ArticleChildhood Obesity: A Transtheoretical Case Management Approach
Section snippets
The Problem of Childhood Obesity
Obesity is more prevalent than ever among American children and adolescents (Harvey et al., 2004). Few children have the knowledge necessary to make healthy nutritional or physical activity choices on their own; therefore, parents are key mediators of obesity prevention among their children. Parents play a large role in influencing the diet and physical activity of their young children by their own actions (Toschke, Beyerlein, & von Kries, 2005). In fact, parental obesity has been noted as one
Health Problems Related to Childhood Obesity
Childhood obesity is a strong risk factor for a number of common health conditions in children. Hyperlipidemia, hypertension, glucose intolerance, insulin insensitivity, mental health concerns (e.g., depression, low self-esteem, and impaired health-related quality of life; Ravens-Sieberer, Redegeld, & Bullinger, 2001), atherosclerosis, asthma (Patel, Welsh, & Foggs, 2004), and orthopedic problems in children are all linked to obesity (Krebs & Jacobson, 2003). Obesity is one of the most common
The Treatment of Obesity and the Barriers to Treatment
Weight loss is a simple equation of decreased caloric intake and increased caloric expenditure through increased physical activity. Interventions to decrease caloric intake and increase caloric expenditure need to concentrate on modifying eating and physical activity habits so that new behaviors are formed, resulting in lasting changes throughout one's life (O'Brien, Holubkov, & Reis, 2004). The goal of modifying diets has been to decrease and stabilize caloric and fat intakes. This is based on
Case Management
A case management approach to facilitating health behavior change has been shown to be an effective method in managing many chronic conditions. Case management is a collaborative process between the case manager, other interdisciplinary health care team members (including primary care physicians, nurse practitioners, dieticians, exercise physiologists, psychologists, social workers, and so on), and the client that involves assessment, planning, implementation, coordination, monitoring, and
The TTM
The TTM, developed by Prochaska and DiClemente (1992), consists of four behavioral stages of change: precontemplation, contemplation, action, and maintenance. The stages of change represent the progress that individuals undergo in an attempt to modify their behavior to change their health. Proper assessment of the stage of change in both the child and the parent is essential in providing effective individualized case management interventions to treat childhood obesity. The first stage,
Case Management for the Treatment of Childhood Obesity
The proposed intervention involves a case management approach administered through the TTM framework, with the goal of reducing BMI among obese children by modifying their eating habits and by increasing their physical activity. The case manager can provide the interventions during an office/clinic visit, with follow-up interactions in person, over the telephone, or through e-mail as intervention methodology. The case manager can individualize the interventions based upon the overweight/obese
Conclusion
Health care providers typically do not have the time, knowledge, or skills necessary to effectively address the emerging problem of childhood obesity during a typical outpatient clinic visit. Due to this emerging epidemic, and the significant comorbidities associated with this condition, practitioners need to develop effective interventions to address this problem. Interventions based on the TTM framework must first identify the stage that the child and the their parent are in and the
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2020, Nutrition ResearchCitation Excerpt :Self-efficacy and SOC reflect an individual’s motivation to change their behavior in the future [12,13]. In previous studies, increased self-efficacy resulted in a median weight loss in obese children [10], and increased SOC has been associated with decreased fat intake and increased vegetable and fruit intake [14-16]. There have been many multidisciplinary intervention studies including nutritional elements for overweight and obese children [17], but there is a lack of intervention studies focused on dietary problems for moderately to severely obese children and adolescents who can be more susceptible to dietary problems and diseases than obese and overweight children and adolescents [1].
From cookstove acquisition to cooking transition: Framing the behavioural aspects of cookstove interventions
2018, Energy Research and Social ScienceCitation Excerpt :This is very different from more homogenous group settings used in the psychology domain to effect behaviour change where targets are employees [68] or smokers who wish to quit [79]. However, there are already notable exceptions, such as a TTM study that targeted parents and children (entities with different motivation triggers) within the same household [100]. In our initial field tests, we study the primary cook’s perception while capturing the perceptions of other key individuals in the injunctive norms of salient referents [73].
Predictors of health-related behaviour change in parents of overweight children in England
2014, Preventive MedicineCitation Excerpt :The transtheoretical model (TTM) describes behaviour change as progression through a series of stages: pre-contemplation (no intention to change behaviour), contemplation (intention to change in the near future), preparation (ready to change), action, maintenance, and relapse (Prochaska and Velicer, 1997). These steps have been used to inform health promotion interventions, including childhood weight management (Howard, 2007; Mason et al., 2008). It is believed that increasing parental recognition of child overweight status through the provision of accurate information will prompt progression through stages of behaviour change, leading to healthier behaviours, including improved diet, increased physical activity and reduced sedentary behaviour (Cottrell et al., 2007; Mooney et al., 2010).
Action competence obstacles to managing childhood overweight: In-depth interviews with mothers of 7- to 9-year-old children
2013, Journal of Pediatric NursingCitation Excerpt :Moens, Braet, and Van (2010) suggest interventions with a multi-disciplinary approach, including healthy eating habits, moderate exercise and cognitive–behavioural techniques since these enable the majority of children to control their weight for at least 8 years following the intervention while several other studies show how difficult it is to achieve long-term weight loss (Oude Luttikhuis et al., 2009; Waters et al., 2011). As supported by other studies, successful lifestyle changes should be approached with sensitivity and non-judgmentally (Mikhailovich & Morrison, 2007), be person-oriented as well as family-centered (Barlow, 2007; Berra, 2010) and use collaborative negotiation (Tyler & Horner, 2008) and a trans-theoretical case management approach (Mason et al., 2008). Moreover, motivational interviewing is recommended as a methodology (Berra, 2010; Tyler & Horner, 2008).
Obesity Risk Knowledge and Physical Activity in Families of Adolescents
2011, Journal of Pediatric NursingObesity in Hong Kong Chinese preschool children: Where are all the nurses?
2010, Journal of Pediatric Nursing