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AN EXPLORATIVE AND EVALUATIVE STUDY OF THE PREVALENCE,

RELATED KNOWLEDGE, ATTITUDE AND EFFECTIVENESS OF AWARENESS

PROGRAM REGARDING OBESITY AMONG SELECTED DEGREE STUDENTS IN

MAHATMA GANDHI UNIVERSITY

SUJA MARY GEORGE

(MRP- 1279/13-14/KLMG034/UGC-SWRO)

A Report of Minor Research Project

Submitted to

University Grants Commission, New Delhi

March 2016

An Explorative and Evaluative Study of the Prevalence, Related Knowledge, Attitude

and Effectiveness of Awareness Program Regarding Obesity Among Selected Degree

Students in Mahatma Gandhi University is an approved minor research project funded

by the University Grants Commission (UGC) at Assumption College, Changanasserry,

affiliated to Mahatma Gandhi University, Kottayam.

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ACKNOWLEDGEMENT

The Researcher wishes to express his sincere appreciation and gratitude to Dr. Sr.

Marykutty Joseph Principal, Assumption College Changanasseerry for providing an opportunity

to conduct this study. With immense pleasure, the Researcher expresses his deep sense of

gratitude and indebtedness to the teachers, staff and students of Assumption College

Changanasserry for their sincere help, advice and support during the course of the study.

Without the financial support from the University Grants Commission, the research project

never have been realized. My sincere thanks to UGC for the financial support.

Kottayam, March 2016

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CONTENTS

Chapter

I. INTRODUCTION

Statement of the problem

Delimitation

Limitation

Definition and Explanation of Terms

Significance of the Study

II REVIEW OF RELATED LITERATURE

III PROCEDURE

Selection of Subjects

Selection of Test items

Collection of Data

Statistical Procedure

IV ANALYSIS OF DATA AND THE RESULT OF

THE STUDY

Statistical Analysis of Data

Findings

Discussion of Findings

V SUMMARY, CONCLUSIONS AND

RECOMMENDATIONS

Summary

Conclusions

Recommendations

BIBLIOGRAPHY

Books

Journals and Periodicals

Websites

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LIST OF TABLES

Title

Table 1 Analysis of selected variables among selected degree students

Table 2 Percentile analysis on BMI

Table 3 Analysis of knowledge score of experimental group

Table 4 Dependent t – test of knowledge score of experimental group

Table 5 Analysis of knowledge score of control group

Table 6 Dependent t – test of knowledge score of control group

Table 7 Analysis of attitude score of experimental group

Table 8 Dependent t – test of attitude score of experimental group

Table 9 Analysis of attitude score of control group

Table 10 Dependent t – test of attitude score of control group

Table 11 Assessment of relationship between selected variables

LIST OF FIGURES

Title

Figure 1 Percentile analysis on BMI

Figure 2 Mean value of knowledge score (Experimental Group)

Figure 3 Mean value of knowledge score (Control Group)

Figure 4 Mean value of attitude score (Experimental Group)

Figure 5 Mean value of attitude score (Control Group)

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Chapter –I

INTRODUCTION

Concept of health and its significance

The human development is a function of three critical dimensions: longevity the

ability to live long and healthy life; education ability to read, write and acquire knowledge

and command over resources the ability to enjoy a decent standard of living and have a

meaningful life. Being healthy is clearly one of the most important objectives of human

beings. According to Nobel Laureate Amartya Sen, health is among the basic capabilities that

give value to human life. Health also includes the ability to lead a socially and economically

productive life. Dr. Halfdan. T. Malher, Director General of WHO (1973-1988) argued that

we must consider health in the broader context of its contribution to social development and

expanded the definition of health to include the ability to lead a socially and economically

productive life. Health is a fundamental right, emphasized the Alma -Ata declaration of 1978.

Since the Alma - Ata conference on health, which focused on equitable and cost effective

primary health care, health has become an important national concern in most countries,

especially in the developing countries in improving the quality of life for individuals, and

profitable for an entire community as health is the engine that drives economic development.

According to Oxford dictionary, the meaning of health is the state of being free from illness

or injury. But, numerous studies in the area of the health have been broadening the definition

of health. Within the social science research community, the concept of health has broadened

beyond the presence or absence of illness to incorporate the notion of well being including

social, economic and psychological well being. This broad concept of health has roots in the

World Health Organization‘s1948 definition of health: Health is a state of complete physical,

mental and social well being and not merely the absence of disease or infirmity. This

definition although well accepted does not lend itself to direct measurement of health of a

given individual or community. It is argued that health cannot be defined 'as a state’, but a

process and there is no satisfactory definition of the term 'well being'. Unless we are able to

measure (in some quantitative terms or indices) the health status of the people, we cannot

assess the benefits of health services. However, to measure the level of health, some

comprehensive and some specific indicators have been advocated by a WHO study group and

many more indices have since been developed. There is also no satisfactory definition of

disease. It has been well conceptualized that multiple factors e.g. biological, genetic,

nutritional, physical, chemical, mechanical, environmental, social, cultural, human behaviour,

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psychological and economic, play a role in the health or disease status of the individuals and

the community. Underlying this broadening conception of health as growing knowledge of

integral role that physical and mental health play in the causes and consequences of social

and demographic behaviour, social and emotional development, and social and economic

status across the life course. Thus health is multidimensional such as Physical implies the

notion of perfect functioning of the body, Mental one who is free from internal conflicts, firm

sense of self identity, good sense of self control, deals with the needs and problem with

balanced mind, Social implies harmony and integration with in the individual, between each

individual and other members of the society and between individuals and the world in which

they live, Spiritual dimension it refers to that part of individual which reaches out and strives

for meaning and purpose in life

Health is not only a basic human right, but it is most desired. In a global survey

commissioned for the Millennium Summit of the United Nations by UN Secretary General

Kofi Annan (Millennium Poll, United Nations 2000), good health is consistently ranked as

the number one desire of men and women around the world. It is also a key precondition to

economic development. Health is central to well being and a prerequisite for individual and

national progress. Data shows that the countries that have good national health indicators

have a greater economic progress and development. In addition, health has an intrinsic value

in creating the human capital of the country. Health is significant factor in the development of

nation, as high levels of population health go hand in hand with national income. Health and

socio-economic progress are very much interdependent and health has been accepted as one

of the welfare component. Higher incomes promote better health through improved nutrition,

better access to safe water and sanitation, and increased ability to purchase more and better

quality health care. However, health may be not only a consequence but also a cause of high

income. Economic capabilities affect health, as low income constraints access to health care

and health promoting opportunities. Improvements in health are important in their own right,

but better health is also prerequisite and a major contributor to economic growth and social

cohesion. Conversely, improvement in people‘s access to health technology is a good

indicator of the success of other development process.

India has achieved considerable improvements in human development factors.

According to Human Development Report 2011of UNDP, the HDI for India is 0.547in

2011with an overall global ranking of 134 out of the 187countries. Life expectancy at birth in

India was 65.4 years in 2011 as against 55.1 in 1980.Infant Mortality Rate has declined

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considerably, 71per 1000 live births in 1997 and reached 47per 1000 live births in 2010. But

the rural (77 in 1997and 51in 2010) & urban (45in 1997and 31in 2010) differentials are still

high. The healthcare in a country as a whole is facing many challenges. India desperately

requires tremendous magnitude of India's healthcare needs and the immense investments

required to improve the health status of people from all parts of India and across all strata of

society. Further, general lack of awareness on healthcare issues and the low public

consciousness of hygiene and sanitation norms will need to be addressed as a starting point

and with it the lack of accessibility to healthcare services. The level knowledge gained

through different mediums and the willingness to make it implemented in ones’ own life been

considered as significant in the case of good health is concerned.

Life style diseases

When ever and where ever the humans questioned the laws of nature, it had given

birth to threats of human life. Lifestyle diseases are considered as one of the most leading

cause of premature death and inefficient life of humans in this era. Lifestyle diseases are

more common as countries become more industrialized. They are caused by an inappropriate

relationship of people with their environment. Lifestyle diseases are different from other

diseases because they are potentially preventable, and can be lowered with changes in diet,

lifestyle, environment, and by supplementing with vitamin D. Until the present era, death was

caused by sudden onset conditions. Sudden Onset conditions are easily curable by Allopathic

Medicine. Today, conditions that slowly develop over many years as we age cause more

deaths. These insidious diseases do NOT lend themselves to a quick fix by Allopathic

Medicine. Lifestyle diseases are a result of an inappropriate relationship of people with their

environment. The onset of these lifestyle diseases is insidious, they take years to develop, and

once encountered do not lend themselves easily to cure.

Poor lifestyle choices, such as smoking, overuse of alcohol, poor diet, and lack of physical

activity and inadequate relief of chronic stress are key contributors in the development and

progression of preventable chronic diseases, including obesity, type 2 diabetes mellitus,

hypertension, cardiovascular disease and several types of cancer. Even though doctors

encourage healthful behaviors to help prevent or manage many chronic medical conditions,

many patients are inadequately prepared to either start or maintain these appropriate, healthy

changes. Most patients understand the reason behind a healthy lifestyle even if they don’t

understand the disease processes that can occur when they don’t maintain healthy habits.

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Despite an understanding of what constitutes a healthy lifestyle, many patients lack the

behavioral skills they need to apply everyday to sustain these good habits. Nevertheless,

healthy lifestyle modifications are possible with appropriate interventions, which include

nutritional counseling, exercise training, and stress management techniques to improve

outcomes for patients at risk and those who already have common chronic diseases. Our food

habits affect our overall health, immunity and vitality. Clinical study shows that a normal

human body constitutes 63% of water, 13% of fat, 22% of protein, and only 2% of minerals

and vitamins. An ideal diet should constitute 65 % carbohydrate, 15% protein and only 20%

of fat. Over the past 50 years, dietary patterns have been drastically changed. A high intake

processed foods high in sugar and saturated fats have become common phenomenon. In

urban communities, a typical diet consists of 28 % carbohydrate, 40% fat, 12% protein and

20% sugar. Fatty buildup in the arteries leads to the occurrence of lifestyle diseases. Most of

the diseases were virtually unheard of before 100 years ago.

Inactive lifestyle can lead to serious health conditions in young people. A survey conducted

by the University of Hong Kong revealed that 20% of people belonging to age group below

35 years died of chronic diseases caused by sedentary lifestyle. Cardiovascular heart diseases,

gastrointestinal complication, respiratory ailments, diabetes and cancers may occur due to

sedentary lifestyle. Following a healthy diet and regular exercise routine will keep diseases

and disorders at bay.

Kerala enjoys a unique position in the health map of India. The health indicators in Kerala are

at par with the Western World. However, the widely acclaimed ‘Kerala model of health’ has

started showing a number of disturbing trends recently. Although the mortality is low, the

morbidity is high in Kerala compared to other Indian states. Hence the Kerala situation was

described as “low mortality high morbidity syndrome” (Panikar and Soman, 1984). It is

interesting to note that both infectious diseases like dengue fever, diarhoea etc and the so

called lifestyle diseases are both prevalent in Kerala. Moreover the incidences of many

lifestyle diseases are more than the national average. It is estimated that there are about 1.5

million diabetic subjects in Kerala. These people need lifetime management involving

lifestyle modifications, drugs and proper diet. Recent surveys in different categories of

subjects in Kerala reveal that one out of three adults in Kerala is hypertensive. Hyper tension

leads to heart attacks, stroke and kidney failure and it is a lifelong disease and needs careful

and sensible management throughout life. Non-communicable diseases especially

cardiovascular diseases, cancer, type 2 diabetics mellitus account for 53% and 43% of all

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deaths and disability. Similarly, overweight and obesity leads to heart attack, hypertension,

breast cancer, diabetes and joint problems (Economic Review, 2011, p. 382). Childhood and

adolescent obesity is not limited to developed countries. It is seen in developing nations too

(Popkin, 1998). In India urbanization and modernization has been associated with obesity

(Yadav and Krishnan, 2008). The prevalence of overweight and obesity is found to be 18.3%

of Kerala children in a sample taken from Thiruvananthapuram (Ramesh K, 2010).

Considering Youth as the vibrant community that intents and leads several future

developments in the society an attempt has been make to conduct an explorative and

evaluative study of the prevalence, related knowledge, attitude and effectiveness of

awareness program regarding obesity among selected degree students.

Lifestyle diseases are our own creation. Most men are unable to resist the temptation of

cocktail partying, obsession with shopping, workaholics, sedentary living environment, ,

blind pleasure psychosis, suffocating dispositions, exchanging conscience and faith with

wealth, consumption-based happiness indices, absence of regular sleep, leisure, socialising,

taking metric kilos of junk food, and finally the mad march against indomitable time. The

only remedy lies in the fact that, man needs to control his senses, freshen up his common

sense to make life more convenient in the long run.

Obesity as a growing problem

Obesity is a term used to describe somebody who is very overweight, with a lot of body fat.

It's a common problem, estimated to affect around one in every four adults and around one in

every five children aged 10 to 11. There are many ways in which a person's health in relation

to their weight can be classified, but the most widely used method is body mass index (BMI).

BMI is a measure of whether you're a healthy weight for your height. You can use the BMI

healthy weight calculator to work out your score.

For most adults:

a BMI of 25 to 29.9 means you are considered overweight

a BMI of 30 to 39.9 means you are considered obese

a BMI of 40 or above means you are considered severely obese

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BMI is not used to definitively diagnose obesity – as people who are very muscular

sometimes have a high BMI, without excess fat – but for most people, it can be a useful

indication of whether they may be overweight. A better measure of excess fat is waist

circumference, and can be used as an additional measure in people who are overweight (with

a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9). Generally, men with a

waist circumference of 94cm or more and women with a waist circumference of 80cm or

more are more likely to develop obesity-related health problems. Worldwide obesity has

more than doubled since 1980. In 2014, more than 1.9 billion adults, 18 years and older, were

overweight. Of these over 600 million were obese. 39% of adults aged 18 years and over

were overweight in 2014, and 13% were recorded as obese. Most of the world's population

live in countries where overweight and obesity kills more people than underweight. 42

million children under the age of 5 were overweight or obese in 2013. Although we have to

believe that obesity is preventable.

Overweight and obesity are defined as abnormal or excessive fat accumulation that may

impair health. Body mass index (BMI) is a simple index of weight-for-height that is

commonly used to classify overweight and obesity in adults. It is defined as a person's weight

in kilograms divided by the square of his height in meters (kg/m2). According to WHO a BMI

greater than or equal to 25 is overweight and a BMI greater than or equal to 30 is obesity.

BMI provides the most useful population-level measure of overweight and obesity as it is the

same for both sexes and for all ages of adults. However, it should be considered a rough

guide because it may not correspond to the same degree of fatness in different individuals.

In 2013, 42 million children under the age of 5 were overweight or obese. Once

considered a high-income country problem, overweight and obesity are now on the rise in

low- and middle-income countries, particularly in urban settings. In developing countries

with emerging economies (classified by the World Bank as lower- and middle-income

countries) the rate of increase of childhood overweight and obesity has been more than 30%

higher than that of developed countries. Overweight and obesity are linked to more deaths

worldwide than underweight. Most of the world's population live in countries where

overweight and obesity kill more people than underweight (this includes all high-income and

most middle-income countries).

Raised BMI is a major risk factor for non-communicable diseases such as: cardiovascular

diseases (mainly heart disease and stroke), which were the leading cause of death in 2012;

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diabetes; musculoskeletal disorders (especially osteoarthritis - a highly disabling degenerative

disease of the joints) and some cancers (endometrial, breast, and colon). The risk for these

non-communicable diseases increases, with an increase in BMI. Childhood obesity is

associated with a higher chance of obesity, premature death and disability in adulthood. But

in addition to increased future risks, obese children experience breathing difficulties,

increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin

resistance and psychological effects.

Obesity is generally caused by consuming more calories – particularly those in fatty and

sugary foods – than you burn off through physical activity. The excess energy is then stored

by the body as fat. Obesity is an increasingly common problem, because many modern

lifestyles often promote eating excessive amounts of cheap, high-calorie food and spending a

lot of time sitting at desks, on sofas or in cars. There are also some underlying health

conditions that can occasionally contribute to weight gain, such as an underactive thyroid

gland (hypothyroidism), although conditions such as this don’t usually cause weight

problems if they are effectively controlled with medication. But regardless of the reasons for

the rise in obesity, maintaining healthy weight ultimately comes down to balancing the

number of calories you eat and drink with the number of calories you burn through exercise

and everyday activities. And we all have the power to achieve this balance. Every day we can

make choices to eat differently, move our bodies more and enjoy a healthier life.

Emotional issues can fuel obesity-promoting habits such as overeating, and they can get

in the way of making change. It’s important to recognize your personal roadblocks and

design quick detours around them. Some of the relevant emotional issues that found very

closely related with obesity and the remedies are briefly explained below:

Stress. Stress provokes lots of unhealthy responses: piling on the portions, eating junk

food, watching TV and not getting enough sleep.

Try: Deep breathing. When you feel stressed, close your eyes and take five deep

breaths, suggests Elizabeth Ricanati, MD, medical director for the Cleveland Clinic’s

Lifestyle 180 program. Deep breathing helps promote a state of calm and mental

focus, so you are better able to make healthier decisions.

Low self-esteem and poor body image. We live in a fat-phobic society where women

in particular feel pressured to look a certain way in order to be accepted. People with

obesity may internalize these negative judgments, and the self-loathing often leads to

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further eating and other unhealthy behaviours, says Michael McKee, PhD, a

psychologist at the Cleveland Clinic who works with obese patients.

Try: Positive self-talk. Remind yourself that you deserve to be healthy and take care

of your body. Compliment yourself for achieving small goals, and encourage yourself

to do more. You may also benefit from joining a weight-loss support group.

Depression. “As BMI increases, so does the risk for depression,” says Leslie

Heinberg, PhD, the director of behavioural services for the Bariatric and Metabolic

Institute at the Cleveland Clinic and an associate professor at the Cleveland Clinic

Lerner College of Medicine.

Try: Professional help. While exercise and losing weight can help you better manage

the symptoms of depression, you may need professional treatment. Tell your doctor

immediately how you’re feeling — don’t wait for the feelings to go away.

Attitudes toward Obesity

Barbara Jaurequi says, in order to better understand the specificity of negative

attitudes and perceptions about obesity, one study examined implicit stereotypes of obese

people and found that the obese are considered lazy, stupid, and worthless in relation to

normal weight people (Teachman, Gapinski, Brownell, Rawlins, & Jeyaram, 2003). In an

effort to persuade study participants to reduce their automatic negative perceptions of obese

people, (i.e., implicit stereotypes) this study provided participants with sad and disturbing

stories of discrimination against the obese to read, along with similar stories about wheelchair

bound individuals to test whether sympathy for an obese person’s plight might override the

tendency to judge that person harshly.

In spite of causal knowledge, it seems attitudes toward the obese remain negative. A

study which explored obesity as a character logical stigma (DeJong, 1993) provided high

school girls with causal information about how a person came to be obese. Obese individuals

were videotaped performing a task. The participants viewed the tapes and were

simultaneously informed about the cause of the obese person’s weight. The cause was either

medically based (a thyroid condition) or behaviourally based (e.g., overeating or lack of

exercise). Even with the knowledge that the cause of obesity was not behaviourally based,

participants did not reduce their negative attitudes toward the obese. The results demonstrated

the persistence of negative attitudes toward, and perceptions of the obese despite medically

based explanations for the obesity. This is a significant finding in that overweight people

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themselves commonly reveal feelings of self-blame regarding their obesity, even if they are

being treated for a causal or contributing medical condition, such as a thyroid condition

(Crandall & Biernat, 1994).

Generalized negativity toward obese people persists even in the medical community

where greater understanding of the organic causes of obesity exists (Kolotkin, Meter &

Williams, 2001; Yanovski & Yanovski, 1999). Research has found that a strong implicit

negative bias exists even among health professionals who specialize in the treatment of

obesity (Teachman, et al. 2003). Scientific research does not indicate that gluttony or sloth is

the primary cause of obesity. Indeed, research evidence supports the notion that body weight

is the result of genetic and metabolic factors, and is only modestly related to dietary habits

(Crandall, 1994; Sobal, et al. 1989). This suggests, perhaps, that disdain for the obese is

emotionally based, forcing rationality into a secondary position within collective awareness.

As several studies have demonstrated, (DeJong, 1993; Teachman, et al. 2003) the belief that

obesity falls within the realm of personal responsibility is far-reaching. Some consider

obesity to be a self-induced condition that can be reversed if the obese individual is inclined

to reverse it (DeJong, 1993). Therefore, in terms of its social psychological implications,

obesity is viewed as an issue of character. By and large, it is assumed that obesity is mainly a

matter of self-control and willpower. Assumptions made about the apparent lack of discipline

in the obese may lead to intensification of these ideas. Research that further supports these

assumptions indicate that anti-fat attitudes reinforce a worldview consistent with the

Protestant work ethic, self-determination, a belief in a just world, and the notion that people

get what they deserve (Crandall, 1994). Negative attitudes toward the obese can actually be

learned in a home where an integral member of the family is obese. For example, if a child in

the family is obese, she or he may be the object of ridicule within the household. The child

may also be negatively compared to thinner siblings. Additionally, the child’s

accomplishments may be minimized because of the inability to solve the weight problem.

The self-esteem of this individual may suffer as a result of this treatment and the child may

come to believe that she or he is entirely responsible for the obese condition. Parents and

siblings, having had an opportunity to observe the obese individual engaging in sedentary

activities or overeating fattening foods, may also believe she has caused her own misery

through laziness and a lack of will power. These learned attitudes and beliefs may contribute

to the marginalization of an obese individual both within and outside of the family unit.

Interestingly, anti-fat attitudes among those who are obese themselves, are quite similar to

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those of non-obese individuals suggesting the pervasiveness of these negative attitudes

(Teachman et al., 2003). What differentiates the negative bias associated with obesity from

other marginalized groups is that both obese and normal weight individuals report similar

levels of dislike toward the obese, suggesting a lack of protective in-group bias (Teachman et

al., 2003). That is, obese people are very likely to think badly of other obese people for the

very thing they have in common. This is particularly disturbing in light of the fact that obese

individuals have first-hand knowledge about the difficulty of overcoming obesity and have

likely experienced weight discrimination themselves. However, one reason obese individuals

may not demonstrate protective in-group bias is that identification with other obese people

does not improve their self-image (Crandall, 1994). One primary reason for identifying one’s

self with a particular group is because association with that group could enhance self-esteem.

Obese individuals may see little opportunity to boost their self-image through proximity to

other obese people. The “proximity” factor was shown by Hebl and Mannix (2003) to trigger

negative bias between obese and non-obese people who are known to not be associated with

one another. They tested the automatic perceptions that subjects had regarding a job applicant

seated next to an obese woman and compared them to the perceptions subjects had when the

applicant was seated next to a person of normal weight. The applicant was rated more

negatively when seated next to the obese woman, suggesting that being in the mere proximity

of an obese person was enough to trigger stigmatization toward the applicant. Many

researchers now argue that further empirical research is needed to understand how these

attitudes are associated in particular population subgroups, what leads to these attitudes, and

how attitudes may be changed. This study was indented to identify the association of attitudes

towards obesity among college students.

An individual’s diet and physical activity habits are influenced by their knowledge of

and attitudes towards healthy behaviours. Investigation of these variables in a population

provides an insight into the factors that may be mediators of motivation to change behaviour.

Theories from health psychology, sociology and social psychology have been proposed to

explain the link between knowledge, attitudes, skills, social and environmental influences,

and behaviour. For example, the health belief model theorises that in order for behaviour

change to take place, an individual must first believe that change is both possible and

beneficial, and that the benefits of changing outweigh any perceived costs of making the

change.1 The model demonstrates the relationship between an individual’s attitudes towards

a particular set of behaviours, and their subsequent willingness or ability to make changes to

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improve or protect their health. For example, if a person does not consider their diet to be

unhealthy, they are unlikely to make any significant dietary changes to improve their health –

especially if they perceive that doing so would mean substituting food they like for food they

may like less. Social cognitive theory also considers the importance of an individual’s

knowledge and attitudes in influencing behaviour and behaviour change.2 In addition, it also

recognises the impact of external factors such as social and environmental influences on

individual behaviour.3 For example, the likelihood of a child eating five portions of fruit and

vegetables a day will be influenced by social factors (e.g. their parents’ views on healthy

eating), and environmental factors (e.g. the availability of fruit and vegetables at home). The

principles of behaviour change theories have been used in research studies to identify

personal and social correlates of healthy eating and physical activity behaviours. A

systematic review identified that the perception of physical activity as being enjoyable was

more highly correlated with participation than any health; benefits.4; The influence of the

social environment and, in particular, the views of peers and ‘significant others’ is a common

theme as people tend to engage in behaviour which is practiced by, and valued by their peers.

Self-efficacy, which is an individual’s belief that they are capable of changing their

behaviours, can also be a key determinant of eating and physical activity behaviour.

Researchers have recommended that motivational education techniques may be useful in

influencing personal belief and therefore support sustained behaviour change.6 A review that

looked at randomised, controlled psychological interventions for overweight or obese adults

supports theories of behaviour change and advocates an approach to weight management that

focuses on using cognitive therapies to change behaviour combined with healthy eating

education and exercise components. All these factors can sum up a healthy life for mankind.

Obesity is an excess proportion of total body weight. A person is considered obese when his

or her body is 20% or more above normal weight obesity has emerged as the most prevalent

serious public health proportion of our country obese is increase though out the world. At

present it is estimated that the all more 250 million people world which affected to be

equalling 7% of the young adult population. Indians are genetically susceptible to weight

accumulated especially around the waist and 5% of the population suffers due to study

obesity in India. An epidemiological survey in 2007 revealed that taking predominant by

2010 it will reach to 17.5% of the population. Adults taking predominant place that adolased

and children by 637. Of the incidence rises it will be more of health to the country. Obesity is

most important factor for osteoarthritis in most joint. Obesity confers nine times increased

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risk in knee total osteoarthritis in women. Considering this as a relevant issue the researcher

made an attempt to conduct a study on the prevalence, related knowledge, attitude and

effectiveness of awareness program regarding obesity among selected degree students in

Mahatma Gandhi University

Statement of the Problem

The purpose of the study was to make an explorative and evaluative study of the prevalence,

related knowledge, attitude and effectiveness of awareness program regarding obesity among

selected degree students in Mahatma Gandhi University.

Objectives:

1. To assess the prevalence of obesity among selected degree students of selected

colleges in M G University.

2. To assess the knowledge and attitude regarding obesity among college students in

experimental and control group.

3. To determine the effectiveness of awareness program regarding obesity in terms of

gain in knowledge and attitude scores of college students in experimental group I.

4. To find the relationship between knowledge and attitude regarding obesity among

college students.

5. To determine the association of level of knowledge and attitude regarding obesity

among college students with their selected personal variables.

Delimitations

1. The study was delimited to female students from selected colleges from Mahatma Gandhi

University.

2. The study was further delimited to female students of age group 18 to 23 years

3. The study was delimited to 300 female students in the exploratory phase and 50 for each

experimental and control group.

4. The study was delimited to the selected variables such as Body Mass Index (BMI) in

order to assess the prevalence of obesity in the exploratory phase.

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5. The study was further delimited to the variables such as level knowledge regarding

obesity and attitudes towards obesity.

Limitation

The assessment of knowledge and attitudes toward obesity was based on

questionnaire survey method. Any bias and insincerity of the subjects that might have crept

into their responses would be considered as the limitation of the study.

Definition of Terms

Knowledge:

It refers to the correct responses of college students to the questions included in the

structured knowledge questionnaire regarding obesity and is expressed in terms of knowledge

scores.

Attitude:

It refers to the general feelings or frame of references around which the college student

organizes his or her knowledge regarding obesity which is evaluated in terms of responses to

the items in the structured attitude scale and expressed in terms of attitude scores.

Obesity:

It refers to a medical condition in which there is a generalized accumulation of excess fat in

adipose tissue in the body leading to more than 20% of the desirable weight and may have an

adverse effect on health, leading to reduced life expectancy and or increased health problems.

In the present study obesity is assessed by anthropometric measurements like height

(Ht),weight (wt),body mass index (BMI)and waist hip ratio (WHR) and categorized as

underweight(BMI less than18.5), normal weight(BMI-18.5-24.9),overweight(BMI-25.0-

29.9), obese(BMI-30 and above).

Awareness program:

An educational program or a campaign aims to enhance the knowledge and positive attitude

regarding obesity and health which includes meaning, causes, risk factors, Effects,

complications and preventive measures about obesity and presented to the group by power

point presentation, charts, models and individual discussion.

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Prevalence:

It refers to the total population with obesity at a given specific time. In the study the

prevalence is estimated among female college students according to WHO standards.

Significance of the Study

Importance of this study to assess the knowledge regarding obesity and its complications

among the college women, to make awareness about prevalence of obesity sensitizes the

college students to participate willingly in the study and awareness program enhances

knowledge and promote positive attitude among college students.

1. The study would give a base line data regarding the knowledge and attitude towards

obesity of college level female students.

2. Body measurements such as BMI and WHR help to assess the prevalence of certain

risk factors associated with this

3. To create an awareness toward obesity and a positive attitude towards obesity.

19

Chapter –II

REVIEW OF RELATED LITERATURE

Penny Gordon (2000) conducted a study on obesity-related knowledge, attitudes, and

behaviours in obese and non-obese urban Philadelphia female adolescents. The purpose of

the study was to examine relationships between knowledge, attitudinal and behavioural

factors, and obesity and to determine how these factors influence obesity status in west

Philadelphia female adolescents. A matched-pairs study was conducted with 32 stature- and

age-matched pairs of obese (body mass index and triceps skinfold 95th percentile of National

Health and Nutrition Examination Survey I) and non-obese (body mass index and triceps

skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination

Survey I) female African American adolescents (aged 11 to 15 years), selected from a school

based study sample, based on obesity status and matching criteria. Adolescents were

compared on the following measures: physical activity, inactivity, dietary intake, eating

attitudes, health behaviour knowledge, body image, self-esteem, and maturation status.

Differences between obese and non-obese females were tested using paired t tests and

Wilcoxon matched-pairs signed-rank tests. It was found that the physical activity, inactivity,

and perception of ideal body size emerged as the most important contributory factorsnto

obesity status. There were no statistically significant matched-pair differences in

macronutrient and micronutrient intakes, self-esteem, eating attitudes, health behaviour

knowledge, or maturation status of these adolescents. Obese adolescents had significantly

lower levels of physical activity, higher inactivity, and a larger perception of ideal body size

than non-obese adolescents. Knowledge and attitudinal factors (with the exception of

perception of ideal body size) had far less association with obesity than activity-related

behavioural factors. These findings suggest that future intervention strategies should pay

particular attention to physical activity, inactivity, and body image attitudes.

L McArthur, M Pena and D Holbert (2001) conducted a study on Effects of socioeconomic

status on the obesity knowledge of adolescents from six Latin American cities The purpose of

the study was to examine the effects of socioeconomic status (SES) on the obesity knowledge

of adolescents in six Latin American cities. Data were collected using a self-administered

questionnaire consisting of demographic questions and a 25-item multiple-choice obesity

knowledge test. Test items were clustered under five topics: the fat and calorie content of

foods and beverages; weight loss methods; energy expenditure; food preparation methods;

20

and the relationship between obesity and health. For the purpose of the study a total of 1272

ninth grade students from higher and lower SES families were recruited at schools in Buenos

Aires, Argentina (n .195); Guatemala City, Guatemala (n.212); Havana, Cuba (n .213); Lima,

Peru (n.218); Panama City, Panama (n.195); and Santiago, Chile (n.239). Analysis of the

results showed that the mean test scores reflected a low level of obesity knowledge among

adolescents from higher and lower SES groups in all six cities. Nevertheless, a trend for

higher scores emerged in favour of adolescents from wealthier families. This income effect

persisted after controlling for gender and weight status. The weakest knowledge areas among

youth from the higher SES groups were food preparation methods and the relationship

between obesity and health while those for adolescents from the lower SES groups were the

fat and calorie content of foods and beverages and the relationship between obesity and

health. Classroom instruction about obesity was generally more available to students from the

higher SES groups. The majority of adolescents from both SES groups were interested in

learning more about weight loss methods, energy expenditure, and the fat and calorie content

of foods and beverages. The topic of least interest was the relationship between obesity and

health. And they concluded that these preliminary findings suggest a need for more obesity

education programs for adolescents, especially for those living in poverty.

G Turconi et. al (2003) conducted a study on Reliability of a dietary questionnaire on food

habits, eating behaviour and nutritional knowledge of adolescents The objective of the study

was to develop a dietary questionnaire on food habits, eating behaviour and nutrition

knowledge of adolescents and to examine its reliability. A cross-sectional baseline survey

was designed and the questionnaire was self-administered to study participants twice with 7

days between each administration among a school community in Pavia, Italy. A group of

students (n¼72, aged 14–17 y, both sexes) studying in a secondary school in the second year

of the course were invited to compile a dietary questionnaire during school time. Informed

written consent was obtained from each subject and their parents. Subjects were initially

recruited for a nutrition intervention; recruitment was opportunistic and school based.

Reliability was assessed using the Cronbach’s alpha and the Pearson correlation coefficients.

The results showed that Cronbach’s alpha ranges from a minimum of 0.55 to a maximum of

0.75, indicating that only two sections have a poor internal consistency. The Pearson

correlation coefficients range from a minimum of 0.78 to a maximum of 0.88, indicating a

very good temporal stability of the questionnaire. All the Pearson correlation coefficients are

statistically significant with P=0.01. They concluded that the present questionnaire has the

21

potential to measure the effects of nutrition interventions on adolescents because of its

stability in making comparisons over time. The instruments are low in cost and easy to

administer and analyse; moreover, it could be modified appropriately to fit the needs of other

populations as well.

Aree Kantachuvessiri et. al (2005) conducted a study on factors associated with obesity

among workers in a metropolitan waterworks authority. The purpose of the study was to

examine the relationship of socio-demographic characteristics, psychological factors,

knowledge, attitude and behaviour towards obesity among metropolitan waterworks authority

(MWWA) officers, a cross-sectional study was conducted between July and September,

2004. Two hundred and eighty-eight obese [body mass index (BMI) ≥ 25 kg/m2] and 106

non-obese persons, aged 20 - 60 years, were recruited as study subjects. Data were collected

by a self-administered questionnaire, comprised of three parts: socio-demographic;

psychological factors (depression and stress); and knowledge, attitude, behaviour related to

obesity. Univariate analyses and Logistic regression models were used to study the

association between obesity and possible risk factors. The results demonstrate significant

associations between older age and obesity. Volunteers in the age groups of 40-49 and 50-59

years had a significantly higher risk of being obese than the age group of less than 40 years

(adjusted OR = 3.4, 95% CI = 1.1-11.1 and adjusted OR = 10.4, 95% CI = 3.3-32.7,

respectively). Volunteers with unhealthy behaviours were at significantly higher risk than

those with healthy behaviours (adjusted OR = 10.3, 95% CI = 2.0-52.4) while persons with

moderately healthy behaviours also had increased risk, but to a lesser extent (adjusted OR =

4.5, 95% CI = 1.7-11.4). There were no associations between psychological factors and

obesity in this group of volunteers. When they focused on whether they consumed more food

when they were stressed, it was found that the obese consumed significantly more food

during stress (p-value=0.003). Watching television, videos, or playing computer continuously

for more than 3 hours, were significantly associated with obesity. They conclude that

although the obese have a good knowledge and attitude towards obesity, they still practise

unhealthy behaviour, have a sedentary lifestyle, and over eat when they are stressed. Future

research regarding behavioural modification should be implemented at both community and

country levels.

Rozane Márcia Trichesa and Elsa Regina Justo Giuglianib (2005) conducted a study on

Obesity, eating habits and nutritional knowledge among school children. The objective of the

study was to evaluate the association between obesity and eating habits and nutritional

22

knowledge among schoolchildren. Weight and height were measured in 573 schoolchildren

of public schools in two cities of State of Rio Grande do Sul, Southern Brazil. Obesity was

defined as Body Mass Index above the 95th percentile based on the National Centre for

Health Statistics (NCHS) criteria. Eating habits and nutrition knowledge were evaluated

using a self administered questionnaire. Simple and adjusted logistic regression models were

used to assess associations. The results revealed that obesity among children was found to be

associated with limited nutrition knowledge and unhealthy eating and habits. These children

were five times more likely to be obese (OR=5.3; 1.1-24.9). They concluded that the level of

knowledge affects the association between obesity and eating habits, and there’s reason to

suspect that children who have more nutrition knowledge report habits known to be healthier

but not necessarily the ones they actually practice. Taking into account children’s level of

knowledge, unhealthy habits were strongly associated to obesity.

Abdallah S Al-Rethaiaa et. al (2010) conducted a study on Obesity and eating habits among

college students in Saudi Arabia: a cross sectional study the review of literature revealed that

during the last few decades, the Kingdom of Saudi Arabia (KSA) experienced rapid socio-

cultural changes caused by the accelerating economy in the Arabian Gulf region. That was

associated with major changes in the food choices and eating habits which, progressively,

became more and more “Westernized”. Such “a nutritional transition” has been claimed for

the rising rates of overweight and obesity which were recently observed among Saudi

population. The purposes of the their work were to determine the prevalence of overweight

and obesity in a sample of male college students in KSA and to determine the relationship

between the students’ body weight status and composition and their eating habits. For that

total of 357 male students aged 18-24 years were randomly chosen from College of Health

Sciences at Rass, Qassim University, KSA for the their study. A Self-reported questionnaire

about the students’ eating habits was conducted, and their body mass index (BMI), body fat

percent (BF%), and visceral fat level (VFL) were measured. Data were analyzed using SPSS

statistical software, and the Chi-square test was conducted for variables. The results indicated

that 21.8% of the students were overweight and 15.7% were obese. The total body fat

exceeded its normal limits in 55.2% of the participants and VFL was high in 21.8% of them.

The most common eating habits encountered were eating with family, having two meals per

day including breakfast, together with frequent snacks and fried food consumption.

Vegetables and fruits, except dates, were not frequently consumed by most students.

Statistically, significant direct correlations were found among BMI, BF% and VFL (P <

23

0.001). Both BMI and VFL had significant inverse correlation with the frequency of eating

with family (P = 0.005 and 0.007 respectively). Similar correlations were also found between

BMI and snacks consumption rate (P = 0.018), as well as, between VFL and the frequency of

eating dates (P = 0.013). Their findings suggest the need for strategies and coordinated efforts

at all levels to reduce the tendency of overweight, obesity and elevated body fat, and to

promote healthy eating habits in our youth.

M. Garaulet et. al (2012) conducted a study on validation of a questionnaire on emotional

eating for use in cases of obesity; the Emotional Eater Questionnaire (EEQ). They noted that

emotions have a powerful effect on our choice of food and eating habits. It has been found

that in some people there is relationship between eating, emotions and the increased energy

intake. This relationship should be measurable to better understand how food is used to deal

with certain mood states and how these emotions affect the effectiveness of weight loss

programs. The purpose of the study was to develop and analyze the psychometric

characteristics of a questionnaire on emotional eating for obesity easy to apply in clinical

practice. A ten-item questionnaire called Emotional-Eater-Questionnaire (EEQ) was

developed and administered to a total of 354 subjects (body mass index, 31 ± 5), aged 39 ±

12, who were subjected to a weight-reduction program. The questionnaire was specifically

designed for obesity. Analysis of the internal structure, internal consistency, test-retest

reliability and convergent validity with Mindful-Eater-Questionnaire (MEQ) were conducted.

After principal components analysis, the questionnaire was classified in three different

dimensions that explained 60% of the total variance: Disinhibition, Type of food and Guilt.

Internal consistency showed that Cronbach´s alpha was 0.773 for the “Dishinibition”

subscale, 0.656 for the “Type of food” subscale and 0.612 for the “Guilt” subscale. The test-

retest stability was r = 0.70. The data showed that the percentage of agreement between the

EEQ and the MEQ was around 70% with a Kappa index of 0.40; P < 0.0001. They concluded

that they have presented a new questionnaire, which classifies individuals as a function of the

relation between food intake and emotions. Such information will permit personalised

treatments to be designed by drawing up early strategies from the very beginning of treatment

programmes.

Parastoo Golshiri et. al (2012) conducted a study on Developing and validating

questionnaires to assess knowledge, attitude, and performance toward obesity among Iranian

adults and adolescents: TABASSOM study. The study described the methods of developing

24

and validating two questionnaires that will be used to investigate the knowledge, attitude and

practice of adults, children and adolescents regarding obesity. To design the questionnaires,

they used the components of the Health Belief Model. The questionnaire for adults consisted

of 6 sections with 50 questions. The questionnaire for children and adolescents included 7

sections and 52 questions. The questionnaires were assessed for face validity, content

validity, and clarity of the items. To determine the internal consistency reliability of the

questionnaires, Cronbach's alpha coefficient was measured for 100 questionnaires. Using the

correlation coefficient, we determined the equivalent reliability of the study tools. They found

that the Cronbach's alpha coefficient ranged between 0.60 and 0.80 for the whole

questionnaires. The Cronbach's alpha coefficient of the questionnaires for adults, children and

adolescents were respectively 0.72 and 0.60 for awareness. The corresponding values for

attitude were 0.70 and 0.75. Using Pearson's correlation coefficient, the inter observer

reliability was determined to be significant (r ≥ 0.80; P < 0.001). They concluded that their

study tools had adequate reliability and validity. They are thus suitable for assessing the

knowledge, attitude, and practices of Iranian adults, and children and adolescents in toward

obesity.

Soriano R et. al (2012) conducted a study on High knowledge about obesity and its health

risks, with the exception of cancer, among Mexican individuals. Mexico has the second

biggest prevalence in the world of obese adults (30%). They conducted a survey to determine

knowledge concerning obesity co-morbidities. Three groups were surveyed with a

questionnaire divided into three sections: demographic characteristics; knowledge and

awareness in relation to obesity being a disease; causes of obesity and the health risks it

represents; weight auto-perception and the subject's personal experiences regarding weight.

In all groups we found high knowledge regarding that obesity is a disease and the causes of

its development, as well as that it greatly increases the risk of presenting type 2 diabetes, high

blood pressure and knee osteoarthritis. However, in all groups, there was a gap in knowledge

regarding the risk obesity poses for the development of breast and colon cancer. Aggressive

health promotion campaigns concerning obesity, which have been implemented recently in

Mexico, must emphasize cancer as a potential outcome for obese patients.

Lisa R. Jenike (2013) conducted a study on a primary care intervention for overweight and

obese children and adolescents. They reviewed that the rising rates of overweight and obesity

in children and adolescents have been accompanied by an increase in adverse health

outcomes such as cardiovascular disease and diabetes. There is a need for evidence-based

25

interventions that can be used by primary care providers to address this issue. The purpose of

the study was to provide education to children and adolescents and their families on healthy

nutrition and physical activity, thus increasing knowledge related to healthy lifestyle patterns

and significantly reducing body mass index (BMI). A primary care healthy choices

intervention program for overweight and obese school-aged children and their parents

(Jacobson & Melnyk, 2012) was the foundation for this project. Their program highlighted

the use of remote methods to offer education regarding healthy choices resulting in decreased

BMI. A 1-group, 7-week pre-/post-test design was used with outcome measures including

BMI percentile and physical activity and nutrition knowledge. Children and adolescents

found the project to be informative and helpful in promoting healthy behaviours. Beneficial

effects of the intervention included decreased BMI percentile and increased knowledge

regarding healthy nutrition and physical activity. This project provides further support that

remote education in conjunction with motivational interviewing can result in beneficial

outcomes and may provide a convenient, cost-effective approach in which to reach this

population.

Lucinéia de Pinho et.al (2013) conducted a study on Development and validity of a

questionnaire to test the knowledge of primary care personnel regarding nutrition in obese

adolescents. They reported that in light of its epidemic proportions in developed and

developing countries, obesity is considered a serious public health issue. In order to increase

knowledge concerning the ability of health care professionals in caring for obese adolescents

and adopt more efficient preventive and control measures, a questionnaire was developed and

validated to assess non-dietician health professionals regarding their Knowledge of Nutrition

in Obese Adolescents (KNOA). The development and evaluation of a questionnaire to assess

the knowledge of primary care practitioners with respect to nutrition in obese adolescents was

carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42

questions and preliminary evaluation of the questionnaire by a panel of experts; 3)

characterization and selection of primary care practitioners (35 dieticians and 265 non-

dieticians) and measurement of questionnaire criteria by contrasting the responses of

dieticians and non-dieticians; 4) reliability assessment by question exclusion based on item

difficulty (too easy and too difficult for non-dietician practitioners), item discrimination,

internal consistency and reproducibility index determination; and 5) scoring the completed

questionnaires. They found out that Dieticians obtained higher scores than non-dieticians

(Mann–Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items

26

were discriminated by correlating the score for each item with the total score, using a

minimum of 0.2 as a correlation coefficient cut-off value. Item difficulty was controlled by

excluding questions answered correctly by more than 90% of the non-dietician subjects (too

easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the

original 42 questions, increasing Cronbach’s αvalue from 0.788 to 0.807. Test-retest

agreement between respondents was classified as good to very good (Kappa test, >0.60).

They concluded that the KNOA questionnaire developed for primary care practitioners is a

valid, consistent and suitable instrument that can be applied over time, making it a promising

tool for developing and guiding public health policies.

Prashanth K and Umarani J (2013) conducted a study on effect of teaching programme on

knowledge and attitude regarding prevention of obesity. The objectives of the study were to

assess the knowledge and attitude on prevention of obesity among adolescents, determine the

effectiveness of a structured teaching programme on knowledge and attitude regarding

prevention of obesity among adolescents, correlate knowledge and attitude regarding

prevention of obesity and find out the association of knowledge and attitude with selected

demographic variables.

The study design selected was pre-experimental one group pre-test and post-test design. The

present study was conducted among the 50 adolescents aged 16 to 18 years studying in I PUC

and II PUC of Pre-university College, Mangalore, Karnataka. The samples were selected by

convenience sampling technique. The tools used were baseline Performa, structured

knowledge questionnaire with 26 questions and five point “Likert scale” with 10 items to

assess the attitude regarding the prevention of obesity. A blueprint of the questionnaire was

prepared and presented as knowledge, comprehension and application category. The items

were prepared on General information – 25%, Causes – 21%, Clinical features – 4%,

Prevention – 38%, and Management – 12%. The intervention given in the study was

structured teaching programme regarding the prevention of adolescent’s obesity. After

obtaining ethical clearance from the institution ethical committee and written consent from

the study participants, the pre-tested and validated tool was administered to the study

samples. The pre-test assessment of knowledge and attitude were carried out and the

structured teaching programme with variety of audio-visual aids was administered on the

same day. Post-test was conducted on the seventh day to assess the knowledge and attitude.

The data collected was then compiled for data analysis. They found out that the ‘t’ value

computed between pre-test and post-test knowledge scores is statistically significant at 0.05

27

level of significance. The calculated ‘t’ value (t=10.57) is greater than the table value

(t (49) =2.0096). This indicates that the teaching programme on prevention of obesity was

effective in improving the knowledge of adolescents. The ‘t’ value computed between pre-

test and post-test attitude scores is statistically significant at 0.05 level of significance. The ‘t’

value (t =3.75) computed is greater than the table value (t (49)=2.0096) and showed that the

teaching programme on prevention of obesity was effective in improving the attitude of

adolescents. For determining the correlation between the knowledge and attitude regarding

prevention of obesity among adolescents, Karl Pearson’s Correlation Coefficient test was

used. The data showed that there was no correlation between knowledge and the attitude

(r=0.2). The data showed that there was no association between pre-test knowledge, attitude

score and demographic variable. The pre-test knowledge score is independent of all variables,

that is, age (c2=2.6, table value=3.84), gender (c2=0.01, table value=3.84), educational status

(c2=2.25, table value=3.84), and area of residence (c2=1.09, table value=3.84), at 0.05 level

of significance. The study concluded that the teaching programme given to adolescents was

effective in terms of gain in knowledge and attitude regarding prevention of obesity. It is one

of the most effective interventions and is concerned with promoting health and preventing

diseases.

Shrivastava S, Shrivastava P. and Ramasamy J. (2013) conducted a study on assessment of

knowledge about obesity among students in a medical college in Kancheepuram district,

Tamil Nadu. The aim of the study was to assess the knowledge of medical students pertaining

to obesity. A cross-sectional descriptive study was conducted among first-year medical

students in March of 2013. A universal sampling method was employed, and all first-year

students were included as subjects in the study. The total sample included 138 students. After

obtaining informed consent, a pre-tested semi-structured questionnaire was administered to

each of the participants. Utmost care was taken to maintain privacy and confidentiality.

Statistical analysis was done using SPSS version 17. Frequency distributions and percentages

were calculated for all the variables. Analysis of the data revealed that lack of physical

activity and the presence of stress were identified as the most common risk factors for obesity

development. Approximately, 73(52.9%) students were of the incorrect opinion that

gynaecoid obesity was more dangerous than android obesity. The most common strategy

cited by 107(77.5%) respondents for prevention of obesity was regular exercise. They

concluded that the study revealed that although the majority of the medical students were

aware of the risk factors of obesity, many gaps, which need to be bridged, were identified in

28

their knowledge. These medical students could be actively involved in awareness campaigns

for delaying the onset of lifestyle diseases.

Kopczynski S ,et. al (2014) con ducted a study on Attitudes towards physical activity and

exercise participation – a Comparison of Healthy-Weight and Obese Adolescents. He

reported that Physical activity and exercise are important in the prevention and treatment of

adolescent obesity. The goal of non-stationary obesity treatment is to encourage long-lasting

sport participation. From the motivational perspective, positive attitudes towards physical

activity and exercise are a key and should be considered when developing obesity

interventions. This study examined potential differences in attitudes towards physical activity

and exercise between adolescents with body mass indices in obese and healthy-weight

ranges. A questionnaire measuring attitudes toward, and current levels of physical activity

and exercise was completed by 395 adolescents recruited from schools and 16 adolescents

recruited from a non-stationary obesity treatment program. This one year obesity treatment

program combined dietary, psychological and physical activity and exercise-related

interventions administered under medical supervision. The study revealed that compared to

adolescents in the healthy-weight range, obese peers showed less positive attitudes towards

intensive exercise/sporting competition and risky sporting activities. Additionally, in both

weight ranges an active lifestyle is attended by a higher value of training and competition

plus social experiences in sports. Independent from weight status, more positive attitudes in

“training and competition” and “social contacts” were related to physical and sport activity.

The study concluded that training, competitive and risky activities offer a lower incentive for

obese adolescents than for healthy-weight peers.

Ranjit Kaur, Ramesh Kumari, and Samuel (2014) conducted a study to assess the knowledge

and attitude of adolescents on obesity at selected senior secondary schools in Amritsar in a

view to develop and distribute information booklet. They reported that adolescents is period

of crucial phase of growth. Adolescence is a particularly vulnerable time for the development

of Obesity. An obese Adolescent is associated with increased morbidity and mortality in their

adulthood. The purpose of the study was to assess the knowledge and attitude of adolescents

towards obesity. The study adopted Descriptive design and conducted at selected Senior

Secondary Schools in Amritsar. A total of 100 Adolescents age group between 15 and 18

years was selected by convenient sampling technique. A Structured knowledge questionnaire

and a Structured Attitude Scale on obesity used. Data analysis is done by Descriptive and

Inferential statistics. The results showed that (67%) samples are having Inadequate

29

knowledge, (32%) samples are having moderately adequate knowledge and (1%) are having

adequate knowledge on obesity. With respect to Attitude (6%) samples are having

Unfavourable attitude, (94%) samples are having moderately favourable attitude and (0%) are

having adequately Favourable attitude regarding obesity. The correlation coefficient (r)

showed that moderately negative correlation between knowledge and attitude. The

association of knowledge with socio demographic variables such as sex, education status,

family income, area of residence, type of family, dietary habits, hobbies found significant

whereas age, education of mother are not significant. Association with attitude and socio

demographic characteristics such as age, sex, family income, area of residence, Type of

family, dietary habits, whereas education status, education of mother, hobbies are not

significant.

Titi Xavier Mangalathil , Pushpendra Kumar and Vikas Choudhary (2014) conducted a

study on knowledge and attitude regarding obesity among adolescent students of Sikar,

Rajasthan. A descriptive study was conducted to assess knowledge and attitude regarding

obesity among adolescent students of Sikar, Rajasthan. A sample comprised of 100

adolescent students were selected, convenience sampling technique was used. The tools used

for data collection were structured knowledge questionnaires and attitude scale. Data analysis

was done by using descriptive and inferential statistics. Findings of the study revealed that

majority of the adolescent students 56% were in the age group of 17-18 years of age and with

regard to educational 61% of the adolescent students were in senior secondary level of

education. Knowledge of the adolescent students ranged between 1- 14 and mean knowledge

score of adolescent students was found to be 5.65 ± 2.907.Range of attitude scores lies

between 65 -101, the mean attitude score of adolescent students 84.88 ± 8.346. Findings

further showed that coefficient of correlation between mean knowledge score and mean

attitude score of adolescent students regarding obesity (0.442) was found to be significant at

0.05 level of significance. Significant association was observed between levels of knowledge

of adolescent students with regard to their age, gender, area of residence, monthly family in-

come, heard of obesity, type of family. Significant association was observed between attitude

of adolescent students with heard about obesity.

Marina A Njelekela et. al (2015) conducted a study on knowledge and attitudes towards

obesity among primary school children in Dar es Salaam, Tanzania. They reported that

childhood obesity has increased over the past two decades. Child obesity is likely to persist

through adulthood and increases the risk of non-communicable diseases (NCDs) later in life.

30

The study assessed knowledge and attitudes towards obesity among primary school children

in Dar es Salaam, Tanzania. A cross-sectional study was conducted in randomly selected

primary schools in Dar es Salaam. A structured questionnaire was used to assess the

knowledge and attitudes. Anthropometric and blood pressure measurements were taken using

standard procedures. A total of 446 children were included in the analysis. The mean age of

the participants was 11.1 ± 2.0 years. The mean body mass index (BMI), systolic blood

pressure (SBP) and diastolic blood pressure (DBP) were 16.6 ± 4.0 kg/m2, 103.9 ± 10.3

mmHg and 65.6 ± 8.2 mmHg, respectively. Prevalence of obesity (defined as BMI >95th

percentile for age and sex) was 5.2%. Half of the children (51.1%) had heard about obesity

from teachers at school (20%), radio (19.4%) and books/newspaper (17.3%). Less than half

(45.4%) had knowledge about the risk factors for childhood obesity and correctly defined

obesity (44.6%). However, a good number of the children (72.1%) were aware that they can

be affected by obesity. Majority of them had negative attitude towards obesity and various

factors leading to or resulting from childhood obesity. The study concluded that knowledge

about childhood obesity among primary school children is moderate and have negative

attitude towards obesity.

31

Chapter- III

PROCEDURE

This chapter describes the procedures that were used for selection of subjects,

selection of variables, collection of data and statistical techniques for the study

Selection of the Subject

For the purpose of the study a total of 300 female college students were randomly

selected from Assumption College, Changanacherry and Bishop Kurialencherry College,

Amalagiri for the Exploratory Phase. 100 female college students (50 Experimental and 50

Control Group) were randomly selected from Assumption College, Changanacherry. Their

age range shall be 18 to 23 years.

Selection of the Variable

For the purpose of the study the following motor variables were selected:

1. Body Mass Index (BMI)

2. Knowledge of Obesity

3. Attitude towards obesity

Description of Test Items

Body Mass Index (BMI)

Body Mass Index of the subjects was calculated using the formula given below:

BMI= Weight (Kg) / Height2 (cm)

The procedures that were adapted to measure height and weight of the subjects were as

follows:

Height:-

Definition: The perpendicular distance between the transverse planes of the vertex and

inferior aspects of the feet.

Equipment: Stadiometer

Procedure: The stretch stature method requires the subject to stand with the feet together and

the heels, but-tocks and upper part of the back touching the scale. The head when placed in

the Frankfort plane need not be touching the scale. The Frankfort plane is achieved when the

Orbitale (lower edge of the eye socket) is in the same horizontal plane as the Tragion (the

notch superior to the tragus of the ear). When aligned, the Vertex is the highest point on the

32

skull. The measurer places the hands far enough along the line of the jaw of the subject to

ensure that upward pressure is transferred through the mastoid processes. The subject is

instructed to take and hold a deep breath and while keeping the head in the Frankfort plane

the measurer applies gentle upward lift through the mastoid processes. The recorder places

the head board firmly down on the vertex, crushing the hair as much as possible. The recorder

further assists by watching that the feet do not come off the floor and that the position of the

head is maintained in the Frankfort plane. Measurement is taken at the end of a deep inward

breath.

(b). Weight

Equipment required: weighing scale

Procedure:- The weight of the subjects were obtained using a standard weighing machine.

3. Knowledge of Obesity:-

A self administered knowledge questionnaire was developed for assessing the knowledge

regarding prevention of obesity. The tool was prepared on the basis of the objectives of the

study. The following steps were adapted in the development of the instrument:

• Review of literature provided adequate content for the tool preparation.

• Researcher’s personal experience, consultation with experts and discussion with peer

groups.

• Prior to structuring the questionnaire the investigator consulted with experts and health

professionals to collected relevant data necessary to construct the items for the knowledge

questionnaire.

• Prior to preparation of the checklist the investigator assessed the knowledge on common

practices of adolescents regarding prevention of obesity.

• Development of Blue print.

• Construction of planned knowledge questionnaire to assess knowledge and regarding

obesity.

Content Validity

It is the assessment of instruments ability to measure what it intends to measure, the degree to

which the data collection tool reflects the body of knowledge pertaining to concept being

studied. 5 experts, comprising of 3 Associate Professors from department of Physical

education, 1 Dietician and 1 Statistician, established content validity of the tool. The experts

33

were requested to give their opinions and suggestions regarding the relevance of the tool for

further modifications to improve the clarity and content of the items. After considering the

experts’ suggestions and modifications, the tool was finalized and it consisted of 40 items on

knowledge regarding obesity.

Reliability of the Tool

Reliability of the research instrument is defined as the extent to which the instrument yields

the same results on repeated measures. It is then concerned with consistency, accuracy,

precision, stability, equivalence and homogeneity. The reliability of the tool is established by

Test –re test method by administering the tool for 30 female college students who fulfilled

sampling criteria. Reliability was established by test – retest method using the Pearson’s

Product –Moment Correlation formula. The reliability co- efficient of the tool was found to

be 0.8715, which showed that the tool was reliable..

4. Attitude towards obesity:-

Attitude Towards Obese Personal Scale (ATOP) was administered among the sample. Before

administration of the questionnaire the purpose of the investigation was made clear for the

subjects and the investigator motivated the subjects to respond as accurately as they can.

Collection of Data

After obtaining formal permission from the college authorities and from the students,

data was collected from 300 students selected by random sampling technique. 50 students

were selected as experimental and 50 were selected as control group. The data on the pre test

was obtained from both the groups and awareness program on obesity was given to the

experimental group. And the data on post test was obtained after the awareness program and

were statistically analysed.

Statistical Analysis

Descriptive statistics such as mean, standard deviation, minimum, maximum and

range were calculated to get the basic distribution of data. Percentile analysis was done for

analysis of prevalence of obesity among selected sample. Dependent t – test was calculated to

find out the difference in pre test and post test mean scores of knowledge and attitude of

experimental and control group. Pearson’s Product Moment correlation was used to find the

relationship between the selected variables.

.

34

Chapter – IV

ANALYSIS OF THE DATA AND RESULTS OF THE STUDY

This chapter includes the level of significance, findings and discussion of findings

Level of significance

Based on the requirement on the study the level of significance was fixed at 0.05.

Findings

The data on Body Mass Index, Knowledge of Obesity and Attitude towards Obesity were

collected and statistically analysed. The details are given below.

Table-1

ANALYSIS OF SELECTED VARIABLES AMONG SELECTED DEGREE

STUDENTS

Variables

N

MINIMUM

MAXIMUM

AM

SD

RANGE

Age 300 18 23 20.12 1.57 5

Height (cm) 300 144 176 158 5.80 32

Weight (Kg) 300 35 69 47.15 7.43 34

BMI 300 14.38 28.35 18.75 2.46 13.97

Knowledge Score 300 13 32 22.23 3.82 19

Attitude Score 300 12 87 61.27 11.71 75

Table 1 show that the minimum and maximum age of the subject was 18 years and 23

years with a range of 5 years. Mean and SD of age of the subjects was 20.12 years and 1.57

years respectively. Minimum and maximum height of the subject was 144 cm and 176 cm

with a range of 32 cm. Mean and SD of height of the subjects was 158 cm and 5.80 cm

respectively. Minimum and maximum weight of the subject was 35 kg and 69 kg with a

range of 34 kg. Mean and SD of weight of the subjects was 47.15 kg and 7.43 kg

respectively. The minimum and maximum BMI of the subject was 14.38 and 28.35 with a

range of 13.97. Mean and SD of BMI of the subject was 18.75 and 2.46 respectively. The

minimum and maximum knowledge score of the subject was 13 and 32 with a range of 19.

Mean and SD of knowledge score of the subjects was 22.23 and 3.82 respe

minimum and maximum attitude score of the subject was 12 and 87 with a range of 75. The

mean and SD of attitude score of the subject was 61.27 and 11.71 respectively.

PERCENTILE ANALYSIS ON BMI

Variable Severe Under

Weight

BMI 15%

Table 2 reveals that 2.5% of the total subjects were overweight, 47.5% were normal

weight, 35% were underweight and 15% were severe underweight category with respect to

their Body Mass Index.

Figure 1. Percentile analysis of BMI

0102030405060708090

100

15

SEVERE UNDER WEIGHT

NORMAL WEIGHT

OBESE

35

minimum and maximum knowledge score of the subject was 13 and 32 with a range of 19.

Mean and SD of knowledge score of the subjects was 22.23 and 3.82 respe

minimum and maximum attitude score of the subject was 12 and 87 with a range of 75. The

mean and SD of attitude score of the subject was 61.27 and 11.71 respectively.

Table 2

PERCENTILE ANALYSIS ON BMI

Severe Under

Weight Under weight

Normal

weight

35% 47.5%

Table 2 reveals that 2.5% of the total subjects were overweight, 47.5% were normal

weight, 35% were underweight and 15% were severe underweight category with respect to

Figure 1. Percentile analysis of BMI

BMI

15

35

47.5

2.5 0

SEVERE UNDER WEIGHT UNDER WEIGHT

NORMAL WEIGHT OVER WEIGHT

minimum and maximum knowledge score of the subject was 13 and 32 with a range of 19.

Mean and SD of knowledge score of the subjects was 22.23 and 3.82 respectively. The

minimum and maximum attitude score of the subject was 12 and 87 with a range of 75. The

mean and SD of attitude score of the subject was 61.27 and 11.71 respectively.

Over weight

2.5%

Table 2 reveals that 2.5% of the total subjects were overweight, 47.5% were normal

weight, 35% were underweight and 15% were severe underweight category with respect to

36

Table 3

ANALYSIS OF KNOWLEDGE SCORE OF EXPERIMENTAL GROUP

GROUP

N

MINIMUM

MAXIMUM

AM

SD

RANGE

Pre-Test 50 14 24 20.08 2.80 10

Post-Test 50 15 30 23.44 3.48 15

The minimum and maximum knowledge score of the subject in pre-test was 14 and 24 with a

range of 10. Mean and SD of knowledge score of the subjects in pre-test was 20.08 and 2.80

respectively. The minimum and maximum knowledge score of the subject in post-test was 15

and 30 with a range of 15. Mean and SD of knowledge score of the subjects in post-test was

23.44 and 3.48 respectively.

Table 4

DEPENDENT t-TEST OF KNOWLEDGE SCORE OF THE EXPERIMENTAL

GROUP

Group N AM t (cal) p- value

PRE TEST 50 20.08

5.54 * 5.95317E-07

POST TEST 50 23.44

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 4 reveals that the mean value of knowledge score of pre test and post test was 20.08

and 23.44 respectively. Since the calculated t value i.e. 5.54 is greater than the t (critical)

value i.e. 2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there

is significant difference exists between the pre-test and post-test score of the experimental

group.

Figure 2. Mean value of Knowledge Score (Experimental Group)

ANALYSIS OF KNOWLEDGE SCORE OF CONTROL GROUP

GROUP

N

Pre-Test 50

Post-Test 50

The minimum and maximum knowledge score of the subject in pre

range of 18. Mean and SD of knowledge score of the subjects in pre

respectively. The minimum and maximum knowledge score of the subject in post

and 30 with a range of 15. Mean and SD of knowledge score of the subjects in post

22.96 and 3.68 respectively.

0

10

20

30

40

50

37

re 2. Mean value of Knowledge Score (Experimental Group)

Table 5

ANALYSIS OF KNOWLEDGE SCORE OF CONTROL GROUP

N

MINIMUM

MAXIMUM

AM

50 13 31 22.68

50 15 30 22.96

The minimum and maximum knowledge score of the subject in pre-test was 13 and 31 with a

range of 18. Mean and SD of knowledge score of the subjects in pre-test was 22.68 and 3.78

respectively. The minimum and maximum knowledge score of the subject in post

and 30 with a range of 15. Mean and SD of knowledge score of the subjects in post

KNOWLEDGE SCORE

20.0823.44

PRE-TEST POST- TEST

ANALYSIS OF KNOWLEDGE SCORE OF CONTROL GROUP

SD

RANGE

3.78 18

3.68 15

test was 13 and 31 with a

test was 22.68 and 3.78

respectively. The minimum and maximum knowledge score of the subject in post-test was 15

and 30 with a range of 15. Mean and SD of knowledge score of the subjects in post-test was

DEPENDENT t-TEST OF KNOWLEDGE SCORE OF THE CONTROL GROUP

Group

PRE TEST

POST TEST

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 6 reveals that the mean value of knowledge score of pre test and post test was 22.68

and 22.96 respectively. Since the calculated t

i.e. 2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

significant difference exists between the pre

Figure 3. Mean value of Knowledge Score (Control Group

ANALYSIS OF ATTITUDE SCORE OF EXPERIMENTAL GROUP

GROUP

N

Pre-Test 50

Post-Test 50

0

10

20

30

40

50

38

Table 6

TEST OF KNOWLEDGE SCORE OF THE CONTROL GROUP

N AM t (cal)

50 22.68

0. 40 *

50 22.96

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 6 reveals that the mean value of knowledge score of pre test and post test was 22.68

and 22.96 respectively. Since the calculated t value i.e. 0.40 is less than the t (critical) value

i.e. 2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

significant difference exists between the pre-test and post-test score of the control group.

Knowledge Score (Control Group

Table 7

ANALYSIS OF ATTITUDE SCORE OF EXPERIMENTAL GROUP

N

MINIMUM

MAXIMUM

AM

50 47 77 62.92

50 42 87 61.12

KNOWLEDGE SCORE

22.68 22.96

PRE-TEST POST- TEST

TEST OF KNOWLEDGE SCORE OF THE CONTROL GROUP

p- value

0.345

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 6 reveals that the mean value of knowledge score of pre test and post test was 22.68

value i.e. 0.40 is less than the t (critical) value

i.e. 2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

test score of the control group.

ANALYSIS OF ATTITUDE SCORE OF EXPERIMENTAL GROUP

SD

RANGE

8.67 30

11.81 45

The minimum and maximum attitude score of the subject in pre

range of 30. Mean and SD of attitude score of the subjects in pre

respectively. The minimum and maximum attitude score of the subject in post

and 87 with a range of 45. Mean and SD of attitude score of the subjects in post

61.12 and 11.81 respectively.

DEPENDENT t-TEST OF ATTITUDE SCORE OF THE EXPERIMENTAL GROUP

Group

PRE TEST

POST TEST

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 8 reveals that the mean value of attitude score of pre test and post test was 62.92 and

61.12 respectively. Since the calculated t value

2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

significant difference exists between the pre

group.

Figure 4. Mean value of Attitude Score (Experimental Group)

0

20

40

60

80

100

39

The minimum and maximum attitude score of the subject in pre-test was 47 and 77 with a

range of 30. Mean and SD of attitude score of the subjects in pre-test was 62.92 and 8.67

respectively. The minimum and maximum attitude score of the subject in post

and 87 with a range of 45. Mean and SD of attitude score of the subjects in post

61.12 and 11.81 respectively.

Table 8

TEST OF ATTITUDE SCORE OF THE EXPERIMENTAL GROUP

N AM t (cal)

50 62.92

0.83 *

50 61.12

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 8 reveals that the mean value of attitude score of pre test and post test was 62.92 and

61.12 respectively. Since the calculated t value i.e. 0.83 is lesser than the t (critical) value i.e.

2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

significant difference exists between the pre-test and post-test score of the experimental

ean value of Attitude Score (Experimental Group)

ATTITUDE SCORE

62.92 61.12

PRE-TEST POST- TEST

test was 47 and 77 with a

test was 62.92 and 8.67

respectively. The minimum and maximum attitude score of the subject in post-test was 42

and 87 with a range of 45. Mean and SD of attitude score of the subjects in post-test was

TEST OF ATTITUDE SCORE OF THE EXPERIMENTAL GROUP

p- value

0.21

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 8 reveals that the mean value of attitude score of pre test and post test was 62.92 and

i.e. 0.83 is lesser than the t (critical) value i.e.

2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

test score of the experimental

40

Table 9

ANALYSIS OF ATTITUDE SCORE OF CONTROL GROUP

GROUP

N

MINIMUM

MAXIMUM

AM

SD

RANGE

Pre-Test 50 12 85 61.92 12.72 73

Post-Test 50 42 77 61.16 9.81 35

The minimum and maximum attitude score of the subject in pre-test was 12 and 85 with a

range of 73. Mean and SD of attitude score of the subjects in pre-test was 61.92 and 12.72

respectively. The minimum and maximum attitude score of the subject in post-test was 42

and 77 with a range of 35. Mean and SD of attitude score of the subjects in post-test was

61.16 and 9.81 respectively.

Table 10

DEPENDENT t-TEST OF ATTITUDE SCORE OF THE CONTROL GROUP

Group N AM t (cal) p- value

PRE TEST 50 61.92

0.34 * 0.368

POST TEST 50 61.16

*at 0.05 level of significance, with 49 degree of freedom t(critical) value is 2.00

Table 10 reveals that the mean value of attitude score of pre test and post test was 61.92 and

61.12 respectively. Since the calculated t value i.e. 0.34 is lesser than the t (critical) value i.e.

2.00, at 0.05 level of significance with 49 degree of freedom, we conclude that there is no

significant difference exists between the pre-test and post-test score of the control group.

Figure 5. Mean value of Attitude Score (Control Group)

ASSESSMENT OF RELATIONSHIP BETWEEN SELECTED VARIABLES

SL. NO Variables

1 Knowledge and Attitude

2 Attitude and BMI

3 Knowledge and BMI

Table 11 revels that there is a

attitude, since the correlation coefficient is

attitude and BMI, since the correlation coefficient is 0.20. A negative correlation exists

between knowledge and BMI, since the correlation coefficient is

The assessment on knowledge of obesity revealed that the mean value of knowledge test on

obesity is 22.23 and the SD is 3.82. This implies that the knowledge level of degree students

in relation to obesity is comparatively lesser, which will have direct i

practices of a healthy lifestyle. The assessment on attitude towards obesity revealed that all

the students have a positive attitude towards obesity. The assessment of prevalence of obesity

reveals that 2.5% of the total subjects were ove

0

20

40

60

80

100

41

of Attitude Score (Control Group)

Table 11

ASSESSMENT OF RELATIONSHIP BETWEEN SELECTED VARIABLES

Variables Correlation value

Knowledge and Attitude

Knowledge and BMI

Table 11 revels that there is a negative correlation exist between knowledge and

attitude, since the correlation coefficient is -0.20. A positive correlation exists between

attitude and BMI, since the correlation coefficient is 0.20. A negative correlation exists

MI, since the correlation coefficient is -0.27.

Discussion of Findings

The assessment on knowledge of obesity revealed that the mean value of knowledge test on

obesity is 22.23 and the SD is 3.82. This implies that the knowledge level of degree students

in relation to obesity is comparatively lesser, which will have direct i

practices of a healthy lifestyle. The assessment on attitude towards obesity revealed that all

the students have a positive attitude towards obesity. The assessment of prevalence of obesity

reveals that 2.5% of the total subjects were overweight, 47.5% were normal weight, 35%

ATTITUDE SCORE

61.92 61.16

PRE-TEST POST- TEST

ASSESSMENT OF RELATIONSHIP BETWEEN SELECTED VARIABLES

Correlation value

-0.02

0.20

-0.27

negative correlation exist between knowledge and

0.20. A positive correlation exists between

attitude and BMI, since the correlation coefficient is 0.20. A negative correlation exists

The assessment on knowledge of obesity revealed that the mean value of knowledge test on

obesity is 22.23 and the SD is 3.82. This implies that the knowledge level of degree students

in relation to obesity is comparatively lesser, which will have direct influence in their

practices of a healthy lifestyle. The assessment on attitude towards obesity revealed that all

the students have a positive attitude towards obesity. The assessment of prevalence of obesity

rweight, 47.5% were normal weight, 35%

42

were underweight and 15% were severe underweight category with respect to their Body

Mass Index. The analysis on the effectiveness of awareness programme regarding the

knowledge of obesity among degree students reveals that the calculated t value i.e. 5.54 is

greater than the t (critical) value i.e. 2.00, at 0.05 level of significance with 49 degree of

freedom, we conclude that there is significant difference exists between the pre-test and post-

test knowledge score of the experimental group. Table 6 reveals that the mean value of

knowledge score of pre test and post test of the control group was 22.68 and 22.96

respectively. Since the calculated t value i.e. 0.40 is less than the t (critical) value i.e. 2.00, at

0.05 level of significance with 49 degree of freedom, we conclude that there is no significant

difference exists between the pre-test and post-test score of the control group. There for we

conclude that there awareness programme was effective in improving knowledge regarding

obesity for degree students. The analysis on the effectiveness of awareness programme

regarding the attitude towards obesity among degree students reveals that the calculated t

value i.e. 0.83 is lesser than the t (critical) value i.e. 2.00, at 0.05 level of significance with 49

degree of freedom, we conclude that there is no significant difference exists between the pre-

test and post-test score of the experimental group. The analysis on control group also

revealed that the calculated t value i.e. 0.34 is lesser than the t (critical) value i.e. 2.00, at 0.05

level of significance with 49 degree of freedom, we conclude that there is no significant

difference exists between the pre-test and post-test score of the control group. Table 11 revels

that there is a negative correlation exist between knowledge and attitude, since the correlation

coefficient is -0.20. A positive correlation exists between attitude and BMI, since the

correlation coefficient is 0.20. A negative correlation exists between knowledge and BMI,

since the correlation coefficient is -0.27.

43

Chapter – V

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

Summary

Health is not only a basic human right, but it is most desired. In a global survey

commissioned for the Millennium Summit of the United Nations by UN Secretary General

Kofi Annan (Millennium Poll, United Nations 2000), good health is consistently ranked as

the number one desire of men and women around the world. It is also a key precondition to

economic development. Health is central to well being and a prerequisite for individual and

national progress. Data shows that the countries that have good national health indicators

have a greater economic progress and development. In addition, health has an intrinsic value

in creating the human capital of the country. India has achieved considerable improvements

in human development factors. According to Human Development Report 2011of UNDP, the

HDI for India is 0.547in 2011with an overall global ranking of 134 out of the 187countries.

Life expectancy at birth in India was 65.4 years in 2011 as against 55.1 in 1980.Infant

Mortality Rate has declined considerably, 71per 1000 live births in 1997 and reached 47per

1000 live births in 2010. But the rural (77 in 1997and 51in 2010) & urban (45in 1997and

31in 2010) differentials are still high. The healthcare in a country as a whole is facing many

challenges. India desperately requires tremendous magnitude of India's healthcare needs and

the immense investments required to improve the health status of people from all parts of

India and across all strata of society. Further, general lack of awareness on healthcare issues

and the low public consciousness of hygiene and sanitation norms will need to be addressed

as a starting point and with it the lack of accessibility to healthcare services. The level

knowledge gained through different mediums and the willingness to make it implemented in

ones’ own life been considered as significant in the case of good health is concerned. An

individual’s diet and physical activity habits are influenced by their knowledge of and

attitudes towards healthy behaviours. Investigation of these variables in a population provides

an insight into the factors that may be mediators of motivation to change behaviour. Theories

from health psychology, sociology and social psychology have been proposed to explain the

link between knowledge, attitudes, skills, social and environmental influences, and

behaviour. Considering this as a relevant issue the researcher made an attempt to conduct a

study on the prevalence, related knowledge, attitude and effectiveness of awareness program

regarding obesity among selected degree students in Mahatma Gandhi University. The

present study was attempted to make an explorative and evaluative study of the prevalence,

44

related knowledge, attitude and effectiveness of awareness program regarding obesity among

selected degree students in Mahatma Gandhi University.

The subjects for the study were 300 degree students (Exploratory Phase), and 100

degree students (50 experimental group and 50 control group) from Assumption College,

Changanacherry. The age of the subjects ranged from 18 to 23 years. The data for height and

weight was obtained using stadiometer and standard weighing machine. The BMI of the

subjects was calculated manually using the formula BMI = Weight (in kg) / Height (in

meter)2 . Structured Knowledge questionnaire was used to assess the knowledge of college

students regarding obesity. Attitude Towards Obese Personal Scale (ATOP Scale) was used

to assess the attitude of degree students towards obesity. For statistical analysis of the data,

descriptive statistics such as Arithmetic Mean (AM), Standard Deviation (SD), minimum,

maximum and range were calculated in order to get basic idea about the data distribution.

Dependent t- test was calculated to find out difference between pre-test and post-test score of

experimental as well as control group in relation to their knowledge and attitude towards

obesity. Pearson’s Product Moment Correlation was calculated to assess the relationship

between selected variables.

45

Conclusions

Within the limitations of the study and on the basis of the results obtained the

following conclusions may be drawn:

1. The assessment on knowledge of obesity revealed that the knowledge level of

degree students in relation to obesity is comparatively lesser, which will have

direct influence in their practices of a healthy lifestyle.

2. The assessment on attitude towards obesity revealed that all the students have a

positive attitude towards obesity.

3. The assessment of prevalence of obesity reveals that 2.5% of the total subjects

were overweight, 47.5% were normal weight, 35% were underweight and 15%

were severe underweight category with respect to their Body Mass Index.

4. The analysis on the effectiveness of awareness program regarding the knowledge

of obesity among degree students reveals that there is significant difference exists

between the pre-test and post-test knowledge score of the experimental group.

5. The analysis on the effectiveness of awareness programme regarding the attitude

towards obesity among degree students reveals that there is no significant

difference exists between the pre-test and post-test score of the experimental

group.

6. The assessment of relationship between selected variables revealed that there is a

negative correlation exists between knowledge and attitude, since the correlation

coefficient is -0.20, a positive correlation exists between attitude and BMI, since

the correlation coefficient is 0.20 and a negative correlation exists between

knowledge and BMI, since the correlation coefficient is -0.27

46

Recommendations

On the basis of the observations and conclusions drawn from the study, the following

recommendations are made:

1. Further researches may be done on other populations such as school students,

employees, sedentary women etc.

2. Further researches may done on analyzing the effect of similar programs for

awareness regarding obesity.

3. Further researches may be done on factors that may influence the effectiveness of

awareness programs on obesity.

47

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