A Thesis Paper Presented to the Faculty of the School of Graduate Studies of

Western Colleges, Inc. Naic, Cavite

In Partial Fulfillment for the Degree Master of Arts in Education major in

Administration & Supervision

(Carol L. Javier)
July 2023
 APPROVAL SHEET

This thesis entitled _______________ prepared and submitted by ______ in

partial fulfillment of the requirements for the degree of Master of Arts in Education
Major in _____, has been examined and is recommended for acceptance and
approval for Oral Examination.

PANEL OF EXAMINERS

Approved by the Committee on Oral Examination with a grade of _____ on ____

Accepted and approved in partial fulfillment of the requirements for the degree
Master of Arts in Education major in Administration & Supervision.

Comprehensive Examinations passed on ___________.

Abner V. Pineda, PhD, EdD, DPA, DBA

Dean, School of Graduate Studies
Title : Adolescent Overweight and Obesity: A randomized controlled school-
based intervention
Researcher : Carol L. Javier
Adviser : Dr. Abner V. Pineda
School : Western Colleges, Inc. Naic, Cavite
Degree : MAED Guidance and Counseling
Date of Completion : July 31,2023

ABSTRACT
 TABLE OF CONTENTS
Page
Title Page
Approval Sheet
Abstract
Table of Contents
List of Figures
List of Tables
INTRODUCTION
METHOD
Initial Stage
Final Stage
RESULTS
Development Stage
Conduct of Exploratory Factor Analysis
Final Results
DISCUSSION
REFERENCES
APPENDICES
Appendix
A. Letter to the Schools Division Superintendent
B. Informed Consent Form
C. Copy of the First Draft of the Instrument
D. Matrix for Development and Validations of the Proposed Instrument on
______
E. Copy for the Instrument Validators
F. Content Validity Index Results
G. Table
H. Figures
I. Semi – Final Draft of the Developed and Validated Instrument :
J. Copy of the Final Instrument
K. Certificate of PlagScan Review (Revised Final Manuscript)
L. Researcher’s Curriculum Vitae

LIST OF TABLES

Table Title/Description Page

LIST OF FIGURES

Figure Title/Description Page

 INTRODUCTION
For decades, adolescent obesity has been a major focus of the discipline of
Adolescent Medicine. Obesity was once a serious but uncommon problem among
young people, but in the last 20 years it has evolved into a global epidemic, affecting
the health and well-being of a substantial section of the world's population. Diabetes,
hypercholesterolemia, hypertension, cancer, and depression are all expected to rise
rapidly as today's teenagers reach adulthood. Additionally, prenatal epigenetic and
postnatal psychological consequences endanger future generations.
After controlling for confounding variables such as gender and family wealth,
child/adolescent obesity has its own relationship with internalizing emotional issues
Negative self-esteem, withdrawal from peer contact, anxiety, sadness, and suicide
are all psychological disorders related with childhood obesity. Almost half of the
obese teenagers express moderate-to-severe depression symptoms, and one-third
experience anxiety. Obese children are more prone to have psychological or mental
disorders than nonobese children. Girls are more vulnerable than boys, particularly
when it comes to self-esteem.
Physical activity plays an important role in preventing the development of overweight
and obesity among young and preventing its progression into young adulthood.
Adolescence is a particularly vulnerable period for the development of obesity since
it is characterized by a preventing of growth and a corresponding drop in physical
activity levels . A considerable minority of teenagers do not meet recommended
physical activity standards. Furthermore, physically active youth have lower levels of
adiposity than inactive youth. Given the substantially increased risk of overweight
adolescents becoming overweight adults engaging young people in physical
exercise remains a key behavioral focus for obesity prevention.
Given the dramatic increase in adolescent overweight and obesity, models are
needed for implementing weight management treatment through readily accessible
venues. We evaluated the acceptability and efficacy of a school-based intervention
consisting of school nurse-delivered counseling and an after-school exercise
program in improving diet, activity, and body mass index (BMI) among overweight
and obese adolescents.
 METHODS AND PROCEDURES
(This part of the paper includes the when, where and how was the study
done, materials being used, and who were / are the respondents / participants of the
study.)
A pair-matched cluster-randomized controlled school-based trial was
conducted in which 8 public high schools were randomized to either a 12-session
school nurse-delivered cognitive-behavioral counseling intervention plus school-
based after school exercise program, or 12-session nurse contact with weight
management information (control). Overweight or obese adolescents (N = 126)
completed anthropometric and behavioral assessments at baseline and 8-month
follow-up. Main outcome measures included diet, activity, and BMI. Mixed effects
regression models were conducted to examine differences at follow-up.
Adolescent overweight and obesity have increased dramatically in recent
decades, with 34% of adolescents currently overweight or obese.1 Adolescent
obesity has negative physical and mental health consequences,2–4 and is strongly
linked with obesity during adulthood.5 Adolescence provides an opportunity to
promote healthy lifestyles affecting physical and psychosocial outcomes during
adolescence and into adulthood, yet adolescent obesity has been understudied
compared with adults and preadolescents.6 One systematic review7 found that
comprehensive behavioral interventions including diet and physical activity
counseling and behavioral management training8 are efficacious for decreasing
youth body mass index (BMI), but they were focused on preadolescents and
conducted in specialty clinics with limited access by youth.7
Models for implementing expert recommendations for weight management
interventions9 with adolescents require development and testing. The school A pair-
matched cluster-randomized controlled school-based trial was conducted with a
convenience sample of 8 public high schools in Massachusetts. The total student
enrollment at these schools ranged from 673 to 1467; the student populations were
predominately white (61.8% to 94.4%) in 7 schools, and Hispanic (42.7%) in 1
school. The percent of students considered low income ranged from 5.7% to 59.7%.
Schools were pair matched on enrollment, and 1 school from each pair was
randomly assigned to the intervention or control condition. Data were collected from
September 2012 to June 2013. Clinical Trial Registration # NCT01463124.
Adolescents in grades 9 to 12 were eligible to participate if they had a BMI ≥
85th percentile for age and sex, provided assent and had parental consent, and had
at least 1 English-speaking parent. Exclusions included plans to move out of the
area; a medical condition that precluded adherence to the intervention;
 RESULTS
(This part includes the answer/s found for the research questions / findings of
the study and whether the tested hypothesis/es are / were true or not.)

DISCUSSION

Obesity is regarded as a major public health concern and is recognized as the

fifth leading cause of mortality worldwide. Overweight and obesity are two of the
most common lifestyle illnesses that cause further health problems and contribute to
a variety of chronic diseases such as cancer, diabetes, metabolic syndrome, and
cardiovascular diseases. The World Health Organization also anticipated that 30% of
global deaths will be caused by lifestyle illnesses in 2030 and can be avoided by
identifying and treating associated risk factors. Variables and behavioral involvement
policies. As a result, screening and diagnosing obesity as early as feasible is
critical, crucial. As a result, the machine learning approach offers a promising
solution for early obesity prediction risk of obesity because it can provide quick,
immediate, and precise results. (E.A. Sundararajan 2021)
Some genetic and behavioral variables influence an individual's likelihood of
adult obesity; thus, the substantial clusters of obesity found in various areas.
Geographical regions and settings also indicate the impact of socioeconomic and
environmental elements in "obesogenic" environments. Understanding the origins
and drivers of obesity is an important first step towards the development of effective
policy and preventative measures due to the aforementioned added complications.
Efforts will not be successful until precise, scientific understandings of them. Obesity
risk factors and the multiple linkages between them. ( Safaei 2021)
Although several studies have concentrated on overweight and obesity,
systematic literature reviews (SLRs) and similar overviews that outline the potential
parameters influencing and causing adult obesity are still needed. Similarly, SLRs
are necessary to identify overlaps between studies of obesity and research methods
such as machine learning (ML). Limited studies have investigated how ML
techniques can predict adult obesity. however, groundbreaking work in any effective,
systematic manner has not been presented to date. Therefore, this SLR
systematically investigates the causes of adult obesity and the current and emerging
research in this investigation. As briefly proposed above, this SLR is intended to
support practitioners and decision-makers by helping them take useful information
from the existing literature. Therefore, this study will support mergers among cutting-
edge research, medical knowledge, and policy makers to propose new evidence-
based approaches and solutions regarding adult obesity. The major contributions of
this SLR include the following:
 To identify existing potential parameters that influence and cause adult
obesity.
 ● To investigate major diseases, conditions, and other negative health
effects related to adult obesity and overweightness.
● To identify the ML techniques currently used in the automatic prediction
and/or identification of adult obesity. (Safaei 2021)
Excessive obesity also causes some common problems in daily life, such as
obese and overweight adolescents having more difficulty making new friends than
normal-weight children, and believing that others made negative comments about
them.). The survey shows that overweight adolescent will frequently have own
concerns about weight and shape, and experience weight-based teasing and
stigmatization by others. Furthermore, overweight children have been observed to be
more socially isolated, which has been classified as more socially diet. Active
isolated study taunting self-esteem withdrawn and seen less beautiful by peers.
(Hestetun et.al.2014).
Teachers should protect overweight children in school and focus on
observation is required, because obese youth are frequently targets of weight-based
teasing and bullying, which has been linked to increased depression and suicide
(Goldfieldet.al.2010). To prevent this, teachers should teach students to be friendly
to obese children. At the same time, learning has become a severe challenge for
overweight children: overweight teenagers were more likely than their normal-weight
counterparts to judge their school performance as below average. (H. Fonseca et al.,
2010) Adolescent obesity is also linked to a gene passed down from parents.
Parents of overweight teenagers were more likely than other parents to report that
their child was withdrawn or did not get along with others (Hestetun et al., 2014).
The number of obese teenagers with depression is higher than the number of
peers with normal weight. Furthermore, there is evidence that depression can raise
the likelihood of youth gaining weight and becoming overweight. (Goldfield et al
2009)There are several factors that contribute to depression. Because they believe
they have a negative body image and a different shape than their peers their age,
there is a huge disparity between reality and the truth, and they may experience
unpleasant feelings such as upset and sadness, which can lead to depression. (Xie
2006 &Unger et al 2010.)
Furthermore, when other people around them know they think down on
themselves, soothers may treat them worse, such as mock and bully them because
of their form and weight. As a result, obese teenagers cannot deal with such kind of
treatment.
Obesity is frequently seen as a potential risk factor for the psychological and
emotional well-being of children and adolescents. (Hestetun,Veel
Svendsen,&Margaret Oellingrath 2014) Obese teenagers have more difficulty
pressing their physical and emotional health problems than younger peers. It is more
simpler to characterise themselves as 'unhappy,' and irritation or bad temper are
more frequently stated. Some research suggests that the degree of overweight in
girls is inversely connected to their level of self-esteem (Fonseca et al 2010). Obesity
can lead to negative thoughts about self-esteem, self-image, lack of confidence, and
self-concept in adolescents (Cornette 2008).
REFERENCES :

C. Patel, ... M.S. Jacobson, in Encyclopedia of Child and Adolescent Health (First
Edition), 2023
https://www.sciencedirect.com/topics/medicine-and-dentistry/adolescent-obesity
https://www.sciencedirect.com/topics/medicine-and-dentistry/adolescent-obesity
https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-9-53
https://eric.ed.gov/?id=EJ1113634&fbclid=IwAR1E3-
BNf9X49Gqi37lTcnN14vkv1tDomB2ZlqR9oom6wP8XyBLjGPqKPZM#:~:text=Metho
ds
https://www.researchgate.net/publication/
353938657_A_Systematic_Literature_Review_on_Obesity_Understanding_the_Cau
ses_Consequences_of_Obesity_and_Reviewing_Various_Machine_Learning_Appro
aches_Used_to_Predict_Obesity/link/6420793aa1b72772e42c23a1/download
https://www.theseus.fi/bitstream/handle/10024/148963/ZHUANG_Huiting.pdf.pdf?
sequence=1&isAllowed=y
 LETTER ASKING PERMISSION
Ma’am:
Greetings of Love, Peace & Respect!
The undersigned is presently on the last stage of her Master of Arts in
Education major in Special Education. She / He is conducting a research entitled
________________________________________________________.

In order for the researcher to finish the said paper, a survey questionnaire has
to be floated to the respondents.

In this regard, may the researcher seek your approval for the conduct of the
study at (your school).

The researcher conveys his/her utmost gratitude for the support you accord to
him / her with regard to his / her study.

Respectfully yours,

Noted By : (Your Name)

Student – Researcher

Dr. Abner V. Pineda

Dean
 LETTER TO THE PARTICIPANTS / RESPONDENTS

Dear __________:

Greetings of Love, Peace & Respect !

The undersigned is presently on the last stage of her Master of Arts in
Education Major in Special Education. She is conducting a research entitled ____
_____________________________________________________________.

In order for the researcher to finish the said paper, a survey questionnaire has
to be floated.

In this regard, may the researcher seek your ample time to answer the
attached survey.
The researcher conveys her utmost gratitude for the support you accord to
her with regards to her study.

Respectfully yours,

(Your name)
Student – Researcher
Appendix D

MATRIX FOR DEVELOPMENT AND VALIDATIONS OF (title)

Part l. Profile of the obese / overweight pupils in terms of :

1.1 Name ______________________________________________ (optional)

1.2 Grade and Section :
1.3 Socio economic Status

Part ll. This set of questions is about your children’s eating habits and
physical activity. The first few questions ask about food, and the rest of the
questions should be answered for each of the children in your household.
Your participation in this survey is voluntary and all answers will be kept
confidential. If there is a question that you do not wish to answer, you can
skip it and move on to the next question. We are hoping that the information
we get from this survey will help us understand the eating behaviors of
children in our community.

Thank you for completing this survey.

Please indicate whether you strongly agree, somewhat agree, somewhat

disagree, or strongly disagree with the following statements:

2.1 Some people are born to be fat and some thin; there is not much you can
do to change this.

01 Strongly agree; 02 Somewhat agree; 03 Somewhat disagree; 04 Strongly

disagree

2.2 What you eat can make a big difference in your chance of getting a
disease, like heart disease or cancer.

01 Strongly agree; 02 Somewhat agree; 03 Somewhat disagree; 04 Strongly

disagree

2.3 When you buy food, how important is each of the following?

2.3.1 How safe the food is to eat ?

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all

important

2.3.2 Nutrition (how healthy the food is)

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all
important

2.3.3 Price?

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all

important

2.3.4 How well the food keeps ?

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all

important

2.3.5 How easy the food is to prepare ?

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all

important

2.3.6 Taste (whether child likes the food ?

01 Very important; 02 Somewhat important; 03 Not too important; 04 Not at all

important

2.4 In your opinion, how important are the following things are to a child’s
present and future health?

2.4.1 What a child eats :

01 Very important; 02 Somewhat important; 03 Not too important; 04 Don’t know

2.4.2 How much a child eats :

01 Very important; 02 Somewhat important; 03 Not too important; 04 Don’t know

2.4.2 How much exercise a child gets :

01 Very important; 02 Somewhat important; 03 Not too important; 04 Don’t know

2.4.3 What the child weighs :

01 Very important; 02 Somewhat important; 03 Not too important; 04 Don’t know

2.5 Please answer the following questions for each of your children:

Child 1 Child 2 Child 3 Child 4

2.5.1 Sex
01 Male
02 Female

2.5.2 Age

2.5.3 Height :
(in feet & inches)

2.5.4 Weight :
(in pounds)

2.5.5 Not counting juice, how often do your children ages 2 and over eat fruit on an
average day?

01 Never or rarely; 02 helping; 03 Don’t know/ not sure

01 Never or rarely

2.5.5 On an average day, how often does each child eat vegetables? (Includes
vegetable salad..)
01 Never or rarely; 02 helping; 03 Don’t know/ not sure

2.5.6 How many times a week does each child eat fast food (McDonalds, Wendy’s,
Taco Bell, etc.)

01 Never or rarely ; 02 1-2 times; 03 3-4 times; 04 5 or more times; 05 Don’t know/
not sure

2.5.7 How many sodas per week does each child drink ?
01 Never or rarely; 02 1-4 sodas; 03 5-7 sodas; 04 8 or more sodas; 05 Don’t know/
not sure

2.5.8 How many times per week does each child play or exercise enough to make
him/her sweat and breathe hard for 20 or more minutes?

01 Never or rarely; 02 1-2 times; 03 3-4 times; 04 5 or more times; 05 Don’t know/
not sure
2.5.9 How would you describe each child’s weight?

01 Very underweight; 02 Slightly underweight ; 03 About the right weight; 04 Slightly

overweight; 05 Very overweight

2.5.10 About how many hours do you estimate each of your children sit and watch
TV or videos on an average school day?

01 Less than 1 hour; 02 1-2 hours; 03 3-4 hours; 04 5 or more hrs; 05 None; 06
Don’t know
Appendix E

COPY FOR THE INSTRUMENT VALIDATORS

Dear Validator :
Greetings of Love, Peace & Respect !
Kindy evaluate the items enumerated that are grounded from my review of
related literature and studies according to the relevance to the research objectives
and its language proficiency to elicit reliable responses.
The research objective is grounded on the definition of the terms indicated
prior to each evaluation table.
Please use the scoring scale below and indicates the necessary remarks
thereafter.

Appendix F
CONTENT VALIDITY INDEX RESULTS
Appendix G

TABLE
Appendix H

Figures
Appendix I

SEMI – FINAL DRAFT OF THE DEVELOPED AND VLIDATED INSTRUMENT

Appendix J

Copy of the Final Instrument

Appendix K
Certificate of Plag Scan Review (Revised Final Manuscript)

Appendix L
Researcher’s Curriculum Vitae

INSTRUCTION :
1. I provided the introduction, methods & procedures, survey questionnaire and
the review of related literature and the data;

2. What you should do is to insert the RRLS into the introduction (50 %) and the
other 50 % under discussion. Instead of supplying you the
authors/researchers, u are asked to find your own RRLS.

3. If you think there is a need to improved the parts provided you may do so but
be sure that the additional information is in congruence with the paper;

4. It has to be in a thesis paper of the college which is also uploaded in the GC;

5. There is a need to re – encode the RRLS to be able to insert it properly to the

designated parts of the paper; and

6. I hope there will be no further questions after providing you all the things that
you should do including the deadline and hardcopy which you should submit
either via courier or personal on / or before Dec. 01, 2021 (before the office
closes at 3 PM, which is the curfew in Latoria, Naic). For those who will send
via courier :

DR. ABNER V. PINEDA

Dean
Western Colleges, Inc.
Barangay Latoria, Naic, Cavite
Tel. 0919 911 5648 / 0915 805 2418