Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Kathy Shadle James, DNSc, RN, CNP, Chairperson; Susan L. Instone, DNSc, RN, CPNP; Mary Jo Clark, PhD, RN


children & youth, lifestyle habits, nursing, Obesity, Overweight, self-esteem, Shapedown


Obesity in children is increased in the United States and globally which creates both physical and psychological health risks and co-morbidities affecting the development of positive self-esteem (Sinton & Birch, 2005; Whetstone, Morrissey, & Cummings, 2007). The development of poor self-esteem in children increases the risk of problem behaviors such as aggression, crime, teenage pregnancy, drug and alcohol use, tobacco use, and eating disorders (Brook et al., 2007). Treatment of childhood obesity is multifaceted, requiring behavioral and lifestyle changes for both child and family to achieve a healthy weight (De-Santis-Moniaci & Altshuler, 2007; Plourde, 2006; Ritchie, Crawford, Hoelscher, & Sothern, 2006; Spear et al., 2007; Vaughn & Waldrop, 2007; Wofford, 2008). Therapeutic intervention must enlist the support of the family to reshape children's perception of him- or herself (Harter, 1999). One method shown to result in positive improvements in attaining healthy weight and lifestyle with children is family-based behavioral treatment (FBBT). The purpose of this study was to evaluate the effect of SHAPEDOWN, an interventional FBBT program, on self-esteem and lifestyle habits and family lifestyle habits. The theoretical models for this research was Bandura's social cognitive theory (1999), and the conceptual framework was based on "Familial Approach to the Treatment of Childhood Obesity; Parent and Child Collaboration" (Golan & Weitzman, 2001). A convenience sample of 12 children and 11 parents were recruited from elementary schools and referred by pediatric primary care providers. The data collection measures included a revised self-esteem scale (Harter, 1985), and the Children's Habit and Family Habit inventories. The inventories were administered pre- and post- a SHAPEDOWN intervention for healthy lifestyle and weight management. Descriptive and inferential statistics were used to describe the study sample and variables. Pearson product moment correlation and dependent group' t-test was used to analyze the data. Although there were no statistically significant results, correlation demonstrated trending toward the positive effect of SHAPEDOWN and its relationship with children self-esteem and lifestyles habits for families and children. The study was limited by attrition and sample size. This study highlights the continued need to explore the barriers associated with effective provision of treatment for overweight children.

Document Type

Dissertation: Open Access



Included in

Nursing Commons