Medical & Health // Role Transition
I. Introduction
Grim global health records in 1990 showed that 32 million children less than five years old were obese (WHO, 2017). These records turned grimmer when they reported that the figure leaped to more than 42 million for the same age group in 2013 by 30%. Of this number, 35 million were reported to be in developing countries. Experts predict that, if the current rate remains, the figure may rise to 70 million in 2015. Without effective widespread interventions today, these obese children are likely to grow up into obese adolescents and adults with all its disadvantages and risks, especially on health. Obesity is one major factor in developing serious diseases and disorders, especially diabetes 2 and health conditions (WHO, 2017).
Findings
Prevention as Early Intervention, Barriers
Benjamin Franklin wise adage that an ounce of prevention is worth a pound of cure has made prevention the central strategy and a public health policy in dealing with this health scare. The lack of perspective by primary care clinicians and parents of children aged 2 to 5 was needed in developing national guidelines tor the task. Bourgeois and her research team (2016) sought the perspectives of 40 interprofessional primary care clinicians and 26 such parents about facilitators and barriers as well as their recommendations for a prevention program in primary care. The researchers noted barriers in the form of behavioral differences, lack of time, and the sensitivity of the issue. But despite these barriers, participating clinicians and parents showed interest in systems-wide obesity prevention intervention programs in primary care. They saw primary care as the appropriate setting in its broad population reach and frequent contact with young patients (Bourgeois et al, 2016).
The Canadian Task Force on Preventive Health Care, however, opposed structured preventive interventions in the said setting for the lack of existing effective interventions and the lack of knowledge among parents and children about interventions (Bourgeois et al, 2016). Further research on these information can provide the basis for the creation and refinement of intervention programs for obesity prevention (Bourgeois et al, 2016).
Re-emphasis on Physical Activity in School and Federal Intervention
The American Heart Association’s Children’s Heart Health Conference re-enforced the role of physical activity in conformity with the goals of Healthy People program in August, 1994 (St. Louis, 2013). This was through guidelines, which would strengthen children’s confidence in engaging in physical activity; establish a substantial weekly amount of physical activity among children; develop competence and participation in meaningful and healthful physical activities; disseminate information on the benefits of physical activity to health; foster proper behavior towards maintaining an active lifestyle; and encourage students’ involvement in games and other physical activities at home, in school and in the community. The solution is clearly to re-emphasize the importance of physical activity in children’s daily lives. This can be realized by initiating walking and biking to and from school; building greater interest in physical education; allotting enticing rewards for physical activity; reducing sedentary tendencies; and requesting healthy celebrities to endorse physical activity and proper nutrition (St. Louis, 2013).
The federal government may provide the finances for these activities, while allowing or encouraging the States to initiate their own activities (St. Louis, 2013). The States have shown a weakness in curbing childhood obesity in the past and now need to exert maximum effort at almost completely taking charge of a solution that could help solve the continuously increasing childhood obesity incidence and prevalence (St. Louis, 2013).
Because of the substantial need for federal intervention and spending, the response to the national epidemic has also incurred enormous health care expenditure (St. Louis, 2013). While the States are empowered to manage and police their respective health, safety, welfare and morals of their populations, the magnitude of the epidemic breaches the limits of the resources of the States. Federal intervention has become necessary (St. Louis, 2013).
But federal intervention itself confronts difficulties in dealing with childhood obesity and obesity in general (St. Louis, 2013). It is particularly costly to control or treat. Thus, prevention needs to be a national priority. One approach has been to mandate all public schools to incorporate physical education into their curricula (St. Louis, 2013).
Lifestyle Change Effective, Studies Say
Researchers (Sargent et al, 2012) reviewed and analyzed 31 studies on adult lifestyle intervention by primary health care nurses in their setting. Their work revealed greater effectiveness in counseling by a primary health care nurse than health screening. Counseling was more effective when based on behavior change theory and slanted towards prevention. Their finding enhances the assumption that these outcomes were linked to weight, blood pressure, cholesterol, attitude towards diet and physical activity, patient satisfaction and willingness as well as readiness to change and to opt for quality of life. Continuing research is recommended with much less bias, more varied outcome methods reflecting risk factors, training for nurse delivery, testing the effectiveness of counseling, which uses behavioral change frameworks (Sargent et al, 2012).
mHealth Strategies: Advantages and Challenges
mHealth Systems offer sophisticated intervention design, delivery, distribution activities and prevention measures (Tate et al, 2013). They are also cost-effective, make possible real-time collection of data, provision of feedback, reduced burden on participants, applicability to varied populations, and high dissemination capability. These systems, however, confront specific challenges, such as the lack of scientific evidence-based effectiveness of their available applications; comparatively slower technology development in the academe; issues in data security; patient privacy; likelihood of increased sedentary screen time and its negative consequences; and reduced attention in lieu of technology use. Intensive partnership between the academe and industry may produce the needed solution in the form of cooperation among all disciplines, creation of new assessment methods, and greater scrutiny of factors, such as screen time sedentary behavior, and focus of attention. mHealth systems may prove to be a new channel in reaching out to large groups of youngsters (Tate et al, 2013)
Childhood obesity is a complicated as well as a multifaceted national health problem (Tate et al, 2013). The application of mHealth strategies to manage this immense health issue thus requires multifaceted and interacting interventions, therefore. The effective use of mobile, multimodal, interactive mHealth tools is recommended to increase and optimize available resources. At the same time, further or possible innovations may surface as a consequence (Tate et al, 2013).
Expansion of Primary Care Role in Prevention
The assessment and treatment of childhood obesity and related conditions have been customarily performed in the clinical environment (Vine et al, 2013). Current realities demand the expansion of such an environment for the health provider. Studies between 2005 and 2012 showed the different roles played by primary care providers that can be utilized in the successful implementation of childhood obesity treatment and prevention initiatives in both clinic and community arenas. The 96 articles reviewed from peer-reviewed sources in the said periods synthesized the significant characteristics, factors or approaches by which primary care providers can succeed in preventing or treating childhood obesity within the community through linkages (Vine et al, 2013).
Vine and her research team (2013) presented nine areas, which primary care providers or nurse professionals may use in promoting the treatment and prevention of childhood obesity in both the clinical and community environments. These areas are evaluation and monitoring of weight status, promotion of a healthy lifestyle, development of clinician skills, development of clinic infrastructure, provision of community program referrals and community health education, implementation of multi-sectorl community initiatives, and policy advocacy. These most potential interventions were aligned with recommendations published in the past decade by prominent health organizations, such as the Institute of Medicine and the American Academy of Pediatrics (Vine et al, 2013).
The alarming and global increase in the incidence and prevalence of childhood obesity clearly requires the urgent need for newer, more adaptive or radical approaches than mere behavior change or evaluation after treatment (Vine et al, 2013). It goes without saying that the prenatal and early childhood periods are more important times of growth when healthy lifestyle should be established. The primary care pediatrician, community health center health worker, and women-infants-and-children’s clinician are in a unique position of access to patients in their first two years of life. This is the precise time to counsel their parents about a healthy lifestyle and to present health models and make the necessary community recourse referrals. Beyond these, the health provider or professional nurse can as role models, educators and promoters of healthy habits and lifestyle. They can function as leaders and innovators in implementing childhood obesity prevention measures in the community in a direct and personal way. National survey data, however, emphasized that primary care practitioners should nevertheless give greater emphasis to their role and responsibilities as clinicians than as health promoters or educators in the community (Vine et al, 2013).
Synthesis
The World Health Organization reported that the incidence of obesity among children aged five and younger had risen from 32 million in 1990 to 42 million in 2013 as the latest figures on the epidemic, representing an upsetting 30% growth (2017). If unabated at present rates, this global epidemic can bloat to produce about 70 million obese children below five by 2015 (WHO, 2017). Treatment is both difficult and costly, so the popular and rational response to the issue is prevention. But Bourgeois and team (2016) present barriers to the initiative in the form of behavior differences among clinicians and parents of children in these ages. However, they expressed interest and cooperation in curbing the epidemic. St. Louis (2013) identified guidelines for regular and greater physical activity in school curricula and the need for federal intervention to supplement resource shortage in the States. Sargent and team (2012) found that counseling by a primary health care nurse is more effective than health screening and that the epidemic is linked to a number of factors. Tate and researchers (2013) underscore the uniqueness as well as the challenges of the use of mHlealth strategies. Stronger partnership between the academe and the industry and the optimum use of available tools as well as the introduction of better initiatives hold much promise. And Vine and team (2013) see greater efficacy in childhood obesity prevention by expanding the primary care professional’s role outside the clinic setting.
Conclusion
Partnership or cooperation between and among schools, the home, industry and the government will most likely prove to be the best initiative against this global epidemic.
WORKS CITED
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