Semester

Spring

Date of Graduation

2010

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Not Listed

Committee Chair

Rose Ann DiMaria-Ghalili.

Abstract

Statement of problem. Appalachian children and adolescents are considered a vulnerable population with a high prevalence of obesity. This study was the first study to apply a vulnerable populations conceptual framework to examine factors associated with overweight and obesity in Appalachian children and adolescents. The purpose of this study was to describe the extent to which resource availability (family income, insurance, family characteristics, parents' education, and transportation) and risk factors (utilization of health care/preventive care, family medical history, and participant medical history) impact overweight and obesity in a vulnerable population. The study also described the frequency of overweight and obesity in a sample of Appalachian children and adolescents.;Methods. The sample for this secondary data analysis was obtained from the Center for Oral Health Research in Appalachia (COHRA). Data analysis was performed using data from WV children and adolescents ages 7 to 17 years of age at the time of first enrollment in the COHRA study (n=509). The extent to which factors associated with a vulnerable population model, resource availability and risk factors, contribute to overweight and obesity in Appalachian children and adolescents were investigated using a descriptive predictive, cross-sectional design. Data were analyzed for relationships among the dependent variable: overweight and obesity and the independent variables: risk factors and resource availability. The analyses included parametric and nonparametric statistics.;Results. The demographic results of this study revealed that this sample is a vulnerable population. A high prevalence of obesity was found in this sample of Appalachian children and adolescents. In the 7 to 10 year old group, 13.5% of the participants were overweight and 26% were obese. The highest prevalence of obesity was found in the 11 to 13 year old group, 16.7% of the participants were overweight and 34% were obese. In the 14 to 17 year old group, 16.9% of the participants were overweight and 26.6% were obese. Frequency of visiting a dentist was the only independent variable that had a significant association with BMI. This study revealed that children (7 to 10 years old) who visited a dentist less frequently were almost three times more likely to report being overweight compared to those children (7 to 10 years old) who visited a dentist more frequently.;Conclusions. Childhood and adolescent obesity continues to be an epidemic that is apparent in the US and Appalachia. Because of the increased prevalence of obesity and the risk of obesity associated chronic diseases, nurses need to be prepared to implement interventions to prevent and identify overweight and obesity in children and adolescents. In order for nurses to design and implement effective interventions and prevention strategies that will improve the health status of Appalachian children and adolescents, further research needs to occur to examine factors associated with overweight and obesity in this vulnerable population.

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