EVIDENCE-BASED NURSING PRACTICE-CHILDHOOD OBESITY.

EVIDENCE-BASED NURSING PRACTICE-CHILDHOOD OBESITY
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EVIDENCE-BASED NURSING PRACTICE-CHILDHOOD OBESITY
Question one: Reasons for the inequity between Indigenous and non-Indigenous
Australians
Childhood obesity is increasingly becoming a global health concern. In Australia, for example,
an estimated 28% of the adolescents and children are obese or overweight. This number is
however much higher among the Torres Strait Islander People and the Aboriginals among other
groups (Healthdirect 2019). Additionally, about 30% of Indigenous Australians are believed to
be obese compared to 25% non-Indigenous Australians. A recent study of weight trends in New
South Wales indicates signifies a widening weight gap between the non-indigenous and
indigenous children. In particular data from the study shows that the obesity and excess weight
rates increased by about 11.8% among non-indigenous children as compared to 22.4% among
Indigenous Australians.
One of the reasons for the inequity among the Indigenous and non-indigenous Australians is
health behaviours. Health behaviours include physical activity and healthy eating. Research
shows that the Aboriginal children have lower odds of eating breakfast compared to non-
indigenous Australian children. Also, they are more likely to have their supper while watching
TV. They are also more likely to have an intake of at least one cup of soft drink in a day and
watch TV excessively throughout. On the same note, researchers also found out that the
Indigenous group’s intake of fruits and vegetables was relatively lower at about one serving per
day as compared to the recommended two servings. Also, they are two times likely to go for a
day without any fruit and seven times more likely to have no daily intake of vegetables as
compared to non-indigenous Australians (Stewar 2014).The second reason is the difference in
the socioeconomic between the indigenous and non-indigenous Australians. Generally, people

from the poor socioeconomic classes are at higher risk of illness, disability and poor health as
compared to people from advantaged backgrounds. Indicators such as income, occupation and
education determine socioeconomic position of a population. To explain, higher education is
linked to better health throughout an individual’s life. The education level of an individual
affects not only their life but also that of their family, especially that of children dependent on
them. Also, wealth and income also play a major role in the socioeconomic position and health
of an individual. In particular, a lower income denies access to services and goods providing
health benefits such as additional healthcare options, housing better food, and more significant
choices in healthcare pursuits (AIHW 2016). An increase in household’s head education leads to
a decrease in childhood obesity. Low education levels among indigenous Australian’s household
heads, therefore, lead to an increase in prevalence of childhood obesity among indigenous
children. Health behaviours and socioeconomic status are therefore some of the reasons for
inequity in prevalence of childhood obesity among indigenous Australians and non-indigenous
Australians.
Question two: Impact of one primary healthcare intervention addressing Childhood
Obesity among Indigenous Australians
Due to the prevalent nature of childhood obesity in Australian, several programs based on
community needs have been rolled out to close the inequality gap. Studies have shown that obese
children stand a higher risk of becoming obese adults. Obesity is also associated with higher risk
of diseases such as Arthritis, diabetes, cancer and cardiovascular disease. Additionally, research
has also shown that minimising the consumption of junk food and sugary drinks from an early
age could be of greater benefit to indigenous children. Apart from junk food and sugar-
sweetened sweet soft drink causes, childhood obesity in Australia is also caused by lack of

access to healthy foods options, especially for the people in urban, regional and remote settings.
Successful interventions to curb this vice would, therefore, be those that focus on reducing junk
food consumption while at the same time increasing acceptability, availability and affordability
of healthier food choices (Thurber et al. 2017). Recent times have also shown an improvement in
closing the gap between the health outcomes for the indigenous and non-indigenous Australians.
These efforts have mostly focused on increasing health checks, improving immunisation rates
and provision of better health outcomes. However, the challenges of the Torres Strait Islander
people have continued to worsen with a greater burden of ill health. In an effort to bridge the gap
between the Indigenous and non-indigenous Australians, several programs have been rolled out
to help manage obesity among children. An example of these programs is the Thumps up
program initially funded by the federal government of Health and Ageing. The program was
founded to improve the overall health outcomes for the indigenous children together with their
families. The program also has a vision of providing nutrition and health education and striving
for excellence in Indigenous Australian’s healthcare. The program is a brainchild of Thumps up
foundation, which works in collaboration with nonprofit and corporate organisations, peak and
statutory health bodies, and territory, state and federal governments. Founded in 2009, The Uncle
Jimmy Thumps up program aimed to bridge food industry, arts sector, education and health
arena. It promotes consumption of healthy foods through education and music programs in
remote communities and schools. Since its formation, the program has made several strides. In
particular, it has conducted 42 workshops; produced 22 songs and videos; achieved successful
participation of more than 1000 children; engaged 16 specialists in the delivering of workshops
and production of videos; distributed 20,000 thumps up merchandise and collaborated with
various other stakeholders. Also, thumbs up foundation has signed memorandum of

understanding with local organisations such as outback stores, Arnhem Land progress to promote
Uncle Jimmy Thumps Up messages in stores (Medicinesaustralia 2019). In conclusion, Uncle
Jimmy Thumps Up program has been quite effective in addressing childhood obesity among
indigenous Australians.
Question Three: Cultural knowledge and Sensitivity in healthcare
The increasing diversity in nations across the world has brought both opportunities and for
policymakers, healthcare systems and healthcare providers. With this diversity, a need created
for healthcare providers to include cultural competence and sensitivity as basic premises in their
practice. Cultural competence is the ability of organisations and healthcare providers to deliver
health care services that are in consistency with the linguistic, cultural and social needs of
patients. The elimination of ethnic and racial disparities can be achieved through a culturally
competent healthcare system. Also, it can also lead to improvement in quality of care and health
outcomes. Cultural knowledge is an important component of an individual’s cultural
competence. Cultural knowledge refers to what is known about a particular culture or
characteristics belonging to members of a particular culture (HealthPolicyInstitute, 2019).
Cultural sensitivity, on the other hand, is the aspect of being aware that similarities and
differences exist among individuals without allocating them a right, wrong, worse, better,
negative or a positive value. Cultural sensitivity is the awareness that people are different and
recognising the fact that your culture as a health care provider is not in any way superior to any
other (Dabbah 2019).
Cultural knowledge makes healthcare providers to respect and be responsive to patient’s
wellness and health practices and belief. It can play a major role in meeting the needs of patients.
An understanding of patient’s relationships with their ancestors, each other, environments and

lands removes any potential barriers between the patients and their healthcare needs. It,
therefore, leads to improved healthcare delivery to patients by eliminating any existing barriers.
For example, an understanding of Torres Strait Islanders and Aboriginals cultural knowledge
would be an effective tool in dealing with childhood obesity between the two groups (McElfish
et al. 2016). Such knowledge would be important in sustaining heal care workforce and play a
role in the resolution of childhood obesity needs within the community. On the other hand,
linguistic and cultural differences may affect level of trust and communication between the
healthcare provider and the patients. Therefore, cultural sensitivity is quite important in the
provision of quality and safe patient care. Cultural sensitivity helps healthcare providers to
provide healthcare services that are responsive and sensitive to the linguistic needs, cultural
aspects, practices and health beliefs of patients, therefore leading to positive health outcomes.
For example for an healthcare provider offering healthcare services to an obese child from the
Torres Strait Islanders or the Aboriginals, cultural sensitivity would require them to seek to
understand the child and ensure that the child understands them too. It would also require him or
her to address the child in a way that is in accordance with the indigenous communities. This
would lead to improved outcomes for the patient (Brooks, Manias and Bloomer 2018).
Therefore, cultural knowledge and sensitivity are important in healthcare

References
AIHW (2016). Australia's health 2016, Chapter 4 Determinants of health - Australian Institute
of Health and Welfare. [online] Australian Institute of Health and Welfare. Available at:
https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/
determinants [Accessed 3 May 2019].
Brooks, L.A., Manias, E. and Bloomer, M.J., 2018. Culturally sensitive communication in
healthcare: A concept analysis. Collegian.
Dabbah, M. (2019). What is Cultural Sensitivity? Discover Definition & Theory. [online] RED
SHOE MOVEMENT. Available at: https://redshoemovement.com/what-is-cultural-
sensitivity/ [Accessed 4 May 2019].
Healthdirect (2019). Obesity in children. [online] Healthdirect.gov.au. Available at:
https://www.healthdirect.gov.au/obesity-in-children [Accessed 3 May 2019]
HealthPolicyInstitute (2019). Cultural Competence in Health Care: Is it important for people
with chronic conditions? - Health Policy Institute. [online] Health Policy Institute.
Available at: https://hpi.georgetown.edu/cultural/ [Accessed 4 May 2019].
Medicinesaustralia (2019). Thumbs Up!. [online] Medicines Australia. Available at:
https://medicinesaustralia.com.au/community/thumbs-up/ [Accessed 4 May 2019].
McElfish, P.A., Long, C.R., Rowland, B., Moore, S., Wilmoth, R. and Ayers, B., 2017.
Improving Culturally Appropriate Care Using a Community-Based Participatory
Research Approach: Evaluation of a Multicomponent Cultural Competency Training
Program, Arkansas, 2015-2016. Preventing chronic disease, 14, pp.E62-E62.

Stewar, R. (2014). Healthy start: closing the gap on Indigenous childhood obesity. [online] The
Conversation. Available at: https://theconversation.com/healthy-start-closing-the-gap-on-
indigenous-childhood-obesity-28769 [Accessed 3 May 2019].
Thurber, K., Dobbins, T., Neeman, T., Banwell, C. and Banks, E. (2019). Aboriginal
#Earlychildhood #Obesity Study: We need to reduce the prevalence of
overweight/obesity in the first three years of life. [online] NACCHO Aboriginal Health
News Alerts. Available at: https://nacchocommunique.com/2017/03/31/aboriginal-
earlychildhood-obesity-study-we-need-to-reduce-the-prevalence-of-overweightobesity-
in-the-first-3-years-of-life/ [Accessed 4 May 2019].