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1 Running head: REVIEW OF LITERATURE: CHILDHOOD OBESITY

Review of Literature: Childhood Obesity and Health Promotion the Nursing Role By: Jacqueline Hendricks, RN Grand Canyon University: NRS429 06/23/12

Review of Literature: Childhood Obesity 2 Review of Literature: Childhood Obesity and Health Promotion the Nursing Role

Health promotion is defined by the World Health Organization as The process of enabling people to increase control over and to improve their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions (WHO 2012). Nurse educators have taught patients for years to manage illness; now the focus is to teach people how to remain healthy. This paper will discuss concepts of health promotion and childhood obesity, the role of the nurse in health prevention of childhood obesity, and implementation methods of primary, secondary, and tertiary promotion and prevention of this epidemic. Purpose of Health Promotion in Nursing Practice The goals of the health promoting nurse are to raise interest regarding health , educate, promote self-awareness, improve self-esteem, encourage the patients to make their own decisions by taking charge of their own health, create positive attitudes and behaviors when it comes to health, and help change the physical and social environment to promote health. As awareness of health based activities grow throughout communities and the public become increasingly more knowledgeable regarding their own health status and that of their families, the overall health of the population will improve. The ultimate goal for nursing is promotion with the core focus still pertaining to health. When caring for patients, both individual and family behaviors must be considered. Nursing practice is not only giving patients and familys knowledge to protect themselves from many health risks, but it also creates a sense of personal responsibility pertaining to the patient and familys own health, providing the ability for the individual to change their own behaviors and their lives.

Review of Literature: Childhood Obesity 3 Nursing and Health Promotion in Childhood Obesity Health promotion of childhood obesity that is relevant to nursing are (a) prevention strategies aimed at the family (parent and child) are key to influencing dietary habits of very young children; (b) interventions aimed at preventing or reducing obesity in children must start early in childhood, prior to established poor dietary patterns; and (c) community support and involvement in developing opportunities for a healthy lifestyle needs to be combined with any intervention aimed at individuals and families. (Berkowitz, 2009, para 31) (b) The growing epidemic of childhood obesity is one of the most serious public health concerns facing America today. Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. About 70% of obese adolescents grow up to become obese adults (Dehghan, AkhtarDanesh, Merchant, 2005). Several environments influence the choices that children make, including home, school, and clinical environments, regarding nutrition and physical activity. Nurses, who are known to hold multiple job titles, some of those include educator and advocate; have a responsibility to educate families regarding childhood obesity. The potentially harmful effects of sedentary activities such as excessive TV watching, video game play, and computer usage needs to be relayed to the parents and children, along with proper nutrition habits and the need to get at least sixty minutes of physical activity daily. Nurses should offer support of the education given with fun and enticing alternatives to help spark their interest, meal plans and ideas, fun outdoor and

Review of Literature: Childhood Obesity 4 indoor activities that incorporate physical activity to help spark the interest of the targeted community. Evolution of the Nursing Role in Health Promotion Early origins of health promotion were based on the fundamental needs of shelter, water, and safety. The more educated health care professionals became on the transmission of disease, the more the focus was on preventing the methods of transmission by initiating interventions such as immunizations. The health and wellbeing of others has been a powerful force in the history of medicine, health education and promotion. The more contemporary approach to nursing focuses on institutionalizing health education, health promotion, and wellness programing. Acuity of patients continues to grow, and growth and disease management of the population close behind, the roles of nurses are increasing in necessity and demand. Social and economic factors along with the decrease in access to medical care also play an important role in the transformation of nursing. Admission to discharge physicians, health care practitioners, and ancillary staff work closely with nursing, yet the ultimate source of education and teaching falls upon the nurses. The education and teaching needed for patients falls within multiple areas of specialty. Including pharmacology, physical therapy, nutritionists and many more subjects are important to patients overall health and involved in health promotion and prevention. Implementation methods for Health Promotion Nurses can use many ways to implement health promotion. Role modeling and implementing the health education we so eagerly give into our own lives is one way of promoting healthier lifestyles. Screening, individual risk factor assessments and immunizations, the use of social advertising relating to health information, health education and skill, promoting

Review of Literature: Childhood Obesity 5 community action and awareness and by creating appropriate settings and supportive environments. Primary Prevention Primary prevention, or promotion, includes the concept of positive health, that encourages the outcome of an acceptable level of health, that will enable families and individuals to lead a more productive life. The idea is to stop and prevent diseases from even occurring. Examples of such prevention and promotion are health promotion programs, immunizations, reducing household hazards, abstinence from illegal substances, and used as evidence for this project, exercise programs. (Berkowitz, 2009) It is the key building block of public health, based on practical evidence based and socially acceptable methods made accessible to individuals and families. Primary Prevention of Childhood Obesity Physicians and health care providers should perform yearly weight assessments of all children, limit the consumption of unhealthy foods, follow current dietary recommendations by using wellness based programs, promote breakfast daily, limit portion sizes and eating outside of the home, and promote at least one hour of physical fitness daily. There are many wellness based programs and information to help guide the educators in the promotion of a fit America. The NFL Play 60 is one of those programs. The vision is Fuel up, meaning with healthy energizing foods and Play 60 inferring the sixty minutes of play and day recommended for an appropriate healthy life style. Secondary Prevention Secondary prevention includes early detection of disease. Examples of secondary prevention and promotion are screening programs. Screening programs offer the ability to label

Review of Literature: Childhood Obesity 6 diseases and offer proper treatment before signs and symptoms occur, effectively aiding in disease management. In Childhood obesity prevention and treatment could include screening for overweight, preventive counseling, weight management assessment and treatment or referral. Tertiary Health Promotion Tertiary prevention and promotion focuses on care of an established disease. In this level of care attempting to restore the patient to their highest functioning is the focus. The goals include preventing further deterioration and maximizing quality of life. It seeks not only to prevent deterioration and complications from a disease or injury, but also to rehabilitate and return the patient to a full physical, mental, and social function as possible (Jenkins, 2009, p.8). Children who are diabetic need help to understand the severity of the disease and importance of compliance to maintain their health. Providing education on insulin, food facts and definitions, meal plans, exercise ideas, and the importance of following up with their doctors is one form of this level of care. Conclusion Advocating for our patients, providing education and ideas of preventive measures will inspire the patient and population by giving them the means to control their own health, overall increasing the longevity and quality of their lives. Even if primary and secondary were not effective tertiary care is established to continue further education and support. The challenge of helping young people adopt healthy eating patterns and regular physical activity to achieve and maintain healthy weights cannot met through the sole efforts of schools or any other organization it requires a communitywide effort, but nurses are in a unique position to play a pivotal role in promoting healthy lifestyles and preventing childhood obesity.

Review of Literature: Childhood Obesity 7 References Berkowitz, B., Borchard, M. (2009), "Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing" OJIN: The Online Journal of Issues in Nursing Vol. 14, No. 1. Manuscript 2. Jenkins, C.D. (2009). Building better health: A handbook of behavioral change. Scientific and technical publication. No. 590 , 3-9. Retrieved June 4, 2012. World Health Organization. Retrieved June 23, 2012, from The World Health Organization, Health Promotion: http://www.who.int/en/ Dehghan,M., Akhtar-Danesh,N., Merchant,A., (2005).Childhood Obesity Prevalence and Prevention. Retrieved June 23, 2012, PubMed. 2005, September 2. Doi: 10.1186/1475-2891-424. http://ncibi.nimm.nih.gov/pmc/articles/pm

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