Promoting Public Health
Part 1: Effectiveness of the Current Health Promotion Measures Addressing South Asian Adult Women and Obesity
In the United Kingdom, one of the major problems of the government regarding health is the increasing rate of obesity. It has been reported that the number of the people who are considered as obese has tripled over the last 20 years, and it is still rising. According to statistic, in the UK, 21% of women are overweight, and 21% are obese, while 46% of men are overweight and 17% of men are obese (2001).
There are different studies that show that compared with the European women; South Asian women are more likely to be obese, however, less likely to rate themselves as overweight (1999).
Local Policy
There are different local policies that are being implemented by the local government in order to support and provide people with information and other service regarding obesity.
One of this is the Bradford & Airedale Primary Care Trusts. The said policy focuses on implementing and conducting different health promotion in order to inform the public regarding the issue about obesity. The policy is using the behavioral model, where in the policy believe that obesity can be prevented by different activities and measures that are related to the lifestyle of the individual. In January 2005, a scrutiny review group was organized and focus on looking at obesity and overweight in the District. Thus, different events regarding food and exercise are being held with the representative coming from the communities of South Asian. Although, their means of generalizing the public in terms of the programs that are being implemented, due to the fact that it will create a mentality of fairness and equality. It is important to consider that South Asian grown up women have different culture, body type and needs compare to the Europeans or locals. For instance, in South Asian diet, rice is considered as an important part of the meal, thus it can be said that it is already a part of their culture.
In addition to that, the council , focuses on tackling obesity by scrutinizing obesity and overweight in the district. Just like the Bradford & Airedale PCT, this policy also uses the behavioral model, where in it believe that obesity can be obtain or result of the lifestyle of each and every individual. However, the Bradford council had been able to connect the entire communities in the health promotion activities; it had included the influence of the employers and working place or environment to the development of obesity, as well as the roles of the supermarkets in informing the public regarding the food items that they are selling. On the other hand, just like PCT, the council is lacking in having a direct communication and relationship with the South Asian women. The said aspect is important due to the fact that the ideas and concerns of South Asian women towards obesity is the same as the views and priorities of the professionals.
Both of the policies had been able to cater on the general demand of the public or community or it uses the community model, where in it focuses on the different environmental as well as the connection of different shareholders such as the working environment as well as the supermarket. However, both of the organization did not focus on the cultural and racial difference of South Asian women compare to the European or locals. Both focus on the behavioral model that emphasize on the lifestyle of each and every individual. It would be better if will also focus on the use of biomedical model, due to the fact that there are studies that shows that obesity can be obtain in terms of genetic and hormonal. And it is understandable that South Asian women have different genetic aspects compare to European, thus hormones of men are different from women.
National Policy
Aside from specific local policies that are being implemented and conducted in different areas and places in the UK, there are different national policies or the basis of those local policies. It serves as the guiding rules and policies for each and every organization and individual in local areas.
National Institute for Health and Clinical Excellence or NICE is an independent organizations that is responsible in providing national guidance in promoting good health and preventing as well as treating ill health. NICE published their guidance for prevention, identification, assessment and management of overweight and obesity in adults and children in December 2006. The said guidelines had been able to show different recommendations for the doctors, nurse, trainers, community and individual regarding the different aspects that are related to the current growing problem of the country.
This guideline uses the socio environmental model where in it views obesity as social, economic and environmental detriments that will help to provide incentives and barriers to the health of the individuals and the entire community. It focuses mainly on the lack of knowledge regarding the activities of buying and cooking food and how diet and exercise can affect health. In addition to that it also focuses on the impact of the cost and availability of healthy foods as well as the opportunities to exercise. Furthermore, it also stated that each and every program must be designed and implemented based on the individual needs, capacity and desires. This is due to the fact that action plan must be based on the culture of a group. In addition to that, it had been able to connect all the important entities in community that can affect the perception of the people towards obesity. But still, there are different problematic areas that must be considered. First is that, the guideline stated that each and every social worker must propose and implement programs based on the demand and needs of the patient, however, the culture and tradition can be a barrier in good communication and understanding between the patient and social worker. That’s why it will be important to make sure that the social worker has a background knowledge regarding the cultures, traditions and beliefs of the South Asian women that can help to ensure the effectiveness of the program.
The DOH of the UK also released its own guidelines regarding the recommendation for preventing and combating obesity. It releases its, Lightening the Load: Tackling Overweight and Obesity in March 2007. Just like the recommendation of NICE, this paper also focuses on the different aspects that are related to obesity as well as the different aspects and entities that are involved in the said process of preventing and combating obesity, from the individual, families, societies and the authorities. In addition to that it also uses the, socio environmental model where in it tackles on the different environmental, social, economical and other important aspects that can be associated with the increasing obesity rate in the country. It proposes the Three E’s Model in tackling the issues regarding achieving lifestyle change. It focuses on the aspect of the Environment, Empowerment and Encouragement. It focuses in supporting individual to change their lifestyle and then provide with the knowledge and skills that will help individual to make a healthy change. This will be supported by the totality of the cultural, social, physical and even economic environment that are required in order to facilitate the improvements in the lifestyle factors like diet and physical activity. In addition to that, it also uses two approaches in order to implement the program, which are, the whole population approach and individual at risk approach. By doing the said approach, it had been able to cater the group and individual demand of the public. One of the problems that must be faced by the government in implementing this guideline is that it is important for the local authorities and social workers to have a full knowledge regarding the cultural background of the individual or group, primarily the South Asian women. This is due to the fact that culture plays an important role in the lifestyle of each and every individual.
Another problems regarding the national policies is that it is not considering the fact that there are also some factors that can cause obesity that is not due to environmental and sociological aspect, there are some studies that shows that genes and other related aspect can also cause obesity. It will be based on the body types of each and every individual. That’s why it will be important to the government to focus also on the different physical and medical aspects regarding the issue of obesity.
Over all, it can be said that the health promotion of the country focuses on the involvement from the public, sustainability of interventions and relationships and building social systems for health. However, all of the said objective and activities are somewhat difficult due to the different barriers that can be caused by cultures and traditions. This will affect the perspective of the South Asian women towards the different local and national policies, as well as their relationship with the authorities.
Part 2: Plan for Promoting Health of South Asian Adult Women
Diet plays a very important role in the overall health of an individual. There is a saying that what you eat is what you are. It is important to consider that healthy eating habit can help to prevent and combat cases of obesity, especially in South Asian Adult women. It is believe that South Asian diet, primarily Indian diet are far too rich in saturated fat and sugar, that’s the reason why many of the upper and middle class suffer from excessive weight problem. And due to the fact that the South Asian women are living in the UK, which is considered as a developed country, most of them are consuming or eating food that is based on the said diet. However, most of the South Asian communities are saying that their opinions were not being prioritized that much compare to the locals, that’s why they don’t have that much knowledge regarding the different aspects that are related to the growing number of South Asian women that are suffering from obesity.
That is the reason why this paper focused on the process of promotion of healthy food in preventing and combating healthy food for South Asian adult women (see Appendix A). The said plan is consists of 4 important events that focuses on the process of promoting healthy foods for the South Asian adult women: informing the South Asian adult women regarding obesity; promotion of healthy foods and diet; reducing consumption of fast food; and spreading awareness.
On the other hand, evaluation of the success of the health promotion program is important and vital due to the fact that it can help to assess the effectiveness of the program. This evaluation will focus on the impact evaluation where in it will measures the short term effects of the program and will focus its concern if the objectives were meet or not. It will measure different changes in terms of behavior, environments, health knowledge, social participation, lifestyle and even the risk factors. Furthermore, it will use the qualitative evaluation method where in it will use words and meanings that will help to focus on describing the experience and feelings of the people towards the program. It is important to use this method due to the fact that South Asian adult women have different culture compare to the locals, and it can affect their perspective about the topic. By giving them the chance to talk regarding their experiences as well as their feelings regarding the program, it can help to gather more data and information that could help to improve the entire program.
Focus group will be used in order to evaluate the result of the program. This evaluation tool is appropriate to the situation, due to the fact that it is important to focus on the side of each and every individual, at the same time, enabling to see and hear the reactions as a group (see Appendix B). By using the said evaluation tool, it will enable the program to gather information or feedback directly from the participants, thus it can be used for the improvement of the program in the future.
During the entire program, the local and national policies regarding obesity will be used in order to ensure that the program is following the standard that have been set by the law and by the government. According to the guidelines by NICE and DOH, it is important to focus on the individual demands that will focus on the cultural aspects. Thus it is important to make the participant feel that all of them are treated as equal as those locals. Thus it is important to know first, the understanding of each individual, regarding obesity. This is because, there can be different perspective about a certain disease, or what we call the health models. Social workers and authorities are not sure if the perspective of the group is the same as their perception. That’s why in order to maintain or sustain healthy communication and understanding in the group, it will be important to let the participants to explain their side first.
There are different factors that can affect the entire health promotion. First is, the issue regarding funding. It is important to consider that due to the fact that focus group will be used, it can be more costly compare to the individual questionnaire, due to the fact that there will be several meetings that must be done in order to evaluate the program. In addition to that, funding has a great influence on how huge the population the program will going to cater.
The program will promote women only session; it means that all of the authorities and social worker who will be involved in the program will all be female. This is due to the culture of the South Asian, where in gender issues are still a huge subject, that’s why in order for the participants to be comfortable, it will be appropriate to implement the said plan. In addition to that, the focus group interview will be done in a close room, where in the group can communicate, talk and exchange opinions without the presence of destructions such as noise and other commotions.
On the other hand, there are some South Asian women who are already fluent to English, while there are some who are not, in order to cope up with the said problem, it will be important to divide the group for those who speak English well, and those who are comfortable in speaking their language. That’s why, it will be important to have social worker who can speak and understand specific language. By doing the said activity, it will enable to gather more information regarding the effectiveness of the program.
This project will be done by having a direct communication with the leaders of the South Asian community. By doing the said activity, it will help the group to have a direct connection with each and every individual member. In order to disseminate and spread the news regarding the program that will help them to understand the growing problem of obesity in the country, as well as in their society. In order to reach out for South Asian adult women, it will be important to give away multilingual leaflets, in order to cater to the language barrier. In addition to that, posters will be placed in most of the crowded places in the entire South Asian community; where in most of women go such as supermarket, church etc. In addition to that, having a direct connection to the employer can also help to inform them regarding the program. Aside from that, talking to the husbands and other family members can also help to encourage them to join the program. In addition to that, it can also be helpful if the program will be launched in the Internet, where in South Asian women can access anytime and anywhere.
There are different barriers that can possibly cause problems in the entire process of health promotion due to the fact that, although South Asian women come from the same region, different race have different characteristics, cultures and behaviors that can cause misunderstanding in the focus group. That is why it will be important to group the participants based on their race, where in they will be able to understand each other. In addition to that, it will also be important if the social worker or the moderators that will be assigned to a particular group have the background regarding the language or traditions, or it will be helpful if the social worker comes from the same race. This will provide light and at ease environment during the evaluation of the program.
Aside from that, it is also important to consider that they have their own lifestyle, culture that had affected their eating habit, thus it will not be easy to inculcate to their mind that some of their eating habit are bad for their health. It will be important to implement the problem in step-by-step manner or slowly-but- surely manner. It will be helpful to provide them the background knowledge regarding obesity, thus can help to ensure understanding from the group. By enabling them to understand the consequences of their eating habit, it will help them to be encouraged to change some aspects of their lifestyle.
Aside from the process of evaluating the program based on its result or outcome from those groups that have undergone the program, it will also be important to have an external comparison; where in the changes and developments in the group will be compare to other groups or communities. This can be done by gathering external statistical data, analyzing it, and then comparing it to the past and current condition of the group.
Appendices
Appendix A: Plan for Promoting Health of South Asian Adult Women
Promoting Healthy Foods
Event
Barrier
Solution
1. Informing the South Asian adult women regarding obesity
§ Most of the South Asian women are not that knowledgeable and informed regarding how diet can affect their health.
§ Informing the communities of the South Asian adult women regarding the importance of diet in the entire health of an individual.
§ Giving lecture regarding the current trend of obesity in the world. It will help them to understand that they are not alone in that situation.
§ Giving background information regarding the cause and effects of obesity.
2. Promotion of Healthy Foods and Diet.
§ Food Culture
§ People are already accustomed with their way of eating.
§ Make some changes in the way that dishes are being cooked, for example decreasing the amount of salt and other sauces.
§ Conducting seminars and meetings that will help them to understand different aspects of obesity as well the different consequences like fatal diseases that can be caused by obesity such as cardiovascular diseases.
§ Presenting tables and data that will show the amount of calories that can be obtain by eating their traditional South Asian menu.
3. Reducing consumption of fast food
§ Some of the South Asian adult women don’t have time to prepare food for themselves and even their family.
§ Implement and conduct a cooking lesson that will teach them to cook healthy and nutritious foods in short period of time.
§ Presenting the amount of calories that can be obtain from different fast foods such as burger and fries, and how it can contribute to their gaining of weight.
4. Adult women are not aware of what they are eating
§ Most of the South Asian adults are not monitoring their diet due to lack of time as well as lack of knowledge and they are not used to it or they are not practicing it.
§ Keeping food diary
§ Daily or regular consultation or meeting with the social worker.
Appendix B: Focus Group
Focus group is an evaluation method where in focuses on the group interviewing the interaction between the moderator and the group, relationship between the group members that can help to produce a level of insight that is rarely derived from the unidirectional information collection devices like observation, surveys and other less international interview techniques. The methods that are used in the process of recording and analyzing the information and data that have been gathered during the focus groups, as well as the strategies that have been used in order to gather unbiased information have helped the evaluation tool to gain credibility as an accurate as well as useful source of information
Advantages and Disadvantages
Like any other evaluation tools, focus group has its edge as well as flaws compare to other tools in terms of application in evaluating the performance and the efficiency of a program.
The following are the advantages and disadvantages of Focus Groups.
Advantages:
- Socially oriented research procedure, that’s why it is useful in obtaining detailed information about individual and group feelings, perceptions and opinions;
- Format allows the moderator to probe, thus it will offer a broader range to seek clarification;
- Discussions have high face validity, thus it can help to ensure validity of information.
- Can be relatively low cost compare to individual interview;
- Can provide speedy results compare to individual interview;
- Enable researchers to increase the sample size of qualitative studies.
Disadvantages:
- Researcher has less control in the group interview than in an individual interview, thus it can create disagreements and irrelevant discussion that can distract from the main focus;
- Data are more difficult to analyze, control and manage;
- Technique requires carefully trained moderators;
- Groups can vary considerably;
- Groups are difficult to assemble and difficult to encourage and range of people in order to participate;
- Discussion must be conducted in an environment conducive to conversation.
Source:, 2006)
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