obesity in children is increasingly drawing concern
The issue of obesity in children is increasingly drawing concern because of the increase in the number of affected children and adolescents. This is public health issue that is extremely troubling because the children are more susceptible to health problems which were once considered as adult problems. These include diabetes, high cholesterol, and high blood pressure. Childhood obesity often translates to adulthood obesity further creating a strain on an existing problem. There is a need to come up with interventions to curb this problem as it helps to promote the health of the child now and in the future. According to WHO, it is one of the most serious public health challenges of the 21st century. In 2016, the number of overweight children worldwide was estimated to be 41 million. The rising numbers are a result of a shift in the diet towards increased intake of foods which are energy-dense, therefore, high in fats and sugars and they are low in vitamins, minerals and other healthy micronutrients (Sahoo et al, 2015).
Many factors increase a child’s risk of being obese in addition to a poor diet. Lack of exercise especially when combined with poor dietary habits increase the chances of obesity. There are family factors where a child brought up in a family of obese people has a high likelihood of being obese. Psychological factors such as personal, parental, and family stress may lead to a child overeating to cope with the problem. Finally, the socioeconomic factors impact childhood obesity because some families do not have the financial capacity to access nutritious foods. They settle for convenience foods which increase the incidence of obesity. The physical complications resulting from childhood obesity are type 2 diabetes, high cholesterol, and high blood pressure. They are also more susceptible to develop asthma, sleep disorders, and bone fractures. Additionally, the children suffer from a nonalcoholic fatty liver disease which is the deposition of fats in the liver leading to scarring and liver damage. The children can also suffer social and emotional complications such as low self-esteem and being bullied, depression, and behavior and learning problems (Sahoo et al, 2015).
Theory
The social comparison theory can be employed in dealing with the public health problem of childhood obesity. This theory states that an individual determines their social and personal worth based on how they compare with those of others. This comparison is aimed at fostering self-motivation and self-improvement while aiming to create a positive self-image. The children can evaluate themselves in the domain of obesity and aim to make improvements where possible. These comparisons are mainly between people who share similar attributes such as age and background. An example of this is when children am to achieve certain milestones at the same time as their peers. However, this theory has disadvantages that should be factored in to ensure that they do not lead to detrimental effects. The comparison may be with overachiever placing unwarranted pressure. It may lead to feelings of dissatisfaction and guilt or remorse causing the development of destructive behaviors (Ten Hoor et al, 2017).
This theory is appropriate because children are competitive and they like comparing their achievements with those of their peers. Many people may argue that this approach is not appropriate as it could lead to detrimental effects on the children. However, the psychological effects of childhood obesity are already an indication that the children are already comparing themselves with others. It is therefore important to harness this and implement it in a positive way to produce the desired positive results. By comparing themselves with others, the children can practice what the others are doing and consequently lead to the desired positive results. However, because the negative effects are known, there is a need to take preventive measures and ensure that they are not experienced.
Constructs of the theory
There are four key constructs of social comparison theory including observational learning, reinforcement, self-control, and self-efficacy. For any theory to bring about change through an intervention, there are stages through which a person goes through before the change can be achieved. These stages include precontemplation, contemplation, preparation, action and finally maintenance. The precontemplation stage is whereby there is no recognition among the target population of the importance and necessity of a change in their lifestyle. Therefore, the target population does not have any interest in targeting the change. The contemplation stage involves thinking about taking the appropriate measures to achieve the required change. The preparation stage is where the target population plans for the required change and they make their decision to venture into it. The action stage is where the target population takes the action of ensuring change by adopting new habits which will help towards achieving the desirable results. Finally, the maintenance stage is where the target population adopt an ongoing practice of new and healthier behaviors which will help in the retainment of the achieved results (Glanz & Bishop, 2010).
Observational learning is the method is where an individual observes the behavior and attitudes of another person and get to learn from it. This is a major component of the social learning theory and it involves four major conditions i.e. attention, retention, reproduction and motivation. Attention is very important when a person wants to learn anything from a model. There are many things which can affect the observer’s attention and for children they are many more. If their attention is distracted, they may not be able to imitate the desirable behavior because they have not been able to observe it well. With this problem, the obese children will be placed together with healthy children who are observing healthy lifestyle habits. This will help to improve the obese children’s eating habits and improve their physical activities and consequently lead to the elimination of the problem of obesity. Retention is the second requirement and without it the target population cannot practice the healthy behavior. Therefore, the intervention measures should ensure that the children are able to remember what they observed and hence practice it. Reproduction is the physical and mental copying of the behavior which has been observed. It should be made known to the target population that being able to practice the desirable behavior may be difficult at the beginning but it becomes easier with practice. Finally, motivation is an important aspect in motivational learning and this involves giving them a reason to imitate the desirable behavior (Glanz & Bishop, 2010). Some of the motivations include providing an incentive or observing the model receiving reinforcement for the desirable behavior.
Reinforcement directly means to strengthen and it can be used in the social learning theory. The reinforcement in the case of childhood obesity can be either positive or negative. Positive reinforcement involves adding something to the participants and negative reinforcement is removing something. This is aimed at increasing a behavior. The aim of an intervention is to overcome the existing problem and therefore, the negative and positive reinforcements are aimed at increasing a behavior. The most common form of positive reinforcement is praise and rewards and this can be offered to the children once they make a positive step towards achieving the positive behavior. Negative reinforcement on the other hand involves taking away something which the participant deems to be important until they are able to achieve a set target (Glanz & Bishop, 2010). For children this is difficult as it may be seen as punishment rather than a reinforcement. However, because poor diets lead to obesity, slowly taking away unhealthy foods will help to achieve the desired results.
Self-control is a key construct of social comparison theory and in intervention measures for childhood obesity, it is very essential. The children need to learn the art of self-control as it is essential in preventing them from indulging in activities which could promote obesity. In many instances, the children do not have the capacity of making this decision and whatever they eat is determined by their parents and guardians. Therefore, the art of self-control has to be with their parents who should shy away from presenting unhealthy foods and should shy away from falling into the temptation whenever their children demand for the unhealthy foods. This is a difficult approach for the parents because the parents find it hard denying their children what they want. Therefore, anyone venturing into this should be ready to overcome all the temptations and ensure that all their children stay on track in the effort towards achieving the desired goals. Self-efficacy deals with the confidence of a person in his/her ability to take an action, overcome the challenges and achieve the desirable results (Glanz & Bishop, 2010). This construct is important in influencing health behavior change efforts. The children believing in their ability to achieve the results which they view in their model helps them to concentrate and be motivated in participating in the intervention.
Interventions for the constructs
For the construct of observational learning, setting up the classroom and lunch sitting in a way that obese and healthy children can interact freely. The setting in the classroom is aimed at fostering friendships between the children which will make the sitting arrangement during lunch time easier. This way, the children can be able to observe the positive behavior from their peers and make the required positive changes in their lives. However, among children, it may be difficult to identify these without being pointed in the right direction. It would therefore be important is they are educated on the beneficial behaviors which can lead to a healthy lifestyle (Zheng et al, 2017). This can be achieved through the teachers holding lessons for the children and highlighting the behaviors which lead to a healthy lifestyle.
For the construct of reinforcement, both the parents and the teachers can be employed to help in achieving it. This is whereby the children are rewarded for participating in healthy behaviors. Whenever a child has been able to eat and finish a healthy meal, it is important that the parents are able to applaud this. The teachers can also help in this by affirming any positive behavior that they may experience in the children. The praise by the teachers should be vocal and ensure that all the other children hear it. This will motivate them to carry out the same activity or behavior so that they can be praised (Zheng et al, 2017). This construct is important as it will enable the children to be able to carry out the positive behavior which will lead to the achievement of the desirable effects.
The construct of self-control is mainly for the parents but the children can also be involved in this construct. For the parents, impulse control training can be carried out on the parents to achieve this construct. This is because the parents are used to accommodating the unhealthy behaviors which lead to an increase in the occurrence of obesity among their children. It would be difficult for them to change this overnight and hence the need to train them on impulse control. This will help them in adhering to the appropriate practices aimed at achieving a healthy life for their children. For the children, reward bundling can help in self-control training where the reward for their achievements is postponed until they are able to achieve greater milestones. This will teach the children self-control as they aim to achieve greater milestones so that they can receive the reward. The anticipation associated with reward bundling will create self-control among the children (Zheng et al, 2017).
The construct of self-efficacy is important as it means that the children believe in their ability to perform the healthy behaviors and activities aimed at achieving a healthy lifestyle. Verbal persuasion is important in ensuring the children believe in their ability to see the activities through. Through verbal persuasion, the children begin to believe that they are able to achieve the set goals. The use of verbal persuasion shows a form of support, helps to reinforce performance and structure the situations faced by the children to achieve success (Zheng et al, 2017).
Intervention evaluation
The intervention involves the people who are closes to the children and hence it has the high chance of success. There is high motivation for the intervention because of the public health problem that child obesity creates. The intervention provides four constructs which will help to achieving the set target of reducing obesity among children. There is great emphasis on motivating the children towards achieving the set goals and becoming healthier. By employing the four constructs and the interventions for each construct, the intervention will have desirable results. However, childhood obesity encompasses both children and adolescents and this intervention places greater emphasis on children while ignoring the adolescents.
Conclusion
Childhood obesity is a great public health problem which needs to be addressed. Obesity among children often translates to adults with obesity and this places greater strain on an already great public health problem. Childhood obesity is caused mainly through poor diets and hence an intervention of improving the children’s diet is the appropriate approach. The social learning theory should be employed as it involves the emulation of good behavior from a model. This theory is applicable because children like to emulate from others and compare with their peers the achievements which they have made. The interventions for the four construct of the social learning theory, observational learning, reinforcement, self-control and self-efficacy, are aimed a achieving the goal which has been set for the intervention.
References
Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in development and implementation of public health interventions. Annual review of public health, 31, 399-418.
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.
Ten Hoor, G. A., Plasqui, G., Schols, A. M., & Kok, G. (2017). Development, implementation, and evaluation of an interdisciplinary theory-and evidence-based intervention to prevent childhood obesity: theoretical and methodological lessons learned. Frontiers in public health, 5, 352.
Zheng, Y., Mancino, J., Burke, L. E., & Glanz, K. (2017). Current Theoretical Bases for Nutrition Intervention and Their Uses. In Nutrition in the Prevention and Treatment of Disease (pp. 185-201). Academic Press.