Childhood Obesity and Parental Education Project

Childhood obesity has become one of the priorities of American health care due to the epidemic nature of this health problem. Various interventions have been developed and implemented to encourage children and their families to have healthier diets and lifestyles (Nyberg et al., 2015; Wright et al., 2016). However, the efficiency of these projects especially linked to their impact on some populations remain largely under-researched (Elgar et al., 2015). This study will involve the evaluation of an educational intervention for low-income Latino parents of elementary-school children affected by obesity who reside in the Southeast region, Charlotte (NC).

The intervention will address such aspects as the benefits of physical activity and proper dietary patterns. The primary goal of this project is to evaluate the effect (if any) of the training that aims at improving obese elementary-school children’s health status. A quantitative research design based on the use of a survey will be employed to address the set research questions. The sample will include 40 parents who will be divided into two groups, one of which will receive training. The participants will complete self-reported body weight, self-reported body height, and physical activity questionnaires.

Background of the Problem

It has been estimated that approximately 20% of children residing in the USA are diagnosed with obesity (Davis, Wojcik, & DeWaele, 2016). Fradkin, Wallander, Elliott, Cuccaro, and Schuster (2016) argue that Hispanic children are twice as likely to be obese compared to White children, which is associated with socioeconomic and cultural peculiarities. Researchers and practitioners have developed numerous interventions to address the problem such as the use of electronic health records analyzed by Cochran and Baus (2015). Nevertheless, Nyberg et al. (2015) note that interventions involving educating children and their families tend to have a positive impact on the target population’s health. At the same time, insufficient information is available on the interventions’ efficacy for the choices made by parents of elementary-school children and health outcomes for these children.

It is noteworthy that researchers pay certain attention to ethnicity and gender as factors influencing people’s behaviors and training intervention effectiveness (Davis et al., 2016; Liu et al., 2017). It is also noteworthy that researchers explore the ways different interventions and measures affect people of different ages. The focus on primary-school students and adolescents (Davis et al., 2016; Neely & Holt, 2014). Little attention is given to elementary-school children and their parents. Gender is often in the spotlight as researchers identify trends in the father-child or mother-child dyad, examine health-related behavior in female and male students and their parents. Nevertheless, gender is not properly examined in terms of the attitudes of elementary-school students’ parents.

Theoretical Foundations

The social cognitive theory will be the guiding theoretical framework for this project. According to this theory, social constructs (including education and socioeconomic status among others) and the way they are perceived by people affect people’s behavior (McGee, Richardson, Johnson, & Johnson, 2017). It is expected that the parents having a higher level of education and economic status may benefit from the participation in the project as they will shape their lifestyles as a result of the intervention.

Review of the Literature and Significance of the Project

The review of the existing literature on the interventions aimed at addressing childhood obesity shows that various aspects have been explored. Some of the most recurrent themes include parental involvement, parents’ awareness, intervention, ethnic and cultural diversity, as well as the involvement of communities and families. Parental involvement is regarded as one of the predictors of positive changes in children’s lifestyles and dietary habits (Epstein et al., 2014; Lauricella, Wartella, & Rideout, 2015; Liu et al., 2017). As far as parents’ awareness it has been found that it positively correlates with participation in educational interventions (Neely & Holt, 2014; Columna, Rocco Dillon, Norris, Dolphin, & McCabe, 2017).

Epstein et al. (2014) found that interventions for parents and children implemented separately were more effective than the ones developed for the participation of both groups. Researchers tend to assess the effectiveness of interventions among particular ethnic groups (Barr-Anderson, Adams-Wynn, Alhassan, & Whitt-Glover, 2014; Fradkin et al., 2016; McGee et al., 2017). The involvement of the family and community is another influential factor, and it has been found that this kind of support is associated with interventions’ positive outcomes (Morgan et al., 2014; Quon & McGrath, 2015). The review helps in the identification of the existing gaps.

For instance, the effectiveness of educational interventions among Hispanic low-income parents of obese children is not fully researched. It is not known whether an intervention aimed at teaching the low-income Hispanic parents of elementary-school children affected by obesity on the disease and its prevention will have positive health outcomes. The significance of the present project is associated with the development and assessment of an educational intervention that can help parents improve their children’s health status. This study is an initial step in the development of an effective program that can be used nationwide.

Problem Statement

The morbidity of obesity, its incidence, and persistence into adulthood make obesity associated with substantial financial losses and hazards to public health (Barr-Anderson et al., 2014). In response to this issue, it is possible to assess the impact of raising affected people’s awareness concerning the associated aspects on their health status. The major contribution of this project will be the identification of the effectiveness of an educational intervention for the target population.

Purpose of the Project

The purpose of this quantitative study is to explore the effects of an educational intervention aiming at the increase in physical activity and the reduction of caloric intake among low-income Latino elementary-school children diagnosed with obesity. The project will include the use of educational survey assessment, BMI calculation, self-reported body weight SRBW and self-reported body height SRBH surveys, and Physical Activity Questionnaire. Pre- and post-test quasi-experimental design will be employed to evaluate the level of participants’ knowledge on the necessary levels of physical activity and proper dietary habits before and after the intervention. These measures are essential for the evaluation of the educational project as people’s behavior is often shaped by their experiences and knowledge. BMI calculations will also be analyzed before and after the intervention as this information will show exact changes in children’s health status.

Clinical Question and Variables

The PICO question guiding this project is formulated as follows:

In parents of elementary-school-aged children residing in the Southeast region, Charlotte (NC), what is the effect of an educational session about physical activity benefits and frequency, as well as healthy diets, across 1 month when compared to no intervention, as measured by educational survey assessment tools, BMI calculations, self-reported body weight SRBW and self-reported body height SRBH, as well as Physical Activity Questionnaire (PAQ)?

The dependent variables will be obesity and physical activity based on the calculation of children’s BMI, SRBW, and SRBH, as well as PAQ-C. The independent variable is the educational intervention provided to the parents of elementary-school students. The intervention will involve discussions, workshops, and lectures, as well as the provision of a substantial bulk of materials on obesity, associated health risks, the benefits of physical activity, and healthy diets.

The demographic variables of this study include FAS (family affluence scale), parental education level, subjective family economic status. The family affluence scale comprises such elements as the ownership of a vehicle, the frequency of holiday travels, the number of computers, and the child’s ownership of a bedroom (Elgar et al., 2015). The educational background (high school, college, or higher) of parents has a considerable effect on their children’s lifestyle, so this variable should be considered (Morgan et al., 2014). The subjective economic status (SES) will be measured with the help of a modified instrument developed by Quon and McGrath (2015). This tool consists of the participants’ response to the question of whether they define their economic status as better, similar or worse compared to their neighbors. These variables will also be analyzed as they provide additional insights into the factors that can have an effect on parents’ views and behaviors.

The rationale for Methodology and Nature of the Project Design

The quantitative research involving the use of a quasi-experimental design will be utilized as it is instrumental in evaluating the effectiveness of an intervention. It is essential to obtain quantifiable data such as the rate of children who lost their weight and increased daily physical activity. This information can help in estimating the extent to which the proposed intervention is effective. The assessment of the intervention outcomes is instrumental in addressing the PICO question. The benefits of the quantitative design include the ability to cover a larger population (compared to the qualitative approach) and identify certain trends (Lauricella et al., 2015). The focus on self-reports is also justified as self-concepts play an important role when related to obesity or similar health problems. According to Quon and McGrath (2015), people’s behavior is often shaped by the way they perceive their socioeconomic status rather than the actual conditions. Since socio-economic factors will also be included in this assessment, it is possible to employ self-reports to measure certain variables. People’s appearance and health are also seen as subjective factors, so self-reporting is justified.

Instrumentation or Sources of Data

This study involves the use of surveys and questionnaires as primary data collection tools. The tools for the collection of primary data will be SRBW and SRBH surveys, and PAQ. Pre- and post-tests will help to assess the exact impact of the intervention. Before and after the termination of the intervention, each participating parent will complete the three surveys. These data will be compared to identify the way parents see their children’s progress and health status (as well as lifestyle) changes. In addition, parents will complete SES and FAS to evaluate some external factors that might have an impact on obese elementary-school students’ health outcomes. Such instruments as SRBW and SRBH surveys, SES, PAQ, and FAS have been regarded as valid and reliable, and widely used in different studies (Morgan et al., 2014; Elgar et al., 2015; Quon & McGrath, 2015). The reliability and validity of these measures are also ensured as self-reports are used in combination with objective measurements such as BMI calculation and family income status.

Data Collection Procedures

Both parents (if possible) of 40 children (20 males and 20 females) diagnosed with obesity will be recruited to participate in the study, so approximately 80 people will take part in the project. This sample is sufficient to obtain preliminary data on the effectiveness of the intervention, and the data will be used to improve the educational program that will be assessed in another study covering a larger population. The parents will be divided into the experimental group that will receive the intervention and the control group where parents will receive some leaflets. The leaflets will contain major data on obesity prevalence, its hazards, and prevention, as well as treatment.

Ethical Considerations

The written consent forms will be sent via email or in the clinical setting. The recruitment process will take place in a local clinic where people visiting a physician will be provided with an invitation letter. Once 80 people are recruited, the process will be stopped. The written consent forms will notify the participants about data confidentiality and anonymity, as well as their right to withdraw from the project at any moment. The present study is not associated with any conflicts of interest.

Data Analysis Procedures

Descriptive statistics will be used to analyze the demographic data of the participants. Linear regression analysis will be employed as the data analysis method since, according to Lauricella et al. (2015), it ensures the identification of the relationship between several independent and dependent variables. Such statistical software as SPSS will be utilized to minimize or eliminate possible errors, increase the analysis reliability, and make it less time-consuming.

References

Barr-Anderson, D. J., Adams-Wynn, A. W., Alhassan, S., & Whitt-Glover, M. C. (2014). Culturally-appropriate, family- and community-based physical activity and healthy eating intervention for African-American middle school-aged girls: A feasibility pilot. Journal of Adolescent and Family Health, 6(2), 1-15. Web.

Cochran, J., & Baus, A. (2015). Developing interventions for overweight and obese children using electronic health records data. Online Journal of Nursing Informatics, 19(1). Web.

Columna, L., Rocco Dillon, S., Norris, M. L., Dolphin, M., & McCabe, L. (2017). Parents’ perceptions of physical activity experiences for their families and children with visual impairments. British Journal of Visual Impairment, 35(2), 88-102.

Davis, K. L., Wojcik, J. R., & DeWaele, C. S. (2016). A comparison of the fitness, obesity, and physical activity levels of high school physical education students across race and gender. Physical Educator, 73(1), 15-31.

Elgar, F. J., Pförtner, T. K., Moor, I., De Clercq, B., Stevens, G. W. J. M., & Currie, C. (2015). Socioeconomic inequalities in adolescent health 2002–2010: A time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. The Lancet, 385(9982), 2088-2095. Web.

Epstein, L. H., Paluch, R. A., Wrotniak, B. H., Daniel, T. O., Kilanowski, C., Wilfley, D., & Finkelstein, E. (2014). Cost-effectiveness of family-based group treatment for child and parental obesity. Childhood Obesity, 10(2), 114-121.

Fradkin, C., Wallander, J. L., Elliott, M. N., Cuccaro, P., & Schuster, M. A. (2016). Regular physical activity has differential association with reduced obesity among diverse youth in the United States. Journal of Health Psychology, 21(8), 1607-1619. Web.

Lauricella, A. R., Wartella, E., & Rideout, V. J. (2015). Young children’s screen time: The complex role of parent and child factors. Journal of Applied Developmental Psychology, 36, 11-17.

Liu, Y., Zhang, Y., Chen, S., Zhang, J., Guo, Z., & Chen, P. (2017). Associations between parental support for physical activity and moderate-to-vigorous physical activity among Chinese school children: A cross-sectional study. Journal of Sport and Health Science, 6(4), 410-415.

McGee, B. B., Richardson, V., Johnson, G., & Johnson, C. (2017). Perceptions of food intake, physical activity, and obesity among African-American children in the Lower Mississippi Delta. American Journal of Health Promotion, 31(4), 333-335. Web.

Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Callister, R., Burrows, T., Fletcher, R., … Lubans, D. R. (2014). The ‘Healthy Dads, Healthy Kids’ community randomized controlled trial: A community-based healthy lifestyle program for fathers and their children. Preventive Medicine, 61, 90-99.

Neely, K., & Holt, N. (2014). Parents’ perspectives on the benefits of sport participation for young children. The Sport Psychologist, 28(3), 255-268.

Nyberg, G., Sundblom, E., Norman, Å., Bohman, B., Hagberg, J., & Elinder, L. S. (2015). Effectiveness of a Universal Parental Support Programme to promote healthy dietary habits and physical activity and to prevent overweight and obesity in 6-year-old children: The healthy school start study, a cluster-randomised controlled trial. PLOS ONE, 10(2). Web.

Quon, E. C., & McGrath, J. J. (2015). Community, family, and subjective socioeconomic status: Relative status and adolescent health. Health Psychology, 34(6), 591-601. Web.

Wright, D. R., Lozano, P., Dawson-Hahn, E., Christakis, D. A., Haaland, W., & Basu, A. (2016). Parental predictions and perceptions regarding long-term childhood obesity-related health risks. Academic Pediatrics, 16(5), 475-481.