“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE REGARDING

THE EFFECTS OF FAST FOOD ON HEALTH AMONG

ADOLESCENTS IN SELECTED PRE UNIVERSITY

COLLEGE OF RAICHUR, KARNATAKA”

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

GINU GEORGE

NAVODAYA COLLEGE OF NURSING,

RAICHUR, DECEMBER 2009

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION.

1. Name of the Candidate : Mr.Ginu George

M.Sc.Nursing 1st Year

Navodaya College Of Nursing,

Raichur.

2. Name of the Institute : Navodaya College of Nursing,

Raichur

3. Course of Study and Subject : M.Sc.Nursing. 1st Year

Child Health Nursing.

4. Date of Admission : 12-06-09

5. Title of the Topic :

“A Study to Assess the Effectiveness of Structured Teaching Programme on

Knowledge Regarding the Effects of Fast Food on Health Among

Adolescents in Selected Pre University College of Raichur,

Karnataka”.

6. Brief resume of the intended work

6.1Need for the study

"It is nice to have money and the things that money

can buy, but it's important to make sure you haven't lost the

things money can't buy."

George Lorimer

Food is an important part of a balanced diet. It is

something everyone needs, every day. Life can be sustained

only with adequate nourishment. Man needs food for growth,

development and to lead an active and healthy life. Food is a

substance, usually composed of carbohydrates, fats, proteins and

water that can be eaten or drunk by an animal or human for

nutrition or pleasure.

Fast food is the term given to food that can be

prepared and served very quickly. The term "fast food" was

recognized in a dictionary by Merriam–Webster in 1951. Fast

food is any food that is quick, convenient, and usually

inexpensive. . It’s delicious, it’s filling, is really affordable, and

readily available just any time of the day, being only a drive

through phone call away .While any meal with low preparation

time can be considered to be fast food, typically the term refers to

food sold in a restaurant or store with low quality preparation and

served to the customer in a packaged form for take-out or take-

away.1

Fast food operations are now an important part

of modern catering practice largely through the growth of

international franchise chains. Fast foods are available in places

sells food and snacks. Vending machines, drive-thru restaurants,

and 24 hour convenience stores are probably the most common

places to find fast food. Fast food is inexpensive because it is

usually made with cheaper ingredients such as high fat meat,

refined grains, and added sugar and fats, instead of nutritious

foods such as lean meats, fresh fruits, and vegetables .2

Adolescence is a transitional period between

childhood and adulthood, which begins from the earliest signs of

secondary sexual characteristics development and ends when a

person has achieved adult status (WHO, 1995).Hence, dramatic

changes and development of the physical, emotional and cognitive

functions occur during adolescence. In order to achieve optimal

growth and development during adolescence, the nutritional

requirements are the highest across the life span. Practicing

healthy eating behavior is one of the important factors to meet the

nutritional needs of adolescents..3

Adolescent period is characterized by heavy

demands of calorie and proteins. The appetite of the child

increases and he tends to consume more carbohydrate foods.

Intake of vitamin C and vitamin A may be low due to improper

habits of eating snacks.4

Consumption of fast food has increased

rapidly since the 1970s among adolescents from all

socioeconomic and racial/ethnic groups across the “United

States," the authors provide as background information in the

article. "An estimated 75 percent of adolescents eat fast food one

or more times per week. The increase in fast food consumption

parallels the escalating obesity epidemic, raising the possibility

that these 2 trends are causally related," the authors suggest.

"Characteristics of fast food previously linked to excess energy

intake [overeating] or adiposity [fat] includes enormous portion

size, high energy density, and palatability, excessive amounts of

refined starch and added sugars, high fat content and low levels of

dietary fiber." 5

The most common fast foods available in India are

burggers, pizzas, wraps and rolls, mini- meals, chips, samosa, pao

bhaji, panipoori, pakodas, Chinese food like gobi manchoori,

noodles, Beverages like soft drinks, coffee, shakes etc. In India

alone the fast food industry is growing by 40% a year. Eating at

home remains very much ingrained in Indian culture and changes

in eating habits are very slow moving with barriers to eating out

entrenched in certain sectors of Indian Society. The growth in

nuclear families, particularly in urban India, exposure to global

media and Western cuisine and an increasing number of women

joining the work face have had an impact on eating out trends.

Adolescent is the age group of enjoyment with friends especially

in fast food corners.

Fast food is kind of addictive; you get hooked

on to it and continue consuming it in an uncontrolled way in spite

of knowing that it is unhealthy. The more you consume, the

more difficult it is for you to opt for healthy foods.6

According to the Massachusetts Medical

Society Committee on Nutrition, fast food is especially high in fat

content, and studies have found associations between fast food

intake and increased body mass index (BMI) and weight gain Fast

food comprises a growing portion of food eaten outside the home.

In 1953, fast food accounted for 4% of total sales of food outside

the home; by 1997, it accounted for 34%. As a percentage of

discretionary food expenditure, fast food doubled from 20% in the

1970s to 40% by 1995. Finally, as a percentage of total energy

intake, fast food quintupled from 2% in the 1970s to 10% in

1995.One-third of US adults report having eaten at a fast food

outlet on any given day; 7% of Americans eat at a fast food

restaurant daily.

Our brain is the organ in affecting how we think and

move. Fast food and junk food are very low in nutrients; instead

they are full with colorings, flavors and preservatives. Researchers

have shown that junk food might cause dyslexia, ADHD

(attention deficit hyperactivity disorder) and worse is autism. An

individual's mood and attention are highly influenced by the food

taken, which means it will affect the concentration.

The effects of fast food include nutritional

deficiencies, obesity,increased cholesterol levels, cardiac problems

and many other threatening health hazards. Most of these quick

and convenient meals contain high amount of sodium, which increases

and aggravates the risks of high blood pressure. According to the

recommendations of the National Research Council of the National

Academy of Sciences 1,200 - 1,500 mg of sodium is the daily sodium

requirement for adults. Although the body requires minimum

quantities of sodium, too much sodium contributes to high blood

pressure. Sodium can also lead to building-up of fluids in case of

people who are suffering from people with congestive heart failure,

cirrhosis, or kidney disease. 7

Fast food is loaded with calories from refined sugar and

fats (especially, the artery-clogging saturated and hydrogenated fats,

which are repeatedly reheated to high temperatures for frying

purposes). Another issue in the fast food industry is the health hazards

that fast food chains are prone to. A particular hazard is the E-coli

bacteria that meat products are susceptible to. Because of the long

supply chain through which fast food chains operate in, the handling

and sourcing of the meat is very hard to monitor.

Eating fast food and leading a sedentary lifestyle leads to

obesity. Obesity leads to other complications like increase in the

cholesterol level, blocking of the arteries, the increased risk of

coronary diseases, in addition to the general physical discomfort

posed by the extra weight. Fast food is also addictive and hence it is

very difficult to give up on their greasy and fatty foods and carbonated

drinks and switch to healthier options.

Structured teaching programme is one among the methods

of health education. It helps the adolescents to get adequate

knowledge regarding the ill or harmful effects of fast foods. If they

get adequate knowledge it helps them to overcome the harmful effects

in a prior stage. In turn it will help them or encourage them to seek

appropriate and timely medical advice.

Though many studies are conducted in the field of harmful

effects of fast foods on health, the researcher could not find any valid

study to assess the effectiveness of structured teaching programme on

knowledge of adolescents regarding the harmful effects of fast food

on health. Hence the researcher felt the need for a study to find the

effectiveness of structured teaching programme on knowledge

regarding the harmful effects of fast food on health among adolescents

in selected PU College of Raichur.

6.2 Review of literature

Review of literature is a key step in research process. Review

of literature refers to extensive, exhaustive and systematic

examination of publications relevant to research project. It is the

reading and organization of previously written materials relevant to

the specific problems to the investigated; framework and methods

appropriate to perform the study.8

A study was conducted to assess the prevalence of

obesity and overweight among adolescents in Dayanand medical

college, Ludhiana, Punjab, India. Thousand samples were selected

by random, purposive sampling. Data were collected by

Questionnaire regarding dietary habits and life style. The results

were analyzed statistically by applying students’t-test, Z-test and

Chi-square (2) test. P-value <0.05 was taken as significant.

Result of this study showed that there is no significant difference

between boys and girls. A significantly greater number of boys

(15%) as compared to girls (10.2%) were overweight. Out of the

total obese children, significant percentages (82.3%) were non-

vegetarian, where as only 8.8% of vegetarians and ova-

vegetarians were obese. They concluded that the incidence of

obesity/overweight was found to be significantly higher in those

adolescents who ate meals outside home.9

A study was conducted to assess the socio-cultural and nutritional

aspects of fast food among adolescents in Allahabad city, Uttar

Pradesh, India. Thirty samples were selected by systemic sampling

method. Data were collected by structured interview schedule. Result

of the study showed that majority of fast food consumers belongs to

the age group 15-18 years and majority 66.7% of respondents had

BMI in the normal range while 29.3% were underweight. They

concluded that socio-cultural and nutritional aspects are having

influence in the consumption of fast foods.10

A study was conducted to examine the eating behaviors among

female adolescents in two secondary schools in Kuantan district,

Pahang, Malaysia.four hundred and seven samples were selected by

random sampling method. Data were collected by self-administered

Questionnaire. Result of the study showed that who usually skipped

meals were those who usually eat alone (Chi2 = 16.933, p < 0.0001),

overweight (Chi2= 15.943, p < 0.05). They concluded that, meal

skipping, snacking and practicing various weight loss behaviors were

some of the unhealthy eating behaviors depicted among adolescent

girls. The study stresses the importance of Focusing on promotion of

healthy eating that stresses on the importance of regular intakes of

main meals during adolescence is crucial for their current and future

health and well-being.11

A study was conducted to examine the relationships with parent and

adolescent food intake, home food availability and weight status. Data

were collected by parent interviews and adolescent surveys from

Project EAT (Eating among Teens). 902 middle-school and high-

school adolescents (53% female, 47% male) and their parents (89%

female, 11% male) were selected as samples. Result of this study

showed that parents who reported purchasing fast food for family

meals at least 3 times per week were significantly more likely than

parents who reported purchasing fewer fast-food family meals to

report the availability of soda pop and chips in the home. They

concluded that fast-food purchases may be helpful for busy families,

but families need to be educated on the effects of fast food for family

meals and how to choose healthier, convenient family meals.12

A study was conducted to assess the socio-environment,

personal and behavioral predictors of fast food intake among

adolescents in Minnesota schools, USA. 806 samples were selected by

random sampling method. Result of this study showed that personal

and behavioral factors, including concern about weight and use of

healthy weight-control techniques, were protective against increased

fast-food intake. Sports team participation was a strong risk factor for

increased fast-food intake among males. They concluded that

addressing socio-environmental factors such as acculturation and

home food availability may help reduce fast-food intake among

adolescents. Additionally, gender-specific intervention strategies,

including working with boys’ sports teams, family members and the

peer group, and for girls, emphasizing the importance of healthy

weight-maintenance strategies and the addition of flavorful and

healthy food options to their diet, may help reduce fast-food intake.13

A study was conducted to assess the effects of fast food on

energy intake in overweight versus lean adolescents in Boston, USA.

Fifty-four samples (26 overweight, 28 lean) were selected by

convenient sampling method. Data were collected by telephone

interviews. Result of the study showed that mean [average] energy

intake from the fast food meal among all participants was extremely

large (1,652 kcal =calories). Overweight participants ate more than

lean participants whether energy was expressed in absolute terms

(1,860 vs. 1,458 kcal) or relative to estimated daily energy

requirements (66.5 percent vs. 57 percent). They concluded that

overweight participants tended to under-report total energy intake

compared with lean participants.14

Statement of the problem

“A study to assess the effectiveness of structured teaching

programme on knowledge regarding the effects of fast food on health

among adolescents in selected Pre university college of Raichur,

Karnataka”.

6.3 Objectives of the study

To assess the existing level of knowledge regarding the effects of fast

food on health among adolescents in selected PU college of Raichur.

To implement structured teaching programme regarding effects of fast

food on health among adolescents in selected PU college of Raichur.

.

To analyze the effectiveness of structured teaching programme on

knowledge regarding effects of fast food on health among adolescents

before and after implementation.

To find the association between the knowledge regarding effects of fast

food on health among adolescents with selected socio demographic

variables.

6.4 Operational Definitions

a. Effectiveness: Determines the extent to which the structured teaching

programme has achieved the desired effect in improving the knowledge of

adolescents regarding effects of fast food on health .

b. Structured teaching programme: It refers to the type of teaching

prepared by the Investigator on the effects of fast food on health to enhance

the awareness of adolescents.

c. Knowledge: It refers to the level of understanding of the adolescents

regarding the effects of fast food on health

d. Fast food: A type of food that is often pre-prepared and served quickly.

e.Effects: It refers to the various hazards created by the fast food over the

adolescent’s normal health

f.Health: It is a state of well being, free from disease.

g.Adolescents: It refers to the children in the age group of 12-18.

6.5 Hypotheses

On the basis of the objectives of the study the following hypotheses

have been formulated.

H₁. There will be significant difference between the pre-test and post-test

Knowledge scores regarding the effects of fast food on the health of

adolescents.

H₂. There will be significant relationship between the knowledge regarding

the effects of fast food on the health of adolescents with Age, Gender,

Religion, Previous orientation training , sources of information, Diet and

Habit of taking fast food.

7. Materials and methods

7.1Source of data

Design:

One group pre-test and post-test pre-experimental design is adopted for

the present study. (O1 X O2)

O1 –pre test

X-intervention

O2-post test

Setting of the Study:

Raichur is one of the backward districts situated in Northern

Karnataka. It has an area of 6389sq.km and consists of 5 towns and 830

villages. Raichur town consists of 35 election wards and 15 revenue wards.

Raichur consists of 20 PU Colleges. Among this L.V.D College is selected

for the present study. This college is located in Ambedkar Nagar, Raichur.

Population:

The population included for the study includes adolescents who are

between the age group of 15-18 years studying in II year PUC in L.V.D

college of Raichur.

Sample Size:

Sample for the study consists of 30 adolescent’s years studying in II

year PUC in L.V.D college of Raichur.

Sampling Technique:

A purposive sampling technique will be used to select the college and

simple random sampling technique will be used to select the samples.

Inclusion Criteria:

The study includes adolescents who are

in the age group between 15-18 years..

willing to participate in the study

available at the time of data collection.

Studying in II year PUC in L.V.D college of Raichur.

Exclusion Criteria:

The study excludes adolescents who are not

in the age group between 15-18 years..

willing to participate in the study

available at the time of data collection.

Studying in II year PUC in L.V.D college of Raichur

Selected Variables: Variables included in the present study are;

Dependent variables: Knowledge regarding effects of fast food on

health among adolescents.

Independent variables: Structured teaching programme regarding

effects of fast food on health among adolescents.

Extraneous variables:

1. Age:

a. 15-16 years

b. 17-18 years

2. Gender:

a) male

b) Female

3. Religion:

a) Hindu

b) Muslim

c) Christian

4. Previous orientation training:

a) Yes

b) No

5. Sources of Information:

a) Mass media

b) Relatives

c) Neighbors

d) Friends

e) Health care professionals

6. Diet:

a) Vegetarian

b) Non-vegetarian

7. Habit of taking fast food:

a) Yes

b) No

7. METHODS OF DATA COLLECTION

7.1 Data Collection Instrument:

Data collection is the gathering of information from sample. The

researcher will develop a structured questionnaire schedule to collect the

data. It consists of two parts namely:

Part I: Deals with socio demographic information.

Part II: Represents knowledge related items regarding effects of fast

food on health among adolescents.

7.2 Data Collection Method:

After obtaining prior permission from concerned authorities and

consent from the sample, the Investigator will personally conduct a

structured questionnaire schedule before and after the implementation of

structured teaching programme. The duration of collecting data will be 25-

30 days.

Data collection will be carried out in 3phases

First phase: Pre-test will be given to assess the initial knowledge

regarding the effects of fast food on health among adolescents in

selected PU College of Raichur

Second Phase: A structured teaching programme regarding the

effects of fast food on health among adolescents in selected PU

College of Raichur.

Third phase: It consists of post-test to adolescents after a week of

structured teaching programme.

Plan for data Analysis:

Data analysis is the systematic organization and synthesis of research

data, the testing of the research hypothesis by using the obtained data. It is

planned to analyze and interpret data with help of descriptive and inferential

statistics. The following methods are planned to analyze the data.

Descriptive statistics like percentages and frequencies will be used to

describe the sample characteristics.

Mean, standard deviation and paired‘t’ test will be used to assess the

effectiveness of structured teaching programme.

Chi square test will be used to find out the relationship between

knowledge regarding the effects of fast food on health among adolescents

with selected variables.

7.3 Projected outcome

The results of the present study gives an insight for the future

researchers to inculcate different methods or types of teaching programmes in

order to improve the knowledge regarding the effects of fast food on health

among adolescents.

7.4 Does the study require investigation or interventions to be

conducted on patients of other humans or animals? If so, please describe

briefly?

Yes, the study requires intervention like enactment of structured teaching

programme and active involvement of adolescents during session.

7.5 Has ethical clearance been obtained from your institution in case of

7.4?

Permission will be obtained from the institutional ethical committee,

Navodaya College of Nursing, Raichur.

Permission will be obtained from the principal of L.V.D College,

Raichur.

Consent will be obtained from the sample

8. REFERENCES

1) Wikipedia the free encyclopedia.

2) Mohd.Nasir .M .T. “Eating behaviors among adolescents”. Pakistan

journal of nutrition 8(4); 425 – 432, 2009.

3) A.B Harrins and G.V.Robbins,”Nutrition in catering”; William hinman

publishers, London, page no; 173-175

4) Shubhangini.A.Joshy, “Nutrition and diabetes” first edition published by

Tata Mchraw-Hill publishing company limited page 183

5) Journal of American Medical Association “Adolescents over eat fast food

but lean compensate for over consumption by eating less” June 15 2004;

20.47.

6) Achieves of pediatrics and Adolescent medicine; volume 161, no.8; Aug

2007.

7) Carol west.Suiter and Merely Forbes “Nutrition –Principles And

Application in Health promotion” second edition 1984 page no;293

8) Basavanthapa.BT; Nursing Research; Bangalore, JP Brothers

Publications.

9) Aggarwal T “prevalence of obesity and over weight in adolescents” from

Ludhiana Punjab July 18 2007 journal of Indian peadiatrics; 45:500-502

10) D.kumar, P.C.Mittal, S.Singh “sociocultural and nutritional aspects of

fast food consumption among teen agers and youth “INDIAN JOURNAL

COMMUNITY MEDICINE, vol: 31, no: 3.

11)”Eating behaviors Among Female Adolescents” Pakistan journal of

nutrition 8(4), 425-432 2009

12) Boutelle.K.N “fast food for family meals” Public Health Nutrition 2007

January 16-21.

13) Kathrine.W.Bauer, “socio environmental personal and behavioral

predictors of fast food in take among adolescents”

14)Charles’s “Adolescents over eat fast food ,but lean adolescents over

consumption eating less “Journal of American medical association

2004 ,20:47

9. Signature of the Candidate :

10. Remarks of the Guide :

11. Name and Designation of :

11.1 Guide : Mrs. Shameem Gulnaz

Unnisa.

Associate Professor.

H.O.D. Child Health Nursing.

Navodaya college of Nursing,

Raichur.

11.2 Signature :

11.3 Co-Guide :

11.4 Signature : Mrs. Shameem Gulnaz

Unnisa.

Associate Professor.

H.O.D. Child Health

Nursing.

Navodaya college of Nursing,

Raichur.

11.5 Head of the Department :

11.6 Signature :

12.1 Remarks of the Chairman

& Principal :

12.2 Signature :