RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE

ANNEXURE-II

PROFORMA FOR REGISTRATION OF

SUBJECTS FOR DISSERTATION

1. / Name of the candidate and Address
(in block letters) / Mr. GIPSON D’SOUZA
I YEAR M. Sc. NURSING
DR. M. V. SHETTY COLLEGE OF NURSING
VIDYANAGAR
MANGALORE-575013.
2. / Name of the Institution / DR. M. V. SHETTY COLLEGE OF NURSING
VIDYANAGAR,
MANGALORE-575013
3. / Course of study and subject / M. Sc. NURSING
MEDICAL SURGICAL NURSING
4. / Date of Admission to Course / 06/07/2010
5. / Title of the Topic:
EFFECTIVENESS OF PLANNED TEACHING PROGRAMME ON HEALTH HAZARDS OF JUNK FOOD AMONG ADOLESCENTS IN A SELECTED PRE-UNIVERSITY COLLEGE AT MANGALORE
6. / BRIEF RESUME OF THE INTENDED STUDY
6.1 Need for the study
“To eat is a necessity, but to eat intelligently is an art.”
-La Rochefoucauld
Food is the prime necessity of life. It can be any substance or material eaten or drunk to provide nutritional support for the body or for pleasure. It usually consists of plant or animal origin, that contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals1. Good nutrition is a high priority among adolescents as it is a period of rapid growth and development, which depends to a large extent on the nutrition. Nutritional intake during this stage may have long term health implication.
In today’s age of convenience, fast food needs no introduction. It’s delicious, filling, affordable, and readily available at any time of the day. Teenagers are typically fond of eating junk food not only for its taste but also for the peer group habits. Salted snack foods, candy, most sweet desserts, fried fast food and carbonated beverages are some of the major junk foods. Most harmful effects of fast food include increased cholesterol levels, cardiac problems, hypertension, obesity, dental caries, cancer and many other threatening health hazards2 .
Globally fast food market grew by 4.8 percent and reached a value of 102.4 billion and a volume of 80.3 billion transactions. In America adolescents aged between 11-18 years visit fast food outlets average of twice a week and by 14 years of age, 32 percent of adolescent girls, 52 percent of boys consume three or more servings of sweetened soft drinks daily. In India fast food industry is growing by 41 percent a year3. A study conducted by the All India Institute of Medical Sciences, Department of Science and Technology found that the consumption of junk food was increasing among teenagers. The same study had shown that this trend and associated lifestyle factors in the urban adolescent and young adult population had resulted in the increase in non-communicable diseases4.
In India nearly 250 million adolescents are obese and experts blame the marketing muscle of fast food chains and quick-serve restaurants for it. The number of overweight and obese children in Delhi has increased from 16 percent in 2002 to 24 percent in 2007. A study was conducted to find the reason for consumption of junk food on 15,872 students from New Delhi, Mumbai, Agra, Jaipur and Allahabad reveals that 73 percent children eat junk food because of taste ,68 percent are tempted by the advertisement, and 63 percent children eat snacks while watching television. There is a substantial link between being overweight and obese in childhood and body weight in later life. Fast food is a primary reason for obesity in India, especially among adolescents5.
A study was conducted to find out relation between consumption of junk food and cholesterol level among 200 adolescents in Los Angels. More than 80 percent of them consumed higher than recommended levels of total and saturated fat. Researchers used ultrasound to measure the thickness of neck artery and compared high risk teens with their healthy counterparts. They found that the thickest artery walls were likely to be those, who were overweight, had high blood pressure or high cholesterol levels. The results showed that 1/3rd of the students had abnormally high cholesterol levels for their age6.
An epidemiological survey was conducted to determine the prevalence of consumption and knowledge regarding junk food among adolescents in Mangalore. A total population of 2636 students from 10 different schools aged between 4-15 were selected. Their knowledge regarding the type of food consumed was obtained by a questionnaire. The 60 percent of students consumed junk food on a daily basis and 70 percent of them were not aware of nutritional content of food consumed by them. This study emphasises education on health hazards of junk food among adolescents7.
Adolescence is a fascinating period of life that makes the transition from being a dependent child to independently functioning adult. The present scenario flashes light on many adult diseases, have their roots in childhood and adolescence. This is due to lack of knowledge and awareness regarding faulty food habits. The above facts reveal that there is an urgent need to educate the adolescents regarding health hazards of junk food. Hence the investigator felt the need to provide knowledge regarding health hazards of junk food among adolescents.
6.2 Review of Literature
An interventional study was conducted to find inclination towards junk food consumption and effect of health education among 904 adolescent school children of 9-11 standard in Chandigarh. The information was collected regarding the dietary intake and eating habits through interview. Most common food item consumed by adolescents were samosa (42.4%), chat (39.7%), burger (24.5%), pizza (23.3%). A team comprising of doctors, medical social workers and supporting staffs gave education regarding diet and nutrition. One month later post test was done . The results showed that 58.8 percent of adolescents preferred fast food items but after intervention it is declined to 31.2 percent8.
An exploratory descriptive approach was adopted to identify the modifiable and non modifiable risk factors of coronary artery disease present among adolescents in Malad, India. A sample of 591 students aged between 12-18 years were selected by non- probability convenient sampling. A structured questionnaire was used to collect the data regarding modifiable and non modifiable risk factors. The results showed that 71 percent of the samples consumed fast food daily and 67 percent of the samples were found to have 3 or more risk factors for coronary artery disease whereas 22 percent of them had 2 risk factors and 11 percent of them had 1 risk factor for coronary artery disease9.
A cross sectional study was conducted to determine the dietary habits and lifestyle among medical students in Karachi. The study samples comprised of 384 students. Among those 53.4 percent were males and 46.6 percent were females. A pre-tested semi structured questionnaire was administered after taking consent. The obtained results showed that 97 percent of the students consumed junk food and according to body mass index 41.7 percent were overweight10.
A survey was conducted to investigate the consumption of ten types of junk food practices among adolescents in Beijing. A sample of 1019 adolescents aged between 8-16 years were selected. A questionnaire technique was used to obtain the information. One month prior to the study 97.5 percent of the adolescents had eaten at least one type of junk food and 15.88 percent of them had eaten all ten types of junk food. Most of the adolescents ate junk food during breakfast at home, without a correct idea on nutrition of junk food11.
A cross sectional study was conducted to find out association between fast food restaurant use and food choices among adolescents in Minnesota. A community based sample of 4746 adolescents of grade 7-12 were selected. Among them 50.2 percent were males and 49.8 percent were females and mean age was 14.9 years. Their dietary intake was assessed by using semi quantitative food frequency questionnaire. The result indicates that 75 percent of the students reported eating at a fast food restaurant during a past week. The most consumed junk food by females were, soft drink 45 percent, cheeseburger 100 percent , French fries 60 percent and by males, soft drink 42 percent, cheeseburger 73 percent, French fries 53 percent 12.
A cross sectional observation was conducted to examine the relationship between carbonated soft drink consumption and bone mineral density among adolescents in Ireland. A sample of 1335 adolescents aged between 12-15 were selected. Among them 591 were boys and 744 were girls. Their beverage consumption was assessed by the dietary history method and bone mass density was measured by Dual energy X ray Absorptiometry. The results showed that a significant inverse relationship between total carbonated soft drink consumption and bone mineral density.(beta, -0.099; 95% cl, -0.173 to -0.025)13.
6.3 Statement of problem
“Effectiveness of planned teaching programme on health hazards of junk food among adolescents in a selected pre-university college at Mangalore”
§  6.4 Objectives of the study
o  The objectives of the study are to:
§  determine the existing level of knowledge on health hazards of junk food among adolescents in a selected Pre-university College by using structured knowledge questionnaire.
§  evaluate the effectiveness of planned teaching programme on health hazards of junk food among adolescents in a selected Pre-university College by using same structured knowledge questionnaire.
§  find the association between pre-test knowledge score on health hazards of junk food among adolescents with selected demographic variables.
6.5 Operational definitions
§  Effectiveness: In this study, effectiveness refers to the extent to which the planned teaching programme on health hazards of junk food , has achieved the desired objectives as evidenced by the gain in knowledge as measured by a structured knowledge questionnaire.
§  Planned teaching programme: In this study it refers to a systematically developed teaching programme designed for Pre-university College adolescents regarding meaning, types, ingredients, promoting factors, and health hazards of junk food.
§  Health hazards of junk food: In this study it refers to selected health hazards of junk food which are included in the structured knowledge questionnaire and planned teaching programme to assess the knowledge of adolescents and to teach.
§  Adolescents: In this study adolescents refer to those who are studying in 11th standard in a selected Pre-university College at Mangalore.
§  Pre-university College: In this study it refers to urban educational institute which provides 11th standard education and which comes under deputy director jurisdiction, who permit me to conduct the study in Mangalore.
6.6 Assumptions
The investigator assumes that:
§  adolescents will have some knowledge regarding health hazards of junk food.
§  planned teaching programme will enhance knowledge of adolescents regarding health hazards of junk food.
§  adolescents will sincerely answer the questions.
6.7 Delimitations of study
The study is delimited to:
·  selected health hazards of junk food.
·  selected Pre-university College at Mangalore.
·  110 adolescents.
6.8 Variables
·  Independent variable: Planned teaching programme on health hazards of junk food.
·  Dependent variable: Knowledge of adolescents regarding health hazards of junk food.
6.9 Hypotheses
The hypotheses will be tested at 0.05 level:
H1: The mean post test knowledge score of adolescents on health hazards of junk food will be significantly higher than mean pre-test knowledge score.
H2: There will be significant association between pre test knowledge score of adolescents on health hazards of junk food and selected demographic variables.
7. / Materials and methods
7.1 Source of data
The data will be collected from adolescents in selected Pre-university College at Mangalore who fulfil the inclusion criteria.
7.1.1 Research design
In this study quasi experimental research design will be used.
One group pre-test, post test design will be selected for the study.
Sample / Pre-test / Treatment / Post-test / Effectiveness
Adolescents / O1 / X / O2 / E=O2 –O1
O1 Pre-test assessment of knowledge on health hazards of junk food among adolescents.
X Treatment (planned teaching programme on health hazards of junk food).
O2 Post effect of planned teaching programme on health hazards of junk food among adolescents.
E Effectiveness
7.1.2 Setting
The study will be conducted in a selected Pre-university College at Mangalore, Dakshina Kannada, Karnataka. The selected Pre-university College is easily reachable and is 10 kilometer away from the college.
7.1.3 Population
In this study, the population consists of all adolescents, who are studying in 11th standard in Pre-university College at Mangalore.
7.2 Method of data collection
7.2.1 Sampling procedure
In this study a type of probability sampling, that is, simple random sampling technique will be used. The samples will be selected by using lottery method.
7.2.2 Sample size
Sample size consists of 110 adolescents from the selected Pre-university College at Mangalore.
7.2.3 Inclusion criteria
Adolescents:
§  who are present at the time of data collection.
§  who are studying in 11th standard.
7.2.4 Exclusion criteria
·  Not willing to participate in the study.
7.2.5 Instruments used
1.  Baseline proforma will be used to study the demographic characteristics.
2.  Structured knowledge questionnaire is used to assess the knowledge regarding health hazards of junk food.
3.  Lesson plan on health hazards of junk food.
7.2.6 Data collection method
The data will be collected after getting permission from the concerned authorities. The objectives of the study will be explained to the principal of selected Pre-university College and his permission will be taken. A sample of 110 adolescents will be selected from a Pre-university College based on inclusion criteria and their written consent will be taken before the data collection. The investigator himself will collect the data. The data will be collected by structured knowledge questionnaire on day 1 and on same day planned teaching programme on health hazards of junk food will be conducted. The post test will be done for all the participants on 7th day of intervention by using same structured knowledge questionnaire to find out the effectiveness.
7.2.7 Plan for data analysis
1.  Organise the data in master sheet. The collected data will be analysed using descriptive and inferential statistics.
2.  Description of the subjects with respect to demographic variables will be presented using frequency and percentage.
3.  Mean standard deviation and mean percentage is used to evaluate the effectiveness of planned teaching programme.
4.  Further statistical significance of the effectiveness of planned teaching programme will be analysed by using Wilcoxon rank test.
5.  The association between the pre-test knowledge score and selected demographic variables will be calculated by Chi-square test.
6.  Analysed data will be presented in tables, graphs and diagrams.
7.3 Does the study require any investigations or interventions to be conducted on patients, or other animals? If so please describe briefly.
Yes, in present study, the investigator plans to use a planned teaching programme on health hazards of junk food.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, ethical clearance has been obtained from the ethical committee of the institution. Permission has been taken from the selected Pre-university College before data collection. Consent from the sample will be taken at the time of data collection.
8 / References
1.  Food. [online] 2010. Available from: URL:http://en.wikipedia.org/wiki/Food
2.  Hazards of junk food. [online]. Available from: URL:http://healthfood-guide.com/fastfood
3.  Statistics on consumption of junk food. [online]. Available from: URL:http://en.wikipedia.org/wiki/fastfood
4.  Junk food popular among teenagers. The Hindu 2005 Aug 11.
5.  Rhythma K. Burger kids putting India to obesity. Hindustan Times 2009 Aug 1.
6.  Junk food boosts teens’ risk of heart disease. CBC News Health 2000 Nov 11.
7.  Kaur M, Hegde MA. Are we aware of what we are , what we eat. Jaypee’s International Journal of Clinical Paediatric Dentistry 2008 Sep-Dec;1(1):13-6.
8.  Puri S, Bhatia V, Swami HM, Rai S, Mangat C. Impact of a diet and nutrition related education package on the awareness and practices of school children of Chandigarh. Internet Journal of Epidemiology 2008;6(1).
9.  Shetty R. Coronary artery disease risk factors among adolescents. Nursing Journal of India 2010 July;7.
10.  Nisar N, Quadri M H, Fatima K. Dietary habits and life style among the students of a private medical university, Karachi. Journal of Pakistan Medical Association 2009 Feb;59(2):98-101.
11.  Zhu SP, Ding YJ, Lu XF, Wang HW, Yang M. Studies on factors related to top ten junk food consumption at 8-16 years of age. Obesity 2008 Aug;29(8):757-62.
12.  French SA, Story M, Neumark D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioural and psychosocial variables. International Journal of Obesity 2001 Dec;25(12):1823-33.
13.  McGartland C, Robson P J, Murry L, Cran G, Savage M J, Watkins D, et al. Carbonated soft drink consumption and bone mineral density in adolescence, Ireland. Journal of Bone Mineral Research 2003 Sep;18(9):1563-69.
9. / Signature of the candidate
10. / Remarks of the guide
11. / Name and designation of (in block letters)
11.1 Guide / PROF. (MRS.) B. V. KATHYAYANI
PRINCIPAL & H. O. D., MEDICAL SURGICAL NURSING,
DR. M. V. SHETTY COLLEGE OF NURSING, VIDYANAGAR, MANGALORE -575 013.
11.2 Signature
11.3 Co-guide (if any)
11.4 Signature
12. / 12.1Head of Department / PROF. (MRS) B. V. KATHYAYANI
H.O.D ,MEDICAL SURGICAL NURSING,
DR. M. V. SHETTY COLLEGE OF NURSING, VIDYANAGAR, MANGALORE -575 013.
12.2 Signature
13. / 13.1 Remarks of the chairman and Principal
13.2 Signature

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