The Role of Parents in the prevention of early childhood obesity

A. Using the Capstone template, develop Chapter 1 as you provide an introduction (suggested length of 46 pages) that explains the rationale for the project by doing the following:

1. Present your topic.

2. Explain why you chose the topic.

3. Discuss why the project is important to your discipline.

B. Explain the problem (suggested length of 35 pages) by doing the following:

1. Outline the problem.

2. Provide background information of the problem.

3. Discuss possible causes of the problem.

C. State your research questions and hypotheses, if applicable.

D. Create Chapter 2 by providing a thorough and well-organized literature review of professional sources by doing the following:

1. Outline research for best practices for your topic.

2. Summarize the professional literature relevant to the topic you have chosen.

3. Provide a conclusion that interprets how the literature applies to the problem being investigated.

Note: The required number of sources varies by program. Please refer to the course of study for your programs requirements.

E. Provide your preliminary reference list.

F. When you use sources, include all in-text citations and references in APA format.


Table of Contents

Chapter 1. 3

Introduction. 3

Presentation of Topic. 3

The Role of Parents in the prevention of early childhood obesity. 4

The role of Schools. 4

Explanation of the Topic. 5

Rationale of the Study. 7

Problem Description. 9

Background of the Problem.. 10

Research Questions. 11

Hypothesis. 12

Definition of Terms. 12

Summary. 12

Chapter 2 Literature Review.. 14

Introduction. 14

Influencing Factors that Lead to Early Childhood Obesity within the Family Environment. 14

Strategies That Influence the Minimization of Early Childhood Obesity. 17

Barriers to Resolution of Early Childhood obesity. 18

Factors That Negatively Affect the Fight against Childhood Obesity. 18

Barriers to Strategies Used to Minimize Early Childhood Obesity. 19

Best Practices against early childhood obesity. 20

Best practices in active parental involvement. 20

Best Practices That Address Factors That Negatively Affect the Fight against Childhood Obesity. 21

Strategies that are Used in the Minimization of Early Childhood Obesity. 21

Summary of Literature Review.. 22

Conclusion. 23


Chapter 1


This section of the document introduces the research topic “Assessing Knowledge and Concern Level of Low Income Parents of Preschoolers” by first of all defining the meaning of the topic and then providing a rationale for the research by explaining the importance of the findings to the key stakeholders in children’s healthcare.

Presentation of Topic

For an appropriate presentation of that the title of this study means, it will be necessary to employ a bottom up approach whose presentations will be moving from the general to the specific. The nursing profession is generally concerned with the provision of healthcare. These healthcare services are provided across the entire population regardless of whether one is young or old. The stakeholders in healthcare are also determined by the subjects of any given intervention measure being taken against a condition that is risky for one’s health. This study’s main focus with respect to the population is children of preschool age and the condition in question is obesity which is basically a situation in which a person’s (or in this case a child’s) weight is way above what is recommended by the healthcare fraternity.

The key stakeholders in the healthcare of a child are the child him or herself, the parents and also the healthcare providers who will be consulted in hospital or clinics from time to time. Among these stakeholders only two qualify to be decision makers in the child’s healthcare. These two are healthcare professionals and parents. The healthcare professionals targeted here are the nurses since they have significantly more contact hours with the pre-school age patients than doctors will. The reason why nurses and parents qualify as key decision makers in the healthcare of the children is the fact that their respective positions in the life of the child as well as in society impose some obligation on them. Parental obligation makes the child’s parents or guardians responsible for the healthcare of the child. This is because they are the primary caregivers and this therefore implies that they provide the children with all their basic needs, healthcare included. Nurses on the other hand have their professional obligations as appropriately captured in the Hippocratic oath they take to do all they can in their capacity to ‘preserve life’ and with respect to the context of this discussion this is the life of pre-school age children being talked about.

The Role of Parents in the prevention of early childhood obesity

With regard to parents it is necessary to highlight the fact that their capacity to attend to the needs of the child is directly determined by the resources that the parents have access to (Jurkowski et al, 2013). The measure of one’s resources can be termed as the wealth one has and this is conventionally determined by the income level of the parent. Income is directly proportional to the wealth of a person and what this implies is that a high income means access to greater resources and thus more wealth (Grandoni, 2011). Low income on the other hand therefore means that the parents have access to less resources and as a result they control a smaller volume of wealth. Those whose income is very low can at times be considered to be living in poverty though there are more complex parameters that come into play in the determination of poverty. As thus, the study will look at it as low income. With low income, the limitations imposed on parents affect the quality of healthcare their children access as well as the quality of living and food the children eat. The issue of food is of central importance to any discussion about obesity. This comes from the direct correlation between a person’s food intake and obesity.

The role of Schools

Given the fact that parents have an influence over the schools where the children attend, it is also worth noting that schools though to a lesser degree, schools are also targeted by this study. This is because other than education, schools also provide children with an opportunity for physical activities through organized sports, outdoor games and in the case of pre-school age children playgrounds (FRAC, 2011). At the same time, these schools also provide food to children during the day in the cafeterias. This implies that the two key determinants of obesity, nutrition and activity are partly handled by the schools making their privity to the findings a necessity.

In a nutshell, the title foreshadows discussions and analyses to be made in this study regarding the implications of parental concern on the issue of early childhood obesity for pre-school age children. Parents whose concern is focused on are those who fall into the low income bracket. The point of view that this study is being approached from is that of a nursing professional and this arises from the fact that nurses are the primary source of healthcare information for pre-school age children as well as the same people who are involved in the analysis of measures conducted on these children to determine whether their weight is acceptable or obese. Another reason why this approach is favored is the fact that any healthcare complications arising from childhood obesity will also be handled majorly by nurses, save for the relatively fewer incidences when the physicians or doctors will interact directly with the children.

Explanation of the Topic

The main reason why this topic was chosen as an area for further interrogation is the fact that healthcare journals and news reports are increasingly reporting about the dangerously high rates with which lifestyle diseases are spreading in the United States and across the world. Obesity in itself is not a disease but it is a risk factor to several lifestyle diseases that are centered around the cardiovascular system (Franks et al, 2010). These include diseases such as heart disease, diabetes type 2, stroke and hypertension among others. Obesity and by extension being overweight is a tell-tale sign of a person’s body storing and carrying around too much fat and this is what leads to the mentioned cardiovascular diseases (CDC, 2013).

The increasing number of cases of disease and death being associated to cardiovascular conditions is a cause for concern specifically since it is now breaking traditional barriers of age and income level (JAMA, 2010). For the better part of the previous century, cardiovascular diseases have been associated with the elderly who contract these diseases due to a sedentary lifestyle as well as complications associated with the aging process. At the same time, lifestyle diseases were largely associated with the wealthier people in society who have higher incomes and thus access to luxuries that increased their propensity to such diseases.

Obesity, a condition characterized by an individual having too much weight was considered a condition mainly experienced by the rich. Today’s healthcare statistics seem to be the ‘polar opposite’ of the above. This is because the current trend shows that the age bracket that is being affected by cardiovascular diseases seems to be expanding downwards meaning that a larger number of younger people are being diagnosed and treated for these health complications brought about by obesity (Ogden et al, 2012). The thing with cardiovascular diseases is that they never strike once. The norm is for them to remain underlying for a long period of time, usually a number of years before the symptoms become full-blown with observable symptoms. The number of people from the low income bracket who are being diagnosed with these diseases is also on the rise. Since the chances of finding out from pre-school age children about the dynamics of obesity is futile, logic dictates that the concern of their parents be investigated so as to shed more light on the matter and in so doing contribute towards the reversal of the deadly trend at hand.

Rationale of the Study

Importance of this Project to Nursing

The reason why this project is important to the nursing discipline is the fact that its findings have the potential to improve the practical as well as theoretical aspects of intervention measures that are currently being taken to address the issue of early childhood obesity among pre-school age children from low income households. The issue of healthcare has been a thorny issue in the United States owing to the fact that the different political forces have been pulling in different directions with respect to the provision of Universal healthcare. The main aim of universal healthcare is to ensure that nobody misses out on the much needed healthcare on the basis that he or she cannot afford the same. This is mainly aimed at capturing the low income population in the government’s national healthcare objectives. At present however there is still a severe shortage of healthcare facilities available to this population and the little which they access is often overwhelmed by the sheer numbers of people seeking health services. This conversely waters down the quality of healthcare they access. As a result, early childhood obesity among those in this population is poorly handled at best, possibly leading to the increasing number of members of this population segment being found to have the healthcare condition. Parental concern for the healthcare of the child is highly influenced by the input of nurses who are the professionals and thus perceived as those with a greater amount of knowledge on the matter.

In healthcare and by extension the nursing profession there are two general forms of intervention that can be taken. They are preventive care as well as reactive care. Preventive care is the process of taking measures to ensure a disease is averted. Reactive measures on the other hand are deliberate actions that are taken to treat a disease whose infection has already taken place. In this context obesity can be taken as a disease but purely for the purpose of giving the intervention measure meaning. As a practicing nurse, one is expected to provide sound advice to parents so as to increase their level of concern and also ensure that their concern is appropriately channeled towards the aversion or treatment of early childhood obesity. This therefore means that this information will have the effect of improving the nurse’s quality as a worker in the healthcare system given he or she will be actively participating in making sure parents from low income households in the fight against early childhood obesity.

The findings of this project can also be used as a viable yardstick in the measurement of the efficacy of approaches employed by existing nurses in combating early childhood obesity. This can be carried out introspectively or institutionally. When the analysis is done introspectively, nurses are supposed to compare the findings against the measures they presently take through simple reflection upon one’s methods. When they are applied institutionally, the general scheme of work that is followed within a given healthcare institution with regard to the approach in combating early childhood obesity can be analyzed against the findings. This would be best done for hospitals and clinics that are found in low-income neighborhoods since the parents found in these areas were the ones featured in the research project. In short, the nursing discipline stands to gain in terms of the capabilities of the professionals with regard to their work in combating early childhood obesity.

Problem Description


It has been noted that the rate of obesity in pre-school age has been increasing at a very high rate. This is therefore indicative of an increasing number of children being exposed to the health complications associated with obesity (CDC, 2013). Many of these are cardiovascular diseases. The main issue that arises with regard to this situation is the role that the parents play in this.  This is because they are the children’s primary care-givers and are clearly failing in ensuring quality healthcare for their children. The concern that these parents have is clearly wanting. This is based on observations that have been made by United States government’s Center for Disease Control and Prevention (CDC).

In the United States, pre-school age lies between two and a half years up to four years. Determination of low income is however not as direct.

Increasing rate of obesity cases over the years

            According to the CDC (2013), the childhood obesity rate almost tripled in preschool children (ages 2-5) from 5 to 14 percent over the past 30 years. Three key symptoms of early childhood obesity are having a higher than normal Body Mass Index or BMI which is an estimation of the total mass carried in relation to the height. The second key symptom of childhood obesity is overeating by the said child. The third symptom of childhood obesity is an overly sedentary lifestyle on the side of the child. Basically he or she prefers to avoid most of the activities that their peers are engaging in (Taveras, 2010). A lack of parental concern will therefore be indicated by a limited knowledge of how these dynamics affect the children’s chances of avoiding or overcoming obesity.

Failure of strategies to combat obesity

Unfortunately however, most if not all of the anti-obesity effort that are taking place by the healthcare system deal with both the symptoms and the intervention measures relevant to the different situations. This is indeed a noble initiative and it even deserves the tag ‘commendable.’ One crucial aspect that repeatedly gets overlooked however is the degree to which parents are concerned about the issue of obesity and its potential effect on their children.

Implications of low income on obesity

The United States of America like any other developed country has problems relating to uncomfortably high levels of income disparity whereby the gap between the rich and the poor is large. In such situations, the population of people considered to be in the low income bracket is usually disproportionately high. The United States of America is no exception. A study conducted by the Census bureau revealed that almost half of the country’s population (48%) are  considered to be in the category of low income. This is based on their net annual income falling below the level of 45000 US Dollars. That is a figure of 146.4 million people. In this group there were those whose case was extreme given the fact that their annual income fell to less than 24000 US Dollars a year. These individuals total just under 50 million. The study is mainly concerned with parents who fall in this category. Judging from the numbers, it is safe to state that the number of parents the study is concerned with is quite a large number (Grandoni, 2011).

Background of the Problem

Statistics that are available from the Center for Disease Control online database show a worrying trend with respect to obesity in children (CDC, 2013).

Research studies that have been conducted to investigate obesity in the United States have revealed that a child’s being obese at the age of two years ultimately increases the chances of him or her being an obese adult and this therefore leads to an early onset of the health complications that result from this state of having excessive weight (Franks et al, 2010). To put this in perspective it is necessary to make use of statistics on early childhood obesity that the CDC has. The comparison in the portion of America’s child population affected by obesity was done for the year 1980 and this was analyzed against data from 2010. Over this 30 year period, the percentages of children who have obesity have steadily risen. In 1980, only 7% of the child population aged between six and eleven years had obesity. Thirty years later, the number of obese children in this age group increased to 18%. A similar increase was noted for those who are between the ages of 12-19 years where the population went up from 5% to 18% over the same period (Babey et al, 2011).

Negative implications of obesity on a person’s health

Given the fact that obese children have an increased risk of being obese adults, their conditions are literally setting them up for a myriad of health complications that adults have due to compromises to their cardiovascular systems (American Academy of Pediatrics et al, 2012). The gravity of this matter is emphasized by the fact that a child who is obese at two years stands a higher chance of maintaining state until adulthood (Wells et al, 2010). Other than cardiovascular diseases, other complications associated with obesity include psychological problems and a number of cancers. Social problems are mainly stress related such as depression. The cancers that are associated with obesity include colon cancer, breast cancer and other cancers that are promoted by a buildup of fat in a person’s system (CDC, 2013).

Research Questions

  1. What are the health educational needs of low income parents of preschool-aged children to increase their obesity and prevention knowledge to effectively prevent early-childhood obesity?
  2. How many low income parents of preschool-aged children will state that they do not need additional health education to effectively prevent early childhood obesity?
  3. What number of low income parents of preschool-aged children is in need of obesity and prevention health education indicated by their test scores?


There exists a relationship between the knowledge and concern of low income parents and the increasing rates of obesity in preschoolers

Definition of Terms

Obesity: a healthcare situation characterized by excessive fat in comparison to muscle and bone mass. This is often determined by comparison of the weight to the height. (CDC, 2013)

Calorific Imbalance: A condition in which the body’s intake of calories greatly exceeds the output of the same. (CDC, 2013)


This chapter generally introduces the topic of the research project through a critical dissection of the different components of the title. The subtopic on the rationale of the study addresses the significance of the research to different stakeholders in the healthcare of children, namely the parents, nurses and to a lesser extend the schools attended by these children. This is then followed by a problem description that critically analyzes the issue at hand, increasing cases of childhood obesity along with a background of the issue addressed from a healthcare perspective. Following these, the project’s hypothesis and research questions are also listed in the final section of the chapter. In a nutshell, the research into parental concern spurns from the fact that they are the most influential decision makers in the healthcare and life of children who are increasingly being exposed to the risk of being obese which spells potential doom for their health. This issue is a particular concern for low income households.

Chapter 2 Literature Review


Below is a review of 30 sources of literature on early childhood obesity and the implications of low income on its occurrence. These sources broadly fall into three categories that include the factors that influence obesity in low income households, obstacles to the effective remedying of this situation in the United States and also selected best practices of strategies that have been found to be effective in combating early childhood obesity.

Influencing Factors that Lead to Early Childhood Obesity within the Family Environment

The influence of parents’ income

Singh et al, (2010) also touched on the influence that income has on childhood obesity. While Evans et al focused on ethnicities, these authors focused on the geographical distribution of incomes across the country and compared the data to the distribution of obesity rates across the United States. The study conducted by Singh et al (2010) exposed the similarity between low income areas on the map with high levels of childhood obesity while the more affluent regions on the map had lower levels of childhood obesity. These factors come into play in the child’s early infancy as well as during the mother’s pregnancy. According to the study, the feeding habits such as weaning of the child as well as exclusive breastfeeding directly influenced the proportion of children who had high adiposity and consequently obesity. A specific measure to counter this is to tackle childhood obesity at infancy through adherence to a balanced diet for the children (Singh et al, 2010).

Influencing Factors That Negatively Affect the Fight against Childhood Obesity

The barrier of parents having inadequate skills

Still on intervention measures, it was established by Pockock et al (2010) that there exists a disconnect and gap in knowledge between parental beliefs about the same and effective action that is expected to follow.  The study that was conducted by Pockock et al (2010) revealed the fact that majority of parents believe in the effectiveness of early intervention measures in the prevention of and overcoming of early childhood obesity. The results of this study were based on the notion that parental opinions about healthcare are considered very influential in the healthcare of their children. The view demonstrated by majority of the parents interviewed illustrates the existence of the right attitude. However the lack of knowledge on actual measures implies that the very little is being done to actually combat the situation of childhood obesity (Pockock, 2010). It is therefore necessary that this positive attitude held by parents be accompanied by the actual knowledge and this then throws the ball back in the court of healthcare providers who are expected to equip parents with the appropriate knowledge that will help them to ensure their children avoid early childhood obesity.

Possible Causes of Early Childhood Obesity in Low Income Households

Obesity is caused by a medical phenomenon known as a ‘calorific imbalance.’ This term is applied to the situation in a person’s intake of calories is significantly higher than the output of the same (Krebs et al, 2007). There are natural as well as artificial causes of this calorific imbalance. The natural cause is genetics and this happens if one’s genetic make-up makes him or her predisposed to retain fat easily and therefore gain weight more easily than other people. This study’s design is however biased towards the artificial causes of obesity. They are commonly referred to as lifestyle factors and they take into account the type of food one takes together with the activity levels that can be observed in a person’s life (CDC, 2013).

Since the focus of this study is the concern of low income parents, it is necessary to analyze the determinants associated to them. In a study conducted by the Food Research and Action Center, FRAC (2010), it was established that there were six main reasons why people in the low income bracket had a higher likelihood of being obese or overweight.

The first of these is that their limitations with respect to resources denies them access to healthy foods. Most of the low income neighborhoods in the United States are not served by large supermarkets that stock up on healthy foods in variety. Such supermarkets are usually located far from these neighborhoods and the convenience stores that are available stock up on cheaper, less nutritious foods that provide more calories for the dollar. As a result, these people tend to miss out on low fat products and instead consume highly processed foods that are of a lower quality. In the few occasions that they have access, it is usually too expensive for them. At the same time, these localities have a higher number of fast food establishments (FRAC, 2010).

As far as physical activities go, there are limited opportunities for those who live in low income neighborhoods and this is brought about by insecurity, a lack of public amenities and also crowded housing arrangements. This means that it is close to impossible for people to enjoy time in public parks, a jog or even a swim. The children have limited time and space for playing in their schools and are therefore less likely to engage in organized sports (FRAC, 2010).

Low income households are characterized by long periods of food deprivation alternating with overeating. When people skip meals to stretch their budgets, they are likely to overeat when they get a chance to eat. The easily accessible high energy foods further increase the likelihood for overconsumption taking place. The term ‘feast of famine’ was coined to refer to the situation in which parents; particularly mothers starve themselves so as to ensure their children do not go hungry. In light of this it is essential to note that studies have confirmed the existence of a link between motherhood obesity and the likelihood of children having the same condition (FRAC, 2010; Anderson et al, 2012).

Higher levels of stress due to issues of inadequate finance, food security and emotional tensions also contribute to obesity in low income neighborhoods (FRAC, 2010). This results from the effects of stress such as unhealthy eating habits as well as hormonal changes that increase the body’s retention of fat.

Low income households also get exposed to a greater volume of obesity-encouraging consumer products such as fast food establishments and video games (FRAC, 2010). This leads to a higher number of people living a sedentary lifestyle and getting obese.

People in the low income bracket tend to have limited access to quality healthcare. This diminishes the chances of them getting a proper diagnosis as well as treatment in the event that the available healthcare services are accessed (FRAC, 2010).

Strategies That Influence the Minimization of Early Childhood Obesity

The influence of parental concern

Moore et al (2012) sheds light on the importance of parental concern about the effects of the child’s lifestyle and diet and how these impact the overall health of the child. Concern on the side of the parents creates awareness and this then turns into actual intervention measures. The absence of this concern diminishes any possibility of action being taken against childhood obesity. There are various reasons that could lead to a lack of concern but what is for certain is that this is never deliberate on the side of parents. Their lack of concern about childhood obesity could spurn from a lack of awareness in the first place concerning measures that need to be taken to adequately combat it. The onus is therefore upon healthcare providers in their various capacities to spark this concern that needs to be held by the parents of young children. During consultations, nurses and physicians should enlighten the parents about the implications of different diets as well as feeding methods that are applied to the children. This way the parents’ concern will lead them to be more proactive when it comes to the prevention and management of early childhood obesity (Moore et al 2012).

Barriers to Resolution of Early Childhood obesity

Barriers to the resolution of Early Childhood Obesity within the Family Environment

The barrier of exclusion of parents from intervention strategies

Another factor that hampers the measurers that have been taken to overcome obesity in American society is the lack of involvement of parents in the campaign against the disease. This is because as much as healthcare providers have more knowledge and skills regarding childhood obesity, parents are the ones who spend a longer amount of time with the children. According to Andrews et al (2010), the success of measures being taken against childhood obesity can only be realized through the active involvement of parents in such measures. Lack of involving parents in these initiatives results in a gap between intention and implementation of the various dietary and lifestyle interventions that will ultimately result in success (Andrews, 2010).


Factors That Negatively Affect the Fight against Childhood Obesity

The barrier of unbalanced focus by healthcare providers

In a study conducted by Spivak et al (2010), it was discovered that healthcare providers particularly nurses and doctors mainly focused on the barriers to effective measures of combating childhood obesity. This is the approach that they employed when dealing with patents and communicating relevant information to them. This indicates that while they have important information, this is not relevant since it is tantamount to troubleshooting and presenting these problems in forums concerning childhood obesity. This means that when they interact with parents and patients who have or are at risk of obesity, a large amount of energy is expended dealing with and communicating the barriers that prevent the children from having the correct weight. This in the authors view presents a problem since there is a little effort that is directed towards the actual solution of this health issue. This then indicates that there still exists a gap in knowledge concerning the actual solution of the healthcare issue that is increasing rates of childhood obesity in the United States of America. What Spivak et al (2010) appears to be suggesting is that there is a need for change in the approach employed in the combating of childhood obesity.

Barriers to Strategies Used to Minimize Early Childhood Obesity

The barrier of parents’ low income

Singh et al, (2010) also touched on the influence that income has on childhood obesity. While Evans et al focused on ethnicities, these authors focused on the geographical distribution of incomes across the country and compared the data to the distribution of obesity rates across the United States. The study conducted by Singh et al (2010) exposed the similarity between low income areas on the map with high levels of childhood obesity while the more affluent regions on the map had lower levels of childhood obesity. These factors come into play in the child’s early infancy as well as during the mother’s pregnancy. According to the study, the feeding habits such as weaning of the child as well as exclusive breastfeeding directly influenced the proportion of children who had high adiposity and consequently obesity. A specific measure to counter this is to tackle childhood obesity at infancy through adherence to a balanced diet for the children (Singh et al, 2010).

Best Practices against early childhood obesity

In the fight against obesity, various approaches are being deployed on a continuous basis with the aim of keeping the number of obese children in the United States at a minimum (Instiitute of Medicine, 2009). The increasing percentages of obese children in recent years is indicative of the fact that recent efforts have been mostly insufficient or impractical to the current situation. In the wake of changing trends that place children from low income households at the highest risk of being obese, it is imperative that best practices be highlighted (Ogden et al, 2012). These are not perfect methods but rather approaches that have proven themselves as more effective than the conventional methods in place.

These best practices are listed and expounded upon with the aim of providing a benchmark which can be applied across the United States in the efforts of healthcare stakeholders who are involved in measures against early childhood obesity.  The three key areas where these best practices are applied are in the Child’s home environment, In the minimization of parent-related ignorance and also in the lifestyle of the child. The respective best practices that have been identified for each of these areas are the active involvement of parents, the verification of the level of parental knowledge and also in directly in the lives of the children.

Best Practices Used Against Factors that Lead to Early Childhood Obesity within the Family Environment

Best practices in active parental involvement

According to Andrews et al (2010), it is essential to incorporate parents and assign them an active role in the management of childhood obesity. Many a time the responsibility for looking into a child’s healthcare is left in the hands of practitioners who despite having a wealth of information and skills, lack the contact hours that parents or guardians will have with the children (Anderson and Whitaker, 2010). Such information needs to be conveyed by the healthcare providers to parents so as to make the recommendation for their active involvement a reality (Andrews et al, 2010). This point of view is shared by Reading (2008) whose research found out that a holistic approach involving school authorities, parents and the rest of society were more beneficial in combating obesity for children and adolescents. These measures encompassed physical activities in combination with dietary interventions. In Reading’s study, the effectiveness of such programs came from the seamlessness given that different forums continued with the same program (Reading, 2008).

Best Practices That Address Factors That Negatively Affect the Fight against Childhood Obesity

Best Practices in the verification of  parental knowledge

Another best practice with respect to ensuring parental knowledge on obesity is the provision of pertinent information to the mothers during their pregnancy rather than waiting for the children to be born to give them the information. This is a recommendation that was provided by Shub et al (2013). This not only acts as an early warning system for mothers about the possibility of obesity for their children but also as a means of ensuring adequate psychological preparation for the same (Shub et al, 2013). This counteracts the limited healthcare knowledge held by parents.

Strategies that are Used in the Minimization of Early Childhood Obesity

Children who are not obese or overweight also need to be subjected to a healthy lifestyle that will ensure they avoid obesity in their childhood or at later stages in their lives. This is not to be achieved by forcing them into strict regimes as this may be counterproductive. On the contrary what is desired is a situation in which the children adopt a healthy lifestyle that they can stick to even in the absence of adult supervision. Meals for instance need to be balanced in that each food group needs to be adequately represented in the appropriate quantity (New York Department of Health, 2012; Betson et al, 2011). At the same time, the issue of physical activity through play should be upheld and not taken for granted whether at home or in the school programs (Milteer et al, 2012).

Summary of Literature Review

This section summarizes the literature that has been used in this exercise. The different sources of information that have been consulted in the compilation of data relating to early childhood obesity in low income households have handled the all aspects of this issue. These aspects are obesity itself, the role of the parents, the increasing number of cases of early childhood obesity in the USA. The issue of low income has also been exhaustively handled with respect to its implications on obesity in the United States. All of these have been analyzed from the perspective of a nursing professional with the aim of exploring and exposing the gaps in knowledge that exist with relation to parental concern.

Data relating to obesity highlights the symptoms as well as its implications on the health of the children. Generally, early childhood obesity places the health of the children who have it in potential jeopardy due to the likelihood of cardiovascular diseases and a number of cancers. Statistical information from government agencies such as the CDC show that the number of pre-school age children who are being diagnosed with the same is in the increase. At the same time, this increase is most noticeable in the low income bracket. Data from the Census board indicates that there are millions of people living in the low income bracket as per the government’s definition. The Literature also illustrates the unique way in which children from the low income bracket are highly likely to be obese as compared to the more affluent segments of the population. Obesity is propagated by high calorie diets and low activity levels. The parents’ role in the children’s healthcare is also illustrated given they have the role of primary caregivers for these children.

The section on best practices outlines potentially effective methods that should be employed in the fight against early childhood obesity for pre-school age children. These best practices are grouped into three. The first of these discusses the active involvement of parents. The second mentions the need for verification of the parents’ knowledge while the final one outlines specific measures that can help in the lives of children both proactively and reactively .


The issue being investigated by this project is the level of parental concern regarding obesity in preschoolers in the United States’ low income population. The literature review’s significance to this proposed study lies in the perspective taken as well as the contents of the review. The perspective taken is that of a healthcare professional such as a nurse while the information presented exhaustively highlights the dynamics of early childhood obesity in the context of parents who have low income. The literature review’s highlighting of recent statistical data helps to emphasize the urgency of the matter given that children from the low income population are seen as the ones who are most exposed to the risk of obesity and conversely the health complications it brings later on in life. This data will also act as an ideal point of reference for the researcher during the design of the research tools and also at the data analysis stage. The different sections of the review show the importance of parental concern in the issue of early childhood obesity. This however appears as a gap in knowledge thus making it a viable topic for further investigation.


Akhtar‐Danesh, N., Dehghan, M., Morrison, K. M., & Fonseka, S. (2011). Parents’ perceptions and attitudes on childhood obesity: AQ‐methodology study. Journal of the American Academy of Nurse Practitioners, 23(2), 67-75.

Akinbami, L. J., & Ogden, C. L. (2009). Childhood overweight prevalence in the United States: the impact of parent-reported height and weight. Obesity, 17(8), 1574-1580.

American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education (2012). Preventing childhood obesity in early care and education: selected standards from caring for our children: national health and safety performance standards; guidelines for early care and education programs. 3rd ed.;

Anderson, S. E., & Whitaker, R. C. (2010). Household routines and obesity in US preschool-aged children. Pediatrics, 125(3), 420-428.

Anderson, S. E., Gooze, R. A., Lemeshow, S., & Whitaker, R. C. (2012). Quality of early maternal–child relationship and risk of adolescent obesity. Pediatrics, 129(1), 132-140.

Andrews, K. R., Silk, K. S., & Eneli, I. U. (2010). Parents as health promoters: A theory of planned behavior perspective on the prevention of childhood obesity. Journal of health communication, 15(1), 95-107.

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