Health Coaching and Childhood Obesity

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Health coaching is an innovative approach to improving health outcomes and reducing health costs by engaging individuals to change unhealthy behaviors. The purpose of this assignment is to evaluate and develop principal elements in a health promotion
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  Running head: Health Coaching 1 Health Coaching and Childhood Obesity Myrna Davis-Washington University of the Rockies  Running head: Health Coaching 2 Abstract Health coaching is an innovative approach to improving health outcomes and reducing health costs by engaging individuals to change unhealthy behaviors. The purpose of this assignment is to evaluate and develop principal elements in a health promotion coaching program. This paper  presents a health coaching program aimed at a target population of elementary school children who are at risk for health conditions related to childhood obesity. It describes the features of the  program, including the description of what the coaching will entail, the operational aspects (frequency, duration, level of intensity, location, and other important operational features), and how success will be measured.  Running head: Health Coaching 3 Health Coaching and Childhood Obesity According to the Centers for Disease Control and Prevention, childhood obesity , which has more than tripled since 1980, is defined as having a body mass index for age (BMI-for-age; relative weight to height) at or above the 95 th  percentile. In the United States, between 16 and 33  percent of children and adolescents are obese, enabling childhood obesity to surpass drug abuse and smoking as the No. 1 health concern among parents in the United States today. In addition to causing a broad range of health problems (i.e., high blood pressure, type 2 diabetes and elevated  blood cholesterol levels) that were previously unseen until adulthood or adolescence, at the earliest; childhood obesity also undermines children’s  psychological health through low self-esteem, negative body image and depression. Although childhood obesity most commonly  begins between the ages of 5 and 6, and during adolescence, studies have shown that children who are obese between the ages of 10 and 13 have an 80 percent chance of becoming obese adults. One sobering correlation in all these statistics is that childhood obesity has been linked to higher and earlier morbidity rates in adulthood. In other words, the 80% of overweight children who have overweight parents will grow up to become overweight adults. Childhood obesity also has economic and social implications; unhealthy weight gain due to poor nutrition and lack of activity or sedentary lifestyles cause over 300,000 deaths each year and cost the nation up to $14  billion each year. These numbers will continue to increase with earlier onsets of chronic diseases such as diabetes and heart disease and the burgeoning of a less healthy and less productive generation who will undoubtedly bequeath their health behaviors to their heirs; unless parents and obese children change their health behaviors by adopting and maintaining healthier patterns of eating and activity. (American Academy of Child & Adolescent Psychiatry [AACAP], 2008; American Heart Association [AHA], 2011; Lovejoy, 2010; Shapingamericasyouth, 2011)  Running head: Health Coaching 4 The purpose of this assignment is to evaluate and develop principal elements in a health  promotion coaching program. The perspective of this paper is that of a health professional who has been asked to implement a health coaching program aimed at a target population of elementary school children who are at risk for health conditions related to childhood obesity. This paper describes the features of the program, including the description of what the coaching will entail, the operational aspects (frequency, duration, level of intensity, location, and other important operational features), and how success will be measured. What Does Health Coaching Entail? Childhood obesity is probably the easiest medical conditions to identify; yet, it is one of the most difficult conditions to treat because children are not in control of their diets or activities and effective treatment must include parental involvement. In spite of educational programs, social stigma, and a plethora of popular diets, obese children and their parents continue to be obese or overweight. Health coaching is a new trend in health care that is quickly gaining the attention of healthcare providers and health professionals as an effective program for the treatment of childhood obesity. As a structured, supportive partnership between the child and the coach, health coaching improves health outcomes and lowers health costs by effectively motivating behavior change. Rollnick, Miller, and Butler (as cited in Huffman, 2010) found that individuals who received health coaching, versus the traditional model of care, were more likely to increase exercise, improve glycemic control, reduce salt and sodium intake, and have fewer hospitalizations. (Huffman, 2010) Health coaching encourages children and their parents to "discover" and address their ambivalence about health behavior change through conversations designed to elicit behavior change by exploring and resolving ambivalence. When treating childhood obesity, health  Running head: Health Coaching 5 coaches refrain from telling children and their parents what they need to do and, instead, use the children’s ' agendas to guide conversation within a new framework. The three basic concepts of this program are: (1) work from the children's agenda (what is of most concern relative to health factors; beliefs and values); (2) use active listening (which requires conscious effort on the part of the health coach to reflect on what the child and his or her parents have said); and (3) engage in change talk (i.e., "I believe I can do it", "I need more support with meal planning", or "I went on the Internet to read about Kids Walk-to- School program”) which identifies individual readiness for change. (Huffman, 2010) The health coaching strategy involves a two-part plan for preventing weight gain above what is appropriate for expected increases in height. The first part consists of a dietary treatment  program involving small but permanent changes in eating (i.e., learning healthy eating habits, reducing caloric intake, gradual weight change, parental involvement, and strong social support of dietary intervention from others involved in preparing food); and (2) a regular physical activity prescription consisting of participation in Kids Walk-to-School (2011) and social support. The importance of continuing these lifestyle changes well past the initial treatment  period will be emphasized to the entire family. (AHA, 2011; Huffman, 2010; Kids Walk-to-School, 2011) Operational Aspects  The health coaching program consists of: (1) participation in an online program (Kids Walk-to-School, 2011) to help parents and caregivers promote healthy habits for children; (2) for  parents, a week-by-week, structured approach to improving family health and reducing risk for childhood obesity; and (3) clear, easy-to-implement strategies that parents and children can incorporate into their daily lives. The online program is personalized and includes a range of
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