INTRODUCTION:

Adolescence is a phase usually between 10-19 years, in which children undergo rapid changes in body size, physiological, psychological and social functioning as stated by Gupta. The adolescent is particularly vulnerable to certain peculiar eating, disorders on account of hormonal and physiological changes say anorexia, burlier and obesity. Obesity is becoming global epidemic courtesies throughout the world are experiencing a marked increase in the prevalence of obesity annoy children and adolescent.

The distressing problem is growing due to many changes in lifestyle caused by industrialization urbanization, globalization and technological advancement. Life style behavior are known to track from childhood to adulthood, the lifestyle changes has influenced many cultural and daily activities of person increasing the list for various health problem.

Lassoer highlighted in his article obesity as growing problem in India. 7.9% all of cases of obesity worldwide found among Indian Urban families. Obesity is associated with increased morbidity in adult hood studies revealed that obese adolescent often experience social problems, prejudices and discrimination, not only from general public but also from health professionals and this may make them reluctant to educate them about obesity and its consequences and how to maintain weight in order to improve their health

OBJECTIVES:

1. To assess the factors contributing to obesity among adolescents.

2. To evaluate the effectiveness of nursing intervening towards modification of health among adolescents in reducing obesity.

3. To find out the association between the contributing the factors to obesity among adolescent.

HYPOTHESIS:

· There is a significant difference between the Pre and Post test knowledge scores on nursing intervention of adolescents regarding obesity.

· There is a significant association between post test scores and selected demographic variables.

CONCEPTUAL FRAMEWORK:

Conceptual Framework based on modified health belief model by Rosen stock and Becke was adopted.

MATERIALS AND METHODS:

Research designs adopted for the study was Quasi experimental design one group pretest and posttest design.

Research Design:

Research design adopted for the study was one group pretest and posttest design.

Variables of the study are:

Independent variable: Nursing intervention towards modification of health of adolescents with obesity.

Dependent variable: Factors contributing to obesity

Setting and Study Population:

The study was conducted in selected schools of Sangrur Districts, Punjab and the study population adolescents of 10-19 years.

Sample size:

The sample size was 400 adolescent studying at schools of Sangrur District.

Inclusion and Exclusion criteria:

Adolescent who can understand English and were willing participate in the study and was available for throughout the study were included in sample.

Sampling technique:

In the present study the sampling technique adopted was simple random technique.

Data collection Tools and techniques:

In the present study the researcher developed and used structured questionnaire to assess the knowledge of the adolescents’ ages between 10-19 years with regards to obesity and lifestyle modification. Before and after administration of STP on obesity and lifestyle modification was developed. BMI also was assessed and the tool was administered through paper pencil method.

Tools for Data collection:-

Section 1: Socio demographic variable – age, gender, educational qualification, education qualification of parents, family income, source of information, schedule of consumption of junk food, pocket money.

Section 2: Questionnaire – Meaning of adolescent, meaning of junk food, causes of obesity, different junk food, ill effects of junk food.

Section 3: Nursing intervention – BMI Assessment, structured health teaching, exercise program, dietary counseling and behavior modifications.

Underweight	:	BMI < 18
Healthy weight	:	BMI = 18.1 to 24.9
Overweight	:	BMI = 25 to 30
Obese	:	BMI > 30

Ethical consideration :

Ethical clearance was taken from Institutions review Board of Himalaya University.

Analysis of Data:

In pretest, adolescents BMI shows 2.3% are under weight, 63% are normal weight 29.5% are overweight and 5.2% are obese. Before nursing interventions, 71.8% of the adolescents are having inadequate knowledge score, 28.2% of them are having moderate knowledge score and none of them are having adequate knowledge score. After the nursing interventions, None of the adolescents are having inadequate knowledge score, 21.5% of them are having moderate knowledge score and 78.5% of them are having adequate score. Considering overall, in pretest, adolescents are having 2.30 score where as in posttest they are having 3.51 score, so the difference is 1.21 score. The difference between pretest and posttest intervention knowledge score on junk food is large and it is statistically significant. Differences between pretest and posttest score was analysed using paired t-test. Considering overall in pretest, adolescents are having 2.30 score where as in posttest they are having 3.51 score, so the difference is 1.21 score.

After nursing interventions, 8.5% of the adolescents are having 45-50 kg, 34.0% of them are having 51-5kg, 52% of them are having 56-60 kg weight and 5.5% of them are having 61-65 kg weight.

Statistical significance was calculated using McNemar test. The association between pretest level of knowledge score and adolescents demographic variables. None of the variables are significant. Statistical significance was confirmed using chi square test. The association between posttest level of knowledge score and adolescents demographic variables. Gender, female, urban, vegetarian and no habit of taking fast food adolescents gained more knowledge than others. Statistical significance was confirmed using chi square test.

DISCUSSION:

The findings of the study have been discussed in terms of the objectives, theoretical base and hypothesis formulated. Findings of the study revealed that the adolescents has low level of knowledge about obesity and lifestyle modification before administration of STP. The simplest method of testing effectiveness of STP is to administer the same set of objectively structures questions before and after the session ad to analyze the difference. In the present study post-test knowledge scores of adolescents were significantly higher than pretest Program. The Structured Teaching programme was found to be an effective strategy in increasing the knowledge of adolescents.

NURSING IMPLICATION OF THE STUDY:

Nursing Implications:

The findings of the study have several implications which are discussed in the following areas:

1. Nursing Administration

2. Nursing Education

3. Nursing Practice

4. Nursing Research

1. Nursing Administration:

Nurse administrators are the backbone to provide facilities to improve knowledge regarding obesity and its prevention. There should be a provision for nurses to devote time for giving health education and conducting school health programmes. Also there is a need to encourage nurses to develop educational material necessary administrative support should be provided to conduct health education in any setting.

2. Nursing Education:

The educational background of a nurse should equip him/her with the knowledge necessary to function as a health education. Health education is the major key to improve the knowledge of adolescents.

Health education programme such as one in the study can be organized by nurses at different levels at high schools, community and parental education making use of power point, charts, videos in order to give lecture discussion at community setup will help to increase the awareness among pupils. The power point presentation could be utilize by the teacher to provide health education to the adolescents regarding obesity and its prevention. This helps the adolescents to gain information on junk food and its ill effects on health.

3. Nursing Practice:

Since the present study shows that most of the adolescents have average knowledge regarding obesity and its prevention. The present study will enable them to enhance their knowledge regarding obesity and its prevention and motivate them to take healthy diet.

4. Nursing Research:

Based on the findings nursing professional and nursing students can conduct further studies on knowledge regarding obesity and its prevention. So nursing students must be motivated and guided to conduct research studies. Presently study tool, structured teaching programme and power point will be used by others or modify it for reuse. The present study can be a source of review of literature for others who are planning to conduct study on the similar topic. The findings of the study can be presented in any conferences and make data available for other nurse researchers. Such studies must be conducted in various schools because today's children are tomorrow's citizens.

CONCLUSION:

The present study concludes that the mean knowledge score of the Pre test was 2.30 whereas; the mean knowledge score of the Post test was 3.51. Further, the enhancement of mean knowledge was found to be 1.21 from Post test to Pre test. The statistical paired ‘t’ test was found to be t=26.37* indicating significant enhancement of knowledge score from Pre test to Post test at P≤0.05 revealing the effectiveness of structured teaching programme on junk food among Adolescents.

RECOMMENDATIONS:

Based on the findings of the study, the following recommendations are made:

1. The study can be replicated in other parts of the country and on large sample.

2. An experimental study can be carried out to find out the effectiveness of a counseling program in reducing the knowledge levels and enhancing attitude strategies of obesity children.

3. An explorative correlative study shall be conducted to find out the relationship between mothers attitude and behavioural problem of children of obesity children.

4. A cross sectional study shall be conducted to assess the impact of culture in attitude behavior of obesity children.

5. An evaluative study on the effectiveness of the knowledge management techniques among obesity children can be done.

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Received on 16.02.2018 Modified on 28.03.2018

Asian J. Nursing Education and Research. 2018; 8(4):517-530.

DOI: 10.5958/2349-2996.2018.00108.8