Signature Assignment-Ecological Research Paper: DRAFT

Running head: Childhood Obesity

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Childhood Obesity

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Childhood Obesity and the Socio-Ecological Model

National University

Childhood Obesity and the Socio-Ecological Model

Throughout the United States, there continues to be a major issue with the increasing number of individuals that suffer from obesity. Unfortunately, this major health issue is not limited to the adult population, children are also being plagued with this serious medical issue. According to the Center for Disease Control and Prevention (2019), obesity affects 1 in 5 children and adolescents in the United States. That is a staggering 13.7 million children and adolescents in the United States alone. Obesity affects all age groups of children and adolescents, but there is a higher prevalence among 12 to 19-year olds. Similar to its cause in adults, obesity in children is caused by both behavioral and genetic factors (CDC, 2019). One way to combat such a major health issue is to address the problem from all levels of influence using the socio-ecological model. The socio-ecological model is an approach that demonstrates that there are separate as well as interconnected factors that can influence an individual’s health behaviors, meaning that an individual can be influences by their own action, the actions of their family, community, organization and even society (Cottrell et al., 2018). The socio-ecological model can help to understand how each level of influence “intersects to shape” the choices that a person makes about their food and physical activity. (U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015). This essay will demonstrate how the application of various levels of the socio-ecological model affects childhood obesity and will show how changes at each level can address the prevention of childhood obesity.

Intrapersonal Level

The first socio-ecological level is the intrapersonal level. This level focuses on and identifies an individual’s “knowledge, attitudes, and behaviors” in regards to actions that they may or may not engage in to prevent or address childhood obesity (Callahan, 2014). Some of the influences in the intrapersonal level can include knowledge or skills, motivations or personal traits. However, it is arguable whether or not a child or adolescent’s personal skills or knowledge is enough to prevent childhood obesity because children are dependent on adults to provide them with recommended healthy choices. According to authors Penney et al. (2014), the choices that children make about the types of food that they may consume depends on the options given to them while at home, school, or at daycare (para. 1). Some important interventions at the intrapersonal level would have to focus on teaching children about what they should do to be healthy. This can include teaching children in school what a healthy meal consists of and the importance of physical activity. The website Nutrition.gov provides activity sheets, videos, songs, games, and activities to teach youth about nutrition in a variety of settings, such as choosing a new food at the grocery, tasting and rating it like a food critic (U.S. Department of Agriculture, n.d.).

Interpersonal Level

The next level of the socio-ecological approach is the interpersonal level. This level focuses on a group of people that have some form of relationship with an individual. For children this would be their friends and relatives (Cottrell et al., 2018). Physicians can also play a role at this level. Individuals around the child hold the greatest amount of influence (Callahan, 2014). The influence that parents or guardians have on a child’s eating habit and the amount of physical activity the child or adolescent receives is the most vital in the prevention of obesity. According to the 2015-2020 Dietary Guidelines, parents need to be actively involved in the providing healthy options for their children and this can decrease the overall prevalence of childhood obesity (U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015). There is a need for programs that teach parents how to properly feed their children, how to organize their time to be able to make healthy meals, how to find healthy foods that fit within their budget and how to reinforce good behavior with things other than food. Schools can host discussions and provide suggestions to parents on how to cook dinner, shop for healthy foods, read labels and pack lunches with their children, as well as do fun family outings like pick fruit or go on hikes (CDC, 2012). Physicians should also play an active role in helping parents with children that are suffering from obesity by having a non-judgmental attitude and using terms that do not stigmatize weight (Gordon, 2019). They can also suggest limiting TV and video time to 2 hours a day and to promote unstructured play at home (Committee on Nutrition, 2003). After-school programs can also influence diet and physical activity by using tools such as the Healthier Out-Of-School Time Assessment to guide these programs in how to include healthy foods and physical activity (Alliance for a Healthier Generation, 2010).

Organizational Level

The next level of the socio-ecological approach is the organizational level. This level includes the “rules, regulations, policies … informal structures” that increase or decrease healthy behaviors (Cottrell et al., 2018). At this level, the focus can be on schools or daycare settings for children. These types of institutions have a continuous amount of contact with children for a majority of their young lives. In the United States alone, 56.6 million children are enrolled in school (National Center for Education Statistics, 2019a). As the place where children are learning and socializing with their peers, schools have been identified as ideal for teaching children how to maintain healthy active lifestyles (CDC, 2018). For example, schools “can adopt policies and practices” to promote eating more fruits and vegetables, to consume less sugary drinks and to increase physical activity (CDC, 2019a). These policies can be cost effective and have a great impact on the reduction of childhood obesity. Schools can make sure to provide plentiful drinking water, use non-food rewards for celebrations and events, limit or eliminate vending machines, and have staff model healthy behaviors (CDC 2019b). Schools can also involve parents in planning school health activities and invite them to participate in physical activities such as walkathons (CDC, 2012). Medical practices can also provide programs with teams of professionals such as dieticians, psychologists and health educators. One example is the IDEAL Clinic at Children’s National Hospital (Improving Diet, Energy and Activity for Life (Gordon, 2019). Doctors can measure BMI yearly in their young patients to identify excessive weight gain and encourage breastfeeding by parents (Committee on Nutrition, 2003).

Community Level

The next level is the community level. The community level is defined as the network of social norms that exist within a community (Cottrell et al., 2018). Implementation and creation of local policies or ordinances can support beneficial health behaviors. Childhood obesity can be a significant issue when the environment is not conducive to having healthy food options available and locations for children to be physically active. How the community is designed can determine the health behaviors of its children and parents (Callahan 2014). If a community lacks adequate recreation space for walking or physical activity and has several fast food restaurants within the community then it is more likely to have an increased obesity rate. The environment that a child lives in can have a direct impact on physical activity. Some interventions that can be put into place are making parks more accessible for children by locating them close to a child’s home, increasing the walkability and safety of the neighborhood and organizing neighborhood walking groups. Community members can push for making healthy foods more available by getting local stores to stock fresh produce. Community health workers can reach out to families to teach them about healthy nutrition and hospitals or non-profits can conduct community health screenings and fairs.

Public Policy Level

The final level to discuss is the public policy level. At the public policy level there are local, state, or federal policies or laws that “regulate or support healthy actions” to address the childhood obesity epidemic (Cottrell et al., 2018). There are currently policies in place that that focus on dietary requirements for schools. National food campaigns, mandated school wellness policies as well as wellness regulations are all some of the ways to promote healthy eating behavior to combat childhood obesity. Other policy and legislative solutions can include agricultural subsidies, regulating exposure to obesogenic chemicals in foods and food packaging, and banning super-sized sodas. There is a need for more policies to support healthier lifestyles choices for children to have proper nutrition and enough opportunity for regular physical activity (Committee on Nutrition, 2003).

In conclusion, childhood obesity is a preventable public health issue. The best way to overcome this issue is through the utilization of the socio-ecological approach. Changes need to be implemented at each of the levels, focusing heavily on the upper levels like the organizational, community and public policy level. Unfortunately, at the individual level children are not in control of making necessary changes to the lifestyle without the help of their caregivers at the interpersonal level. In the end, changes need to be made at every level for there to be a reduction of childhood obesity.

References Alliance for a Healthier Generation. (2020). Out of school time. Retrieved from https://www.healthiergeneration.org/take-action/out-of-school-time Callahan, K. (2014). Assessing the Social and Ecological Factors that Influence Childhood Overweight and Obesity. Retrieved from https://dc.etsu.edu/cgi/viewcontent.cgi?article=3812&context=etd Centers for Disease Control and Prevention. (2012). Parent Engagement: Strategies for Involving Parents in School Health. Retrieved from https://www.cdc.gov/healthyschools/parentengagement/pdf/parent_engagement_strategies.pdf Center for Disease Control and Prevention (2018). CDC healthy schools: School health guidelines. Retrieved from https://www.cdc.gov/healthyschools/npao/strategies.htm Centers for Disease Control and Prevention (2019a). Childhood obesity facts. Retrieved from https://www.cdc.gov/healthyschools/obesity/facts.htm Centers for Disease Control and Prevention (2019b). Comprehensive framework for addressing school nutrition environment and services. Retrieved from https://www.cdc.gov/healthyschools/nutrition/pdf/School_Nutrition_Framework_508tagged.pdf Committee on Nutrition. (2003). Prevention of pediatric overweight and obesity. American Academy of Pediatrics. 112, 424-430. Retrieved from https://pediatrics.aappublications.org/content/pediatrics/112/2/424.full.pdf Cottrell, R. R., Girvan, J. T., Seabert, D. M., Spear, C., & McKenzie, J. F. (2018). Principles and foundations of health promotion and education. Retrieved from https://nu.vitalsource.com/#/books/9780134552002/cfi/6/18!/4/2/2/2/4@0:0 Gordon, M. (2019). How doctors can stop stigmatizing kids and start helping kids with obesity. Retrieved from https://www.npr.org/sections/health-shots/2019/06/05/728812078/how-doctors-can-stop-stigmatizing-and-start-helping-kids-with-obesity National Center for Education Statistics. (2019). Fast facts: Back to school statistics. Retrieved from https://nces.ed.gov/fastfacts/display.asp?id=372g Penney, T., Almiron-Roig, E., Shearer, C., McIsaac, J., & Kirk, S. (2014). Modifying the food environment for childhood obesity prevention: challenges and opportunities. 73(2), 226–236. https://doi.org/10.1017/S0029665113003819 U.S. Department of Agriculture. (n.d.). Nutrition.gov. topics. Retrieved from https://www.nutrition.gov/topics/nutrition-age/children/kids-corner U.S. Department of Health and Human Services and U.S. Department of Agriculture. (2015). 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. Retrieved from https://health.gov/dietaryguidelines/2015/guidelines/.