Children are the most important age group in all societies. Health status and health behavior of later life are laid down at this age group. The children are facing a large number of health problems which include low birth weight, malnutrition, infections, accidents, poisoning, and behavioral problems. Among these problems, malnutrition especially under nutrition attracts the focus of health workers, hence it has close link with mortality and morbidity states in children. Now in contrast to undernutrition but, with equal ill effects a newer health problem arising globally is the childhood obesity.
Obesity is a state in which there is generalized accumulation of excess adipose tissue in the body leading to more than 20% of the desirable body weight. Childhood is a critical period for the initiation of the obesity and associated morbidity. World Health Organization (WHO) has described obesity as `an escalating epidemic' and `one of the neglected public health problems of present time.' Its impact on health is as great as smoking. It has also been reported that obesity has overtaken malnutrition and has become one of the top most health problems in the world. (WHO,1997).
Kaur & Saini, 2007 emphasized that obesity is not only a new challenge, but also rapidly increasing one. It has become a serious health problem both in the developed and developing countries. Worldwide the prevalence of overweight and obesity is increasing. As a result, the number and severity of weight related health problems are also on the rise and that in turn add to the cost of health care. Childhood obesity is increasingly being observed with the changing life style of families with increased purchasing power, increasing hours of inactivity due to television, video games and computers have replaced outdoor games and other social activities.
Studies indicate that childrens' lives may be shortened as a result of this alarming health problem (American Academy of Pediatrics 2003). Obesity increases the risk of several health problems such as Cardio vascular disease and Diabetes. It also contributes to social isolation as result of psychological distress, low self esteem and practical difficulties (WHO, 2004)
Childhood obesity also has been determined to be an independent risk factor for adult overweight or obesity. Park.K, 2005 states that, 50-80% of obese children will continue as obese adults. They fall into risk group of Diabetes, Hypertension, Coronary artery Diseases and many more obesity related diseases. Complications of adult obesity are made worse if the obesity begins in childhood. Effective prevention of adult obesity requires the prevention and management of childhood obesity. Obesity is easier to prevent and treat in children than in adults.
SIGNIFICANCE AND NEED FOR THE STUDY
…
Students Paper:
… THE STUDY
Childhood obesity is one of the most serious public health challenges of the 21st century. Only in …
http://www.who.int
/entity/dietphysicalactivity
/childhood/en/
… the rise
Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is …
… . Only in 1997 did WHO accept that obesity was a major public health problem (James, 2008). The World Health Report (2002) lists over weight as the fifth serious risk factor for mortality in both developed countries and developing countries.
Worldwide estimates currently identify 18,000,000 overweight children (Abbelung et al. 2002). According to WHO (2005) report, 22 million children under 5 years are estimated overweight worldwide. …
Students Paper:
… overweight worldwide. The prevalence has increased at an alarming rate. Globally, in 2010 the number of overweight children under the age of five is estimated to be over 42 million. Close to 35 million of these are living in developing countries. Globally, IOTF report …
http://www.who.int/entity/dietphysicalactivity/childhood/en/
… urban settings. The prevalence has increased at an alarming rate. Globally, in 2010 the number of overweight children under the age of five, is estimated to be over 42 million. Close to 35 million of these are living in developing countries.
Overweight and obese …
… , IOTF report analysis (2010) estimates that up to 200 million school aged children are either overweight or obese, of those 40-50 million are classified as obese.
Global prevalence of childhood obesity varies from over 35% in USA to less than 2% in Africa. Currently the prevalence of overweight or obesity in children is 24.65% in UK 23% in Australia, 17.2% in Saudi Arabia, 15.3% in Japan and 14.2% in Iran (IOTF report analysis, 2010). Although rates vary among different ethnic groups, the overall prevalence of childhood obesity is 17.1%. (Sanjeev, 2009)
The national representative data on childhood obesity are scarce, with very few reports on the prevalence of obesity among children. A school based data by Kapil et al, 2002 demonstrated the prevalence of obesity as 5.6% and 24% among children and adolescents respectively in India. The prevalence of overweight or obesity in urban children in Delhi has shown an increase from 16% in 2002 to about 24% in 2006 (Misra.A et al, 2007). The new IOTF report analysis (2010) estimates the prevalence of overweight or obesity is 14.8% among girls and 15.3% among boys in India.
Edmunds et al, 2001 states that childhood obesity is associated with a range of social, psychological and physical problems including inter personal problems, social isolation, lowered educational attainment, social discrimination, poor self esteem, depression. Studies on Indian school children by Manju Raj et al., 2003-05 have also demonstrated that the prevalence of hypertension in overweight children is significantly higher than that among normal weight children. Reilly et al, 2003 have further states that obesity leads to increased risk of morbidity. Overweight and obese children are more likely to develop non communicable …
Students Paper:
… non communicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity therefore needs high priority.
Golan & Crow …
http://www.who.int/entity/dietphysicalactivity/childhood/en/
… develop noncommunicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity therefore needs high priority.
/entity/dietphysicalactivity …
… .
Golan & Crow 2004 insists that parental involvement is crucial in obtaining favorable outcomes from interventions aimed at achieving sustained weight management in children. The measures …
Students Paper:
… The measures to help parents recognize obesity will help control this growing epidemic among the children …
http://nature.com/oby/journal/v11/n11/full/oby2003184a.html
… with efforts to help parents recognize obesity, will help control this growing epidemic among our children …
… the children. Therefore …
Students Paper:
… children. Therefore parents need to be involved in obesity prevention programs and should …
http://nature.com/oby/journal/v11/n11/full/oby2003184a.html
… will outgrow.
Parents need to be involved in obesity prevention programs. For such …
… and should be taught about preventive practices. Hence nurses and other health care professionals need to develop insights into the ways that parents respond to their children's weight problems.
The investigator had come across obese children admitted with obesity related morbidity during the clinical posting. Thus it was felt need to assess the determinants of childhood obesity among obese and non obese children. As parents influence the child's health, the investigator decided to investigate the parental attitude also.
Statement of the problem
A comparative study to assess the determinants of childhood obesity and the attitude among mothers of obese and non obese school children in a view to develop a learning module on childhood obesity in selected areas at Madurai-2010.
Objectives
To identify the obese and non obese school children in the selected areas
To assess the determinants of childhood obesity among mothers of obese and non obese school children and their attitude regarding childhood obesity
To compare the determinants of childhood obesity among obese and non obese school children and the attitude among mothers of obese and non obese school children
To find out the association between the determinants of obesity with selected demographic variables of obese and non obese school children.
To develop learning module on childhood obesity to modify the life style practices of obese children.
Hypotheses
H1 - There will be significant difference in determinants of obesity among obese and non obese children.
H2 - There will be a significant association between determinants of obesity in relation to selected demographic variables of obese and non obese children.
OPERATIONAL DEFINITIONS
Obese Children
In this study it refers to children, including boys and girls within the age group of 9-17years whose weight is equal to or greater than 95th percentile according to his or her age in the growth chart given by Center for Disease Control (CDC).
Non Obese Children
In this study it refers to children, including boys and girls whose weight is between 5th percentile to less than 85th percentile according to his or her age in the growth chart given by CDC
Determinants of obesity
In this study it refers to factors which contribute to develop obesity in children. It includes questions on genetic predisposition, physical activity, leisure activity, nutritional factor and psychological factor.
Mothers
In this study it refers to women with children between 9-17 years.
Attitude
In this study it refers to way of thinking, perceived beliefs and feelings of mothers regarding childhood obesity as expressed on a 3 point likert scale
Learning module on childhood obesity
This is well structured information for the parents of obese and non obese children on childhood obesity including definition, causes, signs & symptoms, diagnosis, management, prevention and complications.
Assumptions
Determinants influence the occurrence of obesity in children.
Determinants differ in obese and non obese children.
Learning module promotes the health behavior of the children.
Delimitation
The study is delimited only to mothers of obese and non obese children.
The determinants of childhood obesity are assessed only by the subjective response of the mothers and not directly observing the practices of the children.
Projected outcome
The result of the study would help the investigator to identify the determinants of obesity to take possible remedial measures like screening camp, medical checkup, and health education program on obesity and its related health problems.
The finding on demographic variables would help to identify the factors which influence the occurrence of obesity
The study findings will help to promote a positive attitude in mothers about obesity and to reduce the morbidity and mortality caused by obesity
The study will help to frame the best learning module. This learning module can be distributed to parents and will help to improve the knowledge and promote positive attitude of parents regarding obesity
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Master document text
CHAPTER I
INTRODUCTION
"Children are the world's most valuable resource and its best hope for the future"
- John Kennedy
Children are the most important age group in all societies. Health status and health behavior of later life are laid down at this age group. The children are facing a large number of health problems which include low birth weight, malnutrition, infections, accidents, poisoning, and behavioral problems. Among these problems, malnutrition especially under nutrition attracts the focus of health workers, hence it has close link with mortality and morbidity states in children. Now in contrast to undernutrition but, with equal ill effects a newer health problem arising globally is the childhood obesity.
Obesity is a state in which there is generalized accumulation of excess adipose tissue in the body leading to more than 20% of the desirable body weight. Childhood is a critical period for the initiation of the obesity and associated morbidity. World Health Organization (WHO) has described obesity as `an escalating epidemic' and `one of the neglected public health problems of present time.' Its impact on health is as great as smoking. It has also been reported that obesity has overtaken malnutrition and has become one of the top most health problems in the world. (WHO,1997).
Kaur & Saini, 2007 emphasized that obesity is not only a new challenge, but also rapidly increasing one. It has become a serious health problem both in the developed and developing countries. Worldwide the prevalence of overweight and obesity is increasing. As a result, the number and severity of weight related health problems are also on the rise and that in turn add to the cost of health care. Childhood obesity is increasingly being observed with the changing life style of families with increased purchasing power, increasing hours of inactivity due to television, video games and computers have replaced outdoor games and other social activities.
Studies indicate that childrens' lives may be shortened as a result of this alarming health problem (American Academy of Pediatrics 2003). Obesity increases the risk of several health problems such as Cardio vascular disease and Diabetes. It also contributes to social isolation as result of psychological distress, low self esteem and practical difficulties (WHO, 2004)
Childhood obesity also has been determined to be an independent risk factor for adult overweight or obesity. Park.K, 2005 states that, 50-80% of obese children will continue as obese adults. They fall into risk group of Diabetes, Hypertension, Coronary artery Diseases and many more obesity related diseases. Complications of adult obesity are made worse if the obesity begins in childhood. Effective prevention of adult obesity requires the prevention and management of childhood obesity. Obesity is easier to prevent and treat in children than in adults.
SIGNIFICANCE AND NEED FOR THE STUDY
Childhood obesity is one of the most serious public health challenges of the 21st century. Only in 1997 did WHO accept that obesity was a major public health problem (James, 2008). The World Health Report (2002) lists over weight as the fifth serious risk factor for mortality in both developed countries and developing countries.
Worldwide estimates currently identify 18,000,000 overweight children (Abbelung et al. 2002). According to WHO (2005) report, 22 million children under 5 years are estimated overweight worldwide. The prevalence has increased at an alarming rate. Globally, in 2010 the number of overweight children under the age of five is estimated to be over 42 million. Close to 35 million of these are living in developing countries. Globally, IOTF report analysis (2010) estimates that up to 200 million school aged children are either overweight or obese, of those 40-50 million are classified as obese.
Global prevalence of childhood obesity varies from over 35% in USA to less than 2% in Africa. Currently the prevalence of overweight or obesity in children is 24.65% in UK 23% in Australia, 17.2% in Saudi Arabia, 15.3% in Japan and 14.2% in Iran (IOTF report analysis, 2010). Although rates vary among different ethnic groups, the overall prevalence of childhood obesity is 17.1%. (Sanjeev, 2009)
The national representative data on childhood obesity are scarce, with very few reports on the prevalence of obesity among children. A school based data by Kapil et al, 2002 demonstrated the prevalence of obesity as 5.6% and 24% among children and adolescents respectively in India. The prevalence of overweight or obesity in urban children in Delhi has shown an increase from 16% in 2002 to about 24% in 2006 (Misra.A et al, 2007). The new IOTF report analysis (2010) estimates the prevalence of overweight or obesity is 14.8% among girls and 15.3% among boys in India.
Edmunds et al, 2001 states that childhood obesity is associated with a range of social, psychological and physical problems including inter personal problems, social isolation, lowered educational attainment, social discrimination, poor self esteem, depression. Studies on Indian school children by Manju Raj et al., 2003-05 have also demonstrated that the prevalence of hypertension in overweight children is significantly higher than that among normal weight children. Reilly et al, 2003 have further states that obesity leads to increased risk of morbidity. Overweight and obese children are more likely to develop non communicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity therefore needs high priority.
Golan & Crow 2004 insists that parental involvement is crucial in obtaining favorable outcomes from interventions aimed at achieving sustained weight management in children. The measures to help parents recognize obesity will help control this growing epidemic among the children. Therefore parents need to be involved in obesity prevention programs and should be taught about preventive practices. Hence nurses and other health care professionals need to develop insights into the ways that parents respond to their children's weight problems.
The investigator had come across obese children admitted with obesity related morbidity during the clinical posting. Thus it was felt need to assess the determinants of childhood obesity among obese and non obese children. As parents influence the child's health, the investigator decided to investigate the parental attitude also.
Statement of the problem
A comparative study to assess the determinants of childhood obesity and the attitude among mothers of obese and non obese school children in a view to develop a learning module on childhood obesity in selected areas at Madurai-2010.
Objectives
To identify the obese and non obese school children in the selected areas
To assess the determinants of childhood obesity among mothers of obese and non obese school children and their attitude regarding childhood obesity
To compare the determinants of childhood obesity among obese and non obese school children and the attitude among mothers of obese and non obese school children
To find out the association between the determinants of obesity with selected demographic variables of obese and non obese school children.
To develop learning module on childhood obesity to modify the life style practices of obese children.
Hypotheses
H1 - There will be significant difference in determinants of obesity among obese and non obese children.
H2 - There will be a significant association between determinants of obesity in relation to selected demographic variables of obese and non obese children.
OPERATIONAL DEFINITIONS
Obese Children
In this study it refers to children, including boys and girls within the age group of 9-17years whose weight is equal to or greater than 95th percentile according to his or her age in the growth chart given by Center for Disease Control (CDC).
Non Obese Children
In this study it refers to children, including boys and girls whose weight is between 5th percentile to less than 85th percentile according to his or her age in the growth chart given by CDC
Determinants of obesity
In this study it refers to factors which contribute to develop obesity in children. It includes questions on genetic predisposition, physical activity, leisure activity, nutritional factor and psychological factor.
Mothers
In this study it refers to women with children between 9-17 years.
Attitude
In this study it refers to way of thinking, perceived beliefs and feelings of mothers regarding childhood obesity as expressed on a 3 point likert scale
Learning module on childhood obesity
This is well structured information for the parents of obese and non obese children on childhood obesity including definition, causes, signs & symptoms, diagnosis, management, prevention and complications.
Assumptions
Determinants influence the occurrence of obesity in children.
Determinants differ in obese and non obese children.
Learning module promotes the health behavior of the children.
Delimitation
The study is delimited only to mothers of obese and non obese children.
The determinants of childhood obesity are assessed only by the subjective response of the mothers and not directly observing the practices of the children.
Projected outcome
The result of the study would help the investigator to identify the determinants of obesity to take possible remedial measures like screening camp, medical checkup, and health education program on obesity and its related health problems.
The finding on demographic variables would help to identify the factors which influence the occurrence of obesity
The study findings will help to promote a positive attitude in mothers about obesity and to reduce the morbidity and mortality caused by obesity
The study will help to frame the best learning module. This learning module can be distributed to parents and will help to improve the knowledge and promote positive attitude of parents regarding obesity
