Evaluation of Obesity as a National Agenda of Healthy People - Research Paper Example

Evaluation of Obesity as a National Agenda of Healthy People MGMT 551 Fall Term II Table of Contents Executive Summary ………………………………………………………………. 3 2. Purpose of the Report……………………………………………………………... 4 3. Background about organization and program ……………………………………. 4 a. Organization description/history ……………………………………….. 5 b. Obesity Program………………………….……………………………… 6 i. Problem statement…………………………………………… 6 ii. Overall goal(s) of product/service/program………………… 7 iii. Outcomes and performance measures………………………. 7 iv. Activities/technologies of the program……………………... 7 4. Overall evaluation goals …………………………………………………………. 8 a. Rationale and purpose ……………………………………………………. 8 b. Identify key stakeholders…………………………………………………. 9 5. Methodology……………………………………………………………………… 9 a. Types of data/information to be collected ……………………………….. 9 b. How data/information is to be collected …………………………………. 9 c. How data/information is to be analyzed …………………………………. 10 d. Limitations of the evaluation ……………………………………………. 10 6. Interpretations and conclusions …………………………………………………. 11 a. Communicating results ………………………………………………….. 11 b. Implementation strategy ………………………………………………… 11 7. Recommendations ………………………………………………………………. 12 8. Signed/dated completion document……………………………………………… 12 References………………………………………………………………………….. 13 1. Executive Summary Obesity in childhood, teenage and adults is considered an epidemic in the United States. The advancement in technology created rapid changes in the eating habits of individuals globally. However, as countries become more developed in terms of economic status, the greater the availability and affordability of innumerable choices of food that an individual can indulge in. The issue of addressing obesity has been specifically identified as a national agenda in Healthy People 2010. Its relevance and priority to focus on this chronic illness and to seek ways to address it are possible through epidemiology surveillance systems and tools implemented both in the local and state levels. Several local agencies working in conjunction with national health organizations have outlined strategies and measurements to prevent obesity in their specific areas. When collated, the data form part of the national statistics which inform the public of the updates on this chronic illness. The numerous local and state agencies within the country give authoritative data, facts, and statistics; as well as goals, projected outcomes, and recommendations to assist the public afflicted with obesity. Likewise, professionals, both in local and state agencies, are ready to assist individuals in ensuring that an effective successful long term weight loss is achieved. The research aims to evaluate the health promotion program on obesity issues through tools and models applied to attain goals identified in the national agenda. The findings revealed that through regular monitoring and surveillance of the target population’s percentages and statistics on obesity issues, strategies and interventions are adapted and adjusted, as required. Community based response and through the assistance of leadership, social marketing and other measures, ultimately hope to minimize or ultimately prevent the incidence of obesity in the future. 2. Purpose of the Report The issue of addressing obesity has been specifically identified as a national agenda in Healthy People 2010. Its relevance and priority to focus on this chronic illness and to seek ways to address it are possible through epidemiology surveillance systems and tools implemented both in the local and state levels. Several local agencies working in conjunction with national health organizations have outlined strategies and measurements to prevent obesity in their specific areas. In this regard, the research is undertaken with the objective of evaluating the health promotion program on obesity as one of the national issues identified in Healthy People 2010, specifically focusing on the following: (1) to analyze the campaign for obesity to improve population health addressing social, economic, and cultural factors; (2) to evaluate the recommend approaches, such as programs, policies, laws, and environmental aspects, to assess the health and wellness of the target population; (3) to determine the challenges related to improving the population health for the target population by examining global implications, environmental factors, and disease prevention; and (4) to provide a summary of useful epidemiology or other data models managers may use to make decisions on the ground and to anticipate future trends on obesity. 3. Background about Local Agencies and Obesity Program The Office of Disease Prevention and Health Promotion and the U.S. Department of Health and Human Services are the primary agencies involved in monitoring obesity. The following agencies keep track of indicators and demographic factors from local communities and populations, as a whole: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, Weight Control Information Network, The Hormone Foundation, The American Obesity Association, and The International Obesity Taskforce, among others. Inquiries regarding overweight and obesity are directed primarily in these agencies for further referrals to local health agencies, as required. As previously indicated, the issue of addressing obesity has been specifically identified as a national agenda in Healthy People 2010. Its relevance and priority in the nation’s thrust to monitor this chronic illness and seek ways to address it are seen in the following objectives, to wit: “The objectives selected to measure progress among children, adolescents, and adults for this Leading Health Indicator are presented below. These are only indicators and do not represent all the nutrition and overweight objectives included in Healthy People 2010. 19-3c. Reduce the proportion of children and adolescents who are overweight or obese. 19-2. Reduce the proportion of adults who are obese” (Health People 2010, Leading Health Indicators, 2010, par. 3) a. Organization description/history The Centers for Disease Control and Prevention (CDCP) monitors obesity trends among various states in America and compiled findings over the past 20 years. According to their official website, “during the past 20 years there has been a dramatic increase in obesity in the United States. In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia) had a prevalence of obesity equal to or greater than 30%.” (CDCP, 2010, par. 2). Due to the alarming increase in the number of people classified as overweight or obese, the CDCP, in conjunction with various local agencies have outlined models and systems to monitor and address obesity. c. Obesity Program Obesity is defined as a chronic condition of excess fat accumulation in the body. (Medicine.Net, 2009, 1). Medically, obesity can be defined in relation to the body mass index (BMI). The body mass index “determines whether a person’s weight is appropriate for height by dividing the weight in kilograms by the height in meters squared.” (Delaune & Ladner, 2006, 1394) Using this index, obesity is then defined as a BMI of 30 and above. (Medicine.Net. 2009, 1) Healthy People 2010 proffered a comprehensive discourse on specific objectives, agencies involved in monitoring and directly addressing obesity related issues, the models and systems used for monitoring this chronic illness and epidemiologic surveillance systems and tools which guide community based health practitioners and ultimately, national agencies in recommending solutions to this dilemma. i. Problem statement The target population defined at the national level is composed of the general public from 25 funded states: Arkansas, California, Colorado, Georgia, Indiana, Iowa, Massachusetts, Minnesota, Michigan, Montana, Nebraska, New Jersey, New York, North Carolina, Rhode Island, South Carolina, Tennessee, Texas, Utah, Washington, West Virginia, and Wisonsin (CDC: Funded States, 2010, 1). The CDC (2010, 1) likewise reported that the states of Hawaii and New Mexico were added in 2009 as identified target population. Based on surveillance and epidemiologic research, the CDC in partnership with local communities monitors and updates trends on obesity and determines the population requiring immediate action. The data collected by the local communities are gathered and collated and form the basis for updated figures and data on a national scale. ii. Overall goal(s) of Program To reiterate, the nationally identified objectives specific to the issue of obesity are quoted, to wit: “the program goal is to prevent and control obesity and other chronic diseases through healthful eating and physical activity. The goal will be achieved through strategic public health efforts aimed at the following program objectives: (1) decrease prevalence of obesity; (2) increase physical activity; and (3) improve dietary behaviors related to population burden of obesity and chronic diseases.” (CDC, 2010, 1) iii. Outcomes and performance measures The success of the local agencies’ plans towards the accomplishment of goals to address obesity are measured against the plans of the state, the implementation plan outlined per annum, the work plan for the yearly cooperative agreement, and plans forged on a per state basis. The CDCP has outline recommendations for those afflicted with the illness; as well as for public and private health practitioners. The official website provides guidelines and recommendations for local communities in the form of strategies and measurements to prevent obesity in their specific areas. When collated, the data form part of the national statistics which inform the public of the updates on this chronic illness. iv. Activities/technologies of the Obesity Program Through the combined efforts of authors Khan, Sobush, Keener, Goodman, Lowry, Kakietek, & Zaro (2009, 1), they have identified strategies that communities can implement as a response to address obesity. Accordingly, Khan, et.al. averred that “the 24 strategies are divided into six categories: 1) strategies to promote the availability of affordable healthy food and beverages), 2) strategies to support healthy food and beverage choices, 3) a strategy to encourage breastfeeding, 4) strategies to encourage physical activity or limit sedentary activity among children and youth, 5) strategies to create safe communities that support physical activity, and 6) a strategy to encourage communities to organize for change.” (1) These community based strategies are being implemented within the jurisdiction of CDC’s Common Community Measures for Obesity Prevention Project. 4. Overall evaluation goals The goals of the discourse, specifically are: (1) to analyze the campaign for obesity to improve population health addressing social, economic, and cultural factors; (2) to evaluate the recommend approaches, such as programs, policies, laws, and environmental aspects, to assess the health and wellness of the target population; (3) to determine the challenges related to improving the population health for the target population by examining global implications, environmental factors, and disease prevention; and (4) to provide a summary of useful epidemiology or other data models managers may use to make decisions on the ground and to anticipate future trends on obesity. a. Rationale and purpose A workable implementation of recommendations to minimize the incidence and prevalence of obesity through strategies and programs must be designed with a well defined time table. The starting point is always the identification of goals and stakeholders. The short term goals would be: (1) the determination of updated incidence and prevalence of obesity through epidemiologic surveillance tools and systems identified by local and state agencies; (2) a comparison of the deviation from previous findings to determine the trend (increasing or decreasing) given the strategies implemented from the community based response programs and state funded programs; and (3) a determination of the factors which have a significant effect on the deviation from previous results. This short term goals must be measured on its accomplishment within a span of three to six months’ time. b. Identify key stakeholders The key stakeholders are the identified target population defined at the national level is composed of the general public from 25 funded states and all the agencies actively involved in addressing and monitoring issues on obesity. 5. Methodology a. Types of data/information to be collected Local and state agencies that are alarmed with progressively increasing numbers of obesity in American population utilize different models and systems to determine and address the issue. The National Science Foundation and National Institutes of Health accord grants to deserving institutes that delve into research on this field. In one of the studies conducted by the Virginia Bioinformatics Institute, a mathematical model of the immune system’s role in obesity related chronic inflammation was developed and analyzed. (Diaz, P., Gillespie, M., Krueger, J., Perez, J., Radebaugh, A., Shearman, T.,Vo, G. & Wheatley, C.) Data collected are evaluated, classified and analyzed according to parameters: age, gender, income group, sex, environmental factors, and lifestyle, among others. Significant results are highlighted and closely monitored. Additional information are collected to verify the cause of prevalence of alarming factors leading to preponderance of the disease. b. How data/information is to be collected Aside from self-measurement surveys (which proved to be relatively inaccurate), telephone interviews, schools are pinpointed to be reliable sources of accurate information of BMI for the whole school population, local health communities’ managed care data through patient information, and through surveys conducted by local and state agencies to update their current record and file. c. How data/information is to be analyzed Local and state agencies use these behavioral risk factors to monitor any drastic changes in current obesity level per state to be compared to past levels. Any significant deviation would be evaluated and assessed as to the factors which caused it and determine the appropriate action to immediately solve it. The behavioral targets specifically identified include: decreasing the frequency of viewing television; identifying high energy dense food and decreasing consumption for these; minimizing the consumption of sugar laden drinks; increasing intake for high fiber foods such as vegetables and fruits; and encouraging physical fitness and activities. d. Limitations of the evaluation The research evaluates the obesity program in terms of secondary literatures provided on the subject from the CDCP, as the governing agency. In this regard, the questions being answered focus on the objectives identified in the study, to wit: to analyze the campaign for obesity to improve the identified target population in terms of recommend approaches, epidemiology or other data models health practitioners may use to make decisions obesity issues and future trends. There are still various concerns that need to be focused in terms of interventions and measures to ensure sustained weight loss over a longer time frame; any identified counseling or psychological treatment for this chronic illness, if any; and the identification of other multidisciplinary approach to prevent obesity needs to be further addressed. 5. Interpretations and conclusions a. Communicating results The US Department of Health and Human Services,through its agency, the Agency for Healthcare Research and Quality (AHRQ) with a task force formed specifically for screening for obesity, the target population is assessed, monitored, evaluated as to which approach is most effective in addressing obesity. Accordingly, the AHRQ recommends that “clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. The most effective interventions combine nutrition education and diet and exercise counseling with behavioral strategies to help patients acquire the skills and supports needed to change eating patterns and to become physically active. The 5-A framework (Assess, Advise, Agree, Assist, and Arrange) has been used in behavioral counseling interventions such as smoking cessation and may be a useful tool to help clinicians guide interventions for weight loss.” (U.S. Preventive Services Task Force, 2003, 1). b. Implementation strategy The specific strategies that communities plan to implement as a means of addressing and preventing obesity within their localities are as follows: “1. Communities Should Increase Availability of Healthier Food and Beverage Choices in Public Service Venues; 2. Communities Should Improve Availability of Affordable Healthier Food and Beverage Choices in Public Service Venues; 3. Communities Should Improve Geographic Availability of Supermarkets in Underserved Areas; 4. Communities Should Provide Incentives to Food Retailers to Locate in and/or Offer Healthier Food and Beverage Choices in Underserved Areas; 5. Communities Should Improve Availability of Mechanisms for Purchasing Foods from Farms; 6. Communities Should Provide Incentives for the Production, Distribution, and Procurement of Foods from Local Farms; 7. Communities Should Restrict Availability of Less Healthy Foods and Beverages in Public Service Venues; 8. Communities Should Institute Smaller Portion Size Options in Public Service Venues; 9. Communities Should Limit Advertisements of Less Healthy Foods and Beverages; 10. Communities Should Discourage Consumption of Sugar-Sweetened Beverages;” among others (Khan, et.al. 2009). Social marketing enhances awareness on obesity issues to the public through the utilization of basic marketing concepts such as promotions, advertisements, campaigns, among others. The 4Ps of marketing are usually the framework used as the basis for models to be imparted to the public in addressing obesity. 6. Recommendations The success of a health campaign should be measured in terms of its effectiveness in the accomplishment of specifically defined goals. The problem of obesity is continually increasing as it pervades other sectors of the American population. Although it is commendable that local and national agencies join hands in coordinated efforts to monitor, evaluate and assess underlying factors contributing to this illness, the challenges of the future need to be incorporated in obesity programs and plans to create a comprehensive health campaign to ultimately find a solution to this dilemma. Aside from focusing on the primary causes of obesity, the factors contributing to an individual’s vulnerability to this illness must continuously be monitored. The treatment for obesity would involve a long time commitment to change one’s lifestyle in food preference and exercise. In the end, it is still the individual’s determination to lead a happy, healthy life that is first and most important step in the treatment for obesity. 9. Signed/dated completion document References Centers for Disease Control and Prevention (CDCP). (2010). Overweight and Obesity. Retrieved 17 November 2010. < http://www.cdc.gov/obesity/stateprograms/index.html> Diaz, P., Gillespie, M., Krueger, J., Perez, J., Radebaugh, A., Shearman, T.,Vo, G. & Wheatley, C. (n.d). A mathematical model of the immune system’s role in obesity related chronic inflammation. Virginia Bioinformatics Institute. Virginia Tech. Healthy People 2010. (2001). Leading Health Indicators. Retrieved 17 November 2010. Khan, L.K., Sobush, K., Keener, D., Goodman, K., Lowry, A., Kakietec, J. & Zaro, S. (2009). “Recommended Community Strategies and Measurements to Prevent Obesity in the United States.” CDC. MMWR Recommendations and Reports. July 24, 2009 / 58(RR07); 1-26. U.S. Preventive Services Task Force. Screening for Obesity in Adults: Recommendations and Rationale. November 2003. Agency for Healthcare Research and Quality, Rockville, MD.Retrieved 18 November 2010. Read More