Obesity, Prevention and Control in Teens
Obesity refers to accumulation of harmful body fat levels, with excessive loose connective adipose tissues relative to lean body mass (Donatelle, 2002). One of the causes of obesity is high calorie consumption and the individual's inability to burn up the consumed calories. Obesity is said to be the outcome of imbalance of food consumed with energy expended (Venes, 2005). However, there are also considerable studies demonstrating genetic and metabolic deficiencies and disorders in cases of obesity; these include an inactive mechanism by which the body signals 'satiety', as well as deficiency of important proteins that turn off 'hunger'.
Obesity is presently the second reason for preventable deaths in the U.S., after tobacco consumption (Flegal, Carroll, Orden, & Johnson, 2000). Moreover, obesity is considered to be the leading cause for preventable deaths on a worldwide scale. In accordance with a study conducted by the World Health Organization (WHO), obesity has attained epidemic proportions worldwide, with over 1 billion adults in the 'overweight' individuals' category, and no less than 300 million among them in the 'obese' category of individuals (WHO, 2003). Apart from its cosmetic and societal implications, obesity is stated to pose a critical health risk including, but not restricted to, hypertension, type 2 diabetes mellitus, periodontal disease, high cholesterol, stroke, heart disease and certain types of cancer (Goldie & Risbeck, 2006).
Evidence from the United States (U.S.) indicates that childhood obesity cases have increased four-fold within 20 years (Williams et al., 2002 as cited in Lazarou and Kouta, 2010). The occurrence of obesity in children in the United Kingdom (UK) has reportedly risen from 1.5% (1984) to 6.3% in 2003 (Stamatakis et al., 2005). These data include 15.2% girls and 16.8% boys in the age-group of 2-15 years being categorized as obese, according to 2008 estimates (NHS, 2010). The statistics quoted above are disturbing, as the risk of obesity in adulthood is on the order of 1.5-2 times greater in individuals who are overweight in their childhood (Guillaume, 1999; Nicklas et al., 2001 as cited in Lazarou and Kouta, 2010). Roughly 50% of obese children are estimated to remain obese in adulthood (Krauss et al., 1998 as cited in Lazarou and Kouta, 2010). Several risk factors are associated with obesity in children; as well, children hailing from families with hereditary cardiovascular diseases tend to weigh more than those individuals from families without such medical history (Krauss et al., 1998).
Managing obesity can be divided into two parts: medical intervention, and behavioral modification (Wilborn, et al., 2005). The latter refers to applying learning theories to treatment of obesity and is a standard therapy for treating obesity in both children and adults that has been used for the past 25 years (Bray, 2003). The former is concerned with reduction of energy intake (food calories), with simultaneous increase in energy output (Wilborn, et al., 2005). Medical intervention may also include prescription of pharmaceuticals if deemed necessary, and, in extreme cases, one of several 'weight-loss surgeries'.
The phrase "evidence-based medicine" was coined in the 1980s, to depict an approach that employed scientific evidence for determining the most excellent practice. The term was later modified to "evidence-based practice" when clinicians who were not physicians acknowledged the significance of utilizing scientific evidence in making clinical decisions (Beyea & Slattery, 2006). Several ways to define evidence-based practice (EBP) can be found, however, the most common definition is "the explicit, judicious and conscientious utilization of the best current evidence to make decisions regarding the care of each individual patient" (Sackett, Rosenberg, Gray, Hayes, & Richardson, 1996 as cited in Beyea & Slattery, 2006).
Change Model Overview
The model will combine three separate models that are analogous, but with different approaches.
The 1st model, labeled Environmental Nutrition and Activity Community Tool (ENACT), and designed by COTB (Community Obesity Task Force) of Albemarle- Charlottesville and neighboring areas in North Carolina, offers a structure for planning and implementing community programs. Comprising seven categories that encompass a broad vision of community health, the program includes child care, healthcare, after-school, schools, workplace, government and community. Every category is divided into strategies, each having various sub-strategies (Strickler, 2010).
The second adopted model is Marin County's ecological framework for prevention of childhood obesity. This ecological frame understands that development of children does not take place in isolation; rather, it occurs within an arrangement of interconnected social systems. The frame concentrates on various levels of behavioral, environmental and political influences, providing a thorough approach to prevention of childhood obesity. The objective of the framework is increasing collaboration and communication among systems, in addition to integrating policy and environmental changes, which will decrease the rate of obesity in early childhood (Zarate, 2012).
In the ENACT framework, the strategies for healthcare which...
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