Intervention Plan for Adolescent Obesity in Tallahatchie, Mississippi

Intervention Plan for Adolescent Obesity in Tallahatchie, Mississippi

Intervention Plan Components

The proposed project targets students from 4^th graders to sophomores in all schools across Tallahatchie County, Mississippi. Multicomponent interventions will be included in the project to address adolescent obesity in the targeted area. In this case, the following components will be included: Behavior change promotion and modification of the environment. Behavior change promotion component will involve the following activities: identification of behaviours that increase the risk of obesity and overweight and educating the target population on healthy diet practices and physical activity. On the other hand, environmental modification component of the project will include the following approaches: creating opportunities for physical activities in the school; modification of the physical environment in the schools to promote physical activities; increasing the accessibility of healthy foods in the school environment; development of policies that promote healthy eating and participation in physical activities in schools.

The behavior change promotion component of the proposed project is aimed at helping the target population abandon behaviours that increase the risk of developing overweight and obesity while encouraging them to adopt habits that promote the achievement and maintenance of healthy weight. In particular, this component will focus on the dietary habits and physical activity behavior of adolescents in the county. This component incorporates two programs: assessment program and physical and nutritional education program. Concerning the assessment program, the target population will be gauged on the basis of their dietary practices and their levels of physical activity. This program will be carried out at the beginning of the project to identify the gaps in the behaviours of the target population that the project will seek to address.

The education program, on the other hand, will involve the development and delivery of a curriculum aimed at equipping the target population with knowledge and skills to enable them to make informed choices concerning behaviours that can impact on their weight status and health in general. The curriculum will involve dietary and physical education. Concerning nutritional education, the program will cover a wide range of information concerning nutrition. In particular, the students will be taught why it is crucial to consume foods in amounts that allow them to maintain a healthy weight. They will also be informed about eating habits that will help them maintain a healthy weight. Students will gain in-depth knowledge of nutrition after undergoing the program. Concerning physical education, the students will learn about the health benefits of engaging in physical activities and how leading a sedentary lifestyle can increase their risk of becoming overweight or obese. They will be encouraged to limit their involvement in indoor leisure activities such as playing video games. Instead, they will be encouraged to spend more time on outdoor sports activities. The curricula will vary depending on the grade of the targeted students. This approach is meant to ensure that content delivery is conducted in a manner that is relevant to the students.

The environmental modification component is focused on ensuring that the school environment is modified to accommodate the desired behaviours. In this component, the following approaches will be pursued: increasing opportunities for participation in sports and other physical activities in schools; development of infrastructure to support physical activities; advocating for policies that ban selling and advertisement of unhealthy foods near or within the school premises; training on kitchen gardening skills and supporting the students to prepare and manage kitchen gardens at home. Increasing opportunities for participation in sports will be achieved by encouraging schools to change their timetables to allocate at least 2 hours every day for physical activities. Doing so will ensure that students get opportunities to engage in physical activities. Concerning the development of infrastructure, efforts will be made to ensure that all schools have the spaces and facilities needed for conducting various sports. In this case, authorities and the communities will be mobilized to avail resources for developing some sports infrastructure in some schools. Advocacy campaign will also be conducted to encourage authorities to ban the advertisement and selling of unhealthy foods within or near school premises. This approach will ensure that school premises offer conducive environments for healthy dietary behaviours.

The components of the proposed project address various modifiable risk factors of obesity, which include certain behaviours and various environmental factors. Habits such as sedentary lifestyle and unhealthy dietary practices have the most significant impact on the weight status of individuals. They constitute the direct causes of obesity and overweight. Consequently, programs aimed at addressing obesity and overweight should target these risk factors. However, programs aimed at behavior change are not adequate in preventing obesity in a population. Instead, there is a need for expanding the scope of such programs to address the barriers encountered during attempts to adopt the desired behaviours. Various environmental factors constitute such barriers. For example, the availability of calorie-rich foods within or near school premises may undermine efforts towards adopting healthy eating behaviours among students. Therefore, programs aimed at promoting healthy eating habits should also seek to modify the environment to support the desired behavior. The proposed project consists of components that meet these conditions. On this basis, the proposed project is effective in preventing obesity among the target population.

Various cultural factors influence Mississippi residents’ dietary habits. According to White and colleagues (2017), the time required to prepare food and the cost of food is one of the factors influencing decisions on food choices. This implies that some foods are rarely consumed because they take longer to prepare. The attitude of Mississippi residents has also been cited as one of the main factors behind the high prevalence of obesity in the region. Jonsson (2012) reports an opinion by an observer named Mr Edge, in which case the observer indicates that in Mississippi, walking is associated with the inability to afford a car. It is also widely reported that food is a significant component of festivities among various communities living in Mississippi. These attitudes account significantly for the high prevalence of obesity in Mississippi. The low physical activity lifestyle exhibited by the residents of Mississippi significantly informed the proposed project. The project partly seeks to promote physical activity among the target population.

The adolescents who live in Tallahatchie County, like their counterparts in other regions in the United States, are increasingly embracing video games. Consequently, many of them tend to stay most of the time indoors. Besides, many adolescents in Mississippi, like in other regions in the United States, eat a lot of junk foods. According to the Centers for Disease Control and Prevention (CDC) (as cited in Bakalar, 2015), 34.3% of children and adolescents aged 2-19 years reported eating junk foods. CDC further reports that two-thirds of this lot obtain 20% of their calorie intake from junk foods (as cited in Bakalar, 2015). The proposed project seeks to discourage unhealthy dietary behaviour, such as the consumption of junk foods.

Theoretical Foundations

Health belief model and ecological model are some of the theoretical nursing modes relevant to the proposed intervention plan. The ecological model will impact the design of the intervention more than the health belief model in the sense that unlike the health belief model, the ecological model is useful in interventions targeting a population. Health belief model, on the other hand, is more effective in interventions targeting individuals. The ecological model recognizes that various factors at different levels influence health behaviours. First, habits are influenced by individual factors such as attitudes, personality, and beliefs, among others. For example, people who consider walking as a negative task may prefer a sedentary lifestyle. Secondly, interpersonal factors also play a significant role in influencing behaviours. In this case, people who have access to social support are likely to adopt desired behavior than their counterparts who lack such support systems. Another level of factors influencing behaviours is organizational factors. Organizational factors refer to policies and regulations that can affect a given behavior. All these factors influence behaviours that can impact on the weight status of an individual.

Various health care technologies can be used in the proposed project. Smartphone applications and trackers are particularly useful in encouraging users to observe regular physical activity. The two forms of technology are effective in measuring physical activity. In the proposed project, trackers and smartphone applications will be used to help monitor the level of physical activity among the target population to improve their level of adherence to their physical activity regimens. The proposed project focuses on promoting behaviours that encourage the achievement and maintenance of healthy weight. Therefore, the use of the two forms of technology will significantly help the target population to adopt the technology.

Stakeholders, Policy, and Regulations

The project stakeholders include the following: Students in adolescent stages, teachers, parents, community leaders, Mississippi Health Department in charge of Tallahatchie County, and the implementation committee. The Adolescents living in the county stand to benefit from the proposed projects since they are the subjects of the project. They have the most significant influence on the project. Parents are also relevant stakeholders in the project. They influence the home environment. Consequently, they can influence the behaviours of their children. Their involvement in the project is significant for the successful implementation of the project.

Obesity, which constitutes the sole focus of the proposed project, is influenced by various policies and regulations across the United States. Some of such policies include the following: policies concerning nutrition standards of foods that are offered in settings dealing with childcare; food purchase incentives; calorie labelling; zoning on retail food outlets. These policies are applied at different levels of jurisdiction (Chriqui, 2013). For example, the nutrition standards of foods are applied at the state level (Chriqui, 2013). The Mississippi authority and the leadership of Tallahatchie County are responsible for the various policies and regulations under which the proposed project will be run. Consequently, they must be involved in the significant steps of the project.

Ethical and Legal Implications

Various ethical challenges are associated with interventions aimed at preventing obesity among adolescents.  One of the possible ethical challenges, in this case, involves informed choice. In this case, the proposal to restrict access to certain foods may infringe on the freedom of some people.  Psychosocial wellbeing also constitutes a significant ethical challenge of obesity prevention efforts (Ten, 2014). In this case, the intervention in the proposed project may single out specific individuals based on their weight status. This might happen intentionally or unintentionally. The stigma associated with overweight may negatively affect the psychosocial wellbeing of the affected individual (Azevedo & Vartanian, 2015). Concerning legal implications, the proposed project adheres to all the policies and regulations in Mississippi. It is expected that the policy changes recommended to assist in the implementation of the project will be supported.

References

Azevedo, S. M., & Vartanian, L. R. (2015). Ethical issues for public health approaches to obesity. Current obesity reports, 4(3), 324-329.

Bakalar, N. (2015). How Much Junk Food Do Teenagers Eat? The New York Times. Retrieved from https://www.nytimes.com/2015/09/22/health/how-much-junk-food-do-teenagers-eat.html

Chriqui, J. F. (2013). Obesity prevention policies in US states and localities: lessons from the field. Current obesity reports, 2(3), 200-210.

Jonsson, P. (2012, August 14). Mississippi Most Obese State: Southern Diet or Culture on the Skids? The Christian Science Monitor.

Ten Have, M. (2014). Ethical aspects of obesity prevention. Best Practice & Research Clinical Gastroenterology, 28(2), 303-314.

White, M., Addison, C., Jenkins, B. W. C., Henderson, F., McGill, D., Payton, M., & Antoine‐LaVigne, D. (2017). Factors affecting dietary practices in a Mississippi African American community. International journal of environmental research and public health, 14(7), 718.