Ethical Dilemmas During Advocacy Paper

To prepare for this final portion of your paper:

Review provisions 7, 8, and 9 of the ANA Code of Ethics in relation to advocacy for population health.
I have attached a copy of ANA Code of Ethics
Reflect on the ethical considerations you may need to take into account in your advocacy campaign.
Research the ethical considerations and lobbying laws relevant to the location where your advocacy campaign will occur.
Consider potential ethical dilemmas you might face in your campaign.

To complete: Revise and combine parts one and two of your previous papers and add the following:

Parts 1 and 2 have been included in this portion only for reference for you. My campaign is on childhood obesity, nutrition and Physical Activity.

Part 3

Explain any ethical dilemmas that could arise during your advocacy campaign, and how you would resolve them.
Describe the ethics and lobbying laws that are applicable to your advocacy campaign.
Evaluate the special ethical challenges that are unique to the population you are addressing.
Provide a cohesive summary for your paper.

Reminder:

Your paper should be about 3-4 pages of content, not including the title page and references.

Below is parts 1 and 2 of my campaign for your reference and continuity.

Childhood Obesity, Nutrition, and Physical Activity

The issue I have selected is Nutrition, physical activity, and obesity and how it affects the health during childhood. Currently, obesity which is common in childhood is reported to be an epidemic issue in many developed and developing countries. According to Hagman et al. (2017) overweight, lack of proper nutrition, lack of physical exercise and obesity in childhood are considered significant factors that have had an impact on the psychological and physical health and well being of children.Obesity in children continues to affect the person even in their adulthood. It also increases the chances for children to acquire non-communicable diseases like cardiovascular diseases, hypertension, and diabetes at a young age.

How Obesity develops is still undetermined, but various researches have suggested the disorder is brought about by multiple causes such environmental and biological factors.Biological factors entail the genetic influences that contribute to the disorder.The contributing factors that are brought about by environmental issues revolve around lifestyle preferences the child has and cultural environment (Hagman et al. 2017). Alternatively, supporting evidence from nutritional researches indicate that consumption of excessive sugar found in soft drink, increased fraction size, and lack of engaging in physical activity have had significant impacts that lead to the increased obesity rates especially among children. Childhood obesity is known to affect children’s social life, physical health, and emotional well-being which also lead to low self-esteem. Therefore, the child is likely to experience poor academic performance and low quality of life.

Summary of the two advocacy campaigns

Many children who have experienced obesity or overweight related disorders have issues that relate to inadequate physical exercise, poor nutrition, sitting for long periods and excessively watching of the television or playing video games. According to Saxe (2011), the solution is, in the health sector, which advocates for creating awareness of healthy living. Through community-based environmental interventions, the public gets assistance from health practitioners. The strategy focuses on public health education on nutrition which is done through various health institutions. In addition to this, local, state, and federal governments of the U.S specifically health sectors are involved in contributing public sensitization of importance of healthy living among children by focusing on primary based health care and proper nutrition incentives from the pediatricians and other public health experts. The focus is on addressing lifestyle issues at homes and in families with young children.

The second program involves creating awareness through sensitizing the community by offering information through print media. As stipulated by GreenMills et al. (2013) the approach dubbed “Communities for Healthy Living” program used community-based participatory research (CBPR), a strategy that empowers parents with a Head Start parenting program to focus on family-centered prevention methods of obesity prevention. The fundamental component of the program was educating on various misconceptions about obesity using posters, billboards, newspapers and so on. The community advisory board of parents designed the campaign’s approach as a way of targeting specific issues related to obesity in children within their community.

Attributes that made the two campaigns effective

The attributes that made the first campaign effective is the use of medical personnel who are involved in children health being equipped with relevant information and strategies that allow them to give credible information on lifestyle and nutritional habits to the guardians and parents of children as they visited their clinic during early monitoring of child growth and development (Saxe, 2011). With such knowledge, parents practiced the information given to reduce the chances of obesity. Health sector having a synergy of cooperation with White House Task Force on Childhood Obesity was a way of building a culture in the American people to ensure their children do not have obesity and other related illness by fostering a healthy lifestyle, nutrition, and fitness.

The attribute that made the second campaign effective was due to coming together of the community members; information was quickly spread to all people since the posters were in every corner of the community. After the campaign, parents showed remarkable improvement in their childhood obesity awareness (GreenMills et al. 2013). The misconceptions viewed included active children cannot get obese, watching television is always a good thing for the child, processed juice is equal to natural fruit juice, a child’s weight is not a problem, big children show a child is growing well and healthy.

My plan for a health advocacy campaign that seeks to create a new policy or change an existing policy concerning obesity among children.

My health advocacy campaign will focus on school going children where parents and teachers work together through a physical exercise and nutrition program. The program will entail having a scorecard which is used to register information of nutrition the child gets and physical exercises they participate in school and at home to allow proper development of the child as illustrated by Donnelly et al. (2016). The policy’s’ specific objectives are to allow the weekly update on what the child eats and which physical exercises they do, reducing consumption of fatty foods, ensuring the child is psychologically and physically fit and reducing the chances of the child becoming obese. Hence the nutrition program will try as much as possible to reduce the child consuming fast foods like chips, pizza, burgers among others. The plan is to transfer necessary knowledge to guardians or parents and teacher on taking care of children. The plan will help to empower the parent to know what their child ate during school time.

The campaign will answer questions such as; did the child have a balanced diet meal from break time to lunch meal? The main focus is to offer more healthy snacks, decreasing the amount of sugary and fatty food items that are offered as revealed by Alkon et al. (2014). The school will also provide meals and snacks with proper guidance through a nutrition specialist who has invested the time to gain critical knowledge of nutrition for children. The nutrition program will involve the daily meals served as per nutritional regulations. The diet shall comprise of proteins, fruits, vegetables, grains, dairy products. The proteins will have beans, eggs, lean meat, peas, unsalted seeds, and nuts. Fruits and vegetables can be fresh, frozen, canned, or dried. The child should consume various vegetables such as beans, peas, dark green, orange, and red vegetables. Dairy products served will include low fat or fat-free dairy products such as yogurt, cheese, milk, and fortified beverages. The grains should be whole grains such as oatmeal, whole-wheat bread, quinoa, popcorn, brown rice, and wild rice.

The limitation should be emphasized especially for refined grains like pasta, rice and white bread as illustrated by Hagman et al. (2017). Proper limitation on sugars such as corn sweeter, honey, corn syrup, and brown sugar is to be emphasized. For the fats, there should be no hydrogenated fats in their meal. All these must be taken weekly once or often in the case of fruits and proteins. When it comes to the physical exercises, the child should engage in active play for instance stuck in the mud, hide and seek among others. Other activities that will allow the child to work on their physical well-being can include running around, bike riding, dancing, jumping on a trampoline, rope skipping, climbing, and swimming. All these would be geared towards mitigating the issue of childhood obesity through proper nutrition and physical activities.

References

Alkon, A., Crowley, A. A., Neelon, S. E. B., Hill, S., Pan, Y., Nguyen, V., … & Kotch, J. B. (2014). Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index. BMC Public Health, 14(1), 215.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24580983

Donnelly, J. E., Hillman, C. H., Castelli, D., Etnier, J. L., Lee, S., Tomporowski, P., … & Szabo-Reed, A. N. (2016). Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review. Medicine and science in sports and exercise, 48(6), 1197.Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/27182986

GreenMills, L. L., Davison, K. K., Gordon, K. E., Li, K., & Jurkowski, J. M. (2013). Evaluation of a childhood obesity awareness campaign targeting head start families: designed by parents for parents. Journal of health care for the poor and underserved, 24(2 Suppl), 25-33.Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/23727962

Hagman, E., Danielsson, P., Brandt, L., Svensson, V., Ekbom, A., & Marcus, C. (2017). Childhood obesity, obesity treatment outcome, and achieved education: a prospective cohort study. Journal of Adolescent Health, 61(4), 508-513.Retrieved from https://www.researchgate.net/publication/318301600…

Saxe J. S. (2011). In This Issue:Healthcare Policy Affect the Lives of Real PeoplePromoting healthy lifestyles and decreasing childhood obesity: increasing physician effectiveness through advocacy. Annals of family medicine, 9(6), 546-8.

Part 2

Enactment of the Proposed Policy

The challenge of childhood obesity persists to be a significant health issue recognized in the United States with approximately 17% of American youths being obese (National Conference of State Legislatures, 2014).As such, state and the federal government has endeavored to come up with various guidelines and regulations which are aimed at addressing this issue and coming up with intervening measures.Therefore, to enact the current proposed policy, the need for the existing policies and regulations may necessitate modification.

Some of the policies and legislation which need modification include the School Nutrition Legislation such as the Hunger-Free Kids Act of 2010 (P.L. 111-296) as well as other policies which dictate that nutritious foods should be made available to students in school all day long. This policy which seeks to ensure that the children have healthy foods to choose from should be modified to eliminate unhealthy food options and have more healthy foods supplied in school.Provisions should also be added to incorporate the scorecard which keeps tabs of what the child eats to make sure that their diet is saturated with healthier food choices and less of unhealthy food products.

The other legislation is the Physical Education in Schools and School Recess Legislation which seeks to ensure that the children get to engage in physical activities in order to address the obesity challenge. This policy should be modified to incorporate the scorecard which shows how many physical exercises the students participate in both at school and home so that they can develop adequately (Donnelly et al., 2016).Another policy that needs to be modified to ensure the successful implementation of this policy is the School Wellness Policies which are developed by the state, in their attempt to complete federal legislation and so forth.Moreover, for this policy to be enacted the existing policies must be revised and modified to be in line with its proposals and requirements.

Impact of existing Regulations on Advocacy Efforts

As we seek to address the issue of childhood obesity, nutrition, and physical activities, there are existing laws which have been passed to deal with the problem.As such, the laws and regulations could affect the advocacy efforts; opposing, disproving, and disrupting them.For instance, this policy seeks to influence the school feeding program by advocating for more healthy foods and eliminating unhealthy food items.However, the existing regulation School Nutrition Legislation also advocates for healthy foods but does not seek the total elimination of unhealthy food. The advocacy efforts could, therefore, be challenged and seen as overstepping its mandate and taking the choice away from the children.Therefore, to deal with challenges, it is essential for the advocacy process to review current existing legislation and identify potential areas of inconsistency, and if warranted, reconsidered and eliminate the conflict and redundancy.

Lobbying

Just as any other legislative endeavor requires support to enforce, it will be essential to receive both state and local representatives’ support to enact this policy.Further, in order to gain the attention and support of these influential personalities, the services of a lobbyist will be essential.According to Milstead (2016), effective lobbying is similar to a three-legged stool; therefore, in such a case if one of the legs that provide support is missing, the stool would not stand irrespective of the efforts put to maintain balance and give support. In lobbying the three legs of the advocacy effort to entail professional, grassroots and the political.

The first phase of the lobbying process is direct lobbying which must be conducted by professionals in the field. The individual will have to be an expert in nutrition and diet, childhood obesity, as well as the legislative process which is employed when coming up with healthcare laws.These policies will be in the frontline bringing the proposed policy to state and local legislators.

The second leg entails grassroots lobbying which is necessary to succeed in this step; this is the advice given by Milstead, (2016).Milstead notes, to succeed in lobbying efforts, a nurse must join their professional association; such I will seek to join these bodies and seek their support.Furthermore, I will also liaise with experts in the community on the issue of childhood obesity and rally the community to support the initiative.This will be accomplished through written letters, emails, personal visits, phone calls, messages, and so forth.Also, to ensure success, in the process, I will have to employ clarity and consistency in my approach.According to Swanson, being clear and consistent is imperative for success (accessed on January 12, 2019).

The third leg of the lobbying process in the political leg entails the funds spent in the entire legislative process. Milstead (2013), indicates that money plays a crucial role in the process and ignoring is it a detrimental flaw. Through Political Action Committees (PACs) that have been established by different associations that help in endorsing legislators that throw their weight and support to their interest can be able to lobby for their policies successfully. As such I will personally continually give my support to the professional bodies I belong to, and that serve to endorse these legislators.

Challenges encountered in the legislative process and how to overcome them

Some of the major obstacles I could face in the process of legislation include having little understanding of the legislative laws and the lobbying process. However, I intend to overcome this challenge through my membership to the professional bodies such as the nursing association which will provide the needed insight.

Another challenge is grassroots lobbying where I am supposed to get people at this level interested in the policy and give their support to the process. To overcome this hurdle, I will openly and effectively communicate to them the current challenge and passionately rally their support as I remain faithfully committed to the process. Milstead, (2016) indicates that providing a compelling message based on personal experience with the issues at stake can help one attain support.

Another challenge at hand is the lack of funds required for the lobbying process and getting the right legislators to champion the course.To conquer this problem, I will rely on the timing and give my proposal and the entire process of legislation during electioneering period when legislators are more inclined to supporting initiatives which will show them as the ideal candidate who seeks to improve their citizen’s health. Moreover, in this period, these legislators are more open to supporting legislative changes without requiring significant benefits.

Lastly, another obstacle which could be faced is lack of consensus from all parties and opposition. To defeat this obstacle, I will employ perseverance, seek support from prominent legislators and have the determination to achieve the change.

References

Donnelly, J. E., Hillman, C. H., Castelli, D., Etnier, J. L., Lee, S., Tomporowski, P., … & Szabo-Reed, A. N. (2016).Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review.Medicine and science in sports and exercise, 48(6), 1197.Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/27182986

Milstead, J. A. (2016). Health policy and politics: a nurse’s guide. Fifth edition. Burlington, MA: Jones & Bartlett Learning. Chicago / Turabian

National Conference of State Legislatures (2014).Childhood Obesity Legislation – 2013 Update of Policy Options. Retrieved from http://www.ncsl.org/research/health/childhood-obesity-legislation-2013.aspx

Swanson, A., (accessed on January 12, 2019).Lockton Affinity Health.7-Best Practices Avoiding Malpractice Lawsuit.Retrieved from http://locktonmedicalliabilityinsurance.com/7-best…