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Nutrition Program Intervention

Students Name

Course

Instructor

Institution

Date
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Need Assessment

New York State has a primarily urban population, with more than 60% of the state’s

population living in the New York City metropolitan area. New York has a high percentage of

foreign-born residents, making it very diverse. New York State has the 2nd highest American

Asian population in the nation. The high percentage of Hispanics in the state is comprised mainly

of Puerto Ricans and Dominicans. According to the 2020 Census, 55% of the New York State

population were non-Hispanic White, 17.6% Black or African American, 9% Asian, and almost

20% Hispanic or Latino (census.gov, n.d.).

Across the nation and in New York State, obesity has reached epidemic rates. The

percentage of overweight or obese adults in New York State has increased from 42% in 1997 to

63% in 2019. Childhood and adolescent obesity have tripled in the past three decades

(health.ny.gov, 2021). New York State's children are considered overweight or obese.

Obesity may harm the body in various ways, including the risk of developing high blood

pressure and subsequent cardiovascular disease, increased risk of diabetes, asthma, and muscle

and joint problems. Obesity is a chronic health issue which may turn into a lifelong condition if

not addressed in childhood. In addition to physical health risks, obesity negatively affects one's

emotional state. Children with obesity tend to be teased and bullied more than their normal-

weight peers. Obese children and adolescents are more likely to suffer from depression, social

isolation, lower self-esteem, and negative body images. These feelings, in turn, may prompt

stress-eating and contribute to the health issue, resulting in a vicious cycle of overeating and

feeling depressed.
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There is no magic pill or vaccine to reverse this epidemic. The prevention and reversal of

the obesity epidemic will take changes across multiple systems, current state and federal policies,

and built environments. The communities need access to nutritious and affordable foods and

opportunities for safe physical activities in places where people live, work, and learn. A healthy

diet may reduce the risks of many chronic diseases, including obesity, cardiovascular disease,

osteoporosis, diabetes, and even some cancers. According to the 2015-2020 Dietary Guidelines

for Americans, a healthy eating pattern includes a variety of vegetables, fruits, and whole grains;

and limits intake of saturated fats, Tran’s fats, added sugars and sodium. Unfortunately, more

than a third of New York State students report unhealthy dietary habits, such as consuming fresh

fruit less than once daily. The prevalence of obesity risk factors is even more, pronounces in low-

income and minority populations.

In New York City, nearly half of elementary school and Head Start children are reported

to have an unhealthy weight, and one in five kindergarten students and one in four Head Start

children are reported to be obese (nyc.gov, n.d.). According to Health Department data, the rate

of obesity among Black students is 65% greater than among white students. The rate is 97%

greater than among White students among Latino students. Moreover, only 20% of parents

reported their children eating five or more servings of fruits and vegetables per day. Given the

alarming rates of obesity and overweight, there is a clear need in New York City for a nutrition

program aimed at school-age children and their families, particularly among African American

and Hispanic populations, that would help accelerate the efforts to reverse the obesity epidemic.

The dramatic increase in obesity rates in New York City and other places presents a clear

danger to public health. Obesity's association with other health conditions like diabetes, high

blood pressure, heart disease, etc., burdens local, state, federal, and global economies. Obesity-
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related chronic conditions become contributing factors in the socioeconomic and racial/ethnic

health inequalities. Additionally, obesity and its associated health problems have a significant

economic impact on the healthcare system, with CDC estimating the obesity-related healthcare

costs to be $147 billion (cdc.gov, 2021). Obesity and related health conditions thus pose an

economic burden and translate to more days missed from work and school, decreased

productivity while at work and school, and premature disability or death. It is important to take

action to prevent and reduce the obesity rates in children today so that we can have healthy

adults tomorrow!

Mission Statement

The program is aimed at developing measures that will address the obesity epidemic that

is witnessed among children in Bronx county. To develop efficient strategies which will be

sustainable in the life of the program, a systematic review was employed to identify the possible

factors that resulted in the higher number of children who were obese. A systematic review is a

piece of study on its own, and it is aimed to address a broader question, and a single empirical

study cannot describe it (Moser et al., 2019). From the systematic review, the main causes of the

increasing obesity levels among children was as a result of poor lifestyle management.

Therefore, in order to curb obesity among children, a wellness and nutritious program that will

focus on healthy eating habits and provide outdoor spaces for physical activity would be

necessary.

Work Plan

Fiscal Policy to Reduce Consumption of Sugar-Sweetened Beverages

A study carried out in Australia modelled that a 30 percent tax on the beverages that were

sweetened estimated that it would likely reduce the purchasing and consumption of these

products. Thereby, this was seen to bring health care gains positively (Palaiodimos et al., 2020).

Therefore, to protect the number of obese children who are obese in New York, it is necessary to

employ the use of policies which aim at reducing the consumption of sweetened beverages.

Since the children are not aware of the obesity dangers of these products, using fiscal policy to

ensure that their supply to the children in Bronx County does not get access to them may be an

effective way to manage obesity.

Objective

a) Promote sustainable fiscal policies to curb obesity among children.

b) Enlighten communities in the Bronx County about the dangers of sweetened sugar on

children's health.

Activities

Implementing fiscal policy at a county level is difficult due to a large number of

stakeholders' sweet beverages business. Also, the marketing technics of the businesses that took

part in the sweetened sugars were significant. However, by informing the authorities of the

detrimental effects of the sweetened sugars on children's health, significant fiscal regulatory

actions were taken.

Regulating unhealthy food marketing to children

Limiting the exposure of children to the high cost but unhealthy market through which

supplies foods which are poor in nutrition are effective in managing obesity (Machuca et al.,

2016). Therefore, regulation of unhealthy foods may be a significant move in ensuring that the
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obese nature of the children is reduced. The consumption of junk and unhealthy foods is the

biggest promoter of obesity among children.

Objective

a) Plan to prevent the consumption of unhealthy foods by children

b) Encourage the consumption of foods that promote a balanced diet.

c) Acknowledge the contribution that unhealthy food has to the increasing obesity of

children.

Activity

As most parents favour the consumption of unhealthy fast foods, a barrier arises in trying

to inform them of the dangers that unhealthy foods present to their children. Similarly, it was

difficult for the parents who were committed to their daily tasks. The only alternative was to

provide the unhealthy foods readily available to their children. To overcome the barriers which

were presented with the provision of the unhealthy foods, developing a clear method that aided

the understanding of parents on the presence of other alternatives was necessary to help them

make the shift from the unhealthy foods to the healthy foods, which efficiently helped in

reducing the risk of diabetes.

Urban Planning Approaches to Support Active Communities.

Cross-sectional studies have found that the higher the number of neighbourhood parks

and playgrounds within a community, the higher the number of children actively involved in

recreational activities (Zaniqueli et al., 2019). As playgrounds also serve as the ground through

which children get a chance to indulge in physical activities, in the Bronx County, there is a

significant deficit in the number of urban facilities in which children could get involved in the
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physical and extracurricular activities. Mostly witnessed in the poorly developed area, which the

African Americans and the Latinos occupy, it has resulted in an increase in the rates of obesity

among the children in these communities.

Objectives

a) Promote participation of obese children and adolescents in physical activities

b) Raise awareness of the positive health impacts of physical activities

c) Support the development of recreational facilities in the poorly developed parts of the

Bronx County.

Activity

Physical activities are tiring, and therefore encouraging children's participation in these

activities is difficult. Additionally, due to the lack of such facilities in most parts of Bronx

County, it would be challenging to promote children's participation. Consequently, most parents

are skeptical about allowing their children to indulge in strenuous physical activities. Although,

through collective action with county authorities, facilities development is possible. Moreover,

informing parents of the positive attributes of exercise in preventing and managing obesity raised

their awareness, encouraging more participation of their children in such activities.

Logic Model

Resource

In this program, the resources required are essential and need to be addressed. To achieve

success in this program, resource inputs are necessary (Kim et al., 2019). The resources are the

staff within the program, which consists of nurses, nutritionists, physicians and other specialists
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and the program coordinators. Next are children and adolescents who are experiencing obesity.

Additionally, the technology used in the program can be considered a resource as well. The

technology includes emails, telehealth visits and zoom calls. Finances are also a vital resource.

Primarily, finances would include the cost of running the program and the funds necessary for

any program incidentals. Grants and donations can also be considered as funds. Incidentals

would include the materials needed to run the program in the program.

Activities

The activities in the program include consultation with the doctors to identify the extent

of obesity among the patients. It would be followed by meeting with the physical therapists and

nutritionists to develop exercise and meal plans for the children who have been identified to be

obese. Plans must be developed to cater for each child independently. Also, the nutritionists will

set up training to advise both children and their parents regarding their eating habits and food

preparation training.

Outputs

Outputs are connected to the primary stakeholders. It includes the number of children and

adolescents who are considered eligible participants in addressing the obesity management

program versus the number that stick to the program and make positive steps towards losing

weight and maintaining that weight. The parents who participate in the program with the children

and the members of the communities within Bronx county benefit from the knowledge that the

participants use to improve their health. In the program, the output is connected to the outcomes,

both long term and short term. The outcomes are the expected changes that result from the

program and program activities, both long term and short term results. The short term results of
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the research will be the ability of the children and adolescents involved in the research to learn

new and healthy ways of exercising and eating to counter the obesity challenge facing them. The

long-term outputs would be accounted for by the children and adolescents who lose weight, learn

new ways of efficient nutrition, and continuously maintain their activities.

Table Indicating the Input, Output and Outcomes

Inputs Outputs Outcomes

Program staff (nurses, Consultation Short term

Nutritionists) Nutritional and physical Families learn new ways of

Parents and guardians therapy eating healthy

Children and adolescents Meal program design Families learn to exercise

Training and technology Exercise design together

Finances Workshops on nutrition Long term

Materials Workshops on physical Participants lose weight

activities Participants maintain a

healthy weight in the long

run.
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Gantt chart

The Gantt chart of the program shows the program's activities being displayed against

time (Kolich et al., 2019). It helps the program identify the time frame to offer a service to the

children who are experiencing obesity. The time of the Gantt chart is in months.
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Budget

Like any other program, this program entails concessions. As the program continues,

items will wear and break. Since the budget of this project is not large, the concessions will be

made on space. In cases where therapy is needed to address the conditions such as mental health

illnesses brought by obesity, offices will be shared at certain hours of the day (Kahathuduwa et

al., 2019). Since the research involves children, sessions will not be held on the weekends,

enabling the program to save some finances from its budget. Therefore, it is used to cater to

some vital needs in the program. The weekends also help in the saving of materials which would

have been used during the study. Moreover, the daily allowances paid to the staff would be

saved.

The program will also be a non-profit program aimed at serving the residents of Bronx

County. Being a non-profit, it would allow the program to apply for private donations and grants

to enable its operation. Also, funds were obtained from philanthropic ventures interested in the

course addressing the childhood obesity epidemic. The profits made from the program will be

used to cater to the program's expenses, such as paying employees and improving the

technological aspect of the research (Wren, 2015). As the program's future is to expand and serve

other counties in the state of New York, there will be no fixed expenses that the program will

record. Therefore, for the program's sustainability, creating a budget is necessary for the

management of the program's operation. After the rigorous task of accounting, the program's

budget is as follows.
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Nutrition Intervention Program-Budget for the year 2021

2021 budget Budgeted ($) Actual ($) Variance ($)

Fixed expenses

Staff 237,000 208,560 (28,440)

Training 320,225 329,832 9,607

Variable expenses

Technology 437,525 476,902 39,377

Materials 125,000 81,250 (43,750)

Total 1,119,750 888,192 (231,558)

Evaluation Plan

Measures

To acknowledge the program's effectiveness, there needs to be an effective measurement

of the outcomes of the participants in the research. Measuring data helps in measuring,

comparing, and reporting health care outcomes. This plays a significant role in achieving the

quadruple aim of healthcare, which entails improving the experience of care, reducing the cost of
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healthcare, reducing the burnout in medical staff, and improving populations' health. The world

health organization defines outcome measure as the change in people's health and groups of

people attributed to a series of interventions. For this program, my measurements will focus on

the safety and effectiveness of care. Safety refers to mistakes. Hence each patient makes, we will

measure how well the program was tailored to cater for the needs of every child who was

suffering from obesity (Brown et al., 2019). Also, the inherent medical conditions that the obese

children were facing were considered, including chronic illnesses and physical restraints that the

children might face. For the participants' experience, a survey would be given periodically and

randomly given to the families of the children who were obese to acknowledge their thoughts on

the program. For effectiveness, it can be shown by how well the program was followed by the

participant and how they managed to lose weight.

Disparities

The disparities in health care are essential to consider when planning for a community-

based health care program. To accommodate the disparities present in the community, it is

essential to consider the aspects of the program that need to be modified. For example, in our

study, the Latino being the majority of the Bronx county members, it is essential to identify the

language disparity as most Latinos are Spanish speakers. In dealing with children from Spanish

backgrounds, the staff in the research would be accompanied by Spanish interpreters and

handout materials. Also, culture may rise as a disparity. When dealing with children from the

African American community, culture will affect the exercise and meal preparation plan.

Therefore, since the research deals with children from diverse backgrounds, the study must

provide a positive experience. Part of the satisfaction in the research will include accommodation

for language and research.

Evaluation Success

This program aims to address the issue of obesity in children by changing their behaviour

for children regarding food and exercise. The data gathered during the evaluation enables the

staff to formulate the best possible programs, make necessary modifications, and judge the

program's success in achieving the short term and long term outcomes. The data from the

participants will be gathered using activity apps, classes and surveys to monitor individual

surveys as well as the success of the program. The children tackling obesity will follow the

program for three months to show how the successful intervention has been achieved.

Consequently, watching the children over the long term will enable monitoring the program's

long term success.

Health Care Equity

Inequality, as defined by the world health organization, is a systematic difference in the

health status of different populations. According to the Robert wood foundation, equity in health

is when everyone has achieved full health potential, and no one is disadvantaged due to their

social position or any other defined circumstances. This program will be a community-based

program, which means that all the families from the Bronx county whose child is suffering from

obesity and need possible interventions in eating healthy and working to achieve more weight

will be included. This program will meet the needs of all children and will not exclude

participants based on their social and cultural positions.

Conclusion

In conclusion, the program will help introduce the aspect of family-based education and

provide interventions and assistance in curbing childhood obesity in the Bronx county
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community. This program will help families within the Bronx county community make good

food choices and regular physical activities to prevent their children from becoming obese. By

starting with children at home, families will become stronger and learn healthily and develop

regular exercise for life.

References
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