The assignment is a planning, implementation and evaluation of the prevention of the non-communicable diseases and it follows a disease prevention strategy. This study includes a considers a state primary school as a clinical setting where the preventive strategies on obesity and overweight are taken into account. The task takes into account the stakeholders that are associated with the school and it includes the community, families, teachers and pupils. The students will perform the duties of public health officers for the Department of health on planning, implementation and evaluation related to intervention. The main task here is to develop information for the stakeholders in order to promote communication strategies, and an outline for the evaluation strategy. Auditing, a direct link will be developed between the risk reduction and intervention design in the target group.
the School selected for the study is Perth Modern School located in Subaico. It is a co-educational school in the which is a located in the Perth, Australia. The School has a total of 1371 students that have enrolled from the year 7 to year 12. The school is considered as a multicultural campus and it has students from 30 different nationals. Students from all over the regional locations and metropolitan areas in Western Australia comes to the Perth Modern School. In terms of year, the year 7 has 232 students, year 8 has 209 students, year 9 has 220 students, year 10 has 243 students, year 11 has 244 students and year 12 has 223 students. Overall, the total number of students by gender: 760 students are boys and 611 students are girl (perthmodern.wa.edu.au, 2018).
Figure a: Demographic chart of the students in Perth Modern School (source: perthmodern.wa.edu.au, 2018)
The Perth Modern School staffs have three different categories which includes the administration staff, teaching staff and the support staff. There is a total of 18 administration staff which includes the principal, associate principle, student careers/services, GT online, program coordinators and heads of learning areas. Total number of the teaching staffs is 91 which includes the senior teachers, level 3 teachers, level 3 teachers and the other teaching staffs. The total number of the support staffs is 41 and it includes administrative/clerical, maintenance/gardening and other non-teaching staffs (perthmodern.wa.edu.au, 2018).
The school is located in the Subiaco region the demographics of this region is selected for the study. Total population of Subiaco is 9202. With the percentage of males is 48.7 and the percentage of females is 51.3. The median age of the population is 38. There are 2233 families and the average children per family is: families with children is 1.6 and for all the families the average children per family is 0.4 (Quickstats.censusdata.abs.gov.au, 2018).
Table 1: Table of median age and population structure based on age (Quickstats.censusdata.abs.gov.au, 2018)
|
Age |
Subiaco |
|
Median age |
38 |
|
0-4 years |
516 |
|
5-9 years |
416 |
|
10-14 years |
398 |
|
15-19 years |
356 |
|
20-24 years |
552 |
|
25-29 years |
994 |
|
30-34 years |
832 |
|
35-39 years |
739 |
|
40-44 years |
609 |
|
45-49 years |
571 |
|
50-54 years |
615 |
|
55-59 years |
593 |
|
60-64 years |
532 |
|
65-69 years |
547 |
|
70-74 years |
377 |
|
75-79 years |
268 |
|
80-84 years |
148 |
|
85 years and over |
143 |
|
Registered marital status |
Subiaco |
|
People aged 15 years and over |
|
|
Married |
3,326 |
|
Separated |
227 |
|
Divorced |
754 |
|
Widowed |
271 |
|
Never married |
3,298 |
|
Education |
Subiaco |
|
Preschool |
110 |
|
Primary – Government |
414 |
|
Primary – Catholic |
39 |
|
Primary – other non-Government |
63 |
|
Secondary – Government |
224 |
|
Secondary – Catholic |
55 |
|
Secondary – other non-Government |
144 |
|
Technical or further education institution |
93 |
|
University or tertiary institution |
701 |
|
Other |
73 |
|
Not stated |
898 |
|
Level of highest educational attainment |
Subiaco |
|
People aged 15 years and over |
|
|
Bachelor Degree level and above |
3,918 |
|
Advanced Diploma and Diploma level |
628 |
|
Certificate level IV |
102 |
|
Certificate level III |
356 |
|
Year 12 |
960 |
|
Year 11 |
213 |
|
Year 10 |
323 |
|
Certificate level II |
3 |
|
Certificate level I |
0 |
|
Year 9 or below |
181 |
|
No educational attainment |
14 |
|
Not stated |
962 |
|
Occupation |
Subiaco |
|
Employed people aged 15 years and over |
|
|
Professionals |
2,244 |
|
Managers |
805 |
|
Clerical and Administrative Workers |
496 |
|
Community and Personal Service Workers |
341 |
|
Technicians and Trades Workers |
310 |
|
Sales Workers |
302 |
|
Labourers |
173 |
|
Machinery Operators and Drivers |
49 |
Aetiology of Overweight and obesity among the target group- The three major causes or the aetiology of obesity and overweight.
Epidemiology of Overweight and obesity among the target group- in the year 2015, studies have shown that 27 percent of the residents that are aged 16 and above in Western Australia are found to be obese. While it has been noticed that 40 percent of the residents of Western Australia are overweight. It has also been noticed that the greater number of men are more likely to become obese and overweight than the women. In the year 2014, the about 9 percent of the Western Australian teenagers and children are obese and 14 percent of adolescents are overweight. The rates of obesity and overweight increases among the people that are 45 years and older. Studies have indicated that the children that are overweight tend to become obese as adults and are thus at the risk of having future health problems. Physical inactivity and poor nutrition plays a major role in increasing the trends of obesity and overweight. However, there are other environmental factors that play a role in the increasing the rates of obesity. Occurrences of illness from excess weight in Western Australia has cost about 241 million dollars for the Western Australia hospitals, while the it has been estimated that the cost will double in the year 2021 (Ww2.health.wa.gov.au, 2018).
Medically the treatment of obesity and overweight involves the management of the obesity and overweight through the behavioural treatment, exercise, and dietary intervention. Dietary intervention includes the types of diet that involves the very low carbohydrate diet, low carbohydrate diet, low fat diet, and low calorie diet. Physical activity is vital when it is done along with a proper diet regime (Walls et al., 2012).
The stake holder group chosen for the study include the ones that are associated with the school. Thus, the stakeholders are the communities, families, teachers and the pupils that reside near the school and study in the school. For this study a school named Perth Modern School is chosen and this school is located in the Western Australia. There are many factors that lead to overweight and obesity and it occurs due to physical inactivity, intake of energy from the diet and the imbalance of energy. The environmental and the genetic factors all play a major role in the in increasing the tendencies of obesity and overweight. Attention to the physical activity and proper diet helps in attaining a healthy body weight.
The socio-ecological model is a multidisciplinary care model that has the potential to impact both the weight outcomes and energy balance behaviours. The intervention acts as a level of influence on the public and governmental policies, organizational and community factor and intrapersonal factors.
Intervention at the intrapersonal-level- the evidence based practices provide the best source of information for framing the intervention at the individual level. The treatment procedures emphasise on the intra-personal levels and it assists in changing the energy balance behaviours. The nutrition care provisions include the assessment of nutrition take up, and it is followed by the diagnosis and intervention along with the monitoring and evaluation. The entire process is focussed on the intrapersonal level (Raynor & Champagne, 2016). The first and the foremost part of any obesity and overweight treatment plan is to determine the BMI of the patient and the second identification is whether the patient is overweight or obese. The adults that are obese or overweight are referred to medical nutrition therapy and the treatment procedures will be handled by the registered dietician nurses. After the initiation of the care plan, data about the client are collected that include the weight management, housing and living situation and dietary intake. Along with all these measurements, the registered dietician nurse will also assess the nutrient content of the diet and the energy intake. Finally, the registered dietician nurse measures the resting metabolic rate which is necessary to determine the energy requirement for the obese and overweight adults (Raynor & Champagne, 2016).
Dietary intervention- obesity and overweight treatment involves achieving a condition of negative energy balance. This means that the energy content in food must be decreased in order to manage the obesity. There are dietary approaches that have the potential to reduce the energy intake in taken into account. The registered dietician nurse prescribes an individualized diet that the emphasises on the health status of the patient and suggests an individualized diet accordingly. This will enable the target population to achieve the requisite amount of dietary intake. The individualised diet strategy will focus on the calorie intake of men (1500 to 1800 kcal per day) and women (1200 kcal to 1500kcal). The food diets which will be contain restriction on certain diets like the high fat foods, low fibre foods, high carbohydrate foods. The diet is framed in such a way that will have a reduced calorie intake with and an energy deficit (Dombrowski et al., 2012). Weigh maintenance is also prescribed in order to lower the body weight. Small food based alterations can change the energy balance by 100 to 200 kcal in a single day. It has been seen that the small behaviour changes like less sugar intake, less intake of sugar-sweetened beverages can greatly change the macronutrient composition of the diet. Vegetables and fruits is capable in promoting healthy diets and it can greatly reduce the density of dietary energy. Fast foods especially contain high density of dietary energy and reduction in the intake of the fast food can effectively reduce the weight gain. Portion control changes can be achieved by having foods that have the energy content mentioned on it. Energy focussed also play a major role in weight management. The two most well-known strategies that can be integrated in to the dietary regime is the consumption of the low carb diet, and the very low calorie diet. Additionally, the diet can be planned to be primarily dietary pattern focussed, containing high protein, low glycaemic load and glycaemic index, low carbohydrate, avoiding food that are energy dense, timing of the eating, eating frequency and dietary timing (Hoelscher et al., 2013).
Physical activity- through some of the evidence practices it has been found that the combination of exercise and diet is not effective in comparison to the behavioural management that focus in the weight management. Thus, for the weight loss program to it is necessary to have an equilibrium between the energy expenditure and the energy intake. Thus, the weight loss program must include a comprehensive physical activity regime coupled with a proper diet (Ding & Gebel, 2012).
Intervention for the children and adolescents that are school goers- Strategies like school based programs specifically targets the school goers. The intervention plan will include the diet control and regular physical activity. Tiffin boxes can be monitored so that the calorie intake can be restricted. Telephonic interviews can be conducted to inform and aware the parents regarding the proper diet and requisite amount of physical activity.
The communicatio stratgey will involve 4 major sections including the content sources, messengers, channels and audience (figure 1).
The content sources of the communication strategy will inlcude the media rource center for carrying out the campaign, health media center in the community, success stories of the affected people, pictures, videos, infographics, media reports based on obsesity and overweight prevalence, survey results on the occurrence of obesity in the target community, reports and publications based on the obesity and over treatment and management, the various evnets based on the obesity and overweight awareness and the funding announcements by the health departments (Southernobesitysummit.org, 2018).
The messengers of the communication stratgey will incude the department of health, fundraiing department or the development department, subcommittee for marketting, partnerships and colaitions fomed with the different governmental organizations and the non-governmental organzaitions, subcommittee for marketing the health informations, standalone department for marketing of the informations based on overweight and obesity, communication leaders, public and media realtions for maintaining a proper. The chnnels for through which the communication will be carried out include the paid media (advertising and educational campaign), partner media (talking points, newsletters and briefinng metarials), earned media (news features, news releases, community media and ethnic media), social media or digital media (website, blogs, facebook, twitter, youtube). The audiences that are incuded in the communication strategy include the hospitals, schools, community leaders, partners and coalitions in the communication strategy, funders, stakeholders (pupils, teachers, familis, communties), audience segments and general public (Southernobesitysummit.org, 2018).
Figure 1: Outline of communication strategy [Done by author.
Figure 2: Outline of evaluation framework (done by author.
The evaluation framework for the obesity and the overweight management and control involves three main sections of process, output and outcome. In the process section, there is a need for a national or local level leadership on the physical activity and diet. At the national level, the government of the Western Australia will frame policies and that will effectively focus on the diet of the citizens and the target population. In the process section, the local leadership will include the management policies and strategies taken by the local government, healthcare departments and the school administration (Have et al., 2012). The process section is the main driving force behind the obesity and overweight management and prevention. Thus, the healthcare department of Western Australia, the National government and the local government. Along with the extended contribution of the school and the community centres that will help in the playing major in the healthcare monitoring, evaluation and surveillance (Who.int, 2018).
Both the process and the output section is being overlapped by three sub-sections called the supportive programmes, supportive policies and supportive environment. It is important to highlight that only the perfect coordination of the three sub-sections will lead to a proper implementation of the obesity and overweight management and prevention. Supportive environments mean the activities must be proper enough that will influence the target population into having an environment where the target population will be able to make healthier choices and it will be easier for the people to take up the obesity and overweight control measures. Creating a supportive environment will promote and influence the pupils, teachers, people living in a community and the families (Hawkes, Jewell & Allen, 2013). Controlling the diet of the target population will require a strict monitoring of the eating habits of the pupils, teachers and the families that reside in the neighbouring communities. Supportive policies will include the provision and plans that both at the local and the national level. Policies must be framed in a way that will promote the physical activity and at the same time promote healthy diets. The third sub-section deals with the supportive programmes and this includes the effective and efficient implementation of the policies both at the national level and the regional level and this will be one of more stakeholders. It is important to mention that the student will work as a public health officers in the department of health on the planning, implementation and the evaluation of the intervention plan (Dietz et al., 2015). One of the major aspect of is the behaviour change and this will include the behaviour change of the target population. Behaviour change will include the various aspects related to obesity and overweight management and prevention and this subsection falls within the overlapping sections of output and outcome. The next section is outcome and it includes the social, environmental, health and economic benefits that will be accrued by the target population. The mechanism which is established in the framework will have an impact on the decision making process and at the same time will guide the future activities (Langford et al., 2014).
Conclusion
From the above discussion it can be concluded that, children that are overweight tend to become obese as adults and are thus at the risk of having future health problems. Physical inactivity and poor nutrition plays a major role in increasing the trends of obesity and overweight. However, there are other environmental factors that play a role in the increasing the rates of obesity. Medically the treatment of obesity and overweight involves the management of the obesity and overweight through the behavioural treatment, exercise, and dietary intervention. Dietary intervention includes the types of diet that involves the very low carbohydrate diet, low carbohydrate diet, low fat diet, and low calorie diet. Physical activity is vital when it is done along with a proper diet regime.
Reference
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