Teaching Mothers and Their School-Age Children With Obesity and Overweight

Childhood obesity is a rising concern in the United States. Two years ago, a National Epidemiological survey report showed that 18.6% of school-aged children had obesity. The number of children affected by obesity has tripled in the last 4 decades.2 The issue is that obesity is responsible for chronic illnesses that result in a poorer quality of life; illnesses like asthma, type 2 diabetes, bone & joint diseases, sleep apnea and heart diseases affect daily activity. Additionally, obese kids face mental stress from psychosocial isolation at school from healthy peers which results in depression, & low self-esteem.

Obesity in school-aged children in the United States is influenced by various factors that determine the outlook of the disease. Even in an effort to reinforce a positive outlook, the multi-dimensional nature of the health challenge makes it hard to control the epidemic of obesity. The disease is associated more frequently with demographic populations in low income areas.1 These populations do not have the financial capacity to overcome the health care burden of the disease and school-aged kids in these populations are more likely to progress into adulthood with the disease.

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Financial health burden of obesity is reportedly rising in the US over time from a direct per capita cost of $2741 in 2005 to $6811 in 2011. Direct per capita lifetime (>65 years) cost of the disease was estimated at $171, 482 in the US in 2010 (8 years ago). In 2013, a predictive estimate showed that the total per capita cost of obesity in the US was $33,900.00 over a 5 year period and $70,200 over a 10 year period.

What is the role of health education in the development of this disease and why chose the school-aged children as the demographic population? The Health Belief model can be applied to educate mothers & caregivers of obese & over-weight school aged and this can in turn lower the long-term upcoming healthcare & financial burden of obesity in the United States. The school-aged child is uniquely chosen in my application of the Health Belief Model because this demographic population has to learn to distinguish healthy from unhealthy lifestyles (and habits in the society). This population is stepping out of the home environment for the first time and good health education is pivotal in reinforcing positive & desired health behavior which would hopefully & eventually overcome the obesity epidemic. Additionally, this demographic population also serves as educator and role model for younger pre-school siblings. Note also that the preschool child cannot be entrusted with more self-regulatory individualistic models like the common sense model. The Health Belief Model is uniquely suited to this school-aged population as it has the potential to identify perceived health threats and obstacles, and simultaneously educate about benefits & risks, to tilt the decision balance of the care-givers (of this population & the population itself) in favor of healthy lifestyle modification & behavior.

The Main Constructs of the Health Belief Model (HBM) listed and explained – How they influence health behaviors, health education & intervention to promote health behavior change

The Health Belief Model focuses on individual behaviors and attitudes. Health education may influence the behavior and attitude of individuals and so it can serve as a key interventional strategy in this model. Six (6) constructs of this model are used to learn from & educate individuals. These are as follows:

These constructs influence health decision making. For instance, “Perceived susceptibility” evaluates an individual’s insight into the risk of acquiring a disease. “Perceived severity” is the next level of intra-personal self-examination. After a person accepts his or her susceptibility to a disease, the next question is ‘how significant is the risk’, meaning, for instances, will it make the individual just sneeze a few times or will it disable the person? If the illness like obesity causes a disability, then how severe is the final impact on quality of life. Will it make the individual lose a job or perform daily tasks sub-optimally? These first two constructs help the individual to evaluate the “perceived threat”.

The third construct of the Health Belief Model is “Perceived benefit”. Will learning more about the health condition (in this case, obesity) change the course of the illness significantly? When an individual has accepted the “Perceived threat”, he or she tries to navigate through potential solutions or best available options. In this process, treatment options are explored against a checklist of the fourth construct called “Perceived barriers”. This is the stage of benefit-risk assessment. Before an individual can initiate any successful change, the decision balance has to tilt in favor of benefit. The fifth construct is “Cues for Action”, which are environmental or social influencers, for instance, a doctor diagnosing morbid obesity objectively in the clinic & counselling the individual to make drastic lifestyle changes. Peope do listen to others or learn from experience. Finally, the sixth construct is “Self-Efficacy”. This is an individual’s belief that he or she can overcome the obstacle or perceived barrier. A high self-efficacy state enables individuals to take bold steps while a low self-efficacy state makes a person more cautious about taking desired action.

Modifying factors like genetics, age, gender, ethnicity, race, social security or socio-economic status, insurance status, life-changing events can influence any one of the constructs. Self-education also imparts knowledge that results in health seeking behavior. For instance, discovering that family history of diabetes, heart disease or familial cancers increases chances of getting the disease can lead to health clinic visits and self-requested screening tests.

For the purpose of our demographic population, school-aged children and their mothers are enrolled in a systematic process of health education. One-on-one sessions are used to engage the mothers & their obese and overweight school-aged children in health seeking behavior.