The article addresses the problem of childhood obesity, which is a significant issue in health care. The prevalence of obesity during childhood is on the increase across various parts of. Introduction Childhood obesity is becoming a major public health crisis in both children and adults. The American Heritage dictionary simply defines obesity as a condition of increased body weight that is due to excessive build up of fat in the body.
Using this chart, obesity is defined.
Ian Duffy Nature v. This debate is especially interesting in the study of childhood obesity. Childhood obesity is growing at an alarming rate in most developed countries throughout the world and it cannot be understated. Obesity, and more importantly childhood obesity, is drastically effecting the United States of America and other parts of the world, more and more each day. In the last 30 years, the amount of children who are six to eleven years old have doubled, and children who are twelve to nineteen years old have more than quadrupled.
The childhood. WHO, , and if not properly handled, could lead to serious health problems like cardiovascular disease. Owen et al. Childhood Obesity is becoming a major public health problem and if not properly talked could lead to serious case of morbidity and in extreme cases mortality. There is. Thesis Statement: While there are many causes of childhood obesity, most are, in fact, preventable. The research on determinants of eating and physical activity behaviors in children and adolescents has focused predominantly on individual-level determinants of these behaviors for example, attitudes, preferences, intentions and self-efficacy.
Recently, there has been a shift in attention to environmental determinants of eating behavior and the built environment, but the empirical evidence on environmental factors is scant, especially for the food environment. What aspects of the food, physical activity, and built environments are more influential than others and most amenable to change? What are the most feasible and effective environmental interventions and policies that will have the biggest impact on changing eating and physical activity behaviors to reduce childhood obesity? Can the modest effects of behavioral obesity-prevention programs be amplified by the addition of components to foster behavioral-environmental synergy?
What is the intersection between the physical and social environment, perceptions of the environment, and individual behavior? Research : 1 The study of environmental influences on food and physical activity behaviors in children and how they impact weight status is a relatively new science, and the systematic development of conceptual models and theories is lacking.
Strong theoretical models for testing the interactions among personal, social, and environmental factors and the mechanisms and causal pathways by which specific environmental influences might interact with individual factors to influence health behaviors and obesity are needed.
Multiple physician and patient surveys have demonstrated low rates of identification and treatment of adult obesity within the office setting. This is likely due to several factors, including lack of training in obesity assessment and management, low confidence in ability to treat obesity and change relevant behaviors, limited time during office visits, competing demands, and inadequate reimbursement. The focus on the system comes from organizational theories that promote change by altering the system of care.
The chronic care model identifies the essential elements of a healthcare system that encourage high-quality chronic disease care Figure.
These elements are the community, the health system, self-management support, delivery-system design, decision support, and clinical information systems. Evidence-based change concepts under each element, in combination, foster productive interactions between informed patients who take an active part in their care and providers with resources and expertise. The chronic care model has been evaluated for diabetes mellitus, asthma, congestive heart failure, and depression with mixed results; however, application of the chronic care model to the provision of obesity care remains untested.
Download figure Download PowerPoint Figure. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract. Primary care for children and adolescents has traditionally dealt mostly with well-child visits and acute illness. The changing face of primary care for children and adolescents is beginning to address more chronic care conditions, and chronic care models are beginning to be used.
There is currently a low rate of obesity diagnosis and management in the pediatric office setting. In order for child healthcare providers to develop best practices in the prevention of abnormal weight gain and treatment of obesity in children and adolescents, it is necessary to use knowledge gained in other areas of medicine, including care for adults with chronic illness. Particularly important examples include the treatment of heart failure and type 2 diabetes mellitus in adults. These are examples of situations in which systems of chronic care have proved useful in producing improved outcomes in areas in which care is complex and often requires behavior modification.
An example of success in the pediatric population is the development of systems of care to support patients with asthma and their families.kinun-mobile.com/wp-content/2020-02-13/cilim-mobile-number.php
Case Study: Universal Screening and Obesity-related Dyslipidemia
This section presents salient points learned from these disparate settings that could prove useful in developing better care for pediatric patients with obesity and obesity-related complications. The most successful heart failure management interventions involve multidisciplinary teams that incorporate the social network of the patient and provide positive feedback to support complicated lifestyle changes and medical regimens. Consideration of comorbidities and mental health issues is critical in helping patients self-manage their heart failure.
Many studies indicate that multidisciplinary teams that incorporate disease management strategies can lead to improved outcomes for heart failure and thus fewer hospitalizations, improved adherence to medications, improved adherence to lifestyle changes, improved mortality, more likely treatment of depression, and a greater likelihood of overcoming barriers.
Substantial research in diabetes, smoking, and other areas of health promotion indicates that healthy behavior does not persist on its own; health behaviors must be provided ongoing and varied support and facilitation in order to persist. Research shows that diabetes self-management is effective in improving metabolic control and quality of life in diabetes.
The Diabetes Initiative of the RWJF sought to show that diabetes self-management could be implemented successfully in settings such as neighborhood health centers and community organizations. Community health workers can make substantial contributions to self-management programs. Ongoing follow-up and support for diabetes is important, and without it, self-management benefits will not be sustained.
Case Study: Universal Screening and Obesity-related Dyslipidemia
Attention to depression and negative emotions and the promotion of healthy coping are key components of self-management and are feasible in primary care and community programs. Attention needs to be given to organizational structure and support for self-management programs. Community clinic participants can be effective in promoting and supporting self-management. Six evidence-based resources and supports for self-management were identified: Individualized assessment; collaborative goal setting; the opportunity to learn and master skills for diabetes management; community resources, such as for healthy eating and physical activity; ongoing follow-up and support; and continuity of quality clinical care.
A similar challenge of dissemination of a core program in diverse settings is faced by Peers for Progress, a program of the American Academy of Family Physicians Foundation and the Eli Lilly and Company Foundation. The program was designed to validate and promote peer support for diabetes management.
Preliminary development of this program identified a tentative list of key characteristics of peer support for diabetes management: 1 It must have its basis in a personal relationship; 2 it must offer assistance in finding ways to implement self-management plans in family, community, workplace, and other settings of daily life; 3 it should encourage the use of skills and problem solving; 4 it should provide social and emotional support in general and for maintaining diabetes management routines in daily life; 5 it should be a complement to, not a substitute for, diabetes patient education; 6 it should enable monitoring of problems in diabetes management; 7 it should provide linkage to clinical care; and 8 it should be implemented by volunteers.
The implications for approaches to childhood obesity, based on what has been learned from the Diabetes Initiative and Peers for Progress, are as follows: Self-management works in real-world settings; sustained behavior change requires varied intervention modes and ongoing support.
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Choice is key for reaching audiences and engaging those with diverse needs and preferences; program planning should identify and implement many good practices rather than obsess over identifying and limiting offerings to a few best practices. Identification of key program ingredients and approaches provides a base from which individual programs can be flexibly developed to ensure the best fit to settings, organizational and community strengths, and population needs and perspectives.
The prevalence of asthma has increased dramatically over the past 20 to 30 years. The explanation for this increase is not yet clear, but obesity is a likely contributor. The relationship between obesity and asthma was first suggested by a cross-sectional study of children in the late s.
Prospective cohort studies have clearly demonstrated a strong, positive association between BMI and risk of asthma across all ages. Moreover, weight-loss experiments, although limited, suggest that weight loss improves asthma. These guidelines were revised in , and a brief update was released in The National Institutes of Health guidelines, or the Third Expert Panel Report, emphasize the importance of asthma control and of assessing both its severity and control across 2 domains: impairment and risk.
Many different initiatives have been undertaken to improve childhood asthma outcomes, including the RAND report on improving childhood asthma outcomes, the National Asthma Education and Prevention Program report on key clinical activities, and the Expert Panel Report 3 Guidelines Implementation Panel ongoing. These 3 documents demonstrate the importance of distilling information from detailed documents to the activities or messages most likely to produce a significant impact on asthma care processes and outcomes.
How can lessons learned from management of adult and pediatric chronic illnesses best be applied to management of pediatric obesity? How can studies be developed to evaluate the application of components of the chronic care model to address childhood obesity? Can methods that have been successful in the management of adult chronic illness be applied to pediatric patients? How can child healthcare providers develop the kind of medical home that will improve management of chronic illness?
Education : Provide skill-oriented interactive training programs on self-management, behavioral change theories and methods, interdisciplinary care teamwork, and information systems to pediatric primary care. Research : Quality improvement, health outcomes, and health economics will need to be evaluated for delivery of obesity care with the chronic care model versus usual care for childhood obesity. There have been notable public health successes with respect to certain threats to health.
Questions have arisen regarding whether public health efforts to control tobacco might provide insight into how to prevent childhood obesity.
Case Study: A Patient With Diabetes and Weight-Loss Surgery | Diabetes Spectrum
Tobacco control has aspects both similar to and different from obesity as a public health problem: Both problems have guidelines for clinical care and policy interventions. For both, the evidence base for interventions is less robust for children and youth than for adults, and interventions for adolescence and adulthood are poorly defined.
Progress in tobacco control required, and still requires, sustained advocacy and political leadership. Progress in addressing obesity will require the same. There are also some important differences. Nicotine is highly addictive, and there is no safe level of use or exposure, whereas food is not a deadly product and people need to eat every day. This is one reason why the public health response to overnutrition has focused on strategies that rely on the need for individuals to change behavior.
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