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Adolescent Obesity Annotated Bibliography

Introduction

In the United States, obesity represents one of the most common causes of death among preventable diseases. Obesity is a major and chronic illness that causes significant harm to the body’s functions. A combination of complex risk factors is responsible for obesity, including genetics, metabolic factors, socioeconomic factors, lifestyle choices, and some other factors. Poor eating habits combined with low amounts of physical activity tend to cause obesity or over-weightiness. However, lifestyle and genetics also contribute to an adolescent’s weight range. The negative effects of obesity on health are numerous. It can lead to high blood pressure, type 2 diabetes, joint problems, sleep apnea, heart disease, respiratory problems, metabolic syndrome, or even cancer. Besides, physical obesity also leads to different negative psychosocial effects. The number of adolescents and children In the United States that have been affected by obesity has taken a sharp rise and almost tripled in the 1970s. Statistics in 2015-2016 illustrate that nearly 1 in 5 schoolchildren and adolescents (6 to 19 years) in the United States are suffering from obesity (CDC, 2018).

Annotated Bibliography

Hisar Filiz, E. T. (2013). Adolescents’ perceptions about their weight and practices to lose weight. Australian Journal of Advanced Nursing, 31(2), 23-30. Retrieved from https://pdfs.semanticscholar.org/0d39/b365a8b2ab6e195897f7f90726c8178781ec.pdf

This study was selected as it sought to determine differences between the perceived weights and real weights. It aimed to indicate how adolescents and children perceive their own weight and what practices they are willing to adopt. The study discusses training programs and the effect they have on weight loss. For this purpose, a convenience sample was obtained from a public school in Ankara from grades 9 to 12 of adolescents (n=703) who were given a questionnaire in order to evaluate the perceptions, demographic characteristics, weight loss practices, and sources of information regarding weight loss. A statistical analysis was obtained and plotted to explore the case and measure student BMIs relative to their weight perceptions.

Kumari M Rathnayake, T. R. (2014). Nutritional and behavioral determinants of adolescent obesity: a case-control study in Sri Lanka. BMC Public Health, 14(1), 1291. doi:10.1186/1471-2458-14-1291

This research was purposed to identify behavioral risk and nutritional factors related to obesity amongst Sri Lankan school-aged girls reaching adolescence. An interviewer-managed questionnaire was used to predict associated risk factors. A sample of n=100 for a case-control study in each section was chosen from among girls aged 14-18 years to identify possible determinants, and then a multivariable regressions analysis2 was carried out to study the data obtained. The study confirmed predictions that socioeconomic status, which included being firstborn, or behavioral factors such as skipping breakfast, low vegetable and fruit consumption, etc, are key determiners of obesity in school-aged girls.

Mei Yen Chen, J. Y. (2009). Do Overweight Adolescents Perceive the Need to Reduce Weight and Take Healthy Actions? Journal of Nursing Research, 17(4), 270-277. Retrieved from http://connection.ebscohost.com/c/articles/47787082/do-overweight-adolescents-perceive-need-reduce-weight-take-healthy-actions

This research explores is a highy useful study to analyse perceptions and notions of overweight adolescents, the focus of this research, in order to determine whether their perceptions about themselves lead them to consider healthier weight loss lifestyles and behaviors or not. The perceptions of weight and their link to weight loss methods, mental health, or particular risky behaviors are also studied. The research pointed out that adolescents who were overweight sought to reduce weight by choosing unhealthy weight-loss methods. The importance of family health and school promotion in counseling overweight or obese students and its use in helping students adopt healthier habits are also discussed in the conclusion.

Mohammad Reza Movahed, S. B. (2011). Obesity in Adolescence is Associated with Left Ventricular Hypertrophy and Hypertension. Echocardiography, 28(2), 150-153. doi:10.1111/j.1540-8175.2010.01289.x

This study is important because it studies the occurrence and likelihood of LVH and HTN, left ventricular hypertrophy, and hypertension in a large sample population of adolescents. Screening echocardiogram databases were utilized to identify the prevalence of HTN and LVH in students with a BMI greater than 30, using multivariate and univariate statistical analysis. An n=2072 for students between 13 and 19 years was used to predict the results, finding LVH to have a higher prevalence among obese adolescents than HTN. The health risks associated with early obesity and possible impairment of cardiovascular functions as a result from a young age show the importance of an intervention program for students.

R Whittemore, A. C. (2013). Implementation of a school-based internet obesity prevention program for adolescents. Journal of nutrition education and behavior, 45(6), 586-594. doi:10.1016/j.jneb.2013.03.012

The aim of this research was to assess the implementation, adoption, and reach of an Internet obesity prevention program that was school-based, called HEALTH[e]TEEN, to evaluate variations in student satisfaction and participation by gender, school, age, ethnicity, or race. The samples obtained were from Connecticut schools for about eight teachers and n=384 adolescents. The results were analyzed and plotted to demonstrate that there was higher participation and satisfaction from students when the program was implemented in class as opposed to when it was implemented as homework. The programs were designed to reduce adolescents who had reached obesity, and the study concluded high student participation and satisfaction with the program. The setting’s effect on implementation, student age, teacher’s characteristics and notions, and gender were also part of the investigation.

Discussion and Analysis

To study obesity trends, statistics, and perceptions of students, the five selected sources presented findings obtained through multivariate statistical analysis conducted by the researchers to provide useful insights regarding it. The research conducted in a school in Ankara, Turkey (Hisar Filiz, 2013) showed perceptions of adolescents about their weight and practices to lose weight, indicating that perceptions could lead to often unhealthy methods in trying to reduce weight and present a better body image to their peers. The research conducted in Srilanka (Kumari M Rathnayake, 2014) was more focused on determining the cause of childhood and adolescent obesity and indicated what factors led to increasing obesity risks among young school children. The research conducted by Mei Yen Chen (2009) complements the research of Hisar Filiz (2013), but instead of collecting sample data from all the children of the school, only the overweight children were surveyed to see what their perceptions regarding obesity were, and how likely are overweight children to choose unhealthy methods of weight reduction.

Further complementing the research on the causes and the perceptions regarding adolescent obesity, the chosen studies (Mohammad Reza Movahed, 2011) also provided insights into the possible risks of disease for those children suffering from obesity in order for them to seek therapy and weight reduction methods. Finally, a study (R Whittemore, 2013) was chosen to assess the success of obesity control programs in schools and how to further improve them, thereby providing a comprehensive look at adolescent obesity in order to provide guidelines and directions on further research that is to be conducted.

Conclusions

Obesity today is considered to be an epidemic, a problem that plagues millions of people, young and old. Particular social changes and consumption choices such as fast food and lifestyle choices are leading to an upsurge in the young becoming more prone to obesity. Especially in the Western world, it is concluded to be an increasingly worrying problem that will follow on into adulthood and, therefore, requires urgent intervention. However, studies have shown that it is a problem now in developing countries as well. Further statistical research that reveals greater insights into risks, theories, associated diseases, preventative measures, treatments, and efficacy of different interventions needs to be carried out, and successful programs need to be identified and implemented. Schools are a good place to conduct further research into implementing different intervention programs that tackle the problem at both the physical and the psychological levels.

Research Proposal PICO

From the literature review and findings of the studies used, there is room for research into the effectiveness of obesity control programs in schools that can be conducted and how that compares to a school where the program has not been conducted. Earlier research (R Whittemore, 2013) provided insights into the efficacy of the intervention, whereas this research would try to compare a single intervention in two schools, out of which one will undergo a program and one will not. For this purpose, an appropriate research question would be: ‘In school-age children, what is the effect of a school-based physical activity program on a reduction in the incidence of childhood obesity compared with no intervention within a 1-year period’?

For this project, the chosen area of research is schools because even in developing countries, a significantly high population of children study in schools and spend a good amount of time there. Therefore, it is a school where a large proportion of their daily calories are consumed. Schools are also ideal places to teach students about healthy living, energy balance, and healthy food choices. Constant monitoring can take place due to frequent contact and the possibility of continuity. Finally, schools have the manpower, infrastructure, funds, and resources needed to promote interventions for obesity.

To undertake the project, selected schools will be approached to implement a before-school physical activity program based on the Building Our Kids Success BOKS method for one full year in order to carry out the research. The school’s specific characteristics and needs, e.g., competing pressures of other initiatives, availability of resources and funds, and the expertise and interest of staff to ensure that the project plan will be workable in practice, all will be taken into account before selection. The BOKS (Viering, 2018) program will consist of different running exercises, warm-ups, and skills of the day, as well as different awareness and physical activities that will continue for one year. To obtain a suitable sample size, three schools (n=300×3) will be selected to implement the BOKS program, and three schools will be compared with those that have not implemented any substantial physical activity program other than routine classes.

In order to conduct this research, post, and pre-intervention anthropometrics, dietary measures, blood pressure, beliefs, and health knowledge of parents and children data will be gathered. A mean body mass index will be calculated for students post-intervention by having their heights and weights measured by research staff. A questionnaire with pretested questions will be handed out to gather insights into physical activity participation and consumption habits, as well as collect their biometrics. The purpose of the comparison will be to compare indexes in two different sets of data, in which one set of students participated 1 hour before school intervention, and whether they had an improved BMI compared to those where intervention was not conducted. For this purpose, data for the pre-intervention phase will be collected during the 2018–2019 school year, and post-intervention will be collected during the 2019–2020 school year. The gathered data will be analyzed through multivariate analysis and descriptive statistics to determine the results of the intervention on obesity, using excess weight versus normal weight as a dependent variable, separate for both the control group and the intervention group. For the students who were part of the intervention group, the results, after being compiled, will be used to indicate whether a rise of students in the normal weight category and a decrease in the overweight category is observed, which will help judge the protective factor of the intervention against obesity in adolescent schoolchildren.

One of the limitations of the research could be the questionnaire because a false estimation of physical activity behavior or diet given by schoolchildren is possible. The study sample also consists of limited students from 3 schools each, one for the intervention group and one for the control group, as well as the limited time frame. A bias in reported lifestyle patterns is a possibility because they will be self-reported. Furthermore, the actual number of students who participate in the program could be less than intended, therefore reducing the accuracy of the results. The study will also be limited because other factors, such as parental support, fun events, and school activities and their resulting impact, will not be examined as part of the study. However, the overall plan of the research is designed in a way that can provide a good indication of the efficacy and health impact of a before-school physical activity program. If the results are positive, then it would support the notion that moderate to high physical activity is effective and necessary to control obesity in adolescents and young schoolchildren.

References

CDC. (2018, January 29). Healthy Schools: Childhood Obesity Facts. Retrieved from Centres for Disease Control and Prevention: https://www.cdc.gov/healthyschools/obesity/facts.htm

Hisar Filiz, E. T. (2013). Adolescents’ perceptions about their weight and practices to lose weight. Australian Journal of Advanced Nursing, 31(2), 23-30. Retrieved from https://pdfs.semanticscholar.org/0d39/b365a8b2ab6e195897f7f90726c8178781ec.pdf

Kumari M Rathnayake, T. R. (2014). Nutritional and behavioral determinants of adolescent obesity: a case-control study in Sri Lanka. BMC Public Health, 14(1), 1291. doi:10.1186/1471-2458-14-1291

Mei Yen Chen, J. Y. (2009). Do Overweight Adolescents Perceive the Need to Reduce Weight and Take Healthy Actions? Journal of Nursing Research, 17(4), 270-277. Retrieved from http://connection.ebscohost.com/c/articles/47787082/do-overweight-adolescents-perceive-need-reduce-weight-take-healthy-actions

Mohammad Reza Movahed, S. B. (2011). Obesity in Adolescence is Associated with Left Ventricular Hypertrophy and Hypertension. Echocardiography, 28(2), 150-153. doi:10.1111/j.1540-8175.2010.01289.x

R Whittemore, A. C. (2013). Implementation of a school-based internet obesity prevention program for adolescents. Journal of nutrition education and behavior, 45(6), 586-594. doi:10.1016/j.jneb.2013.03.012

Viering, M. (2018). BOKS Fitness Program Gets Kids Moving—and Learning—in the Morning. Retrieved March 14, 2018, from Parenting: https://www.parenting.com/child/health/boks-fitness-program-gets-kids-moving%E2%80%94and-learning%E2%80%94-morning

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