An Exploratory and Evaluative Study of the Prevalence, Related Knowledge, Attitude and Effectiveness of Awareness Program Regarding obesity among Students of Selected Degree Colleges in Mysore City

Ms. Amal Mathews, Mrs. Janet Mathias, Mrs. Usha M. Thomas,

Prof. Sheela Williams, Mrs. Anitha V. Noronha

Department of Medical Surgical Nursing, JSS College of Nursing, Mysore, Karnataka.

Corresponding Author Email: jyamalmathews@gmail.com

ABSTRACT:

Over the decades, the prevalence of obesity among adults and children have increased dramatically and it has now reached at its extreme proportion and stands as a major contributor to the global burden of chronic disease and disability. The aim of the study was to assess the prevalence of obesity and to examine the impact of an awareness program on knowledge and attitude of college students regarding obesity. The prevalence of obesity was determined among 300 college students. In the study, quasi experimental non equivalent control group pretest posttest design was used and non probability convenience sampling technique was adopted to select 90 samples, 45 each in experimental and control group. Anthropometric measurements i.e. the height, weight, waist circumference and hip circumference of the college students were measured by using standardized weighing machine and measuring tape. Structured knowledge questionnaire and structured attitude scale was used to assess the knowledge and attitude of college students regarding obesity. An awareness program was conducted for the experimental group. The analysis of the findings revealed that the overall prevalence of overweight and obesity was found to be 20.00% and 4.77% respectively which puts young females at high risk and claims prior attention. The pretest findings showed that most of the college students had poor knowledge and favourable attitude towards obesity. The awareness program was effective in increasing the knowledge and changing the attitude of college students regarding obesity as the computed ‘t’ (t₄₄=19.32) value was found to be significant at 0.05 level of significance. It was also clear from the findings of the study that there was no significant relation between the knowledge and attitude of college students regarding obesity. There was no association between the pretest level of knowledge of college students with their selected personal variables except for type of family, occupation of parents, childhood eating habits and family history of obesity. None of the personal variables showed significant association with the pretest attitude scores except routine aerobic physical activity. It was concluded that, the prevalence of overweight and obesity is increasing in an alarming rate among college going students and awareness program was effective in enhancing the knowledge and promoting a positive attitude towards obesity among college students. Therefore the study recommends that, it is the need of this hour to organize health campaigns and awareness programs to sensitize young adults to enhance the knowledge and attitude on healthy food habits, healthy lifestyles and a physically active daily routine thereby enabling them to be a healthy citizenry.

KEYWORDS: Obesity, prevalence, college students

INTRODUCTION:

Obesity was rarely seen for thousands of years. Until twentieth century, it was not at all common and only in 1997, WHO formally recognized obesity as global epidemic. It was estimated through the Global Burden of Disease study that, by the year 2020, deaths due to non communicable diseases will be four times higher than the communicable diseases. The non communicable diseases include hypertension, diabetes mellitus, coronary heart disease, stroke and metabolic syndrome where obesity is the common predisposing factor. According to world health organization, in 2005 there were 1.6 billion overweight adults aged 15 years and above and 400 million adults who were obese worldwide.³ The National Health and Nutritional Survey of the year 2005-2006 reported that 32.7% of adults aged 20 years and above were overweight; 34.3% were obese and 5.9% were extremely obese in U.S.⁴

The problem is of a larger magnitude in the developing countries like India where a significant population belongs to a younger age group. According to center for disease control (CDC) in 2000, 15.2 million college students are obese. The CDC also reports that it had increased from 14.4% in 1991 to 20.7% in the year 2000.¹⁰It had been proved that increased consumption of more energy dense, nutrient poor foods with high levels of sugar and saturated fats have led to three fold rise in obesity rates. Decrease in physical activity, increased frequency of dining out, high calorie snacks, junk food revolution, inconsistent meal pattern are some of the forces which underlie the epidemic.

The previous research studies related to obesity suggested that, the overweight and obesity patterns vary from place to place and are associated with factors like age, gender, education, activity level and economical status. The researcher’s experiences too support the fact that college students are more conscious about their weight but are unaware of healthy practices. Hence, the researcher felt, that the study to assess the prevalence of overweight/obesity and to administer a need based awareness program would enhance knowledge and promotes a positive attitude among college students thereby enabling them to be a fruitful citizenry.

STATEMENT OF THE PROBLEM:

“An exploratory and evaluative study of the prevalence, related knowledge, attitude and effectiveness of awareness program regarding obesity among students of selected degree colleges in Mysore city”.

OBJECTIVES:

Objectives of the study were:

1. To assess the prevalence of obesity among students of selected degree colleges in Mysore city.

2. To assess the knowledge and attitude regarding obesity among college students in experimental and control group.

3. To determine the effectiveness of awareness program regarding obesity in terms of gain in knowledge and attitude scores of college students in experimental group.

4. To find the relationship between knowledge and attitude regarding obesity among college students.

5. To determine the association of level of knowledge and attitude regarding obesity among college students with their selected personal variables.

HYPOTHESES:

H₁ :

There will be significant difference in the mean posttest knowledge score of college students exposed to awareness program regarding obesity and those who were not exposed to awareness program regarding obesity.

H₂ :

There will be significant difference in the mean posttest attitude score of college students exposed to awareness program regarding obesity and those who were not exposed to awareness program regarding obesity.

H_3:

There will be significant relationship between the mean knowledge and attitude scores regarding obesity among college students.

H_{4 :}

There will be significant association between the level of knowledge and attitude of college students regarding obesity and their selected personal variables.

Conceptual/ theoretical framework:

The frame work of the study is adopted from Pender’s Health Promotion Model.

Research approach and design :

Exploratory and evaluative approach was used to identify, explore and describe the existing phenomena and its related factors. The research design selected for the study was exploratory survey in phase I and Quasi experimental non equivalent control group pre test ^_post test design in phase II.

Setting of the study:

The study was conducted in JSS Women’s college, Saraswathipuram and Terresian Degree College, Siddarthnagar, Mysore.

Population:

In the present study population comprises female degree college students in the age group of 18-23 years in selected degree colleges of Mysore.

Sample and sampling:

The sample of present study comprises female college students in selected degree colleges of Mysore. Three hundred (300) college students were selected for survey in phase I and ninety (90) college students were selected for phase II with forty five (45) college students each in experimental and control group.

Sampling technique:

Non- probability convenience sampling technique was used in the present study.

Data collection technique and instrument:

The following tools were developed and used to collect the data:

1. Proforma for selected personal variables.

2. Weighing machine and measuring tape to assess anthropometric measurements.

3. Structured Knowledge questionnaire

4. Structured Attitude scale.

Data collection procedure:

Permission for conducting the study was obtained from the authority of selected degree colleges in Mysore. Ethical clearance for conducting the study was obtained from the ethical committee of the college. An informed consent was obtained from each subject to participate in the study. In phase-I, body weight, height, waist ratio and hip ratio was monitored and recorded to assess the prevalence of obesity for 300 college students of selected degree colleges in Mysore. In phase II, On day I, Ninety (90) students who met the inclusion criteria were selected as per sampling technique, 45 students each in experimental and control group respectively and pretest was administered on the same day. Awareness program was given to experimental group on the second day. Posttest was administered to both the groups on the 7^th day. After the post test, awareness program was given to the control group to enhance the knowledge and promote positive attitude regarding obesity.

RESULTS:

Sample Characteristics:

The findings of the present study showed that majority (74.44%) of samples were in the age group of 18-20 years. Most (43.33%) of the samples had to travel 0-1 km from residence to college and 72.22% belonged to nuclear family. Parents of 60% samples, were employed either in private or government settings and had a monthly income of Rupees 12001 and above (54.44%). As many as 46.66% of the samples used to travel to college by walk and 47.88% of the samples participated in games and sports occasionally. Maximum number (91.00%) of the samples opted walking as the routine aerobic physical activity and 37.88% of the samples spent approximately 1-2 hours watching TV. It was found that, 40% of the samples preferred fast food. Almost 67.77% of samples participated in household chores like sweeping and mopping and 40% of the samples had the habit of eating out occasionally but 45.55% of the samples preferred homemade food. Majority (78.85%) of the samples did not have family history of obesity.

The data presented in Table 2 shows that among experimental group the mean difference between pre test and post test scores was -10.58 t₄₄=19.32 indicates that the awareness program had helped to increase the level of knowledge in the experimental group. To find the significance of difference in knowledge, the paired ‘t’ test was computed and the obtained value of paired t₍₄₄₎ = 19.32 was found to be significant at 0.05 level of significance.

2. Prevalence of Obesity:

The data presented in Table 1 shows that majority (71.33%) of the samples had normal weight (BMI= 18.5-24.9), however 20% of samples were in the category of overweight (BMI-25.0-29.9) and 4.77% were obese (BMI-30 and above). It is also evident that, the mean WHR 0.80 which is normal for (86.77%) females, but 13.33% of the sample had WHR> 0.80.

3. Effectiveness of awareness program.

A. Knowledge.

The effectiveness of awareness program regarding obesity paired ‘t’ test was computed and the findings are presented in table 2.

Hence, it was inferred that, there is a significant difference in the mean pretest and posttest knowledge scores of college students among experimental group. Thus, it was concluded that, awareness program was effective in increasing the knowledge of students regarding obesity. Further the significance of difference between gain in posttest knowledge scores of college students among experimental and control group was determined by independent ‘t’ test and the data are presented in table 3.

The data presented in Table 3 shows that the mean difference in post test scores among experimental and control group is 11.73. To find the significance of difference in mean posttest knowledge scores independent ‘t’ value was computed and obtained t₍₈₈₎=20.78 was found to be significant at 0.05 level of significance. Hence, it was inferred that the mean posttest knowledge scores of college students who were exposed to awareness program was significantly higher than the mean posttest knowledge scores of students who were not exposed to awareness program.

TABLE 1 Frequency, percentage and mean distribution of college students based on BMI and WHR n =300

Variable

Frequency (f)

Percentage (%)

Mean

BMI

Underweight (BMI > 18.5)

Normal weight (BMI – 18.5-24.9)

Overweight (BMI-25.0-29.9)

Obese (BMI-30 and above)

214

4.00

71.33

20.00

4.77

19.98

WHR

<0.80

>0.80

260

86.77

13.33

0.80

Table 2 : Mean, mean difference, SD difference, SEMD and paired ‘t’ test of pre test and post test knowledge scores of degree college students among experimental and control group regarding obesity. n =90

Group

Mean

Mean Difference

SD Difference

SEMD

‘t’ Value

Experimental n=45

Pretest

Post-test

19.10

29.68

- 10.58

±0.54

0.51

19.32*

Control n = 45

Pretest

Post-test

18.22

17.22

±0.64

0.72

0.40

t₍₄₄₎ = 2.01; P>0.05; * – Significant; P<0.05

TABLE 3: Mean, mean difference, SD difference, SEMD, and independent 't’ test of post test knowledge scores of college students regarding obesity in experimental and control group. n =90

Group

Mean

Mean Difference

SD Difference

SEMD

‘t’ value

Experimental

n=45

29.68

11.73

±0.89

0.55

20.78*

Control

n =4 5

17.95

t₍₈₈₎ =1.98 ; P<0.05; * –Significant

B. Attitude Gain in attitude:

Comparing pretest and posttest attitude scores.

Significance of difference between pretest and posttest of attitude scores of college students among experimental and control group.

The data presented in Table 4 shows that the mean difference in pre test and post test attitude scores of experimental group is -39.45. This indicates that awareness program had helped college students to gain a positive attitude in experimental group. To find the statistical significance of gain in attitude scores, the paired ‘t’ test was computed and the obtained value of t₍₄₄₎= 22.37 was found to be significant at 0.05 level of significance. Hence, it was inferred that, there is a significant difference in the mean pretest and posttest attitude scores of college students who were exposed to awareness program and those who were not exposed to awareness program. Further the significance of difference between gain in post test attitude scores of degree college students among experimental and control group determined by independent ‘t’ test and the data are presented in table 5.

The data presented in Table 5 shows that the mean difference in post test scores of experimental and control group is 36.98.This indicates that, there was an increase in the attitude scores after undergoing the awareness program. To find the significance of difference in mean posttest attitude scores independent ‘t’ test was computed and the obtained value for the independent t₍₈₈₎= 17.34 was found to be significant at 0.05 level of significance. Hence, it was inferred that mean posttest attitude scores of college students who were exposed to awareness program was significantly higher than the mean posttest attitude scores of students who were not exposed to awareness program.

4. Findings related to the association between level of knowledge and attitude and selected personal variables.

The computed chi-square values to ascertain the association between the level of knowledge and selected personal variables were found to be significant for variables viz. type of family, occupation of parents, childhood eating habits and family history of obesity at 0.05 level of significance and computed chi-square values for other variables i.e., age, distance between college and residence, mode of transport used to travel to college, time spent in watching TV, routine aerobic physical activity, dietary preference, habits of eating out were not found to be significant at 0.05 level of significance.

Table 4: Mean, mean difference, SD difference, SEMD and paired t’ test between pre test and post test attitude scores of college students regarding obesity in experimental and control group. n =90

Group

Mean

Mean Difference

SD Difference

‘t’ value

Experimental n=45

Pretest

Post-test

93.55

133.00

-39.45

±2.69

1.81

22.37*

Control n = 45

Pretest

Post-test

94.66

96.02

-1.36

±0.47

1.82

0.22

t₍₄₄₎ : 2.01; P>0.05; * – Significant P<0.05 ;P< 0.05

Table 5: Mean, mean difference, SD difference SEMD and independent ‘t’ test of post test attitude scores of college students in experimental and control group. n =90

Group	Mean	Mean Difference	SD Difference	SE	Independent ‘t’ value
Experimental	133.00	36.98	±0.98	1.97	17.34*
Control	96.02	36.98	±0.98	1.97	17.34*

‘t’ ₍₈₈₎: 1.98; P<0.05;*- Significant

Hence, it was inferred that, students of employed parents and those who belonged to nuclear family had better options to know more about the hazards of obesity and had better knowledge.

The computed chi square values to determine the association between attitude and personal variables were found to be not significant for any variables except for routine aerobic physical activity indicating that favourable attitude regarding obesity motivated students to participate in aerobic physical activity.

LIMITATIONS:

The limitations of the present study were:

1. This study was limited to college students in selected degree colleges in Mysore.

2. This study adopted non probability convenience sampling, hence the generalization of the findings outside study samples are limited.

3. The sample size was limited to 300 for survey and 90 for experimental study, hence this limits the generalization of findings beyond the study samples.

RECOMMENDATIONS:

1. Similar study can be carried out on a large sample for broader generalization.

2. A comparative study can be performed to compare the eating habits and obesity pattern among urban and rural adolescents.

3. Similar study can be conducted to assess the effectiveness of other educational strategies to improve the knowledge of college students regarding obesity

4. A similar study can be conducted on obesity- related knowledge, attitude and behaviours in obese and non- obese children

CONCLUSION:

The analysis of the findings revealed that the overall prevalence of overweight and obesity was found to be 20.00% and 4.77% respectively which puts young females at high risk and claims prior attention. The pretest findings showed that most of the college students had poor knowledge and favourable attitude towards obesity. The awareness program was effective in increasing the knowledge and changing the attitude of college students regarding obesity as the computed ‘t’(t₄₄=19.32) value was found to be significant at 0.05 level of significance. It was also clear from the findings of the study that there was no significant relation between the knowledge and attitude of college students regarding obesity. There was no association between the pretest level of knowledge of college students with their selected personal variables except for type of family, occupation of parents, childhood eating habits and family history of obesity. None of the personal variables showed significant association with the pretest attitude scores except routine aerobic physical activity. Thus, it was concluded that, the prevalence of overweight and obesity is increasing in an alarming rate among college going students.

REFERENCE:

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2 Kennethe.E. Oghagbon, Valentine.U. Odilil. Body mass index and blood pressure pattern of Students in a Nigerian University. International Journal of Health Research. 2008. une; 2(2):177-182.

3 Serena Low, Mienchewchinl, Mabel. Deurrenberg. Review on epidemic of obesity. Ann AcadMed.[internet].2009[cited 2011 Nov 23]; available from http://www.annals.edu.sg/pdf/.

4 Felicia Schanche Hodge, Suzzanne T. Kotkin-Jaszi. California. Wellness Study. American Indians and obesity.[internet].2009 [cited 2011 oct29 ]; Available from http;//www.cjrp.org/issues SE.

5 Kouteya Sinha. India in the grip of obesity epidemic. [Internet]. 2010 [Cited 2011 Oct23]; available from http://en.wikipedia.org/wiki/Obesity

Received on 11.01.2014 Modified on 28.03.2014

Asian J. Nur. Edu. and Research 5(2): April-June 2015; Page167-171

DOI: 10.5958/2349-2996.2015.00034.8