Childhood Obesity in New Zealand - Doc

Name of the Student
Name of the University
Author Note
Childhood obesity

 Childhood obesity in New Zealand is prevalent among 1 in
8 children
 12% are obese of age 2-14 years, 21% children overweight
 Burden of childhood obesity is very high in Māori and Pacific
children
 18% of Maori and 29% Pacific children diagnosed with
obesity in 2016-2017
 Causative factors- consumption of fast food, sweet
beverages, low physical activity, Maternal obesity,
television advertisement of unhealthy food, Ethnic
differences and low awareness
(Ministry of Health NZ, 2018; Howe et al., 2015)
Assessment 1
What is the issue?

Source: (Ministry of Health NZ
2018)

 Main cause of the preventable deaths in
New Zealand
 Excess prevalence of early life risk factors in
in Māori and Pacific infants
 short term and long term health risks-
cardiovascular disease and type 2 diabetes
 Leads to poor mental health outcomes
 Persistence across life course (Howe et al.,
2015)
Assessment 1
Why is the issue important?

(Source: Ministry of Health NZ 2018)

www.oag.govt.nz, 2018

 Surveillance-monitor health events, and determine
control measures
 Screening - recognise individuals with the health risk
factors
 Health education program- communicate change
related to health issue
 Counselling programmes- promote self-care
 Social media campaigns- create mass awareness (Baker
et al., 2015;
 Public health interventions like physical activity and
social media campaigns are successful in other
countries Briggs et al., 2016)
Assessment 1
Why public health intervention is relevant?

Nutrition based intervention in South Indiana
HEROES initiative - (Healthy, Energetic, Ready,
Outstanding, Enthusiastic, Schools)
school based imitative for childhood obesity
initiative comprise of-
• physical activity education,
• nutrition education,
• nutrition service in school canteen,
• health promotion for staff and family (King
et al., 2014)
Assessment 2
Interventions in other countries

Heroes initiative strategies
• Physical activity- after school walking program,
cardiovascular activities
• Health education- classroom curriculum
integration
• Nutritional services- offering healthy food
mainly fruits and vegetables in school premises
• Administration involvement-support for
HEROES intiative
• Family involvement- family health fair,
communication about wellness
(King et al., 2014)
Assessment 2
Interventions in other countries

Outcomes of HEROES initiative
• Change in school policies
• Instill healthy behavior in children
• Physical education classes/increase in physical
activity
• Decreased consumption- unhealthy food
among students
• Decreases in overweight students
(King et al., 2014)
Assessment 2
Interventions in other countries

 In US, Food4Thought campaign by the British
Heart Foundation has been successful though
moderately in increasing healthy food options
for children and protecting them from
predatory marketing (Wagner, 2015).
 In UK, Change4Life program has been
successful in increasing consumption of 5
portions of fruit and veg each day (Ulijaszek
& McLennan, 2016).
Assessment 2
Interventions in other countries

Nutrition based initiative in Australia-
• “2 Fruit and 5 Veg” campaign as well as
“healthy school canteen strategy” by NSW,
• The “Healthy Together Victoria” campaign
(Dixon et al., 1998)
Nutrition based initiative in Minnesota-
• Successful in Increasing portion size of fruits
and vegetables by 50%, in an elementary
school (oranges, applesauce and carrots)
(Miller et al., 2015)
Assessment 2
Interventions in other countries

 Social media-based exercise in
Philadelphia, increased physical activity-
young and older adults (Zhang et al.,2015)
 In South Africa, football based health
education program was implemented to
increase health knowledge (Fuller et al.,
2010)
Assessment 2
Interventions other than nutrition in other
countries

Aim
• Promote healthy diet and
physical activity among
Maori and Pacific children
of 5-11 years
• Reduce the junk food
habits (King et al., 2014)
• Increase the awareness
childhood obesity and its
prevention (Miller et al.,
2015; (King et al., 2014))
Assessment 2
Nutrition based intervention-Maori and Pacific Population
www.fruitnet.com

Intervention outline
• Target primary school in Christchurch- 500 students
as per HEROES nutrition based initiative (King et al.,
2014)
• Promote Fruit and vegetable consumption by
increasing its availability in canteen as suggested by
Miller et al. (2015); (King et al., 2014); (King et al.,
2014; World Health Organisation, 2012)
• Promote physical activity- racing competition
• Social media campaign as per (Zhang et al.,2015)
• Initiative for 90 days (Miller et al. 2015)
Assessment 2
Nutrition based health intervention

 School intervention - parents and school
teachers spend maximum time with
children (Hemsley-Brown & Oplatka, 2016;
World Health Organisation, 2012)
 Compel to eat fruits and vegetables when
fast food unavailable (Reichmann, 2009;
World Health Organisation, 2012)
 Fruits and vegetables- faster elimination
of fats (Dror, 2014)
Assessment 2
Rationale for Nutrition based intervention

 Physical activity- prevent sedentary
lifestyle in adulthood (Ho et al., 2013, King
et al., 2014)
 Social media campaign- quick mass
awareness/ health literacy/greatly used by
health care providers for health promotions
(Sahoo et al., 2015; Ventola, 2014; Barry et
al., 2014; Zhang et al., 2015)
Assessment 2
Rationale for Nutrition based intervention

 Theory of
observational learning
(Matias, et al., 2014)=
learn by observing others
 Behaviour choice
model (Gutjar et al.,
2015)= pick the best
choice with limited
options
 Theory of health
persuasion= understand
and persuade others
(Dillard & Shen, 2013)
Assessment 2
Theories underpinning intervention
www.pablolinzoain.com
www.wisegeek.com

Diet and physical interventions as per HEROES
intervention
• Prohibit selling of the junk food in the school
• Sell only fruits and vegetable items and low calorie foods (Miller et al., 2015)
• Arranging racing competitions in partnerships with the sports centres in the
city
• one hour session for 30 minutes exercises followed by running for 30 minutes
(Mihrshahi et al., 2017, King et al., 2014)
Assessment 3
Action plan
www.misadallas.com
www.phi.org

Health assessment
• Record height, weight,
waist circumference, BMI,
and other vital signs before
and after interventions
• Assessment of health
awareness through
questionnaires before and
after interventions
(Eldredge et al., 2016)
 Evaluation- top down
approach (Wiskin et al.,
2015; King et al., 2014)
Assessment 3
Action plan
www.easyhealth.org.uk

Social media
campaign
• Facebook- post videos
on healthy food and
physical activity
(Zhang et al., 2015)
• help pacific and Maori
people to cook health
food without
compromising their
cultural values
Assessment 3
Action plan
www.lodestarmg.com

Assessment 3-Key stakeholders
 Parents- monitor the children’s consumption of fruits
and vegetables
 Teachers, principals and school administrators-
food access in canteen/race competitions/physical
activity classes
 Coaches- physical training of children
 Local sports authorities, NGO and other local
government bodies- funding
 Heath science faculty-approval for interventions
 Staff for social media-physical activity and healthy
diet videos/post motivational messages
(McPhail‐Bell et al., 2015; Barry et al., 2014)

Role of government in implementing the nutrition based health
interventions
• Installing healthy eating vending machine in schools
• Develop policy- ban selling of fast food near schools/ban television
advertisement of fast food
• Support with funds
• Galvanise key stakeholders
• Data analysis concerning burden of childhood obesity in Christchurch
• Distribute available resources
• Efficient resource utilisation
• Collaboration with sports clubs and health centres
• Advocate appropriate services- community members (www.cardi.ie
, 2018, World Health Organisation, 2012)
Assessment 3
Role of government

 Lack of effective coordination between teachers,
parents, ad children
 Teachers- ineffective instructions to the children
 Children may visit any local restaurants and fast
food centres
 Poor monitoring by teachers or parents
 Social and cultural obligations by Maori and pacific
population- ethical issue (Ritchie et al., 2015)
 Parental feeding behaviours- vary in different
families (Shloim et al., 2017)
 Poor funds for large scale interventions
Assessment 4
Potential barriers

 Preserve ethics/values/beliefs- Maori and Pacific
population (Kraemer, Spears & Arcury, 2015)
 Implement principle of beneficence, justice, and
non-maleficence Dingwall et al. (2017)
 Educate parents before intervention-healthy cooking
style in traditional way (Mihrshahi et al.,
2017)/overcome the beliefs of fat acceptance
 Questionnaires- before and after intervention/ asses
children awareness (Kipping et al., 2014)
 Teachers and coaches- training before interventions
 Smartphone devices for children to track
interventions (Miller et al., 2015; Kipping et al., 2014).
Assessment 4
Solutions to barriers

Development of questionnaires
• Questionnaires for children to
gauge awareness importance
of physical activity (Fuller et
al., 2010)
• Questionnaires for coaches
• Five point Likert scale
(Eldredge et al., 2016)
• Questionnaires- both English
and local language.
Assessment 5
Monitoring the interventions
blog.yesinsights.com

 Calculation of BMI- before and after interventions
 Data collection tested for statistical significance
 Collect records of attendance
 Collect- records of attendance in physical activity
sessions (Miller et al., 2015, Baker et al., 2015)
Assessment 5
Monitoring the interventions
http://www.pim.com.pk

Monitoring social
media campaign
• Monitor traffic on
facebook pages
• Adobe
SiteCatalyst-
number of clicks,
shares, followers
• Report any
automatically
delivered metrics
(Cdc.gov, 2018)
Assessment 5
Monitoring the interventions
www.mrss.com

Process evaluation
 Analyse- school based
interventions - weekly basis
 issue related to racing
classes to optimise the
methodology
 Ensure the availability of
First Aid
 Effective partnerships with
the sports club
(Robinson et al. 2014; Kipping
et al., 2014)
Assessment 5
Evaluation of interventions
www.tesla-project.eu

Process evaluation
 Feedback from school authorities
 Regulate the awareness on the Facebook
page (Robinson et al. 2014; Kipping et al.,
2014)
Assessment 5
Evaluation of interventions

Process evaluation
 Recruit trained physical instructor
 Training of other volunteers and staff
 Adequate assistance to nurses and General
practioners
(Robinson et al. 2014; Kipping et al., 2014)
Assessment 5
Evaluation of interventions

Process evaluation
 Ensure that the correct instructions have
been given
 Proper development of questionnaire
 Analysis of intervention by regular meetings
(Robinson et al. 2014; Kipping et al., 2014)
Assessment 5
Evaluation of interventions

Evaluation of
outcomes
 Effective feedback
analysis
 Parents - active
engagement
 Children to show
positive response
Flint et al., 2014;
Aldred & Jungnickel
2014
Assessment 5
Evaluation of interventions
www.graphicriver.net

Evaluation of outcomes
 Sports clubs, local and government
organisations
 reduced calorie and fast food consumption
among targeted children
(Flint et al., 2014; Aldred & Jungnickel 2014)
Assessment 5
Evaluation of interventions

Evaluation of outcomes
 greater involvement - in physical exercises
and race competition
 Increase in health literacy among target
population
 Greater knowledge of obesity risk factors
and preventive factors.
 Increased awareness
(Flint et al., 2014; Aldred & Jungnickel 2014)
Assessment 5
Evaluation of interventions

Evaluation of outcomes
 Decrease in BMI and weight of the Obese
and overweight children
 Overall increase in fitness as well as
knowledge of nutrition
 Measure the equilibrium in BMI using
guidelines given by the WHO
(Flint et al., 2014; Aldred & Jungnickel 2014)
Assessment 5
Evaluation of interventions

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