation

Achievement of objectives

  • Adoption of good healthy nutritional practises among children, adolescents and young adults.
  • Children, adolescents and young adults taking physical exercise at will to avoid accumulation of fats.
  • Reduced cases of overweight children, adolescents and young adults.
  • Ability of children, adolescents and young adults to move around comfortably in the physical environment.

Strategy implementation

Review the physical exercise and proper diet implementation, including views of community based centers.

Post implementation review

Follow up with the community based organizations 6 months after distribution to evaluate usage of the impact of the intervention.

References

Agras, W.S., (2001). The consequences and costs of the eating disorders. Psychiatric Clinical Association of Northern America, 24: 371-379.

Borodulin, K., Laatikainen, T., Juolevi, A., & Jousilahti, P., (2008). Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults. European Journal of Public Health, 18(3): 339-344.

Bray, G.A., (2004). Medical consequences of obesity. Journal of Clinical Endocrinology Metabolism, 89(6): 2583-2589.

Brownson, R.C., Boehmer, T.K., & Luke, D.A., (2005). Declining rates of physical activity in the United States: what are the contributors?. Annual Review of Public Health, 26: 421-443.

Caplan, G. (1993). Mental health consultation and collaboration. Cambridge: Cambridge University Press.

Ebbelling, C.B., Pawlak, D.B., & Ludwig, D.S., (2002). Childhood obesity: public health crisis common sense cure. Lancet, 360:473-482.

Flegal, K.M., Ogden, C.L., Wei, R., Kuczmarski, R.L., & Johnson, C.L., (2001). Prevalence of overweight in US children: comparison of US growth charts from the CDC with other reference values for body mass index. American Journal of Clinical Nutrition, 73(6): 1086-1093.

Haines, J., & Neumark-Sztainer, D., (2006). Prevention of obesity and eating disorders: a consideration of shared risk factors. Health Education Research, 21(6): 770- 782.

Hills, A.P., and King, N.A., (2007). Children, obesity and exercise. Oxford, UK: Routledge.

Johnson, J.G., Cohen, P., & Kasen, S., (2002). Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. American Journal of Psychiatry, 159:394-400.

Kushner, R., (2007). Treatment of the obese patient. New Jersey: Humana Press.

Peeters, A., Barendregt, J.J., Willekens, F., Mackenbach, J.P., Al Mamun, A., & Bonneux, L., (2003). Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Annual International Medical Journal, 138(1):24-32.

Shoelson, S.E., Herrero, L., & Naaz, A., (2007). Obesity, inflammation and insulin resistance. Gastroenterology, 132(6): 2169-2180.

Sturm, R., (2007). Increases in morbid obesity in the USA: 2000-2005. Public Health, 121(7):492-496.

WHO (2000). Obesity: preventing and managing the global epidemic. Singapore: World Health Organization.

Withrow, D., & Alter, D.A., (2011). The economic burden of obesity worldwide; a systematic review of the direct costs of obesity. Obesity Review, 12 (2); 131-141.

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