Health Policy: Childhood Obesity

The childhood obesity has become a burning issue of the contemporary society with vivid example seen in the United States of America and other countries. In spite of the actions taken by the local governments and on the national level, we still have “one-third of American children overweight or obese and national health care spending on obesity nearing $150 billion annually” (National Conference of State Legislatures, 2013). In this respect, the funding is inappropriate, because there are no improvements seen either in the nearest future or within the long-term perspective. The resources available include legislature to be introduced with the expected outcomes of reducing the childhood obesity by 5 per cent and health care savings reaching as much as $29 billion annually (National Conference of State Legislatures, 2013). The recommendations include a list of corresponding legislature enacted in all the states opposed to current application of separate positions enacted in 2011. For instance, the State of Georgia as well as the State of Maine has enacted School Nutrition and Physical Education/Physical Activity options, while Nutrition Education and School Nutrition options are available to schoolchildren in the State of Louisiana (National Conference of State Legislatures, 2013). In other words, most states have only applied one of the six options available, whereas a combination of at least three would be more effective in case of such an elevated level of childhood obesity in all states with no exceptions. Dietary behavior, food environment, and physical activity are listed as the factors influencing the obesity trends in the United States. As suggested in the graphs demonstrating the obesity trends in adult population of the America since 1990 to 2009, the fast increase of the obese people is due to dietary behaviors (consumption of

Dietary behavior, food environment, and physical activity are listed as the factors influencing the obesity trends in the United States. As suggested in the graphs demonstrating the obesity trends in adult population of the America since 1990 to 2009, the fast increase of the obese people is due to dietary behaviors (consumption of sugar sweetened beverages and fats), spread of fast food restaurants becoming an integral part of the American culture and lifestyles, and low rates of physical activity (National Center for Chronic Disease Prevention and Health Promotion, 2013). At the same time, what adults show their children becomes an integral part of the family culture and enters the national level with no one talking care of the nutrition education and physical activity of children. Do children have to suffer due to inappropriate dietary behaviors of their parents and lack of healthy food in the environment (school cafeteria, home, places for dining)? There enough laws to solve this issue, whereas their implementation is not as active as it would be needed to meet all requirements and make the nation healthier. The existing laws demonstrate willingness of the legal governments to change the health care situation related to childhood obesity, but they should try harder to adjust the existing rules and regulations regarding school policies related to nutrition, education, and physical activities to the expected standards. “Extensive research shows that regular physical activity is important for preventing and treating obesity and other chronic diseases, disabling conditions, and risk factors for chronic disease” (National Center for Chronic Disease Prevention and Health Promotion, 2013, p. 28). On the one hand, there are sufficient options available to children to get rid of obesity and prevent it. On the other hand, clear guidance and some restriction should be imposed to attain the goals in fight with childhood obesity. The recommended solution for current childhood obesity rates in the United States can be adopted from the findings by Cawley and Liu (2008) who analyzed the “factors associated with state legislative action to address childhood obesity” (p. 162). The current status of the childhood obesity is traced only through the analyses carried out by researchers, but they do not concern the current year. Body Mass Index (BMI) and Student Fitness Screening Legislation enacted by seven states in 2011 enable the school administration and nurses to trace the fitness of children and apply corresponding measures to change their obesity status, if any. In this respect, this can be considered the most accurate and evidence-based information on the current status of the childhood obesity in the United States. The problem is that it should be available in all states with the options for fixing the occurring issues and deviations in children’s weight. Though some barriers to enactment of the anti-obesity

The recommended solution for current childhood obesity rates in the United States can be adopted from the findings by Cawley and Liu (2008) who analyzed the “factors associated with state legislative action to address childhood obesity” (p. 162). The current status of the childhood obesity is traced only through the analyses carried out by researchers, but they do not concern the current year. Body Mass Index (BMI) and Student Fitness Screening Legislation enacted by seven states in 2011 enable the school administration and nurses to trace the fitness of children and apply corresponding measures to change their obesity status, if any. In this respect, this can be considered the most accurate and evidence-based information on the current status of the childhood obesity in the United States. The problem is that it should be available in all states with the options for fixing the occurring issues and deviations in children’s weight. Though some barriers to enactment of the anti-obesity

Do children have to suffer due to inappropriate dietary behaviors of their parents and lack of healthy food in the environment (school cafeteria, home, places for dining)? There enough laws to solve this issue, whereas their implementation is not as active as it would be needed to meet all requirements and make the nation healthier. The existing laws demonstrate willingness of the legal governments to change the health care situation related to childhood obesity, but they should try harder to adjust the existing rules and regulations regarding school policies related to nutrition, education, and physical activities to the expected standards. “Extensive research shows that regular physical activity is important for preventing and treating obesity and other chronic diseases, disabling conditions, and risk factors for chronic disease” (National Center for Chronic Disease Prevention and Health Promotion, 2013, p. 28). On the one hand, there are sufficient options available to children to get rid of obesity and prevent it. On the other hand, clear guidance and some restriction should be imposed to attain the goals in fight with childhood obesity. The recommended solution for current childhood obesity rates in the United States can be adopted from the findings by Cawley and Liu (2008) who analyzed the “factors associated with state legislative action to address childhood obesity” (p. 162). The current status of the childhood obesity is traced only through the analyses carried out by researchers, but they do not concern the current year. Body Mass Index (BMI) and Student Fitness Screening Legislation enacted by seven states in 2011 enable the school administration and nurses to trace the fitness of children and apply corresponding measures to change their obesity status, if any. In this respect, this can be considered the most accurate and evidence-based information on the current status of the childhood obesity in the United States. The problem is that it should be available in all states with the options for fixing the occurring issues and deviations in children’s weight. Though some barriers to enactment of the anti-obesity

The recommended solution for current childhood obesity rates in the United States can be adopted from the findings by Cawley and Liu (2008) who analyzed the “factors associated with state legislative action to address childhood obesity” (p. 162). The current status of the childhood obesity is traced only through the analyses carried out by researchers, but they do not concern the current year. Body Mass Index (BMI) and Student Fitness Screening Legislation enacted by seven states in 2011 enable the school administration and nurses to trace the fitness of children and apply corresponding measures to change their obesity status, if any. In this respect, this can be considered the most accurate and evidence-based information on the current status of the childhood obesity in the United States. The problem is that it should be available in all states with the options for fixing the occurring issues and deviations in children’s weight. Though some barriers to enactment of the anti-obesity legislation can be found on all levels, the findings by Cawley and Liu (2008) suggest thet “enactment of an anti-obesity law is 20% points more likely in states headed by Democratic governors, and that enactment of a school nutrition law is 19.4% points less likely in states with Republican-controlled legislatures” (p. 166). Nevertheless, the state legislature options have been enacted by 50 states in order to measure, prevent, and solve the problems related to childhood obesity on the national level. Local governments may be easier to impact in terms of immediate decision to be made, but the state legislature is more likely to affect more educational facilities and produce a larger effect on the obese children through schools with regard to nutrition, corresponding education, and physical activity.

The problem is that it should be available in all states with the options for fixing the occurring issues and deviations in children’s weight. Though some barriers to enactment of the anti-obesity legislation can be found on all levels, the findings by Cawley and Liu (2008) suggest thet “enactment of an anti-obesity law is 20% points more likely in states headed by Democratic governors, and that enactment of a school nutrition law is 19.4% points less likely in states with Republican-controlled legislatures” (p. 166). Nevertheless, the state legislature options have been enacted by 50 states in order to measure, prevent, and solve the problems related to childhood obesity on the national level. Local governments may be easier to impact in terms of immediate decision to be made, but the state legislature is more likely to affect more educational facilities and produce a larger effect on the obese children through schools with regard to nutrition, corresponding education, and physical activity.

References

https://graduateway.com/client-therapist-relationship/

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Managing resistance to change

1.0. Change Management
1.1.

Managing the Change Process

Change management has been defined as ‘the process of continually renewing an organisation’s direction, structure, and capabilities to serve the ever-changing needs of external and internal customers’. (Todnem, 2005)

Change management entails thoughtful planning and sensitive implementation, and above all, consultation with, and involvement of, the people affected by the changes. If you force change on people normally problems arise. The organisation has impressions like ‘mindset change’ or ‘changing attitudes’. These expressions imply that it’s the people having the wrong mindset which is never the case. (Allen, 2008)

Change such as new structures, new teams, re-locations, etc., all create new
systems and environments, which need to be explained to people as early as possible, so that people’s involvement in validating and refining the changes themselves can be obtained. This tells us that the organisations management style according to McGregor’s theory is X.

1.2.

McGregor’s Theory X and Y Model

McGregor argued that managers operate from their personal view of how employees function. He separated managers into two groups based on Maslow’s Hierarchy of Needs. He related Theory X managers to lower order needs in the hierarchy and Theory Y managers to higher order needs. (Glen) 1.2.1. Theory X

Theory X managers assume that people are intrinsically lazy, take no responsibility, are incapable of self-discipline and only want security. People must be controlled and threatened before they will work. The autocratic leadership style is the only one that works. (Business Balls) 1.2.2. Theory Y

Theory Y managers assume that people like their work, are intrinsically motivated, have self-control and do seek responsibility. Employees can be consulted since individuals are emotionally mature, positively motivated towards their work; and see their own position in the management hierarchy. Managers will find that the participative approach to problem is solving and decision

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making leads to far better results than authoritarian orders from above. (Business Balls)
1.2.3. Example 1.0
Five employees from different functions were asked to fill out the questionnaire. This quick test provides a broad indication as to management style and individual preference, using the ‘X-Y Theory’ definitions. Please
see Appendix A. Table 1 below summarises the type of management style the employers have. Employee

X

1

*

2

*

Y

3


*

4

*

5

*

Table 1.0
1.2.4. Managing X theory boss’s
It is clearly shown that the organisation has an X management style. Working for X management is not always easy but there are ways of managing these people. Avoiding confrontation and delivering results is the key tactics. If an X theory boss tells you how to do things in ways that are not comfortable or right for you, then don’t question the process, simply confirm the
end-result that is required, and check that it’s okay to ‘streamline the process’ or ‘get things done more efficiently’ if the chance arises – they’ll normally agree to this, which effectively gives you control over the ‘how’, provided you deliver the ‘what’ and ‘when’.

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2.0. People factors that influence the Change Process
The failure by managers to take on board the people factors, which can in the long run be critical to the success or failure of change initiatives. Too much attention is given to process issues. These leads to resistance to change as people were faced with new situations, problems and circumstances and are confused.

2.1.

Resistance to Change

There are numerous sources of resistance, including cultural or belief barriers, group

solidarity,

rejection

of

outsiders,

structural

divisions,

technology,

managerial philosophy and managerial style. The most frequent causes of resistance

are

the

way

the

change

is

introduced.

Some

personality

characteristics do not collate well with change (e.g. age, depressions, strong structure goals), but most people do not want to change and may have been waiting many years. (W.Hunt)2
Questioning the motives of managers and blaming initiators for any small organisational hiccup are all familiar tactics. Employees then have no motivation into learning new things because higher management are not listening to them and have not communicated the changes that will affect them. 2.1.1. Maslow’s Hierarchy of Needs

Maslow suggested that as human beings we have series of things we want or need. He defined five models in a pyramid hierarchy that is shown in a pyramid. Figure 1.0 describes the needs.

Figure 1.0: Maslow’s Hierarchy Pyramid

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Maslow’s Hierarchy of Needs states that we must satisfy each need in turn, starting with the first, which deals with the most obvious needs for survival itself. When the lower order needs of physical and emotional well-being are satisfied are we concerned with the higher order needs of influence and personal development. (McIntosh, Topic 4: Motivation)

2.1.2. Example 2.0
Five employees were given the quick Maslow’s test based on hierarchy of needs. It is a quick indicator that can be used for self-awareness and can be used in discussions for the change management process. (Business Balls) See Appendix B for an example.

Employee

A

B

1

2

C

D

3

E

4

5

Table 2.0

Looking at table 2.0 many of the employees are deficiency motivators. This will help managers to identify which particular needs are relevant for employees and thus to determine appropriate motivators. It is a useful technique to explain why people resist to organisational change. Changes such as redundancies can threaten their income and security. Because of structural changes and new responsibilities

they

become

insecure

and

without

any

support

from

management will not be able to cope. In the final analysis the only way to do so effectively is to understand the unique circumstances within each individual that is causing their particular resistance.

2.2.

Motivation

When employees become resistant to change this can have an effect on the work environment and people become de motivated. As shown in example 2.0. Managers need to know to gain the co-operation of staff and how to encourage them to perform in such a manner as to achieve the goals and objectives of the organisation. (McIntosh, Topic 4: Motivation) Maslow’s theory suggested that people are unlikely to be motivated by an environment which fulfils needs at a much higher level when their lower level needs have not been fulfilled.

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2.2.1. Herzberg’s Two Factor Theory
Herzberg discovered that there appeared to be two key factors, influencing
motivation at work. (McIntosh, Topic 4: Motivation) These are: –

Hygiene factors – These are external to the job, for example; salary, personal life, work conditions, security etc.

Motivators – These relate to the job content, for example; recognition, growth, responsibility etc.

The hygiene factors can not necessarily lead to a motivated team but without them can lead to dissatisfaction. Understanding the basic psychological needs of an employee is a starting point.
2.2.1.1.
Impact on Change Initiative
At the planning stage of the change initiative and when reviewing the impact of the change on the people that is affected by it, hygiene theory influences the stakeholder mapping processes and the communication strategy. It focuses change leaders on the impacts of these two dimensions of human needs motivators and dissatisfiers. (Nigel Bassett-Jones, 2005). The stakeholder mapping process will identify who will this change affect and how they will react to it? This is one key activity management have missed and failure to involve the people in the process. There are many other reasons but it is suggested that the route cause is the lack of communication.

2.3.

John Kotter’s principles for managing change

John Kotter’s highly regarded books ‘Leading Change’ (1995) and the follow-up ‘The Heart of Change’ (2002) describes a popular and helpful model for understanding and managing change.
Each stage acknowledges a key principle identified by Kotter relating to people’s response and approach to change, and in which people see, feel and
then change. (Steven H. Appelbaum)

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Figure 2.0

Kotter argued that the first four stages don’t even make any changes, it more about establishing a stage, loosening up the system and establishing a base for which a new system can be created. (Kotter, 1997) These are the key steps company X have missed completely as there was no base built to produce a transformation of significance. It was more like heading straight to step five and putting in the change without anyone being in the loop. They had a vision with any real strategy; assumption was getting enough data about customers and their competition the ideal strategy will emerge. You may come up with alternative strategies but there will be no real base to make the choices. (Kotter, 1997)

Kotter’s eight step model is an excellent starting point for mangers implementing change in their organisation, and applying the model is likely to improve the chances of success.

Discussion
The change programme would have been more effective if transformational leadership was used. Treating the forces against change is a more productive use of resources than simply reinforcing the forces for change. Appropriately managing resistance would require deploying the following recommendations:

Decide on the most powerful of the restraining forces and devote time and energy to weakening these.

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Demonstrate to the fiercest resisters what’s in it for them. Influence them either in terms of personal gain.

Illustrate to change resisters face to face how the current situation disadvantages them in way they can understand.

2.4.

Reflections of Theories

The type of management that exists in company X is according to McGregor’s theory is Type X. With this type of management it is useful to apply Fiedler’s Least

Preferred

co-worker

theory.

This

approach

seeks

to

identify

the

underlying beliefs about people, in particular whether the leader sees others as positive (high LPC) or negative (low LPC). The neat trick of the model is to take someone where it would be very easy to be negative about them. (McIntosh, Topic 5: Leadership and Management)

Putting that aside it is clearly shown that there was no management process in place to make the change successful. When the redundancies were announced no employees were given a valid justification of such a dramatic action. The whole production site was put under a lot of pressure as the company failed to meet customer deadlines. There was no plan put into place of how the operators will cope when sales volumes increases.

From table 2.0: Maslow’s quick self test based on the hierarchy of needs gives you an interpretation the type of needs employees put first.

The more you

understand people’s needs, the better you will be able to manage change and being mindful of people’s strengths and weaknesses. Not everyone welcomes change. Taking the time to understand the people you are dealing with, and how and why they feel like they do, before taking action.

2.5.

Final Analysis

Rather than using the decide announce defend (DAD) model; to get better results a more dynamic model should have been deployed such as InvolveAgree-Implement model (IAI model). It involves all individuals that are impacted by the change, agree on the change/matter and finally implement the change as a whole organisation.

Please see Appendix C – A useful guidance diagram of how to involve individuals. (Circles)
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Any further change programmes that company X would like to implement the following issues should be considered to reduce resistance to change (Lang): 

Involve all employees that will be impacted by the change by asking them for suggestions.

Clearly define the need for change by communicating the strategic decision personally and in written form.

Disrupt only what needs to be changed and form comfortable setting and trust between groups involved.

Announce the strategy of change when the organisation is ready.

Focus on continual positive attributes of the change.

Deliver

training

programmes

which

involve;

communication,

conducting meetings, team building, and self-esteem and coaching.

3.0. Evaluation
The objective of this report was to understand why the organisational changes lead to such negativity and why people are resistant to change. Resistance was considered as a risk within a change implementation program, which needs to be explicitly managed.

It is concluded that the change management process was focused on changing systems, processes and procedures and not enough on changing people and the culture of the organisation. This lead to poor communication, no motivation, stress for employees and a low morale. The culture of the organisations was completely changed which lead to a resistance amongst the employees. Therefore employees are not responsible to manage change but to do their best in the situation. Responsibility with managing change is with management and executives of the organisation. They must manage the change in a way that employees cope. Using the theories explained in this report can help during the change process. It will help managers understand reasons, aims and ways of responding positively according to employees own situations and capabilities.

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For future benefits the company has to encourage a learning culture that can be cultivated as it touches and connects all employees, which in time creates cultural traits and allows the employees to voice their opinions.

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Works Cited
Allen, L. (2008). Managing Change at a workplace: A practical guide. Business Performance. Business Balls. (n.d.). Retrieved from http://www.businessballs.com: http://www.businessballs.com/mcgregor.htm
Circles, S. (n.d.). Dialogue to Change program. Retrieved 04 22, 2013, from Study Circles: http://studycircles.net.au/Content/2011/04/dialogue-to-change-diagram/ Gill, R. (2002). Change management–or change leadership?, Journal of Change Management, 3:4,. Glen, P. Lecture Note: Motivation-People and Change. Rober Gordan University. H.Schein, E. (1992). Organisational culture and Leadership.

Kotter, J. P. (1997). Leading change: A conversation with John P. Kotter. Strategy & Leadership Volume 25 Issue: 1 .
Lang, C. (n.d.). Change is a process not an event.
McIntosh, D. Topic 4: Motivation. The Rober Gordon university . McIntosh, D. Topic 5: Leadership and Management. Robert Gordon University . Morgan, G. 1. (1997). Images of Organization. Sage Publications, Thousand. Nigel Bassett-Jones, G. C. (2005). Does Herzberg’s motivation theory have staying power? Journal of management Development .

Steven H. Appelbaum, S. H.-L. (n.d.). Bake to the Future: Revisiting Kotter’s 1996 change model. Journal of Management Development Volume: 31 Issue: 8 2012 . Todnem, R. (2005). Rune Todnem By (2005): Organisational change management: A critical review, Journal of Change. Journal of Change management , 369-380.

W.Hunt, J. Managing people at work.
Walker, P. (2009, february 2). Dinosaur DAD and Enlightened EDD .

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Appendices

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Appendix A

The ‘X – Y Theory’ Questionnaire

Indicates whether the situation and management style is the ‘X’ or ‘Y’ style: Score the statements (5 = always, 4 = mostly, 3 = often, 2 = occasionally, 1 = rarely, 0 = never) _ 01)

My boss asks me politely to do things, gives me reasons why, and invites my suggestions.

_ 02)

I am encouraged to learn skills outside of my immediate area of responsibility.

_ 03)

I am left to work without interference from my boss, but help is available if I want it.

_ 04)

I am given credit and praise when I do good work or put in extra effort.

_ 05)

People leaving the company are given an ‘exit interview’ to hear their views on the organisation.

_ 06)

I am incentivised to work hard and well.

_ 07)

If I want extra responsibility my boss will find a way to give it to me.

_ 08)

If I want extra training my boss will help me find how to get it or will arrange it.

_ 09)

I call my boss and my boss’s boss by their first names.

_ 10)

My boss is available for me to discuss my concerns or worries or suggestions.

_ 11)

I know what the company’s aims and targets are.

_ 12)

I am told how the company is performing on a regular basis.

_ 13)

I am given an opportunity to solve problems connected with my work.

_ 14)

My boss tells me what is happening in the organisation.

_ 15)

I have regular meetings with my boss to discuss how I can improve and develop.

_

Total Score

60 – 75 = Strong Y Theory Management (Effective long & short term) 45 – 59 = Generally Y Theory Management
16 – 44 = Generally X Theory Management
0 – 15 = Strongly X Theory Management (Autocratic leadership may be effective in the short term but poor in the long term)

Appendix B

Quick self-test based on the ‘Hierarchy of Needs’.
Read the following eight statements and tick below those that apply to you. There are no right or wrong answers. Interpretation guide below.

† A I am successful in life and/or work, and I’m recognised by my peers for being so. I’m satisfied with the responsibility and role that I have in life and/or work, my status and reputation, and my level of self-esteem.

† B I am part of, and loved by, my family. I have good relationships with my friends and colleagues – they accept me for who I am.

† C My aim is self-knowledge and enlightenment. The most important thing to me is realising my ultimate personal potential. I seek and welcome ‘peak’ experiences.

† D Aside from dieting and personal choice, I never starve through lack of food, or lack of money to buy food. Aside from the usual trauma of moving house, I have no worry at all about having somewhere to live – I have ‘a roof over my head’. † E I generally feel safe and secure – job, home, etc – and protected from harm. My life generally has routine and structure – long periods of uncontrollable chaos are rare or non-existent.

References:

https://graduateway.com/imax-case-analysis/

http://www.slideshare.net/jakejohnson2/imax-larger-than-life

https://www.coursehero.com/file/12829594/IMAX-Larger-than-Life/