Tackling childhood obesity with nudge intervention Adapted from Henry Lewis Published in the Jamaica Observer, Tuesday September 25, 2018

1. Recently the Ministry of Health (which should be renamed the Ministry of Health and Well-Being) released the preliminary results of the 2016-17 Jamaica Health and Lifestyle Survey. If you haven't heard as yet, health-wise we are walking time bombs here in Jamaica. Something needs to be done now.

2. The results from the obesity statistics from the survey revealed that "one in two Jamaicans (54 per cent) was classified as overweight (pre-obese or obese). Women were more affected by pre-obesity and obesity, with two-thirds of Jamaican women 15 years or older being classified as having pre-obesity or obesity. The proportion of women with preobesity and obesity was similar among urban and rural dwellers. However, urban-dwelling men (44.7 per cent) had a higher prevalence of pre-obesity or obesity compared to men living in rural areas (33.5 per cent). Jamaicans aged 35-64 years had the highest prevalence of pre-obesity or obesity. Overall 577, 300 Jamaican are obese." ( Jamaica Health and Lifestyle Survey)

3. The World Health Organization in 2016 reported that within 27 years (1990-2017) there has been a doubling of obesity rates globally. If no serious action is done to change the lifestyle and behaviour of Jamaicans now, then in another 20 years Jamaica could be faced with a major public health crisis with close to 70 per cent of the population becoming obese, which would cost the Government millions to address. What is also alarming is the recent data that showed within five years the obesity rate in children ages 13-15 has doubled. Again, bad news for the nation's children.

4. The eminent director of non-communicable disease and injuries prevention in the Ministry of Health Dr Tamu Davidson reported that Cabinet, in 2013, had approved a plan for addressing non-communicable diseases, which included reducing the prevalence of obesity by five per cent 2013-2015. Well, we know the result of that: It increased instead of reduced. I am curious to know what were the policies put in place and the intervention strategies used by the Ministry of Health to accomplish that illustrious goal. Why did it fail to achieve the desired result?

5. Health Minister Christopher Tufton made this announcement in the House of Representatives in June: "Effective January 2019, the Government will implement a policy to restrict certain types of sugary drinks in schools. By sugary drinks, we mean beverages that contain sugar or syrup that is added by the manufacturer. It does not include, Mr Speaker, 100 per cent juice or unsweetened milk." 6. It is a fact that regularly consuming sugary drinks is associated with growing rates of obesity, diabetes and tooth decay, particularly among children. In addition to the ban in schools, what should the national approach be to combat this problem? Fighting noncommunicable diseases like obesity is no easy task for any Government. One tool that the Government can also consider to combat the issues of sugary drinks is the use of health policy in the form of nudge interventions that are aimed at improving the overall health and welfare of Jamaicans. I have no problems with the ban policy in schools. However, what will stop the little Jon Jon from saving up his soda money until after school to satisfy the default habit of having a soda and two bag juice a day? Research has shown that one of the approaches to shaping health policy is the focus on the use of "nudges" as a behavioural strategy for shaping human behaviour.

Nudge intervention strategies

7. What if we build an environment in which sugary drinks were sold in smaller bottles, stores stocked fewer of them, and positioned them less prominently, would children drink fewer of them? The results of a recent study showed that most people find these "nudges" (altering cues in the environment to change people's behaviour) to be acceptable ways to prevent obesity. Banning sugary drinks, however, was only acceptable to a minority. Research also shows that sugary drinks are consumed more by the poorest in society. Unfortunately, educating people about the health harms of consuming an excess of sugary drinks an intervention that most people find acceptable does not reduce their consumption.

8. Surprisingly, the evidence indicates that "nudges" as well as intervention, like bans and taxes, could reduce consumption of sugary drinks. The Ministry of Health should take the bold step and fund nudge research directly linked to lifestyle behaviours. A study was done to compare the acceptability of three nudge interventions (reducing the size of sugary drinks bottles; elongating the shape of cans of sugary drinks so they look larger than current cans; and altering where on the shelf drinks were placed) with two more traditional interventions: education and taxation. The researchers recruited 1,093 participants from the UK and 1,082 from the US. Education was the most accepted intervention more than 80 per cent of participants considered it to be acceptable. Taxation was the least fewer than 46 per cent judged it acceptable. The nudge interventions rated between these ranges 51 per cent to 68 per cent.

9. A small word to my adult friends who 'must' have their sugary drinks: There is no need to order the largest size. Why not go instead for a bottle of water? However if you must have your sweet drink, please ask for the smallest serving size. #nudge2reduceobesity Henry J Lewis is a lecturer of psychology at the University of Technology, Jamaica, School of Humanities and Social Sciences. He is also a certified life coach.

Instructions: Answers ALL questions by selecting the most appropriate response.

1. The writers main claim in the passage is.

a. The government should implement nudge intervention policies to tackle obesity.

b. The government is not doing enough to tackle childhood obesity and improve the health of Jamaican citizens.

c. Jamaican citizens are encouraged to reduce the amount of sugar intake to reduce childhood obesity.

d. The government should consider implementing nudge intervention policies along with the ban on sugary drinks in school in order to effectively tackle childhood obesity.

2. State ONE premise used by the writer in support of his claim.

3. Identify the predominant type of argument that is deployed in the passage

a. Inductive reasoning

b. Deductive reasoning

c. Analogical reasoning

d. Circular reasoning

4. State TWO characteristic features of the predominant type of argument used in the passage.

5. "'...we are walking time bombs...', as stated in paragraph 1 of the article, is an example of?

a) Metaphor

b) Sarcasm

c) Personification

d) Hyperbole

6. What specific type of evidence is used in paragraph 8 of the article?

a) Statistical

b) Anecdotal

c) Analogical

d) Testimonial

7. What specific type of evidence is used in paragraph 4 of the article?

a) Testimonial

b) Statistical

c) Analogical

d) Eye witness

8. "It is a fact that regularly consuming sugary drinks is associated with growing rates of obesity, diabetes and tooth decay, particularly among children" as stated in paragraph 6 of the article emphasizes which rhetorical appeal?

a) Logos

b) Pathos

c) Ethos

d) Kairos

9. Would you say this argument is biased? Give ONE reason in support of your answer.

10. Comment on the sufficiency of the evidence presented by the writer in support of the claim.

11. Comment on the credibility of the evidence used AND the reliability of the sources of information.

12. Which of the following would represent an overall assessment of the currency and relevance of the evidence used by the writer in the article?

a) It is current but not relevant.

b) It is relevant but not current.

c) It is both current and relevant.

d) It is neither current nor relevant.