Childhood obesity is a serious concern that requires the attention of the behavioral community. The U.S. Department of Health and Human Services (2007) recommends that children engage in physical activity for 60 minutes per day. Children spend the majority of their day in school, making school an ideal environment to increase the opportunity for physical activity. Simple, straightforward interventions that can be applied in the school setting, which take into consideration the environment and focus on maintenance by making the process of engaging in physical activity reinforcing, are greatly needed. Video games have been noted in the literature as a contributor to childhood obesity; however, newer video gaming technology, called exergaming, has been designed to capitalize on the reinforcing effects of video games to increase physical activity in children. This study evaluated the effects of exergaming on physical activity among four inactive children in a physical education classroom. Results showed that the exergaming condition produced substantially more minutes of physical activity than the PE condition. In addition, the exergaming condition was socially acceptable to both the students and the PE teacher. Exergaming appears to hold promise as a method for increasing physical activity among inactive children and might be a possible intervention for childhood obesity.

Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to the following themes: how parents became aware of the disease, parents- reaction to the diagnosis, whether the condition was related to genetics or lifestyle behavior, what the obese children eat daily, the importance of regular workout, consequences of obesity, actions taken, and type of help needed. Results demonstrated that most of the participants perceived childhood obesity as having 2 primary causes: food consumption and insufficient physical activities. Data also showed that many of the participants regarded childhood obesity as having negative consequences, not only for the children but also for their parents and other stakeholders. Positive social change can be achieved by parental acknowledgment that obesity has adverse health consequences to be considered seriously. Denial may have severe consequences and the commitment of policymakers and others who can affect lives of the overweight or obese children is needed.

As childhood obesity continues to increase, so do the comorbidities and related health issues, putting youth at a greater risk of developing adult-related diseases such as hypertension, Type 2 diabetes, and cardiovascular diseases. Current literature indicates that healthcare organizations have a significant role in the fight against this epidemic, yet most children's hospitals have no policy to accomplish this task. The purpose of this project was to develop a program proposal for a hospital-based, sustainable obesity program that will aid in improving patient and family awareness of the importance of maintaining an ideal body weight to decrease the incidences of obesity-related comorbidities in pediatric patients ages 2-19 with a Body Mass Index (BMI) greater than or equal to 30. Lewin's theory of planned change and the logic model were used as the theoretical framework to guide the change process for this project through its development. To that end, the proposal was accepted at the site by the executive leadership in consideration for full implementation and evaluation. Key stakeholders and content experts were brought together to create the proposal for the program which includes an algorithm to guide care. The results of this project, once adopted will promote positive change in the quality of life, decrease BMI to a healthy limit, improve overall population health, and reduce healthcare expenditure. Additionally, dissemination of results of the project may stimulate changes in other children's hospitals to adopt the measures of care in the fight against childhood obesity, and contribute to social change. .

Childhood obesity is a prevalent chronic condition affecting millions of children and adolescents in the United States and is rising in record-breaking numbers among African Americans in low-income communities. Guided by the social cognitive theory, the purpose of this evidence-based project was to understand the impact of an educational intervention on parents' perceptions of childhood obesity risk factors, weight status, and prevention strategies in a rural South Carolina community. A convenience sample of parents who attended a church-based community health promotion service in a low-income area (n = 10), aged 28 to 54, completed The Childhood Obesity Perceptions survey before and after the completion of the educational program. The pretest and posttest responses were analyzed with paired sample t tests and frequency tables. There were several responses with a statistically significance change (p < .05), including the impact of obesity on the development of diabetes, stroke, cancer, and bone or joint problems. Survey participants strongly agreed (90%) that they could help their children live a healthier lifestyle by initiating preventive strategies which include providing healthy snacks and increasing exercise. Findings suggest that African American parents in low-income communities would benefit from regularly occurring education on the prevention of childhood obesity, including information on healthy diet choices, exercise, and the risk factors for childhood obesity. By educating parents, healthcare providers and community leaders can begin forming community health and childhood obesity prevention programs that support positive social change and help low-income families to achieve healthy lifestyles.

The nutritional status of children is declining as evidenced by the steady rise in childhood obesity rates over the last three decades. Consuming five servings of fruit and vegetables (FV) daily has shown to help with weight maintenance, but children are consuming far less than the recommended servings. This study was designed to test the efficacy of a sensory-focused multi-component school-based program at increasing vegetable intake among fifth-graders. Classroom, family, and community components allowed children to explore thirteen target vegetables with their senses including taste. Vegetable consumption was measured by digitalized observations of lunchtime vegetable selection and consumption. Vegetable acceptance was evaluated using a selfadministered survey assessing attitude and behaviors related to vegetable consumption. Measures were assessed at multiple time points and compared between the intervention school and a comparison school matched for demographic similarities. Parental consent was obtained for 136 fifth-graders to participate in the multicomponent study and 114 were included in the plate waste study. Data were collected over six days of plate waste observations including two phases: the control phase (CP) and the target vegetable phase (TVP) where target vegetables were served in addition to the regular lunch vegetables. Differences in mean vegetables taken and consumed during each phase of the plate waste study were analyzed using analysis of variance (ANOVA) and paired sample t-tests. When fried potatoes were included as a vegetable in the analysis, the comparison school took (P < 0.001) and consumed (P < 0.001) significantly more vegetables than the intervention school. There were no significant differences in vegetables taken (P < 0.258) and consumed (P < 0.217) when fried potatoes were excluded. Self-administered surveys were analyzed using the Fisher’s exact test and ANOVA. Significantly more children at the intervention school compared to the comparison school reported ever eating bell peppers, butternut squash, and cucumbers. The findings of this study do not show significant differences in vegetable consumption when the intervention school is compared to the comparison school, but do show a small trend toward increased acceptance of target vegetables. Future studies should evaluate a larger sample size with increased frequency of taste testing opportunities.

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The purpose of this dissertation study was to examine the impact of childhood obesity on levels of self-esteem, anxiety, social stress, interpersonal relationship satisfaction, and academic achievement on students in Grades 5, 6, and 7. Professional school counselors need to be aware of how childhood obesity impacts students and how they can help their students personally, socially, and academically. The present research study uses a comparative research design to determine the levels of self-esteem, anxiety, social stress, interpersonal relationship satisfaction, and academic performance among students in Grades in 5, 6, and 7 between two groups: (a) obese children and (b) non-obese children. Height and weight were obtained from each student and entered into a Body Mass Index (BMI) calculator. Students completed the Behavior Assessment System for Children, Second Edition and a demographic survey. Scores from the Mississippi Curriculum Test, Second Edition were obtained as well. Students were coded as obese or non-obese and scores from the two assessments were entered into SPSS. A multivariate analysis of variance found no statistically significant results for the overall model. However, self-esteem and interpersonal relationship satisfaction were statistically significant individually. Though there were no statistically significant differences between groups, the researcher found that the mean scores of dependent variables reflected differences between obese and non-obese groups. School counselors can use this information to utilize the American School Counselor National Model to build a program for these children. Responsive services such as individual counseling, group counseling, classroom guidance, and parent education workshops can all be applied throughout the schools. Research in the future should continue to focus on the mental health implications of childhood obesity. This study provided a new perspective for research on childhood obesity not only for school counselors, but all mental health professionals. By being aware of the possible risks associated with childhood obesity, school counselors can use early intervention and prevention strategies to make a difference not only with an obese child but also within the entire school.

Bakgrund: Fetma är en kronisk sjukdom och är ett stigande folkhälsoproblem internationellt och nationellt. Tidig upptäckt och förbyggande åtgärder har betydelse för deras hälsa. Samverkan mellan BVC-sjuksköterska och skolsköterska för barn med fetma är avgörande för förståelse för barnets livsvärld och utformning av personcentrerad vård. Syftet: Studiens syfte var att belysa skolsköterskors upplevelse av samverkan med BVC sköterska för barn med fetma. Metod: Kvalitativ metod användes där semistrukturerade intervjuer med tio skolsköterskor från två kommuner i Södra Sverige genomfördes. Detta analyserades med tolkande fenomenologisk analys utifrån Ashworts livsvärldsbegrepp språk, tid, projekt, relation och identitet. Analysen resulterade i två centrala teman; närhet och distans. Resultat: Skolsköterskans upplevelse av närhet eller distans till BVC-sjuksköterskan formar huruvida samverkan upplevs positiv eller negativ. Närhet ger upphov till förståelse för livsvärld och personcentrerad vård. Distans leder till upplevd professionell ensamhet, risk för patientsäkerhet samt utgör hinder för skolsköterskans hälsofrämjande arbete. Konklusion: För att skolsköterskan ska uppleva närhet till BVC-sjuksköterskan i samverkan för barn med fetma behövs gemensamma rutiner. Samverkan behöver likt en bro förena de två verksamheternas organisation och möjliggöra förståelse för varandras professionella livsvärld. Närheten i samverkan ger en stabil bro som främjar en trygg övergång från BVC till skolan. / Background: Obesity is a chronic disease and obesity in children is a rising public health problem. Early detection and preventive measures are of great importance for the health of these children. Collaboration between nurses at Children's health centre (CHC) and school nurses for children with obesity is crucial for understanding the child’s lifeworld and designing person-centered care. Aim: The aim of the study was to shed light on school nurses’ experience of collaboration with CHC nurses for children with obesity Method: Qualitative method was used. Semi-structured interviews with ten school nurses from two municipalities in Southern Sweden were conducted. The result was analyzed with interpretative phenomenological analysis based on Ashworth’s lifeworld concepts of language, time, project, relationship and identity. The analysis resulted in two central themes: closeness and distance. Result: The school nurse’s experience of closeness or distance to the CHC nurse shapes if the collaboration is perceived as positive or negative. Closeness gives understanding of the lifeworld and personcentered care. Distance leads to professional loneliness, risk of for patient safety and obstacle to the school nurse’s health promotion work. Conclusion: For school nurse to experience closeness to the CHC nurse in collaboration regarding children with obesity, joint routines are needed. The collaboration is to be seen as a bridge that unites the two organizations and enables understanding of each other’s professionals worlds. A close collaboration provides a stable bridge that promotes a safe transition from CHC to School.

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