Obesity Prevention and Treatment in School-Aged Children Paper Example

Childhood obesity is a major concern for both the developed and the developing countries because of its epidemic nature. The current rise in overweight and obesity in young adult especially the school-aged children can be attributed to the constant nutritional and epidemiological changes around the world brought by environmental transformations and technological transitions. Besides the substantial risk of being an obese adult as observed in developed countries, childhood obesity is often associated with severe health outcomes such as atherosclerosis, hypertension, type 2 diabetes, and dyslipidemia. Additionally, adults who experienced overweight and obesity as school-aged children have a higher risk of developing certain health conditions including sleep apnea, metabolic syndrome and coronary heart diseases compared to those who were healthy during childhood. Ideally, despite its high prevalence rates in developed countries, childhood obesity has currently reached epidemic levels in both developed and the developing countries. Therefore, given the long-term and the immediate effects of the disease, researchers and health professionals need significant evidence-based policy interventions to address the epidemic.

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Childhood obesity and the subsequent development of the condition in adulthood involves a series of interactions among different factors including environmental factors, societal factors, personal factors, physiological factors and most importantly health-related factors. As a result of these numerous factors, different health organizations including World Health Organization have raised concerns about public health problems brought by childhood obesity epidemic and have advised advanced practice nurses on specific research areas to focus on to improve their understanding of the effective obesity and overweight prevention and treatment in school-aged children (Banning, 2005). According to Karp & Gesell (2015), the rate of worldwide obesity has almost tripled since the 1980s, with children between the ages of 2 and 19 years the most affected ones. The same research also indicates that in the United States alone, more than 35 percent of young adults are overweight and with over 18 percent of this number obese. Sadly, over the years, the percentage of obese school-aged children have not significantly changed, leading to worldwide healthcare concerns and obesity declared a worldwide epidemic by the World Health Organization. Moreover, besides the risk of developing short and long-term health problems by overweight and obese children, they are often victims of bullies and are usually stereotyped and ostracized because of their weight problems (Pratt, Stevens & Daniels, 2008). Therefore, it is crucial for health institutions and parents to identify the roles and the importance of using advanced practice nurses as educators for obese patients. As educators and the role model to patients, advanced practice nurses can be the point of contact for obese patients and have an ideal opportunity not only to provide advice and management for patients but also to enhance health-promoting activities that can hinder the risks of being obese (Banning, 2005). The purpose of this paper is to highlight the clinical assessment of overweight children, the available preventive and treatment options and the role of advanced practice nurse in dealing with obese patients.

Specific Research Question

Apart from usual care such as insulin dose-adjustment, what other crucial interventions is significant in reducing blood sugar in school-aged children by increasing the number of children with type 1 diabetes who achieve the optimal HbA1c targets without risking serious weight gain?

Overview of the Guideline

It is evident that Hypoglycemia hinders the safe achievement of optimal glycemia, although, sustained near-normoglycaemia significantly reduces microvascular diabetes or the risk of complications in school-age children with type 1 diabetes. Overall, the optimal levels of glycemia can be beneficial to cardiovascular risk especially if introduced during the early stages of type 1 diabetes. However, the methods that are used currently in achieving blood glucose control often require certain sets of skills and the ability to apply such skills on a day-to-day basis as an advanced practice nurse (Karp & Gesell, 2015). Such skills include insulin dose-adjustment, injection techniques, glucose monitoring, and self-management. Despite strong evidence of success in using these techniques, those trying to decrease the risk of type 1 diabetes in school-aged children inevitably face the fear of hypoglycemia and weight gain. Similarly, it can be difficult especially for young adults and even for advanced practice nurses to fit diabetes management into children's busy school-going lifestyle. Therefore, as a result, young adults often struggle to meet their optimal HbA1c targets; some more successful in their endeavors than others. Ideally, serious studies into new interventions that can incorporate effective education, technologies and advanced practice nursing support in glucose monitoring and insulin replacements are needed to overcome the limitations of hyperglycemia in achieving optimal glycemia in children.Even though children with type 1 diabetes are often made aware of the significance of achieving optimal glucose and HbA1c levels in the blood, daily estimation of insulin requirement needs special skills and concentration from an advanced practice nurse (Banning, 2005). This is because day-to-day estimation of insulin requirement under the current type 1 diabetes management carries certain risks of errors. Particularly, the unpredictable response to insulin and the constant fear of such errors brought by insulin estimation can impede patients' ability to achieve daily insulin management and optimal HbA1c targets. Ultimately, advanced practice nurses need new educative and supportive method with relevant technologies that can easily assist in engaging school-aged children with type 1 diabetes in achieving optimal glucose and HbA1c targets since an improved control in glycemia can further reduce such conditions as diabetic ketoacidosis, long-term complications, hypoglycemia, and weight gain.

Critique of Guideline

Different healthcare technologies can be used by the advanced practice nurses to supplement healthcare provider diabetes care in school-aged children by giving both motivational and educational support. Particularly both mobile phones and Internet-based technological interventions in healthcare can be used to provide school-aged children with individualized care, support self-management behavior and timely information for advanced practice nurses (Garabedian, Ross-Degnan & Wharam, 2015). Even though the use of different types of technologies to facilitate self-management for children living with type 1 diabetes is not a new idea, technological devices have increasingly become available, and new technologies in healthcare emerge on a daily basis. For instance, according to Hunt (2015), a variety of self-management strategies have increased in the recent past through the use of mobile health applications. For example, mobile phones can be used by both advanced practice nurses and their school-aged patients to process and communicate data and findings in real time. According to a recent study conducted on programs for disease management through the use of mobile phones, the results indicate that receiving messages and reminders about self-management and connecting with advanced practice nurse through email can be beneficial for young adults living with type 1 diabetes (Koutsouris et al., 2014). Similarly, different research conducted to promote monitoring of blood glucose levels among teenagers indicate that mobile phones can be effective especially among young adults in monitoring individual blood glucose levels (Greenwood et al., 2017). This is because, with technological improvements, people focus more and responds well to their personal devices than the people around them. Additionally, to advanced practice nurses, mobile phones are effective tools for disseminating or receiving clinical guidelines, alerts or advice to help them stay informed about recent development in their patients' health condition. These clinical guidelines and information are crucial not only in keeping tabs on diabetic patients but also in complementing continuing medical education and receiving medical references. For intensive clinical practice on patients with type 1 diabetes, mobile phones can help provide a timely drug reference, thereby saving time in pharmacy-related inquiries. Moreover, for school-aged children, apart from reminding them of adherence to physical activity and medication, mobile phones have software applications that can be programmed to provide encouraging and educative messages.

In addition to mobile phones, internet-based technology provide different opportunities for motivation for self-management behavior, general support, and diabetes education. For instance, recent research to evaluate the significance of web-based diabetes education on the levels of HA1C in the blood indicates that diabetes type 1 patients exposed to web-based education not only had a remarkable reduction in HAIC levels but also a significant increase in health check attendance (Hunt, 2015). Similarly, research conducted to compare human support in diabetes self-management, and a computer-assisted diabetes self-management indicates that the internet intervention had a significant effect on patient's health behaviors which include healthy eating habits and adherence to physical activities and medication (Riazi, Larijani, Langarizadeh & Shahmoradi, 2015). In addition, randomized research carried out to analyze the effect of web-based data system on HAIC control shows that there is an inverse relationship between HA1C levels in the blood and the frequency of web visit (Garabedian, Ross-Degnan & Wharam, 2015). That is patients who frequently accessed the internet had a remarkable reduction in blood glucose levels compared to those patients who had no internet access. Ideally, both mobile phones and internet-based technology can provide for the individualized care, extend diabetes self-management to the patient and family and give advanced practice nurses easy access to web-based medical information.

Implementation Process of the New Model

Incorporating advanced information and communication technologies in prevention and treatment of type 1 diabetes in school-aged children is a complex process but provides a significant platform able to facilitate self-management practices for people living with diabetes through communication, Patient-Generated Health Data analysis, feedback, and education. For instance, according to Greenwood et al. (2017), communication in healthcare is defined as a two-way communication in which both the patient and the advanced practice nurse are constantly engaged. Since one-way communication had limited impact on patient's outcome, Riazi et al. (2015) indicate that two-way communication incorporated with a way of technology significantly improves outcome and facilitates engagement between patients with type 1 diabetes and the health care providers. Overall, incorporating mobile apps and internet-based technol...