Blog 11 - Action Plan

Because my topic deals with childhood obesity, I think a good specific intervention to act on would be going to the school cafeterias and providing better or healthier options for the kids’ meals. I would plan to implement this strategy in the schools of the children, especially the schools that are in areas with the highest obesity rates. I could also implement part of this strategy in the food companies that sell their food to the school cafeterias. By doing this, I could attempt to stop the problem before it occurred, because then there would not be the unhealthy food options in the cafeterias in the first place. A main barrier to this, on the implementation stage, would be cost because in most cases the more unhealthy food options are the cheaper foods. It is easier to get mass amounts of the more unhealthy food for less money, which is why the cafeterias would look to buy that type of food first. This barrier could be easily managed, however, with a little more money from various outside funds.

For the communication section, the key stakeholders that would need to be on board with this strategy would be the children with obesity, the parents of the children with obesity, the schools’ cafeteria’s employees and/or manager and the food companies that currently sell food to the cafeterias and the companies that will sell the healthier options to the cafeterias. A way to inform the actual kids with obesity and their parents of the new food change in the cafeterias could be just mass emails or postings on the school’s website. I could also send letters to their houses about the change, but that could take a lot of time and money to do. To inform the other groups of stakeholders, I would set up a conference in order to bring the cafeteria employees together with the previous and future food companies and discuss the new plan. Although there could be disagreement among the groups, I think that they could collectively come up with solutions and agreements.

To evaluate the effectiveness of this intervention, I could use surveys to get people’s opinions on the changes. From these surveys, I could make even more changes to the strategy, or less changes if the majority of the surveys show disapproval. Another way to evaluate the effectiveness of this intervention would be to look at the medical records of the obese children before my intervention strategy and then after a few weeks with the strategy in place. Therefore, I could see if the obese children have lost any weight at all due to changing the food in their cafeterias.

Blog 10 - Interventions

Current intervention strategy: Soda taxes. An article says that current soda taxes, which are usually not much higher than 4% in grocery stores, do not have a huge affect on levels of soda consumption or obesity rates. However, children who are already obese, children who are in a family with a low income, or children who are a “minority” seem to be affected more than normal weight children. The article discusses the affect that more taxes could help other obesity prevention efforts. This intervention could be included in the political determinant section because it is a law that has been created in an attempt to reduce obesity rates.

One potential strategy that could address my problem would be to create educational programs in cities in order to inform children and their families about obesity. The programs could explain what obesity is, its various causes, ways to prevent it and ways to reduce the rates once people are already obese. This type of strategy could fall under the political determinant section and could be primary, secondary and tertiary intervention, depending on what stage the person being informed is at. Another strategy that could address my problem would be creating a law making local schools provide healthier food options in their cafeterias. Again, this strategy could fall under the political determinant section because the government would be making this law in an attempt to reduce the obesity rates in the nation. This strategy could be primary, secondary and tertiary intervention as well, depending on what stage of obesity the person is at. A final strategy to address my problem would relate to the food deserts in various cities. The strategy would be to provide the corner stores or various local markets with healthier food options for their menus. This strategy could fall under the environmental determinant section as well as the economic determinant section. It would be more tertiary intervention.

If I were to order or prioritize the above strategies to address my problem, I would implement the third strategy first (reducing food deserts), the law for school cafeterias second, and finally the educational programs third. I chose to order my strategies this way because I believe this order will be most effective at addressing my problem directly. Although the food deserts do not affect everyone, it is a big issue that causes obesity in many cases. If the food deserts were reduced or even eliminated, the obesity rates of many cities would decrease immensely, in children and adults both.

http://content.healthaffairs.org/content/29/5/1052.short

Blog 9 - Stakeholders

My current problem definition is "The rise in obesity among 12 to 18 year olds in the United States over the past 15 years. This week’s blog assignment deals with stakeholders. Stakeholders are persons, organizations or other groups who share a stake in the issue, that is to say those who might be affected by the problem and/or its solution.

For my problem, some stakeholders could be children with obesity, fast food companies, pediatricians, parents of children with obesity, health food companies, hospitals and the FDA to throw a few out there. Some stakeholders would be affected more directly by my problem than others, but they are nevertheless considered a possible stakeholder.

When thinking about interventions, one possible intervention could be to inform the public about proper nutrition and good, healthy diets. With posters or speakers around schools or communities that typically have high levels of obesity among the children. This intervention could be tough because although the information would be provided, it would be the responsibility of the actual children with obesity to utilize the information for effectiveness. Another intervention would be to start the intervention earlier in a child’s life to make it more effective. Programs for infants or toddlers could be set up and utilized early on that would help prevent obesity before it even began.

Blog 8 - Key Determinants

My current problem definition is: The rise in obesity among 12 to 18 year olds in the United States over the past 15 years. This week’s blog post deals with the key determinants for my problem. Key determinants can be the biological, social/cultural, environmental, economic and political factors that relate to the problem and provide a framework for where to look for interventions.

The first type of key determinant is the biological determinants. These would be the anatomic, physical or medical reasons that a problem might exist. A biological key determinant could be relating to genetics. If a parent is obese, his or her child has a 25-50% chance of becoming obese in their life. This percentage can increase to about 75% if both parents are obese.

The next type of determinant is the social and cultural determinants. When looking at childhood obesity, there are many different social/cultural determinants. For example, race/ethnicity affects obesity trends all over the world. “Minority and low-socioeconomic-status groups are disproportionately affected” by obesity (5). Various statistics show that minorities, such as Blacks, Hispanics, Asian/Pacific Islanders and American Indians, all show higher percentages of obesity. This can be due to the different foods they eat, lower rate of physical activity, or other factors. Another social/cultural determinant could be one’s social environment, especially in children. At school, for example, kids could choose the unhealthier foods because their friends choose those foods. (This also relates to peer pressure). Finally, a person’s income definitely helps determine obesity rates. Those with lower income tend to not be able to afford healthier foods, which leads to obesity in the long run.

The next determinant is environmental. These might include weather conditions, geography, air quality levels, and more. One important environmental determinant deals with geography with the food deserts in various cities. A food desert is “a district with little of no access to large grocery stores that offer fresh and affordable foods needed to maintain a healthy diet” (6). Food deserts can lead to higher rates of obesity simply for the reason that those living in a food desert only have access to the more unhealthy foods.

There are many individual economic determinants when looking at childhood obesity trends. For example, families with lower income simply cannot afford the healthier foods that are needed to maintain a healthy diet. According to the CDC, “1 or 7 low-income children is obese” (2).

Finally, there are political determinants, which can be the factors that occur because of the executive, legislative or judicial decisions that exist during a particular time period. One big political determinant could be the lack of universal health care in our nation. Medical care can be crucial for obese patients, but not everyone can afford it. Lack of universal health care can help lead to higher obesity rates in our nation because of the amount of people who are obese and uninsured who cannot get the medical care they need.

http://www.nasbe.org/healthy_schools/hs/bytopics.php?topicid=3115

http://www.cdc.gov/obesity/data/childhood.html

http://cpj.sagepub.com/content/early/2013/03/27/0009922813482750.full.pdf+html

http://www.cdc.gov/features/obesity/

http://epirev.oxfordjournals.org/content/29/1/6.short

http://en.wikipedia.org/wiki/Food_desert