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Health Needs Assessment and Children Obesity Prevention in The U.K
Health Needs Assessment and Children Obesity Prevention in The U.K
Health Needs Assessment and Children Obesity Prevention in The U.K
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PART 1
Childhood obesity is one of the most important health issues. Obesity has a profound
effect on a child's life and increases the risk of illness and it also causes mental and social
problems(Anon 2017). Obesity can affect a child's health, access to education, and quality of life.
Child obesity is one of the most important issues in today's society, especially in England(Wang
and Lobstein 2006). By the beginning of elementary school, about a quarter of all children in the
U.K are overweight or obese. Prevention and treatment of obesity require the full support of
governments, which consider health as an important principle and counteract the damaging
factors(Sonneville et al. 2009). As a result, using the appropriate prevention process helps to
Health Needs Assessment (HNA) is a systematic and practical 5-step process for
addressing health problems that aim to improve health and reduces inequalities. In other terms,
and resource allocation(Tobi 2016). HNA provides effective actions by prioritizing health issues
in a given target population. Increased public engagement, better use of resources and
coordination among factors involved in the problem are all of the advantages of using HNA.
The definition of health is to enjoy complete physical, mental and social well-being, not
illness and disability(Huber et al. 2011). The World Health Organization's Ottawa Charter on the
Concept of Health states that health is the daily capital of humans, based on one's physical and
of health is an ideal and practically unattainable because one cannot find who a person is
perfectly healthy in all three aspects of physical, mental, and public health.
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Health can be divided into two main parts: physical health and mental health. Physical health is a
result of the proper functioning of the organs. Biologically appropriate function of cells and
organs and their harmony together signifies physical health for individuals and is the same good
physical condition that results from daily physical activities such as exercise, proper nutrition,
and adequate sleep and weight management. Mental health is considered to be a positive state
according to the World Health Organisation, in which the person is conscious of his or her
capacity, can face normal living pressures and is accepted in daily community work as a helpful
person. Good or bad health for people is determined by their environment and conditions. It
should be noted that health models influence one another. Physical problems besides having an
impact on physical health also affect mental health. In addition to the physical and mental model,
the social model is another model of health. Therefore, any defects that occur in any of the three
health models disturb the balance of the individual. According to the World Health Organization,
the health status of the environment and where people live is affecting their health.
Public health is a collection of knowledge and art of preventing disease and providing,
maintaining and promoting human health and empowerment by using collective efforts to
promote community development. Public health, such as a physician, analyzes the health of the
population and, after analyzing it, identifies a variety of problems and offers appropriate
solutions for their treatment(Anon n.d.). Public health underpins people, associations, and society
to handle preventable illness, mortality and the inability to utilize three sub-categories of
prevention, protection, and promotion. Health promotion is also one of the main public health
Health promotion emphasizes helping the community to improve health quality and plays
a crucial role in boosting broader and more fantastic definitions of health. Health promotion is a
way that is not just about the health sector, but beyond, and is about providing healthy
lifestyles(Nutbeam and Kickbusch 1998). health promotion activity helps with making ideal
conditions through supporting health and also aims to reduce the contradictions in the current
state of healthcare and create an equal opportunity for all members of society to benefit from
their health potential. A variety of different approaches to health promotion have been
established(Langford et al. 2014). Three are three models of health promotion that have been
recognized as influential key models over the last 30 years: the biomedical model, the social
model, and the ecological model. The biomedical model has been used by most physicians in
today's societies to diagnose diseases. According to the biomedical model, health is free from
disease, pain or deficiency. The treatments performed in such a way that the patient's condition
was considered independent of other external factors and they focused on the patient's individual
characteristics. Researchers have identified nine disciplines that are very effective in advancing
the theory and practice of health promotion, one of which is health education.
The simplest definition of health education is education that promotes one's health
behavior. Although health education often begins with the provision of health information, its
success is when it can replace misbehavior with good health and individual. Therefore, the
"behavior" aspect of health education is very important and without proper health behavior,
health education will not be complete(Boucher 2011). Health education has two main functions:
The first function is to increase public awareness of the impact of the environment on health or
unhealthiness and inequality in the distribution of health resources. The second function involves
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empowering people’s ability to make decisions about their health, their families and the society
For the health needs assessment, Hooper and Longworth explain five steps. These include
determining the target population, identifying health priorities, evaluation of health priority for
In the first step, some obese children in Primary schools in southwest England were
chosen as a target population. In 2011, World Health Organization(WHO) report showed that
childhood obesity is one of the most serious public health problems for the 21st century. The
physical and mental health of a child can have significant effects, which would last on in
adulthood(Morgan and Hansen 2008). The major public health concern is the number of children
with excessive and dangerous weight(Stamatakis, Wardle, and Cole 2010). By the end of six
years, this proportion will increase to more than one-third. Naturally, the treatment and
prevention of this issue are of particular importance to the government. Obesity in children and
overweight can be considered as one of the major health issues for children and parents.
The National Children’s Measurement Program (NCMP) reveals that in 2017/18, 9.5
percent of UK children between the ages of 4 and 5 were obese and 12.8 percent overweight.
Such rates were higher for children aged 6 (10 to 10 years), with 20.1% obese and 14.2%
overweight. In order to determine overweight and obesity rates in children within primary
schools, The National Children's Measurement Program (NCMP) assesses child height and
weight in ages 4 to 10. This program is internationally regarded as a statistical source of public
There are many stakeholders that would be required to effectively carry out a health
needs assessment and establish interventions. HNA stakeholders can include members from the
National Service Framework for Children U.K, health select committee, National Healthy
Schools, National Health Service, Schools, and children's family. HNA process aims at
investigating obesity prevention solutions with the help of the relationship between children and
The second step of the HNA as outlined by Hooper and Longworth includes
identification of the health priorities. It is necessary to develop a health profile of the target
population before identifying priorities. The health profile was formed through the analysis of
Obesity in children exists for many reasons. Doctors say obese parents are more likely to
have obese children than other people, which is due to the wrong habits of their lives. They are
also susceptible to heart disease, diabetes, and poor well-being(Goran, Ball, and Cruz 2003).
There has been a lot of criticism of the British government that the government's measures to
tackle childhood obesity are inadequate and that the government cannot protect children from
unhealthy advertisements and harmful foods(Story, Nanney, and Schwartz 2009). The
advertisement for unhealthy products, like fast-food, is one of the most effective ways to cause
The determinants which could influence health condition can be described as economic,
social and biological factors. According to statistics, 80% of obese children in adulthood will
also have problems that can reduce life expectancy by up to 10 years and in special
diabetes alone cost the UK economy $ 35 billion dollars and cost the national health
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system(NHS) 6.6 billion dollars per year. One of the common social problems among obese
children is their low self-esteem, which plays an important role in the development of depression
and makes them prone to drug abuse. Also, obesity in children is one of the most common causes
of a risk of mental illness which can continue into adulthood and decrease the quality of
The Healthy Lifestyles programme (HeLP) has been used as a prevention method for
obesity in schools. The program aims to build a positive atmosphere to change the unhealthy
habits of children by changing the relationships among children, teachers, and families.
Part 2
According to Hooper and Longworth, the third stage in HNA is to assessing the health
priority for action. This next step is to evaluate the improvements in any health condition. The
The main focus of National Health Service in England was on formulating a children’s
obesity prevention program to increase the participation of schools, children and their families
assessments of all influencing factors. The role of teachers in communicating with children and
enhancing their physical activity is critical to increasing the effectiveness of the obesity
prevention program(Davidson 2007). The HeLP plan (Healthy Lifestyles programme) is utilized
to provide the necessary health action in order to adjust the established need(Lloyd, Wyatt, and
Creanor 2012).
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The HeLP is a feasible plan that provides the best intervention in light of theories of
behavior change among teachers, families, and children involved in the obesity problem. This
stage of the health need assessment is evaluated to identify the changes needed to prevent
obesity(Wyatt et al. 2011). In recent years, the proportion of obese children in the UK has
doubled, and many children are suffering from obesity. According to the proposed programs for
this need, the use of the HeLP is the most comprehensive obesity prevention trial to date, which
includes a large national sample of children and the use of preapproved standard methods for
analysis. Social interaction has been an important factor in fostering child health and education
and the performance of the HeLP plan has been effective in improving the quality of children's
social interaction with family and school members. The HeLP program developed a solution to
the prevention of obesity, which focuses on improving the interaction between schools, children
and their families during the intervention(Sahota et al. 2001). Also, it has been highly effective
and is believed to have changed the behavior of children. The HeLP system as a way to prevent
obesity enhances the physical activity and mental health. Therefore, it can be concluded that the
evidence from this project applies to many targets(Lloyd and Wyatt 2015).
The National Institute for Health and Care Excellence (NICE) primarily tried to establish
positive and trustworthy interactions by hiring suppliers with unique skills and competences.
Previous studies on obesity prevention in children had shown that parental involvement in
improving children's behavior was poor. It was found that the conventional approaches like
lessons on the importance of healthy food children used in the school setting were not
sufficiently diverse, innovative and encouraging for children to speak with their parents about
obesity issues at home. The researchers concluded that further analysis of both educational and
environmental elements was required in order to develop a new program. Therefore, HeLP was
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introduced as an identified feasible and effective intervention that played a reinforcing role in
relationships between school and child and family. Moreover, the HeLP program will help in
The Healthy Lifestyles programme has created a new intervention in English schools
based on the theory of behavioral change as well as the widespread use of stakeholders(Lloyd et
al. 2017). It also aims to encourage children to have a better lifestyle and increase the role of the
family to support them. In order to include and encourage children and their families in the
positive lifestyles, the Healthy Lifestyles Programme (HeLP) has been used. HeLP consists of
Changeability is the next criterion for determining a health priority and focuses on
successful intervention at different rates of disease prevention. HeLP program gives children
with obesity the ability to make changes in preparation for their real-life situations, and empower
themselves. This intervention targets a variety of populations and is carried out over multiple
periods. HeLP program performs three important steps to promote a healthy life balance and
reduce the problems associated with childhood obesity. The three steps are decreasing the
consumption Soft drinks such as sugary drinks and artificial sweeteners; Adding healthy snacks
to diet and reducing the activities that keep children inactive(Lloyd et al. 2011).
This program builds interdependent relationships between the school, children and their
family members and is a positive step in creating opportunities for comprehensive local
community support for obese children. The results have shown how this program has led the
intervention process and has a maximizing role in family participation and made it acceptable for
the school’s leader and children. Implementation of health changes will require time and
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someone's commitment to the program (HeLP coordinate). Time and HeLP coordinates are
The fourth step in assessing health needs is to prepare an appropriate strategy for health
operation. After evaluating the health priority, potential actions for health needs assessment
should be specified. As a result, the plans that are needed to succeed should be stated and risks
and potential problems should be managed by stakeholders. The aim of this health needs
assessment is to implement a healthy lifestyles programme to prevent obesity and its problems
and to be able to engage their parents to intervention's goal(Hooper and Longworth 2002).
The HeLP is a four-stage program that follows the Information, motivation and
behavioral(IMB) model. The IMB model explicates the psychological functional features of
activities capable of enhancing health outcomes and improving problems(Fisher, Fisher, and
Harman 2009). The extension of the IMB model is intended to reduce the limitations of existing
theory in social and health psychology(Craig et al. 2008). Most of these limitations are due to the
lack of interactions among the factors affecting health, which are known as important factors for
interpreting and modifying health behaviors(Craig et al. 2008). Proper modeling of the IMB
provides an appropriate framework for converting the outcomes of the program into behavioral
theory models.
Phase 1, called Creating a Supportive Context, provides a positive state for future actions
by building relationships between children and team members and also raising awareness of
HeLP. The purpose of this step is to reinforce the relationships between all stakeholders (e.g.,
headteachers, teachers, government staff, children and parents). Professional staff performs
supportive relationships to motivate and demonstrate the importance of a healthy lifestyle and
strive to create a promising atmosphere for the next steps. At the end of this phase children share
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the abilities they have learned with their parents, and the HeLP program helps them make better
Phase 2 is known as intensive Healthy Lifestyles Week includes education lessons that
aid children with learning how to change and modify their behavior. Lessons are taught each
morning by the class teacher, and at the end of each session, children are provided with a number
of tasks that they must complete by the start of the next session. The assignments are designed to
reflect the three main behaviors of the obesity prevention program. Also during the week, there
are special drama programs that children can interact with. The content of the drama is based on
Phase 3 is recognized as Personal Goal Setting with parental support, making children's
goals (predicted by HeLP) consistent with parental goals. In this regard, each child meets with
the person whose task is to analyze the goal-based HeLP. The person has the task of sending a
leaflet containing the child's personal information to his or her parents and working with them to
achieve the goals. Another Copy of this information is also kept at the children's school.
Finally, Phase 4 consists of factors that focus on the activities of children and parents in
This program, with the support of the British Government through the use of motivation
intervention and psychological skills, seeks to adopt mediation behaviors to prevent overweight
by improving diet and increasing physical activity(Molnar and Livingstone 2000). In addition,
improving the bond between children and their parents to address the issue of obesity during the
intervention phase is another advantage of the program. Also, this program will have an effective
impact on the school environment(Kropski, Keckley, and Jensen 2008). The four-step HeLP
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specifies the school and family setting to get an overall target and teaches them strategies for
achieving the triple steps (Healthy Snack-Physical activity and sugar drinks).
Over a specified 24-month period, 36 schools were identified to enter the program, four of which
were on the waiting list. In other words, 32 schools with 1371 eligible children were declared
ready, of which 1324 participated in the study. To evaluate the results, two groups were divided
into 16 groups (676 children) in the intervention group and 16 schools (648 children) in the
control group. In the intervention group, the program was tested on obese children and the
control group continued their daily activities. The results were measured with specific indices at
18 and 24-month intervals. BMI index and BMI SDS were used to measure body weight loss and
were converted to the normalized standard using the LMS method(Cole 1990). Body mass index
is a common index for measuring adult weight that is dependent on human height. it is one of the
most widely used tests for children obesity evaluation. Also, BMI determines the relative weight
of a child based on the age of sex of the child(Brown and Summerbell 2009). Having overweight
parents and diverse ethnicity among children are among the most significant risks of this project.
Stakeholders can determine a person who has knowledge of managing risk(Chinn, Hughes, and
Rona 1998).
The final step of the health needs assessment process includes proving the achieved
outcomes and objectives of the project. The plan needs to be analyzed carefully. It should also be
determined whether the actions have shown acceptable performance. There might be additional
challenges that should be evaluated by the team. The intervention's key accomplishments should
This project has largely achieved its goals. The results can be examined from several
approaches. From a physiological point of view, the children in the intervention group who
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followed the HeLP program remained obese over an 18-month period and lost weight at the end
of the program period. In contrast, for the control group, no significant improvement was
observed, and it can be stated that the HeLP program had a positive effect on the intervention
group. Also, the percentage of children in the control group who watched television and did on-
screen activities was higher than the children in the intervention group. The children in the
intervention group consumed fewer drinks than their counterparts in the control group in terms of
sweet and fatty drinks. Also, the level of physical activity was increased for the intervention
group.
The project has demonstrated that HeLP has been significantly effective in engaging
school members with children and their families and also is recognized as a feasible and
acceptable method to them. A small sample of English schools was chosen for population target,
and it is clear that this intervention cannot be fully stated. However, the results show that
improvements have been made in the physical and mental health of obese children as well as in
their involvement with school and family. While assessments of the disparities between
intervention and control groups remain a little inaccurate, it is promising to see that there has
been a relatively positive effect on the actions of the target goals. This finding is encouraging
that the program is capable of creating supportive actions for children and their families to bring
about new changes in their lifestyles and remain in the longer term.
Providing the HeLP program as cost-effectiveness of a new plan to tackle the problem of
childhood obesity alone does not accomplish all of its goals. This program contains unique
features that use children's behavioral and motivational approaches to create a better life
message. But it is essential for all school leaders to have the same motivation as children. In the
future, the impact of other environmental and psychological factors should be taken into account.
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Part 3
Obesity has physical and psychological consequences during childhood, adolescence, and
adulthood. Obesity itself is one of the direct causes of childhood illnesses, including
Obesity in children is one of the key issues in society today, especially in England.
Childhood obesity can lead to behavioral and emotional problems such as depression, as well as
inappropriate social relationships and reduced academic success. Childhood obesity is one of the
major causes of adult obesity, which has known health and economic consequences for both the
individual and the community. Studies are underway about the costs that childhood obesity will
bring. Further studies have addressed the economic costs of childhood obesity. Prevention of
childhood obesity leads to significant economic and physical benefits for the present and future
generations. A comprehensive and effective method for the prevention of childhood obesity must
Health Needs Assessment is a process in which people's health problems are identified
and prioritized for implementation based on criteria that lead to productivity improvement.
Although identifying needs and measuring them accurately is essential to increase and improve
the quality of medical education and health, implementing needs assessment projects at each
level requires clear actions and interventions. In short, the most essential step in planning any
health promotion solution is the health need assessment process, which utilizes complete
information about the target population, the program is designed and then implemented, and the
relationships between families, children, and the school. The main goal of the plan is to create a
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supportive environment for children to replace unhealthy behaviors in their lives with healthy
behaviors. The HeLP programm takes three crucial steps to encourage a balanced lifestyle
balance and reduce childhood obesity-related problems. The HELP program puts children in the
habit of consuming less sugary drinks, adding nutritious snacks to their diet, and doing more
physical activity.
An evaluation was carried out based on various parameters and described how to plan it.
Two equal groups of children were selected and the results of the program were reported on
different time periods. In addition to the physical approach, their social and psychological
approaches were discussed. The HeLP program had a positive effect on preventing obesity for
the intervention group. Also, the group's physical activity was increased compared to the control
group and they ate more healthy meals. The parents 'involvement in solving the children's'
problems and creating a stronger relationship between them and the school members were all
positive effects of the program. However, there are barriers to better outcomes and the impact of
Finally, stakeholders, groups, and families need concerted action to encourage positive
messages among children in collaboration with the school leaders. The Health Lifestyles
programme allows these children with obesity to strengthen social interactions and their
achievements.
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