Disease Prevention and Management

This study focuses on the prevention and management of non-communicable diseases, specifically obesity and overweight, in a state primary school in Perth, Australia. The stakeholders involved include the community, families, teachers, and pupils. The intervention includes a socio-ecological model that impacts weight outcomes and energy balance behaviors. The intrapersonal level involves evidence-based practices, nutrition care provisions, and dietary interventions. The dietary intervention focuses on achieving negative energy balance through individualized diets and small behavior changes.

0DISEASE PREVENTION AND MANAGEMENT
Disease Prevention and Management
Name of the Student:
Name of the University:
Author Note:

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Table of Contents
Introduction......................................................................................................................................2
Demographic characteristics of the school and the surrounding community..................................2
Aetiology and epidemiology of overweight and obesity in the target group..................................7
Justification of stakeholder group selection....................................................................................9
Description of the intervention........................................................................................................9
Outline of communication strategy...............................................................................................11
Outline of the evaluation framework.............................................................................................14
Conclusion.....................................................................................................................................16
Reference.......................................................................................................................................17

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Introduction
The assignment is a planning, implementation and evaluation of the prevention of the
non-communicable diseases and it follows a disease prevention strategy. This study includes a
considers a state primary school as a clinical setting where the preventive strategies on obesity
and overweight are taken into account. The task takes into account the stakeholders that are
associated with the school and it includes the community, families, teachers and pupils. The
students will perform the duties of public health officers for the Department of health on
planning, implementation and evaluation related to intervention. The main task here is to develop
information for the stakeholders in order to promote communication strategies, and an outline for
the evaluation strategy. Additionally, a direct link will be developed between the risk reduction
and intervention design in the target group.
Demographic characteristics of the school and the surrounding community
the School selected for the study is Perth Modern School located in Subaico. It is a co-
educational school in the which is a located in the Perth, Australia. The School has a total of
1371 students that have enrolled from the year 7 to year 12. The school is considered as a
multicultural campus and it has students from 30 different nationals. Students from all over the
regional locations and metropolitan areas in Western Australia comes to the Perth Modern
School. In terms of year, the year 7 has 232 students, year 8 has 209 students, year 9 has 220
students, year 10 has 243 students, year 11 has 244 students and year 12 has 223 students.
Overall, the total number of students by gender: 760 students are boys and 611 students are girl
(perthmodern.wa.edu.au, 2018).

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Figure a: Demographic chart of the students in Perth Modern School (source:
perthmodern.wa.edu.au, 2018)
The Perth Modern School staffs have three different categories which includes the
administration staff, teaching staff and the support staff. There is a total of 18 administration
staff which includes the principal, associate principle, student careers/services, GT online,
program coordinators and heads of learning areas. Total number of the teaching staffs is 91
which includes the senior teachers, level 3 teachers, level 3 teachers and the other teaching staffs.
The total number of the support staffs is 41 and it includes administrative/clerical,
maintenance/gardening and other non-teaching staffs (perthmodern.wa.edu.au, 2018).
The school is located in the Subiaco region the demographics of this region is selected for
the study. Total population of Subiaco is 9202. With the percentage of males is 48.7 and the
percentage of females is 51.3. The median age of the population is 38. There are 2233 families
and the average children per family is: families with children is 1.6 and for all the families the
average children per family is 0.4 (Quickstats.censusdata.abs.gov.au, 2018).

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Table 1: Table of median age and population structure based on age
(Quickstats.censusdata.abs.gov.au, 2018)
Age Subiaco
Median age 38
0-4 years 516
5-9 years 416
10-14 years 398
15-19 years 356
20-24 years 552
25-29 years 994
30-34 years 832
35-39 years 739
40-44 years 609
45-49 years 571
50-54 years 615
55-59 years 593
60-64 years 532
65-69 years 547
70-74 years 377
75-79 years 268
80-84 years 148
85 years and over 143

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Table 2: Table of registered marital status (Quickstats.censusdata.abs.gov.au, 2018)
Registered marital status Subiaco
People aged 15 years and over
Married 3,326
Separated 227
Divorced 754
Widowed 271
Never married 3,298
Table 3: Table of education statistics (Quickstats.censusdata.abs.gov.au, 2018)
Education Subiaco
Preschool 110
Primary - Government 414
Primary - Catholic 39
Primary - other non-Government 63
Secondary - Government 224
Secondary - Catholic 55
Secondary - other non-Government 144
Technical or further education institution 93
University or tertiary institution 701
Other 73
Not stated 898

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Table 4: Table of highest education attainment (Quickstats.censusdata.abs.gov.au, 2018)
Level of highest educational attainment Subiaco
People aged 15 years and over
Bachelor Degree level and above 3,918
Advanced Diploma and Diploma level 628
Certificate level IV 102
Certificate level III 356
Year 12 960
Year 11 213
Year 10 323
Certificate level II 3
Certificate level I 0
Year 9 or below 181
No educational attainment 14
Not stated 962
Table 5: Table of occupation statistics (Quickstats.censusdata.abs.gov.au, 2018)
Occupation Subiaco
Employed people aged 15 years and over
Professionals 2,244
Managers 805
Clerical and Administrative Workers 496
Community and Personal Service Workers 341
Technicians and Trades Workers 310
Sales Workers 302
Labourers 173

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Machinery Operators and Drivers 49
Aetiology and epidemiology of overweight and obesity in the target group
Aetiology of Overweight and obesity among the target group- The three major causes or
the aetiology of obesity and overweight.
 Energy intake- the amount of the food that a body requires depends on the
whether a woman is pregnant or is breastfeeding, level of physical activity, body
size, sex, and age. Body converts carbohydrate, fat and protein into energy. Fat is
considered to be the most concentrated source of energy. Among the target
communities and the school students, it is noticed that the year 2011-12, the
calorie intake ranged from 6000 to 9000 kilojoules from children aged between 2-
3 years and adolescents aged between 14 to 18 years respectively. While for the
adults that are aged 19 and above, the average intake of calorie for women is 7500
kilojoules and for the men is 10,000 kilojoules (Fock & Khoo, 2013).
 Energy expenditure- the expenditure of energy in the human body takes place in 3
different ways, such as basal metabolism (energy used to maintain the vital
process in the body), physical activity (energy required in digestion and
absorption of food) and thermic process (energy required to move around).
Physical activity is a variable part of energy expenditure and it is the vital
component that a person needs to control. For an active person, physical activity
contributes only about 20 percent of the everyday expenditure of energy
(Markwald et al., 2013).
 Balance- physical activity and healthy eating are the important part of an active,
healthy life. Maintaining a proper body weight corresponds to the energy entering

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the body and also the energy used for growth, repair and physical activity to keep
the bodily actions working. Adolescents and children require proper food for
proper development and growth. The older people also need to be eat healthy food
and remain physically active and have proper muscle strength. The imbalance
between the both leads to the symptoms like overweight and obesity (Pasco et al.,
2012).
Epidemiology of Overweight and obesity among the target group- in the year 2015,
studies have shown that 27 percent of the residents that are aged 16 and above in Western
Australia are found to be obese. While it has been noticed that 40 percent of the residents of
Western Australia are overweight. It has also been noticed that the greater number of men are
more likely to become obese and overweight than the women. In the year 2014, the about 9
percent of the Western Australian teenagers and children are obese and 14 percent of adolescents
are overweight. The rates of obesity and overweight increases among the people that are 45 years
and older. Studies have indicated that the children that are overweight tend to become obese as
adults and are thus at the risk of having future health problems. Physical inactivity and poor
nutrition plays a major role in increasing the trends of obesity and overweight. However, there
are other environmental factors that play a role in the increasing the rates of obesity. Occurrences
of illness from excess weight in Western Australia has cost about 241 million dollars for the
Western Australia hospitals, while the it has been estimated that the cost will double in the year
2021 (Ww2.health.wa.gov.au, 2018).
Medically the treatment of obesity and overweight involves the management of
the obesity and overweight through the behavioural treatment, exercise, and dietary intervention.
Dietary intervention includes the types of diet that involves the very low carbohydrate diet, low

9DISEASE PREVENTION AND MANAGEMENT
carbohydrate diet, low fat diet, and low calorie diet. Physical activity is vital when it is done
along with a proper diet regime (Walls et al., 2012).
Justification of stakeholder group selection
The stake holder group chosen for the study include the ones that are associated with the
school. Thus, the stakeholders are the communities, families, teachers and the pupils that reside
near the school and study in the school. For this study a school named Perth Modern School is
chosen and this school is located in the Western Australia. There are many factors that lead to
overweight and obesity and it occurs due to physical inactivity, intake of energy from the diet
and the imbalance of energy. The environmental and the genetic factors all play a major role in
the in increasing the tendencies of obesity and overweight. Attention to the physical activity and
proper diet helps in attaining a healthy body weight.
Description of the intervention
The socio-ecological model is a multidisciplinary care model that has the potential to
impact both the weight outcomes and energy balance behaviours. The intervention acts as a level
of influence on the public and governmental policies, organizational and community factor and
intrapersonal factors.
Intervention at the intrapersonal-level- the evidence based practices provide the best
source of information for framing the intervention at the individual level. The treatment
procedures emphasise on the intra-personal levels and it assists in changing the energy balance
behaviours. The nutrition care provisions include the assessment of nutrition take up, and it is
followed by the diagnosis and intervention along with the monitoring and evaluation. The entire

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process is focussed on the intrapersonal level (Raynor & Champagne, 2016). The first and the
foremost part of any obesity and overweight treatment plan is to determine the BMI of the
patient and the second identification is whether the patient is overweight or obese. The adults
that are obese or overweight are referred to medical nutrition therapy and the treatment
procedures will be handled by the registered dietician nurses. After the initiation of the care plan,
data about the client are collected that include the weight management, housing and living
situation and dietary intake. Along with all these measurements, the registered dietician nurse
will also assess the nutrient content of the diet and the energy intake. Finally, the registered
dietician nurse measures the resting metabolic rate which is necessary to determine the energy
requirement for the obese and overweight adults (Raynor & Champagne, 2016).
Dietary intervention- obesity and overweight treatment involves achieving a condition of
negative energy balance. This means that the energy content in food must be decreased in order
to manage the obesity. There are dietary approaches that have the potential to reduce the energy
intake in taken into account. The registered dietician nurse prescribes an individualized diet that
the emphasises on the health status of the patient and suggests an individualized diet accordingly.
This will enable the target population to achieve the requisite amount of dietary intake. The
individualised diet strategy will focus on the calorie intake of men (1500 to 1800 kcal per day)
and women (1200 kcal to 1500kcal). The food diets which will be contain restriction on certain
diets like the high fat foods, low fibre foods, high carbohydrate foods. The diet is framed in such
a way that will have a reduced calorie intake with and an energy deficit (Dombrowski et al.,
2012). Weigh maintenance is also prescribed in order to lower the body weight. Small food
based alterations can change the energy balance by 100 to 200 kcal in a single day. It has been
seen that the small behaviour changes like less sugar intake, less intake of sugar-sweetened

11DISEASE PREVENTION AND MANAGEMENT
beverages can greatly change the macronutrient composition of the diet. Vegetables and fruits is
capable in promoting healthy diets and it can greatly reduce the density of dietary energy. Fast
foods especially contain high density of dietary energy and reduction in the intake of the fast
food can effectively reduce the weight gain. Portion control changes can be achieved by having
foods that have the energy content mentioned on it. Energy focussed also play a major role in
weight management. The two most well-known strategies that can be integrated in to the dietary
regime is the consumption of the low carb diet, and the very low calorie diet. Additionally, the
diet can be planned to be primarily dietary pattern focussed, containing high protein, low
glycaemic load and glycaemic index, low carbohydrate, avoiding food that are energy dense,
timing of the eating, eating frequency and dietary timing (Hoelscher et al., 2013).
Physical activity- through some of the evidence practices it has been found that the
combination of exercise and diet is not effective in comparison to the behavioural management
that focus in the weight management. Thus, for the weight loss program to it is necessary to have
an equilibrium between the energy expenditure and the energy intake. Thus, the weight loss
program must include a comprehensive physical activity regime coupled with a proper diet (Ding
& Gebel, 2012).
Intervention for the children and adolescents that are school goers- Strategies like
school based programs specifically targets the school goers. The intervention plan will include
the diet control and regular physical activity. Tiffin boxes can be monitored so that the calorie
intake can be restricted. Telephonic interviews can be conducted to inform and aware the parents
regarding the proper diet and requisite amount of physical activity.

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Outline of communication strategy
The communicatio stratgey will involve 4 major sections including the content sources,
messengers, channels and audience (figure 1).
The content sources of the communication strategy will inlcude the media rource center
for carrying out the campaign, health media center in the community, success stories of the
affected people, pictures, videos, infographics, media reports based on obsesity and overweight
prevalence, survey results on the occurrence of obesity in the target community, reports and
publications based on the obesity and over treatment and management, the various evnets based
on the obesity and overweight awareness and the funding announcements by the health
departments (Southernobesitysummit.org, 2018).
The messengers of the communication stratgey will incude the department of health,
fundraiing department or the development department, subcommittee for marketting,
partnerships and colaitions fomed with the different governmental organizations and the non-
governmental organzaitions, subcommittee for marketing the health informations, standalone
department for marketing of the informations based on overweight and obesity, communication
leaders, public and media realtions for maintaining a proper. The chnnels for through which the
communication will be carried out include the paid media (advertising and educational
campaign), partner media (talking points, newsletters and briefinng metarials), earned media
(news features, news releases, community media and ethnic media), social media or digital
media (website, blogs, facebook, twitter, youtube). The audiences that are incuded in the
communication strategy include the hospitals, schools, community leaders, partners and
coalitions in the communication strategy, funders, stakeholders (pupils, teachers, familis,
communties), audience segments and general public (Southernobesitysummit.org, 2018).

Content sources
Funding announcement
Events
Publications and reports
Survey results
Media reports
Infographics
Videos
Pictures
Success stories
Health media centre in
the community
Media resource centre
for campaign
Messengers
Communication leaders
Standalone department for
marketing
Public relations and media
Partnerships and
coalitions
Subcommittee for
marketing
Fundraising department or
development department
Department of Health
Channels
Social media/digital
media including
YouTube, Twitter,
Facebook, blogs, website
Earned media- news
features, news releases,
ethnic media/community
media
Partner media- talking
points, briefing materials,
newsletters
Paid media- educational
campaign and advertising
Audience
General market- public
Audience segments- public
Stakeholders-community,
families, teachers, pupils
Funders
Coalitions/partners
Leaders of the community
Schools
Hospitals
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Figure 1: Outline of communication strategy [Done by author]

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Process Output Outcome
National or
local strategic
leadership on
physical
activity and
diet
Supportive
programmes
Supportive
environment
Supportive policies
Behaviour
change
Economic
Environmental
Health
Social
Surveillance, evaluation and monitoring
Outline of the evaluation framework
Figure 2: Outline of evaluation framework (done by author)

The evaluation framework for the obesity and the overweight management and control
involves three main sections of process, output and outcome. In the process section, there is a
need for a national or local level leadership on the physical activity and diet. At the national
level, the government of the Western Australia will frame policies and that will effectively focus
on the diet of the citizens and the target population. In the process section, the local leadership
will include the management policies and strategies taken by the local government, healthcare
departments and the school administration (Have et al., 2012). The process section is the main
driving force behind the obesity and overweight management and prevention. Thus, the
healthcare department of Western Australia, the National government and the local government.
Along with the extended contribution of the school and the community centres that will help in
the playing major in the healthcare monitoring, evaluation and surveillance (Who.int, 2018).
Both the process and the output section is being overlapped by three sub-sections called
the supportive programmes, supportive policies and supportive environment. It is important to
highlight that only the perfect coordination of the three sub-sections will lead to a proper
implementation of the obesity and overweight management and prevention. Supportive
environments mean the activities must be proper enough that will influence the target population
into having an environment where the target population will be able to make healthier choices
and it will be easier for the people to take up the obesity and overweight control measures.
Creating a supportive environment will promote and influence the pupils, teachers, people living
in a community and the families (Hawkes, Jewell & Allen, 2013). Controlling the diet of the
target population will require a strict monitoring of the eating habits of the pupils, teachers and
the families that reside in the neighbouring communities. Supportive policies will include the
provision and plans that both at the local and the national level. Policies must be framed in a way

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that will promote the physical activity and at the same time promote healthy diets. The third sub-
section deals with the supportive programmes and this includes the effective and efficient
implementation of the policies both at the national level and the regional level and this will be
one of more stakeholders. It is important to mention that the student will work as a public health
officers in the department of health on the planning, implementation and the evaluation of the
intervention plan (Dietz et al., 2015). One of the major aspect of is the behaviour change and this
will include the behaviour change of the target population. Behaviour change will include the
various aspects related to obesity and overweight management and prevention and this
subsection falls within the overlapping sections of output and outcome. The next section is
outcome and it includes the social, environmental, health and economic benefits that will be
accrued by the target population. The mechanism which is established in the framework will
have an impact on the decision making process and at the same time will guide the future
activities (Langford et al., 2014).
Conclusion
From the above discussion it can be concluded that, children that are overweight tend to
become obese as adults and are thus at the risk of having future health problems. Physical
inactivity and poor nutrition plays a major role in increasing the trends of obesity and
overweight. However, there are other environmental factors that play a role in the increasing the
rates of obesity. Medically the treatment of obesity and overweight involves the management of
the obesity and overweight through the behavioural treatment, exercise, and dietary intervention.
Dietary intervention includes the types of diet that involves the very low carbohydrate diet, low
carbohydrate diet, low fat diet, and low calorie diet. Physical activity is vital when it is done
along with a proper diet regime.

17DISEASE PREVENTION AND MANAGEMENT
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