Educating About the Devastating Effects of Obesity, Essay Example

Problem Statement

Scholars have suggested various interventions for managing obesity. These interventions generally center on nutrition education and behavior change in terms of dietary behavior and physical activity (Lindberg, Stevens & Halperin, 2013). A major problem, however, is that the outcomes of most interventions appear to be skewed to certain ethnic communities. In essence, the interventions appear to be more effective in some communities than others. The lower prevalence of obesity amongst Caucasians as compared to minority communities attests to this. This brings in the question of cultural relevance in as far as health promotion initiatives are concerned.

Obesity is commonly caused by sedentary lifestyles and unhealthy dietary behaviors, which are predominantly influenced by cultural beliefs. Black Americans, for instance, are accustomed to consuming more meat and fewer fruits and vegetables (Cowart et al., 2010). In addition, while 23% of American adults do not participate in physical activity, more than 50% of Black American women and more than 30% of Black American men do not exercise (Cowart et al., 2010). Moreover, excess weight is more culturally accepted amongst Black Americans as compared to Whites. This sentiment is shared by Benjamins & Whitman (2010), who argue that dietary practices vary from one belief system to the other. These factors explain why standard weight loss programs have been less effective for minority communities.

The lack of cultural sensitivity in nutrition education programs is also emphasized by Benjamins & Whitman (2010). Focusing on schools, the researchers decry the lack of a model tailored for Jewish American school children despite the increasing availability of school-based wellness initiatives. Benjamins & Whitman (2010) show that a school-based intervention adapted to the unique features of the Jewish culture yields significant increases in student knowledge about obesity and its associated consequences. In a similar study, Lindberg, Stevens & Halperin (2013) highlight the inadequacy of weight-loss prevention programs tailored to Hispanic populations. Most of the programs dubbed as “culturally tailored” provide little or no information about the particular cultural adjustments made.

The implication is that cultural background must be taken into consideration when providing education and other treatment interventions for obesity. This is particularly true for minority communities since they are at a greater risk of becoming overweight (Benjamins & Whitman, 2010). Noia et al. (2013) emphasize that an educational intervention for obesity must be culturally sensitive if it is to yield the desired results. As explained by Carter, Barba & Kautz (2013), education is arguably the best intervention for dealing with the lifestyle disease burden in the US. Nevertheless, the education can only be effective if it is individualized on the basis of cultural considerations.To this end, the PICO question can be stated as follows: Is culturally sensitive education more effective in helping obese people live a fulfilling and rewarding life as compared to culturally insensitive education? The PICO question can be summarized as shown below:

 Context

Obesity continues to be a major healthcare problem in the US. It is associated with increased risk for serious health complications such as diabetes, hypertension, heart disease, stroke, asthma, certain cancers, and respiratory distress (Cowart et al., 2010). Obesity also increases the risk of complications during surgery or pregnancy, lower quality of life, cognitive decline, and premature death. In addition, obesity increases overall mortality (Lindberg, Stevens & Halperin, 2013). This is not to mention the economic burden the disease imposes on individual, families, communities, and the government. Owing to the devastating consequences associated with obesity, the condition is now classified as a disease.

A more worrying trend is that obesity is more prevalent in minority communities as compared to Whites. This is particularly true for African Americans. According to Cowart et al. (2010), the prevalence of obesity amongst African Americans is higher than the national prevalence. In particular, whereas the proportion of overweight American adults stands at 65%, the proportion of overweight African Americans stands at 70%. In their analysis, Noia et al. (2013) also point out that African Americans are disproportionately affected by lifestyle diseases such as obesity. Latino Americans are also one of the major groups at risk of obesity and related complications (Lindberg, Stevens & Halperin, 2013). Essentially, ethnic communities are significantly overrepresented amongst the obese and overweight population in the US.

This raises significant questions in terms of the effectiveness of the prevailing treatment interventions for obesity across all ethnic communities. The question simply is: why does the prevalence for obesity remain higher for minority communities as compared to Whites given that the same treatment interventions are administered to all communities? A great deal of literature demonstrates that the ineffectiveness of standard education programs stems from lack of cultural specificity (Cowart et al., 2010; Benjamins & Whitman, 2010; Noia et al., 2013; Carter, Barba & Kautz, 2013). According to Taylor et al. (2013), the significance of targeting minority communities in health promotion initiatives cannot be overemphasized. Of more importance, however, is the need to be sensitive to the deep-rooted cultural beliefs that define a given ethnic community.

Approach

The Intervention Mapping (IM) framework offers arguably the most appropriate approach for implementing the proposed intervention. The framework incorporates theory into the design, implementation, and evaluation of an intervention and is suitable for a multi-cultural population (Taylor et al., 2013). IM encompasses six major steps: 1) assessment of needs, 2) identification of outcomes and objectives, 3) consideration of evidence base, 4) designing the intervention, 5) implementing the intervention, and 6) evaluation (Taylor et al., 2013). Since the intervention purposes to provide culturally sensitive education to individuals with obesity, it is important to incorporate cultural perspectives in each stage. This entails identifying and addressing obstacles to participation, developing culturally relevant communication strategies, considering cultural beliefs that hinder or encourage behavioral change, and recognizing the extent of cultural or ethnic identification (Taylor et al., 2013).

The first step of the model entails assessing the needs of the target population. This involves ascertaining whether the problem actually exists by reviewing epidemiological evidence (Taylor et al., 2013). In this case, the research would want to determine the prevalence rate of obesity as well as risk factors. Literature should also be reviewed to single out the theoretical factors associated with the behaviors in question. The second step entails identifying the outcomes and objectives of the intervention. The overall outcome in this case would be to promote a fulfilling and rewarding life in obese people. Achieving this requires behavior change in terms of exercise and dieting. This behavior change is in turn achieved by providing culturally sensitive education. In addition, performance objectives must be specified. Given the above outcome, for instance, an ideal objective would be to influence individuals to make healthy food choices.

After identifying outcomes and performance objectives, the next step is to choose appropriate, evidence-based methods to facilitate behavior change and to operationalize the behavior change (Taylor et al., 2013). As mentioned before, an ideal objective in this case would be to influence individuals to make healthy food choices. Methods that can be used to achieve this objective include provide education about the consequences of unhealthy eating and obesity, and identifying and addressing possible barriers. The next step is to create a plan for implementing the proposed intervention. This mainly entails defining the scope and limit of the intervention, determining who will be involved in the delivery of the intervention, determining the most appropriate mode of delivery, and developing session materials (Taylor et al., 2013).

Implementation entails the actual delivery of ENACT, which is designed to be culturally sensitive. Finally, it is important to carry out an evaluation to gauge the effectiveness of the proposed intervention in achieving the identified outcomes and objectives (Taylor et al., 2013). For instance, if the intervention influences behavior change in terms of dieting, then it would be deemed to be effective.

References

Benjamins, M., & Whitman, S. (2010). A culturally appropriate school wellness initiative: results of a 2-year pilot intervention in 2 Jewish schools. Journal of School Health, 80(8): 378-386.

Carter, B., Barba, B., & Kautz, D. (2013). Culturally tailored education for African Americand with type 2 diabetes. MEDSURG Nursing, 22(2): 105-123.

Cowart, L., Biro, D., Wasserman, T., Federman, R., Reider, L., & Brown, B. (2010). Designing and pilot-testing a church-based community program to reduce obesity among African Americans. The ABNF Journal, pp. 4-10.

Lindberg, N., Stevens, V., & Halperin, R. (2013). Weight-loss interventions for Hispanic populations: the role of culture. Journal of Obesity, Article ID 542736, pp. 1-6.

Noia, J., Furst, G., Park, K., & Byrd-Bredbenner, C. (2013). Designing culturally sensitive dietary interventions for African Americans: review and recommendations. Nutrition Reviews, 71(4): 224-238.

Taylor, N., Sahota, P., Sargent, J., Barber, S., Loach, J., Louch, G., & Wrigth, J. (2013). Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (healthy and active parenting programme for early years) study. International Journal of Behavioral Nutrition and Physical Activity, 10: 142.