American society as any other industrialized country has to face major public health issues. Such diseases as cancer, cardiovascular disorders, diabetes are regarded as some of the primary areas of concern. Obesity is one of the major issues to address as over two in three adult Americans are obese or overweight (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). The problem is even more persistent among children and adolescents. According to Centers for Disease Control and Prevention (2017), approximately 17% of children and teenagers aged between 2 and 19 are obese. At that, the rate of obesity in different ethnic groups varies considerably. For instance, the Hispanic population is the most vulnerable as over 21% of Latino children and adolescents are obese as compared to over 14% of the white population (CDC, 2017). It has been acknowledged that obesity in early years and adolescence is associated with major health hazards that persist in their adulthood (Montoya, Boursaw, Tigges, & Lobo, 2016). The prevalence of obesity among Hispanic children and teenagers is an alarming trend that has received quite a substantial attention among healthcare practitioners, scientists, and scholars.
It is found that such health issues as cardiovascular disorders, diabetes, and even cancer are associated with obesity (National Cancer Institute, 2017). Major risk factors have also been well-researched and described. Arcan, Culhane-Pera, Pergament, Rosas-Lee, and Xiong (2017) claims that cultural peculiarities, genetic characteristic features, and socioeconomic status of families have a substantial influence on the development of obesity in children. It is also clear that nursing professionals can have a positive impact on patients’ health habits and diets (Reifsnider et al., 2016). Different interventions have been implemented, and they have proved to be effective. Nurses provided certain training and educated patients and their caregivers concerning healthy lifestyles, healthy diets, health risks associated with obesity and excessive body weight, etc. The effectiveness of such interventions is often ensured by the development of proper relationships with patients and their caregivers. Nurses are healthcare professionals who tend to spend more time with patients and their close ones as compared to other healthcare practitioners.
Nevertheless, it is rather unclear whether nurses are prepared to perform such roles, and whether they have the necessary skills and knowledge. When it comes to providing care to ethnic minorities, cultural and linguistic issues come into play as well. Nurses should have the necessary knowledge concerning Hispanic people’s attitudes towards the problem, common lifestyles, and so on. Nurses should be able to explain everything and help patients and their families adjust their habits. These healthcare professionals should find the right arguments to persuade people who tend to have various beliefs and biased views on the matter. Importantly, nurses should also take into account the socioeconomic status of patients and their families when providing their recommendations and training. Hispanic families tend to face numerous social and economic issues that prevent them from having healthy lifestyles and dietary habits (Frederick, Snellman, & Putnam, 2014). The offered plans and changes in patients’ lifestyles should be accessible to them. Nurses should also provide information concerning available resources (programs, initiatives, and so on).
Therefore, it is necessary to assess nurses’ knowledge concerning the central factors contributing to the development of obesity in Hispanic children and adolescents. To narrow down the scope of the research, it is possible to focus on the Hispanic school-age population affected by the disorder. The study can also explore nurses’ skills necessary to educate and train the population in question. The focus should be on cultural aspects and nursing professionals’ ability to destroy myths, encourage young people to change their habits, and so on. Thus, the purpose of this study is to examine nursing practitioners’ knowledge and skills necessary to train and educate the Latino school-age population suffering from obesity concerning their health, lifestyles, and diets.
Literature Review
Obesity among children is regarded as one of the top health issues to address. It has been estimated that approximately 17% of American children and adolescents are obese or overweight, which is an alarming figure since adolescents with excessive body weight are likely to have major health issues in their adulthood (Montoya et al., 2016). Hispanic children are more likely to be obese than the Caucasian population (Tucker & Lanningham-Foster, 2015). Researchers have paid significant attention to different aspects of the problem with the focus on the factors affecting children’s weight and the effectiveness of interventions related to obesity prevention. In many cases, quantitative designs were used to address research questions and hypotheses, but qualitative studies can also be found. The studies provide important insights into the matter, but they are also characterized by certain limitations that are quite similar.
Major Factors
As far as the major factors affecting children’s weight are concerned, researchers identify cultural, socioeconomic, and biological factors. For instance, Franckle et al. (2015) note that insufficient sleep contributes to the development of obesity among Hispanic children. Many researchers focus on the external factors such as maternal beliefs and behaviors. For example, it has been acknowledged that maternal chronic depression is associated with obesity in 7-year-old children (Audelo et al., 2016). Martinez, Rhee, Blanco, and Boutelle (2016) stress that maternal perspectives on children’s weight are an influential factor as well. The researchers also claim that socio-economic issues have a considerable effect as well. Children in rural areas are more likely to have excessive weight than their urban counterparts. Underprivileged groups are also more affected by the issue. It is found that Hispanic mothers understand that chubby children can have some health issues associated with their weight, but having a chubby child is still accepted or even preferable among Latino females.
Apart from cultural and biological factors, socioeconomic status of families and the environment also affect people’s lifestyles and dietary patterns. For instance, Frederick et al. (2014) claim that adolescents coming from low-income families are more likely to become obese or overweight as compared to well-off teenagers. It is found that socioeconomic issues Hispanics face have a more significant impact on the public health in terms of the obesity epidemic (Rogers et al., 2015). Therefore, it is clear that interventions aimed at reducing obesity among Latino adolescents cannot be confined to addressing cultural aspects of the issue.
Different Perspectives
The studies reviewed provide insights on the perspectives of different stakeholders. For instance, Martinez et al. (2016) explore mothers’ cultural beliefs concerning weight, children’s obesity, healthy lifestyles, and so on. Clearly, parental views and health habits are likely to be adopted by their children, so it is vital to evaluate these views and shape them. Montoya et al. (2016) shed light on children’s views on the matter. It is found that children do not assess their body weight adequately. They also tend to regard underweight figures as ideal. This information can help in developing effective interventions aimed at obesity prevention as informing people about appropriate body weight can help them maintain healthy lifestyles. Nurses should also know opinions of all the stakeholders involved to educate patients and their parents.
Intervention Evaluation
It is noteworthy that various interventions aimed at preventing obesity have been implemented. Many researchers measure the effectiveness of such interventions and programs. For example, Tucker and Lanningham-Foster (2015) evaluate a nurse intervention implemented at two schools. Although the interventions had no significant effect on children’s body weight, they affected children’s health-related behavior. Children started consuming more vegetables and fruits. They also became more physically active. Therefore, the intervention was regarded as effective. Such assessments make it clear that an effective obesity prevention intervention should focus on tools used, stakeholders’ views, factors contributing to the development of the disorder, and so on.
Methods Used
One of the peculiarities of the studies on the matter is the choice of methods. In many cases, researchers implement quantitative research designs that focus on associations and correlations between different variables. The benefits of these data include generalizability and reliability. Researchers manage to unveil the existing trends, which is instrumental in the development of cost-effective interventions and policies. However, qualitative methods are also employed. Martinez et al. (2016) examine maternal views on the matter with the use of focus groups discussions. Females shared their views and noted that they preferred having chubby children although they understood that obesity is a serious disorder. Qualitative methods have proved to be applicable as they help explore different factors affecting children’s weight.
Limitations and Future Research
One of the major similarity among the reviewed articles is associated with their limitations. All the studies in question involve the participants who live in quite small communities and are dispersed within a single state. The lack of data obtained across the nation is apparent. It can be beneficial to examine the correlations between different variables through the analysis obtained in different states. Besides, the sample size of the vast majority of the reviewed studies is quite limited. The data can hardly be generalized as only several dozens or hundreds of people participated. Therefore, it is crucial to implement studies that will involve thousands of people living in different states.
Conclusion
On balance, it is possible to note that obesity among Hispanic children is quite a well-researched topic. Researchers shed light on different aspects affecting the development of the disorder. The effectiveness of nursing interventions is also assessed. The major limitations include a small sample and geographic homogeneity. It is also necessary to note that nurses’ views’ and knowledge on the matter have received little attention. It is unclear whether nurses have the necessary information concerning obesity among Hispanic children and different ways to address the problem.
Methods
The purpose of this research was to explore nurses’ knowledge and skills needed to educate the Hispanic school-age population affected by obesity concerning their lifestyles, health conditions, and dietary habits. Four pediatric (non-Hispanic) nurses took part in the research. The nursing practitioners worked in different departments (two of them work in gastroenterology departments). The qualitative research design was chosen as it enabled the researcher to identify major themes and trends existing in the clinical setting. Nurses were interviewed, and their answers were digitally recorded. The semi-structured interviews were chosen as they helped nurses to share as much information as possible. The questions asked were related to the topics discussed with patients, their caregivers, time spent discussing these issues, major difficulties nurses encounter during these discussions, and the like. Nurses were also asked to evaluate their readiness to train the target population regarding their health and dietary habits. Major themes and codes were identified and analyzed.
Results
According to the data obtained, the nurses report the lack of knowledge and skills necessary to provide training to children as to their dietary habits, health conditions, and lifestyles. All the participants named cultural issues as the primary concern. They stated that they often felt they were unable to understand their patients’ habits and preferences. They also were unable to encourage their patients to change their habits in many cases. It was quite expected that the nurse working in the gastroenterology department was more knowledgeable and willing to discuss the issues in question with the patients. Other nurses often focused on health issues related to the department they worked in. Time pressure is another influential factor affecting nurses’ willingness to discuss dietary and health habits. The participants stressed that they often had little time to discuss such issues with their patients and especially their caregivers. The nurses stated that they did not have enough knowledge and skills, as well as resources (mainly, time), to educate and train Latino children and adolescents regarding health, diets, and lifestyles.
Limitations to the Study
Although the study provides valuable insights to the knowledge base on obesity, it is characterized by several limitations. First, the sample size is quite small as only four people take part in the study. The generalizability of the results can be quite doubtful. All the participants work at one healthcare facility, which can also have a certain impact on the reliability of data. The results can be different at other hospitals as all healthcare facilities have different cultures and approaches to the provision of health care and staff training.
Implications and Further Study
This study can have several implications that can advance the nursing practice and enrich the existing knowledge base concerning obesity. For instance, the study can be used as a starting point for the development of interventions aimed at training the Hispanic school-age population concerning obesity, major risk factors affecting its development, healthy lifestyles and diets, existing cultural bias and prejudice, etc. This study can help researchers unveil persisting gaps in the knowledge base on the matter. Nurse practitioners can benefit from reading this manuscript as they will enrich their knowledge concerning obesity among Latino children and adolescents as well as ways to educate and train this population. Finally, parents of children and teenagers suffering from the disease can also find the study valuable as it provides insights into factors contributing to the development of obesity, associated health issues, ways to address the issue, and so on.
The further research can be associated with such areas as the evaluation of particular interventions with the focus on patients’ health outcomes and satisfaction. It is possible to develop various interventions aimed at educating the population under study. When developing these interventions, it is vital to pay attention to such areas as cultural peculiarities of the population, socioeconomic status of families, biological and clinical aspects. Peer pressure and environment can become appropriate variables for further study. The effects of popular culture on adolescents’ views on obesity, their lifestyles and dietary habits should also be considered.
As far as the methodology of the further research, it is necessary to increase the number of participants considerably. It can be beneficial to engage nursing practitioners working at different healthcare facilities or even hospitals located in different communities or states. Furthermore, the involvement of nurses pertaining to different ethnic groups can be quite valuable. Hispanic nurses and nursing practitioners of a different cultural heritage can have different views and approaches, which can result in different health implications for patients. Focus group discussions can be employed as this data collection method enables researchers to involve a considerable number of participants within quite a short period of time.
It can be necessary to identify major barriers to the provision of the corresponding training and education to the population in question as seen by nursing practitioners. Nurses’ attitudes towards obesity as a health issue should also be explored as healthcare professionals’ opinions and beliefs affect the way they deliver care. The focus can be on Hispanic nurses while other ethnic groups’ perceptions can also be examined. Participants can also be different in terms of gender and age.
Nursing professionals’ views on different factors causing obesity also need researchers’ attention. These views shape nurses’ recommendations given to patients and their families. Finally, nurses’ perceptions of the effectiveness of training provided or availability of the corresponding training can help researchers develop effective interventions and programs. It is possible to address nurses’ participation in the advocacy processes related to the attempts to address obesity among adolescents. It is clear that the problem requires a complex approach that involves nursing professionals’ attitudes, healthcare facilities’ cultures and approaches to the problem, policymakers’ perspectives, the collaboration among stakeholders, and the like. The further research will address the existing gaps and will potentially contribute to the decrease in the number of obese Hispanic adolescents.
References
Arcan, C., Culhane-Pera, K. A., Pergament, S., Rosas-Lee, M., & Xiong, M. B. (2017). Somali, Latino and Hmong parents’ perceptions and approaches about raising healthy-weight children: A community-based participatory research study. Public Health Nutrition, 1-15.
Audelo, J., Kogut, K., Harley, K., Rosas, L., Stein, L., & Eskenazi, B. (2016). Maternal depression and childhood overweight in the CHAMACOS study of Mexican-American children. Maternal and Child Health Journal, 20(7), 1405-1414.
Centers for Disease Control and Prevention. (2017). Childhood obesity facts. Web.
Franckle, R., Falbe, J., Gortmaker, S., Ganter, C., Taveras, E., Land, T., & Davison, K. (2015). Insufficient sleep among elementary and middle school students is linked with elevated soda consumption and other unhealthy dietary behaviors. Preventive Medicine, 74, 36-41.
Frederick, C., Snellman, K., & Putnam, R. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338-1342.
Martinez, S., Rhee, K., Blanco, E., & Boutelle, K. (2016). Latino mothers’ beliefs about child weight and family health. Public Health Nutrition, 20(06), 1099-1106.
Montoya, C., Boursaw, B., Tigges, B., & Lobo, M. (2016). Mirror, mirror on the wall: Children’s preferences and self-perceptions of weight in a rural Hispanic community. Journal of Pediatric Health Care, 30(6), 528-534.
National Cancer Institute. (2017). Obesity and cancer. Web.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Overweight & obesity statistics. Web.
Reifsnider, E., Shin, C. N., Todd, M., Jeong, M., Gallagher, M., & Moramarco, M. (2016). How did they grow: An intervention to reduce stunted growth in low-income Mexican-American children. Research in Nursing & Health, 39(2), 105-120.
Rogers, R., Eagle, T., Sheetz, A., Woodward, A., Leibowitz, R., Song, M., … Eagle, K. (2015). The relationship between childhood obesity, low socioeconomic status, and race/ethnicity: Lessons from Massachusetts. Childhood Obesity, 11(6), 691-695.
Tucker, S., & Lanningham-Foster, L. (2015). Nurse-led school-based child obesity prevention. The Journal of School Nursing, 31(6), 450-466.