Question

Obesities prevention in secondary school children of victoria. what will be the health promotion model,health promotion policies at SEM levels in Primary prevention?

Answer 1

Childhood obesity immediately and distally impacts physical and psychological health . The stubbornly high prevalence of obesity globally and persistence of childhood obesity into adulthood with resultant increased morbidity and mortality highlights the imperative to develop effective prevention and monitoring strategies for childhood obesity.

Evidence of success in preventing childhood obesity in a variety of specific settings (e.g., school-based , community-based ,home-based is tempered by challenges in sustaining the long-term impact of these interventions and applying the interventions at the population level .The most recent Cochrane review of obesity prevention has identified that multifaceted and multilevel strategies are required to prevent obesity. The Foresight Obesity Systems Map provides corroboration for this assessment through the visualization of obesity as a complex systems problem .Support is growing for population level efforts to prevent childhood obesity to apply systems thinking in the expectation that systems thinking may improve intervention implementation, effectiveness and sustainability of changes. To date, no known initiative has applied a ‘whole of systems’ approach to prevent childhood obesity. Healthy Together Victoria’s (HTV) large-scale complex whole of system approach to the primary prevention of chronic disease, in the state of Victoria, Australia is a world first. Taking a population-level approach to reducing chronic disease and specifically obesity through improving associated determinants (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in the specific communities where they “live, learn, work and play”

Commencing in 2012, HTV’s multi-faceted intervention includes a boosted capacity at the local level of >170 staff in 12 communities .These personnel were employed to support and deliver ‘system activation’ for healthy environments and healthy living in schools, early childhood settings, workplaces and communities through a variety of means. Systems activation refers to initiating actions on the systems that influence the health and well-being of individuals, families and communities. These actions include delivering multiple strategies, policies and initiatives at both the state and local levels to target all Victorians. Complementing the state-wide systems activation and programs, HTV also contributes resources and effort towards improving the health of children through a quality framework to support the creation of healthier school environments through a range of services such as the Healthy Together Victoria Achievement Program and Healthy Eating Advisory Service and is complemented by a range of community based healthy living programs and state-wide and local social marketing of health promotion messages.

HTV includes a cluster randomized trial of the ‘whole-of-system’ intervention. With increasing intervention complexity, evaluation approaches require a degree of flexibility in order to accordingly engage with complexity. In this paper, we outline the methodological approaches that will be taken to comprehensively measure the impacts of HTV on childhood obesity through two parallel research programs with the following aims:

1. To measure the impacts of HTV on anthropometry and obesogenic behaviors among Victorian children and the environments in which they live, learn and play

2. To measure the effects of change to community-level system factors on rates of childhood obesity among Victorian children.

Health Promotion and Wellness efforts aim to address sexual violence by applying the public health framework of primary prevention. The purpose of primary prevention is to try and prevent violence before it occurs by eliminating exposure to situations that could lead to violence, changing behaviors that could lead to violence, and creating an overall culture of respect that does not tolerate any type of violence.

Types of Prevention

In public health, there are three types of prevention. Health Promotion and Wellness’s violence prevention work is mainly within the realm of primary prevention, yet it is important to understand all three types.

• Primary Prevention: aimed at the general population, primary prevention seeks to reduce incidences by preventing risk and vulnerability. Examples include education and legislation about proper seat belt use, regular exams/screenings to monitor risk factors for illness, and education about health behaviors such as good nutrition and the effects of tobacco.
• Secondary Prevention: targets and existing risk factor and seeks to remove or reduce it. Examples include recommending regular exams/screenings for people with known risk factors for an illness and providing workplace modifications for injured works.
• Tertiary Prevention: implemented when a condition exists and seeks to minimize further complications or negative outcomes. Examples include cardiac rehabilitation after a heart attack, patient support groups.

Socio-Ecological Model

Health Promotion and Wellness focuses on primary prevention through the implementation of the Socio-Ecological Model (SEM) . The Socio-Ecological Model incorporates multiple levels of primary prevention ranging from personal to societal. Illinois State University and Bloomington-Normal have developed programs, policies, and initiatives that work with national components to address each level.

Individual Level

• Alcohol Wise course  
• Not Any More course
• Redbird Respect: Bystander Empowerment
• Restroom Messages

Interpersonal/Relationship Level

• The Body Project
• G Spot Wellness Gazebo
• Wellness Ambassador Programs: Students and Faculty/Staff
• Alcohol Education – Sanction

Community/Organizational Level

• Alcohol Policy http://deanofstudents.illinoisstate.edu/conflict/conduct/code/
• Anti Harassment & Non-discrimination Policy
• Campaigns: Redbird Respect, Its On Us ISU
• Bloomington Normal Community Campus Committee (BNCCC) coalition addressing high-risk drinking
• American College Health Association Standards of Practice

Public Policy/Societal Level

• Healthy Campus 2020
• Sexual Assault Prevention in Higher Education – Illinois
• Title IX
• Clery Act
• VAWA

Sources

• Shifting the Paradigm: Primary Prevention of Sexual Violence Toolkit. American College Health Association

Causes of Violence

Research on violence has increased our understanding of factors that make some individuals more likely to commit violence  

Below are factors that increases the likelihood of a person committing a violent act. These risk factors are not direct causes of violence. Instead, risk factors contribute to violence.

Individual Risk Factors

• Alcohol and drug use
• Delinquency
• Empathic deficits
• General aggressiveness and acceptance of violence
• Early sexual initiation
• Coercive sexual fantasies
• Preference for impersonal sex and sexual-risk taking
• Exposure to sexually explicit media
• Hostility towards women
• Adherence to traditional gender role norms
• Hyper-masculinity
• Suicidal behavior
• Prior sexual victimization and/or sexual criminal history

Interpersonal/Relationship Risk Factors

• Family environment characterized by physical violence and conflict
• Childhood history of physical, sexual, or emotional abuse
• Emotionally unsupportive family environment
• Poor parent-child relationships, particularly with fathers
• Association with sexually aggressive, hypermasculine, and delinquent peers
• Involvement in a violent or abusive intimate relationship

Community/Organizational Risk Factors

• Poverty
• Lack of employment opportunities
• Lack of institutional support from police and judicial system
• General tolerance of sexual violence within the community
• Weak community sanctions against sexual violence perpetrators.    

Societal Risk Factors

• Poverty
• Lack of employment opportunities
• Lack of institutional support from police and judicial system
• General tolerance of sexual violence within the community
• Weak community sanctions against sexual violence perpetrators

Protective Factors: anything that decreases the likelihood of a person being a perpetrator / committing a violent act. Research in this area is ongoing; however, there are a few protective factors that have been identified.

• Parental use of reasoning to resolve family conflict
• Emotional health and connectedness
• Academic achievement
• Empathy and concern for how one’s actions affect others