Nursing health care issue related to health policy or health care economics.

Advocacy on Ways of Prevention and Management of Childhood Obesity
Author
Institution
Abstract
Childhood obesity is a serious setback towards the US Government’s intention of providing effective healthcare to all. It is rapidly spreading among the school children and with it the other related health conditions like cardiovascular diseases and hypertension. The purpose of this paper is to formulate an advocacy plan in conjunction with the government agencies, affected community and medical practitioner that strives to prevent and manage childhood obesity. The authors seek to present background on childhood obesity in the USA. The paper also presents measures that can be done by nurses in the community to create awareness and help in the elimination of the problem. The author argues on the pros and cons of the advocacy of the health problem. The author finally presents an opinion on the best way forward according to the research done. From the findings the author encourages nurses to collaborate with the community, the government officials and other healthcare providers to come up with a health policy that works towards preventing childhood obesity in the Country.
Advocacy on Ways of Prevention and Management of Childhood Obesity
Obesity is a big problem in the whole world; this is especially true in urban areas where the lifestyle is sedentary, and most residents perform very limited physical activities. The problem is made worse by the proliferation of fast food joints and increase in availability of processed foods.

Every corner of the street there is a joint that deals with fast foods. The mass media has also made a substantial contribution towards the menace, by bombarding the viewers and readers with those colorful adverts of fast foods and processed food they create the urge for consumers to partake the artery-clogging products. The problem is steadily rising especially in the children aged between 1 year and 16 years. This age group who should be the most active have been reduced to couch potatoes, and they either spend their time playing video games, watching TV, and surfing the internet on their smartphones and personal computers. The only physical activity done by these children is the short walk to the fridge or kitchen to get more snacks before going back to their paused activities. The city authorities are also to blame for allowing private developers to illegally use land set aside for public utilities for other purposes. They also have done so little to encourage their citizens to observe a healthy lifestyle by discouraging the fast food joints and the media by levying high taxes to make the products expensive. In an Australian town, they came up with a framework that controls affordability of healthy foods, in private and public places, the creation of public places for leisure and restriction of marketing and advertisement in school zones ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/j.orcp.2013.07.001”, “ISBN” : “1871-403X (Print)\r1871-403X (Linking)”, “ISSN” : “18780318”, “PMID” : “25091361”, “abstract” : “Background Successful obesity prevention will require a leading role for governments, but internationally they have been slow to act. League tables of benchmark indicators of action can be a valuable advocacy and evaluation tool. Objective To develop a benchmarking tool for government action on obesity prevention, implement it across Australian jurisdictions and to publicly award the best and worst performers. Design A framework was developed which encompassed nine domains, reflecting best practice government action on obesity prevention: whole-of-government approaches; marketing restrictions; access to affordable, healthy food; school food and physical activity; food in public facilities; urban design and transport; leisure and local environments; health services, and; social marketing. A scoring system was used by non-government key informants to rate the performance of their government. National rankings were generated and the results were communicated to all Premiers/Chief Ministers, the media and the national obesity research and practice community. Results Evaluation of the initial tool in 2010 showed it to be feasible to implement and able to discriminate the better and worse performing governments. Evaluation of the rubric in 2011 confirmed this to be a robust and useful method. In relation to government action, the best performing governments were those with whole-of-government approaches, had extended common initiatives and demonstrated innovation and strong political will. Conclusion This new benchmarking tool, the Obesity Action Award, has enabled identification of leading government action on obesity prevention and the key characteristics associated with their success. We recommend this tool for other multi-state/country comparisons. u00a9 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.”, “author” : [ { “dropping-particle” : “”, “family” : “Martin”, “given” : “J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Peeters”, “given” : “A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Honisett”, “given” : “S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mavoa”, “given” : “H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Swinburn”, “given” : “B.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Silva-Sanigorski”, “given” : “A.”, “non-dropping-particle” : “De”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Obesity Research and Clinical Practice”, “id” : “ITEM-1”, “issue” : “4”, “issued” : { “date-parts” : [ [ “2014” ] ] }, “title” : “Benchmarking government action for obesity prevention – An innovative advocacy strategy”, “type” : “article-journal”, “volume” : “8” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=74408da7-df9b-44e0-9c20-575da80aaaf6” ] } ], “mendeley” : { “formattedCitation” : “(Martin et al., 2014)”, “plainTextFormattedCitation” : “(Martin et al., 2014)”, “previouslyFormattedCitation” : “(Martin et al., 2014)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Martin et al., 2014). In a study done involving nurses in the advocacy of prevention of childhood obesity, the findings indicate that there is the need to make changes in the eating habits of the family and the introduction of intervention measures early in the life of the child ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.3912/OJIN.Vol14No1Man02”, “ISBN” : “1091-3734”, “ISSN” : “10913734”, “abstract” : “In this article the authors provide a background for the discussion of childhood obesity, examine factors contributing to overweight and obesity in children, review the literature describing interventions and prevention strategies for childhood overweight, and describe nursing skills to prevent childhood obesity. The literature supports a family- focused approach to influencing dietary habits of very young children, prevention interventions that start early in childhood prior to established poor dietary patterns, and the need for community support and involvement. Given these findings, nurses are encouraged to develop skills, such as advocacy, collaborative leadership, and social marketing skills, that will contribute to the prevention of childhood obesity.”, “author” : [ { “dropping-particle” : “”, “family” : “Berkowitz”, “given” : “Bobbie”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “The Online Journal of Issues in Nursing”, “id” : “ITEM-1”, “issue” : “1”, “issued” : { “date-parts” : [ [ “2009” ] ] }, “page” : “1-9”, “title” : “Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing”, “type” : “article-journal”, “volume” : “14” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=7c1da203-1514-4662-8f63-4c7b4fbb0133” ] } ], “mendeley” : { “formattedCitation” : “(Berkowitz, 2009)”, “plainTextFormattedCitation” : “(Berkowitz, 2009)”, “previouslyFormattedCitation” : “(Berkowitz, 2009)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Berkowitz, 2009). In another study, it was found that there is a great need to involve the community in the advocacy plan to fight against juvenile obesity. This important duty belongs to everyone, not just the politicians and the healthcare practitioners ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/S0140-6736(14)61743-8”, “ISBN” : “1474-547X (Electronic)\r0140-6736 (Linking)”, “ISSN” : “1474547X”, “PMID” : “25703113”, “abstract” : “Public mobilisation is needed to enact obesity-prevention policies and to mitigate reaction against their implementation. However, approaches in public health focus mainly on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity-prevention policies include refinement and streamlining of public information, identification of effective obesity frames for each population, strengthening of media advocacy, building of citizen protest and engagement, and development of a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration between diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity prevention can make specific contributions to engaging, mobilising, and coalescing the public. The shift from a top-down to a combined and integrated bottom-up and top-down approach would need an overhaul of current strategies and reprioritisation of resources.”, “author” : [ { “dropping-particle” : “”, “family” : “Huang”, “given” : “Terry T.K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Cawley”, “given” : “John H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ashe”, “given” : “Marice”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Costa”, “given” : “Sergio A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Frerichs”, “given” : “Leah M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Zwicker”, “given” : “Lindsey”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Rivera”, “given” : “Juan A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Levy”, “given” : “David”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hammond”, “given” : “Ross A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “V.”, “family” : “Lambert”, “given” : “Estelle”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kumanyika”, “given” : “Shiriki K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “The Lancet”, “id” : “ITEM-1”, “issue” : “9985”, “issued” : { “date-parts” : [ [ “2015” ] ] }, “page” : “2422-2431”, “title” : “Mobilisation of public support for policy actions to prevent obesity”, “type” : “article-journal”, “volume” : “385” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=b809cd60-17a5-4758-9a9b-c0d2e85e1b30” ] } ], “mendeley” : { “formattedCitation” : “(Huang et al., 2015)”, “plainTextFormattedCitation” : “(Huang et al., 2015)”, “previouslyFormattedCitation” : “(Huang et al., 2015)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Huang et al., 2015). The best approach towards the elimination of the problem is by catching it in the early stages, by using the BMI to gauge weight increase in children and then making recommendations to keep it in check ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1542/peds.112.2.424”, “ISBN” : “1098-4275 (Electronic)”, “ISSN” : “1098-4275”, “PMID” : “12897303”, “abstract” : “The dramatic increase in the prevalence of childhood overweight and its resultant comorbidities are associated with significant health and financial burdens, warranting strong and comprehensive prevention efforts. This statement proposes strategies for early identification of excessive weight gain by using body mass index, for dietary and physical activity interventions during health supervision encounters, and for advocacy and research.”, “author” : [ { “dropping-particle” : “”, “family” : “Krebs”, “given” : “Nancy F”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jacobson”, “given” : “Marc S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Pediatrics”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : [ [ “2003” ] ] }, “page” : “424-30”, “title” : “Prevention of pediatric overweight and obesity.”, “type” : “article-journal”, “volume” : “112” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=cbb846e0-df13-4d45-96ba-a44449c90a03” ] } ], “mendeley” : { “formattedCitation” : “(Krebs & Jacobson, 2003)”, “plainTextFormattedCitation” : “(Krebs & Jacobson, 2003)”, “previouslyFormattedCitation” : “(Krebs & Jacobson, 2003)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Krebs & Jacobson, 2003). All in all, there is a great need to involve healthcare systems and healthcare providers to initiate advocacy for policy changes in the management of juvenile obesity by involving the community members ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/j.pcl.2011.09.001”, “ISBN” : “00313955”, “ISSN” : “00313955”, “PMID” : “22093867”, “abstract” : “Policies at many levels may help to shape environments that promote healthy weight and prevent obesity. We present policies to support obesity prevention for young children. We highlight policy Sand environmental systems change examples in the areas of promoting breastfeeding and providing healthy affordable food and information about food in community and child care settings and promoting physical activity in child care and the community. We address the role of the health care system and health care professionals to shape and advocate for policy and environmental systems change and provide resources for pediatric health care professionals to engage in community-based advocacy. u00a9 2011 Elsevier Inc.”, “author” : [ { “dropping-particle” : “”, “family” : “McPherson”, “given” : “Marianne E.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Homer”, “given” : “Charles J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Pediatric Clinics of North America”, “id” : “ITEM-1”, “issue” : “6”, “issued” : { “date-parts” : [ [ “2011” ] ] }, “page” : “1521-1541”, “title” : “Policies to support obesity prevention for children: A focus on of early childhood policies”, “type” : “article”, “volume” : “58” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=976a5272-7d0f-4457-9094-cc84dea24ebe” ] } ], “mendeley” : { “formattedCitation” : “(McPherson & Homer, 2011)”, “plainTextFormattedCitation” : “(McPherson & Homer, 2011)”, “previouslyFormattedCitation” : “(McPherson & Homer, 2011)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(McPherson & Homer, 2011).
Benefits of The Child Obesity Prevention Advocacy in America
Obesity in children has almost tripled in the past thirty years this translates to one in every three children below the age of nineteen is either suffering from obesity or has weight problems. About ninety percent of these children will live with obesity into adulthood it is estimated that it costs more than fourteen billion dollars to treat and manage obesity in children in America ADDIN CSL_CITATION { “citationItems” : [ { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1542/peds.112.2.424”, “ISBN” : “1098-4275 (Electronic)”, “ISSN” : “1098-4275”, “PMID” : “12897303”, “abstract” : “The dramatic increase in the prevalence of childhood overweight and its resultant comorbidities are associated with significant health and financial burdens, warranting strong and comprehensive prevention efforts. This statement proposes strategies for early identification of excessive weight gain by using body mass index, for dietary and physical activity interventions during health supervision encounters, and for advocacy and research.”, “author” : [ { “dropping-particle” : “”, “family” : “Krebs”, “given” : “Nancy F”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jacobson”, “given” : “Marc S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } ], “container-title” : “Pediatrics”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : [ [ “2003” ] ] }, “page” : “424-30”, “title” : “Prevention of pediatric overweight and obesity.”, “type” : “article-journal”, “volume” : “112” }, “uris” : [ “http://www.mendeley.com/documents/?uuid=cbb846e0-df13-4d45-96ba-a44449c90a03” ] } ], “mendeley” : { “formattedCitation” : “(Krebs & Jacobson, 2003)”, “plainTextFormattedCitation” : “(Krebs & Jacobson, 2003)”, “previouslyFormattedCitation” : “(Krebs & Jacobson, 2003)” }, “properties” : { }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Krebs & Jacobson, 2003).
It goes without saying that prevention of obesity will in the first place enable the majority of the children to lead a healthy lifestyle. Since the advocacy involves incorporation of healthy meals in schools and mandatory physical activities during school hours. The children will reap the benefits of good diet and exercise.
Provision of healthcare is expensive and most medical insurance providers charge more for patients with the chronic condition. Obesity and being overweight is usually accompanied by many other chronic conditions which required many visits to the health facilities. The drugs for management of the conditions are not cheap and, in many cases, it is a lifelong condition, so that translates to depending on drugs for the entire life. By advocating for the prevention of juvenile obesity, the community stands to gain by saving lots of money which may be used to fund other beneficial projects.
Impediments to The Child Obesity Prevention Advocacy in America
One of the recommendations in the advocacy plan includes measures that discourage and prohibit consumption of fast foods by children. By requiring the advertisers to avoid placing the billboards around school zones, and including a disclaimer in the advert that tells the consumers the negative effect of consuming a high-fat diet. It is also recommended that the products should be heavily taxed to discourage consumers from accessing the products. The downside to this approach is that it will most likely face rejection by the business community who have made investments and hoped to profit from their ventures. Since they are law abiding the only option is to sensitization of the community on the disadvantages of consuming these products.
Fast foods cost relatively cheaper than the healthy foods, for this reason, it goes without saying that most of the communities living in the poor neighborhoods can only afford these products. It is challenging to discourage a person from consuming the only food he or she can afford. Since the alternative involves digging deeper into the pockets to provide a healthy meal to the family, the advocacy is more likely going to face a challenge in this section of the community. Similarly, the same socially disadvantaged communities have no access to recreation facilities so the campaign may face obstacles also.
Due to the tender age of most of the subjects in this advocacy plan, it is prudent to exercise extreme caution when approaching the subject of obesity. Stigma, denial, and indifference may be encountered in the process of the campaign. Due to the sensitivity involved it might be a hindrance with some guardians refusing to label their children as obese. Since all children will be involved in the advocacy plan, the children with weight problems may feel stigmatization from their peers, and this may affect the success of the program.
Conclusion
The benefits of advocating for the prevention of obesity in children far outweigh the impediments. By preventing obesity in the early stages of life guarantees the individual a long healthy life. The proper diet and exercising are beneficial to all people not only children, not forgetting the huge savings of dollars that may have ended up in medical fees. The advocacy not only encourages healthy living, but it also targets morals which may suffer due to the exposure to too much internet and television by the children. It is the safest option that the medical practitioners, healthcare providers, and the American community have towards having a healthy future. Prevention of obesity in children will result in a wholesome, productive and moral future society.

ReferencesADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Berkowitz, B. (2009). Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing. The Online Journal of Issues in Nursing, 14(1), 1–9. https://doi.org/10.3912/OJIN.Vol14No1Man02
Huang, T. T. K., Cawley, J. H., Ashe, M., Costa, S. A., Frerichs, L. M., Zwicker, L., … Kumanyika, S. K. (2015). Mobilisation of public support for policy actions to prevent obesity. The Lancet, 385(9985), 2422–2431. https://doi.org/10.1016/S0140-6736(14)61743-8
Krebs, N. F., & Jacobson, M. S. (2003). Prevention of pediatric overweight and obesity. Pediatrics, 112(2), 424–430. https://doi.org/10.1542/peds.112.2.424
Martin, J., Peeters, A., Honisett, S., Mavoa, H., Swinburn, B., & De Silva-Sanigorski, A. (2014). Benchmarking government action for obesity prevention – An innovative advocacy strategy. Obesity Research and Clinical Practice, 8(4). https://doi.org/10.1016/j.orcp.2013.07.001
McPherson, M. E., & Homer, C. J. (2011). Policies to support obesity prevention for children: A focus on of early childhood policies. Pediatric Clinics of North America. https://doi.org/10.1016/j.pcl.2011.09.001