What: As the number of overweight adolescents grows, the need for intervention becomes more and more vital. I work at a school that has been approved to create an afterschool program for overweight middle school students in order to reduce the risk of cardiovascular disease and diabetes. I am to come up with an action plan and present it to school officials and parent-teacher groups, while highlighting my approach, strategies and activities. It is important for these children to understand the importance of including exercise in their daily lives and changes in behavior need to happen quickly and effectively while they are still young.
So What: The benefits of physical exercise on a regular basis are something we have all heard about. According to Gill and Williams (2008) “physical inactivity has been linked to nearly all major health problems, including heart disease, diabetes, osteoporosis, and negative psychological conditions such as depress and anxiety” and at least 25% of the world does not exercise at all. (p. 148). Knowing this, it’s hard to imagine that people don’t exercise more. I am just as guilty as the other 60% of the world’s population in that I don’t get the recommended 30 minutes per day on a consistent basis. Some days I don’t have the time, while other days I simply don’t have the motivation. Whatever the case may be, it’s important that the children of today don’t fall into the same habits the rest of society has. Granted, children don’t have ideal behaviors modeled for them. That just makes it that much more important to intervene quickly so they don’t fall into the same life-style so many people before them have.
Now What: There are countless approaches that could be used to try to get overweight children to start exercising. In this program, I wouldn’t want to single out only the overweight children. I would start by showing all children in the middle school some sort of visual (either a video or an actual live presentation) on the importance of exercise and how it can avoid the most preventable and deadly diseases. Education is vital to cognitive-behavioral approaches as it enables the person to really look at themselves and understand why change is necessary. During the presentation, it may useful to explain to them that their loved ones that have had heart attacks or suffer from diabetes may have been able to prevent those things from regular exercise. Hopefully this will hit home, give them something to relate to, and help them realize the importance of taking care of their bodies. Similar to “community-wide campaigns” mentioned in The Task Force On Community Preventive Services (2002) article, advertising the exercise program throughout the school can also increase cognitive understanding and importance of the program. From there, getting the children to make out contracts might be a good way to hold them accountable, and should be focused on attendance more than anything else. As Gill and Williams (2008) mention, peak performance is not the goal of exercise, but instead maintenance of physical activity is. Getting the children to take that first step is important, and hopefully the fun and engaging exercise will keep them coming back. Some suggestions for activities could include: jump roping, roller-blading, swimming aerobics, swimming teams, running club, walking club, football, basketball, soccer, etc. Things that are both fun to do as well as keep the children moving at all times.
The next step will come once the children show up to the first day of the program. Based on the Transtheoretical Model presented by the Cancer Prevention Research Center (2010) as well as in Gill and Williams (2008) the children are probably in the contemplation stage as they are just now starting to think about changing their behaviors. This is a very important stage as they can be easily turned off and regress back to the Precontemplation stage. On the other hand if they enjoy the exercise they may move on to the Action stage, so it is very important to engage them in an activity that is both fun and challenging. The Task Force on Community Preventive Services (2002) strongly recommends both social support interventions as well as individually-adapted health behaviors. The children could be grouped into two or even four people. I think it would be beneficial for there to be diversity in strengths and weaknesses between each person in the group so everyone is being pushed in a different aspect of exercise. If you put four children who are all good at the same thing they may only focus on what they are good at. Also each child should have individualized goals to focus on what needs the most work. Some children may not enjoy competition, so they could focus more on individualized activities. Others may benefit more from team games and competition so that could be part of their plan. Whatever the children find enjoyable that still gets them engaged in physical activity is the main goal. Moreover, the goals should not be focused on weight loss. Focusing on weight loss implies that they are overweight. Whether they are or not, this could create a variety of negative emotions. The goal is not necessarily to lose weight, it is to become a more healthy and active person. Finally, I feel it would be important to provide the children with constant feedback as well as positive reinforcement and praise. If children are just expected to go and play, they might become bored. If they can track their increased performance in some way, this may keep them coming back. If the children have a dress code at school, one way to provided positive reinforcement could be to allow them to dress in jeans and a tee-shirt if their attendance and performance is adequate. Giving them days off from exercise is not a form of positive reinforcement.
Conclusion: Preventing childhood obesity through exercise has countless advantages and is something to be addressed immediately. Physical inactivity is addressed above by creating an after-school program aimed at preventing cardiovascular disease and diabetes. This plan takes important aspects from cognitive-behavioral approaches as well as the Transtheoritical model discussed both by the Cancer Prevention Research Center (2010) as well as in Gill and Williams (2008). The plan discussed involves education on exercise, using contracts, social support groups, individualized behavior plans, as well as interactive and interesting activities to keep the children active and engaged. The main goal of the program not to lose weight, but instead to get the children to take part in physical activity regularly.
Cancer Prevention Research (n.d.). Detailed overview of the transtheoretical model. Retrieved August 17, 2010 from http://www.uri.edu/research/cprc/TTM/detailedoverview.htm.
Gill, D. L., & Williams, L. (2008). Psychological dynamics of sport and exercise (3rd Ed.). Champaign, IL: Human Kinetics.
Task Force on Community Preventative Services. (2002). Recommendations to increase physical activity in communities. American Journal of Preventative Medicine, 22 (4S). 67-72.