We simply must

An article I read in The Age yesterday got me fired up for all the right reasons…

In a bold effort to combat obesity, primary schools in the UK are introducing a fat report card. Just as parents are sent reports on their child’s academic progress, they will now also receive notification about their child’s weight relative to national measures and standards. Under the scheme, all parents (unless they choose to opt out) will automatically be sent a ‘fat report’ when their child is five then again at age ten. This report will be accompanied by advice on healthy eating, recommended levels of physical activity, and local support services. Some pretty big names in the Australian obesity debate have appaulded the initiative. Boyd Swinburn (an obesity specialist at Deakin University), Dr Tim Gill (chief executive of the Australasian Society for the Study of Obesity), and Professor Paul Zimmet (head of the International Diabetes Institute in Melbourne) have thrown their support behind a similar initiative being introduced into Australian primary schools.  

The scheme has been dubbed ‘conroversial’ with critics worried about the negative effect a direct focus on the issue would have on both parents and overweight/obese children. Professor Ian Caterson, director of the Institute of Obesity, Nutrition and Exercise at the University of Sydney said the approach was “too heavy-handed and would stress parents without getting results” (The Age 28 July 2008). God forbid we would want anything too heavy-handed…afterall complacency and cotton wool have worked so well in the past. People are getting fatter, younger. Australia currently holds the title of worlds fattest nation. 26 per cent of Australians are obese, not overweight…OBESE! (The Age 20 June 2008, pp. 15). In the UK predictions estimate that by the year 2020, one quarter of ALL British children will be obese (telegraph.co.uk). This is scary.

I am sick to death of seeing six year olds who weigh more than me and will probably be outlived by their parents. I can’t believe we are worried about stressing out the parents. Some of these parents need to be locked up. There are parents out there who are feeding their children McDonalds for breakfast, KFC for lunch and Red Rooster for dinner. In my opinion it is akin to child abuse. Intervention is needed.

As for the children…

A piece of paper indicating that the a child is clinically obese and suggesting ways to combat this illness is hardly stressful. I imagine it pails in comparison to the horror obese children face in the school yard. Kids are cruel. I recently read about a study which was conducted on a group of six year olds. Each of the children were given photographs of other (anonymous) children in a similar age range. They were then asked the rank them in order of who they would like to be friends with. Each of the photographs featured children with some sort of medical condition such as down syndrome, server burns, obesity, stunted growth etc. Nearly all of the children ranked the obese kid as the person they would least like to be friends with.  On the playground the obese kid is bullied and ridiculed. It happened in my school and I’m sure it happened in yours. One of the biggest differences between my sisters 4th grade class (currently) and my 4th grade class (12 years ago) is that the fat kid no longer exists. It is now the fat kids. Plural.

The fact that obesity is now so prevalent may actually lead parents to ignore or be unaware of their own child’s weight problem. They may see their 60kg 6 year old as healthy because he is the same size as many of the other obese kids in his class. According to Swinburn, several studies have shown that parents “grossly under recognised” overweight and obesity in children. In fact Australia does not even have accurate childhood obesity statistics upon which to measure or standardise a child’s weight. How can we be expected to treat the problem if we can’t identify it? In her book The big fat conspiracy (2007 pp. 282), Melissa Sweet notes that around half of the parents of ‘obese’ children thought that their children were of normal weight or even underweight.  All the current data we have on childhood obesity is based on expert estimations. As The Age article referenced above indicates, the last comprehensive study into obesity in Australian children and adolescents is now more than a decade old. Back then it was estimated that 21 per cent of children and adolescents were overweight or obese. It is widely and expertly acknowledged that these figures have climbed dramatically. Not only will a fat report card system make parents aware it will also provide current, relevant, measurable and accurate data around obesity.

The time to take radical action is now. Obesity is linked to a number of PREVENTABLE diseases such as type 2 diabetes, stroke, heart disease, and range of mental afflictions. Already our hospitals are over populated and under-bedded. Imagine the situation in 40 years time when otherwise healthy patients are cuing up for coronary bypass surgery. Conservative estimates suggest that if current trends continue obesity will cause 123,000 premature deaths, cost $6 billion in medical expenses and require an extra 700,000 hospital beds (Stark 2008). From a purely politcal perspective the economic strain on our health system is too great to ignore.

Critics say the ‘fat report card’ is too radical. Wrong. It’s not radical enough. This is the health of Australian children. We simply must act. Lets be bold and make changes that have a real and immediate positive impact. The most successful publicity campaigns are those with emotional impact. Look at TAC. Look at QUIT. In both instances drastic, graphic and startling measures were used to change behaviour. Lets put children and parents under a bit of emotional stress. At the risk of being contentious I’m going to say that with the exception of climate change, there is no bigger issue on the political, social or economic agenda. Unlike climate change we don’t need a duel nation legally binding agreement to solve the problem. “Fat report cards” are one radical idea. Here are some others I came up with:

• Graphic images on fast food packaging. Cigarettes kill so we have plastered cartons with burnt out lungs and disintegrated brains. High cholesterol kills so lets plaster McDonald’s french fry boxes with images of a 30 year old undergoing a triple bypass. Or how about a 12 year old boy getting teased because be takes up 2 seats on the school bus.
• Age restrictions on fast food outlets. You can’t purchase alcohol until your 18 lets do the same with the Whopper. No ID? sorry go to subway.
• A petition to have cookies changed from a “sometimes” food to a “never” food (nutritional value zip).
• The forced closure of Krispy Kreme…yes I know they are worth being fat for. A drug addict probably thinks that little white rock is worth beating up an old lady for.
• Government subsidies on gym memberships and personal trainers.
• Making the Certificate 3 in fitness a compulsory subject for all year 11 students. Your body is the most important tangible item you will ever own. You should know how it works and how to look after it.

Abstract (‘S)

What follows is my abstract for my honours thesis/research project. This is a work in progress and will be updated and modified as I begin preliminary research and get feedback from LABsome.

Australian children are damaging their health by not spending enough time exercising and making poor nutritional choices. This is the result of an increasing reliance on digital technology (computers, video games, music devices) to fulfil entertainment and communicative needs, coupled with a lack of education around physical activity and proper nutrition. At present xxx number of primary school children (5 – 12 years) can be categorised as overweight or obese. I am interested in researching methods of promoting healthy and active lifestyles to primary school age children in a manner that they find relevant, motivational, and interesting. I am also interested in comparing the health, lifestyles, and motivational drivers of children in different geographical (i.e. design of community is not conducive to encouraging children to exercise outdoors in a safe environment) and socio-economic areas of Melbourne.

 Thinking about this further here are some questions I am battling with:

• I will need to speak to children about this – what are the ethics involved with interviewing children? Will it be difficult to get clearance from the ethics committee?
• In addition to children who else should I interview (town planners, nutritionists, teachers, physiologists)
• What areas of Melbourne should I focus on (I was initially thinking Toorak, perhaps Broadmeadows, Brunswick)?
• What is likely to motivate children to exercise and eat nutritional food, or parents/teachers to promote healthier lifestyles? Are these the motivators similar or vastly different?

Early (unresearched) instinct was that children from higher socio-economic areas would be less likely to participate in a healthier lifestyle because their parents would likely be able to afford more digital technology (x-box, Internet etc.). However talking (casually not academically) to people I’m starting to question this initial gut-reaction. Children from higher socio-economic areas may be better educated about making healthier choices (this may even come from some forms of new media such as the Internet). Also I know that some areas that are seen as less developed (such as Wallen) do not have footpaths, bike tracks, modern sports facilities etc. They do not make it easy for children to exercise. Even simple tasks such as walking to school safely are difficult.

BACK TO THE DRAWING BOARD (28 March)

 After having the original proposal (see above) slammed down in LABsome – Too big! Too grey with ethics! Not specific!…here is my new one. (work in progress)

Numerous studies have been done addressing issues of child nutrition and physical exercise habits. From these studies a range of global and local initiatives have been implemented. I would like to investigate a collection of these studies and health initiatives. From this I hope to gain an understanding of how to effectively use public relations to promote healthy lifestyle choices to primary school aged children in a manner that they find relevant, interesting, and motivational.

Methodology

Based on my abstract as it currently stands I will use a lot of secondary research. Looking at studies that have already been completed and initiatives that have been or and in the process of being implemented. I would like to do some primary research (namely interviews) on the topic but this will depend on time and ethics considerations.  I intend to use quantitative research to draw similarities in statistics and recommendations from each existing study. However, I will also use qualitative research to analyse the discussions presented in each research paper and draw similarities from any primary research I am able to undertake. Also many international studies/initiatives may need to be analysed and placed in a localised context.    

Building on my existing Abstract – My (hopefully) Final Abstract…(May)

Filling out my ethics approval form this week was immensely helpful in helping me clarify my research thesis.

The number of Australian primary school aged children (5 to 12 years) who are categorised as overweight or obese* is higher than ever before. Many researchers and media outlets have declared the current situation an epidemic.

Numerous studies have been done addressing issues of child nutrition and physical exercise habits. From these studies a range of global and local initiatives have been implemented. I would like to investigate a collection of these studies and health initiatives.

My research will include but not be limited to the analysis of:

• academic studies
• localised and national advertising campaigns (both government and privately funded)
• sports initiatives (such as Auskick, YMCA programs)
• school initiatives (such as healthy canteen meals, educational content)
• corporate initiatives (such as McDonald’s ‘healthy’  heart-foundation approved happy meals).

Outcomes that will be analysed include but are not limited to:

• ability to educate
• ability to instigate behavioral change
• ability to be remembered
• ease of implementation
• relevance
• results of any control group studies
• general analysis
• credentials and professions of those involved in implementation

The outcomes of existing research will be measured for both children and caregivers**.

From analysing a range of studies and initiatives I hope to gain an understanding of how to utilise public relations to effectively promote health and ultimately curb the epidemic.

 

 New Abstract September 2008

This report serves to analyse the effectiveness of social marketing as an appropriate strategy to engender behaviour change in a democratic society. Specifically, it looks at improving eating habits and increasing physical activity in Victorian children. Methods of mandatory legislation (chapter 5) will be considered as an alternative to social marketing. The Victorian State Government funded Kids – ‘Go for your life’ program will be profiled and critiqued as a social marketing campaign. It will also be secondarily critiqued using the ROPE process (of public relations) to provide a richer less rigid basis for analysis. Conclusions and recommendations will be made based on research outcomes including relevant literature around: social marketing (chapter 1), the ROPE process (chapter 2), and the Australian obesity ‘epidemic (chapter 3); available social marketing plans (appendix 3 and 4); critical analysis (chapter 4); and an interview with Kids – ‘Go for your life’.