Childhood obesity and hypertension are serious health conditions affecting the globe. These conditions are preventable if necessary interventional strategies are applied at the appropriate time. Consequently, nurse practitioners can play a significant role in the management of childhood obesity as a way of preventing hypertension. This research, therefore, seeks to determine how еру nurse-led education-based programs can result in this management. It conducts a literature review of scholarly articles to achieve an overview of the two conditions. It establishes that primary care providers can utilize educational-based programs to enlighten patients on how dietary factors, socioeconomic factors, physical activities, parental determinants, and sleep factors contribute to obesity and hypertension. Numerous instructional and evaluation strategies can be implemented during educational programs to assess the level of patient understanding and experience.

Impact of Nurse Practitioners on Managing Childhood Obesity to Prevent Hypertension

The world is experiencing rapid nutrition modulation occasioned by nutrition deficiencies as manifested by the prevalence of anemia and iron deficiencies. Incidentally, there the cases of obesity, diabetes, and cardiovascular diseases are constantly increasing. Of particular interest, obesity has reached chronic levels that can no longer be ignored by medical practitioners, healthcare facilities, as well as, the relevant disease prevention government organizations. Apparently, the highest prevalence rates of obesity have been reported in the developed countries with new cases emerging in the developing ones. Evidence-based research suggests that obesity is more prevalent in females than males with the underlying reason being the hormonal differences that are more pronounced in females and that the genesis of different types of cardiovascular diseases starts in childhood (Kim et al., 2016). The majority of cardiovascular disease cases are traced back to childhood obesity, insinuating that obesity is an important contributor. There has been a sharp rise in the number of children getting obese in the last three decades, especially in first-world countries (Simmonds et al., 2016). Studies from second-world countries, such as India support, this growing trend. As such, there is a need for the conceptualization of the root causes of nutritional deficiencies as a major step toward the control of obesity and linked cardiovascular diseases.

Childhood obesity is one of the most severe health problems facing children from low and medium-income households. It is particularly pronounced in urban settings. The definition of child obesity has evolved over time, and there is no consensus on what weight or fatness constitutes obesity. However, healthcare providers generally accept that obesity is when the body fat falls within the 95% mark of the body mass index (BMI) (Laws et al., 2015). The causes of childhood obesity are broad, but the underlying issue is the lack of balance between energy consumption and expenditure. This increase in positive energy is derived from unhealthy lifestyles and feeding behaviors. There is rising evidence that individual genetic factors are also essential factors in the determination of obesity risk. As such, genetics (compounded by environmental and behavioral factors) is one of the leading causes of childhood obesity in the sense that it is one of the factors that promote an imbalance in energy consumption and usage. Genetic risk contributes to less than 5% of childhood cases, which suggests that as much as it plays a critical role in childhood obesity, it is not the cause of the dramatic growth of childhood obesity (Sahoo et al., 2015). The basal metabolic rate is also a significant cause of obesity given that it controls energy consumption and expenditure. Low metabolism is ultimately linked to the growth in obesity cases in children. Perhaps, the major cause of childhood obesity and contributor to rising cases of obesity is dietary factors. Dietary factors have been extensively studied in the past for their contribution to obesity. Such factors include the consumption of sugary beverages, snack foods, and fast foods. In particular, sugary beverages increase BMI in little amounts, which over time leads to obesity. On the other hand, snack foods, including baked products, candy, and chips, increase the overall caloric intake, which is linked to being overweight, while fast diets are associated with high caloric value with meager nutritional value. Other causes of childhood obesity include environmental factors, and psychological factors, such as depression and anxiety, self-esteem, body dissatisfaction, eating disorders, and emotional problems.

The growing problem of childhood obesity can be controlled if relevant stakeholders combine efforts toward its eradication. In particular, nurse practitioners can play a pivotal role in managing child obesity, which, in turn, will prevent cardiac complications among children. A combined diet and physical activity nurse-aided interventional strategies within the communities and in schools can help this population steer clear of hypertension.

Causes and Impacts

The World Health Organization (WHO) defines childhood obesity as one of the most critical community health problems of the 21st century, which is currently affecting children from low and middle-income households. According to the WHO (2018), as of 2016, there were over 41 million children under the age of 5 that were obese, half of which lived in Asia while a quarter resided in Africa. This high prevalence rate has reached uncomfortable levels given that the condition is largely preventable. This is because the causal elements are widely known and comprehensively researched.

This revelation prompts Williams et al. (2015) to employ a qualitative study design to conduct a review of factors related to children’s overweight and obesity. The authors establish that biological, medical, individual, genetic, and social factors correlate well with childhood overweight and obesity. In addition, they report that despite the escalating attention to health problems, the rates of obesity among children are on the rise worldwide with the contributing factors evolving with time. As such, they recommend a range of innovative solutions to address the problem. Top on their agenda is increased research on the dietary composition of food taken by children, further studies on microflora, pharmacologic interventions, as well as surgical procedures to rectify the problem. Besides, critical changes in the social systems, such as the alteration of school programs to incorporate personal, family, health providers, and cultural experiences strategies are necessary to enhance the prevention of health problems. Unfortunately, their research is limited in that it fails to comprehensively link obesity to the causal factors, which would have outlined the relevant risks for different causal factors.

Sahoo et al. (2015) elaborate on the findings of the World Health Organization and those of Williams et al. (2015) by conducting a literature analysis of scholarly articles to comprehensively define the issue of childhood obesity, its causes, and its impacts on society. As such, Sahoo et al. (2015), define childhood obesity as a situation where the body fat exceeds 25% for males and 30% in females. This finding is informed by previous research in which 3,320 children between the ages of 5 to 18 years were studied for obesity. They adopt an alternative definition mainly advocated by the Centers for Diseases Control and Prevention as a situation in which weight rests above the 94th percentile of the Body Mass Index. On the causes, the authors delineate at least six classes of causation factors or contributors to obesity. These are genetics, parental factors, basal metabolic rates, government and social policies, and dietary factors. They outline that although genetics play a part in the development of obesity, it is not the cause of the dramatic increase in obesity rates witnessed around the globe. However, they find a positive correlation between increase and dietary, the BMR, and parental factors. Dietary factors in this case include portion size, snack foods, sugary beverages, fast food consumption, and the level of physical activity. Nonetheless, they highlight unsafe environments, fear of child predators, and unsafe walking routes as some of the environmental contributors to obesity. The article is of great significance because it directly links obesity to cardiac problems experienced later in life. Besides, its pokes holes in some existing myths surrounding childhood obesity. For instance, it fails to establish causal relationships between fast foods, snacking, and sugary drinks to obesity levels.

Casey et al. (2014) look into specific determinants of childhood obesity. However, they stay clear of all other factors and concentrate on the built environment factors as key determinants of obesity. Thus, in the framework of the Environmental Links to Physical Activity, Nutrition, and Health, they adopt a qualitative study design and perform a systematic review of the links between the built environment and the weight status of underage individuals. The literature search comprises 25 papers based on at least 20 population studies. 18 of these resources reveal one statistically significant relationship. However, only 24 out of 63 associations test significantly. As such, weight is determined to be directly linked to spatial access to convenience shops and inversely linked to access to recreational physical activity infrastructure. However, links with food retail outlets, restaurants, and parks produce inconsistent results. Consequently, the researchers recommend further studies necessary to understand the complex pathways in which the built environment and socio-economic conditions impact childhood weight.

Hajian-Tilaki, Heidari, and Hajian-Tilaki (2016) predict hypertension from childhood obesity. Through a cross-sectional study design involving 750 respondents, the authors derive critical data on blood pressure measurements to assess the interrelationship between obesity, hypertension, and diabetes. The results of the study indicated that obesity exerted negative influences on the body. As such, obese patients returned high risks of hypertension. Patients with normal weight exerted the least influence on blood pressure. This was more pronounced in women. The findings support that obesity is a risk factor of hypertension and dealing with obesity will lead to similar influences on hypertension.

Nurse Interventions

Apparently, nurse interventions can be utilized to lower the incidences of childhood obesity. These interventions can be achieved through school-based programs aimed at reducing overweight and obese children, as well as in primary care settings. According to Tucker & Lanningham-Foster (2015), nurses’ intervention in obesity reduction is gaining momentum in response to the reduction in physical activities in schools, poor diet, sedentariness, as well as soaring obesity rates. Drawing on multiple systematic reviews, Tucker and Lanningham-Foster (2015) outline that nurse’s school-based obesity prevention and treatment strategies are efficient; although, few studies have actually exploited the matter to a greater depth. This is supported by results from refined health messaging (Let’s Go 5-2-1-0) that is provided to fourth and fifth graders (sample size comprising 72 respondents) by a school nurse with assistance from on-site health coaching nursing students. Two elementary and nursing schools participate in this research, and the results of the study show statistically significant increases in physical activity levels and improved reported health habits. As such, school nurses can play a pivotal role in influencing obesity prevention. The article is of great significance in the sense that it makes a positive correlation between nurse intervention and reduced obesity rates.

The above revelations are timely given that school nurses are usually an overlooked resource in minimizing childhood obesity. According to Schroeder et al. (2016), schools are necessary settings for childhood obesity interventions, but nurses are rarely included in the delivery of the necessary interventions. Schroeder et al. (2016) perform a systematic review and a meta-analysis of over 2412 articles. Only 11 articles meet their selection criteria for a systematic review that required 4 randomized controlled trials, 7 quasi-experimental, and 8 meta-analyses. To avoid bias, they make sure none of the papers used in their research has ever been utilized in prior meta-analyses. 4 of the studies were limited to overweight and obese children, while 7 included children regardless of their body weight. The results are similar to those of previous meta-analyses on school-based interventions and support that nurse practitioners can play a pivotal role in implementing sustainable and effective school-based obesity interventions.

While few researchers have exploited the topic of nurse practitioners’ interventional strategies, Bonde et al. (2014) extensively exploit motivational interviewing as a strategy for preventing childhood obesity. They define motivational interviewing as a method likely to bring behavior change, especially to obese children. The researchers adopted a quantitative methodology by interviewing at least 12 nurse practitioners working in schools and who have adopted motivational interviewing in their daily practice along with other methods. The nurses reveal three dilemmas. These are when children are obese, and parents disregard this as a problem; when a kid and parents are at disparate stages of motivation to change; and when applying an individualized approach is a complex problem. However, the research raises essential issues, which should be considered, relating to whether motivational interviewing can be regarded as a counseling method or as a prevention strategy.

Impacts

Nurse interventional strategies would have long-lasting implications for children, parents, and society. Laws et al (2015), argue that obesity prevention in the early stages of life will result in overall positive outcomes, especially for maternal and child health nurses. This is premised on the fact that young children are recipients of primary health care services. Consequently, nurses’ support to families during breastfeeding and lifestyle behaviors at the early opportunities is likely to reduce the burden on care facilities. This argument is supported by the mixed methods study involving a survey of at least 56 Maternal and Child Health nurses. 16 respondents participated in semi-structured qualitative interviews to investigate the extent to which nurse practitioners promoted healthy feeding practices for infants, healthy eating, reduced sedentary behaviors, and encourage active play with children younger than five years. Results indicated that at least a quarter of nurses rarely used growth charts that would identify infants at inherent risk of getting obese or overweight. Luckily the majority of healthcare professionals reported that critical advice on several aspects of infant feeding related to obesity prevention should be provided. This is reported to have reduced hospital visits, which are particularly beneficial to maternal and child health nurses as their workload is significantly reduced. Dietz et al (2015), note that preventing obesity is a step further in realizing overall positive health outcomes. This is because obesity is a trigger of more severe chronic diseases. Such diseases include type 2 diabetes and cardiovascular conditions. With respect to cardiovascular diseases, obesity is known for its deleterious influences on the cardiovascular system and its definite link to numerous cardiovascular disorders (Kim et al., 2016). This is because the condition affects the transport of oxygen and nutrients in the body tissues. This, in turn, leads to diabetes and high blood pressure, the main risk factors for cardiovascular diseases. As such, applying the necessary obesity prevention strategies at the early stages of life is likely to lead to reduced incidences of cardiovascular diseases and a reduced workload for nurse practitioners, as well as the entire healthcare system.

Standards of Practice

Childhood obesity is closely linked to hypertension. As such, reducing overweight and obesity is likely to produce similar results on the incidence and prevalence of hypertension. Given that the target population comprises children, invoking nurse practitioners (NP) standards of practice is necessary to direct the obesity interventional process. Briefly, these standards outline the professional and legal accountabilities and obligations of NPs during practice (Fisher, 2017). Besides, the standards outline the professional skills, judgment, and knowledge required in safe practice while at the same time identifying the performance levels that the NPs are required to achieve in practice. Most importantly, the policies set professional and legal limits for NP practice (Masters, 2013). In this case, nurse practitioners managing childhood obesity to prevent cardiac complications, such as hypertension, are required to observe several standards of practice. First of all, nurses need to demonstrate a high-level grasp of responsibility and accountability. This standard requires nurse practitioners to provide safe, compassionate, competent, and ethical care to obese children. In addition, they are required to practice autonomously and communicate regularly with obese children and their parents in the most sensitive, respectful, and honest manner that responds to their issues and concerns (Fisher, 2017). This includes informing the parents of the specific contributing or risk factors to obesity and ways of preventing the condition. Besides, the NPs in this task are required to collaborate with the obese children and their parents during the construction of the plan of care, including an in-depth discussion of the rationale, advantages, and risks associated with any of the interventional strategies. This is important as it will confirm the patient’s understanding of the plan of care. Finally, they are obliged to maintain and transfer health information records, including the growth charts for every child. As outlined by Laws et al. (2015), these charts are critical in narrowing down to children who are at risk of obesity and cardiac complications.

Secondly, observing assessment and diagnosis standards of practice is particularly important in this exercise. This standard expects nurse practitioners to provide holistic patient-centered strategies critical in assessing and diagnosing clients with acute or chronic medical conditions that could be life-threatening. As such, the NPs overseeing obese and overweight children are required to undertake a comprehensive assessment of the client’s situation and conditions, thus leading to disease besides conducting screening and diagnostics based on the latest evidence-based policies and standards (Fisher, 2017). This is critical especially when explaining the relevant benefits and risks of screenings, expected outcomes, and treatment plans for each and every child. This is to ensure that the nursing interventional strategies are helpful at an individual level given that a range of factors contribute to obesity and cardiac complications, and understanding each contributor is critical in the development of a treatment plan.

Thirdly, underscoring client care management standards is paramount in this essential task. Often, care management is directed by the best available determinants of health and necessary evidence. This is critical in prescribing weight reduction medications, and helpful therapies as well as advising the children’s parents when to use prescription and non-prescription drugs, vital invasive and non-invasive interventions required to treat childhood obesity (Masters, 2013). This is because only parents can consent to nurses’ interventional strategies for their children. Finally, NP’s comprehension of the collaboration, consulting, and referral standard would be effective in the overall childhood obesity treatment. This is because nurses are required to institute collaborative relations with other healthcare professionals. This is vital especially when health care needs for specific obese children go beyond nurse practitioners’ regulated or individual scope of practice. For instance, some obesity cases may require corrective surgery, which only qualified physicians can undertake (Masters, 2013). As such, advising and recommending such interventions would serve to produce appropriate results. These pieces of advice can be done in person, through phone conversations, or in written form as required by the specific conditions. Therefore, considering the above standards of practice while focusing on the management of childhood obesity as a way of preventing hypertension is a rule rather than an exception.

Theoretical/ Conceptual Framework

Childhood obesity presents one of the largest challenges to public health. This is because the drivers of obesity are found in the personal, community, and social systems. Failure to regulate these factors at the earliest opportunity leads to other complications. Notable complications that further intensify the severity of the problem include diabetes, hypertension, and other forms of cardiac complications. Unfortunately, the level at which prevention efforts should be targeted remains unresolved for many years. In the current research, nurse practitioners can make the most significant impacts in the management of childhood obesity that will prevent hypertension by understanding the complex interactions of multiple factors that lead to childhood obesity. The comprehension of these factors will help determine which factors could be adjusted to lead to overall positive impacts. Basically, these factors can be broadly classified into two: unmodifiable and modifiable factors.

Unmodifiable Factors

Non-modifiable childhood obesity factors are those conditions related to genetic traits. Essentially, there are four sub-categories of factors under this classification. Firstly, ethnicity is a critical risk factor for childhood obesity. For instance, children born to non-Hispanic whites are at the greatest risk of acquiring childhood obesity followed closely by children born to non-Hispanic black parents (Sahoo et al., 2015). This class is followed by children born to Mexican-American parents. Secondly, genetic factors contribute significantly to cases of childhood obesity. Genetics contributes to two kinds of childhood obesity: monogenic and polygenic obesity. Monogenic obesity is rare and severe and is associated with endocrine disorders, while polygenic obesity is attributed to single gene mutations (Sahoo et al., 2015). The last class of unmodifiable factors is the intrauterine factors. The precise factors, in this case, include maternal obesity, gestational weight gain, gestational diabetes, intrauterine environment, as well as epigenetics (Dietz et al., 2015). Children from obese parents are more likely to become obese than those from parents of normal weight. Characteristically, an interplay of genetics and intrauterine factors lead to increased risks for children to get obese at an early age. The connecting factors between these variables are environmental interactions.

Modifiable Factors

Modifiable factors for childhood obesity are closely related to the factors in pregnancy and early infancy stages. These factors can be grouped into five major sub-classes. The first sub-class is the socioeconomic status of the parents. Precise factors in this line are family income and the environment – rural and urban settings. Children from low-income families and those living in urban areas are most susceptible to childhood obesity and related cardiac complications, such as hypertension (Williams et al., 2015). The second sub-class is physical activity, and the precise factors are sedentary behaviors, little exercise, screen time, and academic engagement. It is conceived that all of the above factors lead to slowed metabolism, leading to the accumulation of weight and obesity. The third sub-class comprises parental factors: smoking and working schedule. Children with smoking parents and on tight working schedules are more likely to get obese (Sahoo et al., 2015). This is because there is not enough time to prepare healthy food, resulting in the consumption of fast foods, junk materials, and candy, while maternal smoking is linked to the infant’s weight status. The fourth factor is sleep, in which the duration of sleep and the presence of obstructive sleep disease affect the infant’s weight. Lack of sufficient sleep leads to childhood obesity. Finally, diet is perhaps the most significant factor in the modifiable class. It includes breastfeeding, energy-dense food, fast food, sweetened beverage, junk food, breakfast consumption, food marketing to children, and convenience food (Williams et al., 2015). A diet with high caloric value and insufficient physical activity mostly leads to childhood obesity. The current research, therefore, concentrates on modifiable factors as the pathway for nurse practitioners to make the most significant impacts during the management of childhood obesity to prevent cardiac complications.

Teaching Plan

The teaching plan in this regard will focus on the modifiable factors or risks of childhood obesity. As identified in the sections above, these are the most significant contributors to obesity and related cardiac complications and are highly preventable. The teaching plan will, therefore, focus on every one of the five classes of modifiable factors.

Socioeconomic Status Plan

Learning objectives

At the end of the teaching session, the learners must be able to:

• Outline how family income affects dietary or feeding factors in a family.
• Describe how urban or rural settings influence the children’s weight.
• Describe how gross national income affects children’s weight and obesity.

Course outline

1. Discussion of the family income.
2. Discussion of urban and rural infrastructure that influences weight.
3. Discussion of the national income and children’s weight.

Methods of presentation

• PowerPoint presentation.

Time allotted:

• 45 minutes.

Resources:

• National economic and financial data.

Methods of evaluation:

• Pre-tests and post-tests

Outcomes:

• The learners must achieve 70% of the total test weight.

Physical Activity Plan

Learning objectives:

At the end of the teaching session, the learners should be able to:

• List at least three forms of physical activity.
• State the ways of overcoming sedentary behaviors.
• Underscore the importance of everyday physical activities.

Content outline:

1. Review the topic of physical activity.
2. Review CDC guidelines on physical activity.

Method of presentation:

• PowerPoint presentation
• Actual physical exercises.

Time allotted:

• 45 minutes.

Resources:

• CDC standards on physical activity.

Method of evaluation:

• • Multiple choices quiz.

Outcomes:

The learners must have at least 85% of the total quiz weight.

Parental Determinants Identification Teaching Plan

Learning objectives.

 At the end of this lesson, the learners should be able to:

• List the effects of maternal smoking during pregnancy.
• Outline the ways of quitting smoking as a measure of avoiding childhood obesity to prevent hypertension.
• State the impacts of working parents on their children’s weight status.
• Outline the related health impacts for children as a result of working parents’ schedules.

Content outline:

1. Discuss smoking, its risks factors, and consequences during pregnancy.
2. Review the evidence-based research on ways of ceasing smoking.
3. Review the CDC guidelines on smoking cessation.

Methods of presentation:

• PowerPoint Presentation.
• Video demonstration of the impact of smoke on weight.

Time allotted:

• 45 minutes

Resources:

• CDC guidelines on maternal smoking.
• Video tutorials.

Method of evaluation:

• Post-test.

Outcomes:

• The learners must get at least 70% in the post-test.

Sleep Teaching Plan

Learning objectives.

At the end of the teaching session, the learners must be in a position to:

• Describe the importance of sleep to children.
• List some sleep disorders and their effects on children’s weight.
• Discuss the ways of ensuring children have sufficient sleep, every day.

Course outline:

1. Discussion of sleep to children.
2. Brainstorm the importance of sleep.
3. Discussion of the relationship between sleep and weight.

Methods of presentation:

• Video tutorials.

Time allotted:

• 45 minutes.

Resources:

• CDC guidelines on children’s sleep.

Methods of evaluation:

• Prompt quizzes.

Outcomes:

• The learners must get at least 50% on the impromptu test.

Diet Teaching Plan

Learning objectives.

At the end of the presentation, the learners must be able to:

• Describe healthy behaviors related to nutrition and fitness.
• Describe unhealthy behaviors linked to nutrition and fitness.
• Demonstrate comprehension of the contents of a healthy diet.

Content outline:

1. Discussion of healthy diets.
2. Discussion on unhealthy diets.
3. Brainstorm of the importance of proper diets and fitness.

Methods of presentation:

• PowerPoint presentation.
• Group discussion.
• Printed images on the types of food.

Time allotted:

• 45 minutes.

Resources:

• CDC guidelines on diet and nutrition.
• Printed images.

Method of evaluation:

• Post-test

Outcomes:

• The learners must get at least 95% in the post-test.

Instructional Strategies

Instructional strategies are tools used by nurse practitioners or any other tutors in helping patients become independent learners. Specifically, these strategies motivate patients and help them gain focus, organize their understanding of health topics, as well as monitoring and assessing learning. Instructional strategies that are particularly effective in health education and which could be used in this particular situation include cooperative learning, group discussion, role-playing, and service learning.

Cooperative Learning

Cooperative learning involves participants working in small groups to complete tasks or projects. Activities are structured so that each group contributes to the successful completion of the tasks. The method is particularly beneficial in enhancing participants’ abilities, needs, and interests in the subject matter (Shin, Park, & Kim, 2015). This enables them to take responsibility for their learning. In this context, the tool will be used to instruct various physical activities that are likely to minimize sedentary behaviors. Such strategies include walking, cycling, or participating in soccer or other types of games. The overall objectives would be achieved through the delegation of duties to each of the members. This is to ensure each member contributes positively towards the comprehension of the advantages of physical activities in lowering childhood obesity. Such roles include a checker, timekeeper, questioner, encourager, and reporter. These physical exercises would be repeated on a daily basis.

Group Discussion

Group discussion is an essential part of the comprehension of health topics facing select populations. The tool is vital in understanding background information, creating motivation, and giving the participants a platform for expressing and exploring new ideas and information concerning health or medical issues. Group discussion can be achieved through taking circles or brainstorming (Bradshaw & Hultquist, 2016). In this context, group discussion between the nurse practitioner and the participants or students would serve to explore how socioeconomic factors influence childhood weight. Taking circles would seek to create a safe environment for each student to share his/her point of view. The nurse practitioner would seek to moderate the discussions while elaborating on complex economic and social terminologies. Brainstorming, on the other hand, would be powerful in generating a list of ideas, the creation of enthusiasm, and interest in new concepts. For instance, the gross national income (GNI) would be too technical for children involved in the group discussions. Overall, the instructional strategy would serve to ensure children understand that low income cause families without access to food of required nutritional content and those residing in urban areas where transport is readily available are at risk of obesity. The high gross national income, on the other hand, would enhance the development of infrastructure further promoting inactive behaviors.

Role-Playing

Role-playing is yet another instructional strategy that can be applied by nurse practitioners in revealing information critical to the management of childhood obesity. This technique is significant, especially in enhancing communications and awareness of issues surrounding childhood obesity. This technique would be dominant in instructing about healthy and unhealthy diets. Thus, a specific number of learners would be allocated the topic of healthy foods, while the others would be allotted the unhealthy foods. The essence of this approach is to ensure the learners understand what constitutes a healthy diet. In practice, a healthy diet is one which comprises carbohydrates, proteins, and vitamins. Water is essential in promoting food digestion. Thus, taken in the right proportion, these types of food would ensure childhood obesity is significantly reduced. Therefore, students would be asked to discuss why certain foods are classified as unhealthy whereas others are marked as healthy.

Service Learning

Service learning is an action that creates benefits for all participating individuals. Precisely, the technique strengthens learners’ academic knowledge, builds positive relationships, and discovers new interests and goals (Bradshaw & Hultquist, 2016). For nurse practitioners, the technique benefits them through close involvement with the students and reaching out to them with difficulty in the standard curriculum. In this case, therefore, the tool would be used to dig into parental factors and sleep factors that lead to childhood obesity.

Issue-based Inquiry

An issue-based inquiry is a perfect instructional strategy given the many complex health and social issues surrounding particular types of diseases. This strategy is two ways in the sense that it allows the instructors to communicate fundamental issues while at the same time enabling the learners to enhance their thinking and decision-making skills (Bradshaw & Hultquist, 2016). The importance of this strategy is that it enables the identification of prevailing issues, the investigation of issues, decision-making, and the evaluation of results. In this context, the tool is viable in educating how sleep affects children’s weight status. It is widely known that a lack of sufficient sleep leads to weight gain (Bonde, Bentsen, & Hindhede, 2014). This is because sleep deprivation activates stress hormones that trigger an increased appetite for food. Therefore, the instruction tool will be paramount in educating patients on the importance of sufficient sleep, how to ensure the body gets adequate rest, and the ways of ending the cycle of sleep deprivation. This will undoubtedly lead to positive effects on the patients.

Evaluation Methods

Evaluation in healthcare serves many purposes that include gathering feedback from patients and the development of task portfolios, which is essential to nursing practitioners. In this regard, the evaluation would be crucial in gathering input on the level of patients’ and parents’ comprehension of the ways of managing childhood obesity to prevent hypertension. As such, the evaluation would center on the contributing factors to childhood obesity. As outlined in the preceding section, these factors are broadly categorized as non-modifiable and modifiable factors. Learners or patients, therefore, would be assessed on these issues. To improve this feedback-gathering process, several methods would be relevant. Firstly, the use of reflection assessment will play a critical role in the evaluation process. Reflection assessment is a formative process used to assess the thinking capacity of learners while at the same time allowing them to engage others (Bradshaw & Hultquist, 2016). This method will be a milestone in the entire learning process given that it will be patient-centered. Thus, the shortcomings and strengths of every patient or learner regarding the management of childhood obesity to prevent hypertension will be known. This will inform the next course of action. That is if the learner demonstrates a grasp of key concepts, he/she will be marked as successfully passing the assessment, and if the opposite is true, then the student will be subject to further training. Secondly, individual and group assessments will be implemented to discover the level of personal understanding as well as the evaluation of their contribution in the group settings. This is critical given that nurse practitioners are few compared to the patient population. As such, learners could be used to pass down learned information to their communities. This will be critical in mobilizing everyone in the community to implement healthy behaviors and lifestyles as a way of managing childhood obesity to prevent hypertension. This will continuously improve health outcomes, especially for children in the communities. Thirdly, the administration of service learning surveys will be a practical strategy for the evaluation of the nursing education program (Ozcan, 2016). This strategy is particularly important in the sense that it discovers feedback from numerous areas of nursing education and not necessarily on the subject matter. For instance, the surveys are useful in identifying the level of satisfaction measured on a Likert scale, which will be relevant, especially to nurse practitioners (Shin, Park, & Kim, 2015). This will inform them whether or not they met the goals and objectives of the learning process. As such, they will use the feedback to polish their learning skills and improve their teaching practice for the next group of learners. Finally, the learning process will implement diagnostic evaluation as a basis for considering different levels of learning experience to learners and hence determine those that are slow, average, and fast learners. The essence of this practice is to analyze the specific nature of the difficulties facing each patient. This will help in planning remedial activities that will assist them in meeting their specific needs and interests. This method will be assisted by a formative type of assessment that will determine how well the patients are doing to accomplish learning as well as a way of motivating them to improve their participation in the learning process. It would be expected that the evaluation methods would improve the entire learning process concerning the ways of managing childhood obesity to prevent hypertension.

Conclusion

Childhood obesity is one of the most challenging health conditions of the 21st century. The disease is attributed to lifestyle and behavioral factors although other non-modifiable factors, such as genetics and environmental factors, also contribute to the disease. Healthcare organizations and evidence-based research hold that childhood obesity is a preventable condition, and the application of necessary interventional strategies at the appropriate time is likely to reduce or minimize the severity of the condition. This is because the lack of early interventions contributes to other health complications. Precisely, obesity inhibits the free flow of blood and oxygen in the body tissues. This limitation and constriction of the blood supply system lead to cardiac complications, such as hypertension. Hypertension is a condition in which the force of blood against the artery walls is too high to support the normal functioning of the heart. Obesity is closely linked to hypertension, with obese patients recording the high rates of hypertension than healthy-weight individuals. As such, the pathway to preventing hypertension is to manage conditions that contribute to childhood obesity. These conditions are broadly categorized as modifiable and non-modifiable factors. It is proven that modifiable factors lead to the high incidences of obesity than non-modifiable ones. Nurse practitioners can impact positively the management of childhood obesity to prevent hypertension. This can be achieved through nurse-led school-based educational programs. These programs would center on ways of reducing childhood obesity by concentrating on the modifiable factors given their contribution to the conditions. Specifically, the nurse-led education programs would focus on teaching what constitutes healthy and unhealthy diets, the importance of physical behaviors in improving health outcomes, the necessity of adequate sleep as an obesity management and prevention strategy, how parental factors lead to the condition, and how the socioeconomic status leads to lifestyle changes and the subsequent obesity and hypertension. The necessity of the education program is to contribute positively towards the management of childhood obesity, which, in turn, will prevent hypertension. As such, numerous instructional strategies would be employed in order to produce the required results. Such procedures include cooperative learning, group discussions, role-playing, and service learning. These methods will be significant in ensuring high performance at both the individual and group levels, which will lead to expected outcomes. At the end, of the nurse-led educational program, different types of evaluation techniques will be applied to discover the level of teaching experience for both the learners and the nurse practitioners. Such assessment criteria include diagnostic evaluation, reflection assessment, group assessment, as well as formative evaluation. As expected, these methods would ensure the learners understand and incorporate healthy lifestyle behaviors in their everyday activities. This will undoubtedly prevent hypertension cases in children.