URJHS Volume 13

Promoting Healthy Lifestyle Changes

Alexandra Alford
Chanal Carlisle
Bridgett Clinton*

University of Maryland Eastern Shore (UMES)

Keywords: childhood obesity, nutrition, healthy eating, healthy lifestyles

Abstract

Obesity is affecting children all over the world and it is increasingly recognized as a major public health epidemic. There have been more and more cases of non-communicable chronic diseases occurring in young children, due to increased weight in children (Slusser et al., 2011). Researchers are constantly trying to find ways to fight this problem by determining what is most effective. Numerous studies suggest that the incidences of key non-communicable chronic diseases are heavily associated with lifestyle and physical activity. The issue of childhood obesity was examined in this study by surveying parents of an after-school program located on the campus of a Historically Black College. A survey was created to measure parent's willingness to accept nutrition education and their level of commitment to making healthy lifestyle changes for their families. Survey results revealed that parents want to better their lifestyles for themselves and their children. However, they need help with implementing healthy lifestyle changes.

Introduction                           

Childhood obesity is a public health epidemic and 22 million children under the age of five are affected (Slusser, Prelip, Kinsler, Erausquin, Thai, & Neumann, 2011). Several factors are proven to be correlated with childhood obesity. Some of the factors include America's restaurant portions, availability of ready-to-eat food in grocery stores, fast food restaurants, and time spent in front of a screen. Even parental factors can contribute to childhood obesity, including one or both parents being overweight, low income and rural families, mothers not completing high school, and the amount of sleep the child gets each night (Slusser et al., 2011).

The purpose of this research paper is to determine if parents are willing to accept nutrition education and be committed to making healthy lifestyle changes. This is important because parents play a major role in the obesity prevention of their children. The following research question was addressed in this paper, "Are parents of younger children willing to accept nutrition education and commit to making healthy lifestyle changes for their children?" Future research in this area needs to determine what specific parental factors will prevent childhood obesity.

Cranfield and Blandon's (2010) research measured the difficulty of healthy eating as a single latent construct and also assessed which dietary guidelines consumers find more or less difficult to fulfill using the Rasch model approach. The researchers hypothesized that certain guidelines would be difficult for the 113 participants based on age, gender, education, and household income. The results of this study revealed significant scale variations by age, gender, education, and household income. The scale variations highlighted the importance of socio-economic and demographic factors on the difficulty of healthy eating. This study's finding can help reduce the gap between dietary recommendations and consumer dietary behavior. If the participants were willing to receive education, it would be feasible to reduce the gap.

The topic of nutrition education and healthy lifestyle behaviors related to healthy eating index and obesity is discussed in the next article. Warden, Paratakul, and Bray (2004) examined the relationship between diet quality and health in the population. The Healthy Eating Index (HEI) was developed as a composite of diet quality by the U.S. Department of Agriculture (USDA). The researchers hypothesized that they could use HEI to assess diet quality of the U.S. population and population groups. Additionally, researchers believed there would be a correlation between HEI and obesity. The results indicated that the majority of participants had low HEI scores. The percentage of individuals classified as having a poor diet varied by age, gender, race/ethnicity, income, and education. A low HEI score was associated with overweight and obesity. The findings of this study are relevant because if the participants are willing to accept nutrition education they can improve their HEI scores overall. Because the HEI is based upon the U.S. Dietary Guidelines, the use of these guidelines may be a way to improve individuals' eating and lifestyle habits.

Lemelin, Gallagher, and Haggerty (2012) conducted research that focused on promoting healthy lifestyles at an early age to prevent increasingly over-weight toddlers. Lemelin et al. (2012) hypothesized that if parents of preschoolers were educated, they could prevent non-communicable chronic diseases. The stages of the transtheoretical method were used by the researchers to help identify when change in thoughts, intentions, attitudes, or behaviors occurred. This approach was significant because the researchers were able to identify and develop potential intervention strategies with preschoolers and produce a clinical tool, reflecting the views of parents and nurses working with preschoolers' parents. This study connected to the topic of this research paper because it has assisted with identifying certain factors that impact individuals' willingness to adopt healthy lifestyles.

The topic of nutrition education and healthy lifestyle behaviors related to parenting styles was  addressed by Honajee, Mahomoodally, Subratty, and Ramasawmy (2012). According to their study, children are dependent on their parents and cannot choose what foods are prepared. Based on this premise parents are the major reason why their children do or do not make healthy choices and if they will or will not in the future. These authors gathered data using a questionnaire to assess how socio-demographic status, food frequency, and parenting styles affect children's healthy eating activity. The results of the study revealed that parental discipline and monitoring were positive influences on children's healthy eating habits.

The study by Honajee, Mohomodally, Subratty, and Ramaswmy's (2012) is relevant to the topic of this paper because it supports the notion that parents must be willing to accept nutrition education and make the necessary lifestyle changes to have any kind of positive effect in lives of their children. It is clear, based on the research, that what parents do affects their children. Therefore, if parents accept more education, they will have more nutrition knowledge to teach and pass on. This will have a domino effect on generations to come. According to Honajee et al., (2012) parents were concerned about their children's nutrition. Thus, it can be concluded that if parents are concerned with their children's nutrition, they are more likely to receive nutrition education and make lifestyle changes.

Tovar, Chui, Hyatt, Kuder, Kraak, Choumenkovitch, Hastings, Bloom, and Economos's (2011) research addressed the topic of nutrition education and healthy lifestyle behaviors. This study focused on lifestyle behaviors of healthy, overweight, and obese children. Authors already knew that the levels of overweight and obese children were much higher in rural areas compared to more urban areas. However, they hypothesized that the children that were in a healthy weight range engaged in healthier behaviors compared to their overweight and obese counterparts. Findings of this study revealed that this hypothesis was not true. The authors assumed that the overweight and obese children engaged in healthier activities because their parents were aware of the problems they had that resulted in parents taking action to change the health behaviors of their children. This study is relevant because parents were shown to be willing to accept more education when they were aware of their child's health issues.

Slusser, Prelip, Kinsler, Erausquin, Thai, and Neumann (2011), examined parents' knowledge regarding healthy foods, factors associated with food purchasing and preparation, and current nutrition education sources. The authors found barriers and promoters to establishing healthy eating habits for children and families. Results of this study, revealed that the most common barriers to eating healthy foods were cost and difficulty of getting children to eat healthy. The results of this study supported the premise of this research which is that families need nutrition education. This is certainly a barrier to establishing healthy eating habits for children and families.

In conclusion, the literature presented here supports the research question of this paper, "Are parents of younger children willing to accept nutrition education and commit to making healthy lifestyle changes for their children?" The review of literature discussed here indicates that parents are willing to accept nutrition education; however they are resistant to change.

Method

This study examined parents' healthy lifestyle habits based on their willingness and commitment to change by receiving nutrition education. It utilized a descriptive design to obtain data using a survey approach. A descriptive research design was chosen for this study because a good deal of research already exists on nutrition education and lifestyle changes and the goal of this study was to provide a clear profile of the research question that once addressed will render explanations and understandings about parents' willingness and commitment to adopt healthier lifestyle habits.

A nonrandom method of a convenience sample was used to obtain information from the research participants. The convenience sample consisted of parents on the UMES community (e.g. faculty, staff, and parents with children attending the after-school program).  Because a convenience sample was used the generalizability of the findings will be limited.

A self-report survey was used to obtain data from participants. The survey included two sections. The first section requested demographic information including race/ethnicity, educational background, marital status, and number of children in household. Section two of the survey gathered data from participants regarding their child's health status, eating and lifestyle habits of the family, and their willingness to enhance their knowledge of nutrition education. The independent variable examined in this research paper is healthy lifestyle habits. The dependent variable that this study presumes will have an influence on the independent variable is commitment to make change, willingness to accept education, and motivation to take action.

Results

The sample consisted of 50 female parents and the majority of participants were African American (88%), had a bachelor's degree (38%), were married (57%), and had two to three kids (51%). They were selected based on accessibility and whether or not they were a parent (See Table 1).

Table 1. Demographics

Demographics
	N	%
Race
Caucasian/White	3	6%
African American/Black	43	88%
Spanish	0	0%
Biracial	3	6%
Education
Some high school	2	4%
GED	6	13%
High school diploma	12	25%
Some college	9	19%
Associate's	0	0%
Bachelor's	18	38%
Master's	0	0%
Doctorate	1	2%
Marital Status
Single	12	24%
Married	28	57%
Divorced	9	18%
Number of Kids
0-1	7	14%
2-3	25	51%
4-5	13	27%
6+	4	8%

Accepting Counseling

Based on participants' responses, the majority of parents were willing to accept counseling. The majority of the parents were interested in child nutrition education (60%), a short nutrition workshop (64%), and quick healthy meals and snacks (64%). Although parents were interested in more counseling and education, the majority of participants were not willing to have a family health intervention with a dietitian (54%). (See Table 2).

Table 2. Accepting Counseling

Accepting Counseling
Survey Questions		N	%
Are you interested in child nutrition education?	Yes	30	60%
	No	20	40%
Are you interested in family nutrition counseling?	Yes	27	54%
	No	23	46%
Would you like to attend a short nutrition workshop?	Yes	32	64%
	No	18	36%
Are you willing to have a family health intervention with a dietitian?	Yes	23	46%
	No	27	54%
Are you interested in quick healthy meals and snacks?	Yes	29	64%
	No	16	36%

Taking Action towards a Healthy Lifestyle

This participants of the study reported that they were willing to take action towards a healthy lifestyle based on their responses to several questions. If parents found out their child was considered overweight they would be willing to take serious action (71%). Parents were also willing to reduce their fast food intake (61%). Additionally, parents wanted to incorporate more exercise at home (74%) and make healthy lifestyle changes (68%) to take action. However, parents reported that they would allow their children to determine when they were going to eat (61%), which may adversely impact the development of healthy eating habits (See Table 3).

Table 3. Taking Action towards a Healthy Lifestyle

Taking Action towards a Healthy Lifestyle
Survey Questions		N	%
Are you willing to take serious action if your child is overweight according to their body mass index (BMI)?	Yes	32	71%
	No	13	29%
Are you willing to reduce your fast food intake?	Yes	29	61%
	No	19	39%
Are you going to allow your children to determine when they are going to eat?	Yes	30	61%
	No	19	39%
Are you willing to reduce your child's screen time?	Yes	29	58%
	No	21	42%
Would you be willing to incorporate exercise at home?	Yes	37	74%
	No	13	26%
Are you willing to make healthy lifestyle changes?	Yes	34	68%
	No	16	32%

Discussion

The purpose of this study was to investigate parent's willingness to accept nutrition education and commitment to making healthy lifestyle changes. Based on this premise, we proposed that parents of younger children are willing to accept nutrition education and commit to making healthy lifestyle changes for their children. This study's finding regarding childhood obesity is influenced by parent's knowledge of nutrition. In addition, the study revealed that parents want to better their lifestyles for themselves and their children, but they need help. Thus, the research question presented in this study was supported. Similarly, Henson, Blandon, and Cranfield (2010) noted that parents have a hard time trying to make healthy choices. This suggests a need for partnerships between professionals, parents and experts. This is expected to lead to interventions to promote the adoption of healthy lifestyles and prevent childhood obesity.

An important question raised by this study is whether the HEI adequately captures the overall diet quality. Like-wise, the effectiveness of the Dietary Guidelines for Americans in chronic disease has been questioned as well. Based on the results, future research should focus on what factors would actually encourage all of the parents to make the necessary changes for a healthier lifestyle. Researchers should create faster techniques to get parents excited to change their family lifestyle. There is a lot more with childhood obesity that needs to examined, other than just socio-demographics.

The findings of this research paper are limited in that the sample only included parents of a small HBCU community. A broader sample could assess what a more diverse population of parents think and what they would like to change. Future research should examine the causes of childhood obesity. It is important to know the cause of every problem in order to make a long-lasting change. Although it is known that energy-dense, nutrient-poor foods are the true cause, what is making parents feed these foods to their children? Is it just cost or are there other factors? All of these factors contribute to the problem that must be solved.

According to Lemelin et al. (2012), reaching children at a younger age is most effective. If researchers can find ways to reach the younger generations, they may be able to affect more people in the long run. If children grow up learning healthy habits, they will more than likely not struggle as much in the future. The key is to provide nutrition education throughout a person's life. Future research needs to really focus on how to effectively educate younger generations.

References

Henson, S., Blandon, J.,  & Cranfield, J. (2010). Difficulty of healthy eating: A Rasch model approach. Social Science & Medicine, 70(10), 1574-1580.

Guo, X., Warden, B. A., Paeratakul, S., & Bray, G. A. (2004). Healthy eating index and obesity. European Journal of Clinical Nutrition, 58(12), 1580-1586.

Honajee, Kevina, Fawzi Mohomodally, M, Anwar Subratty, H, and Deerajen Ramaswmy. "Is Parenting Style and Sociodemographic Status of Parents Related to Children's Healthy Eating Activity in a Multicultural Society Like Mauritius?" Asian Journal of Clinical Nutrition 4.4 (n.d.): 151-56. Web.

Lemelin, Lucie, Frances Gallagher, and Jeannie Haggerty. "Supporting Parents of Preschool Children in Adopting a Healthy Lifestyle." BMC Nursing 11.1 (2012): 12. Print.

Slusser, Wendelin, Michael Prelip, Janni Kinsler, Jennifer Toller Erausquin, Chan Thai, and Charlotte Neumann. "Challenges to Parent Nutrition Education: A Qualitative Study of Parents of Urban Children Attending Low-income Schools." Public Health Nutrition 14.10 (2011): 1833-841. Print.

Tovar, Alison, Kenneth Chui, Raymond R. Hyatt, Julia Kuder, Vivica I. Kraak, Silvina F. Choumenkovitch, Alia Hastings, Julia Bloom, and Christina D. Economos. "Healthy-lifestyle Behaviors Associated with Overweight and Obesity in US Rural Children." BMC Pediatrics 12.1 (2012): 102. Print.