FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH

AND WELL-BEING PROGRAM

A Thesis Presented to The Faculty of The Graduate School of Education University of Perpetual Help Las Pias City

In Partial Fulfillment of the Requirements for the Degree Master of Arts in Nursing Major in Nursing Administration

Carlo G. Almazar October 2011

APPROVAL SHEET This thesis entitled FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM prepared and submitted by CARLO G. ALMAZAR in partial fulfilment for the degree of Master of Arts in Nursing major in Nursing Administration has been examined and recommended for acceptance and approval for final defense.

ALBERTO P. MENDOZA, EdD Adviser

ORAL EXAMINATION COMMITTEE Approved by the Committee on Oral Examination with a grade of _____________________.

IMELDA O. JAVIER, RN, MAN Member

HAZEL N. VILLAGRACIA, EdD Member

FLORENCIA MARFIL, EdD Chairman

Accepted and approved in partial fulfilment of the requirements for the degree of Master of Arts in Nursing major in Nursing Administration.

Irineo F. Martinez Jr., LLB, MBA, PhD Dean/School Director

ACKNOWLEDGMENT

The researcher would like to extend his utmost gratitude to the following people who contributed significantly parts in the completion of this study:

DR. NIEVES M. MEDINA, former Dean, Graduate School of Education, University of Perpetual Help System DALTA, for encouraging and inspiring the researcher through her sincerity and by endlessly supporting all graduate students in their earnest desire to attain their degrees;

DR. ALBERTO P. MENDOZA, for accepting the researcher as an advisee. Thank you for your patience and research acumen that led to the successful accomplishment of this study;

MRS. IMELDA O. JAVIER, RN, MAN, Dean of the College of Nursing, UPHR-Dalta and member of the thesis review panel for her substantial inputs, suggestions and recommendations that enhanced this study; DR. HAZEL N. VILLAGRACIA, Chief Nurse, St. Dominic Hospital, and Professorial Lecturer of the Graduate School of Education, University of

Perpetual Help System DALTA - Las Pias as well as member of the thesis

review panel, for her systematic scrutiny of the data used in the study and for the intellectual assistance and inspiration, thereby enabling the researcher to proceed with the study;

DR. FLORENCIA MARFIL, Dean of the College of Education, UPHRDalta and member of the thesis review panel for her suggestions and for the recommendations that truly made the study more significant; DR. JESUS GOLLAYAN, for his expertise in the statistical treatment of the data that provided the researcher with substantial inputs and clear directions in the accomplishment of the study;

SCHOOL PRINCIPALS: SR. MA. ALMA IMMACOLATA MANGAHAS, SFSC, Mrs. NILDA S. SERGIO, Ms. EDNA SEBASTIAN and most importantly, to the STUDENTS, for the great support and cooperation tendered wholeheartedly during the data gathering;

PARENTS AND STUDENTS, for their support to the researcher during the conduct of surveys and group discussions;

FATHER CONRADO SR., HIS MOTHER MARIA CLARA AND BROTHERS CONRADO JR. AND ALLAN, who constantly reminded the researcher that he had to seize the day;

RUBY CABELLO, for all the tender love and support; and

Finally, GOD ALMIGHTY, for the strength He bestowed upon the researcher that made things possible for him to accomplish his goal and dream.

C.G.A.

ABSTRACT

Name of the Institution Address Title

: University of Perpetual Help System DALTA : Alabang-Zapote Road, Las Pias City : FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM

Author Degree Major Date of Completion

: Carlo G. Almazar : Master of Arts in Nursing : Nursing Administration : October 2011

STATEMENT OF THE PROBLEM:

This study attempted to establish the relationship between the perceptions of the parents and the pupils on the determinants affecting the rising incidence of obesity among primary pupils in private schools in

Paraaque City specifically in grade levels 1-3 and to come up with programs that would improve their health and well-being.

Specifically, the following questions were answered:

1. What is the profile of the pupil-respondents according to1.1 Age; 1.2 Sex; 1.3 Medical conditions 1.4 Weight; 1.5 Height; and 1.6 BMI-for-age? 2. What is the profile of the parent-respondents according to2.1 Weight; 2.2 Height; and 2.3 BMI? 3. Is there a significant relationship between the BMI of the parentrespondent and the BMI percentile of the pupil-respondent? 4. What are the factors affecting child obesity as perceived by the pupil-respondent and the parent-respondent in terms of: 4.1 cultural factors; 4.2 social factors; 4.3 environmental factors;

4.4 physiologic factors; 4.5 genetic factors? 5. Are there significant relationships between the perceptions of the pupil-respondents and the parent-respondents on the following factors affecting obesity: 5.1 cultural factors; 5.2 social factors; 5.3 environmental factors? 6. Based on the findings, what collaborative health and well-being program may be proposed to reduce the incidence of child obesity in schools?

NULL HYPOTHESES:

1. There is no significant relationship between the BMI of the parentrespondents and the BMI percentile of the pupil-respondents.

2. There is no significant relationship between the perceptions of the parent-respondents and the pupil-respondents on the factors affecting obesity.

METHODOLOGY:
The study employed the descriptive and qualitative research methods in gathering the data. The descriptive research method provided the quantitative

description of the assessment of the respondents and enriched by the qualitative research methods of focus group discussions. There were 2 groups of respondents in this study, the Pupil-respondents were purposively chosen by getting their BMI percentile and selected the percentile value of 85 in which the value is classified as overweight onwards. The parents of the classified overweight and obese children constituted the parent-respondents. Only pupils of grades 1-3 currently enrolled in the selected private schools mentioned during the school year 2011-2012 were included. Furthermore, a tapered total of 160 pupil-respondents and 160 parentrespondents, specifically mothers were taken and analysed due to the completeness of the data furnished by both groups. The survey questionnaires which were self-structured were validated by experts chosen by the Dean of Graduate School. Revisions were made based on comments and suggestions received. Findings The study came up with the following findings: 1. The pupil-respondents profile was vital in determining their BMI percentile. There are 85 or 53.125% male and 75 or 46.875% female respondents with age ranges of 5 years and 9 months to 10 years and 7 months; height ranges from 113cm to 150.5cm; weight ranges from 22.2 kg to

55.5 kg; and BMI percentile ranges of 85.2 to 99.7 wherein 67 are overweight and 93 are obese. 2. The profiles of the parent-respondents such as their height and weight were critical in determining their BMI. The fathers height ranges from 4 feet 11 inches to 6 feet 1 inch while the mothers height ranges from 4 feet to 5 feet 8 inches; the fathers weight ranges from 110 pounds to 385 pounds while the mothers weight ranges from 100 to 220 pounds. The fathers BMI ranges from 14.5 to 58.7 while the mothers BMI ranges from 14.2 to 61. 3. The correlation of the BMI of the parent-respondents and the pupilrespondents computation showed the computed t-value of 0.069 is lower than the critical t-value of 1.966 which shows that the relation between the two groups is not significant. A correlational analysis was done to obtain the relationship for familial predisposition which showed the computed t-value of 1.015 which is lower than the critical t-value of 1.960 that indicates a low correlation that reveals a non-significant relationship on the test. The results supported the decision to accept null hypothesis 1. 4. The data gathered from the parents and pupils responses on the perception on the following factors are as follows: 4.1 The responses on cultural factors from both parents and pupils showed an overall mean of 3.12 and 2.89, respectively which has a verbal description of sometimes on both values. Indicator 5 My child loves to eat was ranked number 1 on both groups.

4.2 The responses on social factors from both parents and pupils showed an overall mean of 3.37 and 3.32, respectively which has a verbal description of sometimes on both values. Indicator 4 My child likes physical activities was ranked number 1 on both groups. 4.3 The responses on environmental factors from both parents and pupils showed an overall mean of 3.03 and 2.98, respectively which has a verbal description of sometimes on both values. Indicator 1 My family loves to eat was ranked number 1 on both groups. 4.4 The medical conditions that the pupil-respondents had does not show any link to physiologic factors that may contribute to childhood obesity. 4.5 The genetic predisposition on obesity was not a major factor in the respondents increased incidence of obesity, however, the respondents do not discount the involvement of this factor. The correlation analysis result showed the same wherein it resulted in a decision to accept null hypothesis 1. 5. The correlation between the perceptions of the parent and the pupils response on the cultural, social and environmental factors affecting obesity shows that only social factors depict a significant t-value of 2.329 which exceeds the critical t-value of 1.966, while cultural and environmental factors with t-values 1.504 and -0.697 respectively do not exceed the critical t-value of

1.966 which means that the two are not significant. However, upon the overall computation of all three factors on their t-value shows that the t-value of the three factors combined manifests that all three are significant since their tvalue of 2.0115 exceeded the critical t-value of 1.966. 6. A health and well-being program was developed for administrators, teachers and parents that is focused on Daily Physical Activity wherein students are expected to have at least 30 minutes of physical activity daily. This program was adopted from Daily Physical Activity handbook developed in Alberta, Canada. Conclusions Based on the findings of the study, the following conclusions are drawn: 1. The typical overweight to obese pupil in the study has BMI percentile ranging from of 85.2 to 99.7. 2. BMI scores of both fathers and mothers started at 14.5 and 14.2, respectively which are characterized as severe thinness and 58.7 for fathers and 61 for mothers. Both values are characterized as obese class III. 3. There is no indication that the genetic factor affects the occurrence of childhood obesity in all three schools. 4. The three factors that were entered in the questionaire which were cultural, social and environmental factors do sometimes affect childhood

obesity while no conclusion can be made in relation to genetic and physiologic factors because of insufficient data. 5. Cultural, social and environmental factors prove to be significantly related to the incidence of childhood obesity. 6. Physical activity plays an important role in reducing childhood obesity but it needs to be systematically planned and implemented. Recommendations Based on the findings and conclusions drawn from the result of the study, the following recommendations are hereby presented:

1. For the School Administration 1.1 Schools should take part in developing programs that would foster behavioral change by the pupils as early as grade 1 or earlier to foster good behavior toward good food choices. 1.2 The schools and the homes should create a conducive environment for good eating habits and good food choices. 1.3 The School Clinic should monitor the growth and development of each pupil through annual reports and school PTA meetings.

2. For the Parents 2.1 Parents should create a role-playing environment for the child in order to lead them to adopt a saying Treat the parents, the child only follows what he or she sees. 2.2 Parents should exert effort to reduce sedentary activities of children such as tv viewing, handheld computer games and instead, create/plan enjoyable physical activities at home. 2.3 Parents should actively participate in PTA meetings, identify problem areas and plan collaborative programs that both groups can easily monitor and evaluate.

3. For Health Workers 2.1 Health workers should take part in monitoring the growth of children and advise parents on programs and alternatives they could take in the prevention of childhood obesity. 2.2 They should be advocates of research in preventing obesity.

TABLE OF CONTENTS

PAGE TITLE PAGE i

APPROVAL SHEET ACKNOWLEDGMENT ABSTRACT TABLE OF CONTENTS LIST OF TABLES LIST OF FIGURES

ii iii vi xvi xx xxii

CHAPTER 1 THE PROBLEM AND ITS BACKGROUND

Introduction Setting of the Study Theoretical Framework Conceptual Framework Statement of the Problem Null Hypotheses Scope and Limitations of the Study Significance of the Study Definition of Terms 18 19 21 7 9 14 15 17 1

REVIEW OF RELATED LITERATURE

Related Literature Obesity BMI Factors Affecting Obesity Incidence of Obesity Consequences of Obesity Effects of Obesity on Academic Performance 39 33 37 27 30 25 25

Laws Targeting Obesity

40

Related Studies

42

Foreign

42

Local

46

Synthesis

48

METHODOLOGY
Research Design 51

Population and Sampling Respondents of the Study Research Instrument Validation of the Instrument Data-Gathering Procedure Statistical Treatment of Data 64 58 62

53 55

62

PRESENTATION, ANALYSIS AND

INTERPRETATION OF DATA

67

SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

Summary 105

Findings

108

Conclusions

111

Recommendations

112

REFERENCES

114

APPENDICES

Daily Physical Activities for School

118

Date of Birth, Date of Measurement, Height, Weight and BMI Percentile of St. James Pupils 133

Date of Birth, Date of Measurement, Height, Weight and BMI Percentile of Olivarez Pupils 135

Date of Birth, Date of Measurement, Height, Weight and BMI Percentile of IHMC Pupils 139

Parents Questionnaire

150

Pupils Questionnaire

153

G
H

Height, Weight and BMI of Both Parents

St. James FGD

155
160

IHMC FGD

169

Olivarez College FGD

177

International Classification of Adult Underweight, Overweight and Obesity According to BMI

185

Girls BMI-for-Age Growth Chart

186

Boys BMI-for-Age Growth Chart

187

Letter of Request to Conduct Research In IHMC 188

Letter of Request to Hold a Focus Group Discussion in IHMC 189

Request to Hold a Focus Group Discussion In Olivarez College 190

Letter of Invitation for Parents FGD

191

Letter of Designation for Dr. Gollayan

192

Letter of Request to Hold a Research in St. James College 193

Letter of Request to Hold a Research in Olivarez College 194 195

Data Computations

CURRICULUM VITAE

213

LIST OF TABLES TABLE PAGE

Grades 1-3 Pupil Population in the Participating Schools 54

Distribution of Pupil and Parent-Respondents of Grades 1-3 (Pupils Classified as Having a BMI Percentile of 85) 55

Frequency Distribution and Percentage Participants of the Classified Samples

of

Willing 57

Interpretation Scale for the Questionnaire for PupilRespondents Interpretation Scale for the Questionnaire for ParentRespondents Age, Height and Weight Ranges of the PupilRespondents Frequency Distribution and Percentage of PupilRespondents According to Sex in Grade Levels 1-3 Diagnosed Medical Conditions of the Pupil-Respondents According to their Parents Frequency Distribution of Pupil-Respondents(n=160) Categorized as Overweight and Obese Frequency Distribution of Height Ranges of Both Parents

59

61

67

69

70

72

10

74 11 Frequency Distribution of Weight Ranges of Both Parents 75 12 Distribution of BMI Scores of Both Parents According to the International Weight Classification for Adult Correlation Between the BMI Score of the ParentRespondents and the BMI Percentile Scores of PupilRespondents 78

76

13

14

Correlation Between the BMI Scores of the ParentRespondents (n=52) to the Respective PupilRespondents BMI Percentile 79

15

Frequency, Weighted Mean, and Rank Distribution of Parent-Respondents Ratings on Cultural Factors (n=160) 81

16

Frequency, Weighted Mean, and Rank Distribution of Pupil-Respondents Ratings on Cultural Factors (n=160) 83

17

Frequency, Weighted Mean, and Rank Distribution of Parent-Respondents Ratings on Social Factors (n=160) 85

18

Frequency, Weighted Mean, and Rank Distribution of Pupil-Respondents Ratings on Social Factors (n=160) 87

19

Frequency, Weighted Mean, and Rank Distribution of Parent-Respondents Ratings on Environmental Factors (n=160) 89

20

Frequency, Weighted Mean, and Rank Distribution of Pupil-Respondents Ratings on Environmental Factors (n=160) 91

21

Distribution of Mean Ratings of the Parent-Respondents

and the Pupil-Respondents on the Factors Affecting Obesity 22 The Relationship of the Parent and the Pupil-respondents on the Factors Affecting Obesity

94

96

LIST OF FIGURES

FIGURES

PAGE

1 2 3 4

Health Belief Model Transtheoretical Model Social Cognitive Theory Conceptual Paradigm of the Study

10 11 13 14

Chapter 1 THE PROBLEM AND ITS BACKGROUND Introduction A study in the United States showed that childhood obesity increased approximately 400% in the last 40 years. Translating this figure to numbers meant that about nine million students in the United States who were over the age of six met the Center for Disease Control and Preventions definition of obesity; that is, more than two- thirds of children ten years and older who are obese will become obese adults. These figures were alarming considering that this was not a phenomenon only in the United States but also alarming rates have been reported worldwide. Globally, the International Obesity Task Force (IOTF)/The International Association for the Study of Obesity (IASO) estimates that 200 million school-aged children are either overweight or obese, of those 40-50 million are obese(Dietel 2002). The United States continues to lead the way in childhood obesity, with as many as 37% of its children and adolescents carrying around too much fat. But other countries are rapidly catching up. More than 20% of European youngsters between the ages of 5 and 17 are either overweight or obese. Children in North Africa

and the Middle East are not far behind. The trend to childhood obesity has been documented even in urbanized areas of sub-saharan Africa. Asia lags behind the United States and Europe in its obesity statistics, but Thailand, Malaysia, Japan, and the Philippines have all reported alarming increases in childhood obesity in recent years. In China, where one-child-per-family policy has created millions of spoiled and overfed children, the rise in childhood obesity is truly disturbing. Up to 10% of Chinas 290 million children are believed to be overweight or obese and that percentage is expected to double a decade from now. (Retrieved Jan. 9, 2011 at http://www.campshane.com/childhoodobesity.htm) At the turn of the century, only a few are paying close attention to their physical image and exercise. School-age is quite a critical phase in an individuals life; advertisments on media programs are giving them mixed messages. These messages are even compounded with sprouting fastfood chains and households that have no regard for preparing nutritious meals or at worst, are not affordable nor are capable of preparing nutritious meals for their children. Children spend more time in schools and what better way to start a community-based prevention program is to start it in an environment that can support and educate children in the process of the program. Starting a preventive program is

having the school community to take part in collaborating with parents, guardians and school nurses. This program would ensure a wholistic approach wherein cultural, religious, and socio-economic aspects would be considered. This problem of obesity, being a public health issue, will be addressed initially on a community-based level to ensure that programs would be well implemented and from this model would be a prototype of future preventive programs. Childhood Obesity has become of public health importance because of the tremendous adverse impact it has on our countrys youth and on the well-being of our society. Obesity affects all aspects of the childs life; most significantly, by contributing to poor health. Negative social perceptions by society and some researches even show a significant decline in their academic performance. Given the nature of this growing problem and its implications for the future of the health and well-being of affected individuals, it is believed that the most effective solutions will be achieved through programs that focus on preventive efforts. Schools are perfect and favored locations to intervene because children spend a third of their day inside schools. The school being what it is, empowers children through enriching their knowledge, attitudes and skills that they need to live a healthy lifestyle. Programs launched inside the school could be better monitored and with the help of parents, as

collaborators, can follow up childrens progress at home and monitor them while outside the school. School-based health workers such as school doctors, nurses and nutritionists can easily modify programs as the need arises. The Government and Health Organizations have mounted programs to prevent this global epidemic on child obesity. The World Health Organization (WHO 2009) developed a global strategy on diet, physical activity and health (DPAS). This DPAS program urges member states to strengthen existing, or established new structures for implementing the strategy through the health and other concerned sections, for monitoring and evaluating their effectiveness and for guiding resource investment and management to reduce the prevalence of non-communicable diseases and the risk related to unhealthy diet and physical activity; and to define this purpose consistent with national circumstances, measurable process and output indicators that will permit accurate monitoring and evaluation and a rapid response to identified needs. On the developement of the DPAS program on May of 2004, member States heeded the call for enactment (Retrieved of laws Jan. towards 9, stronger programs and the obesity had 2011 begun. at

http://www.who.int/dietphysicalactivity/Indicators%20English.pdf )

In the United States, a legislation was made to promote healthy eating through the federal program. Under the program, lunches must meet nutritional standard prescribed by the secretary of agriculture on the basis of tested nutritional research. Along with the legislation , in the food service areas of U.S. schools, foods of minimal nutritional value (FMNV) must not be sold in competition with food provided under the federal meal program. Countries like Guam, American Samoa, Palau, and Marianas have already adopted the program and 60-90% of their countries schools are already into the monitoring level. Although the mainland America has no specific law on a national level, that is why local federal states create laws as applicable to their state. (Retrieved Jan. 9, 2011 at www.

wpro.who.int/internet/resources.ashx/NUT/Final+obesity+report.pdf) In the Philippines, Miriam Defensor Santiago, a Senator of the Thirteenth Congress drafted a bill in response to the World Health Organizations call on the prevention and control of obesity. This was the Childhood Obesity Reduction Act of 2005 which aimed to reduce and prevent childhood obesity by encouraging schools to develop and implement local, school-based programs which would promote increased physical activity and improved nutritional choices.( Retrieved Feb. 20, 2011 at http://www.senate.gov.ph/lisdata/31842372!.pdf)

Obesity, being a global problem is fast becoming a menacing disease in developing countries like the Philippines. Filipinos are slowly learning to eat western fat-laiden food from fastfood centers and also adopting a slowly growing portion size being served in restaurants. Television also plays a big part in the incidence of obesity since people watching it gets mixed messages and would surely make your mouth water every commercial break. Advertisements, social and cultural norms and so many more factors contribute to the rise in obesity in our country; sadly, children are the most susceptible to these factors; thus arousing the researchers interest to delve into this study. As a nurse, it is natural for the researcher to be concerned about this problem; more so, that this problem of obesity has been with his family for two generations. Preventing and battling obesity is a lifelong battle for the researcher and his family. Obesity affects physical health and well-being, triggers complications that are life-threatening and can even lead to unhappiness and mental illness. Obesity, given the multifaceted nature of the problem and its implications to health deserves the importance given in preventing and controlling it. Hence, this studys proposed solution was achieved through programs that are school-based and mainly focused on preventing the disease. This

research output defined the health condition and analyzed the causal

factors related to childrens obesity. The data gathered from the respondents enabled the researcher to create bases wherein programs included the participation of the school and its resources, the parents, guardians, in promoting a positive behavior from the child by developing healthy habits within the home and school thereby decreasing the incidence of childhood obesity within the school community. In Philippine schools, it has been observed that a small percentage of obese children can be seen in public schools, whereas a great number of obese children can be seen in private schools. What factors lead to obesity of children in private schools? This question prompted the researcher to focus the present study on private schools in Paraaque where he is connected as an active community member. Setting of the Study The study was focused on three private schools in Paraaque City namely Olivarez College-Paraaque Campus which is located along Sucat Road in Barangay San Dionisio, St. James College of Paraaque which is located along Sucat Road in Barangay BF Homes, and lastly Immaculate Heart of Mary College-Paraaque which is located inside Barangay San Antonio.

Olivarez College is a private, non-sectarian and stock-profit educational institution concieved and established in the belief that providing educational opportunities for the masses is the best legacy one can offer to the Filipino nation and to the world. It is a family-owned educational institution committed to the intellectual, cultural, moral and physical development of its students. It is the only school in Paraaque City accredited by both PAASCU and PACUCOA. St. James College of Paraaque is a non-sectarian academic institution established by the late Jaime T. Torres, a successful businessman involved in brokerage, real estate and agricultural development business and Myrna Montealegre-Torres, a former educator at the St. Jude Catholic School and Stella Maris College. The said institution started operation in 1987 as St. James School of Paraaque; it is the second branch of the St. James College System (established 1971) which is comprised of the Quezon City Campus, Calamba City-Laguna Campus, and Paraaque Campus. Immaculate Heart of Mary College-Paraaque is a Catholic private educational institution that serves middle-class constituents of Paraaque City and nearby major areas. It was formerly known as Immaculate Heart of Mary School , which was founded on June 1979 by the Franciscan Sisters of the Sacred Heart. Government recognition was

obtained in 1987 when the first batch of high school students graduated. Today, with the persistent demand for higher education, Immaculate Heart of Mary School has transformed into the Immaculate Heart of Mary College-Paraaque. These three private schools have been chosen because of the similarities in the socio-economic class they cater to, school population, socio-cultural patterns, recreational and cultural facilities and the like which affected children both as human beings and as pupils. Theoretical / Conceptual Framework

Obesity is a disease that every individual should be aware of and should take part in its prevention and treatment. The individual should be conscious enough to create and/or obtain a plan or program that would help regain his or her well-being. The researcher has cited models that supported the study like Health Belief Model by Rosenstock and Becker, another model is the Transtheoretical Model by Prochaska and DiClemente and the theory of Albert Banduras theory known as Social Cognitive Theory.

Figure 1. Health Belief Model

The Health Belief Model by Rosenstock and Becker (Shown on Fig. 1, above) predicts that individuals are most likely to act and change their health behavior when at risk and when the percieved benefits of taking action outweigh the percieved cost or barriers(Glanz K. et al 2002). This model spells out 4 constructs representing the percieved threats and net benefits which are: percieved susceptibility, percieved severity, percieved benefits, and percieved barriers. It is believed that when an individual has percieved all 4 constructs the individual would activate that readiness and stimulate overt behavior. After realizing all these, the individual will gain confidence to successfully perform an action.

1. Precontemplation
No intention of changing behavior.

Relapse fall back into old patterns of behavior

2. Contemplation
Aware a problem exist. No commitment to action

5. Maintenance Sustained changenew behavior replaces old 4. Action Active modification of behavior.

3. Preparation Intent upon taking action.

Figure 2. Transtheoretical Model

The Transtheoretical Model (Shown on Fig.2) claims that individuals move through a series of five stages of change in the adoption of healthy behaviors or cessation of unhealthy ones. These five stages are precontemplation, contemplation, preparation, action, and maintenance. The Transtheoretical Model is often used in tailored health interventions. The model describes how people modify a problem

behavior or acquire a positive behavior. The central organizing construct of the model is the Stages of Change. The model also includes a series of independent variables, the Processes of Change, and a series of outcome measures, including the Decisional Balance and the

Temptation scales. The Processes of Change are ten cognitive and behavior activities that facilitate change. These ten behaviors are consciousness raising, dramatic relief, environmental reevaluation, social liberation, self-reevaluation, stimulus control, helping relationships, counter conditioning, reinforcement management, and self-liberation. In Albert Banduras Social Cognitive theory( Shown on Fig.3), personal factors, behavior and evironment are main independent factors. In the model, the interaction between the person and behavior involves the influences of a persons thoughts and actions. The interaction between the person and the environment involves human beliefs and cognitive competencies that are developed and modified by social influences and structures within the environment. The third interaction, between the environment and behavior, involves a persons behavior determining the aspects of their environment and in turn, their behavior is modified by that environment. (Retrieved Dec. 19, 2010 at http://www.istheory.yorku.ca/socialcognitivetheory.htm)

Personal Determinants

Behavioral Determinants

Environmental Determinants

Figure 3. Social Cognitive Theory

The foregoing concepts and theories have been brought to bear on the present study by incorporating them in a paradigm patterned after Schultzes Input-Process-Output model (shown on Figure 4).

Fig. 4. Conceptual Paradigm of the Study Using Schultzes Input-Process-Output model showed the studys work flow is presented. Profile of the pupil-respondents was taken from

the Nursing Service Office (School Clinic) such as age, gender, weight and height. Pupil-respondents categorized to be overweight to obese on their BMI scores were automatically included in the study. These pupils were given a questionaire that obtained information on their lifestyle, eating habits, physical activities and the like as they perceived it. Parentrespondents were given a questionaire to gather information on the same. This also gathered information from the parents on their weight and height of both parents to categorize them according to the BMI scale. The rationale behind it is that it might be a genetic factor that caused their offspring to be overweight. The questionaires given to the parent-respondents were used to gather information on their perceived factors that influence the childs behavior toward obesity. The data gathered were analyzed and statistically treated to obtain a rational

outcome on what the relationship of the two variables had. The researcher then had a leverage on what kind of inputs he might propose/consider to improve the school-childrens health and well-being.

Statement of the Problem

This study attempted to establish the relationship between the perceptions of the parents and of the pupils on the determinants of obesity among primary pupils in private schools in Paraaque City

specifically in grade levels 1-3, to come up with a program that would improve their health and well-being.

Specifically, the following questions were answered:

7. What is the profile of the pupil-respondents according to7.1 Age; 7.2 Sex; 7.3 Medical conditions 7.4 Weight; 7.5 Height; and 7.6 BMI-for-age? 8. What is the profile of the parent-respondent according to2.1 Weight; 2.2 Height; and 2.3 BMI? 9. Is there a significant relationship between the BMI of the parentrespondent and the BMI percentile of the pupil-respondent? 10. What are the factors affecting child obesity as perceived by the pupil-respondent and the parent-respondent in terms of: 10.1 10.2 cultural factors; social factors;

10.3 10.4 10.5

environmental factors; physiologic factors; genetic factors?

11. Are there significant relationships between the perceptions of the pupil-respondents and the parent-respondents on the following factors affecting obesity: 5.1 cultural factors; 5.2 social factors; 5.3 environmental factors? 12. Based on the findings what collaborative health and well-being program may be proposed to reduce the incidence of child obesity in schools?

Null hypotheses

1. There is no significant relationship between the BMI of the parent-respondents and the BMI percentile of the pupil-respondents.

2. There is no significant relationship between the perceptions of the parent-respondents and the pupil-respondents on the factors affecting obesity.

Scope and Limitations of the Study

The study included primary pupils in three private schools in Paraaque City namely St. James College-Paraaque, Olivarez CollegeParaaque and Immaculate Heart of Mary College-Paraaque during school year 2011-2012. The respondents of the study are limited only to primary grades 1-3 pupils and their parents. The desired sample size were categorized according to their BMI percentile score of 85; the parents of these categorized students were consequentially constituted as the parent-respondents. Furthermore, the sample size depended on the willingness of the parent to be included in the study.

The computations done in the study depended on the completeness of the information given by the parents. Since the mothers constituted the group that provided the complete data, they were the only group to be tested for relationsips on the pupils variables. Furthermore, the test for the genetic factors wherein the the researcher tested two variables that used different kinds of unit of measure cannot be supported by authorities that has done the same. However, another test was done to obtain the childs familial predisposition to obesity.

The researcher further notes that the data gathered from these schools are not indicative of a generalized pattern of all private schools

in Paraaque and results that were derived from this study e.g. summary, findings, conclusions and recommendations may not be applicable to all private schools.

Significance of the Study

The results of this study would benefit the following sectors:

Pupils. The findings of the study would make them aware and understand about obesity among children and will stimulate them into participating in the program proposed by the study.

Parents. The findings of the study would make the parents cognizant of their childrens nutritional problems; thus enabling them to take time in planning weekly menus that are nutritionally well-balanced, participate in exercising with their dependents, and act as front-liners of the needed programs.

Teachers. The findings of the study would motivate the teachers to encourage their students to live a healthy lifestyle, inform the students of the existing programs that they can take advantage of, serve as role models, and seek other routes and innovative methods in teaching children how to fight obesity and idleness.

School. The findings of the study would help the schools create programs that would involve the teachers, parents, school nurses,

students and the school community as well as the surrounding food establishments around the community and to collaborate in upholding a healthy environment for the students. The said findings would also help the school to create policies on nutritional school lunches and snack that children can buy or bring home.

School Canteen. The findings of the study would enable the school canteen concessionaires and food stall concessionaires to be

responsible in preparing and dispensing nutrient-rich meals.

School Nurses. The findings of the study would motivate school nurses to design programs that would suit their clients in preventing and controlling obesity.

Future researchers. The findings of this study would help future researchers to prerform further inquiries related to the battle of childhood obesity.

Definition of Terms

In order to establish a common frame of reference between the reader and the researcher, important terms in the study were either conceptually or operationally defined.

Age. This refers to the length of time that an individual has existed, usually expressed in years. Bioelectrical Impedance Analysis (BIA). This refers to a commonly used method for estimating body composition, BIA Machine. Body Mass Index (BMI). This refers to an index that expresses an individuals weight in relation to height. It is calculated as weight in kilograms divided by height in meters squared. BMI-for-age. This refers to ranking the childs weight based on the CDCs growth charts and matches the childs BMI-for-age with children of the same age and sex. The CDC growth charts display weight status categories such as underweight, normal weight, overweight and obese. Calorie. This refers to a unit for the amount of heat needed to raise the temperature of one gram of water one degree celsius.

Cultural factor. This refers to beliefs of a particular group/ethnic group or age group such as youth culture or generation. Densinometry. This refers to a test used to estimate the percentage body fat, since fatty tissue is less dense than lean tissue. Its equation is body mass (scale weight) divided by volume. Environmental factor. This refers to external conditions

influencing the life activities of people, such as homes, school, community, food availability and cost, and mass media. Factor. This refers to something that contributes to or has an influence on the outcome of something. Gender. This refers to the sex of the person. Genetic factor. This refers to the causes of obesity that may be passed through heredity or may have a link through familial disposition. Health. This refers to the general condition of a person in all aspects. It is also a level of functional and/or metabolic efficiency of an organism, often implicitly human.

Height. This refers to the distance between the lowest and the highest point of somebody, a measurement of how tall an individual is that can be measured in metric or English system. Hepatic steatosis. This refers to a collection of excessive amounts of triglycerides and other fat inside liver cells also known as fatty liver. Hyperlipidemia. This refers to an excess of fats or lipids in the blood. Hypertension. This refers to an arterial disease in which chronic high blood pressure is the primary symptom. Obesity. This refers to an abnormal accumulation of body fat usually 20% or more over an individuals ideal body weight. Physiologic factor. This refers to a physical or medical condition in which the physical or medical condition itself causes the problem of obesity. It may also be secondary to a condition in which the medicine taken for that condition causes the problem of obesity. Profile variable. This refers to the characteristics of human population or population segments. In this study, these are individual characteristics such as age, sex, weight, height, and BMI scores.

Social factor. This refers to influences on individual behavior attributing to the social values and/or behavior of the groups to which an individual belongs or aspires to belong. In this study, this may also include the persons lifestyle and nutritional status. Total Body Water (TBW). This refers to all the water within the body, including intracellular and extracellular water plus the water in the GI and urinary tracts. Viceral fat. This refers to the fat found deep in the abdomen. Weight. This refers to the quality of heaviness of an individual, determined by their mass or quantity of matter as acted on by the force of gravity. It is usually expressed in metric or English system. Well-being. This refers to a variety of physical attributes such as strength, agility, skilled coordination, good posture, endurance and other attributes to indicate physical health.

Chapter 2 Review of Related Literature and Studies This chapter presents the related literature and studies on obesity among children from foreign and local researchers and journal writers. They tackle obesity, its definition, obesity in different developmental levels as well as its different aspects such as internal and external determinants of obesity and the programs that have been used to curb the rising incidence of obesity specifically on children. Laws and bills of both foreign and local are discussed as well as World Health Organizations program on obesity. This chapter also includes foreign and local studies that account for the works that have been published on the topic by accredited scholars and researchers. This is closely connected with demonstrating what is known about obesity. It is the knowledge of the disease that allows one to identify the gap, which the research will fill. Related Literature Obesity Obesity has recently become very common in children and its prevalence is still increasing rapidly. Strategies to combat childhood obesity have been overtaken by the scale and speed of the childhood

obesity epidemic. Most parents, professionals in health, social care and education on children are uncertain about basic issues such as what we mean by obesity in children, why it matters and what we might do to prevent it. The aim of the present review was to summarize recent systematic reviews on these topics in order to provide an informed basis for future interventions intended to tackle the childhood obesity epidemic. International Obesity Taskforce (IOTF) is a global network of expertise, a research lead think tank and advocacy of the international association for the study of obesity. According to IOTF Obesity is defined as a medical condition described as excess body weight in the form of fat. When accumulated, this fat can lead to severe health impairments. This conditions may be brought about by certain factors which are social, cultural, environmental, and physiologic or genetical. (Dehghan M.,

Danesh N.A., Merchant A.T. @ Nutrition journal 2005) Although the mechanism of obesity development is not fully understood, it is confirmed that obesity occurs when energy intake exceeds energy expenditure. There are multiple etiologies for this imbalance, hence, and the rising prevalence of obesity cannot be addressed by a single etiology. Genetic factors influence the susceptibility of a given child to an obesity-conducive environment. However, environmental factors, lifestyle preferences, and cultural environment seem to play major roles in the

rising prevalence of obesity worldwide. In a small number of cases, childhood obesity is due to genes such as leptin deficiency or medical causes such as hypothyroidism and growth hormone deficiency or side effects due to drugs (e.g. steroids). Most of the time, however, personal lifestyle choices and cultural environment significantly influence obesity. For this reason, the World Health Organization has created a criteria and a formula to determine the height to weight proportion which is the BMI or the Body Mass Index. Body Mass Index (BMI) The basis of the body mass index (BMI) as a means of defining obesity in children is discussed, a high BMI for age constitutes obesity. In recent years the prevalence of obesity has increased dramatically across most of the world. Despite a widespread perception that obesity in childhood is a cosmetic issue, the research evidence shows that it does matter to physical and psychological health and that there are adverse health risks for both the obese child and the adult who was obese as a child. Few interventions aimed at preventing or treating childhood obesity have been successful. There is an urgent need for more research on better strategies that will enable children and adolescents to make long-term changes to their dietary and physical activity behavior in order to prevent obesity (Reilly J.J. 2007, retrieved

Sept.

13,

2010

at

http://onlinelibrary.wiley.com/doi/10.1111/j.1099-

0860.2007.00092.x/full). Recent systematic reviews have shown that the

body mass index (BMI), i.e. weight (in kg) divided by height in (m2) provides the best simple means of defining overweight and obesity in children and adolescents (Reilly J.J. 2007). The formula based on your height and weight the body mass index (BMI) to determine if you are obese. A BMI of 30 or higher are considered obese. Extreme obesity, also called severe obesity or morbid obesity, occurs when you have a BMI of 40 or more. With morbid obesity, you are especially likely to have serious health problems. (Retrieved Dec. 19, 2010 at
http://www.mayoclinic.com/health/obesity/DS00314)

The World Health Organization (WHO) has also stated that BMI values are age-independent and the same for both sexes. However, BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI gradings in relation to risk may differ for different populations. In recent years, there was a growing debate on whether there are possible needs for developing different BMI cut-off points for different ethnic groups due to the increasing evidence that the associations between BMI, percentage of body fat, and body fat distribution differ across

populations and therefore, the health risks increase below the cut-off point of 25 kg/m2 that defines overweight in the current WHO classification (seen on Appendix K.). There had been two previous attempts to interpret the BMI cutoffs in Asian and Pacific populations, which contributed to the growing debates. Therefore, to shed the light on this debates, WHO convened the Expert Consultation on BMI in Asian populations (Singapore, 8-11 July, 2002). (Retrieved Jan. 15, 2011 at

http://apps.who.int/bmi/index.jsp?introPage=intro_3.html) (excerpt from the

The Lancet, 2004; 157-163)

There are also several methods to measure the percentage of body fat, like underwater weighing (densitometry), multi-frequency bioelectrical impedance analysis (BIA) and magnetic resonance imaging (MRI). In the clinical environment, techniques such as body mass index (BMI), waist circumference, and skin fold thickness have been used extensively. Waist circumference seems to be more accurate for children because it targets central obesity, which is a risk factor for type II diabetes and coronary heart disease. To the best of our knowledge there is no publication on specific cut off points for waist circumference, but there are some ongoing studies. (Retrieved Sept 14, 2010 at
http://www.nutritionj.com/content/4/1/24)

For children and teens, the United States Center for Disease Control stated that BMI is age and sex-specific and is often referred to as BMI-for-age. After BMI is calculated for children and teens, the BMI is plotted on the BMI-for-age growth charts for either girls or boys to obtain a percentile ranking (BMI-for-age growth charts for girls and boys seen on Appendix L and M respectively). Percentiles are the most commonly used indicator to assess the size and growth patterns of individual children. The percentile indicates the relative position of the childs BMI number among children of the same sex and age. The growth chart show the weight status categories used with children and teens (2-20 years old).

The BMI-for-age weight status categories and the corresponding percentile range are as follows: less than the 5 th percentile as under weight; 5th percentile to less than the 85th percentile as healthy weight; 85th percentile to less than the 95th percentile as overweight; and, equal to or greater than the 95th percentile as obese.

Factors Affecting Obesity

The development of obesity in childhood and subsequently, in adulthood involves interactions among multiple factors that may shape daily diet and physical activity behaviors. According to Viriplant a

slimming and weight loss company, that obesity has factors that influences obesity such as genetic factors in which obesity tends to run in families, suggesting a genetic cause. Yet families also share diet and lifestyle habits that may contribute to obesity. Separating these from genetic factors is often difficult. Even so, science shows that obesity is linked to heredity. In one study, adults who were adopted as children were found to have weights closer to their biological parents than to their adoptive parents. In this case, the persons genetic makeup had more influence on the development of obesity than the environment in the adoptive family home.

Genes do not destine people to a lifetime of obesity; however, environment also strongly influence obesity. This includes lifestyle behaviors such as what and how often a person eats and his or her level of physical activity. Americans tend to eat high fat foods, and put taste and convenience ahead of nutrition. Also, most Americans do not get enough physical activity. Although you cannot change your genetic makeup, you can change your eating habits and levels of activity.

Physiologic factors also plays a part in influencing obesity. Some illnesses can lead to obesity or a tendency to gain weight. These include hypothyroidism, a deficiency in the production of thyroid hormones or the

slowing of the metabolic rate that results. A severe deficiency can result in sluggishness and weight gain. Cushing syndrome is also an illness in which an increase level of the hormone cortisol may also lead to

obesity. Depression and certain neurological problems may also lead to overeating. Also, drugs such as steroids and some antidepressants may cause weight gain.

Social factors such as cultural norms, advertising and food marketing, social networks, technological developments, economics, and the like plays a big role in influencing obesity. This factor usually influences the individual subliminally, the fast integration of western culture and food gives individuals a taste of the first world country. Not to mention the marketing strategies that these food chains employ which slowly brainwash the childs mind into eating high fat, high calorie foods that comes in huge portions. This is aggravated by technology which also the western countries brought in that lessens the individuals physical activity. Children can be seen playing the computer for hours, sitting in front of the tv for another couple of hours lessening the physical activity needed by the child to burn the calories he or she took in. Constant idleness can easily accumulate fat for the highly inactive child.

Lastly, cultural factors which is hard to separate from social and environmental; factors. Children have their own culture or what others call the youth culture. The current generation youth are exposed to technological advances, fastfoods and peer pressure which gives the child the craving to do what others are doing just to belong to that status

Incidence of Obesity

The increased incidence of childhood obesity cannot be blamed on either environment or genetics alone. Changes in the environment (i.e. nutrition and lifestyle) are primarily responsible for the current pandemic because it is not possible for the gene pool to change in less than a generation. The past few decades have brought marked lifestyle changes throughout the world, which have resulted in a decrease in physical activity and an increase in caloric intake. Children use automobiles and other automated means of transportation, including elevators and escalators, rather than walking or climbing stairs to get from place to place. The amount of time that children spend playing outside has diminished over the past few decades, and physical education programs in the schools have been reduced or eliminated (Livingstone et al 2003) . The majority of families now have both parents

or the single parent working, resulting in the need to find nonparental supervision after school. Fear of children playing outside without adult supervision has led many parents to admonish their children to stay inside after school. Children are thus spending more time watching television and playing on the computer than exercising (Saelens et al 2002) . Television watching has been directly linked to obesity in childhood, with a rate of obesity that is 8.3 times greater in children who watch over 5 hours of television per day compared with those who watch 2 hour or less of television per day (Proctor et al 2003). Many parents rely on schools to provide their children with appropriate exercise, but only a few participate actively on physical education classes.(Burgeson et al 2001). (Retrieved Sept. 14, 2010 at

http://jcem.endojournals.org/cgi/content/full/89/9/4211)

Changes in diet have also contributed to pediatric obesity. Portion sizes in food outlets have more than doubled over the past two decades (Nielsen et al 2003). In addition to a baseline increase in portion sizes, most fast food restaurants offer up to 20% larger portion sizes for minimal additional cost, adding hundreds of extra calories. Fast food is marketed to children using toys, music, and social icons. Studies have found that childrens food preferences are influenced by just 30-second exposures to television commercials. Additionally, many schools now

offer fast food concessions as an alternative to school lunch. Even children who receive free school lunches will spend their money to buy preferred high-fat food. The schools receive financial incentives to allow vending machines, thus providing increased availability of soda, juice, snack cakes, and chips. (Retrieved Sept 14, 2010 at

http://jcem.endojournals.org/cgi/content/full/89/9/4211 )

According to Jenny Miller et al. of the Department of Endocrinology, University of Florida in Gainesville Florida. Obesity has become a pandemic, with more than a billion people affected worldwide (Kimm,Obarzanek 2002). Over the past 30 years, the frequency of overweight children, defined as a body mass index (BMI) greater than the 85th percentile for age and sex, has tripled (Thibault, Rolland 2003). More than 30% of children in the United States are overweight or obese (BMI > 95th percentile) (Fox 2003). Data from the International Obesity Task Force indicate that 22 million of the worlds children under 5 yr of age are overweight or obese (Deitel 2002). Obesity has replaced malnutrition as the major nutritional problem in some parts of Africa, with overweight/obesity being as much as four times more common than malnutrition (Dutoit, van der Merwe 2003). More than two thirds of children 10 yr and older who are obese will become obese adults (Must 2003, Magarey et al 2003). Obesity in young adults decreases life

expectancy by 520 yr (St-Onge,Heymsfield 2003). Pediatric obesityrelated hospital costs have increased 3-fold during the past 20 years, reaching $127 million per year, and continue to rise (Goran et al 2003). The increased frequency and severity of childhood obesity is accompanied by the expected medical complications. One in four overweight children in the 6- to 12-yr age group has impaired glucose tolerance, and 60% of these children have at least one risk factor for heart disease (Steinberger, Daniels 2003). Childhood obesity threatens to thwart the reduction in cardiovascular mortality achieved over the past decades through control of hypertension, hyperlipidemia, and smoking. (Retrieved Sept.14, 2010 at

http://jcem.endojournals.org/cgi/content/full/89/9/4211).

Clark et al(2007) has stated from their study that obesity among 6 to 11-year-old children has increased from an estimated 4.2% in 1963-1965 to an estimated 18.8% in 2003-2004 (Ogden, Carroll, Curtin, McDowell, Tabak, & Flegal, 2006). Similar percentages have been reported for adolescents ages 12 19, with an estimated 4.6% in 1963-1965 and an estimated 17.4% in 2003-2004 (Ogden, Flegal, Carroll, & Johnson, 2002). These percentage estimates of obesity reflect an increase of approximately 400% in the 40 year time period. Translating these percentages into numbers means that about nine

million students in the United States who are over the age of 6 meet the Centers for Disease Control and Prevention (CDC, 2007) definition of obesity.

If the focus is placed on a specific state such as Texas, the one in which student data were gathered for this study, the prevalence of children and adolescents being overweight is greater than the national prevalence rates. According to Hoelscher et al. (2005), 42% of Texas fourth grade children, 39% of eighth grade adolescents, and 36% of eleventh grade adolescents were in the weight categories of obese and overweight in 2004-2005. When examining only the obese category, 20% of Texas eighth grade students were obese (Hoelscher et al., 2005), compared with the national average of 17.4% (Ogden et al., 2002). Clark et al. however, says that readers should note that these percentages are substantially higher than the percentages of obesity and overweight at a national level.

Consequences of Obesity

Clark et al. also included in their study related consequences of Obesity. Wherein he said, persons are aware of the health-related consequences of obesity in general, although they may not be familiar with the health-related consequences of obesity in childhood. According

to the CDC (2007), children and adolescents who are obese may experience not only immediate health difficulties, but also health difficulties later in adulthood. Health-related difficulties obese children and adolescents may experience include, but are not limited to, cardiovascular disease, high blood pressure, high cholesterol levels, abnormal glucose tolerance, asthma, hepatic steatosis, sleep apnea, and Type 2 diabetes (CDC, 2007, Rodriguez, Winkleby, Ahn, Sundquist, & Kraemer, 2002).

These health-related consequences of obesity have an economic effect as well. Koplan, Liverman, and Kraak (2005) reported that obesityrelated hospital visits in 1997-1999 cost 127 million dollars, compared with an estimated cost of 35 million dollars in 1979-1981. In this time period of approximately 20 years, the costs had increased over 300%. With adult obesity alone costing an estimated 129 billion dollars in 2004 and with childhood and adolescent obesity increasing at a tremendous rate, the economic consequences of children and adolescents remaining obese to adulthood are severe (Koplan et al., 2005). If costs for only a single state are analyzed such as Texas, the current costs for dealing with obesity-related health consequences will increase from the current 10.5 billion dollars to an estimated 39 billion dollars by 2040 (Texas Department of State Health Services, 2004). Readers should be able to

see the reasons why obesity is viewed as being such a serious national public health priority.

Effects of Obesity on Academic Performance With Clark et al.s study they believe that the issue of obesity is quite relevant for educational administrators. School leaders have seen a reduction, and in some cases, the elimination of physical education at their schools (Trost, 2007). At the same time, educational administrators have seen an increase in the percentage of their students who are obese. This reduction and elimination, in some cases, of physical education classes has coincided with an increased emphasis on improving students test scores in response to the accountability focus of the No Child Left Behind Act (2001). It would be ironic if, in this effort to enhance student achievement by providing more class time, that student obesity would increase, particularly if student obesity influences student academic performance. Educational administrators would be welladvised to examine their physical education programs at their schools, particularly if these programs have been reduced or eliminated at their schools.

Previous researchers have established a relationship between student obesity and academic performance. In a recent study, Crosnoe

and Muller (2004) utilized a national database, the National Longitudinal Study of Adolescent Health, to address this issue for adolescents. In an analysis of data from 11,658 students enrolled in 126 schools across the U.S., Crosnoe and Muller (2004) found that adolescents who were at risk of being obese had lower academic test scores than did adolescents who were not at risk of being obese. Though their study was of much younger children from the Early Childhood Longitudinal Study database, Datar, Sturm, and Magnabosco (2004) reported that the math and reading scores of children who were overweight were significantly lower than the math and reading scores of children who were of normal weight.

Laws targeting Obesity The government and other health organization are currently planning strategies to prevent this global epidemic. Locally, here in manila, a Senator of the Thirteenth Congress Senator Miriam Defensor Santiago drafted a bill in response to the World Health Organizations call on the prevention and control of obesity. Miriam Santiagos Childhood Obesity Reduction Act of 2005. This is an act to reduce and prevent childhood obesity by encouraging schools to develop and implement local, school-based programs designed to reduce and prevent childhood obesity, promote increase physical activity and improve nutritional choices.(Retrieved Feb. 20, 2011 at

http:www.senate.gov.ph/lisdata/31842372!.pdf). Another senator heeded the call of the World Health Organization program on malnutrition, Senator Loren Legarda drafted a bill which addresses the constitutions plan of action for nutrition for 2008-2010. This bill was called Child Nutrition law of 2010. It supported the Millenium Developement Goals (MDG) set by the World Health Organization (WHO), although this law did not address the problem of childhood obesity but addressed the other side of malnutrition which is undernutrition. This catered to public school attendees to support their nutrition and feeding programs in the intermediate level to sustain their growth and developement in their formative years. (Retrieved on Jan. 9, 2011 at

http://www.senate.gov.ph/lisdata/102928811!.pdf) In the United States, a legislation was made to promote healthy eating through the federal program. Under the program, lunches must meet nutritional standard prescribed by the Secretary of Agriculture on the basis of tested nutritional research. along with the legislation , in the food service areas of U.S. schools foods of minimal nutritional value (FMNV) must not be sold in competition with food provided under the federal meal program. Countries like Guam, American Samoa, Palau, and marianas has already adopted the program and 60-90% of their countries schools are already into the monitoring level. Although the

mainland America has no specific law on a national level thats why local federal states create laws as applicable to their state. (Retrieved Jan.9,2011at www.

wpro.who.int/internet/resources.ashx/NUT/Final+obesity+report.pdf) Related Studies Foreign A study entitled Factors Associated with Obesity was

undertaken with the objective of identifying factors associated with poor nutrition due to excess caloric intake in Aruban school children ages 611 years old. The study has concluded that childhood obesity in the population studied appears to be associated with insufficient

breastfeeding, premature introduction of complementary nutrition, skipping breakfast, and excessive caloric intake in meals taken later in the day and at night, as well as insufficient consumption of fruits and vebetables (Visser et al 2007).Conditions which promote childhood obesity exist in the schools in the form of sales of foods high in simple sugars and a lack in of opportunity to participate in moderate to intense physical activity. Furthermore, the researchers indicated that there is lack of critical understanding concerning childhood obesity and its risks among the parents, teachers, food handlers and merchants studied.

A longitudinal study was made on children in the Pediatric Obesity Clinic(POC) in Calgary, Alberta (Wilson et al 2008). This study was undertaken to examine the psychosocial factors associated with higher BMIs among childrento assess the efficacy of a multi-disciplinary familybased behavioral obesity treatment program showed that children with a higher BMI reported that they have lower social support for health behaviors, lower physical functioning and enjoying in engaging in health behaviors less. Additionally, parents of children with higher BMIs reported that they have less efficacy to get their children to engage in physical activity and eat healthy foods. After 3 months in treatment, children reported increased physical functioning and enjoyment of health behaviors , and parents reported increased social support and efficacy. The findings suggest that the POCs multi-disciplinary family-based behavior obesity treatment program may be effective in improving psychosocial factors, which previous studies have found lead to increased physical activity, healthy eating and quality of life.

Mo-suwan et al, conducted a study in thailand on overweight school children in grades 7 through 9 reported that students grade point averages were statistically related with their weight category. That is, lower grade point averages were present for overweight 7th through 9th grade students in their study than for students in the normal weight

category. Also reported by Mo-Suwan et al. was that grade point averages tended to decrease as adolescent weight increased

(Hildenbrandt J., 2010).

In a second international investigation of 10,000 Finnish individuals, Laitinen, Power, Ek, Sovio, and Jarvelin (2002) found that obese individuals at 14 years of age were more likely to have poorer academic performance at 16 years of age than were non-obese individuals. This relationship between weight classification and academic performance was present throughout the age ranges in their study. Findings from this study were supported by Mikkila, Lahti-Koski, Pietinen, Virtanen, and Rimpela (2003) who reported a statistically significant association between obesity and poor academic performance at school. In their study of over 60,000 Finnish adolescents, obese teenagers had lower school performance than did adolescents who were of normal weight. In the most recent research study found in which student weight and academic performance was analyzed, Bagully (2006) utilized the National Longitudinal Survey Year 97 database. In his analysis of the BMI scores of 1,626 teenagers and their test performance in math, he discovered that math test scores were significantly lower for obese students than for students who were not obese.

A study in Saudi Arabia on obesity and the turn of westernization of food eating habits of college students wherein a total of 357 male students aged 18-24 years were randomly chosen from College of Health Sciences at Rass, Qassim University, KSA for the present 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 current data 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 < 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). (Retrieved Oct.16, 2010 at

http://www.nutritionj.com/content/9/1/39/abstract)

Local A Philippine study on obesity was published that aimed to determine the incidence and causes of obesity among elementary and high school students in Baguio City. Of the 2,823 students examined, 155 or 5.49% of them are overweight or obese. This reflects a low level of incidence when compared to the national statistics. There are more males who were identified as overweight or obese than the females. Moreover, majority of the cases belong to the 13-17 yrs. age group. Most of them do not engage in any physical activity such as walking, exercising and sports. Majority of them are engaged in computer and/or television viewing activities (Cruz et al 2009). A longitudinal study was done in St. Lukes Medical Center to determine the effects of a weight loss program, by using a multidisciplinary intervention consisting of combined dietary, exercise, and behavioral methods in obese children. At the end of the 3-month program, patients demonstrated a decrease in weight, BMI, BMI z-score, body fat, systolic blood preesure, and waist circumference. The decrease in weight, BMI, and fat were significantly correlated to number of sessions attended. The researchers concluded that the use of a

multidisciplinary 3-month staged program resulted in weight loss in obese Filipino children, which was directly related to the frequency of sessions attended. (Ting A.M.T. MD, Llido L. MD (2009)) In a study conducted by Food and Nutrition Research Institute (FNRI) in 2003, it was found that 90% of Filipinos had one or more of the following risk factors: physical inactivity, smoking, obesity, hypertension, diabetes and abnormal cholesterol. Alarmingly, more and more children and adolescents are becoming exposed to Non-Communicable Diseases (NCD) risk. The latest FNRI study, carried out in 2008, shows the prevalence of NCD risk factors among adults as follows: hypertension (25%), overweight (27%), high blood sugar (5%), and abnormal cholesterol (10%). It is also estimated that about two-thirds (60%) of adults are physically inactive. The obesity trend is also catching up with the young. Prevalence of overweight among adolescents aged 911years doubled from 2.4% in 1993 to 4.8% in 2005. Similarly, the prevalence rate of overweight for children aged 6-10 years doubled from 0.8% in 2001 to 1.6% in 2005. Numerous studies have shown a tendency for obese children to remain obese in adulthood. It is also estimated that about 2% of teenage students are overweight and 30% are physically inactive, spending 3 or more hours per day sitting and watching television, playing computer games, talking with friends or

doing

other

sedentary

activities

(WHO

2010

URL:

http://www.wpro.who.int/NR/rdonlyres/C6DFBEF8-AEF6-4A65-89DA2EA19FF81D9E/0/30finalPhilippines2010.pdf)

Synthesis

Studies have shown that for the past 40 years the incidence of obesity has risen 400 percent. This was already a wake-up call for the government and school authorities to enact laws and implement programs to control and prevent this menacing disease. Western counterparts have already started enacting laws towards obesity and managing good healthcare programs. It will be a challenge for government of different nations to do a concerted effort to focus on this growing health problem. Researchers have been racing to develop control and prevention programs that are evidence-based and with a high efficacy rate. These past few years, only studies on prevalence of obesity have been done on different parts of the world. Now that the problem of obesity is increasing and its occurrence is worldwide, researchers are focused on studies to control the disease through nutrtion and behavior programs.

A perfect example is the longitudinal study made in Pediatric Obesity Clinic in Calgary, Alberta. Their study was an eight week

program wherein parents and teachers were a part in the whole intervention. It primarily focused on the support on behavioral programs within the family. The program engages in slowly modifying nutrition and reinforcing positive behavior towards good food choices. A similar study locally done would be the study of Drs. Ting and Llido, wherein they designed a multidisciplinary intervention consisting of combined dieting, exercise and behavioral change in obese children. Both these studies were long term and integrated repeated sessions for the program to work. Implemented programs like these require close monitoring to ensure its effectiveness. This research undertaking would took into account these past studies since programs should have a reliable

monitoring system and an evaluation program to determine its effectiveness but did not conduct a longitudinal study. This study rather found out the occurrence of obesity in primary pupils for the school administrators to be aware of the problem thereby strengthening and even creating innovative programs that the children can easily follow and live by.

Comparing further the mentioned study to what the researcher to embarked on, the current study samples were limited to only three grade levels. The proposed program would depend on the result the researcher would obtain after the collection of data. Same as with the study Factors

Associated to Obesity which had the same intention as with this study, the investigatot determined factors that could influence the occurrence of obesity. However, there was a difference in the design, and sample size as well as the socio-economic/cultural status in the present study which might affect the data gathered.

The studies in Finland and Thailand focused on the effects of obesity on academic performance. It studied different age brackets in which both showed grade point averages were statistically related with their weight category, that obese children were most likely to have poorer academic performance. The current study no longer delved into the academic performances of the school children. However, this study obtained information on food choices and eating habits similarly with the study made in Saudi Arabia but did not acquire data regarding body fat and viceral fat level. The main focus of the on-going study was to raise the conciousness of the school administration together with the parents to control and prevent obesity in children attending the schools mentioned.

Chapter 3 METHODOLOGY This chapter presents the research methodology of the study. The presentation includes the research design, population and sampling, respondents of the study, research instrument/s used, validation of the instrument/s used, data-gathering procedure and statistical treatment of data. Reasearch Design The descriptive research method was used. According to Polit and Beck (2004), the purpose of descriptive studies is to observe, describe, and document aspects of a situation as it naturally occurs and sometimes to serve as a starting point for hypothesis generation or theory developement. This method was appropriate for the study since the study needed information on the pupils particularly grades 1-3 of selected private schools in Paraaque City. However, a qualitative research method in the form of a focus group discussion was likewise employed. This was added for the parent-respondents to get an in-depth analysis on their opinions and behavior on the topic of child obesity. Information on the students profile and family background were also

taken to establish the relationship of the students profile with the determinants of obesity. This study has involved the collection of data in order to test the hypothesis and to answer questions concerning the current status of the subjects of the study. To support the study , questionaires were given to subjects to further investigate on the subjects family background and their food preference in their homes as well as the the subjects own preference on food, the researcher basically gathered information that are percieved as factors in contributing to the occurrence of obesity. These factors may be social, cultural, environmental, and physiologic or genetic. There already have been studies of obesity in the past and in different levels of development. This study is focused on currently enrolled primary grade school children studying in selected private schools in Paraaque City in the school year 2011-2012. Most of the studies were conducted on children as a foundation of the perception that obesity starts in that stage of developement and that in this stage of development of these primary grade school students they are more susceptible to behavior change.

The main objective of the program would be creating an environment that is conducive for the children to have behavioral changes towards nutrition and self-care during the childs formative years. Constant evaluation and monitoring would be needed after a program has been launched to attain the desired effect in reinforcing positive behavior towards the program. The monitoring aspect would fall in the collaborators hands such as the parents, guardians, school nurses, teachers and the school administrators as well. Copies of this study will be given to the schools that participated in the study to help them in formatting and designing innovative programs, policies and subjects that would suit their students. Population and Sampling As shown in Table 1, the study identified the population, which consisted of primary pupils, grades 1-3 of three private schools in Paraaque City namely St. James College-Paraaque, Olivarez CollegeParaaque, and Immaculate Heart of Mary College-Paraaque. The primary pupils were chosen on the perception that obesity starts in that stage of development and that these primary pupils are more susceptible to environmental and behavioral change. The size of samples, determined by the profile of the pupil, is on the category of having a BMI percentile of 85.00 which according to the World Health Organization is

the cut-off point of being overweight. The corresponding parent of the classified pupil was included in the study as the parent-respondent. According to Polit and Beck (2008), populations are not restricted to human subjects. Population might consist of all records of a particular institution. The researcher accessed student clinic files to gather information on the subjects and to gain a better perspective on the target population. Table 1 Grades 1-3 Pupil Population in the Participating Schools (n=677) School St. James Olivarez College IHMC Total Male 49 67 229 345 Female 29 65 238 332 Total 78 132 467 677

This table shows the total number of pupils in grades 1-3 in the three participating schools. Immaculate Heart of Mary College, having a bigger population of pupils with 467 pupils, followed by Olivarez College with 132 pupils and St. James College with 78 pupils which has a total of 677 pupils currently enrolled on all three schools on grade levels 1-3.

Respondents of the Study As shown in Table 2, the respondents of the study are currently enrolled primary pupils of the three aforementioned private schools. The pupil-respondents were constituted by having their BMI computed and categorized. The pupil, having a BMI percentile of 85.00 was the pupilrespondent. The parent-respondents were constituted by having to correspond to the pupil previously categorized as having a BMI percentile of 85.00. The parent-repondent may be the father or the mother of the pupil-respondent chosen in which only one would be given the opportunity to be included in the study. Table 2 Distribution of Pupil-Respondents of Grades 1-3 (Pupils Classified as having a BMI Percentile of 85) (n=243) School St. James Olivarez College IHMC Total Pupil-Respondent 37 41 165 243 Percent 15% 12.5% 72.5% 100%

This table shows the total pupil-respondents wherein the study took the pupils weight and height to compute for their BMI, a BMI percentile of 85 would constitute the pupil-respondent. The table shows St. James School having 37 pupils which is 15 percent, Olivarez College having 41 pupils which is 12.5 percent and IHMC having 165 pupils which is 72.5 percent of population all attaining a BMI percentile of 85. A total of 243 pupil-respondents and 243 parent-repondents was included in the study. Upon gathering the data, only a number of the classified samples showed interest in participating in the study as shown in Table 3.

Table 3 Willing Participants of the Classified Samples and its Percentage from the Total Population (n=677) School St James Olivarez College IHMC sub-total (willing participants) total (non-participants) Grand Total 677 100% 517 76.37% Pupil 24 20 116 Percent from the Total Population 3.55% 2.95% 17.13%

160

23.63%

This table shows the willing participants who returned the questionaires for this study in which St. James College has 24 respondents which is 3.55% of the total population, Olivarez College with 20 respondents which is 2.95% of the total population, and IHMC with 116 respondents which is 17.13% of the total population having a total of 160 respondents which is 23.63% of the total population. The total nonparticipants are 517 pupils which is 76.37% of the total population when

added to the willing participants is 677 pupils or 100% of the total population. Research Instruments The instrument that was used to collect data is a self-structured questionaire. Two sets of questionaires will be made for every respondent group. Questionaire1 (Q1) was for the pupil-respondent. Q1 was written in Filipino for the students to easily understand the questions, a rating scale provided for the pupils ease in answering

them. It used a statistical trait using excel generation interval, (Shown on Table 4.) with 4.6-5 as Palagi, which is the highest and 1-1.5 as Hindi kailanman, which is the lowest. This means that the the higher the achieved statistical trait, the more probable the determinant to be the cause of the problem. The pupils questionaire consisted of two parts. The first part was designed to obtain their profile while the second part was the rating scale that was divided into three parts which consisted of the three factors namely cultural, social and environmental. Each factor has five questions. These three factors were then statistically treated to show the relationship of the responses of the two groups.

Table 4 Interpretation Scale for the Questionare for Pupil-Respondent Range or interval Scale Word description Verbal description
Ang estudyante ay naniniwala na ang isinasaad ng tanong/pangungusap ay palagi niyang ginagawa. Ang estudyante ay naniniwala na ang isinasaad ng pangungusap/tanong ay malimit niyang ginagawa. Ang estudyante ay naniniwala na ang isinasaad ng pangungusap/tanong ay minsan niyang ginagawa. Ang estudyante ay naniniwala na ang isinasaad ng pangungusap/tanong ay bihira niyang ginagawa. Ang estudyante ay naniniwala na ang isinasaad ng pangungusap/tanong ay hindi niya kailanman nagawa.

4.5-5

Palagi

3.5-4.49

Malimit

2.5-3.49

Minsan

1.5-2.49

Bihira

1-1.49

Hindi kailanman

Questionaire 2 (Q2), written in English was given to parentrespondents. Questionaire (Q2) had questions that sought out probable determinants of obesity that lingered parents who are percieved by students as role models. A cover page was attached to explain what the

survey is all about and an initial height and weight of both parents were asked, a rating scale then followed. It used a statistical trait using excel generation interval (Shown on Table 5.) with 4.6-5 as Always, which is the highest and 1-1.5 as Never, which is the lowest. This means the higher the achieved statistical trait is the more probable the determinant to be the cause of the problem. The parents questionaire consisted of two parts. The first part obtained the parents profile while the second part consisted of five parts. II-A, II-B and II-C was the rating scale for the three factors such as cultural, social and environmental respectively which had five questions for every section. II-D, on the other hand, obtained the physiologic aspect of the study wherein a question answerable with a yes or no, was asked if their child was ever diagnosed of a medical condition. It had a supplemental question on what the condition was and the medication taken for it. Section II-E obtained the genetic aspect of the study (BMI), the previous data gathered from the parents were used to compute for their BMI. The pupil-respondents profile was partly taken from the schools nursing service office (school clinic) while the other data were taken from either the registrars office or the guidance councilors office. This process proved helpful in updating their clients data sheet; i.e., the progress and development form for the clinic. A focus group discussion

was added to give the data a more in-depth explanation and seek the opinion of the parents on the topic of obesity in children. Questions that were asked in the focus group discussion were wholly dependent on the result of the survey data from the parent-respondents. Table 5 Interpretation Scale for the Questionaire for Parent-Respondent Range or interval 4.5-5 Word description Always

Scale

Verbal description
Respondent believe that the indicator given is always being done. Respondent believe that the indicator given is very often being done. Respondent believe that the indicator given is sometimes being done. Respondent believe that the indicator given is seldom being done. Respondent believe that the indicator given is never been done at all.

3.5-4.49

Very often

2.5-3.49

Sometimes

1.5-2.49

Seldom

1-1.49

Never

Validation of the Instruments To validate the content and effectiveness of the tool, the Dean of Post-Graduate School assigned experts in the field of nursing research. Authority included therein are members of the validation team of the Post-Graduate School. The researcher also sought the advise of a medical doctor to have the tool validated. Upon the return of the validated tool, the researcher revised the tool in accordance to the recommendation of the validators. After the content validation, the suggestions or recommendations were incorporated in the questionaire. The revised questionaire underwent pilot-testing of grade 1 pupils that tested the questions clarity and comprehensibility. A week after, a reliability test was done involving a different set of pupils that resulted with an .89 reliability. The final form of the quetionaire was then reproduced and distributed and answered by the respondents. Data-Gathering Procedure A letter of request addressed to the school administration/principal of the 3 schools was delivered personally by the researcher. Upon the approval of this request, a list of primary pupils of all three levels per school was obtained. A visit to the school clinic was done to gather

current pupils profile so that in the event that the data gathered were obsolete, the researcher could update these data with the help of the school clinic staff. Upon updating the school clinics data of all primary pupils, the researcher then computed the BMI scores of all pupils in these three levels to acquire pupil-respondents that would fit in the category needed in this study. The corresponding parent-respondents were then be informed of the research and were asked to participate through a letter attached to the survey questionaire sent to them. The survey questionaire (Q1) was then distributed to the pupil-respondents to be answered in a separate room to provide them with a quiet environment and was properly assisted by the researcher and his assistant facilitator. Another set of questionaire (Q2) was sent to the parents of the chosen pupils to be answered and submitted the following day. Upon the return of the answered questionaires, the data gathered was tabulated, analyzed, and statistically treated to provide the researcher a more comprehensible data for ease of interpretation. After the tabulation and analysis of the gathered data, a focus group discussion was conducted involving parent-respondents to explore depth and nuances of their opinions regarding the issue. This would also test the reaction of the parent-respondents on the proposed programs as well as their evaluation of current programs.

Statistical Treatment of Data

The data collected from the accomplished questionaires by the parent-respondents and the pupil-respondents were tabulated and organized to facilitate data processing. Microsoft Excel program using the tool Data Analysis was applied with the following statistical measures.

A. Descriptive Statistics

Frequency count and Percentage. These statistical measures were used in presenting the population and sampling data of the respondents.

Frequency Count and Weighted Mean (W.M.). This statistical measure was applied to the assessment in the survey. Five-point Likert scale, where 5 is the highest and 1 is the lowest, was adopted to measure the perceptions of the respondents on the factors affecting child obesity in terms of cultural, social, and environmental factors. The weighted mean was verbally described based on statistical limits constructed as follows:

statistical limits 4.5-5 3.5-4.49 2.5-3.49 1.5-2.49 1-1.49 5 4 3 2 1

vebal description Always Very often Sometimes Seldom Never

Ranking. This was used in assigning relative position or degree of the value on mean ratings.

B. Inferential Statistics Correlation Analysis. Pearsons coefficient of correlation, r, was the statistical measure applied to test the significant relationships between variables chosen in problems numbers 3 and 5 in this study. The test was subjected to five percent (5%) level of significance using ttest. The correlation analysis was verbally described based on the statistical limits constructed as follows:

statistical limits 0.01- 0.30 0.31-0.50 0.51-0.70 0.71-0.90 0.91-0.99

vebal description Negligible correlation Low correlation Moderate correlation High correlation Very high correlation

Chapter 4 PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents the results of the survey analysis, and interpretation of the data gathered based on the six problems to be answered by the study. Sub-problem number 1. The Profile of pupil-respondents according to sex; medical conditions; weight, height and BMI percentile. Table 6 presents the age ranges, sex, height and weight ranges of the pupil-respondents in grades 1, 2, and 3. Table 6 Age Range, Height and Weight Ranges of the Pupil-Respondents Grade level Age 5 yrs. and 9 mos. 8 yrs. and 1 mo. Height Weight

Grade 1

113cm-133.3cm

22.2Kg- 43Kg

Grade 2

6 yrs. and 1 mo. - 8 yrs. and 6 115cm-142.2cm mos. 8 yrs. and 1 mo. 10 yrs. and 7 mos. 117.8cm150.5cm

24.5Kg- 50.5Kg

Grade 3

28.5Kg- 55.5Kg

Note: * Actual list of Date of birth, Height and Weight of the pupils can be seen on appendix B, C and D. * These data are necessary in the computation of the BMI percentile.

The first column showed that grade 1 age ranged from 5 years and 9 months as the youngest to 8 years and 1 month as the oldest. Grade 2 ranged from 6 years 1 month as the youngest to 8 years and 6 months as the oldest. Lastly, Grade 3 which ranged from 8years and 1 month as the youngest to 10 years and 7 months as the oldest pupil in the study. The second column showed the height ranges of Grades 1-3 that is expressed in centimeters, in which grade 1 has a range of 113cm as the shortest to 133.3cm as the tallest. Grade 2 pupils height ranges from 115cm as the shortest to 142.2cm as the tallest and lastly, Grade 3 pupils height ranged from 117.8cm as the shortest to 150.5cm a s the tallest pupil in the study. The last column showed the weight ranges of the 3 grade levels expressed in kilograms. Grade 1 pupils weight ranged from 22.2 kg. as the lightest to 43 kg. as the heaviest. Grade 2 pupils weight ranged from 24.5 kg. as the lightest to 50.5 kg. as the heaviest. Lastly, Grade 3 pupils weight ranged from 28.5 kg. as the lightest to 55.5 kg. as the heaviest in the level. Table 7 presents the frequency and percentage distribution of pupil-respondents according to sex in all three levels.

Table 7 Frequency and Percent Distribution of Pupil-Respondents According to Sex in Grade Levels 1-3 (n=160) Male Grade level F Grade 1 Grade 2 Grade 3 Total 21 27 37 85 % 13.125% 16.875% 23.125% 53.125% F 23 27 25 75 % 14.375% 16.875% 15.625% 46.875% F 44 54 62 % 27.50% 33.75% 38.75% Female Total

160 100%

Note: *Actual list of gender of all students can be seen in appendix B, C and D. * These data are necessary in the computation of the BMI percentile.

The table showed Grade 1 having 21 male pupils or 13.125% and 23 female pupils or 14.375%; Grade 2 having 27 male or 16.875% and 27 female pupils or 16.875%; and lastly, Grade 3 which has 37 male or 23.125% and 25 female pupils or 15.625% that were included in the study having a total of 160 pupils. Table 8 presents the existing medical conditions that were gathered from the tool that may affect childhood obesity physiologically. The data in this table were obtained from the parent questionaire wherein the parents were asked if their children were ever diagnosed with a medical condition.

Table 8 Diagnosed Medical Conditions of the Pupil-Respondents According to their Parents Medical condition Asthma UTI Pneumonia Allergic Rhinitis Recurrent Tonsilitis G6PD Atopic Dermatitis Primary Complex TB Number of Cases 29 4 2 1 1 1 1 2

The leading medical condition that had been entered in the list by the parents were: asthma which has 29 cases, urinary tract infection which has 4 cases, pneumonia which has 2 cases, allergic rhinitis with 1 case, recurrent tonsilits with 1 case, G6PD with 1 case, atopic dermatitis with 1 case, And TB primary complex with 2 cases. These data were gathered for the purpose of getting the diseases that may affect the childs physiology which dramatically could increase obesity. incidence of

Taking it singly, It could be seen that asthma was the leading medical condition that has been diagnosed. This can be attributed to effects of our deteriorating environment or perhaps a genetic inheritance. Allergens could also play a part in contracting the disease. According to the CDC website, asthma itself will not contribute to obesity but the medications containing steriods would. However, when the medication stops, the effects would stop as well. Therefore, the researcher can safely conclude that medications on asthma may not affect obesity on a short term treatment but with chronic use may have a significant effect on the childs physiology specifically on his weight. The next leading medical condition is that of urinary tract infection in which children were prone to contracting perhaps from not urinating enough during the day. The third highest was respiratory problems such as pneumonia and primary complex/TB which could probably be caused by the environment the child frequents since these medical conditions can be transfered through droplet, wherein a weakened immune sytem would readily propagate its wrath on the system of the child. The rest of the condition listed are allergic rhinitis, atopic dermatitis, recurrent tonsilitis and G6PD or glucose 6 phosphate deficiency. The first two cases might be triggered by allergens or perhaps be a reaction to sensitivity. Recurrent tonsilitis might be of a viral or a bacterial infection,

while G6PD is a disease that might be passed through genes. On an overall assessment of the cases mentioned, none has been deemed to affect the child physiologically wherein it will result to obesity. According to the viriplant website as discussed in the related literature, illnesses such as hypothyroidism, cushing syndrome, depression and neurological problems may affect the weight of the person. Drugs such as steroids and anti-depressants may likewise cause weight gain. The data gathered would imply that none of the diagnosed medical condition may affect the childs weight significantly. Table 9 presents the BMI percentile score ranges of pupilrespondents in Grades 1, 2, and 3 that are included in the study.

Table 9 Distribution and Percentage of Pupil-Respondents (n=160) Categorized as Overweight and Obese
BMI percentile Grade 1 (n=44) F Overweight Obese Total 17 27 44 % 38.636% 61.364% 100% Grade 2 (n=54) F 25 29 54 % 46.296% 53.704% 100% Grade 3 (n=62) F 25 37 62 % 40.323% 59.677% 100%

Note: *Actual list of BMI percentile of pupils can be seen in appendix B, C and D

The second column showed the distribution of grade 1 pupils categorized according to their BMI percentile. In Grade 1, 17 or 38.636% of them are overweight while 27 or 61.364% are obese. The third column showed grade 2 distribution wherein there are 25 pupils or 46.296% that are overweight while 29 or 53.704% are obese. Lastly, grade 3 that has 25 or 40.323% overweight and 37 or 59.677 are obese. The category only showed two levels (overweight and obese) since the respondents were purposively chosen and all three levels showed numerical results 85th percentile to 95th percentile. Sub-problem number 2. The profile of the parent-respondents according to Weight, Height and BMI. Table 10 and 11 presents the Height and Weight Distribution of both parents.

Table 10 Height Range Distribution of Both Parents Father F 1 25 113 3 142 % .704% 17.606% 79.577% 2.113% 100% Height (feet/inch) 40-45 45 -50 5 -55 55 -60 6 -65 Total F 1 25 123 11 160 Mother % .625% 15.625% 76.875% 6.875% 100%

Note: *Actual list of parents height and weight can be seen in appendix G. * Height and weight of parents were taken to compute for their BMI score.

The first column revealed the height distribution of the fathers in which the height ranged from 411 which fell on the 45 - 50 range to 61 as the tallest which fell on the 6 - 65 range, the third column showed the height of the mothers which ranged from 40 which fell in the 40 to 45 range as the shortest to 58 which fell in the 55 - 60as the tallest.

Table 11 Weight Range Distribution of Both Parents Father F 8 31 68 26 3 4 1 1 142 % 5.634% 21.831% 47.887% 18.310% 2.113% 2.817% .704% .704% 100% Weight (in pounds) 90-120 121-150 151-180 181-210 211-240 241-270 271-300 301-330 331-360 361-390 Total F 54 79 22 4 1 160 100% Mother % 33.75% 49.375% 13.75% 2.5% .625% -

Note: *Actual list of parents height and weight can be seen in appendix G. * Height and weight of parents were taken to compute for their BMI score.

The table showed 8 or 5.634% and 54 or 33.75% of the father and mother respectively fell on the 90-120 pound range. Next is 31 or 21.831% and 79 or 49.375% of the father and mother respectively fell on the 121-150 pound range. On the 151-180 pound range 68 or 47.887% and 22 or 13.75% was listed on the fathers and mothers respectively. Following is the181-210 pound range with 26 or 18.310% and 4 or 2.5%

for both fathers and mothers respectively, then for the 211-240 pound range 3 or 2.113% and 1 or .625% listed for both fathers and mothers, respectively. Next is 241-270 pound range which listed 4 or 2.817 of fathers while the 301-330 and 361-390 pound range listed both 1 or .704% both on the fathers. Table 12 presents the BMI scores of both parents.

Table 12 Distribution of BMI Scores of Both Parents According to the International Weight Classification for Adults Father Classification (n=142) Underweight Normal Overweight Obese Total 1 48 76 17 142 0.704% 33.803% 53.521% 11.972% 100% % (n=160) 6 102 35 17 160 3.750% 63.750% 21.875% 10.625% 100% Mother %

Note: *Actual list of parents BMI score can be seen in appendix G.

It could be gleaned that the father and mothers BMI ranged from underweight to obese. On the second row, showed that 1 or .70422% and 6 or 3.750% was classified as underweight on fathers and mothers respectively. 48 or 33.80281% and 102 or 63.750% was classified as

normal weight for both fathers and mothers respectively, while 76 or 53.52114% and 35 or 21.875% was classified as overweight for both fathers and mothers respectively. lastly, 17 or 11.97183% and 17 or 10.625% was classified obese for both fathers and mothers respectively, that totalled to 142 fathers and 160 mothers who submitted their height and weight data that enabled the researcher to compute for their BMI scores. Problem number 3. Is there a significant relationship between the BMI of the parent-respondent and the BMI percentile of the pupilrespondent? Table 13 presents the correlation between the parent-

respondents BMI and the pupil-respondents BMI percentile, while Table 14 presents the correlation between the BMI Classification of parentrespondent to the respective pupil-respondent.

Table 13 Correlation between the BMI Score of the Parent-Respondents and the BMI Percentile Scores of Pupil-Respondents. Computed CORRELATES r-value Parent and Pupil - BMI's 0.005 t-value* 0.069 Interpretation Negligible correlation Decision Accept null hypothesis 1 Computed

*t-crirical value ( = 0.05, 2 tailed, 158 df) = 1.966

The table showed that r-value of 0.005, being positive, indicated a direct relationship between the BMI of the parent-respondents and the BMI percentile of the pupil-respondents. The relationship reveals that parent-respondents tended to have high BMIs as the pupil-respondents, and that when parent-respondents have a low BMI the pupil-respondents would likely have a low BMI. The relationship is not significant since the computed t-value of 0.069 is lower than the critical t-value of 1.966. This table showed that even if the r-value indicates a positive relation on the BMI of the two groups, the t- value computed showed that it is still insignificant. This data showed that for this sample, the possibility of passing the obesity gene is not supported thereby accepting null hypothesis 1. The relationship of the two variables was further tested on the significance of familial predisposition shown on Table 14.

Table 14 Correlation Between the BMI Score of the Parent-Respondent (n=52) to the Respective Pupil-Respondents BMI Percentile Computed CORRELATES r-value Parents BMI respective to Pupils BMI%
.142114082

Computed t-value* 1.015 Interpretation Low correlation Decision Accept null hypothesis 1

Note: *t-crirical value ( = 0.05, 2 tailed, 50 df) = 1.960 * Data could be seen in Appendix N

The overweight and obese parents and the overweight and obese pupils were tested if there was a correlation between their BMI scores to indicate a probable familial predisposition of obesity. This was based on the proportion of 52 parents ot of 160 or 32.5% were classified as overweight and obese. Correlation analysis reveals that there is no significant relationship between parents BMI and pupils BMI percentile, since the computed value of t=1.015 is less than the critical value of t=1.960 at 5% level of significance.

Taking it singly, this may imply that familial predisposition may not be the cause of the respondents obesity problems. According to John J. Reilly on the website endojournals, genetic factors influence the susceptibility of a given child to an obesity-conducive environment. Children have more chances of being obese having obese parents if

they continue to be exposed to an environment that foster physical inactivity and poor diet. Even genetically predisposed to obese parents, children may resolve and prevent obesity through proper diet and physical activity.

Problem number 4. The factors affecting child obesity as perceived by the pupil-respondent and the parent-respondent in terms of cultural factors; social factors; environmental factors; physiologic factors and genetic factors

4.1 Cultural factors

Tables 15 and 16 present the habits/behavior patterns related to the cultural factors affecting child obesity as perceived by the parentrespondents and the pupil-respondents respectively.

4.1.1 Parent-Respondents

Table 15 Frequency, Weighted Mean, and Rank Distributions of ParentRespondents Ratings on Cultural Factors (n=160)
indicator
My child is influenced by his friends on what kind of food he eats. My child is influenced by his friends on what he wants to play. My child likes more of the processed foods like hamburger, tocino, longganisa, than vegetable dishes. My child loves to imitate what he sees on tv. My child loves to eat.

v-o

so

se

wm

description

rank

64

57

30

2.34

SE

33

75

26

18

2.92

SO

27

43

58

28

3.38

SO

26

71

40

18

2.75

SO

60

32

4.21 3.12

V-O sometimes

overall mean

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

Table 15 showed that indicator My child loves to eat

was

ranked 1 with a mean score of 4.21 which is verbally described as very often. It was followed by indicator My child likes more of the processed foods like hamburger, tocino, longganisa, than

vegetable dishes with a mean score of 3.38 (SO) as rank 2. Indicator My child is influenced by his friends on what he wants to play got a mean score of 2.92 (SO) which was ranked 3 followed by indicator My child loves to imitate what he sees on tv with a mean score of 2.75 (SO) and lastly, indicator My child is influenced by his friends on what kind of food he eats with a mean score of 2.34 (SE) ranked 5th on cultural factors. An overall mean of 3.12 with a verbal description of sometimes was depicted.

Taking it singly, the top ranked indicator could probably be rooted in the childs behavioral pattern at home and in school. According to one parent from the focus group discussion held at IHMC, she said, my child loves to eat specially after school and at the company of his sisters who cooks whatever he likes. He enjoys afternoon meals. The comment was from a mother whose child was thin when he was a toddler and worked to keep her childs appetite to gain weight which in effect, made the child obese. It could also be explained by an erroneous Filipino belief that being fat is healthy. (The Focus Group Discussion in IHMC can be seen in Appendix I)

4.1.2 Pupil-Respondents

Table 16 Frequency, Weighted Mean, and Rank Distributions of PupilRespondents Ratings on Cultural Factors (n=160)
INDICATOR
Naaakit ako sa mga pagkain na kinakain ng aking mga kaklase Naaakit ako sa mga laro na kinagigiliwan ng aking mga kaklase Nagigiliw akong kumain ng pagkaing katulad ng hamburger, tocino, longganissa higit sa pagkaing gulay Ginagaya ko ang nakikita ko sa telebisyon Nagigiliw akong kumain

V-O

SO

SE

WM

DESCRIPTION

RANK

26

29

25

71

2.34

SE

40

15

55

17

33

3.08

SO

54

15

44

33

14

3.39

SO

18

11

25

22

84

2.11

SE

62

21

40

17

20

3.55 2.89

V-O sometimes

OVERALL MEAN

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

Topping the pupils response is indicator Nagigiliw akong kumain with a mean score of 3.55 (V-O) is ranked 1st, followed by indicator Nagigiliw akong kumain ng pagkaing katulad ng

hamburger, tocino, longganissa higit sa pagkaing gulay with a mean score of 3.39 (SO) ranked 2nd. Indicator Naaakit ako sa mga laro na kinagigiliwan ng aking mga kaklase with a mean score 3.08 (SO) ranked 3rd while indicator Naaakit ako sa mga pagkain na kinakain ng aking mga kaklase ranked 4th with a mean score of 2.34 (SE). The last indicator Ginagaya ko ang nakikita ko sa telebisyon with a mean score of 2.11 (SE) is ranked 5th and an overall mean of 2.89 with a verbal description of sometimes was depicted. Taking it singly, the top ranked response was the same as of the parents which was he loves to eat. According to the website viriplant.com, children are exposed to peer pressure which gives them the craving to do what others are doing just to belong to that status . The child sometimes enjoy eating because the child associates it with keeping pace with the groups desire. This attitude might also be due to the childs attempt to satisfy his parents; i.e. to finish the food served to him. However, it is likewise a truism that not all the pupil-respondents share the fondness in eating since every individual manifests different behavior toward food. 4.2 Social Factors

Tables 17 and 18 present frequencies, weighted means and ranks of reponses of parent and pupil-respondent, respectively on the five indicators regarding social factors as percieved by both groups.

4.2.1 Parent-Respondent

Table 17 Frequency, Weighted, Mean and Rank Distributions of ParentRespondents Rating on Social Factors (n=160)
INDICATOR
My child like to go out and play with his friends My child is influenced by what he sees on tv My child glows up when its time to eat My child likes physical activities My child watches television for long hours

V-O

SO

SE

WM

DESCRIPTION SO

RANK

35

43

58

14

10

3.49

32

75

36

11

2.91

SO

33

60

51

14

3.68

V-O

54

52

44

3.93

V-O

30

63

45

14

2.83 3.37

SO SOMETIMES

OVERALL MEAN

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

Heading the parents responses on social factors is indicator My child likes physical activities with a mean score 3.93 (V-O) followed by

indicator My child glows up when its time to eat with a mean score 3.68 (V-O) which is ranked 2nd. Indicator My child likes to go out and play with his friends with a mean score 3.49 (SO) is ranked 3rd while indicator My child is influenced by what he sees on tv with a mean score of 2.91 (SO) is ranked 4th. Trailing last is indicator My child watches television for long hours with a mean score of 2.83 (SO) is ranked 5th having an overall mean of 3.37 with a verbal description of sometimes is revealed. Taking it singly, the tables top ranked indicator which is My child likes physical activities could probably be established by the fact that they see their child running around or being physically active all the time. According to endojournals.com, a journal written by Livingstone et al, obesity can be prevented primarily with physical activity. However, the amount of time that the children spend playing outside has diminished over the past few decades. Most children are active and love to move around; however, not all share the same active lifestyle. The parents want to believe that their child is active; hence, this indicator was ranked 1st, however they might not have accounted how long or how much the activity was spent. These parents also believe that an active child is a healthy child. This was also strengthened in the focus group discussion held in Olivarez College

wherein a parent claimed(translated) that his child loves to play all day and sees this attitude as normal for his child. (from FGD in Olivarez College, the whole document may be seen in Appendix J)

4.2.2 Pupil-Respondent

Table 18 Frequency,Weighted Mean, and Rank Distributions of PupilRespondents Ratings on Social Factors (n=160)
INDICATOR
Naglalaro ako sa labas ng bahay kasama ng aking mga kaibigan Naiimpluwensyah an ako ng mga patalastas na napapanuod ko sa telebisyon Nasisiyahan ako pag oras na ng pagkain Nagigiliw akong gumawa ng mga pisikal na gawain Nanunuod ako ng telebisyon pag nasa bahay

V-O

SO

SE

WM

DESCRIP -TION

RANK

56

15

50

30

3.36

SO

21

10

34

31

64

2.33

SE

75

19

24

21

21

3.66

V-O

79

14

29

16

22

3.70

V-O

58

14

59

14

15

3.54 3.32

V-O SOMETIMES

O VERALL MEA N

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

Ahead in the pupils response on social factor indicators is indicator Nagigiliw akong gumawa ng mga pisikal na gawain with a mean score 3.70 (V-O) as rank 1 followed by indicator Nasisiyahan ako pag oras na ng pagkain with a mean score of 3.66 (V-O) as rank 2. The indicator Nanunuod ako ng telebisyon pag nasa bahay with a mean score 3.54 (V-O) is ranked 3rd next is Indicator Naglalaro ako sa labas ng bahay kasama ng aking mga kaibigan with a mean score 3.36 (SO) is rank 4th and Indicator Naiimpluwensyahan ako ng mga patalastas na napapanuod ko sa telebisyon with a mean score of 2.33 (SE) as ranked 5th having an overall mean of 3.32 with a verbal description of sometimes is depicted. Taking it singly, the pupils top response was the same as of the parents response Nagigiliw akong gumawa ng pisikal na gawain. This statement could mean that children really love to move around and burn excess energy. The researcher believes that physically active kids are more alert, academically motivated and they are more likely to build self esteem. Physical activity also fosters good bonds with friends in any age group enabling the children to play and interact with their peers.

4.3 Environmental Factors

Tables 19 and 20 present frequencies, weighted means and ranks of reponses of parent and pupil-respondent respectively on the five indicators regarding environmental factors as percieved by both groups.

4.3.1 Parent-Respondent

Table 19 Frequency, Weighted Mean, and Rank Distributions of ParentRespondents Ratings on Environmental Factors (n=160)
INDICATOR
My family loves to eat I allow my child to buy the food he wants to eat in school I dont mind my child eating cookies, chips, chocolates, candies, etc. I only cook the type of food my my child wants to eat I cook meat dishes and processed foods more than vegetable dishes

A 55

V-O 70

SO 35

SE 0

N 0

WM 4.13

DESCRIPTION V-O

RANK 1

12

65

53

22

2.57

SO

21

71

45

18

2.69

SO

13

29

65

43

10

2.95

SO

25

72

47

2.84

SO

OVERALL MEAN

3.03

SOMETIMES

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

The table revealed that the top ranked response is the indicator My family loves to eat with a mean score of 4.13 (V-O) as rank 1, followed by the indicator I only cook the type of food my my child wants to eat with a mean score 2.95 (SO) as rank 2. The Indicator I cook meat dishes and processed foods more than vegetable dishes with a mean score 2.84 (SO) as rank 3, followed by the indicator I dont mind my child eating cookies, chips, chocolates, candies, etc. with a mean score 2.69 (SO) as rank 4, and the indicator I allow my child to buy the food he wants to eat in school with a mean score 2.57 (SO) as rank 5 with an overall mean of 3.03 depicted as sometimes.

Taking it singly, the top ranked response of parents was indicator 1 which is my family loves to eat. This could probably be brought about by the long hours that the parents spend in their offices that at dinner they would make sure that they would have a festive ambience during mealtime with the whole family. This may also be because of the presence of an extended family as one parent depicted in the focus group discussion held in St. James School, that every mealtime was like a family get together that they will be cooking huge portions to accomodate the number of people about to partake the food.( The FGD held in St. James school can be seen in Appendix H)

4.3.2 Pupil-Respondent

Table 20 Frequency, Weighted Mean, and Rank Distributions of PupilRespondents Ratings on Environmental Factors (n=160)
INDICATOR
Masigasig ang pamilya namin sa oras ng pagkain Bumibili ako ng pagkaing gusto kong bilihin sa eskwela Pinapayagan ko ang aking magulang na kumain ng mga tsitserya kagaya ng chips, tsokolate, kendi, atbp. Sinasabi ko sa nanay ko ang pagkaing gusto kong kainin Nagluluto si nanay ng hotdog, tocino, o ano pa mang ma-karneng pagkain sa halip na pagkaing gulay

V-O

SO

SE

WM

DESCRIPTION

RANK

76

42

13

20

3.68

V-O

25

18

62

25

30

2.89

SO

12

14

50

32

52

2.39

SE

39

15

37

34

35

2.93

SO

39

16

44

32

29

3.03

SO

OVERALL MEAN

2.98

SOMETIMES

*Legend: A- Always(4.5-5), V-O- Very Often(3.5-4.49), SO- Sometimes(2.5-3.49), SE- Seldom(1.5-2.49), N-Never(1-1.49), WM- Weighted Mean

The top ranked indicator in this table is indicator Masigasig ang pamilya namin sa oras ng pagkain with a mean score of 3.68 (V-O) is ranked 1st, next is indicator Nagluluto si nanay ng hotdog, tocino, o ano pa mang ma-karneng pagkain sa halip na pagkaing gulay with a mean score of 3.03 (SO) is ranked 2nd, followed by indicator Sinasabi ko sa nanay ko ang pagkaing gusto kong kainin with a mean score of 2.93 (SO) is ranked 3rd. Indicator Bumibili ako ng pagkaing gusto kong bilihin sa eskwela with a mean score of 2.89 (SO) is ranked 4th and last is indicator Pinapayagan ko ang aking magulang na kumain ng mga tsitserya kagaya ng chips, tsokolate, kendi, atbp. with a mean score of 2.39 (SE) as ranked 5th having an overall mean of 2.98 with a verbal descrpition as sometimes is revealed.

Taking it singly, the top ranked response of pupils in this table is indicator 1 which was masigasig ang pamilya namin sa oras ng pagkain which probably was brought about by the childs perception that mealtime was a happy family affair which the child sees and feels. Filipinos simply enjoy eating, this is the time Filipinos associate food as a bonding event with the family. Parents seem to pass on that behavior to their children.

4.4 Physiologic Factors

(Please see Table 8 Diagnosed Medical Conditions of the PupilRespondents According to their Parents) The diagnosed medical conditions that were stated by parents did not show any association nor link to the incidence of obesity. However, medications that were given to cure asthma did have steroids which may cause obesity, but these medications such as puffs, and nebules that dilate air passages may only contain small amounts of steroids and were not used for prolonged periods of time. 4.5 Genetic Factors (Please see Tables 13 and 14 on the correlation between the BMI scores of the parent-respondents and the BMI percentile scores of the pupil-respondents and the correlation between the BMI scores of the parent-respondents to the respective pupil-respondents.) The data showed that for these two groups of respondents genetic factors are not significant in the increasing incidence of obesity even with the testing for familial predisposition on obesity which showed the same result. According to the focus group discussion held in all three schools, parents are solely responsible for the kind of food they eat and the activity that their children do, nevertheless, they also believe that

genetics plays a role in the proliferation of obese children. However, tests done with this group resulted otherwise. Problem number 5. Significant relationships between the perceptions of the parent-respondents and the pupil-respondents on the following factors affecting obesity; cultural factor; social factor; environmental factor. Table 21 presents a parallel presentation of responses of the two groups on the three factors of obesity namely cultural, social and environmental with their computed means and verbal description for a visual comparison. Table 21 Distribution of Mean Ratings of the Parent-Respondents and the PupilRespondents on the Factors Affecting Obesity
PARENT-RESPONDENTS WEIGHTED MEAN Description 3.12 Sometimes 3.37 Sometimes 3.03 Sometimes 3.17 Sometimes PUPIL-RESPONDENTS WEIGHTED MEAN Description 2.98 Sometimes 3.32 Sometimes 2.98 Sometimes 3.06 Sometimes

Factors Cultural Social Environmental GRAND MEAN

Legend: Factors refer to items listed in previous tables presented regarding cultural, social, and environmental factors.

This table showed a parallel presentation of both parent and pupil responses on all 15 indicators that seemingly have a similar result. Starting with the cultural factor wherein the weighted mean resulted to

3.12 and 2.89 for both parent-respondents and pupil-respondents, respectively. Social factor followed with weighted means of 3.37 and 3.32 for parent-respondent and pupil-respondent respectively and lastly, is the environmental factor which showed weighted means of 3.03 and 2.98 for both parent-respondent and pupil-respondent, respectively. The grand mean resulted to 3.17 and 3.06 for parents and pupils response respectively, it also depicts the same verbal description since values showed only slight differences. A t-test was performed to determine significant relationship of the two groups responses. Table 22 presents the correlation coefficients and the t-test results on the correlation analysis of the perceptions of the parent-respondents and the pupil-respondents on the factors affecting child obesity.

Table 22 The Relationship of the Parent and Pupil Responses on the Factors Affecting Obesity Computed Computed r-value t-value* Significance 0.119 1.504 Not Significant Significant

CORRELATES Cultural Factors: Parent and Pupil Ratings Social Factors: Parent and Pupil Ratings Environmental Factors: Parent and Pupil Ratings Overall Factors: Parent and Pupil Ratings

0.182

2.329

-0.055

-0.697

Not Significant Significant

0.158

2.0115

*t-crirical value ( = 0.005, 2 tailed, 158 df) = 1.966

The table showed that in relation to cultural and social factors, computed r-values of 0.119 and 0.182, respectively, being positive indicated direct relationship between the perceptions of the two groups of respondents. The relationships revealed that parent-respondents tended to have high ratings as when the pupil-respondents had high ratings too. However, the relationship is not significant since the computed t-value of 1.504 on cultural factor is less than the critical tvalue of 1.966. In spite of this, the social factor which showed a computed t-value of 2.329 has exceeded the critical t-value of 1.966 which made it significant.

On the other hand, the table shows that r-value of -0.055 on environmental factor, being negative, indicated an inverse relationship between the respondents. The relationship revealed that the parentrespondents tended to have relatively higher ratings when the pupilrespondents had lower ratings. The relationship was found not significant since the computed t-value of -0.697, in absolute value, does not exceed the critical t-value of -1.966.

Furthermore, the table showed that on the overall factors, r-value of 0.158 being positive, indicated a direct relationship between the respondents perceptions. The relationship revealed that parentrespondents tended to have ratings as the pupil-respondents. The relationship is significant since the computed t-value of 2.0115 is higher than the critical t-value of 1.966. Hence, the null-hypothesis that there is no significant relationship and the between the perceptions on the of parentand

respondents environmental

pupil-respondents

cultural

factors affecting obesity, is not rejected. However,

analysis on social factors was found significant. Then again, overall analysis revealed significant relationship on their perceptions rejecting the said null hypothesis on the three factors.

The table revealed a significant relationship on all three factors. It could be due to the three factors slight nuance in definition. These factors may be perceived by both groups to be almost the same since one could barely set it apart from the other. These factors are intertwined in our lives that even in the focus group discussion held in Olivarez College, one parent informed the researcher that (translated) the three factors are almost the same and that her child is influenced by these three factors equally. (The FGD in Olivarez College may be seen in Appendix J)

Problem number 6. A proposed Collaborative health and wellbeing program to reduce the incidence of child obesity in schools Health and Well-being Program for Schools Rationale: Children spend much of their time in two places, home and school; which makes their two most influential groups of people, parents and teachers. Parents either model active or inactive lifestyles. They determine what food is brought in the home and decide mostly for the child. At a certain age these children will be enrolled in school, where much of their childhood will be spent. Although students are required to take physical education of at least 2 to 3 times per week this wouldnt be enough with the kind and frequency of food they take in. On a normal day in school, the students receive two meals a day in school plus a snack in the afternoon. The researcher recommends at least 30 minutes of physical activity per day within the school to burn off excess energy. The health and well being program would play a positive role in obesity prevention and may even enhance self-esteem and mental performance.

This program is adopted from the Daily Physical Activity: A Handbook for grades 1-9 Schools. This Handbook was chosen to guide administrators and teachers in planning, implementing and monitoring a collaborative health and well-being program.

Target: Administrators Teachers Parents Students Objectives: 1. To instill knowledge, skill and attitude that lead to active, healthy lifestyles, and such learning to begin in childhood. 2. To equip administrators with a framework to provide physical activity opportunities and develop a desire for lifelong participation in physical activities. 3. To ensure all students are physically active for a minimum of 30 minutes through activities organized by the school. 4. To include collaborators such as parents, guardians and the rest of the community in supporting the daily physical activity programs to ensure a sustained activity plan environment. on all areas of the childs

Action Plan for the Proposed Health and Well-being Program for Schools Steps Activity Guidelines
Create ways for participants to reflect on their personal vision before bringing them together to do shared vision work. Consider using a facilitator from outside the school to allow all participants to fully participate in discussion and activities. At the organizational meeting, discuss the concept of shared responsibility for school implementation and the need for everyones involvement in making DPA a success.

Invite people from various areas of 1. Organize the school community ( Teachers, the DPA Administration, Parents/Guardians) plan team to be part of your daily physical activity plan team.

2. Discuss the vision and evaluate the current situation

- Write a vision for your DPA plan Example: To implement an instructional program that creates good

Provide a logical explanation and rationale, highlighting the need for, and benefits to be derived from, the plan. Create a forum for

behavioral practices towards physical activities.

discussion in which individuals have the freedom to share their feelings and beliefs. This provides the opportunity to discuss existing challenges and to share vision and goals for the students. Divide the team into groups and have each group contribute thoughts and ideas on the topic. Rotate and have the groups add to the work of the group before them. At the end, have each individual mark the most important points. Count up the marks and focus on the points that were marked most often.

- Assess the equipment and other resources currently available to the school.

- Assess strengths, weakness, opportunities, and threats to the schools vision.

3. Create DPA plans

- Use information from your analysis to write goals that will help your school achieve its vision. Example: We will implement instruction practices and create a school culture

Using a solutionfocused approach is often the most successful strategy to develop action plans. A how can we do this perspective for providing Daily

that is supportive of the daily physical activity by achieving the following goals: School: Integrate physical activity and quality learning opportunities in all subject areas. Community: Involve parent and community resources in schoolorganized physical activities. Stakeholders: Involve all students in DPA, including those not currently active. Environment: Develop a social and physical environment that is supportive of DPA.

Physical Activity allows staff to provide positive input. Create mentoring relationships that allow more experienced teachers to provide leadership to teachers less familiar or comfortable with DPA. Create staff pairing or small groups to allow teachers with similar needs to collaborate, network and support each other. Provide sufficient time for stakeholders to consider the proposed actions and their effects.

- Write an action plan for each goal including : Actions/strategies for achieving the goal Resource needs Communication strategies Assessment strategies Schedule

Encourage individuals to suggest new or alternative activities or organizational formats for annual events that would help DPA. Develop a leadership program for students and involve them throughout this process.

- Create a yearly schedule or timeline for all actions in the DPA plan.

- Integrating DPA to current subjects. Examples may be seen with the sample activities as cross curricular linking. Refer to Appendix A

Develop and post class and school calendars that indicate dates for activities and events. Acknowledge the challenges that may be encountered and that adaptations to the original plan may be necessary. Align the change process related to DPA with professional development opportunities. Provide sufficient professional development opportunities to create an understanding of DPA and to allow individuals to build and strengthen their

4. Follow DPA action plans

- Assign tasks to various members of the DPA team based on the actions identified into the action plan. Meet regularly to assess team progress, critically offer reflect and offer support.

- Inform parents/gurdians and other stakeholders in your school community about your schools DPA implementation plan.

DPA practices. Include DPA information in all newsletters to parents/guardians.

- Prepare a monitoring checklist to easily identify problem areas as well as strengths.

Monitor and adjust the implementation time line and strategies when necessary.

5. Monitor and review process

- Using information gathered during DPA monitoring, reflect on success, challenges, and future improvements. On a yearly basis create a new action plan to address this review.

Evaluate the involvement of all students when determining the success of DPA implementation strategies.

*Adopted from Daily Physical Activity: A Handbook for Grades 1-9 Schools (2006); a full citation can be seen in bibliography. Note: Please refer to Appendix A for samples on daily physical activities .

Chapter 5

Summary of Findings, Conclusions and Recommendations

This chapter presents the summary of findings, the interpretations and conclusions drawn from the analysis of the information and data gathered and the proposed recommendations of the researcher to address the problems and concerns revealed in the six problems stated in this study.

Summary The study sought to find out the the factors affecting childhood obesity in primary pupils in selected private schools in Paraaque City, namely Olivarez College-Paraaque Campus, Immaculate Heart Of Mary College of Paraaque and St. James School of Paraaque. The primary level was chosen because of the child s susceptibility to behavior change at this age of development. Specifically, the study sought to answer the following questions: 1. What is the profile of the pupil-respondents according to1.1 Age; 1.2 Sex;

1.3 Medical conditions 1.4 Weight; 1.5 Height; and 1.6 BMI-for-age? 2. What is the profile of the parent-respondents according to2.1 Weight; 2.2 Height; and 2.3 BMI? 3. Is there a significant relationship between the BMI of the parent-respondent and the BMI percentile of the pupilrespondent? 4. What are the factors affecting child obesity as perceived by the pupil-respondent and the parent-respondent in terms of: 4.1 cultural factors; 4.2 social factors; 4.3 environmental factors; 4.4 physiologic factors 4.5 genetic factors? 5. Are there significant relationships between the perceptions of the pupil-respondents and the parent-respondents on the following factors affecting obesity:

5.1 cultural factors; 5.2 social factors; 5.3 environmental factors? 6. Based on the findings, what collaborative health and wellbeing program may be proposed to reduce the incidence of child obesity in schools?

Methodology The study employed the descriptive and qualitative research methods in gathering the data. The descriptive research method provided the quantitative description of the assessment of the respondents and enriched by the qualitative research methods of focus group discussions. There were 2 groups of respondents in this study, the Pupilrespondents was purposively chosen by getting their BMI percentile and selected the percentile value of 85 in which the value is classified as overwieght onwards. The parents of the classified overweight and obese children constituted the parent-respondents. Only pupils of grades 1-3 Currently enrolled in the selected private schools mentioned during the school year 2011-2012 were included. Furthermore, a tapered total of 160 pupil-respondents and 160 parent-respondents specifically mothers

were taken and analysed due to the completeness of the data furnished by both groups. The survey questionaires which was self-structured was validated by experts chosen by the Dean of Graduate School. Revisions were made based on comments and suggestions received. Findings The study came up with the following findings: 1. The pupil-respondents profile was vital in determining their BMI percentiile. There are 85 or 53.125% male and 75 or 46.875% female respondents with age ranges of 5 years 9 months to 10 years 7 months; height ranges from 113cm to 150.5cm; weight ranges from 22.2 kg to 55.5 kg; and BMI percentile ranges of 85.2 to 99.7 wherein 67 are overweight and 93 are obese. 2. The profiles of the parent-respondents such as their height and weight were critical in determining their BMI. The fathers height ranges from 4 feet 11 inches to 6 feet 1 inch while the mothers height ranges from 4 feet to 5 feet 8 inches; the fathers weight ranges from 110 pounds to 385 pounds while the mothers weight ranges from 100 to 220 pounds. The fathers BMI ranges from 14.5 to 58.7 while the mothers BMI ranges from 14.2 to 61.

3. The correlation of the BMI of the parent-respondents and the pupil-respondents computation showed the computed t-value of 0.069 is lower than the critical t-value of 1.966 which shows that the relation between the two groups is not significant. A correlational analysis was done to obtain the relationship for familial predisposition which showed the computed t-value of 1.015 which is lower than the critical t-value of 1.960 that indicates a low correlation that reveal a non-significant relationship on the test. The results supported the decision to accept null hypothesis 1. 4. The data gathered from the parents and pupils responses on the perception on the following factors are as follows: 4.1 The responses on cultural factors from both parents and pupils showed an overall mean of 3.12 and 2.89 respectively which has a verbal description of sometimes on both values. Indicator 5 My child loves to eat was ranked number 1 on both groups. 4.2 The responses on social factors from both parents and pupils showed an overall mean of 3.37 and 3.32 respectively which has a verbal description of sometimes on both values.

Indicator 4 My child likes physical activities was ranked number 1 on both groups. 4.3 The responses on environmental factors from both parents and pupils showed an overall mean of 3.03 and 2.98 respectively which has a verbal description of sometimes on both values. Indicator 1 My family loves to eat was ranked number 1 on both groups. 4.4 The medical conditions that the pupil-respondents had does not show any link to physiologic factors that may contribute to childhood obesity. 4.5 The genetic predisposition on obesity was not a major factor in the respondents increased incidence of obesity, however the respondents do not discount the involvement of this factor. The correlation analysis result showed the same wherein it resulted in a decision to accept null hypothesis 1. 5. The correlation between the perceptions of the parent and the pupils response on the cultural, social and environmental factors affecting obesity shows that only social factors depict a significant t-value of 2.329 which exceeds the critical t-value of 1.966, while cultural and environmental factors with t-values 1.504 and -0.697 respectively do not

exceed the critical t-value of 1.966 which means that the two are not significant. However, the overall computation of all three factors on their t-value shows that the t-value of the three factors combined shows all three are significant since their t-value of 2.0115 exceeded the critical tvalue of 1.966. 6. A health and well-being program was developed for administrators, teachers and parents. this is focused on Daily Physical Activity wherein students are expected to have at least 30 minutes of physical activity daily. This program was adopted from Daily Physical Activity handbook developed in Alberta, Canada. Conclusions Based on the findings of the study, the following conclusions are drawn: 1. The typical overweight to obese pupil in the study has BMI percentile ranging from of 85.2 to 99.7. 2. BMI scores of both fathers and mothers started at 14.5 and 14.2 respectively which are characterized as severe thinness and 58.7 for fathers and 61 for mothers which both values are characterized as obese class III.

3. There is no indication that the genetic factor affects the occurrence of childhood obesity in all three schools. 4. The three factors that were entered in the questionaire which was cultural, social and environmental factors do sometimes affect childhood obesity while no conclusion can be made in relation to genetic and physiologic factors because of insufficient data. 5. Cultural, social and environmental factors prove to be significantly related to the incidence of childhood obesity. 6. Physical activity plays an important role in reducing childhood obesity but it needs to be systematically planned and implemented. Recommendations Based on the findings and conclusions drawn from the result of the study, the following recommendations are hereby presented: 1. For the School Administration 1.1 Schools should take part in developing programs that would foster behavioral change by the pupils as early as grade 1 or earlier to foster good behavior toward good food choices. 1.2 The school and the homes should create a conducive environment for good eating habits and good food choices.

1.3 The School Clinic should monitor the growth and development of each pupil through annual reports and school PTA meetings. 2. For the Parents 2.1 Parents should create a role-playing environment for the child in order to lead them to adopt a saying Treat the parents, the child only follows what he or she sees. 2.2 Parents should exert effort to reduce sedentary activities of children such as tv viewing, handheld computer games and instead create/plan enjoyable physical activities at home. 2.3 Parents should actively participate in PTA meetings, identify problem areas and plan collaborative programs that both groups can easily monitor and evaluate. 3. For Health Workers 2.1 Health workers should take part in monitoring the growth of children and advise parents on programs and alternatives they could take in the prevention of childhood obesity. 2.2 They should be advocates of research in preventing obesity.

REFERENCES ONLINE REFERRENCES: Alberta. Alberta Education(2006). Learning and Teaching Resource Branch. Dily physical activity: a handbook for grades 1-9 schools. URL: http://education.alberta.ca/media/318500/handbook.pdf Al-Rehaika A., Fahmy, A., Shwaiyat N. (2010). Obesity and Eating Habits Among College Students in Saudi Arabia: A Cross sectionnal Study. URL: http://www.nutritionj.com/content/9/1/39/abstract Bagully, M. (2006). The impact of childhood obesity on academic performance. Masters thesis. Georgetown University. WRLC Digit Repository. Digital Collections (GT). Electronic Theses and Dissertations. Public Policy. Retrieved January 31, 2007 from URL: http://hdl.handle.net/1961/3590 Burgeson CR, Wechsler H, Brener ND, Young JC, Spain CG (2001). Physical education and activity: results from the School Health Policies and Programs Study 2000. J Sch Health 71:279293[Medline] Centers for Disease Control and Prevention (CDC). (2007). Overweight and obesity. Retrieved January 4, 2008, from the Department of Health and Human Services Web site: http://wwwtest.cdc.gov/nccdphp/dnpa/obesity/resources.htm Crosnoe R., & Muller, C. (2004). Body mass index, academic achievement, and school context: Examining the educational experiences of adolescents at risk of obesity. Journal of Health and Social Behavior, 45(4), 393-407 URL: http://hsb.sagepub.com/content/45/4/393.abstract Cruz V. A., Hisa Q.Z.T., Imson M.G., Mang-Usan D.A. (2009). Obesity in School Children: Prevalence and Causes. University of the Cordilleras, Baguio, Phils. URL: http://www.eisrjc.com/journals/journal_1/ucvol1no4-6.pdf Datar, A., Sturm, R., & Magnabosco, J. L. (2004). Childhood overweight and academic performance: National study of Kindergartners and First-Graders. Obesity Research, 12(1), 58-68. URL:http://findarticles.com/p/articles/mi_m0887/is_2_23/ai_113935602/?tag=m antle skin;content Dehgan M., Danesh N.A,Merchant A.T.(2005).Childhood Obesity, Prevalence and Prevention URL: http://www.nutritionj.com/content/4/1/24 Deitel M (2002). The International Obesity Task Force and "globesity". Obes Surg 12:613614[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Du Toit G, van der Merwe MT (2003). The epidemic of childhood obesity. S Afr Med J 93:4950[Medline]URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211

Fox R. (2003). Overweight children. Circulation 108:e9071 (Editorial). [Crossreferrence]URL:http://jcem.endojournals.org/cgi/content/full/89/9/4211 Glanz, K., Rimer, B.K. & Lewis, F.M. (2002). Health Behavior and Health Education. Theory, Research and Practice. San Fransisco: Wiley & Sons. URL: http://www.utwente.nl/cw/theorieenoverzicht/Theory%20clusters/Health%20Cm munication/Health_Belief_Model.doc/ Goran MI, Ball GD, Cruz ML (2003). Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 88:14171427[Abstract/Free Full Text] URL:http://jcem.endojournals.org/cgi/content/full/89/9/4211 Hildenbrandt, J. (2010). Link Between Nutrition and Academic Performance. Suite101.com journals. URL:http://www.suite101.com/content/link-betweennutrition-and-academic- performance-a278743 Hoelscher, D. M., Perez, A., Lee, E. S., Sanders, J., Kelder, S. H., Day, R. S., & Ward, J. (2005). School physical activity and nutrition (SPAN) III Survey, 20042005. UT School of Public Health, Houston. Kimm SY, Obarzanek E (2002). Childhood obesity: a new pandemic of the new millennium. Pediatrics 110:10031007[Free Full Text] URL:http://jcem.endojournals.org/cgi/content/full/89/9/4211 Koplan, J. P., Liverman, C. T., & Kraak, V. A. (2005). Preventing childhood obesity: Health in the balance. Institute of Medicine. National Academy of Sciences. Available at http://www.nap.edu/catalog/11015.html Laitinen, J., Power, C., Ek, E., Sovio, U., & Jarvelin, M. R. (2002). Unemployment and obesity among young adults in a northern Finland 1966 birth cohort. Intertantional Journal of Obesity Related Metabolic Disorders, 26(10), 13291338. Legarda L. (2010). AN ACT PROVIDING FOR A MANDATORY NATIONWIDE CHILD NUTRITION PROGRAM IN ALL PUBLIC ELEMENTARY SCHOOLS AND BARANGAY DAY CARE CENTERS, PROVIDING FUNDS THEREFORE AND FOR OTHER PURPOSES URL: http://www.senate.gov.ph/lisdata/102928811!.pdf Livingstone MB, Robson PJ, Wallace JM, McKinley MC (2003). How active are we? Levels of routine physical activity in children and adults . Proc Nutr Soc 62:681 701[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211

Magarey AM, Daniels LA, Boulton TJ, Cockington RA (2003). Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord

27:505 513[CrossRef][Medline] http://jcem.endojournals.org/cgi/content/full/89/9/4211 Mayoclinic (2010, Oct.). Obesity. Mayoclinic.com. Retrieved Dec. 19, 2010. http://www.mayoclinic.com/health/obesity/DS00314

URL:

URL:

Mikkila, V., Lahti-Koski, M., Pietinen, P., Virtanen, S. M., & Rimpela, M. (2003). Associates of obesity and weight dissatisfaction among Finnish adolescents. Public Health Nutrition, 6(1), 49-56. Miller, Jennifer, Rosenbloom A. and Silverstein J. (2004). Childhood Obesity http://jcem.endojournals.org/cgi/content/full/89/9/4211 with cross references: Must A (2003). Does overweight in childhood have an impact on adult health? Nutr Rev 61:139 142[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Nielsen SJ, Popkin BM (2003). Patterns and trends in food portion sizes, 19771998. J AMA 289:450453[Abstract/Free Full Text] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Nutritionjournal (2005). Childhood Obesity (http://www.nutritionj.com/content/4/1/24) with cross references: Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M.(2006). Prevalence of overweight and obesity in the United States, 19992004. Journal of The American Medical Association, 295, 1549-1555. Ogden, C. L., Flegal, K. M., Carroll, M. D., & Johnson, C. L. (2002). Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of The American Medical Association, 288, 1728-1732. Polit D.F., Beck C.T.,(2004). Nursing Research Principles and Methods. 7th ed.,Lippincott, Williams, Wilkins. Proctor MH, Moore LL, Gao D, Cupples LA, Bradlee ML, Hood MY, Ellison RC (2003). Television viewing and change in body fat from preschool to early adolescence: The Framingham Childrens Study. Int J Obes Relat Metab Disord 27:827 833[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Reilly, John J. (2007 ). Childhood Obesity an Overview. URL:http://www.onlinelibrary.wiley.com/doi/10.1111/j.10990860.2007.00092.x/full Rodriguez, M. A., Winkleby, M. A., Ahn, D., Sundquist, J., & Kraemer, H. C. (2002). Identification of populations subgroups of children and adolescents with high asthma prevalence: Findings from the Third National Health and Nutrition Examination Survey. Archives of Pediatrics & Adolescent Medicine, 156, 269275.

Saelens BE, Sallis JF, Nader PR, Broyles SL, Berry CC, Taras HL (2002). Home environmental influences on childrens television watching from early to middle childhood. J Dev Behav Pediatr 23:127132[Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Santiago M.D. (2005). Childhood Obesity Act of 2005 URL: http://www.senate.gov.ph/lisdata/31842372!.pdf Steinberger J, Daniels SR (2003). Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 107:14481453[Free Full Text] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 St-Onge MP, Heymsfield SB (2003). Overweight and obesity status are linked to lower life expectancy. Nutr Rev 61:313316[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 The Lancet. (2004). Appropriate body-mass index for Asian populationsand its implications for policy and intervention strategies. WHO expert consultations. URL: http://apps.who.int/bmi/index.jsp?introPage=intro_3.html Thibault H, Rolland-Cachera MF (2003). Prevention strategies of childhood obesity . Arch Pediatr 10:11001108 (French)[CrossRef][Medline] URL: http://jcem.endojournals.org/cgi/content/full/89/9/4211 Ting A.M.T. MD, Llido L. MD (2010). Outcome of a Hospital Based Multidisciplinary Weight Loss in Obese Filipino Children. URL: http://www.eisrjc.com/journals/journal_1/ucvol1no4-6.pdf Trost, S. G. (2007). Active education: Physical education, physical activity and academic performance (Research Brief). San Diego, CA: Robert Wood Johnson Foundation Active Living Research. Available: www.activelivingresearch.com/alr/alr/files/Active_Ed.pdf Visser R. DC-Phd, Lacle G. MD, Gonzalez T. MD-Phd, Caballero A. PhD. (2007). Factors Associated with Childhood Obesity. Oranjestad, ARUBA. URL: http://www.drvisser.com/articles/Article-Factors-Obesity.pdf Wilson A.J., Latimer A.E., Meloff L.R. (2008). EFFECTIVENESS OF A CHILDHOOD OBESITY PROGRAM BASED ON QUALITY OF LIFE. Queens University, Kingston ON, Pediatric Obesity, Calgary AB, April. URL: http://www.pediatricobesityclinic.com/docs/2008_03_effectiveness%20.pdf World Health Organization (2010). Program on Diet, Physical activity and Health.

URL: http://www.who.int/dietphysicalactivity/indicators%20English.pdf, http://www.wpro.who.int/NR/rdonlyres/C6DFBEF8-AEF6-4A65-89DA2EA19FF81D9E/0/30finalPhilippines2010.pdf

URL:

APPENDIX A Diet and Physical Activity Programs Alphabet Popcorn Language Arts Focus Classroom or Small Space

Equipment: index cards with the letters of the alphabet written on them

1. Have students stand in an open area of the classroom. Move around the area, giving each student a letter of the alphabet. Letters can be written on index-sized cards. 2. As each student receives their letter, they squat down. 3. Instruct students to listen carefully as you will be calling out different letters of the alphabet. When the letter on their index card (or a word that begins with their letter) is called, they pop up and then quickly squat or sit down again. 4. If the word alphabet is called, everyone pops up. 5. Once all students have had a turn to pop up, try spelling some words. Choose words that are presently being defined and applied in spelling, reading and writing assignments and from all subject areas.

Cross-curricular Linking Mathematics Assign each student a number rather than a letter. Call out or write down

equations, e.g., 3 x 2 =, and have the students pop up when their number is the answer to the equation. If All Numbers is called out, everyone pops up. Have the students take turns calling out or writing down equations.

Alphabet Search Language Arts Focus Classroom or Small Space

Equipment: whiteboard or flashcards with letters and vocabulary words 1. Starting with the letter A, call out each letter of the alphabet and a corresponding word or phrase that begins with that letter. After identifying a word or phrase, ask the students to perform an action that incorporates this word or phrase. For example, call out or hold up a letter A, saying the word apple and then ask the students to pretend they are picking an apple high up in a tree. L is for ladder, and they pretend to climb a ladder. S is for snake and they slither around like snakes. 2. After each movement, review the letter, the word and the letter sound and then ask students to call out the letter that comes next. 3. Continue through the whole alphabet, selecting certain letters each day from different points in the alphabet. Have students brainstorm words to use with each letter for this activity. 4. At the end of the activity, ask students to write or draw pictures of some of the letters and action words that were used to describe them.

Cross-curricular Linking Science Identify a topic in science. Call out a letter of the alphabet and ask the students to provide topic-specific vocabulary for that letter of the alphabet before they run to get an ice cream stick located on a table across the room. For example, the topic could be types of animals and the teacher calls out d. The students spell out their answer, for example, dinosaur. Other topics could include plants, reptiles or parts of the solar system. Once all the ice cream sticks are gone from the table, the activity ends.shgfjhg Studies Social Studies Identify a topic in social studies. Call out a letter of the alphabet and ask the students to provide topic-specific vocabulary for that letter of the alphabet before they run to get an ice cream stick located on a table across the room. For example, the topic could be types of land features and the teacher calls out p. The students spell out their answer, for example, prairie. Other topics could include countries of the world, cities and rivers. Once all the ice cream sticks are gone from the table, the activity ends.

Body Spelling Language Arts Focus Classroom or Small Space

Equipment: none required

1. Have students stand in an open area of the classroom. 2. Call out a letter and have the students form that letter by shaping their bodies into the letter. Letters that work well are: A, X, S, C, F, J, I, L, U, V, K, Z. Encourage students to stretch long and hold the stretch for a count of eight. Try counting in a different language. 3. Have students work with a partner to each form a different letter and then form a two-letter word. Suggestions for two-letter words include: on, it, of, to, oh, so, hi, do, go, no, by, is, ox, an, at, in. 4. In groups of three to four, have students form their bodies to spell a word; e.g., the name of an animal, a girls name or a boys name. 5. As a variation, have the students walk around in the shape of the letter called.

Cross-curricular Linking Mathematics Have the students form numbers instead of letters. Have older students form the answer to equations in groups, using decimals or fractions.

Flash Up, Flash Down Classroom or Small Space

Equipment: paper 1. Provide each student with pieces of scrap paper. 2. Ask the students a review question and have the students quickly write their answers on the paper. 3. Call out 321 Flash Up! and have the students jump out of their desks and show their answers to the front of the class. 4. Call out Flash Down! and the students sit while you review the correct answer to the question.

Cross-curricular Linking Language Arts Use the activity to reinforce spelling skills and use words from the weekly spelling list. As an extension, students could create sentences using the words from the activity. Social StudiesStudies Have the students answer questions, spell or define vocabulary on a topic recently covered; e.g., communities of the past, Albertas history, geography of Canada, the Aztecs, rights and freedoms. Scienceience Have the students answer questions on a topic recently covered; e.g., creating colour, five senses, magnetism, plant growth, chemistry, heat and temperature, weather patterns, aerodynamics, animals,

seasonal changes, electricity, mechanical systems, chemical change, tectonic plates

Indoor Circuit Classroom or Small Space

Equipment: (optional)

hoops, benches, dynabands,

pylons,

paper, music

Around the Room 1. Set up a variety of stations around the classroom that will help students develop strength, target, agility and cooperative skills. For example: Station 1: hoops (throwing, jumping) Station 2: beanbags (throwing, balance) Station 3: dynabands (strength, flexibility) 2. Have students work through the stations, allowing a set amount of time for each station. Students can work individually or with a partner. Play music to provide additional motivation for the students. Mission Possible Circuit 1. Prepare a list of several different missions or activities related to a subject area (one for each station) and divide the students into groups of six or seven. Assign each of the groups to a station. 2. On a signal, have one student read out the task for their group and then have them work together to perform the activity. 3. Students complete as many of the tasks as possible within a set amount of time or until a song has finished playing.

Cross-curricular Linking Social Studiesdies With the left toe, touch five objects in the room that are a colour found on the Nunavut flag. Do one jumping jack for each letter in the name of Indias capital city. Choose a Great Lake and spell it on the floor using all group members bodies to form the letters. Mathematics Math Incorporate number operations, variables or equations into the stations; e.g., recite times tables while spinning the hoop or solve an equation and toss beanbags into baskets labelled with possible answers. Science Science Line up in single file and pass a binder over the head, then through the legs until the binder has been passed once for every letter in the word photosynthesis. Ar Language Arts Incorporate grammar or vocabulary into the stations; e.g., conjugate verbs while spinning the hoop or toss beanbags into baskets labelled with adverbs.

Language Lights Language Arts Focus Classroom or Small Space

Equipment: none required

1. Assign students consonants or vowels, adjectives or verbs, masculine or feminine nouns, and so on and then assign different movements to each word type. 2. Call out a colour of a streetlight and have students move as the colour dictates. For example, red light means stop and yellow light means jog on the spot. When you call out green, students must move according to their word type; e.g., vowels do jumping jacks, consonants bend over and touch their toes. 3. If you call out Pit Stop, students stop and complete a stretch, holding it for eight seconds. Perform of stretching exercises.

Cross-curricular Linking Mathathematics Assign numbers instead of word types and have the students move based on whether their number is odd or even, whole, decimal or fraction, tens, hundreds or thousands, a square root or not, or it is divisible by a particular number.

Sciencece

Assign animals, plants, simple machines, weather or types of rock instead of word types and have the students move to simulate the vocabulary they have been assigned. Memory Match Language Arts Focus Classroom or Small Space

Equipment: cards or paper plates

1. Write rhyming words, homonyms or other matching words on the bottom of paper plates or cards and divide students into groups of two. 2. Scatter half the paper plates or cards turned upside down around one side of the classroom. The matching paper plates or cards are scattered on the other side of the playing space. 3. Have each group start at a different spot and, using a specific locomotor pattern (e.g., hopping on one foot, skipping, twirling), move to one side to pick a paper plate or card. Then they move, using the same locomotor pattern, to the other side of the playing area to find their matching word. If they turn over a card that matches, they bring it back. If it doesnt, they place it back on the floor upside down for the other teams to find. Partners must stay together and can only turn over one card at a time. Cross-curricular Linking Mathematics Write equations on the paper plates or cards and have the students match them with the correct solution. Social Studies

SocialTape pictures and their matching words or dates (e.g., countries, cultures, historic figures, historic events) to the paper plates or cards and have the students match the pictures to the words.

Musical Hoops Language Arts Focus Classroom or Small Space

Equipment: one hoop per student, clipboards, markers, index cards with letters written on them, music

1. Place one hoop per student randomly on the floor of a cleared area of the classroom. Place a clipboard with a blank sheet and a marker inside each hoop. 2. Play music and have students move about this cleared space using a specific locomotor skill (e.g., skip, hop), or have students walk in a variety of ways (e.g., baby steps, backwards, crab walk, side step, quick steps, long strides). 3. When the music stops, have the students move to the closest hoop. Using the paper and clipboard, students write the letter, word or shape that is currently indicated on the front board or is called out by the teacher. Alternatively, teachers orally ask a question and the students write the answer. For example, In what part of the body will you find a chamber? For younger students, place beanbags in the hoops with numbers, letters or shapes marked on them. When students get to the hoop they write the shape they see on the beanbag on the paper. Give students time to finish and while waiting they can perform a stationary skill, such as marching or jogging on the spot.

4. Upon a signal, the students place the clipboard down in the hoop and move again to continue the activity with a new letter, word or shape that will be indicated.

Cross-curricular Linking Math Have the students answer simple equations, write out long numbers, finish a pattern, answer a word problem or describe the characteristics of 3-D and 2-D shapes as they arrive at each hoop.

Over Under Language Arts Focus Classroom or Small Space

Equipment: a small, sturdy object for passing

1. Have students stand in a row, one behind the other in groups of five or six. 2. Have the students pass a rubber chicken, beanbag, ball or chalkboard eraser down the line, alternating over the head and between the knees. 3. When the object gets to the end of the line, the last person runs to the front and starts passing it again. 4. After students practise passing the object, add alphabet challenges. Have students say a letter of the alphabet as they pass the object. Students say a word that starts with each letter of the alphabet; e.g., first person says apple, second person says banana, third person says cat, fourth person says dog. Another variation is saying a twoletter word and when the person runs to the front of the line, the group must say a three-letter word, then a four-letter word. Continue to the appropriate level of skill.

Cross-curricular Linking Math

Have the students create and continue a pattern; e.g., counting by twos, threes or fours.

Health Have the students identify healthy and nutritious foods for breakfast as they pass the object down the line. Do the same for lunch and dinner.

Scarf Juggling Classroom or Small Space

Equipment: scarves or plastic grocery bags

1. Demonstrate the cascade pattern of juggling: Pinch one scarf in the middle and let the rest of the scarf hang down. Raise one arm across the chest and throw the scarf as high as it will go. With the other arm, catch the scarf palm down in front of the body below the waist. The scarf makes a figure eight pattern. Throw across, catch down, throw across, catch down. With a scarf in each hand, toss the first one across and when it gets to the top, look at it briefly and throw the second scarf across the body in the opposite direction. The scarves will make an X as they cross in front. With both scarves in the air, catch the first scarf straight down in front and then catch the second one in front with the other hand. The first one thrown will be the first one caught, but caught with the opposite hand. 2. Have the students follow along and work to establish an even rhythm with the two scarves. 3. Demonstrate juggling with three scarves: Hold two scarves in the dominant hand, one deep in the hand and the other one loose at the fingertips. Hold one scarf in the nondominant hand. The one in the fingertips of the dominant hand is the first scarf to throw. When it gets to the top, throw the second one from the nondominant hand. As the

hand goes down from throwing the second one, it quickly catches the first one. Then, throw the third scarf from the dominant hand. As the hand comes down from throwing the third one, it quickly catches the second one, and then throw the fourth one (which is really the first one). Keep alternating hands right, left, right, left working to develop an even rhythm. 4. Have the students follow along and work to establish an even rhythm with the three scarves. Have the students juggle with a partner with two and three scarves.

Cross-curricular Linking Language Artsrts One student stands in the middle of a group of 3 to 4 students, holds a scarf and is the dropper. When the student in the middle is ready, he or she says a letter and drops the scarf. The other students say a word that begins with the letter called out by the dropper and try to catch the scarf before the other students do or before it drops to the floor. The student who says the word and catches the scarf takes the place of the student in the middle and calls out the next letter. Vary the body part that the scarf must be caught with, such as a finger, head, foot or shoulder. Health Health The student in the middle says a food group and the other students call out a food that is an example of that food group and tries to catch the scarf before it drops to the floor. Mathematics Mathematics

The student in the middle says an equation and the other students call out the answer and try to catch the scarf before it drops to the floor.

APPENDIX B Date of Birth, Date of Measurement, Height, Weight and BMI Percentile of St. James Pupils

ID (optional) SJ-1A

Name (optional) AJ BM CT DT EL LL LJ NL PJ RD RR RJ SJ SL SH SJ VB AJ CE EJ JS ME MA ST VN VA

Sex M M M M M M M M M M M M M M M M M F F F F F F F F F M M M M

Date of birth 9/25/2004 3/30/2004 10/15/2004 10/15/2004 11/4/2004 6/24/2005 9/2/2004 10/8/2004 2/12/2004 4/19/2005 6/20/2004 11/12/2004 7/17/2004 6/15/2004 4/13/2005 6/28/2004 10/5/2004 4/2/2005 6/7/2004 8/15/2004 8/30/2004 11/24/2004 10/3/2004 1/2/2005 6/25/2005 8/23/2004 11/5/2003 10/25/2003 5/13/2003 3/16/2005

Date of measurement 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011

Height (centimeters) 120.4 113.8 113 112.9 123 119.5 122 126.6 116.7 113.8 120 116 120.2 128 121.8 123.5 116.4 115.2 115 128.5 115.8 122.5 129.5 118.5 112 129.4 125.2 123.5 124 118.5

Weight (kilograms) 28 25 21 22 36.6 25.4 23 31 20.5 19 25.6 21.2 26 32 31 25.5 18.5 26 20 24.5 19.5 23 29 21 18.5 37.5 28 31 27 22

BMI 19.3 19.3 16.4 17.3 24.2 17.8 15.5 19.3 15.1 14.7 17.8 15.8 18.0 19.5 20.9 16.7 13.7 19.6 15.1 14.8 14.5 15.3 17.3 15.0 14.7 22.4 17.9 20.3 17.6 15.7

BMI %ile 95.6 94.4 72.6 84.2 99.5 91.4 48.5 95.8 33.8 26.7 87.5 57.8 89.4 95.5 98.7 75.5 4.2 96.0 40.1 33.9 26.5 48.7 82.5 39.4 35.7 98.4 85.2 95.9 79.5 57.0

SJ-2A

AT AC AJP AA

CA LJP MJ MH MH PJ PR SJ UP DA MM OE TR TH SJ-3A AA AR BW CK DV DLJ DJ FEJ FKC GK MG PM PR RB SH TH VR YC ZW AM BM CS DRC DM EC FM LL LA LA MM PM SS

M M M M M M M M M F F F F F M M M M M M M M M M M M M M M M M M M F F F F F F F F F F F F F

8/26/2003 8/27/2003 12/24/2004 7/28/2003 1/28/2004 8/4/2003 12/17/2003 2/7/2003 3/13/2004 4/6/2004 5/14/2003 2/2/2004 2/26/2004 11/27/2003 3/6/2002 11/21/2002 2/18/2002 8/15/2002 9/22/2002 10/28/2002 11/25/2002 9/7/2002 8/26/2003 3/27/2004 12/21/2001 2/3/2001 11/21/2002 6/6/2002 11/1/2002 5/11/2002 2/7/2003 12/18/2002 10/30/2002 11/17/2002 8/14/2003 9/21/2002 12/6/2002 10/12/2003 8/18/2003 7/20/2002 4/8/2002 8/30/2003 2/14/2003 6/21/2002 12/1/2002 12/19/2002

9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011

121.5 127.5 128.5 118.5 130.4 128 120.8 133.2 135.1 123 121.9 117.9 135.5 132.5 132.5 130.9 127.5 133.9 143.5 135.4 123.5 132.8 120 126 138 134 127.2 131.5 130.1 150.5 127 132.1 130.2 126.8 131.1 125.6 130 113.5 122.1 134 141.8 129.2 139 141.2 134.8 133

25 25 23 22 29 28 31 37 50.5 28.5 27.5 25 49.5 38 29 40 38 39.5 50.5 31 29 35 23.5 24.5 40.5 37.5 25.5 34.5 40.5 67 33 27 39 27 42 24 26 19.5 21 30 42 23.5 38.5 35 34.5 30.5

16.9 15.4 13.9 15.7 17.1 17.1 21.2 20.9 27.7 18.8 18.5 18.0 27.0 21.6 16.5 23.3 23.4 22.0 24.5 16.9 19.0 19.8 16.3 15.4 21.3 20.9 15.8 20.0 23.9 29.6 20.5 15.5 23.0 16.8 24.4 15.2 15.4 15.1 14.1 16.7 20.9 14.1 19.9 17.6 19.0 17.2

73.2 39.6 8.1 46.5 77.8 75.1 97.4 95.5 99.6 91.0 84.8 84.9 99.4 96.9 52.8 97.9 97.2 96.4 98.4 66.2 88.6 91.6 62.2 45.2 93.8 90.2 42.9 91.2 98.2 99.3 94.6 36.4 97.6 61.0 98.6 28.4 33.8 35.4 12.1 56.4 91.6 12.1 91.2 68.6 85.6 68.7

VD VC

F F

9/22/2003 12/19/2002

9/7/2011 9/7/2011

130 139.5

22 41

13.0 21.1

1.5 94.2

APPENDIX C Date of Birth, Date of Measurement, Height, Weight, BMI and BMI percentile of Olivarez College Pupils

ID (optional) OC-1A

Name (optional) AAC BJD BKM CDS DJA DJC EPET PNY RLAP SJPE ULAE BAM BLD CJG DSB FCR JRS MAGV MCS NBL PZ PPAB RJP RM SBG SCA VBD

Sex M M M M M M M M M M M F F F F F F F F F F F F F F F F M M

Date of birth 11/16/2004 8/2/2005 11/8/2004 10/19/2005 3/5/2004 12/18/2004 11/14/2004 4/11/2005 5/8/2004 11/1/2004 3/16/2005 10/21/2004 6/6/2005 9/7/2004 6/15/2004 11/7/2004 4/20/2005 4/12/2004 2/3/2004 5/19/2004 6/13/2004 7/17/2004 6/17/2004 11/21/2004 7/12/2004 12/18/2004 11/14/2004 2/23/2004 4/19/2005

Date of measurement 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011

Height (centimeters) 124 119.4 119 110 118.3 109.4 119.4 126.5 128.5 110.5 115.3

Weight (kilograms) 31 33.5 24 21 20.5 17.5 20 26 36.5 18.5 29

BMI 20.2 23.5 16.9 17.4 14.6 14.6 14.0 16.2 22.1 15.2 21.8

BMI %ile 97.4 99.7 80.8 89.0 22.9 24.7 9.9 71.2 98.5 40.3 99.1

9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011

114.2 120.2 119.1 113.5 104.1 129.5 115.2 120.4 121.8 124.1 120 114 113.7 116.5 105 127.1

17 21 19 17 16 43 31.5 24.8 21.5 25 27 18.5 18 25.5 17 32

13.0 14.5 13.4 13.2 14.8 25.6 23.7 17.1 14.5 16.2 18.8 14.2 13.9 18.8 15.4 19.8

1.7 26.4 4.4 2.8 35.5 99.2 98.6 78.1 24.1 66.0 91.3 19.7 12.0 93.1 50.8 95.5

OC-1B

AAAD AJB

BRV CRAR DCJAD HJA LCE LCG NJKQ PMM SSB AMM BEB BJG CJC CLG DGSC FPA IMM LCG MSS PAB PMEL RSS R AS SMI VVB OC-2A AJC AJS ACS AAF BBM BSC CLM DSJF DGC DJRO EJA EJB IRG JJNA MBF NKG PJS PID RRS RRB SJM

M M M M M M M M M F F F F F F F F F F F F F F F F M M M M M M M M M M M M M M M M M M M M M

11/2/2004 9/6/2004 7/8/2005 2/18/2004 2/21/2005 3/10/2005 6/16/2004 6/11/2005 1/7/2005 9/7/2004 9/12/2005 6/18/2004 2/10/2005 11/6/2004 6/20/2005 10/16/2004 8/6/2004 3/10/2003 9/7/2005 1/31/2005 12/1/2005 12/10/2004 9/23/2003 12/3/2004 12/28/2004 2/22/2004 12/23/2003 2/13/2003 2/8/2004 12/22/2003 6/3/2004 5/12/2004 11/15/2003 2/3/2003 9/28/2003 2/21/2004 2/12/2003 12/14/2003 1/3/2004 10/3/2004 1/24/2004 4/2/2003 5/15/2003 4/17/2003 2/27/2004 5/10/2005 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 9/7/2011 9/12/2011 9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 9/7/2011 9/7/2011 9/12/2011 9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 131 119.5 118 132.4 122.1 124 117 129.5 123.5 131.5 118 130.5 118.5 132.8 128.5 125 127.5 119.4 134.9 124 134.1 121.2 115 27.5 26 27 28 23.5 23 19.5 23.5 32 39 23.5 30 20 32 22 23 27 22.5 30 25 41 24 26 16.0 18.2 19.4 16.0 15.8 15.0 14.2 14.0 21.0 22.6 16.9 17.6 14.2 18.1 13.3 14.7 16.6 15.8 16.5 16.3 22.8 16.3 19.7 54.9 90.3 95.0 58.5 52.1 24.8 13.0 8.4 97.7 98.7 73.9 78.3 12.0 88.7 1.1 23.8 70.5 57.8 68.5 57.6 98.0 59.6 95.1 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 118.2 106.8 110 118 116.3 129.5 120.3 111.2 122.4 112 104.2 22 17.5 19.5 20 26 25.5 26 20 28.5 17.5 17.5 15.7 15.3 16.1 14.4 19.2 15.2 18.0 16.2 19.0 14.0 16.1 63.7 45.8 68.0 22.7 95.6 44.8 87.4 52.8 95.5 13.7 72.5 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 116.8 119 132.2 98 116.5 116 119 121 19 25.5 30.5 14 21 19.5 24 30 13.9 18.0 17.5 14.6 15.5 14.5 16.9 20.5 7.9 92.8 82.9 23.7 51.4 19.8 83.4 98.0

SRWR TNM VBG BA BBY CYC CAY DGGC DJM EPT JNR KAB MDG MNM RKG RAS SPE SCF SZP SANS OC-3A ARJS AFS AJA BCN CL CEA DCCP DMJ DAO GCF GMF JJC KMJ MDAM MJJS NSG OJT PJPC PJJB RRC ZKJ BAM FNB GCP HAA LSF

M M M F F F F F F F F F F F F F F F F F M M M M M M M M M M M M M M M M M M M M M F F F F F

11/26/2002 9/14/2003 9/21/2003 9/12/2003 8/16/2003 11/11/2003 7/25/2003 10/25/2004 1/31/2003 10/3/2003 4/12/2004 8/8/2003 1/3/2003 6/16/2004 7/19/2004 11/21/2003 3/13/2004 10/19/2003 2/27/2003 9/14/2003 4/25/2003 8/12/2001 3/4/2003 5/12/2002 9/22/2002 2/11/2003 10/5/2001 5/18/2001 5/27/2002 12/28/2002 12/28/2002 2/22/2003 5/9/2002 9/4/2001 5/15/2002 12/6/2002 9/11/2000 7/20/2002 3/7/2003 10/25/2002 1/15/2003 12/26/2002 12/10/2002 1/10/2003 7/18/2003 8/27/2002

9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011

129.5 118 128.5 134.4 126.7 120.8 120.5 115 124.7 122.9 126.3 138.5

32 26 32.5 27 30 28 22.5 24.5 25 26.5 37 37.5

19.1 18.7 19.7 14.9 18.7 19.2 15.5 18.5 16.1 17.5 23.2 19.5

89.0 90.1 94.1 30.3 87.4 91.0 41.9 91.5 49.8 78.7 98.5 91.5

9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 9/7/2011 9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011

113.5 124.4 124.5 121.5 123 123.2 122 126.3 136.7 116.2 140 137 115 134.9 144.7 129.8 122.5 127 132.5 129.8 142.4 133.9 129.7 137 135.8 120.5 134.5 124 121.8 126.4 126.6 118.8 134.8 21.5 27 42.5 24 29.5 35 41 24.5 43 31.5 28 43.5 37 22 29.5 31.5 21 26 27 21.5 27

18.5 29.5 34 31 27 19 25.5 28 31 21.5 44.3 35

14.4 19.1 21.9 21.0 17.8 12.5 17.1 17.6 16.6 15.9 22.6 18.6 16.3 14.8 20.3 14.2 19.7 21.7 23.4 14.5 21.2 17.6 16.6 23.2 20.1 15.2 16.3 20.5 14.2 16.3 16.8 15.2 14.9

21.0 92.8 97.2 96.6 82.0 0.2 73.4 79.0 48.4 49.3 96.7 85.5 56.3 13.6 88.8 7.6 91.9 96.6 98.1 11.7 93.0 72.2 62.4 95.0 92.0 30.1 54.6 94.5 10.8 52.3 63.3 35.7 20.9

LFCA LCG MSA MKB NMS PBKA PIM PCA SKP TAS UKA

F F F F F F F F F F F

6/12/2002 3/5/2002 5/6/2002 3/13/2003 4/6/2002 8/8/2002 10/30/2002 8/23/2002 2/8/2003 1/22/2004 5/29/2003

9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011 9/12/2011 9/7/2011 9/7/2011 9/7/2011 9/7/2011

122.5 150.1 126.4 120.6 130.5 129.8 147.8 131 126.5 125.8 129.5

22 81.5 28 21.5 26 30.5 49 32.5 31 27.5 25.5

14.7 36.2 17.5 14.8 15.3 18.1 22.4 18.9 19.4 17.4 15.2

16.0 99.7 67.1 23.1 25.7 76.2 96.2 83.7 88.7 79.0 33.9

APPENDIX D Date of Birth, Date of Measurement, Height, Weight, BMI and BMI percentile of IHMC Pupils

ID (optional) IHMC-1A

Name (optional) AJAD BYS BJG CRD DM EVM FLN LMLA OBACG PCPC QSS RJG RCL VTAC AJQ BMS BNM CCC DBE FJC KSP MFD RSD RMD ZCAE

Sex M M M M M M M M M M M M M M F F F F F F F F F F F M M M M M M M

Date of birth 3/15/2005 2/14/2005 12/19/2003 7/4/2004 12/2/2004 9/15/2004 12/3/2004 8/3/2004 6/3/2005 5/2/2005 9/30/2004 5/10/2003 7/21/2005 5/11/2005 2/3/2005 12/3/2004 10/2/2004 7/20/2004 4/22/2005 3/12/2005 12/7/2005 3/28/2005 12/29/2004 9/29/2004 12/19/2004 9/6/2004 3/31/2003 11/11/2004 1/20/2005 2/13/2005 8/27/2005 10/13/2004

Date of measurement 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/7/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011

Height (centimeters) 137.1 127 127 130.8 125.7 124.4 116.8 132 115.5 119.3 130.8 127 115.5 123.1 119.3 133.3 119.3 121.9 121.9 119.3 115.5 116.8 121.9 119.3 118.1 124.4 129.5 124.4 124.4 121.9 116.8 121.9

Weight (kilograms) 45.4 29.5 32.2 35.9 31.8 25.4 24 33.1 21.8 24 31.8 21.8 23.1 30.9 24 41.8 19.7 28.6 28.1 27.2 23.6 22.7 25.9 25.4 24.5 33.1 30.4 34 26.8 21.8 24.5 30.9

BMI 24.2 18.3 20.0 21.0 20.1 16.4 17.6 19.0 16.3 16.9 18.6 13.5 17.3 20.4 16.9 23.5 13.8 19.2 18.9 19.1 17.7 16.6 17.4 17.8 17.6 21.4 18.1 22.0 17.3 14.7 18.0 20.8

BMI %ile 99.7 93.5 95.8 98.1 97.7 72.5 88.6 94.8 74.4 82.5 93.8 2.4 88.4 98.5 80.5 99.1 11.3 94.0 94.8 95.1 91.2 78.4 85.9 88.0 86.9 98.5 84.9 99.0 86.5 26.6 93.2 98.2

IHMC-1B

ATIC BJL FBN FGF JJIG GJLA MRA

MNB PBJ RJD SJC SJG SGV ALD BFS BSN DML GEM GNP LCA MSR OLA OJD TCJ IHMC-1C GJG CJM CAD GRJ MJK MNM RMC SLS TKD TEB YKS AMAO AMLE BCB CZH DSF DNA GSC LMA MAJ MNB SLR TKS TSL YBCB IHMC-1D ACT AMR CJJ DRH

M M M M M M F F F F F F F F F F F M M M M M M M M M M M F F F F F F F F F F F F F F M M M M

7/25/2005 4/26/2005 9/5/2004 7/20/2005 9/13/2004

7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011

119.3 121.9 125.7 102.8 125.7

20 26.3 27.2 31.3 30.9

14.1 17.7 17.2 29.6 19.6

10.2 90.6 83.7 99.9 96.3

4/2/2004 6/5/2005 3/22/2005 3/21/2005 4/25/2004 6/22/2005 9/1/2004 12/18/2004 2/14/2005 7/28/2005 6/5/2005 11/28/2004 8/21/2004 12/7/2004 1/27/2005 10/12/2004 2/2/2005 3/31/2005 8/5/2003 4/25/2004 4/25/2004 9/14/2005 10/9/2004 2/3/2005 11/4/2004 6/26/2005 1/10/2005 9/7/2004 10/10/2004 10/19/2005 11/21/2004 7/25/2005 4/22/2005 9/2/2004 2/16/2004 4/23/2004 10/18/2004 12/5/2004 12/3/2003 5/19/2005

7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/26/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 7/14/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011

111.7 109.2 111.7 119.3 125.7 114.3 127 119.3 127 121.9 116.8 120.6 119.3 111.7 121.9 121.9 118.1 115.5 119.3 116.8 128.2 119.3 113 113 111.7 115.5 114.3 125.7 119.3 114.3 119.3 106.6 114.3 127 127 119.3 118.1 127 127 121.9

18.1 18.6 19.7 22.7 28.6 17.2 28.1 21 30.9 27.7 22.2 22.7 20.9 32.7 25.4 25.9 21.3 17.7 25.9 18.1 28.6 19.7 18.6 21.8 17.7 18.6 19 31.3 25.9 14.6 23.6 15.4 16.9 30.9 21.8 19 25.9 23.6 33.6 33.1

14.5 15.6 15.8 15.9 18.1 13.2 17.4 14.8 19.2 18.6 16.3 15.6 14.7 26.2 17.1 17.4 15.3 13.3 18.2 13.3 17.4 13.8 14.6 17.1 14.2 13.9 14.5 19.8 18.2 11.2 16.6 13.6 12.9 19.2 13.5 13.3 18.6 14.6 20.8 22.3

24.1 59.4 62.7 66.1 87.5 2.4 83.9 34.2 95.0 94.4 73.4 54.7 26.1 99.7 84.3 86.5 45.5 1.1 87.3 1.3 84.1 6.2 28.3 82.8 18.8 14.0 28.7 95.7 90.2 0.0 75.4 6.6 1.2 94.0 5.6 4.0 93.4 24.9 96.9 99.4

DJC ERE LRJ MTX MIC PMD SJL SHC SAD TSL VCA AAS BJR CJA FSA MTO PCJ QJT SJA SLS TMR VAL IHMC-1E ACD BLK BMC BJP ELM GHS JVC MMM QVM ROA SJD SHP SLB VCM AJM AFL BTM DJM ECV FPJ GJK MMG MCS NVL

M M M M M M M M M M M F F F F F F F F F F F M M M M M M M M M M M M M M F F F F F F F F F F

5/24/2005 11/24/2004 12/8/2004 7/31/2004 12/29/2004 1/15/2005 5/11/2004 12/3/2004 12/31/2004 6/21/2005 9/23/2004 9/29/2004 11/12/2004 1/31/2005 11/13/2004 4/15/2005 5/9/2004 9/2/2004 11/29/2004 4/5/2005 12/11/2004 2/9/2005 8/4/2004 10/28/2004 2/14/2004 12/11/2004 11/20/2004 9/18/2004 12/5/2004 8/25/2004 9/18/2004 2/17/2005 11/12/2004 10/2/2004 7/16/2005 8/14/2004 9/2/2004 7/1/2004 5/13/2004 6/5/2005 12/2/2004 3/5/2005 10/17/2004 7/29/2005 1/16/2004 3/5/2004

9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011

123.1 128.2 121.9 121.9 127 127 124.4 119.3 125.7 114.3 119.3 119.3 127 116.8 109.2 121.9

34.5 23.6 29.4 22.7 41.3 33.1 27.7 27.2 32.7 17.2 23.6 25 26.3 19.7 17.7 21.9

22.8 14.4 19.8 15.3 25.6 20.5 17.9 19.1 20.7 13.2 16.6 17.6 16.3 14.4 14.8 14.7

99.5 17.4 97.0 42.9 99.7 98.1 88.0 95.5 98.2 0.7 74.7 85.1 69.9 25.6 35.6 34.7

9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 127

121.9 113 109.2 121.9 119.3 119.3 21.3 25.9 18.1 17.2 18.1 19.5 33.6 40.5

26.8 20.9 16.3 23.6 22.7

18.0 16.4 13.7 15.9 15.9 15.0 16.1 14.5 14.4 12.7 13.7 15.0 23.2

88.3 71.2 8.5 62.2 64.8 33.8 65.0 19.1 19.1 0.1 4.7 35.3 99.2

111.7 109.2 119.3 119.3 149.8 132

9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011

113 110.4 116.8 115.5 121.9 113.1 124.4

22.7 17.2 17.7 25.4 33.6 33.1 21.8

17.8 14.1 13.0 19.0 22.6 25.9 14.1

90.2 11.6 0.3 96.6 99.0 99.4 15.2

9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011 9/1/2011

123.1 119.3 127 111.7 121.9 129.5

30.9 20.4 29.5 18.1 25.9 29

20.4 14.3 18.3 14.5 17.4 17.3

96.9 23.1 90.3 28.9 79.6 78.9

PYD TMM IHMC-2A ABB AAN AMAO AJD BBB BJF CLE GED GKP MLM SML SJM TRH TDC TTS UMC VJP BMM BRM BHB CDC DMA DRH DJO EAN GHE LVE LVT NME NEA SJN SJF SRV SJF IHMC-2B AJI BMF CEM CAB CAF EEN HCE ICB JIJ LRV

F F M M M M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F M M M M M M M M M M

4/13/2005 1/13/2005 7/13/2003 5/2/2003 2/18/2004 6/15/2004 9/18/2003 2/18/2004 2/7/2004 2/17/2004 11/21/2004 8/9/2003 7/29/2003 9/25/2003 4/17/2004 4/24/2004 7/1/2003 11/29/2003 12/28/2003 6/6/2004 12/20/2003 7/15/2003 4/2/2004 8/28/2005 5/30/2004 11/29/2003 2/1/2004 10/26/2003 6/2/2004 10/28/2003 5/29/2004 7/7/2003 4/9/2003 10/9/2003 11/22/2003 10/9/2003 5/3/2003 9/3/2003 11/14/2003 4/24/2004 3/28/2003 8/23/2003 5/15/2005 11/13/2003 5/17/2004 6/5/2003

9/1/2011 9/1/2011 8/24/2011

121.9 109.6 127

20.9 22.2 26.8

14.1 18.5 16.6

16.6 92.1 67.3

8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 8/24/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

124.4 124.4 119.3 124.4 129.5 116.8 127 129.5 133.3 121.9 127 119.3 127 142.2 133.3 130.8 124.4 128.2 127 132 121.9 135.8 127 120.6 123.1 125.7 119.3 139.7 132 116.8 129.5 121.9 130.2 119 122.5 127 123 126.2 120 125.5 119 132.5

22.2 25.9 22.2 32.9 25 20.9 28.1 33.1 40 21.8 26.3 21.3 21.8 49.5 28.6 29.5 21.3 30.4 31.4 31 19.5 27.2 24 23.6 20.4 28.6 21.3 43.6 35.5 44.5 29 25.9 35 22.5 28 39 23 26 21 23 25 45.5

14.3 16.7 15.6 21.3 14.9 15.3 17.4 19.7 22.5 14.7 16.3 15.0 13.5 24.5 16.1 17.2 13.8 18.5 19.5 17.8 13.1 14.7 14.9 16.2 13.5 18.1 15.0 22.3 20.4 32.6 17.3 17.4 20.6 15.9 18.7 24.2 15.2 16.3 14.6 14.6 17.7 25.9

15.4 75.8 46.2 97.7 29.8 41.6 86.4 94.1 98.1 21.6 67.1 32.5 2.4 99.1 60.4 80.2 8.3 85.9 93.5 90.6 2.2 27.4 31.7 60.1 5.1 84.5 36.1 97.2 93.3 99.7 77.1 77.8 95.5 52.7 90.6 99.2 31.7 62.1 24.1 20.3 86.0 99.1

OJC RCJ SJG SRG SMJ TJR AMM AMJ BFN CPA CBA EGD EKI GUM JMC LEP MJD MJY MCS SMB TCR VMP IHMC-2C ABM ACL CRG CNR DFA DNO DPB FDM GJD GKC IJM LRA MMA MMM MNA PHS QMA RM SE AG BG CV CA CY

M M M M M M F F F F F F F F F F F F F F F F M M M M M M M M M M M M M M M M M M M F F F F F

1/17/2003 2/14/2003 7/4/2003 8/10/2004 8/23/2003 10/17/2003 1/30/2004 11/11/2003 12/3/2003 1/31/2003 6/14/2003 8/11/2003 2/21/2004

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

125 125 119.5 131.5 120.5 134.9 132.5 123 121.5 125 130.9 120.5 115.5

24.5 26 25 37 26 39 34.5 26 23.5 22.5 25.5 28.5 17.5

15.7 16.6 17.5 21.4 17.9 21.4 19.7 17.2 15.9 14.4 14.9 19.6 13.1

42.2 63.9 79.6 98.3 84.4 97.4 93.4 75.2 54.3 15.0 26.9 91.8 2.1

12/17/2003 3/9/2004 6/14/2003 8/9/2003 3/29/2003 11/5/2003 12/28/2003 8/18/2003 10/7/2003 2/22/2004 4/6/2003 4/2/2004 10/30/2003 5/25/2004 2/26/2004 9/1/2003 2/29/2004 9/15/2003 4/12/2004 12/31/2003 7/25/2003 4/3/2003 2/14/2004 9/9/2004 12/11/2003 2/25/2004 7/28/2004 4/4/2003 3/10/2003 10/19/2003 3/5/2004 1/11/2003

9/13/2011 9/13/2011 9/13/2011 9/13/2011

129.5 120.4 126 122

34.5 26 25 20

20.6 17.9 15.7 13.4

95.4 85.0 46.3 3.9

9/13/2011 9/13/2011 9/13/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/13/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011

108 106.5 124.5 129.5 128.2 135.8 134.6 129.5 122.2 127 124.4 129.5 124.4 128.2 121.9 130.8 139.7 129.5 116.8 119.3 121.9

14 16.5 21 35 27.2 35 33.6 27.2 23 29.5 23.7 40 18.2 41.3 28.6 31.5 33.6 35.4 20 22.7 23.6

12.0 14.5 13.5 20.9 16.5 19.0 18.5 16.2 15.4 18.3 15.3 23.9 11.8 25.1 19.2 18.4 17.2 21.1 14.7 15.9 15.9

0.0 22.9 5.0 96.7 70.4 90.0 91.5 61.6 45.3 89.7 38.0 99.0 0.0 99.4 93.6 88.0 74.4 97.5 25.1 56.4 56.4

9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011

137.1 130.8 119.3 129.5 128.2

26.3 38.6 18.6 36.8 23.6

14.0 22.6 13.1 21.9 14.4

9.4 97.0 1.7 97.6 14.2

GKC GHE JL MM NME NP RA SM TS VA VSR IHMC-2D AG AA AJI DJ DJ EC FDM GA IJJ MAV NJ PA QR RG BL BSA BA BD CNR CK DK EN GE LJ LAB MMG MSM OC RJ RER SAR SRP TRL VSR IHMC-2E AJI

F F F F F F F F F F F M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F F F F M

1/24/2004 9/13/2003 10/29/2003 9/26/2003 7/22/2003 4/22/2003 3/26/2004 7/11/2003 2/28/2004 9/13/2003 2/1/2004 11/30/2003 8/7/2003 3/9/2004 7/13/2003 6/18/2003 7/17/2004 6/3/2004 4/15/2004 4/25/2004 8/10/2003 9/4/2003 4/16/2003 5/8/2004 9/16/2003 4/3/2004 2/3/2004 6/7/2003 3/13/2004 6/6/2003 3/31/2003 3/5/2004 9/15/2003 11/30/2004 7/2/2004 3/6/2004 11/20/2003 8/19/2004 6/7/2004 4/16/2004 12/2/2003 2/14/2004 5/6/2004 3/20/2004 4/27/2004 2/21/2004

9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/5/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011

123.1 116.8 132 133.3 118.1 127 124.4 121.9 118.1 124.4 129.5 135.8 124.4 120.6 130.8 129.5 121.9 121.9 124.4 127 128.2 132 134.6 121.9 129.5 124.4 119.3 124.4 129.5 129.5 121.9 124.4 127 120.6 130.8 121.9 127 129.5

28.1 25 30.4 34.5 20.1 34 27.2 17.9 22.2 21.8 30.9 35 30 19.2 40.4 35 19.5 23.6 23.6 27.7 23.1 31.3 37.3 25 25.4 29 25 26.8 24.5 41 29.5 27.2 25.4 20 32.2 20 31.8 34

18.5 18.3 17.4 19.4 14.4 21.1 17.6 12.0 15.9 14.1 18.4 19.0 19.4 13.2 23.6 20.9 13.1 15.9 15.3 17.2 14.1 18.0 20.6 16.8 15.1 18.7 17.6 17.3 14.6 24.4 19.9 17.6 15.7 13.8 18.8 13.5 19.7 20.3

88.6 85.4 78.2 91.5 17.8 95.0 82.2 0.0 56.6 12.4 88.0 92.3 92.8 1.0 98.6 96.1 0.7 58.2 40.4 80.7 8.3 85.2 95.3 76.2 33.7 90.4 81.1 73.6 25.6 98.5 91.4 81.8 48.8 9.6 91.7 4.8 93.0 96.2

9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/9/2011 9/2/2011

132 130.8 116.8 119.3 116.8 125.7 132

30.4 30 21.3 20 22.7 21.8 33.6

17.4 17.5 15.6 14.1 16.6 13.8 19.3

81.2 79.7 49.5 14.0 70.3 9.4 94.1

BJ DGT GR GE GC HL JC LRA NL PS PJ PG PJ RT VJ ZV AF AC BB BM CA CJ EX GE GL HP INA JJE LAR TAN TRAM TAM VAI ZA IHMC-3A AAH ARC AM AV AC BM BSA BJ CM CM CA DJ

M M M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F F M M M M M M M M M M M M

11/11/2003 11/8/2003 9/29/2003 1/5/2004 4/17/2004 7/11/2003 8/3/2003 2/8/2003 9/2/2003 9/21/2003 9/21/2003 7/6/2003 8/3/2003 6/9/2003 11/8/2003 2/5/2004 6/7/2004 8/9/2003 8/14/2003 12/4/2003 7/14/2004 3/4/2003 10/23/2003 8/25/2003 9/12/2003 3/13/2004 1/4/2004 10/4/2003 8/26/2003 3/2/2003 8/7/2003 4/14/2004 8/23/2003 8/12/2004 8/17/2003 2/15/2003 1/26/2003 10/22/2002 12/1/2002 3/5/2003 5/30/2002 3/20/2002 6/19/2002 3/17/2003 5/21/2002 11/18/2002

9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011 9/2/2011

139.7 121.9 133.3 137.1 129.5 133.3 133.3 132 134.6 135.8 123.1 129.5 124.4 119.3 132 138.4 133.3 140.9 140.9 128.2 132 127 121.9 134.6 124.4 134.6 124.4 132 130.8 130.8

37.2 23.6 28.1 49.5 32.2 26.3 26.3 45 33.6 31.8 23.6 25 22.7 19.5 40.4 43.1 26.8 42.7 47.2 41.3 41.3 23.1 20.2 40 25.9 32.7 20.4 31.8 25.4 25.4

19.1 15.9 15.8 26.3 19.2 14.8 14.8 25.8 18.5 17.2 15.6 14.9 14.7 13.7 23.2 22.5 15.1 21.5 23.8 25.1 23.7 14.3 13.6 22.1 16.7 18.0 13.2 18.3 14.8 14.8

92.5 54.2 51.7 99.4 94.2 23.6 24.0 99.0 89.3 78.1 45.4 26.2 20.7 3.7 98.6 98.5 39.1 96.3 98.3 99.0 98.9 14.3 5.8 97.1 67.7 86.1 2.4 85.2 27.7 24.3

9/2/2011 9/2/2011 9/2/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

121.9 127 121.9 127.5 129.5 126 117.8 132 136 135 141.1 136 127 139 116.5

28.1 25.4 22.7 38 25 26 31.5 26 30 29 46 28 23 32.5 22

18.9 15.7 15.3 23.4 14.9 16.4 22.7 14.9 16.2 15.9 23.1 15.1 14.3 16.8 16.2

91.4 48.4 45.4 98.5 23.6 58.3 97.3 22.6 55.9 41.8 97.0 24.3 10.5 60.5 53.0

IR MR NK PM TB AV AJI AL AJI CT CAR DK FG LE MB MM NM PX QS RD RD SP VK IHMC-3B AK AM BN BP BB CC CD GL JM MC OE OA TA VA BF CM CJ FP FJ GE HD MF MY

M M M M M F F F F F F F F F F F F F F F F F F M M M M M M M M M M M M M M F F F F F F F F F

6/21/2003 2/13/2003 12/10/2002 5/24/2003 5/28/2003 1/28/2003 5/6/2003 3/17/2003 12/3/2002 10/10/2002 5/7/2003 6/9/2003 2/7/2003 4/23/2003 3/15/2003 10/10/2002 9/19/2002 6/24/2002 10/28/2002 11/28/2002 2/14/2003 4/1/2003 2/23/2003 7/27/2003 6/23/2003 11/16/2002 11/16/2002 6/11/2002 9/2/2002 5/18/2002 3/7/2003 7/1/2002 5/3/2002 1/4/2002 12/19/2003 11/27/2002 5/10/2003 5/21/2003 8/27/2003 7/26/2003 5/17/2003 10/7/2002 8/14/2002 8/30/2003 7/22/2003 7/21/2001

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

122.9 140 135 121.2 135.2 137 129 123 131.8 138.2 128.5 133.5 125.2 125.3 131.2 136.2 145.5 124 136.7 144 116.7 128.2 134.5 121 127.2 131 128.5 128.8 139 123.8 139 140.5 125.1 137 126 128.2 133.5 128.2 139.9 127 130.6 136 122.2 122.1 122.2 144.5

28 50 47.5 32.5 30 39.5 27 23.5 35 29.5 39.5 30.5 29.5 27.5 28 41 43.5 25 32 51.5 18 25.5 30.5 24 29.5 38.5 23.5 23.5 34 25 42.5 47 24 49.5 22 40 36 28 30 32 29.5 31 29 20.5 26 45.5

18.5 25.5 26.1 22.1 16.4 21.0 16.2 15.5 20.1 15.4 23.9 17.1 18.8 17.5 16.3 22.1 20.5 16.3 17.1 24.8 13.2 15.5 16.9 16.4 18.2 22.4 14.2 14.2 17.6 16.3 22.0 23.8 15.3 26.4 13.9 24.3 20.2 17.0 15.3 19.8 17.3 16.8 19.4 13.8 17.4 21.8

88.3 98.9 99.0 97.5 61.9 94.3 55.1 39.3 91.3 33.6 98.2 70.8 85.4 75.0 54.5 95.7 91.9 47.3 65.6 98.3 2.0 39.3 64.5 62.9 86.2 97.2 8.9 6.7 74.9 50.3 97.1 97.8 27.7 98.6 6.1 98.4 94.6 69.3 38.7 92.4 72.7 59.2 86.6 7.3 75.6 92.1

NM ON PF RR RA RA SE SA TRAM IHMC-3C AJI BJ CS CJ CD EA MR MW OJD RD RG SA TL TJ UC VL AMM AM BMM BSF CA DSC AY FM FCP FM GN MB OA QA SA SJ SS TJ VA ZM IHMC-3D BA

F F F F F F F F F M M M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F F F F M

10/22/2002 5/5/2002 6/25/2003 2/21/2002 5/31/2002 8/24/2002 3/11/2003 3/14/2003 8/23/2002 3/12/2003 9/8/2002 6/3/2003 8/13/2002 9/23/2002 7/29/2002 10/7/2002 9/10/2002 10/4/2002 12/25/2003 9/14/2002 8/14/2003 9/8/2002 1/18/2003 12/6/2002 6/13/2003 12/22/2002 5/12/2003 12/2/2002 8/25/2002 12/12/2002 3/13/2003 11/25/2002 4/15/2003 9/10/2002 2/15/2003 5/6/2002 8/24/2002 11/5/2002 9/22/2002 4/21/2003 2/17/2003 5/12/2002 12/7/2001 7/29/2003 5/25/2002 2/25/2003

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

125.5 130.5 132.2 124.5 123.6 125.2 121.1 134 119.4 134.8 138.8 119.5

30 25.5 36.5 22.5 22 24.5 22 41 21 34.5 46.5 21.5

19.0 15.0 20.9 14.5 14.4 15.6 15.0 22.8 14.7 19.0 24.1 15.1

85.3 20.7 94.9 12.1 11.7 36.2 27.5 97.2 18.3 89.6 98.2 29.3

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

127.8 134.5 137.5 132 119 125.5 136 125.8 145.2 120.5 124.5 130 134.5 136.5 128.8 130.5 135 132 120.8 129.2 127 127 131.5 126.8 131.5 129.5 128.3 117.5 125.5 133 129.5 126.5 126.9

34.5 30 41 36.5 20.5 31.5 30 34.5 55.5 22 24.5 31.5 32.5 43 26 26 35.5 31 21.5 32.5 26 35 38 31 42 21 26.5 25.5 22.5 45 29.5 30 31.5

21.1 16.6 21.7 20.9 14.5 20.0 16.2 21.8 26.3 15.2 15.8 18.6 18.0 23.1 15.7 15.3 19.5 17.8 14.7 19.5 16.1 21.7 22.0 19.3 24.3 12.5 16.1 18.5 14.3 25.4 17.6 18.7 19.6

95.2 57.8 96.2 94.7 12.5 95.5 51.5 97.5 98.9 29.0 44.2 88.8 77.4 97.6 39.7 28.8 88.5 77.2 20.0 89.9 46.7 95.7 94.6 85.9 97.9 0.2 52.2 83.0 9.9 97.8 77.8 80.6 92.0

BAN CB CJ DJ EF EJ FE FJ GR HR LJ MC PCP VM VA AA BP BD CB CV CI CA DJ DM EJ HJ MB MM RR TN TM VT VTR WC IHMC-3E AA BJ BA CT DK DJ GJ GJ MJ MG NM PR

M M M M M M M M M M M M M M M F F F F F F F F F F F F F F F F F F F M M M M M M M M M M M M

7/13/2003 6/20/2002 10/29/2002 11/18/2002 1/9/2002 10/14/2002 3/12/2002 10/16/2002 12/16/2002 5/19/2002 7/5/2002 12/24/2002 3/3/2003 7/15/2002 9/5/2002 10/10/2002 1/1/2003 6/16/2003 7/15/2002 8/10/2003 7/26/2003 6/18/2003 1/11/2003 12/27/2003 1/13/2003 10/30/2002 6/21/2003 11/22/2002 6/30/2003 8/23/2002 12/5/2002 4/25/2002 10/12/2002 4/21/2003 5/29/2002 4/7/2003 1/23/2003 4/19/2003 8/30/2002 1/22/2002 6/5/2003 3/26/2003 7/25/2003 5/15/2002 12/10/2001 3/21/2003

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

139 133.4 121.3 120.4 123.5 134.8 140.8 137.8 125

53 31 23 22 27 42.5 38 49 44

27.4 17.4 15.6 15.2 17.7 23.4 19.2 25.8 28.2

99.4 71.0 39.0 28.3 71.2 97.8 86.2 98.8 99.3

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

137 134.8 131 121 129.5 128.8 136.3 130.2 130.5

40.5 39 43 21.5 24 23 35.5 32 29

21.6 21.5 25.1 14.7 14.3 13.9 19.1 18.9 17.0

95.5 96.2 98.8 15.2 9.4 6.4 86.7 87.6 61.4

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

123.5 127.5 124.5 124.2 130 122.5 134.3 140.5 132 148.2 141.5 141.2 131.1 122 118.2 127.5 126 135.1 130.8 121.1 137.8 137.4 127.5 127.8

26 28 25 23 36 25 44.5 37 37.5 49 54 57.5 27 23 21 29.5 25 28.5 31.5 28.5 53 39 29.5 35

17.0 17.2 16.1 14.9 21.3 16.7 24.7 18.7 21.5 22.3 27.0 28.8 15.7 15.5 15.0 18.1 15.7 15.6 18.4 19.4 27.9 20.7 18.1 21.4

66.3 76.6 50.2 23.0 95.7 58.7 98.6 82.2 95.0 95.1 98.9 99.4 37.0 38.3 26.1 84.6 40.3 31.6 87.2 91.8 99.4 93.3 76.0 96.5

SS SM TM VJ BSF DSC DJ EA FM FP HM LV MC NA OC PK RE TM TJ TA UA

M M M M F F F F F F F F F F F F F F F F F

8/3/2002 8/3/2003 9/8/2002 1/6/2003 11/9/2002 11/9/2002 4/27/2002 5/25/2002 5/7/2002 10/7/2002 8/21/2002 7/25/2003 7/3/2003 1/23/2003 8/27/2002 11/18/2002 7/2/2003 5/12/2002 9/3/2002 7/12/2002 12/14/2002

9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011 9/13/2011

122 124.2 130.8 127.2 120.5 133.5 128.5 124.5 145.8 129.6 130.2 125.1 132.5 134 140.2 132 133 136.5 127.6 140.3 126.9

22 30.5 53.5 26.5 25.5 29 25.5 28.5 43.5 30 29.5 27 29 28 40.5 28.5 46 36 34 32.5 25.5

14.8 19.8 31.3 16.4 17.6 16.3 15.4 18.4 20.5 17.9 17.4 17.3 16.5 15.6 20.6 16.4 26.0 19.3 20.9 16.5 15.8

17.4 94.0 99.5 57.8 71.9 51.3 29.5 77.4 90.3 74.7 67.9 73.7 62.0 39.3 91.9 53.1 99.0 84.6 92.8 52.5 43.4

APPENDIX E Parents Questionaire

QUESTIONAIRE ON PARENTS PROFILE AND PARENTS PERCEPTION ABOUT THE PRACTICES RELATED TO THE DIFFERENT FACTORS AFFECTING CHILD OBESITY

Dear Parent/s, The questionaire below is part of an ongoing research to assess the communities awareness and knowledge on childhood obesity. All the answers will be very important in creating programs to prevent and control childhood obesity. Rest assured that the information gathered in this study will be kept confidential and not be used commercially. Thank you very much for your cooperation.

(Sgd.) Carlo G. Almazar, RN Researcher

FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PAR AAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM

( FOR PARENTS) Directions: Please fill in the necessary information

I. PARENTS PROFILE Students name: ___________________________ Mothers height: __________ weight: _________ Fatherss height: __________ weight: _________ Age:_______ Sex: (M) (F) BMI: _______ BMI: _______

II. PARENTS PERCEPTIONS ABOUT THE PRACTICES RELATED TO THE DIFFERENT FACTORS AFFECTING CHILD OBESITY. Directions: Read statement and indicate your level of agreement by putting an (X) in the box that best describe your agreement toward the sentence. Consider the following rating scale in indicating your response.

54321-

Always Very often Sometimes Seldom Never

5 A. CULTURAL 1. My child is influened by his friends on what kind of food he eats. 2. My child is influenced by his friends on what he likes to play. 3. My child likes more of the processed foods like hamburger, hotdogs, tocino, longganisa more than vegetable dishes. 4. My child loves to imitate what he sees on tv. 5. My child loves to eat. B. SOCIAL 6. My child likes to go out and play with his friends.

7. My child is influenced by what he sees on tv commercials. 8. My child glows up when its time to eat. 9. My child likes physical activities. 10. My child watches television for long hours.

5 C. ENVIRONMENTAL 11. My family loves to eat. 12. I allow my child to buy the food he wants to eat in school. 13. I dont mind my child eating cookies, chips, chocolates, candies, etc. 14. I only cook the type of food my child wants to eat. 15. I cook meat dishes and processed foods more than vegetable dishes.

D. PHYSIOLOGIC 1. Has your child ever been diagnosed with any medical conditions? ____ yes ____ no

2. If yes, please indicate the condition and the medication/s being taken.

_________________________________________________________

E. GENETIC

(Parents BMI will be computed according to the information given regarding their height and weight.)

APPENDIX F Pupils Questionaire

I. TALATANUNGAN TUNGKOL SA GAWAIN AT MGA PERSEPSYON NG BATA NA NAGSASANHI NG KATABAAN SA KABATAAN. (Para sa mag-aaral) Pangalan:____________________________ Antas/Pangkat:________________________ Araw ng kapanganakan: ________________ Taas: _________ Timbang: _________ BMI: _________

Panuto: lagyan ng ekis (X) ang kahon na tumutugon sa iyong sagot. Makinig sa tagapangasiwa/facilitator para sa karagdagang impormasyon ukol sa pagsagot ng mga sumusunod na tanong. 5 - Palagi 4 - Malimit 3 - Minsan 2 - Bihira 1 - Hindi kailanman

5 4 3 2 1 A. PANGKALINANGAN 1. Naaakit ako sa mga pagkain na kinakain ng aking mga kaklase. 2. Naaakit ako sa mga laro na kinagigiliwan ng aking mga kaklase.

3. Nagigiliw akong kumain ng mga pagkaing katulad ng hamburger,hotdog, tocino, longganisa,higit sa pagkaing gulay. 4. Ginagaya ko ang mga nakikita ko sa telebisyon. 5. Nagigiliw akong kumain. B. PANLIPUNAN 6. Naglalaro ako sa labas ng bahay kasama ng aking mga kaibigan. 7. Naiimpluwensyahan ako ng mga patalastas na napapanood ko sa telebisyon. 8. Nasisiyahan ako pag oras na ng pagkain. 9. Nagigiliw akong gumawa ng mga pisikal na gawain. 10. Nanunuod ako ng telebisyon pag nasa bahay.

5 4 3 2 1

C. PANGKAPALIGIRAN 1. Masigasig ang pamilya namin sa oras ng pagkain. 2. Bumibili ako ng pagkaing gusto kong kainin sa eskwela. 3. Pinapayagan ako ng aking magulang na kumain ng mga tsitserya kagaya ng chips, tsokolate, kendi, atbp. 4. Sinasabi ko sa nanay ko ang pagkaing gusto kong kainin. 5. Nagluluto si nanay ng hotdog, tocino, o ano pa mang ma-karneng ulam sa halip na pagkaing gulay.

APPENDIX G Height, Weight and BMI of Both Parents Height , Weight and Computed BMI of Both Parents
FATHER 5'4 / 154 lbs. 6'0 / 180 lbs. BMI 26.4 24.4 MOTHER 5'0 / 158.4 lbs. 5'6 / 130 lbs. 5'51/2 / 150 lbs. 5'7 / 160 lbs. 25.1 5'4 / 150 lbs. 5'2 / 140 lbs. 4'11 / 110 lbs. 5'8 / 180 lbs. 6'0 / 183 lbs. 5'11 / 190 lbs. 5'5 / 140 lbs. 5'10 / 180.4 lbs. 5'3 / 132 lbs. 5'8 / 172 lbs. 5'8 / 165 lbs. 5'7 / 158.4 lbs. 5'7 / 165 lbs. 5'10 / 180.4 lbs. 5'6 / 132 lbs. 5'6 / 130 lbs. 5'5 / 170 lbs. 22.2 27.4 24.8 26.5 23.3 26.1 23.4 26.1 25.1 24.8 25.8 25.9 21.3 21 28.3 5'6 / 135 lbs. 5'2 / 122 lbs. 5'2 / 130 lbs. 5'1 / 132 lbs. 5'3 / 120 lbs. 5'4 / 130 lbs. 4'11 / 102 lbs. 5'2 / 148 lbs. 5'4 / 163 lbs. 5'2 / 136.4 lbs. 5'2 / 100 lbs. 5'4 / 130 lbs. 4'11 / 105.6 lbs. 5'2 / 136 lbs. 5'4 / 145 lbs. 4'11 / 105 lbs. 5'6 / 143 lbs. 23.1 5'3 / 176 lbs. 5'7 / 176 lbs. 5'10 / 130 lbs. 5'7 / 198 lbs. 5'2 / 171.6 lbs. 18.7 31 31.4 5'5 / 100 lbs. 5'4 / 121 lbs. 4'9 / 187 lbs. BMI 30.9 20.7 24.6 25.7 25.6 21.8 22.3 23.8 24.9 21.3 22.3 20.6 27.1 28 24.9 18.3 22.3 21.3 24.9 24.9 21.2 31.2 27.6 16.6 20.8 40.5

5'8 / 176 lbs. 5'4 / 120 lbs.

26.8 20.6

5'4 / 132 lbs. 5'1 / 90 lbs. 5'2 / 121 lbs.

22.7 17 22.7 22 22.1 18.7 29.1 21.2 26.2 22.5 25.3 21 23.4 24 24.3 30.4 22.3 20.5 26.6 20.6 22.3 23.8 61 23.4 35.5 21.3 30.2 22.7 33.3 24.6 31 20.1 26.2 21.5 28.2 21.6 25.8 20.6 25.2

5'7 / 140 lbs. 5'9 1/2 / 175 lbs. 5'11 / 154 lbs. 5'8 / 308 lbs. 5'6 / 130 lbs. 5'6 / 165 lbs. 5'2 / 123 lbs. 6'1 / 110 lbs. 5'8 / 170 lbs. 5'7 / 165 lbs. 5'10 / 165 lbs. 5'6 / 165 lbs. 5'6 / 152 lbs. 5'8 / 180 lbs. 5'8 / 160 lbs. 5'6 1/2 / 191.4 lbs. 5'10 / 190 lbs. 5'8 / 185 lbs. 5'7 / 165 lbs. 5'6 / 138 lbs. 5'5 1/2 / 140 lbs. 5'7 / 120 lbs. 5'6 / 187 lbs. 5'10 / 190 lbs.

21.9 25.5 21.5 46.8 21 26.6 22.5 14.5 25.8 25.8 23.7 26.6 24.5 27.4 24.3 30.4 27.3 28.1 25.8 22.3 22.9 18.8 30.2 27.3

5'3 / 124 lbs. 5'3 / 125 lbs. 5'1 / 99 lbs. 5'1 / 154 lbs. 4'11 / 105 lbs. 5'2 / 143 lbs. 5'0 / 115 lbs. 5'3 / 143 lbs. 5'2 / 115 lbs. 5'0 / 120 lbs. 5'4 / 140 lbs. 5'3 / 137 lbs. 5'0 / 155.9 lbs. 5'4 / 130 lbs. 5'3 / 116 lbs. 5'0 / 136.4 lbs. 5'4 / 120 lbs. 5'4 / 130 lbs. 5'2 / 130 lbs. 4'0 / 200 lbs. 5'1 1/2 / 126 lbs. 5'6 / 220 lbs. 5'3 / 120 lbs. 5'1 / 160 lbs. 5'4 / 132 lbs.

5'4 / 132 lbs. 5'4 / 200 lbs. 5'10 / 200 lbs. 5'6 / 176 lbs. 5'7 / 176 lbs. 5'5 / 130 lbs. 5'11 / 170 lbs. 5'6 / 189 lbs. 5'7 / 140 lbs. 6'0 / 160 lbs. 5'7 / 180 lbs.

22.7 34.3 28.7 28.4 27.6 21.6 23.7 30.5 21.9 21.7 28.2

5'1 / 176 lbs. 5'1 / 130 lbs. 5'3 / 175 lbs. 5'2 / 110 lbs. 4'9 / 121 lbs. 5'0 / 110 lbs. 5'6 / 175 lbs. 5'5 / 130 lbs. 5'6 / 160 lbs. 5'4 / 120 lbs. 5'2 / 138 lbs.

5'6 / 138.6 lbs. 5'7 1/2 / 143 lbs. 5'7 / 172 lbs. 5'6 / 135 lbs. 6'0 / 270 lbs. 5'7 / 170 lbs. 5'7 / 171.6 lbs. 5'6 / 121 lbs. 5'4 / 143 lbs. 5'5 / 170 lbs.

22.4 22.1 26.9 21.8 36.6 26.6 26.9 19.5 24.5 28.3

5'2 / 110 lbs. 5'1 / 121 lbs. 5'8 / 158 lbs. 5'1 / 108 lbs. 5'6 / 140 lbs. 5'1 1/2 / 140 lbs. 5'4 / 92 lbs. 5'2 / 146 lbs. 5'1 / 121 lbs. 5'0 / 100 lbs. 5'2 / 170 lbs.

20.1 22.9 24 20.4 22.6 26 15.8 26.7 22.9 19.5 31.1 34.3 22.9 20.1 20.4 21.5 21.8 21.9 24.7 23.4 25.3 22.8 19.5 29.2 27.4 23.8 23.4 21.9 23.4 27.5 22.4 20.8 24.1 30.2 23.4 24.1 20.8 19.5 25.6

5'6 / 160 lbs. 5'7 / 170 lbs. 5'8 / 150 lbs. 5'7 / 270 lbs. 5'5 / 160 lbs. 5'5 / 200 lbs. 5'6 / 130 lbs. 5'10 / 180 lbs. 5'8 / 162.8 lbs. 5'6 / 160 lbs. 5'8 / 175 lbs. 5'8 / 192 lbs. 5'11 / 200 lbs. 5'6 / 140 lbs. 5'7 / 180 lbs. 5'7 / 200 lbs. 5'8 / 150 lbs. 5'6 / 160 lbs. 5'10 / 175 lbs. 5'10 / 176 lbs. 5'10 / 132 lbs. 5'3 / 125 lbs. 5'7 / 189.2 lbs. 5'6 / 175 lbs. 5'5 / 143 lbs. 5'3 / 130 lbs. 5'9 / 180 lbs. 5'11 / 220 lbs.

25.8 26.6 22.8 42.3 26.6 33.3 21 25.8 24.8 25.8 26.6 29.2 27.9 22.6 28.2 31.3 22.8 25.8 25.1 25.3 18.9 22.1 29.6 28.2 29.1 23 26.6 30.7

5'4 / 200 lbs. 5'2 / 125 lbs. 5'2 / 110 lbs. 5'4 / 119 lbs. 5'4 / 125 lbs. 5'4 / 127 lbs. 5'0 / 112 lbs. 5'2 / 135 lbs. 5'3 / 132 lbs. 5'0 / 129.8 lbs. 5'3 / 129 lbs. 5'3 / 110 lbs. 5'4 / 170 lbs. 5'2 / 150 lbs. 5'2 / 130 lbs. 5'0 / 120 lbs. 5'2 / 120 lbs. 5'2 / 128 lbs. 5'4 / 160 lbs. 5'8 / 147.4 lbs. 5'1 / 110 lbs. 5'2 / 132 lbs. 5'2 / 165 lbs. 5'6 / 145 lbs. 5'0 / 123.2 lbs. 5'1 / 110 lbs. 5'0 / 100 lbs. 5'2 / 140 lbs.

5'2 / 165 lbs. 5'2 / 140 lbs. 5'8 / 171.6 lbs. 26.1 5'2 / 165 lbs. 5'4 / 128 lbs. 5'2 / 114.9 lbs. 5'9 / 230 lbs. 5'9 / 200 lbs. 6'0 / 220 lbs. 5'6 / 180 lbs. 5'11 / 200 lbs. 5'7 / 154 lbs. 5'7 / 120 lbs. 5'6 / 175 lbs. 5'11 / 160 lbs. 5'6 / 149.6 lbs. 21 34 29.5 29.8 29 27.9 24.1 18.8 28.2 22.3 24.1 4'9 1/2 / 114.1 lbs. 5'5 / 150 lbs. 5'3 / 140 lbs. 5'4 / 120 lbs. 5'4 / 150 lbs. 5'11 / 102 lbs. 5'2 / 140.8 lbs. 5'4 / 110 lbs. 5'4 / 140 lbs. 5'3 / 100 lbs. 5'1 / 118.8 lbs. 5'4 / 174 lbs. 5'2 / 160 lbs. 5'4 / 120 lbs. 5'6 1/2 / 178 lbs. 5'9 / 180 lbs. 6'1 / 242 lbs. 5'11 / 210 lbs. 5'4 / 130 lbs. 20.6 28.3 26.6 31.9 29.3 22.3 5'2 / 140 lbs. 5'3 / 120 lbs. 5'2 / 115 lbs. 5'3 / 154 lbs. 5'3 / 115 lbs. 5'0 / 100 lbs. 5'5 / 132 lbs. 5'4 / 140 lbs. 24 5'2 / 120 lbs. 5'1 / 120 lbs. 5'4 / 154 lbs. 5'10 / 200 lbs. 5'9 / 147.4 lbs. 5'5 / 170 lbs. 5'4 / 165 lbs. 5'8 / 170 lbs. 5'6 / 175 lbs. 5'9 / 215.6 lbs. 5'7 / 168 lbs. 5'8 / 170 lbs. 5'8 / 185 lbs. 5'5 / 195 lbs. 5'8 / 184.8 lbs. 26.4 28.7 21.8 28.3 28.3 25.8 28.2 31.8 26.3 25.8 28.1 32.6 28.1 5'3 / 110 lbs. 5'3 / 175 lbs. 5'1 / 134 lbs. 5'4 / 190 lbs. 4'11 / 136.4 lbs. 5'0 / 120 lbs. 5'2 / 130 lbs. 5'2 1/2 / 110 lbs. 5'1 / 120 lbs. 5'5 / 150 lbs. 5'4 / 130 lbs. 5'6 1/2 / 209 lbs. 5'2 / 121 lbs.

30.2 25.6 30.2 22 22.5 25 24.8 20 .6 25.7 14.2 25.7 18.9 24 17.7 22.4 29.9 29.3 25.6 21.3 21 27.3 20.4 19.5 22 21.9 22.7 19.5 31 25.3 32.6 27.5 23.4 23.8 19.5 22.7 25 22.3 33.2 22.1

5'6 / 163 lbs. 5'7 / 172 lbs. 5'9 / 193 lbs. 5'4 / 140 lbs. 5'8 / 173 lbs. 5'8 / 181 lbs. 5'7 / 180 lbs. 5'6 / 179 lbs. 5'7 / 173 lbs. 5'8 / 184 lbs. 5'6 / 173 lbs. 5'7 1/2 / 178 lbs. 5'9 / 190 lbs. 5'8 1/2 / 186 lbs. 5'5 1/2 / 148 lbs. 5'7 / 169 lbs. 5'5 / 148 lbs.

26.3 26.9 28.5 24 26.3 27.5 28.2 28.9 27.1 28 27.9 27.5 28.1 27.9 24.3 26.5 24.6

5'0 / 112 lbs. 5'4 / 130 lbs. 5'3 / 154 lbs. 5'1 / 143 lbs. 5'4 1/2 / 125 lbs. 5'2 / 112 lbs. 5'2 / 138 lbs. 5'1 / 110 lbs. 5'2 1/2 / 115 lbs. 5'2 / 112 lbs. 5'4 / 128 lbs. 5'4 / 134 lbs. 5'2 / 143 lbs. 5'1 1/2 / 118 lbs. 5'3 / 129 lbs. 5'0 / 118 lbs. 5'4 / 128 lbs.

21.9 22.3 27.3 27 21.1 25.2 25.2 20.8 20.7 20.5 22 23 26.2 21.9 22.8 23 22

APPENDIX H St. James FGD Thesis Title: FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM Discussion Dates:>>>> Method: Structured Focus Group Discussion Topic: Childhood Obesity Target Audience: Parents of primary pupils with a BMI percentile of 85 from selected private schools in Paraaque City Principal Investigator(s): Carlo G. Almazar, RN Assistant Moderator: Ruby Cabello

Instrument Title: Discussion Guide: Focus Group I: Topic Generation

Total Participant time required: 1 hour, 10 minutes 1 hour, 50minutes Total focus group time: Break: 1 hour, 10 minutes 1 hour, 50 minutes 0 minutes

OVERALL QUESTION TO ANSWER IN FOCUS GROUP DISCUSSIONS:

 The purpose of the study is to explore the depths and nuances of opinions regarding Obesity. To understand what factors are perceived by the parents to be the major cause of obesity in children. To understand different perspective of parents on the topic of obesity and its management. To generate a list of factors, probable management programs that will effectively eliminate childhood obesity in their community. After a list has been generated, to review for clarity, accuracy, completeness. Below is a general guide for leading our focus groups. We may modify this guide as needed as each focus group may have different reservations.

The Focus Group Discussion will be facilitated by the researcher with the help of an assistant moderator.

I. Introduction (10 m)

Welcome participants and introduce myself and the assistant moderator. Explain the general purpose of the discussion and why the participants were chosen. Discuss the purpose and process of focus groups Explain the presence and purpose of recording equipment and introduce observers. Outline general ground rules and discussion guidelines such as the importance of everyone speaking up, talking one at a time, and being prepared for the moderator to interrupt to assure that all the topics can be covered. Reviews break schedule and where the restrooms are. Address the issue of confidentiality. Inform the group that information discussed is going to be analyzed as a whole and that participant' names will not be used in any analysis of the discussion. Read a protocol summary to the participants.

This study is intended to elicit and clarify the knowledge, attitudes, and practices parents whose children are considered overweight or obese.

Childhood Obesity has become of public health importance because of the tremendous adverse impact it has on our countrys youth and on the wellbeing of our society. Obesity affects all aspects of the Childs life; most significantly by contributing to poor health, negative social perceptions by society and some researches even show a significant decline in academic performance. Given the nature of this growing problem and its implications for the future of the health and well-being of affected individuals, it is believed that the most effective solutions will be achieved through programs that focus on preventive efforts. Schools are perfect and favored locations to intervene because children spends a third of their day inside schools. The school being what it is empowers children through enriching their knowledge, attitudes and skills that they need to live a healthy lifestyle.

To achieve a low incidence rate of childhood obesity within the community, it will require identifying and implementing strategies that can further reduce the incidence of childhood obesity. Understanding current knowledge, attitudes, practices, prevention and control efforts and successful innovations for addressing barriers and limitations will help make the prevention of childhood obesity feasible.

Discussion Guidelines:

We would like the discussion to be informal, so theres no need to wait for us to call on you to respond. In fact, we encourage you to respond directly to the comments other people make. If you dont understand a question, please let us know. We are here to ask questions, listen, and make sure everyone has a chance to share.

If we seem to be stuck on a topic, we may interrupt you and if you arent saying much, we may call on you directly. If we do this, please dont feel bad

about it; its just our way of making sure we obtain everyones per spective and opinion.

We do ask that we all keep each others identities, participation and remarks private. We hope youll feel free to speak openly and honestly.

As discussed, we will be tape recording the discussion, because we dont want to miss any of your comments. No one outside of this room will have access to these tapes and they will be destroyed after our report is written.

Helping me is my assistant Ms. Ruby Cabello. She will be taking notes and be here to assist me if I need any help. Lets begin. Lets find out some more about each other by going around the room one at a time. Tell us your first name, the job you have, and how many children you have. Ill start.

II. Topic Generation (50-90 minutes)

The focus group facilitator will explain:

This will help us understand the issues parents face in their childs physical and nutritional needs. If there is some confusion during the discussion about how a topic is relevant clarifying comments will be requested, but the conversation will quickly move on.

Lets get started!

ST. JAMES COLLEGE-PARANAQUE Number of attendees: 2

LEGEND: R Researcher P Parent

R- Ang purpose ng ating focus group napag-alaman po namin kung hindi obese, overweight ang mga anak ninyo. Since na kelangan namin ng permission kaya we invited some parents. R- When we say obesity what comes into mind? P1- Mataba ang bata. R- may negative connotation po ba yan? P1- before kasi yung pamangkin ko mataba, madalas magkasakit, mabilis hingalin, hindi makatakbo kasi nga sobrang taba. R- so ibig po ninyong sabihin ang obesity para sa inyo mataba, hingalin, madaling dapuan ng sakit. P2- mahirap umakyat sa hagdan. R- so fear nyo baka maapektuhan ang puso nya. P2- pag-umaakyat kasi ng hagdan mabilis hingalin. P1- mabilis masira uniform, nagkakaron ng darkening of the skin lalo na sa batok. R- maikwento ko lng may mga pinsan ako na obese, maitim na batok so ginawa ng parents nila pina-derma nila so habang tumatanda sila nagbago sila ng lifestyle nag-gym sila so ngayon magaganda na katawan nila. P2- kami schedule ng exercise namin ng anak ko every Monday, Wednesday & Friday. We do jogging & walking.

P1- kelangan talaga discipline, ok lang na kumain ng kumain kaya lang dapat small frequent of meals lang. P2- hindi ka nga kakain pero kapag kumain naming isang bultuhan naman. R- as a parent role ano po ba perception natin of obesity? Sa tingin ninyo maam may pagkukulang ba kayo. Now, do you think healthy lang anak ninyo? P1- hindi namin mapigilan sa pagkain as a mother hindi mo kaya tiisin ang anak mo di ba. Ang gusto kasi niya longganisa, hotdog, tocino. Pero mahilig naman siya sa sports. P2- mataba ang anak ko pero kumakain siya ng fish & Vegetables. Minsan lang siya magbaon ng hotdog. Na-train ko kasi siya. Yung asawa ko din kasi hindi kumakain ng karne more on fish & vegetables siya. P2- malakas lang talaga sa rice ang anak ko. C- nabanggit ninyo kanina mahilig sa sports ang anak ninyo? P1- yung anak ko mahilig talaga kasi palagi siya sinasama ng pinsan niya na magbasketball, skate board & badminton. R- aware po ba kayo na ang mga anak ninyo is obese or over weight? P2- ako aware lang na overweight lang siya, wala ako idea na obese na pala anak ko, so ngayon babawasan ko na rice niya. P1- hindi ko naman iniisip na papunta na siya dun kasi tinitingnan ko naman anak ko tumangkad at pumayat na din siya ng konti kasi nga mahilig siya sa sports. Kelangan lang talaga na madagdagan pa activities sa labas. R- so you both agree to add activities outside? You also agree to give them a healthy menu like vegetables, do you think ang mga anak ninyo mababago pa ang eating habits? P1- oo willing naman, kaya lang yung mga in-laws ko since na sa amin sila nakatira mahilig sila sa hotdogs, bacon, nuggets. So ang hirap kasi kasama namin sila sa bahay. Pero kung kami lang kaya naman specially ngayon yung husband ko overweight na din talaga kaya naggym na siya. Kelangan na din nya magbawas ng timbang specially rice. P2- ako naman before 165 lbs. Ginawa ko 2 spoons of rice lang kinakain ko more on fish & vegetables lang ako.

R- in terms of management willing naman po kayo magpalit ng menu? P1- kumakain naman anak ko ng malunggay ginagawa ko kasi nagbibilad ako ng malunggay then ginagawa kong powder. So hinahalo ko sa mga niluluto ko. Kahit sa juice hinahalo ko din. Masarap naman wala sila nalalasahan. Gumagawa na lang ako ng paraan para maging healthy kinakain nila. R- sa tingin po ninyo ano ba yung ginagawa nating mali? P2- mahilig siya sa donuts, chocolates, cupcakes yun lang pagkakamali naming mag-asawa spoil namin anak namin. P1- nung pumasok na lang siya sa school naglabasan na kasi ang mga longganisa, hotdogs, bacon, tocino. Before naman ok siya sa kalabasa, patatas, tofu eh. R- so sinasabi natin we have plan to change menu, pwede naman nating gawin paunti-unti. R- physical activities, do you think kelangan pa dagdagan? P2- basta kasama ko kasi madalas naman kami magswimming & basketball. P1- ok na siguro sa akin activities nila like basketball, badminton, skate board & swimming dagdagan na lang siguro yung oras. After school kasi may time pa sila magbasketball, so ako naman naglalakad sa subdivision namin habang sila andun sa court. P1- biking pwede din idagdag sa activity nila on the weekends. R-regular po ba kayo nagpapacheck-up sa doctor? P1- October last year yun ang last na punta namin sa doctor. P2- December last nung nilagnat siya natakot kasi kami baka dengue. R- pumupunta lang kayo kapag may sakit ang mga anak ninyo. R- yung binigay ko po sa inyo na questionaires kayo po ba sumagot? Pwede ko po ba malaman yung rate ng budget sa food. Do you think malaki ba yung spending amount natin for food para magkaroon tayo ng matabang anak. P1- sa tingin ko 1 factor din yun, kasi since na madami kami sa bahay dun talaga napupunta sa food yung budget namin. Pero kung 4 lang kami mas maliit ang budget.

P2- 3-6 thousand budget namin for the whole month pero more on fish & vegetables. R- nagbibigay po ba kayo ng allowance sa mga anak ninyo sa school? P1- madalang kong bigyan ng allowance ang anak ko. Nagbabaon siya ng food. P2- hindi ko siya binibigyan, may baon talaga siyang food. R- nagcocomputer na ba anak ninyo? P2- once a week lng computer games tumatagal lng 1-2hrs. P1-PSP lang pero hindi araw-araw, 2-3hrs. R- do you think maam the computer games may kinalaman sa pagtaba ng anak ninyo? P1- oo kasi hindi naman sila pinapawisan, nakaupo lng sila hindi gumagalaw tapos kain lng ng kain. P2- meron talaga kasi habang nagfb anak ko kain siya ng kain. R- watching tv po ilang oras? P1- atleast 2hrs. a day. P2- atleast 2hrs. a day. R- kayo po ba sumagot ng questionaires. were you able to see it. Eto po yung questionaires na binigay namin kung mapapansin po ninyo pare-pareho lang ang mga tanong like for example, may family loves to eat, may child loves to eat. I read the five factors, 1. Cultural- refers to youth culture or generation eto yung pagkakaroon ng advancement, pagkakaroon ng mga fastfoods, di ba kapag nag-crave ang mga bata mas gusto nila kung ano nakikita nila sa tv. 2. Environmental- child sees inside the school or house, kung ano nakikita sa school yun din ang gagawin sa bahay. Ang bata naman kung ano ilagay mo sa mesa kakainin di ba? 3. Genetic- if both parents are obese there is 80% chance of child will being obese. 4. Physiologic- sakit or inborn that may affect the medical condition of the child. 5. Social- refers to individual behaviour like advertising, marketing, social networks & subliminal integration of the 1st world. Sa nakikita ninyo saan ba tayo mas lamang social ba, cultural or environmental ba?

P1- parents ang may responsibilidad talaga, kelangan balance ang pinakakain sa mga anak. R-sinabi po ninyo kelangan balance food so environmental factor po yan, kung ano nakikita niya araw-araw sa bahay yun lng kakainin niya. Kelangan simulan natin baguhin. R- mahilig ba sa candies, cookies ang mga anak ninyo? P1- anak ko hindi naman, pag may nakita lang sa ref. Or kung may nagbibigay. P2- anak ko mahilig talaga kasi may tindahan kami. R- i can say that this focus group discussion is finished. Mas aware na siguro tayo now and pwede naman natin or mag suggest in our next PTA meeting kung ano ang mga gusto nating mga pagbabago sa school natin. Para din sa mga anak natin yun.

APPENDIX I IHMC FGD IMMACULATE HEART OF MARY COLLEGE Number of attendees: 3

LEGEND: R- Researcher P- Parent GP- Grandparent

R- when we say obesity what comes into mind? P1- overweight, madaling dapuan ng sakit. P2- overweight R- sinabi po ninyo overweight, hindi po ba yan threats sa health ng anak ninyo? As a parent po kayo kasi ang expert sa mga anak ninyo kaya po kayo ang pinakamagandang tanungin wala po kayong nakikita in the future na magiging problema niya? or naiisip nyo lang na healthy lang ang anak ko. P2- for me kasi old school pa yan, unlike ngayon iba na kasi nga pinapalabas na ang biggest loser so dun natin nakikita about obesity.

R- ngayon nga po theres even laws sa atin na ginawa about obesity drafted pa lang by Sen. Santiago kasi ang laws lng natin dito is malnutrition kasi we are a 3rd world country. Ang nakakatawa malnutrition lang ginagawa nila dati. siguro 5 years ago pa yung draft regarding obesity. Hindi ko lang alam kung naipasa na kasi matagal yan. Sa ngayon po do you think as parents aware po ba kayo na overweight or obese ang anak ninyo. P1- overweight talaga, before kasi payat siya kaya pinakain ko ng pinakain, 3 years old siya nag-gain ng weight niya. before kasi sakitin din siya, nung lumaki naman nasobrahan naman mahirap tuloy magdiet. Madali lang pala patabain pero mahirap papayatin hindi na namin macontrol ayaw na papigil ng pagkain specially rice. R- rice is the main source of energy kaya lang kapag hindi nasunog it turns into fat. Sa family ninyo wala mataba or does your child want fatty foods, fried foods? P1- hindi naman siya ganun, more on fish kaya lang marami nga lang siyang magrice. Mahilig din siya sa sweets like cupcakes. R- on the parents role, right now you do anything about the problem? P2- yung samin sa case ko, we live on the same compound with my mother, alam mo naman si lola gusto niya pakainin ng masarap apo nila so it happens that way now tumaba na ulet siya. Pero ako kasi kapag kasama sa bahay let say ako uuwi for dinner control ko rice niya hindi naman siya nagrereklamo yun ginagawa namin. I make it appoint na sinisita ko siya minsan. Kung gusto niya pa konti lang i dont allow him too much rice yun ang diet na ginagawa ko pero in terms of proper diet hindi kami nagpa-practice sa bahay. R- what about you maam? P1- yung rice namin binabawasan na namin ngayon kasi hindi siya kagaya ng ibang mga bata na mahilig tumakbo-takbo wala kasi siya kalaro sa bahay. Malalaki na kasi kapatid niya, kapag weekend lang nakakapaglaro siya. Kaya minsan dinadala ko siya sa parents ko para may makalaro. Subdivision kasi yung samin wala makalaro na mga bata kaya madalas sa loob lang siya ng bahay. Pero pag andyan mga ate niya nakakapaglaro sila. Pero mostly, bata kasi computer ang nilalaro niya kaya wala din hindi din nabu-burn yung fat niya. R- what do you think about the school in regulating what they eat?

P2- for me yes, kasi like my son kasi grade 3 so maaga pa labas niya however hindi siya nahahatid ng 1st trip so 2nd trip pa siya mag-hihintay pa siya dyan sa gate. We give him money so wala din control, kahit pagsabihan na wag magsosoftdrinks so far kung ano role ng school hindi natin alam kung paano nila maco-control. Kung anong gagawin ng school if they can do that. P1- may baon pero 20 pesos lang, hindi ko allow anak ko na bumili sa canteen, pinapabaunan ko talaga siya. Minsan lang siya bumili sa canteen kapag nagkukulang lng water niya. R- government role, do you think kelangan pa nating ilapit para maipasa lang ang bill na nabanggit ko kanina or let it go & focus on the community aspect kasi pwede naman natin iregulate sa bahay & sa school. Do you think the government needs to do something about it? P1- siguro para aware lang ang parents & yung school. P2- awareness lang siguro pero ngayon naman marami nang nagiging health conscious kasi yun nga hindi natin iniisip minsan yung problema. We better understand about obesity para alam ng majority na ito ang posibleng mangyari. Obesity is more on awareness kasi nagconcentrate tayo sa malnutrition lang hindi alam ng marami obesity is also a sample of malnutrition. R- we will concentrate on awareness starting in the community. P1- kagay ng sinabi mo sa school siguro kelangan i-practice talaga. P2- malaki kasi influence ng teacher sa mga anak natin, kapag sinabing teacher sumusunod ang bata. Kunwari kami ang magsasabi kelangan ganito, ganyan hindi sila makikinig kung sa school 2 forces ang magsasabi sa kanila. Ang school ang magtuturo tayong mga parents taga follow-up. Pwede din nila isama sa mga subjects nila. R- number 1 talaga po is to add another subject parang araw-araw may sibika sila so why not to add to make them aware what theyre eating. then follow-up na lang. Dapat may collaboration between the parents, school & the community itself pag lumabas sa school dapat yung nagtitinda aware sila what they selling. Too bad nga at hindi ako dito nagtatrabaho unless they have good relationship with the school. R- lets go to management, is it physical activity, yung anak po ba ninyo mahilig ba sila sa sports?

P2- theyre not into sports, eventhough gustuhin man walang time kasi on weekdays 5:30 na sila makakauwi from school, on weekends they, habulan, football sa compound lang namin. R- so during weekends lang. How about you maam? P1- kami kasi kapag naggo-golf husband ko, nagswimming kami sa clubhouse. Sa school kasi once lang sila may P.E. mostly na sa bahay lang hindi mo naman pwede palabasin mag-isa kasi delikado din naman. R- naiisip nyo ban a kelangan mag-add ng P.E. subject? P2- yes, actually nung PTA meeting it was suggested na kelangan ng physical activity like basketball they allow lang kasi is grade 6 yung anak ko gusto sumali andun yung interest pero theres no way of joining, gusto niya matuto kaya lang may try-outs pa. Paano kung bumagsak ka so problema pa yun. Gusto niya magbasketball. Hindi mo naman kelangan na magaling basta marunong ka. Sana may program na ganun even in a young age. P1- hindi rin kasi makasali anak ko kasi hindi siya marunong magbasketball. R- have you noticed the school facilities? P2- actually meron silang gym before kaya lang for renovation pa. P1- meron dati baka daw kasi lagyan ng swimming pool kaya under renovation kaya sa labas pa sila minsan. R- do you think in the near future things can be better? P2- meron naman kung facilities ang pag-uusapan natin they have a gym naman before. R- youve already suggested the programs, paano po ba natin sisimulan? Unlike today, we invited 69 parents ilan lang dumating 2 lang, although ganito rin sa ibang school sa dami ng obese ganito rin ang percentage. Mas mababa ang percentage ng attendees dito kasi nga mas marami population dito. Paano natin suggest sa parents kung hindi naman sila dumadating sa mga meeting na kagaya nito. P1- dati kasi may highschool din ako dito more on sila sa sports like volleyball, basketball kahit babae & badminton ngayon lang siguro nawalan kasi nga wala sila gym. Highschool talaga sila more on sports wala talaga sila sa elementary.

P2- on elementary students limited lang sports nila. R- physical activity programs marami pwede for kids like skate board but not riding them like the adults, maghabulan sila they will enjoy doing that. Kelangan lang siguro more interesting ang program. P2- kapag umuulan since nga na wala sila gym tendency sa loob lang sila ng classroom nila. P1-bata pa lang anak ko mahilig na siya sa sports yun nga lang wala lugar. R- lets go to the attitude what did you do? may pagkakamali ba tayo or may nagawa ba tayong mali kaya napapakain natin ng sobra ang mga anak nitin? P1- cut down na kami sa pagkain, kaso kapag andyan si lola naku masipag magpakain may kalusugan talaga anak ko, pag sinabi ko na bawal ang softdrinks bibigyan ng softdrinks. R- is your wife or husband obese? P1- hindi naman P2- sa mother side, diba sa genes din yan right? Pero ngayon limit na rice niya, pumayat na naman siya ng konti pero sa gatas siya bumabawi. R- atleast your starting on cutting down. P1- vacation may diet siya pagdating ng school lumalaki na naman, siguro kumpleto baon. More on rice talaga siya. Rice sa umaga, tanghali pati sa gabi. P2- anak ko pag-uwi ubos ang pagkain, nung minsan nga umuwi siya sa bahay na may star tinanong ko kung bakit siya may star yun pala naubos daw niya yung food nya. P1- kahit fruits nga ubos, yun nga lang more on water siya kaysa sa juice. P2- buti nga yung sa akin si lola kasi more on iced tea, so ngayon more on water na siya. Before kasi gumagaya kay lola. R- pero si grandparent lang yun? P2- yes. R- spoiler talaga si grandparent yun talaga trabaho nila.

P2- pagdating din siguro natin sa age na ganun hindi din tayo marunong magdicipline. P1- sabi nga din ng husband ko malamang maging ganun din tayo. R- so napag-usapan PTA meeting, we are going to suggest ba kung ano napag-usapan natin ngayon? last year ba nagkaroon na kayo ng general meeting? P2- may PTA meeting naman kaya lang by section lang, first siguro suggest lang sa adviser ganung level muna. Ill check kasi this coming Saturday magkakaroon ng meeting, ill try to talk to them na rin. R- pinag-usapan natin kanina regulating the food what they eat, ano ba sa tingin nyo kaya ba nating pakainin ang mga anak ninyo nga gulay atleast 3 times a week. P1- kumakain naman ng gulay ang anak ko, pag nilagyan mo sa pinggan kakainin niya wag lang monggo & okra. P2- kumakain naman, wala nga lang kaming diet-diet in terms of eating, portion size lang talaga. R- is your child having regularl check-ups with the doctor? P1- hindi kasi normally naman kapag pumunta ka sa doctor check lang nila yung height, weight, kung tama ba yung height & weight nila sa age. R- kayo po ba sumagot ng questionaires. Do you able to see it. Eto po yung questionaires na binigay namin kung mapapansin po ninyo pare-pareho lang ang mga tanong like for example, may family loves to eat, may child loves to eat. I read the five factors, 1. Cultural- refers to youth culture or generation eto yung pagkakaroon ng advancement, pagkakaroon ng mga fastfoods, di ba kapag nag-crave ang mga bata mas gusto nila kung ano nakikita nila sa tv. 2. Environmental- child sees inside the school or house, kung ano nakikita sa school yun din ang gagawin sa bahay. Ang bata naman kung ano ilagay mo sa mesa kakainin di ba? 3. Genetic- if both parents are obese there is 80% chance of child will being obese. 4. Physiologic- sakit or inborn that may affect the medical condition of the child. 5. Social- refers to individual behaviour like advertising, marketing, social networks & subliminal integration of the 1st world. Sa nakikita ninyo saan ba tayo mas lamang social ba, cultural or environmental ba? Since na binasa ko sa inyo ang definition if you were to rate sa anong bahagi ba nakaka-attract para maging mataba ang anak ninyo?

GP- environmental, social then cultural wala po siya ginagawa nuod lang ng tv & toys niya.Pagdating naman sa pagkain hindi siya malakas kumain kaya lang malakas siya uminom ng gatas. Para nga siyang baby. P2- environmental, social then cultural more on environmental thing he sees and remembers what they eating, like sa Jollibee siya pa una nakakaalam kung ano bago. More on passionate eater. P1- social, environmental then cultural ditto lang talaga siya nakakapaglaro. Wala din naman siya nakikita sa bahay. R- nagrerequest po ban g food ang apo ninyo? GP- minsan lang pero kapag nagrequest siya expected mo na yun talagang madami siya kumain. 7 years pa lang siya pero magugulat ka talaga sa kain niya. R- sa inyo po ba may malakas kumain? P1- wala naman. P2- anak ko pagkain talaga, normal eating habit. Sabi nga ng tita niya hindi ako malulugi pagkasama ko sa eat all you can. Before nga kapag lumalabas kami may take home pa kami ngayon wala na. Eventhough grade 3 na siya, siya pa rin baby namin. R- masasabi ba natin na we give what they want? P1- samin kaya siya tumataba kapag dumadating ang mga tae niya from school tatanunginsiya kung kumain na sasabihin niya hindi pa, kaya nagdodoble ang kain niya. may mga college na kasi ako kaya yun kapag dumarating sila may mga pasalubong palagi. Magluluto sila ate kakain ulet siya. R- sino-sino po ba kayo sa bahay? GP- 3 apo ko. Yung dalawa ko kasing apo payat naman 1 lang mataba talaga baby pa lang overweight na siya. 8 months pa lang pinagdidiet na pero wala naman siyang medical condition. Malakas lang talaga sa gatas, 3 glasses of milk kaya niya ubusin sa gatas talaga siya tumataba. Kakain lang siya pag gusto niya ulam. Huwag mo rin tatawagin or gagalawin kapag naglalaro kasi may sarili siyang mundo. R- may anak po ba kayo na kapag gutom na umiinit na ulo?

P1- wala naman. Ayaw niya lang mag-hintay ng matagal sa pagkain. GP- pag nagugutom na siya bababa yun sakin magtatanong na siya kung ano food. P2- anak ko lang nagpapaawa, sasabihin nun mommy im hungry! R- ang mga bata naman kapag nagugutom bigyan mo lang ng konti mawala lang gutom nila ok na. R- i can say that this focus group discussion is finished. I hope you learned something today and sana may maisip tayong programs for the school na pwede nating i-suggest sa mga PTA meetings natin.

APPENDIX J IHMC FGD OLIVAREZ COLLEGE-PARANAQUE Number of attendees: 7

LEGEND: R- Researcher P- Parent

R- when we say obesity what comes into mind? P1- needs exercise, sobrang lusog R- pagsinabi ba nating malusog, in positive or negative connotation? P1- syempre pagsinabing sobra hindi na na siya physically fit, hirap kumilos, kaya minsan hindi na makasali sa takbuhan, hindi makasabay sa mga classmates niya. Dapat tama or proper lang ang katawan. P6- sa tingin ko hindi naman mataba ang anak ko. Nagtataka lang ako kung bakit makasama anak ko. R- kinukuha po kasi namin ang weight, height & BMI percentile ng mga anak ninyo, para malaman kung overweight or obese sila, kung sa tingin po ninyo hindi siya mataba yun kasi po ang lumabas sa result na kinuha namin. Ang bata kasi mabilis magbago ng katawan baka ngayon overweight siya by next year normal weight na siya. Iba din po ang babae sa lalaki kasi mas marami fat ang babae kaysa sa lalaki. P2- mabilis naman maglose ng weight ang anak ko kapag nagkakasakit, pero mabilis din siya tumaba. P3- hindi naman siya mahilig sa junkfood mas kinakain niya prutas, sobra sa edad ang weight nya. Tinanong ko din kasi sa pedia niya ang katawan daw ng anak ko hindi tataba hanggang dun na lang.

P4- nagtataka rin ako kung bakit napasama ang anak ko kasi maliit sila for grade 3, siguro yung weight niya sobra sa height niya. Minsan junkfood kasi mahilig siya talaga. Pagpinababaunan ko ng pera mukhang junkfood din binibili niya. P5-mataba talaga anak ko, diet na namin hindi na kumakain sa umaga gatas na lang. Kung pawisan kasi sobra. R- on the parents role ano ba usually ginagawa ninyo, do you think as a parent pag narinig ninyo ang obesity ano ba naiisip ninyo sino ba ang may responsibilidad? Ako ba, school, food na pinakakain ko or food na nakikita niya sa mga classmates niya? P1- malakas siya sa kanin, diet ko talaga siya after school kasi kanin pa din gusto niya. Minsan kasi pagod na pagod sa school rice talaga siya malaki na stomach niya simpleng tinapay hindi siya nabubusog parang hindi niya kakayanin. P6- tamang pagkain ang ibigay para maiwasan. Wala naman kasing problema feeling ko nabawasan pa siya ng weight eh. P2- bawasan lang ang rice hindi nman siya mahilig sa junkfood. Kaya lang mayat maya siya kumakain. R- 12 years old ang next growth spurt ng bata. Napapansin ninyo ba na bumabagal ang paglaki ng anak ninyo? P3- sa bahay kasi namin walang junkfood, naglalagay ako sa mga jar namin ng cookies, bread & fruits. Mas malakas pa nga siya sa banana, apple, rambutan. Before kasi sa school niya hindi sila pinapayagan na hindi magdadala ng fruits, hindi rin kami allow magdala ng chuckie. Water lang & juices, fruits, puto hindi pwede magdala ng pera pagkain lang talaga. Ensaymada, mamon, cupcakes hindi rin pwede kelangan daw habang bata pa lang turuan na sila kumain ng prutas. Kaya ngayon saging, itlog, tubig at mansanas baon niya. P4- dagdag ko na din sa kanila, wala talaga silang extra curricular kasi dito lang talaga nakakalabas, sa bahay kasi sa loob lang sila. P5- hindi siya lumalabas, pero kung kasama ko sa labas ayon tumatakbo-takbo siya. Kapag weekends hanggat gusto niya maglaro bahala siya. R- sa school role, ano ba gusto ninyo mangyari dapat ba ay may ginagawa ang school para maiwasan ang pagka-obese/overweight?

P7- ipagbawal na dapat ang softdrinks & junkfood, sa ibang school naman implemented na yan. Kaya nga ayaw ko na bigyan ng pera ang anak ko. R- so regulate the food thats being sold. P1- may age lang na kelangan nilang pagbentahan kasi may high school din naman dito, grades school huwag na lang muna. R- sana nga po impose ng ched ang ganitong patakaran, ang mga progressive school kasi hindi dapat i-allow magtinda ng mga food like junkfood, softdrinks para hindi mag-over ang non- nutritional intake nila. Hindi lang naman sa matatamis yan it can be carbohydrates like rice & bread lalo na sa mga bata once na pinainom mo ng softdrinks takbo yan ng takbo ang hirap awatin. So limit the food intake, simple sugar like fruits. P7- ayaw kumain ng fruits ng anak ko, kahit nung maliit pa siya ayaw talaga. P1- huwag na lang muna siguro bigyan ng pera, food na lang. Panganay ko kasi nasanay na walang pera na baon. R- lahat ba tayo sang-ayon na iregulate ang snacks sa school canteen. Ano ba dapat nating sabihin sa school. P7- concentrate tayo sa grades school kelangan baon na lang. R- kapag nagkaroon ba kayo ng PTA meeting mai-impose ba natin ang napagusapan natin ngayon? Sa school pwede ba nating sabihin na strict regulation, impose a rule to regulate the concessionaires on what they sell. Or suggest na i-regulate ang food na pwede nilang dalhin sa school. P1- siguro kelangan step by step kelangan makausap din muna ang mga parents. Kelangan during orientation pa lang din i-impose na kaagad na bawal magbaon ng pera. P4- ngayon aware na tayo noon kasi walang idea tayong mga parents di ba. P7- minsan talaga nabibigyan ko ng pera ang anak ko kasi baka may ibang food na makita sa classmate niya bigla siyang mang-agaw. R- naiisip nyo ba kung bakit grades 1-3 lang invite ko na parents? P3- para ngayon pa lang ma-train na sila habang bata pa. P1- grades 1-3 kasi nakikinig pa sa parents nila.

R- kaya sila ang pinili ko kasi kayo ang susceptible sa behavioral change. Eto yung age na tama or nakikinig pa ang mga bata. Let say for example, nagstart ang mga bata na pakainin ng fruits araw-araw, so syempre ang mga bata kung ano nakikita nila sa classmates nila yun din ipapabili nila sa parents nila. Parang behavioral skills yan araw-araw nyo pakainin ng malunggay, okra kakainin nila yan. Kaya nga tayo may family day di ba para matuto sila ng good food habit so kelangan good food habit nakikita nila. R- present awareness on obesity dumarami ba talaga ang obese dito sa pilipinas? Kaw sir hindi mo ba napansin na marami ding matataba ditto satin. Umiikot kasi ako sa mga community madami akong nakikitang matataba. Pero hindi ibig sabihin ng matataba tama ang kinakain nila, basta anything na sobra masama. R- opinion on management. Paano ba natin maiiwasan yan sa mga bahay natin wala ba tayong naiisip how to manage our children. P7- sa pamamalengke. R- so lahat ba tayo kapag namamalegke isang bultuhan lang? Ilan ba kayo sa family? P1- 4 in the family P2- 6 in the family P3- 3 in the family P4- 6 in the family P5- 4 in the family P6- 2 in the family P7- 7 in the family R- may over 3,000 ba ang budget for food? P7- kami kasi 500 a day. Sa pagkain lang yan. R- ano po ba normal food ninyo? P7- sa morning kung ano hinanda ko for breakfast yun na din baon nila.

R- sa inyo po ganun din kapag nagluto kayo ng breakfast ganun na din prepare nyo sa mga anak sa school. P1- sa amin o ganun din, kung ano mnatitira yun na din breakfast naming. C- management awareness, naniniwala ba kayo na kung mas malaki ang budget nyo sa food mas malaki ang chance na lumaki ang anak nyo? Dun ba sa budget nyo for food kasama na ba mga cookies, cupcakes, juices? P7- bawasan ang kain sa labas kasi kapag lumalabas kami gusto nila kumain talaga. R-isa pa yan sa laki ng budget sa food, on our part lumalaki lalo gastos natin. Sa school may management pa ba tayo naiisip? P7- ditto kasi pag dating sa exercise hinahayaan ko lang na tumakbo takbo siya kahit na makmukhang basahan ang damit niya ok lang mapawisan lang siya. P4- sakin hinahayaan ko din kasi hindi nga sila nakakapaglaro sa bahay. P5- kaya din kasi tumataba anak ko kasi katabi naming bakery palagi siya andun. R- attitude maam, sa tingin nyo lack of awareness ba yan. Ngayon lang natin napansin na lumalaki na anak natin. Or may mga grandparents ba tayo spoil nila apo nila. Or is it environment, satin ba or sa school? P6- isa na din yun kasi nga hinadi ka aware, minsan kasi kapag iniyakan kana maaawa ka talaga hindi mo tuloy alam kung saan ka lulugar. Kapag nagwala na sige na nga. P5- kagaya ng anak ko konti lang talaga baon niya isang hoydog lang kaya feeling ko kawawang kawawa siya. Minsan nga humihingi daw ng pagkain ang anak ko sa classmate niya kasi nagsusumbong sakin yung classmate niya. syempre ako tatay maaawa ka talaga sa anak mo. R- paano ba natin maawat ang gusto ng mga anak natin? P7- ako kasi minsan tinitiis ko talaga. R- lets go to behaviour change, so kelangan at an early age sinasanay or natetrain natin ang mga anak natin. Ano plano nyo pagdating sa bahay, lessen the food? Ano po ba game plan nyo?

P7- kaya lang kapag working mother mahirap, pero kung housewife lang ako matutukan ko talaga ang mga anak ko, maco-control ko lahat. R- so meron talagang problema sa environment hindi kasi natin matutukan kaya nangyayari na mas open ang mga bata na kumain. P4- lalo na yung mga anak ko nagkukwentuhan na nga lang sa bahay pagkain pa din nasa isip nila. R- ano ba katapat ng tv & computer? Ano bang mga activities na pwede natin ibigay inside ang outside the house? P3- computer sa anak ko kasi kapag weekdays 30 mins. Chat kasi sila ng classmate niya. weekends 30 mins- 1 hr. Lang. Ginagawa ko na lang para hindi siya mainip sa bahay pinagwawalis ko siya ng bahay. Sabi kasi ng teacher niya before hayaan lang na makabasag ng baso, pinggan para habang bata matrain sila. Kapag naglalaba nga ako gusto niya kasama siya. Siya din tagasampay ko, natuto kasi siya at an early age. P7- lalaki kasi anak ko, so takbo lang siya ng takbo wala siyang kapaguran. R- walang problema kung lalaki anak nyo. P7- yung anak ko minsan nagsusuot ng apron gusto niya magluto. R- planning menus, may plano na ba tayo for the week na eto food natin may gulay on Monday- Sunday. Lahat ba kumakain ng gulay ang mga anak natin? P1- sabaw lang ng sinigang gusto niya. P3- masipag kasi pedia niya, so amplaya kumakain siya sinanay na naming habang bata pa lang siya. P7- yung anak ko talaga tinatanong kung ano daw yung nilagay sa pinggan siya tapos separate talaga niya. R- mga anak ba natin napapacheck-up natin regularly? P1- pag may sakit lang. P3- renewal lang kami para sa mga injection niya. pero kapag may sipon hindi nakuha sa water pupunta na kami sa pedia niya. P4- pag may sakit din lang talaga.

P7- may health card naman kami kaya ok lang naman. R- malaking tulong kapag may health card kasi namo-monitor ang paglaki ng mga bata kagaya nun pumunta pa sa pedia to check kung ano yung letter na binigay namin. kayo po ba sumagot ng questionaires. were you able to see it. Eto po yung questionaires na binigay namin kung mapapansin po ninyo parepareho lang ang mga tanong like for example, may family loves to eat, may child loves to eat. Ill read the five factors, 1. Cultural- refers to youth culture or generation eto yung pagkakaroon ng advancement, pagkakaroon ng mga fastfoods, di ba kapag nag-crave ang mga bata mas gusto nila kung ano nakikita nila sa tv. Ang mga bata ngayon iba na, iba na taste nila sa food. 2. Environmental- child sees inside the school or house, kung ano nakikita sa school yun din ang gagawin sa bahay. Ang bata naman kung ano ilagay mo sa mesa kakainin di ba? 3. Genetic- if both parents are obese there is an 80% chance of the child will obese according to one study yan ah. 4. Physiologicsakit or inborn that may affect the medical condition of the child. 5. Socialrefers to individual behavior like advertising, marketing, social networks & subliminal integration of the 1st world. Sa nakikita ninyo big portion of food, fatty foods, hamburger, hotdogs, processed foods. Yun ang mga nakakasira sa diet ng mga anak ninyo. Saan ba tayo mas lamang social ba, cultural or environmental ba? P7- more on environmental then cultural kasi minsan binibigyan ko pera kasi naaawa ako. P4- parang halos pare-pareho lang yung tatlo na nakakaimpluwensya sa anak ko. P5- environmental then cultural, saka genetic din dahil malalaki kami eh. P3- oo nga genetic din pati sa mga commercials kasi dun siya nakakakuha ng idea, sa school nakikita naman niya sa mga classmates niya. P2- environmental kasi nakikita niya sa mga tita niya. P6- ganun din environmental, cultural then social kahit bigyan ko ng time hihirit pa yun ng extent pa. P1- environmental kasi nakikipaglaro siya sa kuya niya, kapag may homework pag nakita niya si kuya gagawa din siya. Minsan naman maglalaro siya kasama pa din dapat si kuya.

R- physiologic, sino ba ang may anak dito na may hika. May mga gamot kasi na nakakataba. P7- nebulize, pero pinatigil ko na kasi nasasanay anak ko sa inhaler, nagbigay na lang maintenance for allergy. R- marami tayo sa environmental kasi bahay andun na lahat. May family na talagang masasarap kumain. Lahat kasi kayo malalaki budget sa food. One reason also parents is giving-in. Role modeling, kelangan parent modeling dib a? Habang bata kaya pa nating baguhin ang behavior skills. R- PTA meeting sana makapunta kayo, be active then sana maisuggest ninyo kung ano man ang napag-usapan natin dito kasi anak ninyo din naman ang makikinabang di ba. On the recap perception natin, attitude & management we can cut down on budget of food. P7- oo kung wala siya makikita sa bahy siguro mababawasan pagkain niya. R- ang mga bata naman pwede fish araw araw portion size kelangan. Minsan tama nga pinapakain natin pero big portion naman di ba, so tataba talaga anak ninyo. P5- paano naman papayat anak ko may 10 pesos sakin sa umaga, tanghali then sa hapon. R- i can say that this focus group discussion is finished. Maybe we can apply all what weve learned and discuss this in your PTA meetings, so we can suggest, plan & add programs sa school.

APPENDIX K The International Classification of adult underweight, overweight and obesity according to BMI

BMI(kg/m2) Principal cut-off points Underweight <18.50 Severe thinness <16.00 Moderate thinness 16.00 - 16.99 Mild thinness 17.00 - 18.49 Classification Normal range Overweight Pre-obese Obese Obese class I Obese class II Obese class III 18.50 - 24.99 25.00 25.00 - 29.99 30.00 30.00 - 34.99 35.00 - 39.99 40.00

Additional cut-off points <18.50 <16.00 16.00 - 16.99 17.00 - 18.49 18.50 - 22.99 23.00 - 24.99 25.00 25.00 - 27.49 27.50 - 29.99 30.00 30.00 - 32.49 32.50 - 34.99 35.00 - 37.49 37.50 - 39.99 40.00

Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.

APPENDIX L Girls BMI-For-Age Growth Chart

Source: (PMJ) Reilly J J Postgrad Med J 2006;82:429-437

APPENDIX M Boys BMI-For-Age Growth Chart

Source: (PMJ) Reilly J J Postgrad Med J 2006;82:429-437

APPENDIX N Letter of Request to Conduct a Research in IHMC

APPENDIX O Letter of Request to Hold a Focus Group Discussion in IHMC

APPENDIX P Letter of Request to Hold a Focus Group Discussion in Olivarez College

APPENDIX Q Letter Of Invitation for Parents Focus Group Discussion in Olivarez College

APPENDIX R Letter of Designation as Statistician to Dr. Gollayan

APPENDIX S Letter of request to Hold Research in in St. James College July 18, 2011

MRS. NILDA S. SERGIO Principal Basic Education Dept. St. James College Paraaque

Dear Mrs. Sergio, Greetings! I am currently enrolled in thesis writing as a final requirement for the degree Master of Arts in Nursing major in Nursing Administration in the University of Perpetual Help Dalta Las Pias Campus. My research is entitled FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM. The focus of the study is to raise the awareness of the community and create interesting physical programs to prevent the increasing incidence of childhood obesity. In line with the objective of the study, I would like to seek your permission to allow me to gather information from primary students levels 1-3 and their parents. Rest assured that their identity and responses from questionaires and fora that will be done will be kept confidential. Hoping for your favorable response regarding this request. Sincerely,

Carlo G. Almazar, RN

noted:

Dr. Florencia C. Marfil GSE Dean

APPENDIX T Request Letter to Hold Research in Olivarez College July 18, 2011 Dr. ERIC OLIVAREZ VP Academics Olivarez College-Paraaque

Dear Dr. Olivarez, Greetings! I am currently enrolled in thesis writing as a final requirement for the degree Master of Arts in Nursing major in Nursing Administration in the University of Perpetual Help Dalta Las Pias Campus. My research is entitled FACTORS AFFECTING OBESITY AMONG PRIMARY PUPILS IN SELECTED PRIVATE SCHOOLS IN PARAAQUE CITY: BASIS FOR A COLLABORATIVE HEALTH AND WELL-BEING PROGRAM. The focus of the study is to raise the awareness of the community and create interesting physical programs to prevent the increasing incidence of childhood obesity. In line with the objective of the study, I would like to seek your permission to allow me to gather information from primary students levels 1-3 and their parents. Rest assured that their identity and responses from questionaires and fora that will be done will be kept confidential. Hoping for your favorable response regarding this request.

Sincerely,

Carlo G. Almazar, RN

noted:

Dr. Florencia C. Marfil GSE Dean

APPENDIX U Data Computations

DATA AND COMPUTATION OF PARENT AND PUPILS RESPONSES ON CULTURAL, SOCIAL AND ENVIRONMENTAL FACTORS (RELATIONSHIP)
PARENTS 3.6 3 2.8 3 2.6 3.4 3.6 3.6 3.8 4.4 4 3 3.6 3.2 2.4 2.6 3.8 3.4 3.2 3.2 3.6 3.6 3.8 3.2 3.8 2.8 2 2.8 3.8 3 2.8 3.4 PUPILS 4.4 3.6 4.2 4.2 3 4.4 3 3.8 3.8 4.8 3.2 3.8 2 3.2 2.6 3 3.6 1.8 4.2 1.6 3.2 4.8 2.6 2.6 1.8 1.8 2.6 3.4 2.6 3 3.4 4.4 PARENT 2.4 3 3.2 3.4 3.6 3 3.4 3.4 4.2 4 4.6 3.8 3.6 3.6 3.6 3.2 3.6 4.4 3.2 3 3.2 3.8 3.8 2.6 3 3.4 3.4 3.6 3.8 2.8 3.4 4 PUPILS 3.4 4.6 3.8 3.2 4 3.2 3 4.6 3.8 4.2 3.4 3.8 3.4 3 1.4 3 4.2 3.4 4.8 4 2.8 4.8 3 1.6 2.2 2.2 1.8 2.6 4 3.6 5 4 PARENT 3.8 3 2 2.8 2.4 2 3.6 3 3.4 4 3.4 2.6 3.4 2.4 2.6 3.4 2 3.4 2.6 3.2 3.2 3.2 3.6 3 2.8 3.2 2.6 2.4 3.4 3.6 3.2 3.4 PUPILS 3.4 2.6 3.8 3.8 4.2 3 3 4.2 3.4 2.6 2.2 3.4 3 3.2 2 3 3.4 3 4.8 2.6 3.4 3.4 3.2 1.6 3 2.6 2.2 3.8 2.4 2.6 3.4 3.6 PARENTS 3.267 3.000 2.667 3.067 2.867 2.800 3.533 3.333 3.800 4.133 4.000 3.133 3.533 3.067 2.867 3.067 3.133 3.733 3.000 3.133 3.333 3.533 3.733 2.933 3.200 3.133 2.667 2.933 3.667 3.133 3.133 3.600 PUPILS 3.733 3.600 3.933 3.733 3.733 3.533 3.000 4.200 3.667 3.867 2.933 3.667 2.800 3.133 2.000 3.000 3.733 2.733 4.600 2.733 3.133 4.333 2.933 1.933 2.333 2.200 2.200 3.267 3.000 3.067 3.933 4.000

3 3.6 1.4 4.4 3.2 3 2.6 3.2 1.8 2.8 3.2 3 3 2.4 3.8 3 4.4 3.2 3.4 3.6 3 3.8 4.2 3.6 3.2 3.2 2.6 3 2.8 3.4 3.6 2.8 2.4 2.8 4.6 3.6 3.2 2.8 2.8

3 4.2 2.8 3.6 2.6 4.4 2.8 2.2 5 5 2.2 3.8 2.6 4 3.6 2.4 2.6 2.8 1.8 4.2 4.2 3.4 3 2.2 1.8 2.8 2.4 2.8 3.6 1.8 1.6 3.4 3.4 3.4 1.8 2.6 3 3.8 3.4

3.8 3.4 2.2 2.6 4.2 3.8 3.6 3.2 2.6 3.6 3.4 3 3.4 3.4 3.6 3.8 4.6 3.4 4 4.2 4.4 3.8 4.4 3.4 4.2 3 3.4 3.8 3 3.2 3.4 3.6 2.6 3.6 4.6 3.6 3 3.2 2.6

3.4 2.8 2 3.8 3.8 3.2 3.6 2.4 3.6 3.8 1.4 3.6 3.8 4.6 1.8 3 3.4 2.6 3.8 3.4 2.2 3.4 3.4 3.6 3.6 4.2 2.4 3.4 2.8 1 3.6 4.2 2.2 3.4 3 3 2.8 4.8 4.6

3 3.2 1.8 3.8 2.4 3.4 2 2.4 2.2 2.6 2.6 3.6 2.4 3.2 3.6 2.8 3 2.6 3.6 3 4.6 3.8 3.6 3.6 3.2 2 3 3.4 3.8 2.4 2.6 2.6 2.4 2.4 3 3 3 3.2 3

2.8 4.2 2.4 3.6 3.6 2.8 3.4 3.4 4.4 4 3 3.4 3.4 3.8 2.6 2.4 2.4 2.4 3.2 3 2.2 2.4 2.6 2.2 3.2 1.8 2.2 4.2 3.6 3.4 3.6 4.2 3 3.4 3.4 3 2 3.2 3.4

3.267 3.400 1.800 3.600 3.267 3.400 2.733 2.933 2.200 3.000 3.067 3.200 2.933 3.000 3.667 3.200 4.000 3.067 3.667 3.600 4.000 3.800 4.067 3.533 3.533 2.733 3.000 3.400 3.200 3.000 3.200 3.000 2.467 2.933 4.067 3.400 3.067 3.067 2.800

3.067 3.733 2.400 3.667 3.333 3.467 3.267 2.667 4.333 4.267 2.200 3.600 3.267 4.133 2.667 2.600 2.800 2.600 2.933 3.533 2.867 3.067 3.000 2.667 2.867 2.933 2.333 3.467 3.333 2.067 2.933 3.933 2.867 3.400 2.733 2.867 2.600 3.933 3.800

3 4 1.8 2.8 2.8 3.8 3.4 3.8 2.6 3.4 2.8 3.2 3.6 2.4 3.6 4.2 2 3.2 3.4 2.4 2.4 2.4 2.8 3.4 2.8 2.6 3.8 2.8 3.4 3 2.8 2.4 3.2 2.6 3.6 2.2 2.8 3.6 2.4

3.4 3 2.6 4 2.8 1.8 2.6 2.8 3.4 2.6 3.2 2.2 3.4 3.2 3.2 3 1.8 3.8 3.4 1.4 1.8 1.2 2.8 2.8 3.4 2.4 2.2 3 3 3.4 4 1.2 2.6 3 2.6 2.6 1.4 2.8 3.6

3.2 4 2.4 2.6 2.8 2.8 3.6 4.4 2.8 3.6 3 3.6 4.2 3.2 4 3.8 2.2 3.2 2.4 3.2 3.8 2.6 3.4 3 3.6 2.6 4 3.2 3.4 3.6 3 3 4.2 3.6 3.8 2.6 2.2 3.6 3

3.4 3.6 3.8 4 2.4 4.2 4.2 4.6 4.2 3.4 4.6 4.6 4.8 5 5 3 3.2 4.2 3 1 2.6 1.8 4 2.8 3 2.6 4.2 3.4 4.4 3.2 2 1.4 2.6 3 3 2.6 1.6 2.8 3.8

2.6 3.8 2 2.2 3 2.6 3 2.8 2.4 3.2 2.4 2.8 3.8 2.2 3 3 2.6 2.8 3 2.4 3 3.2 2.8 2.8 3 3 4 2 3.2 3.2 2 3.8 2.6 3.2 3.4 2.6 3.8 3.2 2.6

3.4 3.4 2.2 3.6 1.6 3.2 4.2 3.8 3 3 3.8 3.4 3.8 2.8 4.2 2.8 2.2 4.2 3.2 1.4 3 1.8 4 2.4 3.4 1.6 3.8 2.4 3.6 2.6 1.2 1.8 3.4 2.8 3 2.4 1.4 2.6 3.4

2.933 3.933 2.067 2.533 2.867 3.067 3.333 3.667 2.600 3.400 2.733 3.200 3.867 2.600 3.533 3.667 2.267 3.067 2.933 2.667 3.067 2.733 3.000 3.067 3.133 2.733 3.933 2.667 3.333 3.267 2.600 3.067 3.333 3.133 3.600 2.467 2.933 3.467 2.667

3.400 3.333 2.867 3.867 2.267 3.067 3.667 3.733 3.533 3.000 3.867 3.400 4.000 3.667 4.133 2.933 2.400 4.067 3.200 1.267 2.467 1.600 3.600 2.667 3.267 2.200 3.400 2.933 3.667 3.067 2.400 1.467 2.867 2.933 2.867 2.533 1.467 2.733 3.600

3.2 3.2 3.6 3 2.8 2.8 3.4 3.2 3.4 2.6 3.2 2.4 3.6 3.2 2.8 3.6 1.6 3.4 2.8 4 2.6 2.8 2.6 3.8 1.8 3.6 2.2 2.8 3.6 3.4 3.2 2.8 3.4 2.2 3 2.4 3.2 3.6 4.2

3.4 3 4.2 2.6 2.8 2.2 3 2.6 4.2 1.6 2.4 2 2.2 2.2 2.2 3 2.8 2.6 2.4 3 2.4 2.4 2.8 2.2 2.2 4 2.2 2.8 2.2 3.4 2 2.6 2.2 3 3.2 3.2 1.4 2.6 3.8

2.6 3.4 3.4 4 3.4 3.8 3.8 3 3.6 3 3 3.2 3.2 3.2 2.8 3.8 3 3.2 3.2 4.2 3.6 3.8 3 4 1.8 3.6 3 2.6 4 3.2 2.6 2.6 4.4 3 3.2 3.2 1.6 3.6 4.6

3.8 3.4 3.4 4.2 3.8 3 1.8 3.6 4 2.8 3 3 3.4 3.6 1.8 4.6 3.4 3.4 3.2 3.6 3.4 3 3.6 3 4.4 3.6 3 2.8 2.8 4.8 2.6 3.6 4.2 2.6 3.4 3.4 2.4 2.6 3

4.8 3.2 2.6 2.2 3.2 3.8 5 3 3.6 2.6 2.8 2.6 3.4 3.8 3.8 4 3 3 2.8 4 3.2 3.4 3.8 3 1.6 2.6 2.2 3.6 3.4 3.2 3.4 2.8 2.8 2.8 2.4 3.2 2.4 3.4 3.4

3.6 3.4 3.8 3.4 3.2 2 2 2.2 3.2 2.6 3.6 2 3.4 2.6 2.8 3.8 2.8 3.8 1.8 3.4 2.4 3 2.8 2.8 2 3.2 2.2 3 2.4 3 2.8 4.2 2 3 4.4 3 2 2.6 2.8

3.800 3.267 3.200 3.067 3.133 3.467 4.067 3.067 3.533 2.733 3.000 2.733 3.400 3.400 3.133 3.800 2.533 3.200 2.933 4.067 3.133 3.333 3.133 3.600 1.733 3.267 2.467 3.000 3.667 3.267 3.067 2.733 3.467 2.667 2.933 2.933 2.400 3.533 4.067

3.600 3.267 3.800 3.400 3.267 2.400 2.267 2.800 3.800 2.333 3.000 2.333 3.000 2.800 2.267 3.800 3.000 3.267 2.467 3.333 2.733 2.800 3.067 2.667 2.867 3.600 2.467 2.867 2.467 3.733 2.467 3.467 2.800 2.867 3.667 3.200 1.933 2.600 3.200

3 3.2 4.2 2.4 3.4 3.6 1.6 2.8 2.8 3.6 2.6 3.110

2 1.6 3.6 1.4 2.6 1.8 2.4 3.4 3 2.2 1.8 2.891

2.8 4 4.6 3.8 3.2 3.6 2.8 2.2 3.6 3.4 2.6 3.373

2.2 3.2 3 3.6 3.8 3.8 3 2.8 3.8 3.8 2.8 3.319

3.6 3.8 4 2.6 3 3 4.2 3.2 2.4 3.4 2.6 3.031

2 1.8 3.6 2.8 2.8 2.4 3.2 2.6 3.4 2.4 2 2.980

3.133 3.667 4.333 2.933 3.267 3.333 2.933 2.733 3.067 3.333 2.600

2.067 2.200 3.400 2.600 3.067 2.667 2.867 2.933 3.400 2.800 2.200

CULTURAL PARENTS PUPILS

PARENTS 1 0.1188011

PUPILS

SOCIAL PARENT PUPILS

PARENT 1 0.1821491

PUPILS

ENVIRONMENTAL PARENT PUPILS

PARENT 1 -0.055364

PUPILS

OVERALL PARENTS PUPILS

PARENTS 1 0.1580193

PUPILS

Computed CORRELATES Cultural Factors: Parent and Pupil - Ratings Social Factors: Parent and Pupil - Ratings Environmental Factors: Parent and Pupil - Ratings Overall Factors: Parent and Pupil - Ratings 0.158 -0.055 0.182 0.119 r-value

Computed t-value* Significance

1.504

Not Significant

2.329

Significant

-0.697

Not Significant

2.0115

Significant

Relationship on BMI of parents and BMI percentile of pupils

PARENTS 3.267 3.000 2.667 3.067 2.867 2.800 3.533 3.333 3.800 4.133 4.000 3.133 3.533 3.067 2.867 3.067 3.133 3.733 3.000 3.133 3.333 3.533 3.733 2.933 3.200 3.133 2.667 2.933 3.667 3.133 3.133 3.600 3.267 3.400

PUPILS 3.733 3.600 3.933 3.733 3.733 3.533 3.000 4.200 3.667 3.867 2.933 3.667 2.800 3.133 2.000 3.000 3.733 2.733 4.600 2.733 3.133 4.333 2.933 1.933 2.333 2.200 2.200 3.267 3.000 3.067 3.933 4.000 3.067 3.733

N G1 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

BMI of Parents (Mothers) 30.9 21.9 20.7 24.6 25.7 25.6 21.8 22.3 24.9 22.3 21.2 27.3 31.2 27 22.5 25.3 21.1 21 23.4 24 24.3 30.4 22.3 25.2 20.5 26.6 20.6 22.3 23.8 61 23.4 35.5 21.3 30.2

BMI Percentile of Pupils 95.6 94.4 95.8 87.5 89.4 98.7 96 98.4 97.4 99.7 99.1 99.2 93.1 95.5 94 93.5 95.8 98.1 98.5 99.1 94.8 95.1 91.2 88 93.2 98.2 87.5 94.4 87.3 95.7 90.2 94 99.4 99.5

1.800 3.600 3.267 3.400 2.733 2.933 2.200 3.000 3.067 3.200 2.933 3.000 3.667 3.200 4.000 3.067 3.667 3.600 4.000 3.800 4.067 3.533 3.533 2.733 3.000 3.400 3.200 3.000 3.200 3.000 2.467 2.933 4.067 3.400 3.067 3.067 2.800 2.933 3.933

2.400 3.667 3.333 3.467 3.267 2.667 4.333 4.267 2.200 3.600 3.267 4.133 2.667 2.600 2.800 2.600 2.933 3.533 2.867 3.067 3.000 2.667 2.867 2.933 2.333 3.467 3.333 2.067 2.933 3.933 2.867 3.400 2.733 2.867 2.600 3.933 3.800 3.400 3.333

35 36 37 38 39 40 G2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

22.7 33.3 24.6 31 20.1 26.2 25.2 23.8 20.8 24.9 21.3 22.3 16.6 20.8 40.5 22.7 17 22.7 22 20.7 21.5 28.2 21.6 25.8 20.6 20.5 20.1 22.9 24 20.4 22.6 26 15.8 26.7 22 22.9 19.5 31.1 34.3

99.7 88.3 99.2 90.2 96.9 92.1 85.2 95.9 99.6 91 99.4 96.9 98.7 88.7 98 94.1 87.4 91.5 98.5 92.8 97.7 99.1 93.5 90.6 97.2 93.3 99.7 95.5 99.1 98.3 97.4 93.4 91.8 95.4 91.5 89.7 99 99.4 97.6

2.067 2.533 2.867 3.067 3.333 3.667 2.600 3.400 2.733 3.200 3.867 2.600 3.533 3.667 2.267 3.067 2.933 2.667 3.067 2.733 3.000 3.067 3.133 2.733 3.933 2.667 3.333 3.267 2.600 3.067 3.333 3.133 3.600 2.467 2.933 3.467 2.667 3.800 3.267

2.867 3.867 2.267 3.067 3.667 3.733 3.533 3.000 3.867 3.400 4.000 3.667 4.133 2.933 2.400 4.067 3.200 1.267 2.467 1.600 3.600 2.667 3.267 2.200 3.400 2.933 3.667 3.067 2.400 1.467 2.867 2.933 2.867 2.533 1.467 2.733 3.600 3.600 3.267

34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 G3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14

22.9 20.1 20.4 21.5 23 21.8 21.9 24.7 23.4 25.3 26.2 19.5 29.2 27.4 23.8 23.4 21.9 23.4 27.5 22.4 20.8 24.1 30.2 23.4 24.1 20.6 21.9 27.1 28 24.9 18.3 22.3 21.3 22.8 24.9 23 22.1 18.7 29.1

88.6 91.5 95 92.3 92.8 98.6 96.1 95.3 90.4 98.5 91.4 91.7 93 96.2 94.1 99.4 89.3 98.6 98.5 96.3 98.3 99 98.9 97.1 91.4 97.9 97.2 96.4 91.6 90.2 98.2 99.3 98.6 91.6 91.2 96.7 85.5 88.8 91.9

3.200 3.067 3.133 3.467 4.067 3.067 3.533 2.733 3.000 2.733 3.400 3.400 3.133 3.800 2.533 3.200 2.933 4.067 3.133 3.333 3.133 3.600 1.733 3.267 2.467 3.000 3.667 3.267 3.067 2.733 3.467 2.667 2.933 2.933 2.400 3.533 4.067 3.133 3.667

3.800 3.400 3.267 2.400 2.267 2.800 3.800 2.333 3.000 2.333 3.000 2.800 2.267 3.800 3.000 3.267 2.467 3.333 2.733 2.800 3.067 2.667 2.867 3.600 2.467 2.867 2.467 3.733 2.467 3.467 2.800 2.867 3.667 3.200 1.933 2.600 3.200 2.067 2.200

15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53

21.2 26.2 20.8 19.5 25.6 22 22.3 30.2 25.6 30.2 22 22.5 25 24.8 29.8 25.7 14.2 24.1 25.7 18.9 24 17.7 22.4 29.9 29.3 25.6 21.3 20.4 19.5 22 21.9 22.7 21 27.3 19.5 31 25.3 21.8 32.6

98.1 92 97.3 99 94.3 98.2 95.7 98.3 97.2 97.8 98.6 98.4 94.6 92.4 92.1 94.9 98.2 95.2 96.2 94.7 98.9 97.6 88.5 89.9 94.6 97.9 97.8 97.8 99.3 95.5 96.2 87.6 92 99.4 95.7 98.6 95 98.9 98.8

4.333 2.933 3.267 3.333 2.933 2.733 3.067 3.333 2.600

3.400 2.600 3.067 2.667 2.867 2.933 3.400 2.800 2.200

54 55 56 57 58 59 60 61 62

27.5 23.4 23.8 19.5 22.7 25 22.3 33.2 22.1

91.8 93.3 96.5 94 99.5 90.3 91.9 99 92.8

Computed CORRELATES Parent and Pupil - BMI's r-value 0.005

Computed t-value* 0.069 Significance Not Significant

Frequency and Mean Rating of the Two Groups

PARENT-RESPONDENTS

A. CULTURAL FACTOR INDICAT OR 1 2 3 4 5 ALWA YS 2 8 27 5 67 VERY OFTEN 7 33 43 26 60 SOMETIM ES 64 75 58 71 32 NEVE R 30 18 4 18 0 WEIGHTED MEAN 2.34 2.92 3.38 2.75 4.21 3.12 DESCRIPTI ON Seldom Sometimes Sometimes Sometimes Very Often Sometimes RAN K 5 3 2 4 1

SELDOM 57 26 28 40 1 OVERALL MEAN

B. SOCIAL FACTOR INDICAT OR 1 2 3 4 5 ALWA YS 35 6 33 54 8 VERY OFTEN 43 32 60 52 30 SOMETIM ES 58 75 51 44 63 NEVE R 10 11 2 1 14 WEIGHTED MEAN 3.49 2.91 3.68 3.93 2.83 3.37 DESCRIPTI ON Sometimes Sometimes Very Often Very Often Sometimes Sometimes RAN K 3 4 2 1 5

SELDOM 14 36 14 9 45 OVERALL MEAN

C. ENVIRONMENTAL FACTOR INDICAT OR 1 2 3 4 5 ALWA YS 55 8 5 13 7 VERY OFTEN 70 12 21 29 25 SOMETIM ES 35 65 71 65 72 NEVE R 0 22 18 10 9 WEIGHTED MEAN 4.13 2.57 2.69 2.95 2.84 3.03 DESCRIPTI ON Very Often Sometimes Sometimes Sometimes Sometimes Sometimes RAN K 1 5 4 2 3

SELDOM 0 53 45 43 47 OVERALL MEAN

PUPIL-RESPONDENTS

A. CULTURAL FACTOR INDICAT OR 1 2 3 4 5 ALWA YS 26 40 54 18 62 VERY OFTEN 9 15 15 11 21 SOMETIM ES 29 55 44 25 40 NEVE R 71 33 14 84 20 WEIGHTED MEAN 2.34 3.08 3.39 2.11 3.55 2.89 DESCRIPTI ON Seldom Sometimes Sometimes Seldom Very Often Sometimes RAN K 4 3 2 5 1

SELDOM 25 17 33 22 17 OVERALL MEAN

B. SOCIAL FACTOR INDICAT OR 1 2 3 4 5 ALWA YS 56 21 75 79 58 VERY OFTEN 15 10 19 14 14 SOMETIM ES 50 34 24 29 59 NEVE R 30 64 21 22 15 WEIGHTED MEAN 3.36 2.33 3.66 3.70 3.54 3.32 DESCRIPTI ON Sometimes Seldom Very Often Very Often Very Often Sometimes RAN K 4 5 2 1 3

SELDOM 9 31 21 16 14 OVERALL MEAN

C. ENVIRONMENTAL FACTOR INDICAT OR 1 2 3 ALWA YS 76 25 12 VERY OFTEN 9 18 14 SOMETIM ES 42 62 50 NEVE R 20 30 52 WEIGHTED MEAN 3.68 2.89 2.39 DESCRIPTI ON Very Often Sometimes Seldom RAN K 1 4 5

SELDOM 13 25 32

4 5

39 39

15 16

37 44

34 32 OVERALL MEAN

35 29

2.93 3.03 2.98

Sometimes Sometimes Sometimes

3 2

MOTHER height 50 5'0 5'6 1/2 5'5 1/2 5'4 5'2 5'6 5'2 5'4 5'2 5'1 5'1 5'3 5'4 4'11 5'2 5'2 5'4 5'2 5'2 5'4 4'11 5'3 5'2 weight 158.4 lbs. 112 lbs. 130 lbs 150 lbs. 150 lbs. 140 lbs. 135 lbs. 122 lbs. 130 lbs. 130 lbs. 132 lbs. 132 lbs. 120 lbs. 130 lbs. 102 lbs. 143 lbs. 148 lbs. 163 lbs. 136.4 lbs. 100 lbs. 130 lbs. 105.6 lbs. 154 lbs. 136 lbs. BMI 30.9 21.9 20.7 24.6 25.7 25.6 21.8 22.3 22.3 23.8 24.9 24.9 21.3 22.3 20.6 26.2 27.1 28 24.9 18.3 22.3 21.3 27.3 24.9 OB N N N OW OW N N N N N N N N N OW OW OW N N N N OW N 7 4 5 6 2 3 1 height 120.4 113.8 126.6 120 120.2 121.8 115.2 129.4 125.2 123.5 135.1 123 135.5 132.5 130.9 127.5 133.9 132.8 134 130.1 150.5 131.1 141.8 139

PUPIL weight 28 25 31 25.6 26 31 26 37.5 28 31 50.5 28.5 49.5 38 40 38 39.5 35 37.5 40.5 67 42 42 38.5 BMI % 95.6 94.4 95.8 87.5 89.4 98.7 96 98.4 85.2 95.9 99.6 91 99.4 96.9 97.9 97.2 96.4 91.6 90.2 98.2 99.3 98.6 91.6 91.2

5'4 5'1 4'11 5'0 5'3 5'3 5'5 5'4 4'9 5'4 5'1 5'2 5'3 5'4 1/2 5'6 5'3 5'1 5'1 4'11 5'2 5'0 5'3 5'2 5'2 5'0 5'4 5'3 5'0 5'4 5'5 5'3 5'0 5'4 5'4

145 lbs. 143 lbs. 105 lbs. 118 lbs. 176 lbs. 140 lbs. 100 lbs. 121 lbs. 187 lbs. 132 lbs. 90 lbs. 121 lbs. 124 lbs. 125 lbs. 145 lbs. 125 lbs. 99 lbs. 154 lbs. 105 lbs. 143 lbs. 115 lbs. 143 lbs. 112 lbs. 115 lbs. 120 lbs. 140 lbs. 137 lbs. 155.9 lbs. 130 lbs. 150 lbs. 116 lbs. 136.4 lbs. 120 lbs. 130 lbs.

24.9 27 21.2 23 31.2 24.8 16.6 20.8 40.5 22.7 17 22.7 22 21.1 23.4 22.1 18.7 29.1 21.2 26.2 22.5 25.3 25.2 21 23.4 24 24.3 30.4 22.3 25 20.5 26.6 20.6 22.3

N OW N N OB N U N OB N U N N N N N N OB N OW N OW N N N N N OB N OW N OW N N 16 15 14 13 12 11 10 9 8

124 119.4 115.3 129.5 116.5 122.4 131.5 132.8 134.1 128.5 126.7 115 126.3 124.4 140 137 144.7 122.5 132.5 135.8 121.9 127 127 130.8 123.1 133.3 121.9 119.3 115.5 119.3 116.8 121.9 125.7 121.9

31 33.5 29 43 25.5 28.5 39 32 41 32.5 30 24.5 37 29.5 44.3 35 42.5 29.5 41 37 28.6 29.5 32.2 35.9 30.9 41.8 28.1 27.2 23.6 25.4 24.5 30.9 28.6 27.7

97.4 99.7 99.1 99.2 93.1 95.5 98.7 88.7 98 94.1 87.4 91.5 98.5 92.8 96.7 85.5 88.8 91.9 98.1 92 94 93.5 95.8 98.1 98.5 99.1 94.8 95.1 91.2 88 93.2 98.2 87.5 94.4

5'2 4'0 5'1 1/2 5'6 5'3 5'1 5'4 5'1 5'1 5'3 5'2 4'9 5'0 5'6 5'5 5'6 5'4 5'2 5'2 5'1 5'8 5'1 5'6 5'1 1/2 5'4 5'2 5'2 5'1 5'0 5'2 5'4 5'2 5'2 5'4

130 lbs. 200 lbs. 126 lbs. 220 lbs. 120 lbs. 160 lbs. 132 lbs. 176 lbs. 130 lbs. 175 lbs. 110 lbs. 121 lbs. 110 lbs. 175 lbs. 130 lbs. 160 lbs. 120 lbs. 138 lbs. 110 lbs. 121 lbs. 158 lbs. 108 lbs. 140 lbs. 140 lbs. 92 lbs. 146 lbs. 138 lbs. 121 lbs. 100 lbs. 170 lbs. 200 lbs. 125 lbs. 110 lbs. 119 lbs.

23.8 61 23.4 35.5 21.3 30.2 22.7 33.3 24.6 31 20.1 26.2 21.5 28.2 21.6 25.8 20.6 25.2 20.1 22.9 24 20.4 22.6 26 15.8 26.7 25.2 22.9 19.5 31.1 34.3 22.9 20.1 20.4

N OB N OB N OB N OB N OB N OW N OW N OW N OW N N N N N OW U OW OW N N OB OB N N N 29 30 27 28 26 25 24 23 22 21 20 19 18 17

119.3 125.7 119.3 127 121.9 123.1 127 121.9 132 113 123.1 109.6 124.4 142.2 127 132 139.7 132 116.8 130.2 132.5 131.5 134.9 132.5 120.5 129.5 134.6 127 129.5 128.2 129.5 123.1 133.3 127

25.9 31.3 25.9 30.9 33.1 34.5 41.3 26.8 40.5 22.7 30.9 22.2 32.9 49.5 31.4 31 43.6 35.5 44.5 35 45.5 37 39 34.5 28.5 34.5 33.6 29.5 40 41.3 36.8 28.1 34.5 34

87.3 95.7 90.2 94 99.4 99.5 99.7 88.3 99.2 90.2 96.9 92.1 97.7 99.1 93.5 90.6 97.2 93.3 99.7 95.5 99.1 98.3 97.4 93.4 91.8 95.4 91.5 89.7 99 99.4 97.6 88.6 91.5 95

5'4 5'1 5'4 5'0 5'2 5'3 5'0 5'0 5'3 5'4 5'2 5'2 5'0 5'2 5'2 5'4 5'8 5'1 5'2 5'2 5'6 5'0 5'1 5'0 5'2 5'4 5'2 1/2 5'2 5'2 5'2 5'4 4'9 5'5 5'3

125 lbs. 110 lbs. 127 lbs. 112 lbs. 135 lbs. 132 lbs. 129.8 lbs. 120 lbs. 110 lbs. 170 lbs. 150 lbs. 130 lbs. 120 lbs. 120 lbs. 128 lbs. 160 lbs. 147.4 lbs. 110 lbs. 132 lbs. 165 lbs. 145 lbs. 123.2 lbs. 110 lbs. 100 lbs. 140 lbs. 128 lbs. 115 lbs. 165 lbs. 140 lbs. 165 lbs. 128 lbs. 114.1 lbs. 150 lbs. 140 lbs.

21.5 20.8 21.8 21.9 24.7 23.4 25.3 23.4 19.5 29.2 27.4 23.8 23.4 21.9 23.4 27.5 22.4 20.8 24.1 30.2 23.4 24.1 20.8 19.5 25.6 22 20.7 30.2 25.6 30.2 22 22.5 25 24.8

N N N N N N OW N N OW OW N N N N OW N N N OB N N N N OW N N OB OW OB N N OW N 40 37 38 39 36 35 34 32 33 31

135.8 124.4 130.8 129.5 134.6 124.4 129.5 121.9 130.8 127 129.5 132 137.1 134.6 132 138.4 140.9 140.9 128.2 132 134.6 121.9 117.8 135 137 128.5 136.2 144 131 140.5 137 128.2 133.5 127

35 30 40.4 35 37.3 29 41 29.5 32.2 31.8 34 33.6 49.5 33.6 40.4 43.1 42.7 47.2 41.3 41.3 40 28.1 31.5 47.5 39.5 39.5 41 51.5 38.5 47 49.5 40 36 32

92.3 92.8 98.6 96.1 95.3 90.4 98.5 91.4 91.7 93 96.2 94.1 99.4 89.3 98.6 98.5 96.3 98.3 99 98.9 97.1 91.4 97.3 99 94.3 98.2 95.7 98.3 97.2 97.8 98.6 98.4 94.6 92.4

5'4 5'4 5'11 5'1 1/2 5'2 5'4 5'4 5'3 5'1 5'4 5'2 5'2 5'3 5'3 5'0 5'5 5'2 5'1 5'2 5'3 5'3 5'3 5'1 5'2 5'4 4'11 5'0 5'2 5'2 5'1 5'5 5'4

120 lbs. 150 lbs. 102 lbs. 118 lbs. 140.8 lbs. 110 lbs. 140 lbs. 100 lbs. 118.8 lbs. 174 lbs. 160 lbs. 140 lbs. 120 lbs. 115 lbs. 100 lbs. 132 lbs. 120 lbs. 120 lbs. 115 lbs. 154 lbs. 110 lbs. 175 lbs. 134 lbs. 112 lbs. 190 lbs. 136.4 lbs. 120 lbs. 130 lbs. 110 lbs. 120 lbs. 150 lbs. 130 lbs. 209 lbs.

20.6 25.7 14.2 21.9 25.7 18.9 24 17.7 22.4 29.9 29.3 25.6 21.3 20.4 19.5 22 21.9 22.7 21 27.3 19.5 31 25.3 20.5 32.6 27.5 23.4 23.8 19.5 22.7 25 22.3

N OW U N OW N N U N OW OW OW N N N N N N N OW N OB OW N OB OW N N N N OW N 51 49 50 47 48 46 43 44 45 42 41

144.5 132.2 138.8 127.8 137.5 132 145.2 136.5 135 129.2 131.5 131.5 133 134.8 125 137 134.8 130.2 126.9 139 130 134.3 132 141.5 137.8 121.1 137.4 127.8 124.2 130.8 145.8 140.2

45.5 36.5 46.5 34.5 41 36.5 55.5 43 35.5 32.5 38 42 45 42.5 44 40.5 39 32 31.5 53 36 44.5 37.5 54 49 28.5 39 35 30.5 53.5 43.5 40.5

92.1 94.9 98.2 95.2 96.2 94.7 98.9 97.6 88.5 89.9 94.6 97.9 97.8 97.8 99.3 95.5 96.2 87.6 92 99.4 95.7 98.6 95 98.9 98.8 91.8 93.3 96.5 94 99.5 90.3 91.9 MOTHER BMI MOTHER BMI PUPIL BMI%

5'6 1/2

33.2

OB

52

133

46

99

5'2

121 lbs.

22.1

N proportion of OB/OW to N =

127.6

34

92.8

PUPIL BMI%

0.142114082

r = 0.14

p=

0.325

32.50%

CURRICULUM VITAE

Name Address

Gender Date of Birth Place of Birth Civil Status Religion Present Position Office Address EDUCATIONAL BACKGROUND Graduate Studies:

: Carlo G. Almazar : #7 Sandalwood St., Phase 2, Greenwoods Executive Village, Pasig City : Male : July 28, 1971 : Pasay City : Single : Roman Catholic : Volunteer Nurse : Medical Center Paraaque- Sucat Rd. Pque. : Master of Arts in Nursing major in Nursing Administration University of Perpetual Help System Dalta Las Pias City : Bachelor of Science in Nursing Olivarez College Paraaque Bachelor of Science in Hotel and Restaurant Management UST-Espaa, Manila : La Salle Greenhills Ortigas Ave., Mandaluyong City : La Salle Greenhills Ortigas Ave., Mandaluyong City

Tertiary:

Secondary: Elementary:

EXAMINATIONS PASSED

: Nursing Licensure Exam (NLE) June 2009 : Career Service Sub-professional Examination (CS-CAT) CSC-NCR, Quezon City. April 18, 2001

WORK EXPERIENCES

: Volunteer Nurse Medical Center Paraaque, Pque. City Oct. 2009- Present : Clerk I- Paraaque Livelihood and Resource Management Office Paraaque City Government June 2006- June 2007 : Clerk I- Accounting Department Paraaque City Government March 2000- June 2006 : Assistant Manager NAIA Caltex (Chevron) Feb. 1995- Oct. 1999

SEMINARS/TRAININGS ATTENDED

: Investigator Training Program and Good Clinical Practice Workshop UPHDMC, Las Pias. Oct. 2010 : Dialysis Nursing UPHSD, Las Pias. Sept. 2010 : Nurse Entrepreneurship: Alternative Road to Success UPHSD, Las Pias. Sept. 2010

: Values Integration in Different Learning Areas Towards Human Capital Development UPHSD, Las Pias. July, 2010 : Care for those with Chronic and Life Threatening Illnesses Asian Hospital and Medical Center Alabang, Muntinlupa City. March, 2010 : Regular I.V. Training Program MPI- Medical Center Muntinlupa, Muntinlupa City. Oct, 2009 : Basic Life Support Training PNRC- Las Pias City sub-chapter. Sept. 2009 : Client Safety, Security and Privacy Requirements in Medical-Surgical Nursing Practice: A Seminar Workshop for Nursing Students and New Professionals. by: Dr. Joyce M. Black, RN, CPCN, CWCN SMX Convention Center, Pasay City. Jan. 2009 : Nursing InformaticsKey to Global Competency and Competitiveness Olivarez College, Pque. City. Nov. 2008 : Therapeutic Communication Techniques in Psychiatric Nursing: Practicing Responsible, Assertive and Caring Client Interactions. by: Dr. Sheila Videbeck, RN World Trade Center, Pasay City. Aug. 2008

: The 2nd Basic mini Audiology Workshop SSMC, Pque. City. July 2007 : Managers and Supervisors training Course Caltex Philippines Inc. (Chevron), Makati City. May 1998