Exploring Knowledge and Perception of Mothers, School Staff and Healthcare Staff to Address Childhood Obesity in India: A Qualitative Study

Title: An exploration of knowledge and perception of mothers, school staff and
healthcare staff to address childhood obesity in India: A qualitative study
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Table of contents:
1 Summary 3
2 Introduction 3
3 Background and rationale 4
4 Research questions 5
5 Aims and objectives 6
5.1 Aims 6
5.2 Objectives 6
6 Research design 6
6.1 Qualitative research 6
6.2 Methodological framework: Phenomenology framework: 6
7 Research process 7
7.1 Setting of the study 7
7.2 Study population 7
7.2.1 Sampling criteria 8
7.3 Data collection procedure 8
7.3.1 Interview 8
7.3.2 Focus group 10
7.4 Data analysis 10
8 Ethical consideration 11
9 Rigour 12
10 Proposed limitations of the study 12
11 Timeline 12
12 References 13
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1 Summary:
This research aims to explore the knowledge, attitude and perception of mothers, school staff
and healthcare staff about childhood obesity. This is a qualitative study which adopts
constructivist theory as the main methodological framework. Participants of this study will be
mothers of children (4-14 years), school staff and healthcare staff. These participants will be
from the rural part of India and this study will be carried out at Primary Health Centre (PHC).
This study will implement interview and focus method for data collection and thematic
analysis for data analysis.
2 Introduction:
Childhood obesity is a global health issue and its consequences on health of an individual are
well documented (Weihrauch-Blüher and Wiegand, 2018). Childhood obesity is attributable
to different factors such as lack of physical activity, excessive consumption of calorie and
lifestyle related factors. All these factors can be effectively monitored by family members
and school staff of the children (Kar, and Khandelwal, 2015). In India, childhood obesity is
being ignored topic because India has been considered as the country associated with the
problem of malnutrition (Misra et al., 2011). It is evident that overnutrition is the significant
reason for the occurrence of obesity in the school going children. Calorie intake from fat is
estimated to be 25 % more in children as compared to the normal diet (Sahu et al., 2015).
Hence, it is essential to give equal attention to the problem of childhood obesity to prevent
further epidemic. Multisectoral efforts need to be implemented for the prevention of obesity
in the children. Along with family members, schools and primary care settings should come
forward to address the issue of childhood obesity in India (Ranjani et al., 2016). Schools and
primary healthcare centres should arrange obesity-focused education for children and their
family members. Since, schools are the best places for providing education to augment
awareness about specific issue among the stakeholders. Schools can contribute significantly
in the prevention of childhood obesity through promoting physical activity, banning
unhealthy foods in cafeteria, incorporation of physical activity and nutrition-based education
in school curriculum and training teachers about nutrition education. Family members can
improve healthy lifestyle in children through limiting television and other media, improving
physical activity and restricting junk food consumption at home (Misra et al., 2011). Audio-
visual media should be used for providing nutrition and physical education to the children
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and family members. Primary health centres should arrange clinical counselling programmes
for children and family members (Aggarwal and Jain, 2018).
It is mandatory to address childhood obesity because it is attributable to health consequences
such as hyperlipidaemia, hypertension and abnormal glucose tolerance, sleep apnoea,
pseudotumor cerebri (increased intracranial pressure) and orthopaedic complications
(Rawlins, Baker, Maynard, and Harding, 2013). Moreover, childhood obesity is also
associated with social and emotional issues such as negative self-esteem, negative self-image,
anxiety, loneliness, social isolation and risky behaviour (Rawlins, Baker, Maynard, and
Harding, 2013). Approximately 80 % childhood obesity get carried to the adulthood due to
lack of proper intervention.
3 Background and rationale:
Epidemiological studies estimate that worldwide over 22 million children are obese and
approximately 1 in 10 children are overweight. Proportion of obesity in school going children
have doubled in 2010 in comparison to the 2000 (Ranjani et al., 2016). Though, there is
limited data available for the burden of obesity and overweight children in India; few of the
studies reported prevalence of obesity and overweight children among school aged children.
Prevalence of overweight and obesity among school aged children in India was 14.4% and
2.8% by International Obesity Task Force (IOTF) cut offs, 14.5% and 4.8% by Centre for
Disease Control (CDC) cut offs, and 18.5% and 5.3% by World Health Organization (WHO)
(Ranjani et al., 2016).
Both physical activity and healthy eating play significant role in the prevention of childhood
obesity (Aggarwal and Jain, 2018). Interventions for childhood obesity prevention are
complex in nature; hence, it is difficult to conclude contribution of individual stakeholder in
the prevention of childhood obesity (Aggarwal and Jain, 2018). Quality research proved
beneficial in getting insight into attitude, perception, opinions, motivations and concerns of
the key stakeholders such as children and young people, parents and guardians, national
health service (NHS) staff and school authority staff. In turn, it is useful in understanding key
stakeholders and their role in obesity prevention. Few studies have explored parents and child
perceptions on the development phase of obesity prevention intervention (Pallan, Parry,
Cheng, and Adab, 2013; Pocock, Trivedi, Wills, Bunn, and Magnusson, 2009). However,
there is scarcity of literature available on the evaluation phase of the obesity prevention
intervention.
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