Graduation project

Our Supervisor

CONTENTS : Objectives Background Information Problem of statement Literature Review Project Paradigm The Conceptual Framework Methodology Add conclusion References

BACKGROUND INFORMATION: Obesity is defined as an excessive accumulation of body fat (MOH,2014). According to WHO over 340 million children and adults aged 5-19 were overweight or obese in 2016. Nationally, in 2017 we found in Oman the rate of obesity in men 20.6% and 36.9 % in women. ( Yousuf ,2017).



BODY MAX INDEX

CAUSES:

EFFECT: The life span of obese people is shorter than normal people for the following reasons



OBJECTIVE: 1. Identify the magnitude of the problem among school-age grades (8-9) in Sur Wilayat. 2. Enumerate the number of students who suffer from obesity by calculating body mass index. 3. Increase awareness among the school students about obesity 4. Modify the unhealthy behaviors that are contributing to the obesity problem among the students. 5. Aid the students to find solutions for the lifestyle behaviors which they follow that in turn can cause obesity

PROBLEM STATEMENT: Obesity is becoming a problem in the world that is growing rapidly. Overweight and obesity occurrence among children and adolescents aged 5-19 has dramatically increased from just 4 percent in 1975 to just over 18 percent in 2016 (WHO, 2018). In the U.S., child obesity influences approximately 12.5 million children and adolescents (17 percent of that population). Approximately over 30 percent of the Gulf countries ' population is obese and more than 60 percent have the highest weight range. Furthermore, in 2017, the percentage of obesity in Oman raised to around 57 percent of the entire population (Andersen & R. Aro, 2019).

School Health Appraisal Report for the academic year 2018-2019 shows that around 100 overweight and 60 obese female students in grade 7 in compare to 28 overweight and 51 obese male in same grade. This indicates that problem of overweight and obesity is a serious issue. The highest numbers of obese students are in Al- Marwah Girls School with 22 cases and in Bild Sur Girls School with 11 cases.

LITERATURE REVIEW: Definition : (WHO.2018) In the 21st century, obesity and overweight are becoming a more significant public health problem, especially among children. The scientists defined obesity, as an accumulated fat that affects health. The statistics showed that 350 million are obese and 1billion over weight in the world.

Body mass index (BMI), which is weight in kilograms divided by height in meters squared, is one of the common ways used to measure obesity. For adults, when a BMI reaches 25.0 to 29.9 kg/m2 is defined as overweight and when a BMI is 30 kg/m2 or higher is defined as obese.

Prevalence (United states) (kingdom of Saudi Arabia) (Kuwait) (Jonathan Q ,Purnell,2018) (Alnohair,2014) •BMI of chilled ,adolescent (Alnohair,2014) •36% male and 48% and adult are increased 74% female are obese. from 1991 to 2001. •28% males and •44% females are obese. •74 % male and 77% •In 2008 ,10% man and females are over weight. 14% women are obese •66% males and 71% are over compeer to 5% of man and weight. 8% of women are obese in 1980.

The annual report of Ministry of health showed that • grade 1 student (2% in 2010 to 9.6 in 2016) • in grade 7(9,7% over weight and 6.7 % obese) •in grade 10 (10.6% overwiegt and 7.8 obese) The number of obese student age group (15-18) •In 2011, 2258 •In 2012,1155 •In2013,2031 •In 2016,2698 •In 2018,3021 •In our region and according to the annual statistics for grade 7 students we found the same differences between female and male. Around 100 overweight and 60 obese female students in compare to 28 overweight and 51 obese male in same grade

(Gulf country) (sultan AL nohair,2014) •Culture restriction in lifestyle •Limited exercise •TV and computer •Multiple pregnancy (In India) (Sunee IPiryani,et al,2016) (EI Kabbaoui M et al,2015) (Morocco

(Caroline M. Apovian et al,2016) Antipsychotics medication that lead to weight gain •30% of patient taking olanzapine •16% of patient taking quetiapine •14% of patient taking risperidone •12% of patient taking perphenazine •7% of patient taking ziprasidone The objective of the study is to investigate the relationship between family history (FH) for obesity and cardio metabolic diseases and the severity of childhood obesity. In this study, Two hundred and sixty overweight and obese children and adolescents (139 female), aged between 2.4 and 17.2 years Maria Francesca,et al, 2018)

EFFECT: More than 3.4 million deaths, Such disease: cancers, Type 2 diabetes, hypertension, stroke, Coronary Artery Disease, Congestive Heart Failure, asthma, chronic back pain, osteoarthritis, pulmonary embolism, gallbladder disease. (Med Sci, 2015 ). The increasing problem of weight and obesity has cost billions of people, not only their wellbeing but also the economy. ( TREVIR NATH, 2019). social rejection. (Roberts et al. 2003)

PREVENTION: A. The first step is to assess weight regularly by counting the body mass index B. increased daily physical exercise(Wirth et al., 2014). C. eating nuts between primary meals because nuts have more fat and it is healthy and aid to feel full Tommy (Johnson, 2019).

School nurses should play a major role in enhancing nutrition and contributing to physical activity to help prevent obesity; National Healthy Schools Program (2016). Physical education policies for all district-level school levels and about 89 percent of districts need schools for teaching physical education ( Nihiser et al., 2013).

PARADIGM: A work breakdown structure (WBS) is a deliverable-oriented breakdown of a project into smaller components. The idea behind any work breakdown structure is to prepare several sections of a project into manageable sections that organizes the team's work. Moreover, it composes project into stages, then work packages then into sub-activities per work-package.

THE CONCEPTUAL FRAMEWORK Health Exhibition Activities Initial Planned activity Intended outcome Phase -Meeting with the officials: -Directorate General of Education. -To know the number of students enrolled in cycle two schools. -Directorate General of Health Services - To know number of obese students in grade 7 in department of: these schools according to the annual screening oStatistical o School Health

Planned activity Intended outcome - Screening of grade 8-9 students -To demonstrate to the student how to calculate the BMI Second Phase -Planning the biggest loser competition -To enumerate the number of students who suffer from obesity by in Al- for 10 students and the competition Marrwah Girls School. -To encourage students to reduce the will last for six weeks. The weight. completion will be under supervision Intended outcome -To increase awareness among the of obese clinic, with coordinating of school students about obesity -To help students and their parents to school schools health and our team. find healthy food alternatives. -To illustrate to the students how they Final Phase Planned activity can maintain their weight. - Conducting the proposed health -To modify the unhealthy behaviors exhibition that are contributing to the obesity problem among the students.

METHODOLOGY

PROJECT DESIGN: It will include four main sections which are detection section. In which we will demonstrate how obesity can be detected and what the main way of measuring obesity. 1/ The section will be carry out by school health nurses and member of our team. 2/. The second section will be about statistics and facts about obesity and what are the services provided by Willayat Sur in order to reduce the obesity problem, members of Sur City Project and some our team member will carry out this section.

3/. third section will be about \" nutrition and diet and alternatives healthy food and will be presented by dietitian and our team member. 4/. The fourth section will be about prevention in which we will emphasis on physical activity and lifestyles behavior that can help participants to maintain their weight. This section will be presented by Sur Youth Complex and a Gym center.

Target Audience: Our target audience will be cycle two school students from grad 5-9 in Sur. Having to know that the total numbers of students in these schools are around 5600 out of which 886 recorded in grade 7. According to statistics 12.5% of students in grade 7 are obese, and 14.5% are overweight. We are aiming to reach 1000 Visitors.

SUGGESTED TIMETABLE FOR THE OPENING DAY ACTIVITIES: The opening ceremony of the health exhibition will organized in the conference hall of our college under patronage of the member of Al-Shura Council Sheikh. Jehad Bin Abdullah Al- Fanna on 9th April 2020. We are planning to invite school health nurses, school principles of targeted schools and officials from both Directorate General of Health Services and Directorate General of Education, teachers and colleagues from our college

PROJECT PLAN Interventions in health promotion and prevention aim to avoid diseases and maintain health. Prevention programs can be classified as behavior-oriented (individual-based intervention). Current prevention approaches have focused mainly on behavioral interventions, while current gaps in obesity prevention lie mainly in the area of community-/environment-based interventions (Weihrauch et al., 2018).

The initial phase: we collect the statistics related to students from directorate general of education, as well as statistics related to the recorded obese cases and services provided by school. health department from directorate general of health services.

The second phase: we will extend the screening that is done by school health department to include grades 8 -9 female students in Al-Marawah Girls School. The total numbers of students that we will screen are 170 students.

The final phase: we will organize the health exhibition for our target group. The exhibition will be conducted on 9/04/2020 and will cover many aspects related to obesity among school students from detection to prevention

ETHICAL CONSIDERATION We will obtain all formal approval to do the planned body mass index screening in Al-Marrwah Girls School grades 8 to 9. We will obtain inform consent of participants and their parents as whether to participate in biggest loser competition.