Question

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There are several possible ways of intervening to prevent overweight in adolescents, including clinical intervention and public health intervention. What is the difference between clinical intervention and public health intervention? What are the potential difficulties associated with each approach?

Answer 1

Public health intervention includes policies or efforts initiated in order to improve the health status of a particular population. Clinical interventions are procedures or set of procedures which are either invasive or non invasive, including diagnostic tests as well as therapeutic measures to rule out and treat certain disease conditions. Clinical interventions are basically provided on one to one basis.

Before starting with interventions the possible causes must be identified. Main causes of over weight and obesity in adolescents are improper eating habits, lack of exercise, a family history of obesity, disorders including endocrine or neurological problems, intake of certain ,medications including steroids and mental stress.

Public health intervention for preventing obesity in adolescents may include:

• These includes family and community based interventions.
• Creating awareness regarding negative effects of obesity through school health programs or health campaigns for teenagers and adolescents.
• Establishing policies or organizations to monitor and promote health and nutritional status of children and adolescents
• Policies to reduce the barriers to physical activities in school and residential areas
• Creating space for recreational activities in school compounds
• Training teachers to promote physical activities including educating children about dietary control to prevent obesity
• Policies regarding proper food labelling
• Family based interventions to change faulty eating habits and food choices
• Implementing policies in schools that restricts junk foods
• Access to facilities like gym and physical education at community levels

Challenges faced by public health interventions are:

• Lack of adequate funding
• Lack of cooperation from the public
• Lack of properly trained professionals to educate the public
• Social stigma regarding obesity
• Lack of self esteem among individuals to reach out for treatment measures

Clinical interventions for obesity includes :

• Appropriate diagnostic tests to rule out underlying diseases
• Introducing weight reduction program to adolescents who doesn't have any comorbidities
• Weight reduction strategies including dietary management and physical activities under supervision of trained professionals
• Pharmacological therapy with drugs like orlistat that prevents fat absorption from gut
• Bariatric surgery to prevent complications of obesity

Challenges:

• Clinical measures are expensive
• Lack of accessibility to resources for low income group
• Limitation in insurance authorization for cosmetic surgeries
• Weight reduction programs are long term measures. So inadequate follow up and coordination can occur.