Public Health Promotion Project: Obesity in Indigenous Youth (NUR329)

This report presents a public health promotion project aimed at addressing obesity among indigenous teenagers and young adults (12-25 years) from middle-class families in rural areas of the Northern Territory, Australia. The project emphasizes the importance of health education and awareness programs to reduce the prevalence of obesity, a significant health risk factor. The report outlines the target group's characteristics, including the high rates of obesity and related socioeconomic determinants. It details the project's aims, goals, and rationale, highlighting the associated health risks and economic burdens. The project adopts a tertiary health promotion approach, focusing on improving self-management skills through educational activities, stakeholder engagement, and the use of various resources such as poster and PowerPoint presentations. The report also includes an evaluation plan to assess the effectiveness of the health promotion activities. The project's goal is to reduce health inequalities and improve the overall health and well-being of the target population through community-based and school-based interventions.

Running head: PUBLIC HEALTH PROMOTION
Public Health Promotion: Teenagers and Young Adults (12 to 25 years) from the
Middle Class Indigenous population from the rural area (Northern Territory) suffering
from obesity due to lack of health awareness
Name of the Student
Name of the University
Author Note

1
PUBLIC HEALTH PROMOTION
Introduction
According to the World Health Organization (2011), health is defined as a state of
complex physical, mental and social well-being and can never be defined as absence or
presence of disease. In other words, it can be stated that health is beyond the description of
the disease prevalence or disease occurrence. Health can also be defined s the poor lifestyle
habits that make an individual vulnerable towards developing chronic diseases. The Public
Health Association of Australia (PHAA) (2019) has defined public health under
multidisciplinary set of activities that protects and promote health and well-being while
preventing the disease development. Health promotion deals with assisting people and
communities to improve their health through self-management skills. The following health
promotion project will focus on indigenous young adults or teenagers in between the age
group of 12 to 25 years and are suffering from obesity and residing in the middle class
families in rural areas. The selection of the young adults will be done from the Northern
Territory of Australia as it has a significant portion of Aboriginal population in Australia.
Northern Territory Government (2019) stated that majority of the indigenous population in
the Northern Territory suffers from lack of health literacy and thus they experience high level
of health inequality. Thus the health promotion project plan will promote health through
health education and this will be followed by the implementation of the health promotion
program for improving the overall health and well-being of the target population.
Outline of the Target Group and Health Risk Factors
Obesity percentage
Obesity is a major risk factor of developing cardiovascular disease, type 2 diabetes
mellitus (T2DM), musculoskeletal complications and cancer. 25% of the adolescents who are
age between 12 to 25 years are obese during 2017 to 2018. This percentage increased by 19%

2
PUBLIC HEALTH PROMOTION
by 1995. The obesity among the teenagers or the young adults is responsible for 8.4% of the
disease burden in Australia (Australian Institute of Health and Welfare [AIHW], 2019). The
rate of obesity is higher in boys in comparison to the girls. The statistics published by AIHW
(2017) reported that during 2014 to 15, adolescents or the young adults residing in the outer
regions or rural areas are likely to be obese (1.5 times more vulnerable) in comparison to the
girls residing in the major cities. During 2014-15, 1/3rd (33%) of boys from the low socio-
economic group are obese in comparison to the 22% of the indigenous boys residing in the
higher socio-economic group and the percentage is 24 for the indigenous girls. The
indigenous boys or girls are likely to be obese during 10 to 14 years of age and they develop
obesity at the age of 15 to 15 years.

3
PUBLIC HEALTH PROMOTION
Figure: Obesity percentage among the young adults up to 18 years of age
(Source: AIHW 2017)
Socio-economic determinants and obesity
Thurber et al. (2018) stated that high body mass index (BMI) is the second leading
cause of high disease burden among the Australian teenage and young adult population. The
disease burden is higher among the indigenous population in comparison to the non-
indigenous population residing in the rural areas and who are from the middle class families.
Figure: the distribution of BMI rate among boys and girls of the indigenous population in
Australia
(Source: AIHW, 2017)

4
PUBLIC HEALTH PROMOTION
The main reason behind the high BMI among the indigenous teenagers and young
adults (12 to 25 years) are due to lack of physical activity, high smoking rates, increased
screen time, lack of proper education and area remoteness and are level disadvantages. Thus
it can be said that socioeconomic factors and the health factors are potential targets behind
high level of BMI and obesity among the indigenous young adult and teenage population.
AIHW (2017) reported that 39% of health gap among the indigenous and non-indigenous
population in Australian are the reason behind the poor health outcomes. The majority of
indigenous population residing in the Northern territory of Australia and in New South Wales
are the victims of obesity (Thurber et al., 2018).
Aim of health promotion
The aim of this health promotion program is to reduce the disease burden over the
indigenous young adults and teenage population from the middle class families, residing in
the rural areas by reduces the trend of high BMI or obesity. The main mode of the health
activity promotion will include educational and awareness program.
Goals of health promotion
1. To increase the health awareness of the teenagers via school based health awareness
program (12 to 18 years) like taking part in games and healthy eating
2. To promote health awareness among the college students by health awareness program like
smoking and alcohol prevention and physical activity (19 to 23 years)
3. Health awareness among the young adults (23 to 25 years) through community-based
awareness oration and education about the side-effects of sedentary life

5
PUBLIC HEALTH PROMOTION
Rationale of health promotion program
Obese young adults are susceptible towards several health risk factors like breathing
problems (asthma), hyper-tension, T2DM (insulin resistance) and development of early
markers of cardiovascular disease. Obesity is also associated with back pain, renal problems,
gout and osteoarthritis.
Figure: Risk factors associated with obesity
(Source: AIHW, 2017)
Increased prevalence of health risk factors associated with obesity is the reason
behind the high rate of mortality and morbidity among the teenagers and the young adults of
the indigenous population in the rural areas and thus creating health inequalities among the
Australian population. In 2011, the disease burden in Australia arising out of obesity is 63%
and this 35% constitutes the indigenous population. Obesity and its health threats also cast

6
PUBLIC HEALTH PROMOTION
strong economic impacts over the Australian government. In 2008 the financial burden
arising out of obesity reached the bar of $8.3 billion of them 44% or $3.6 billion of loss is
associated with loss of productivity and 24% or $2.0 billion loss is associated with health and
23% or $1.9 billion loss is associated with carer costs (AIHW, 2017).
Decrease trends in the obesity among the target population will help to reduce the
health inequalities among the target population while reducing the health and economic
burden from the society. The heath promotion done through educational approaches will help
to strengthen the health awareness.
Health promotion management perspectives
The Ottawa Charter of Health Promotion deals with five basic parameters that is
highlighted in the figure below:

7
PUBLIC HEALTH PROMOTION
Figure: Ottawa Charter of Health Promotion
Source: WHO, 2019
However, Fleming and Parker (2015) have reported that in order to up help the health
promotion principles of Ottawa Charter of Health, the health promotion plans must include
primary, secondary and tertiary objectives in order to cover all the aspects of the Ottawa
Charter of health promotion. Primary health promotion aims to limit the incidence of the
disease or disability of the population by eliminating or decreasing the factors that is
hindering the promotion of good health. Secondary health prevention deals with prevention
of the negative prognosis of the disease through early detection and implementation of
interventions. The tertiary health promotion objectives include reduction of the consequences

8
PUBLIC HEALTH PROMOTION
of the disease development by reducing the negative progression of the disease and by
improving the individual's quality of life. Tertiary health promotion mainly focuses on
improving the disease self-management skills.
The following health promotion program is a tertiary health promotion program.
According to Fleming and Parker (2015) tertiary health promotion program aims of decrease
the impact of the ongoing the illness by helping the people manage their health condition.
The aim of this program is to imbibe awareness of health and healthy lifestyle factors like
physical exercise, diet and substance abuse in order to reduce the obesity. Phillips et al.
(2013) highlighted in their cross-sectional study that moderate to high level of physical
activity and compliance to healthy yet nutritional diet helps to increase the likelihood of
metabolically healthy obesity (MHO). However, stratification of the obese individuals
depending on their metabolic health phenotype might be crucial in ascertaining the proper
therapeutic measures of intervention strategies for obesity management. The maintenance
education of the importance of the healthy lifestyle factors helps to increase the disease self-
management skills,
Stakeholder
The additional stakeholders of this health promotion program apart from the obese
teenagers and the young adults are their teachers (schools and colleges) and the human
resource managers in the corporate offices. Pasarica and Topping (2017) stated that the
presence of te teachers ate curial for the promotion o health awareness in the obesity
prevention programs among the teenager. During the high schools, the students look up to
their teachers as their role model and thus presence of the teachers in the health promotion
programs and taking their in-puts will helps in improving the overall outcome of care.
Pasarica and Topping (2017) further stated that clinically appropriate recommendations for

9
PUBLIC HEALTH PROMOTION
obesity management through healthy lifestyle requires detailed person-centered intervention
planning by the community healthcare nurse. The community healthcare nursing
professionals will educate the nutritional importance of different diet plans and the intensity
of physical exercise that needs to be performed and how it will help to reduce the BMI levels.
The community healthcare nursing professionals will also help to educate the mass about the
effective evidence-based practice for the obesity management (Pasarica & Topping, 2017).
Additional stakeholder will include culturally competent nurse and non-government
organization who will function as the main funding body for the health promotion program.
Health-Message
Be in shape, say no to disease and shine in confidence
Health Promotion Activity
Health promotion for 12 to 18 years (school-based)
The activity will include educating the teenagers about the harmful effects of junk
food and sedentary life. Further education will be given regarding how these factors lead to
the development of obesity and associated physical co-morbidity. This will activity will be
executed by the community-based healthcare professional under the presence of the school
teacher and during the recess period. The mode of education will be power-point presentation
of 15 minutes each week lasting for one month (4 days approximately).
Health promotion activity for 19 to 23 years (community-based)
Under the college based health awareness program, the young adults and teenagers
will be educated about the harmful effects of smoking and alcohol consumption. This will be
followed by awareness regarding how smoking and alcohol promote the development of
obesity. The education will be given by community-based nurse with the help of poster

10
PUBLIC HEALTH PROMOTION
presentation in the community healthcare settings. A culturally competent community-based
nurse will guide in designing of the posters. In order to increase the participation of the
potential candidates, participation incentives will be given to the students. The education will
be followed by training in the physical activities that is required to be fun
Health promotion activity for 24 to 25 years (office-based)
The health promotion activity for young adults includes who are either working
professionals or have complete their studies will be educated through interactive sessions.
The main information will be gathered from the website of AIHW. The culturally competent
nursing professionals will be present during the interactive sessions in order to generate
culturally competent health promotion plan for the young adults. The interactive sessions will
be followed by few poster presentations and there are highlighted below:

11
PUBLIC HEALTH PROMOTION
Figure: Health environment and obesity
(Source: AIHW, 2017)

12
PUBLIC HEALTH PROMOTION
(Source: AIHW, 2017)

13
PUBLIC HEALTH PROMOTION
(Source: AIHW, 2017)
Main resources that will be used in health promotion
1. Poster presentations
2. Power-point presentations
3. Human resources: Community health nurses and culturally competent nurses

14
PUBLIC HEALTH PROMOTION
Evaluation of the outcome
The evaluation of the health promotion plan will be done be done through semi-
structured interview conducted by the use of the open-ended questionnaire. The questions
used in the semi-structured interview be framed in such a way that it helps in understanding
the whether the mindset of the teenagers and the young adults have changed depending upon
the healthy lifestyle interventions. However, Harmon-Jones, Bastian and Harmon-Jones
(2016) stated that self-reported questionnaire at time lead to the generation of biased results.
Conclusion
Thus from the above discussion, it can be concluded that, the indigenous population
in Northern Territory Australia encompassing the young adults and the teenagers are the
victims of obesity and high BMI that make them vulnerable to develop several chronic health
conditions. The poor socio-economic determinants of health like lack of health awareness and
health literacy promote the disease development. The tertiary healthcare interventions
targeting improvement in the disease self-management skills can be prove to be helpful in
reducing the disease burden and health inequality. The equitable participation of the
stakeholders like the community health nurses, culturally competent nurses and the NGOs as
the funding agency will help in successful implementation of the health promotion program.
The evaluation of the success of the health promotion program will be done with the help of
semi-structured interview under the use of the open-ended questionnaire.

15
PUBLIC HEALTH PROMOTION
Reference
Australian Institute of Health and Welfare [AIHW]. (2017). Aboriginal and Torres Strait
Islander Health Performance Framework 2017 report: Northern Territory. Access
date: 9th September 2019. Retrieved from:
https://www.aihw.gov.au/getmedia/0e60dc3c-a582-4b7f-a4d1-1e623a91745e/aihw-
ihw-186-2017-hpf-nt.pdf.aspx?inline=true
Australian Institute of Health and Welfare [AIHW]. (2017)a. A picture of overweight and
obesity in Australia 2017. Access date: 6th September 2019. Retrieved from:
https://www.aihw.gov.au/getmedia/172fba28-785e-4a08-ab37-2da3bbae40b8/aihw-
phe-216.pdf.aspx?inline=true
Australian Institute of Health and Welfare [AIHW]. (2017). Aboriginal and Torres Strait
Islander Health Performance Framework (HPF) report 2017. Access date: 6th
September 2019. Retrieved from: https://www.aihw.gov.au/reports/indigenous-health-
welfare/health-performance-framework/contents/tier-2-determinants-of-health/2-22-
overweight-and-obesity
Australian Institute of Health and Welfare [AIHW]. (2019). Overweight & obesity. Access
date: 6th September 2019. Retrieved from:
https://www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/
overview
Fleming, M. L., & Parker, E. (2015). Introduction to Public Health eBook. Elsevier Health
Sciences.

16
PUBLIC HEALTH PROMOTION
Northern Territory Government. (2019). Aboriginal and Torres Strait Islander health. Access
date: 9th September 2019. Retrieved from:
https://health.nt.gov.au/professionals/aboriginal-and-torres-strait-islander-health
Pasarica, M., & Topping, D. (2017). An evidence-based approach to teaching obesity
management to medical students. MedEdPORTAL: the journal of teaching and
learning resources, 13.
Phillips, C. M., Dillon, C., Harrington, J. M., McCarthy, V. J., Kearney, P. M., Fitzgerald, A.
P., & Perry, I. J. (2013). Defining metabolically healthy obesity: role of dietary and
lifestyle factors. PloS one, 8(10), e76188.
Public Health Association of Australia (PHAA).(2019). Public Health.Access date: 6th
September 2019. Retrieved from: https://www.phaa.net.au/
Thurber, K. A., Joshy, G., Korda, R., Eades, S. J., Wade, V., Bambrick, H., ... & Banks, E.
(2018). Obesity and its association with sociodemographic factors, health behaviours
and health status among Aboriginal and non-Aboriginal adults in New South Wales,
Australia. J Epidemiol Community Health, 72(6), 491-498.
World Health Organisation [WHO].(2011). Definition of Health in 1948. Access date: 6th
September 2019. Retrieved from:
http://www.euro.who.int/__data/assets/pdf_file/0003/152184/RD_Dastein_speech_we
llbeing_07Oct.pdf