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Health Education Promotion Intervention In Reducing

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Discuss about the Health Education Promotion Intervention In Reducing Obesity Among The Students.



Obesity is a health problem condition caused by excess accumulation fat in the body to the extent that some of the body physiological functions can be greatly affected (Uzogara, 2017; Crum et al. 2010). According to (Abu et al., 2010), the trend regarding the change of lifestyle in the world is immensely contributing to the high number of obesity recorded in the world in terms the prevalence. It is estimated that in the United States, more than 35% of the population are obese (Flegal et al. 2012). BMI (Body Mass Index) has been used as an indicator to classify obesity and overweight by the World Health Organization. Having a BMI of 25 to 29.9 kg/m2 qualifies a person to be categorized as overweight, while a BMI of ≥30 kg/m2 is a classical obese. Obesity and overweight can be such complex, it is a multifactorial chronic disease and it cuts across the socio-demographic. In the United States, it is estimated that 20 % of the health-care expenditure is channeled towards management and treatment of obesity (Cawley and Meyerhoefer, 2012).

Prevention of childhood obesity is the international public health top priority, this has been necessitated by the fact that child obesity has a significant impact on some acute and chronic disease, and the health of the general population at large. According to (World Health Organization [WHO], 2012), it is estimated that globally one hundred and seventy millions of children between 1-17 years of age are suffering from child obesity. There is a surge in number of reported cases in developed countries. For example, research has revealed that almost a third of children in the Unites States and a fifth in Europe are suffering from obesity (Langford et al., 2015).

WHO has developed intervention strategies that comprise of three different approaches. The WHO strategies focus majorly on a population-based approach that propagates prevention measures rather than individual clinical intervention. One such intervention strategies by the WHO is Health-promoting Schools (HPS) frame (WHO, 2012). The objective of such intervention strategy is the food environment, physical activity environment and socioeconomic environment such as taxation and education, thus indirectly influences the behavior of the population. In other studies school environment has been considered as the target for the implementation of the health promotion intervention program to help in reducing cases of obesity among the student population (Blain et al., 2017; Foster et al., 2008). Schools play key role in providing daily meals and physical activity facilities to children bearing in mind that poor nutrition and obesity can negatively impact children. Therefore, schools are the optimum settings for the implementation obesity prevention effort (Carlson et al., 2013).

Dietary education intervention program focuses majorly at an individual level and at community level. According to the recommendation by, diet therapy as an intervention program is an essential component of any intervention program focusing on reducing cases of obesity. The regime is planned for each individual and for community with same condition, depending on the obese status this is with a view to create about 500 to 1000 kcal/day. The government policy can also greatly influence the implementation of the dietary proposed health intervention program at the population level by putting high exercise tax on the sugar sweetened drinks and processed fat products with high levels of saturated and trans-fat according to (Jensen et al., 2014).


Population-wide policies

It involves the creation of an environment that encourage healthy a diet, physical education and discourage sedentary life and bad dietary behavior. Research findings have established that behavior of an individual has a direct link and effect on the population characteristic such mortality and prevalence of the health problem (Loos et al., 2008). For example, a study conducted by (Khaw et al., 2008), revealed that individual who consumed more than moderate required alcohol were found to be less physically active and as a result did not adhere to the dietary requirement of eating five fruits and vegetables in a day, the result established that these individuals were more than four times likely to die of obesity as compared to less alcohol-consuming individuals.

The effect of behavior change as an intervention measure of obesity can be felt at an individual level. The behavior changes involved targets the lifestyle with a focus on the relationship health and physical environment (Evans et al., 2016). For example, change in the government policy has been established to be an effective way of influencing change in individual behavior pattern. A good example is when government put high exercise duty tax on processed beverages with added sugar and alcohol, this action may influence individual behavior change toward the products. Behavior change interventions have been proven to be effective in improving public health-care as suggested by (Johnson et al., 2010). At an individual level, the behavior change involves change of a key determinants of behavior found in an individual the same can be said when group based interventions are carried out such interventions that target lifestyle.

Individual intervention for example weight loss programs formulated targeting the entire university students can have a direct effect on the population contrary to just an individual student.

According to (Ruiter et al., 2012), information can be targeted if it is easy to perform individual’s behavior change. Moreover, easily understood and accessible information is key element of behavior change but may not be enough to provoke behavior change.


Health education promotion intervention in schools

The types strategy instruments generally used as part of health education promotion intervention component of a comprehensive childhood obesity prevention strategy include regulations, and health education campaigns that affect the population as a whole (or large population groups). These policies typically affect both adults and children, as the parents of the students can be trained the importance of intervention program, before they are recruited as part of intervention implementers besides teachers. Such initiatives are usually undertaken by national or state governments, in contrast to the community-based intervention.

There is a positive relationship between health education and healthy well-being of individuals within the population according to (Sassi et al., 2010). However, the established causal relationship is still subject of research (Evans et al., 2017; Devaux et al., 2011). The research findings on the positive relationship between health education and reduction of number of reported obesity cases have also been supported by the findings from a research conducted by (Sassi, 2009), the findings of this research revealed that socio-demographic plays a key role, and the association were found to be much stronger in women as compared to men. The association was attributed to accessibility to health education and information on healthy a dietary practices. According to ( Foster et al., 2008; Hoppu et al., 2010), schools offers good settings for implementation and promotion of health education intervention programs through teaching good dietary behavior and provision of healthy diet. Therefore the students adopt and accept the new lifestyle that has positive impact on their dietary behavior.  It has been established that more studies have focused a lot on the increasing physical activities as an intervention measure to attain reduced number of obesity cases among the children. It has been established that health education intervention curriculum developed to tackle cases of child obesity differs from one school to another and also from one country to another hence this has necessitated the need for more research to be carried out develop more uniting intervention (Ogden et al., 2012). The approach of using health education as an intervention strategy towards child obesity prevention has been used by European Union through EU- school fruit scheme it has been described as a wide voluntary scheme whose main objective is to provide fruits and vegetables to children aged 6 to 10 years and the strategies involved in the implementation of the scheme include health education and awareness- initiatives (WHO, 2012). According to (Foster et al., 2008), after implementation of the health education intervention program in the schools for two years, the study findings revealed that it 41% less likely to develop child obesity in the intervention school as compared to the control schools. It is therefore very clear that there is an association between health education intervention and reduction in child obesity based on the consistency in the findings by different researchers. Multiple intervention strategies focusing on the population have the potential to achieve larger health gains than individual interventions, and often with greater cost-effectiveness (WHO, 2012).


Physical activity intervention

Researchers have established that both physical activity and sedentary lifestyle have direct influence on the general health condition of the students, the students who are greatly involved in physical activity have been proved to lower risk of health problem such as obesity as suggested by (Deliens et al., 2015; Craig et al., 2008). Therefore, this intervention program is focusing at the student’s life hence it based at individual level.  According to (Jensen et al., 2014), physical activity plays a pivotal role in weight loss therapy, this is because it results to increased metabolic activities in the body resulting to increased energy expenditure at the same time increased physical activities impede food intake in obese individuals (Catenacci et al. 2007).

Physical activity materials focus on the themes of the actively participating in physical activities and inactivity of the individual student and the entire student community. The students are encouraged to perform self-assessment on the level of engagement in activity and inactivity and setting their own goals on how to achieve high levels of activity by replacing the inactive time with moderate or intense engagement in physical activity of their desire.

The students should be encouraged carry out physical activity by engaging into the exercise slowly and gradually increasing the intensity (King et al., 2013). The first activities may involve walking or swimming at slow space this can then be adjusted to 45 minutes of vigorous walking not less than 5 days in a week. If this plan is adhered to it can lead to 1000 to 2000 loss of calories in a day as suggested by (Jensen et al., 2014). The student should then be encouraged to set their own targets of accumulating time in carrying out physical activity on most days of the week. Moreover, students can be encouraged to enroll and participate in competitive sports that can enable them achieve self-satisfaction such sports include football tennis among others.


Pharmacological Management and intervention of Obesity

This intervention method involves the use of prescribed drugs to manage weight gain and encourage weight loss. According to (Apovian et al.,2015), the drugs approved for weight management can very useful assisting lifestyle change for individuals whose weight gain have persisted despite good dietary regime and intense physical activities. Most drugs prescribed for the management of chronic disease have known side effect if either promoting weight gain or inducing loss of weight, hence good prescription can help in management the obesity and thus improve life of the individuals and the population at large.

In all obesity management programs, it is recommended that physical activity, good diet, and behavioral modification have to be combined to achieve the desirable outcome (Apovian et al. 2015; Jensen et al. 2014). Research has shown that drugs may play critical role in behavior modification by and helps in improved participation on physical activities according to (Apovian et al., 2015). For example, sexually active university students who seek contraceptive drugs and have BMI ≥ 30 kg/m2 it is recommended that they be prescribed oral contraceptive rather than injectable contraceptive which are highly associated with aiding weight gain. At the same time HIV patients on Anti-retroviral therapy are also at great risk of weight gain due the drugs interference with fat metabolism and distribution in the body.


The interventions that focuses on the population are most efficient and effective oppose to interventions on individual’s behavior change. Moreover, there is evidence to suggest that multiple intervention strategies such the one focusing on the population have the potential to achieve larger health gains than individual interventions, and often with greater cost-effectiveness. Therefore interventions that are focusing on the population should be encouraged to tackle the rising cases of obesity among the students.



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Apovian, C.M., Aronne, L.J., Bessesen, D.H., McDonnell, M.E., Murad, M.H., Pagotto, U., Ryan, D.H. and Still, C.D., 2015. Pharmacological management of obesity: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 100(2), pp.342-362.

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Crum-Cianflone, N., Tejidor, R., Medina, S., Barahona, I., & Ganesan, A. (2008). Obesity among patients with HIV: the latest epidemic. AIDS patient care and STDs, 22(12), 925-930012–2014. Preventing Chronic Disease, 14.

Deliens, T., Deforche, B., De Bourdeaudhuij, I. and Clarys, P., 2015. Determinants of physical activity and sedentary behaviour in university students: a qualitative study using focus group discussions. BMC Public Health, 15(1), p.201.

Devaux, M., Sassi, F., Church, J., Cecchini, M. and Borgonovi, F., 2011. Exploring the relationship b Kamijo, K., Pontifex, M.B., Khan, N.A., Raine, L.B., Scudder, M.R., Drollette, E.S., Evans, E.M., Castelli, D.M. and Hillman, C.H., 2013. The negative association of childhood obesity to cognitive control of action monitoring. Cerebral cortex, 24(3), pp.654-662.etween education and obesity. OECD Journal: Economic Studies.

Evans, A., Ranjit, N., Hoelscher, D., Jovanovic, C., Lopez, M., McIntosh, A., Ory, M., Whittlesey, L., McKyer, L., Kirk, A. and Smith, C., 2016. Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go!(TGEG) cluster randomized controlled trial. BMC Public Health, 16(1), p.973.

Flegal, K.M., Carroll, M.D., Kit, B.K. and Ogden, C.L., 2012. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. Jama, 307(5), pp.491-497.

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Hoppu, U., Lehtisalo, J., Tapanainen, H. and Pietinen, P., 2010. Dietary habits and nutrient intake of Finnish adolescents. Public health nutrition, 13(6A), pp.965-972.

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