Tackling Childhood Obesity: A PICO Approach

Introduction

According to the World Heath Organisation (WHO)obesity among children is the most critical international public health issue of 21st century(Jeihooni et al. 2019). It further states that obesity is has a great impact on children's health. The assignment will discussliterature health promotion literature relating to obesity in childrenusing the PICO format. It will describe how literature was chosen using data bases.(Hamulka et al. 2018). It willdiscuss the chosen. inclusion and exclusion criteria for the chosen articles. It will then critically appraise them. .Evidencewill be provided onhow effective health promotion is at tackling this issue.(Wadolowska et al. 2019). .

Background

For past 30 years research claims that the world is suffering with childhood obesity in higher rates (Ogden et al. 2018). In 2010 childhood obesity prevalence internationally was 6.7% whereas in 1990 it was 4.2 % (Meral, 2018). The rate even confirms that in 2020 it would be 9.1 % which is a large increase.(Meral, 2018). Further, 43 million children internationally are termed as overweight and 92 million children are at the verge of becoming overweight (Lee and Joo ,, 2016). Obesity can be defined as extra body fat which creates a level and health gets adversely affected through it. It is even approved method to check obesity by measuring BMI where weight supposed to be proportionate to height. 25 to 29 BMI is referred as overweight and reaching of 1 to 30 is considered as obese. Obesity and overweight results are different for children and adults (Catunda, Marques and Januário, 2017). Young person’s BMI if goes beyond 85 centile then can be referred as overweight and if it reaches beyond 95 centile then they used to be referred as obese. Connection between overweight and BMI gets changed as per gender and age. In 1997 WHO exclaimed that obesity is going to raise rapidly and by 2010 it would be referred as Global epidemic. Researchshows that for past decades obesity has become a public health concern for different countries followed by negative health impact. Health consequences which are result of obesity is costly and much .rich countries are subjected of the issue more (Lee and Mannix, 2018).

Overweight and obesity can bring major problems for adolescent and children which are mostly health issues like musculoskeletal difficulties, pre-diabetes, asthma, breathing problems, stigmatization and most importantly deterioration of mental health including self-esteem. Obese adolescents are biggest warning for the chosen population to understand the importance of healthcare. Prolonged obesity can act as a precursor of cardiac issues (Lee and Joo, 2016). It further raises chances for premature mortality, disability and morbidity in adulthood with a threatening for cardiovascular difficulties and type 2 diabetes

Methodology

The data bases used for this search werePubMed, ERIC, CINAHL. is academic search premier to have electronic database regarding clinical research. .All the databases mentioned here provide a huge variety of research data about health and well being. PICO format was founded by Richardson to transform medical questions as searchable keyboard. It futher helps to make better clinical questions as the model supports in basic formatting (de Melo Boff et al. 2017). The PICO format stands for population, intervention, comparison and outcome. The Pico used for assessment of obesity Population-adolescents aged13 to 18years. Intervention-health eating education Comparison- no comparison was used Outcome-Weight loss? While formulating a question, PICO suggests recognizing key concepts to include it in the search strategy to locate articles which can best answer the research questions (Sari and Sartika, 2018). By using the PICO format the research question was:

Is healthy eating education is effective to reduce obesity for adolescent aging 13 to 18 years?

PICO stands for: Patient Problem, (or Population) Intervention, Comparison or Control, and. Outcome. It helps a person remember the components of a well focused clinical question. It is a strategy used in the first step of Evidence Based Practice (EBP) to assess and ask when researching to formulate a searchable clinical question by helping to develop key terms In this search method the word “and” plays an important role to offer better outcome including variations to and helps to have better appropriate result. Thereby researchers are of the view that using words like ‘and’, ‘or’, ‘not’ helps to access better and appropriate database (Jayawardena et al. 2017). The keywords, for the research were as follows:

Obesity in adolescents

Obesity in youth

Healthy eating habits

The articles written in English language were considered for the research study, The research additionally works with recently published articles, the ones published in the last decade. It is observed that initially 1273 records are there from the database where 272 articles get removed for its duplicate nature and excluded 243 non relevant records as well. In order to avoid all these issues PICO is the most useful as primary surgical criteria get empowered to it (Butcher, Williams and Jones, 2018). Suitable search strategies are established through systematic literature reviews by the help of PICO framework. The articles chosen were ethically approved, the research participants were not forced to participate against their wills. The parental consent was taken for the underage participants. The exclusive ethic concern pertaining to the current research is the right acknowledgement of the work undertaken by previous researchers.

Results

Obesity and overweight being major health issues for adolescence. In USA 17% are considered as overweight where as 16% are bearing continuous thrait to be obese. Report finds out that school based prevention programs are best to deal with obesity issue as intervention team confirms it (Elumalai et al. 2017). The adolescence participants confirm that they are more eager to live healthy life and physical activities. However different barriers become obstacles for their healthy living. Throughout the concern the main issue which gets highlighted is irresponsibility and lack of accountability as the involved parties are not much aware of healthy lifestyle and thus unknowingly practicing unhealthy behaviors with accusing each other in the entire program. In everyday life teenagers often face different challenges and harassment due to their obesity or overweight. Further they even suffer from different other health issues in near future (Lee and Joo, 2016). Being pressurized through the increasing number of obesity among adolescents UK Government depends on certain recommendations. Preoperative assessment projects are identified for those teenagers who are obese or overweight. Research even found that gender doesn't play an important role here as both boys and girls are affected by the issue equally.

As youth obesity is the rising problem of USA and it gets increased rapidly thereby it can be stated that the entire population of USA is affected through it (Barcellos et al. 2018). However an exception can be found in this regard as racial, socio-cultural or socio-economic people are not that affected comparing to the higher class. Report confirms that Alabama rural School can be the pathfinder in this regard as 13.6% obese people at there in the local areas. The report even confirms that 41.2% are there for the girls who can be referred as obesity overweight whereas the rate is 43 % for boys as girls are more concerned about their weight (Amin, Dunn and Spector 2018). In countries like USA, Australia it has been saying that a part of adolescents are emerged as obese or overweight. In order to deal with the issue Australian teenagers get involved with healthy lifestyle, activities where fruit and vegetable are inclusion and fast food is exclusion and this study aims to track the record for the concern (Jeihooni et al. 2019). The study confirms that appropriate eating behavior can reduce the risk among the teenagers who joint healthy program initiated by different schools. The school is guided by public health guidelines with sheer encouragement. Thereby it is not possible for the study to record all eating behaviors of overweight adolescence (Hamulka et al. 2018). In UK the proportion of children overweight is increasing and it becomes the concern of the government. It confirms that 34% girls and boys are overweight rather can be referred as obese among whom 19% are girls and 18% of boys aged between 11 to 15 years. Teachers are playing important role in this regard as they are providing educational lessons naming healthy lifestyles weak and these are even accompanied by drama activities to make it more attractive and noticed (Wadolowska et al. 2018). Local theatre groups even help them to spread the concern internationally.

Critical appraisal

The observed heterogeneity is critical to the study as it works on improving the diversity between the approaches chosen for research. A mixture of methodological and clinical heterogeneity is likely to be implemented for future study in the area that can help in exploring the possible degree to which each of these variables such as education, exercise and nutrition can influence the health outcomes related to obesity (Meral, 2018). The limited amount of study related to outcome of exercise diet and supplement measures grouping explode the heterogeneity implementing funnel plots in several incidents. However the research was able to do so for Meta analysis of the effect of education on obesity. For the purpose of exploration the study excluded individual cases from analysis and found that Sari and Sartika (2018), is responsible introducing the aspect of asymmetry even when the study was not included from analysis Change in diet includes a properly considered uptake plant based proteins or animal protein such as chicken, fish and milk. The study additional works on recommending commercial formula drinks while nutrition education could work on promoting improvement in current dietary variety especially in regards to intake of protein as it works on building muscle strength (Jayawardena et al. 2017). Initiatives suggest goals setting activities in a group and checklist can work on improving the nutritional status through the consumption of a proper balanced diet. The current studies leave with limitations as the database searches were based on literature published in one particular language, English. Selection of one language can act as a source of potential by towards selection of positive results only which are likely to be reported in international language journals while negative results may appear in local language journals (McPhee et al. 2016). The confinement of language aptitude and time blocked full inclusion. It is hard to decide the danger of predisposition, concerning chosen concentrates since preliminary conventions when not distributed in the recovered articles. Anyway the hazard would be weakened to a limited degree by focusing on announced feebleness and related measures. The exploration could remember a set number of studies for the meta-examination since for some random intercession they didn't utilize similar measurements of result (Elumalai et al. 2017).

Emerging themes

Generally there remains no significant difference between intervention and comparison group in terms of career and education proving the point that parents exhibit equal knowledge and awareness about obesity irrespective of the career choices and level of education. Education has considerable influence on the nutrition score. The result showed that educating children about a healthy lifestyle could have a significant and positive impact on their life. The results obtained in the research for that education using suitable methods like role play animation can improve the lifestyle of the students (Lee and Joo, 2016). The educators are familiar with education principals as a result the education can have a considerable effect on the lifestyles of the students in the group. The score of lifestyle surrounding nutritional physical activity was changed and significantly modified in research evening to educate the school students about changing their poor diet habits and nutrition intake while increasing the level of physical activity. The result of the study indicated that the average dietary functions of the student before and after the intervention of health education coupled with the average duration of the physical activity were considerably modified (Barcellos et al. 2018). School based study concentrated on physical activity programs having a greater impact on the fitness of children. A ubiquitous resource for the young individual is regular daily activities cycling for school or walking for the classes. There is an average decrease in BMI in the interventional group and increase in the control one. Study conducted by Amin, Dunn and Spector (2018), which reduces a percentage of body fat work on examining the school children for a period of 3 years. The result provided no significant reduction of energy from fat. An attempt to control increasing rates of obesity revealed an important change in prevalence of obesity after taking action as per the necessary intervention. However there was a marked difference in the children's level of education and the functional levels were seen to improve. Furthermore, Ogden et al. (2018) the study concentrated on watching over the TV nutrition and relation between both physical activity. The result stated the fact the prevalence of obesity among young children in intervention school reduces with no differences between both the genders. Between 1980 and 2014 the prevalence of increasing body weight among adolescents increased till a greater extent. The establishment of long lasting great wellbeing is laid on adolescence and outside of school nothing gives all the more advancing experience to the youngsters then the time being spent in schools (Jeihooni et al. 2019). Subsequently it very well may be effectively presumed that schools have a more extensive territory in improving the strength of the little youngsters and tackle issues, for example, corpulence and the perfect. One of the fundamental roads at school can actualize for emphatically influencing wellbeing is in the immediate line of the school's capacity: teaching the understudies. Dietary and physical movement exercises can be actualized in the educational plan and the school projects can deal with showing the abilities that help the youngsters to pick and keep up solid way of life decisions.

Extra to training proof based sustenance and movement messages should deal with getting the understudies occupied with excellent action every day. School scanners chip away at advancing soundness of the understudy outside the study hall by encompassing the understudies with degree to eat well and stay dynamic (Hamulka et al. 2018). For improving the current degree of nourishment schools can chip away at presenting sound nourishment contributions in the cafeteria while dispensing with showcasing of lousy nourishment. To improve movement e these organizations can take a shot at creating common exercises inside the break time, for example, safe working and biking. Health programs for the educators can be fundamental in improving the school condition which goes about as an ethical lift to persuade the understudies (Wadolowska et al. 2018). As per the social learning theory that can be clearly stated that the young minds are often influenced by the observation they make around the external environment. In regards to the mentioned theory can be conclusively stated, using the teachers and parents following a healthy lifestyle and having a healthy diet in order to reduce the weight can help the students to mimic the practiced behaviour (Meral, 2018). Moreover, educational institutes can work on acting as an important source of data related to student health. With good evidence, a health education program can work on preventing obesity. As with education in general the sooner a person acts the better.

Recommendation and conclusion

Healthy eating is the most essential part to have healthy lifestyle as explained in the early ages. It even depicts that reduction of the use of salt and increasing fibers in the food items can be referred as healthy eating as per the guideline. In order to have a snacks item vegetable or fruits can be there in the menu where drink with high consumption of sugar needs to be avoided. Further baked or boiled food items are better alternative than having fried chicken. Use of red meat even needs to be reduced. Around the globe it gets highlighted that 43 million add relations are measured as obese or overweight. Additionally it can even be stated that 92 million are going to be overweight considering childhood obesity become the primary national concern. Thereby reducing adolescent obesity becomes the most important intervention of the present era. In order to achieve the goal the concern can be or needs to be accomplished by the collective strength as well as joint effort of society, children, extended family and most importantly School to turn off obesity trend in the whole world. the indirect and direct economic expenses for different countries as overweight is rising issue and the rate is increasing day by day which is followed by costly obesity disease treatment. For the developing countries it is not that easy to meet up with those highly cost healthy diet plans with less healthy resources. in order to come up with effective methods it is essential to choose helpful food choices and it's availability, skill building improved understanding, community norms and relations, family and school teachers to have better health behavior considering multi-element intervention. Hopefully by applying proof based obesity prevention interventions can direct to decrease rate of overweight or obese issues globally.

Reference list

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