DOI

https://doi.org/10.25772/KZKS-RY56

Defense Date

2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Dr. Nancy Jallo

Second Advisor

Dr. Jo Robins

Third Advisor

Dr. Amanda Gentry

Fourth Advisor

Dr. Jane Chung

Fifth Advisor

Dr. Carla Nye

Abstract

Abstract

Background: The prevalence of obesity and associated health risks and costs continue to increase. The majority of these health and cost ramifications manifest in adulthood, making it imperative to intercept the problem during childhood. Unfortunately, an overwhelming majority of the research surrounding adolescents and obesity to date involves subjects that are already overweight or obese, and the focus of those interventions are on secondary and tertiary prevention. Focusing on primary prevention of childhood obesity could ultimately decrease the incidence, prevalence, and disease-related burden to society. It is posited that the 20% difference in obesity prevalence between adults and children originates from children with a normal body mass index (BMI) who do not perceive themselves to be at risk for becoming obese, whose caregivers do not perceive them to be at risk, and as a result of risk misperception, do not participate in obesity prevention behaviors. This suggests that children may be unknowingly at risk for developing obesity which underscores the need for research focused on primary prevention.

Purpose: The purpose of this study was to describe and compare differences between and relationships of ecological system level factors related to obesity prevention in caregiver-adolescent dyads across BMI categories - normal, overweight, obese - with a specific focus on obesity knowledge and obesity risk knowledge.

Methods: This was a descriptive comparative cross-sectional pilot study. Two validated instruments were used to measure obesity knowledge and obesity risk knowledge. Height, weight, BMI, and body fat percentage were obtained from adolescents and their caregivers. The Ecological Systems Theory was used to describe the environments of the microsystem and mesosystem where the adolescent and caregiver reside and interact with.

Results: At the microsystem level, caregiver and adolescent KAP and ORK/AORK scores were low. Caregivers also underestimated adolescent weight. At the mesosystem level, practitioners do not provide obesity education to adolescents with a normal BMI. In addition, school system directors for nutrition, physical education, and nursing all believe that obesity prevention is important but are uncomfortable with approaching the caregiver or adolescent to discuss it.

Conclusion: Feasibility was partially established in this pilot study. Participants demonstrated the willingness to participate in and complete the study. However, unanticipated restrictions prevented acquiring the desired sample size. Although statistically not significant, comparisons of ecological system factors including obesity knowledge and BMI were obtained.

Implications for Practice: Knowledge deficits were found at all BMI levels in both caregivers and adolescents in this study. Future research in a larger more diverse sample sample is necessary to determine if there are in fact differences in knowledge across BMI levels. In addition, a future mixed methods study will introduce caregiver role modeling and adolescent motivation for obesity prevention behavior. This study demonstrated an overall need and opportunity for obesity prevention education interventions.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-8-2024

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