Public Health Promotion Plan for Prevention of Obesity in Primary School Children

This article discusses a public health promotion plan aimed at preventing obesity in primary school children through the implementation of a breakfast program and a walking to school initiative. The plan targets children aged 4-12 years attending Balmain public primary school and focuses on promoting healthy eating and physical activity. The article also highlights the benefits of school breakfasts and the importance of community-based programs in preventing childhood obesity.

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Public Health Promotion Plan for Prevention of Obesity in Primary School Children: Family
Breakfast at School and Walking School Bus
Introduction
There is an increasing global concern about the pervasiveness of obesity in school going
children in third world nations (Gortmaker et al., 2011). The Australian Institute of Health
and Welfare (2018) found out that 1 out of 4 children aged 2-17 years was overweight.
Childhood obesity is a significant public health issue because of its fast-growing incidence
and related severe medical and social impacts. Most of the existing public health strategies
for obesity prevention in school going kids have had minimal success (Swinburn et al.,
2011). The scientific community has advocated for community-based programs in the
deterrence of obesity in children (King, Gill, Allender, & Swinburn, 2011). The Colac Be
Active Eat Well is an Australian community-based programme for the aversion of obesity
among 4-12-year-old. The programme led to a minimal increase in bodyweight by 1 kg and
waist circumference by 3 cm (Sanigorski, Bell, Kremer, Cuttler, & Swinburn, 2008). More
significantly, the study did not show any indication of inequalities in health or mental
damage. Another community-based intervention programme for obesity prevention among
5-year-old children showed a substantial decline in the incidences of high BMI (de Silva-
Sanigorski et al., 2010).
The family breakfast at school project is initiative of Obesity free coalition for Children in
Balmain, NSW in collaboration with Balmain public primary school to increase the activity
level of kids and avoid obesity by promoting walking to school. The plan will also involve
intervention on healthy eating that will emphasize on promoting nutritional, and culturally
diverse school breakfasts.
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Health Promotion and Target Group outline
The health promotion plan will target primary school children aged 4-12 years, and
attending Balmain public primary school and not meeting physical activity
recommendations. The target group will consist of both the Indigenous and non-indigenous
Australian peoples. It is estimated that a total of over 500 children will participate in the
programme. The school is ethnically diverse and most of the children are from low-income
families which also make up the racial/ethnic minorities and are thus at a high risk of
developing childhood obesity. A school-based intervention will be used to reach the primary
school children.
This public health promotion project will be beneficial to the target population in multiple
ways. There is an increasing incidence of obesity among primary school children and has
thus become a public health problem (O’Dea, & Dibley, 2014). Some of the most successful
projects of overcoming childhood obesity is to promote safe and pleasurable physical
activity (Bleich, Segal, Wu, Wilson, & Wang, 2013). School lunches are organized to meet
approximately 33% of the daily energy needs of a child, whereas breakfast meets 25% of
those requirements (de la Hunty, Gibson, & Ashwell, 2013). Moreover, the school
atmosphere and curriculum offer a lot of opportunities to inspire the decisions of the
children regarding physical activities and food choices (Frerichs et al., 2015; Koch, 2016).
Whereas there has been a lot of emphasis on the lunch menus in schools as a means of
preventing obesity and promoting healthful living, minimal attention has been given to
school breakfast. Studies have indicated that school breakfasts are vital in addressing
obesity in children and in efforts to fight food insecurity (Safdie et al., 2013). Kids who
consume healthy breakfast are twice more likely to meet the goal of 5 servings of fruits and
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vegetables daily. Moreover, children who take their breakfast at school are likely to
consume more fibre, calcium, and vitamin C and minimal sugar that non-participants (Wang
et al., 2017). The health promotion plan will also help to prevent obesity by regulating body
weight. Gundersen, Lohman, Eisenmann, Garasky, & Stewart (2008) found out that school
girls from low-income families were protected from becoming overweight through their
participation in school breakfast. Eating nutritional breakfast reduces fat intake and helps
avoid snacking during the rest of the day. The habit of skipping breakfast has been shown in
cross-sectional studies to be prevalent among obese kids (Kesztyüs, Traub, Lauer, Kesztyüs,
& Steinacker, 2017). Additionally, breakfast intake has also been found to improve test
scores (Adolphus, Lawton, & Dye, 2013; Edefonti et al., 2014). Based on the above benefits
of this health promotion plan, Balmain public primary school is likely to agree to the
partnership.
Health Promotion Aims
This health promotion plan purposes to prevent obesity in primary school going children by
involving them in school breakfast and encouraging walking-to-school. The focus will be on
Balmain public primary school children aged 4-12 years, and the project will take a period of
one year. The success of the project will be measured by the percentage reduction in body
weight after a period of 3 months.
A part-time coordinator will be responsible for the promotion in collaboration with the
nutrition staff at Balmain public primary school.
Health Promotion prevention management perspective (primary, secondary or tertiary)
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This public health promotion plan falls under primary prevention because it aims at
protecting kids vulnerable to developing childhood obesity by promoting a healthy lifestyle.
The objective of primary prevention is to avoid the development of a disorder and to
emphasize on the interventions that sustain a healthy life. Additionally, its objective is to
decrease the susceptibility of a given population to a given disease (Fleming, & Parker,
2015). This public health promotion plan aims at reducing the vulnerability of primary
school going children in Balmain primary school from childhood obesity. This population is
at a higher risk of developing such a disorder. Studies have indicated that children from low-
income backgrounds in developed nations are likely to develop childhood obesity because
they do not meet the dietary requirements on a daily basis and thus end up consuming a lot
of starch (Tzioumis, & Adair, 2014). This predisposes them to childhood obesity.
Stakeholders and community consultation
The key stakeholders for this project will include:
Lead partner: Obesity Free Coalition for Balmain children.
• Evans A. Karlish, PhD, Director. Box 48383, Eaton St, Balmain NSW. Email:
[e-mail]. The director of the project will serve as the community relations link
for the programme. He will be work with the project coordinator to impact school policy, to
foster good relations with school principal and staff. A project coordinator will also be
engaged for this programme and will be responsible for maintaining good relations with
stakeholders, managing target groups, addressing community inquiries, and working with
the staff of Balmain primary school to achieve the objectives of the project.
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• Ellen James, MD., Community Coordinator, Obesity Free Coalition for Children. The
community coordinator will be responsible for the development, coordination, and
management of the project, will determine and provide the best method of service or
promotion, consult and collaborate with the families and community members. She will
also be responsible for creating and maintaining all the required reports.
• Jackline Revance, M.A., Director of community and Government affairs on children
welfare, policy and advocacy. This partner will be responsible for providing direction on any
change in policy
The collaborating stakeholders include:
• Brand Keygen, Principal of Balmain Public primary school. The school principal will be
the initial contact person and will be responsible for influencing his staff to accept and help
promote the project
• Joan King, MSW. Director of Nutritional services, Balmain public primary school. The
director of nutritional services at the school will be responsible for the development of the
breakfast menu in accordance with the established Australian Dietary guidelines for
children. She will also play an advisory role in the development of physical activities for the
children.
• Walking buses initiative, a pedestrian advocacy organization and sponsor promoting
walk-to-school activities at Balmain primary school. Contact person: Peter Walsh, MA. The
organization will be responsible for implementing and assessing a walking school bus
programme at the school.
• Kirsten Curtis, MD MPH, The University of Sydney; academic focus on health promotion
in ethnic communities and program assessment for childhood obesity prevention strategies.
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The scholar will provide consultancy services on the most appropriate, evidence-based
health promotion activities for ethnic communities.
Community consultation will involve seeking consent from the parents of the children
through the school’s administration. Written letters will be sent to parents of the target
population requesting them to give consent to the child’s participation in the health
promotion project.
The community security council will also be involved in the consultation because the
children will be encouraged to walk to school and back home. Therefore, there is a need
that their security is guaranteed.
Consultation with the state government will also take place with a specific focus on
ensuring that the sidewalks are clear and the road signs are functional.
Health Message/Logo
Walking away obesity and school breakfast
Health Promotion Activity Description
The health promotion plan will achieve its aim by improving participation in three major
ways: evaluating and improving breakfast meals; encouraging school policies on transport
to adapt and improve breakfast participation, and to actualise promotional activities to
influence family participation in breakfast. The programme will foster walk to school
activities, increase community-based family activities, and promote family involvement in
nutritious, culturally sound breakfast meals. Two specific methods will be used to promote
the project:
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1. Increasing cultural- suitability, dietary value and attractiveness of school breakfast. This
will be achieved by the use of bulletin board and promotional materials such as the use of
multilingual brochures distributed to school families. The brochures and bulletin board will
remind the families and students about the importance and availability of school breakfast.
Close interrogation with parents of low-income, the working population will help to
comprehend their needs and preferences and to design the intervention in a way that best
addresses their culture and preferences. The collaboration with the parents and school staff
will allow the inclusion of culturally relevant breakfast items that are common to both the
Indigenous and Non-indigenous Australian communities.
2. Changes in the school environment, policy and schedule. Studies have indicated that
the effectiveness of school breakfast programmes is significantly affected by the arrival time
of the school bus (Leos-Urbel, Schwartz, Weinstein, & Corcoran, 2013). The programme
coordinator will work to ensure that kids arrive at school 20 minutes before the school
sessions begin. The children whose families live far will be dropped at specific locations and
then expected to walk to school. There will be “in class” breakfast distributions for all
children during the first hour in their classrooms. This will be designed to make the school
breakfast enjoyable and palatable to the children. The cafeteria will also be made attractive
and a popular location for the parent, staff and students. By doing so, the cafeteria is likely
to be a place to spend time before the school sessions commence. Bulletin boards will
strategically be placed at each site to show the organized breakfast activities and menus.
Additional activities during breakfast will include recorded music, teaching English as a
second language, or assistance with homework.
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Health Promotion Evaluation Proposal
The health promotion evaluation will involve process measures to verify the achievement of
the promotion plan as planned including changes in menus and promotional activities. The
impact evaluation will consist of modifications in the participation of school breakfast, the
number of students, parents and teacher groups participating in school breakfast, and the
arrival times at school. A survey will be conducted before and after the health promotion to
ascertain the alterations in breakfast habits, attitude towards school breakfast, and cultural
tolerability of school breakfast programme. The project coordinators will also work as a
team with the school administration and staff to record the difficulties, successes and
alterations in the school environment, parent involvement, and absence or presence of
children during implementation.
Conclusion
The Obesity free coalition for Children in Balmain, NSW in collaboration with Balmain public
primary school will work to improve the dietary and activity level of the students and to
prevent obesity by providing free or subsidised school breakfast meals and by walking to
school programme. The school breakfast will consist of a healthy diet and culturally-sound
school breakfasts. Community consultations with key stakeholders such as parents and
school staff will ensure that the nutritional needs of the children are identified and thus the
programme tailor-made to address specific health needs. Walking to school and the
provision of nutritious and healthy breakfasts will significantly prevent childhood obesity in
Balmain, NSW.
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