Project
Title: Determination of the difference in the body mass
index for obese elementary school children whose parents receive training on
reduction of childhood obesity and those who do not
Abstract
This proposed project seeks to address the issue of
increased cases of childhood obesity through the provision of education and
training to parents on effective ways of health promotion regarding childhood
obesity. The increased cases can be attributed to either lack of or limited
access to such educational services to parents. The intervention activities
proposed in this project include the provision of proper nutrition, adoption of
healthy lifestyles, and engagement in physical exercises which are considered
appropriate in enhancing positive health outcomes for obese children. The
measurement of the outcomes will be through the use of BMI values reported as a
comparison of the pre-and post results of the intervention period. T-tests will
be used in determining whether there is any significant statistical difference
in the BMI results before and after the intervention period. The data analysis
and interpretation stage will indicate whether the provision of education and
training to parents has a significant impact on the reduction of childhood
obesity.
Introduction
Childhood obesity remains to be a significant issue that
affects the health outcomes of children and occurs when children are above the
normal healthy weight for their age and height (World Health Organization,
2015). Children with obesity are prone to high blood pressure, high cholesterol
which is risk factors for cardiovascular disease, impairment of glucose
tolerance, type II diabetes, breathing and joint problems, and fatty liver
disease (Ogden, Carroll, Kit &Flegal, 2012). It also results to other
factors such as psychological problems, low self-esteem, and social stigma. The
aim of this project is to determine whether the provision of education to
parents whose elementary age group children have childhood obesity promotes
healthy weights for their children. Lifestyle modifications including diet and
behavior have positive impacts on the health outcomes of children with
childhood obesity (Kitzmann, et al. 2010). The expected outcomes are that
children whose parents receive training on how to address the issue will have
healthy body weights and heights based on their Body Mass Index (BMI) readings.
For children, it is necessary to consider the age and sex about BMI (CDC,
2015). The PICOT question that helps to address the issue of childhood obesity
is: For elementary age group children with childhood obesity (P), does the
provision of parent education (I) compared to no action(C) for the duration of
one year (T) promote healthy weights for the children (O)?
Evidence
review and synthesis
The project is evidence based in nature and thus requires
adequate review and synthesis of evidence from recently published research
articles. In this regard, I searched for articles from various databases
including CINAHL & MEDLINE Simultaneous search, CINAHL Plus with Full Text,
Cochrane Database of Systematic Reviews, and ProQuest Central. I found the
databases useful in identifying relevant and updated articles for use in
gathering background information about children obesity and the intervention
methods for promoting healthy weight of children. Each of the databases gave
insightful articles, but of different types, since some were systematic
reviews, randomized controlled trials, and others were Cohort studies and with
various levels of evidence. A high level of evidence of a research paper
indicates a high grade and strength of recommendation to clinical practice
(Burns, Rohrich& Chung, 2011). The search tracker and evaluation table used
in search of the articles has been provided in the appendix section towards the
end of the paper.
In a randomized controlled trial study by Chen, Weiss,
Heyman, and Lustig (2012), Sixty-seven Chinese American children aged 8 to 10
years, (normal weight and overweight) and their families participated in a
healthy weight and behaviors program. The results indicated a significant
effect of the intervention on proper diet and healthy lifestyle. The major
strength of the study is the use of specific sample characteristic that
generates reliable findings. However, the focus on various variables could make
it inconclusive hence necessary to focus on few variables for better results.
The study was considered for use in the project because it provides insight on
the need to deal with the risk of childhood overweight and obesity through
child centered and family programs. In a different randomized intervention
study, CHANGE intervention was identified to have a positive influence on body
size outcomes for the overweight and obese children. The interventions
discussed in the article include physical activity (PA), nutrition education,
and healthy weight which showed the need for combined school-based PA and
nutrition interventions for long term benefits to affected children
(Fairclough, et al., 2013). The study was selected for use since it aligns with
the proposed project regarding addressing childhood obesity through providing
nutrition education to children for enhanced outcomes. Hatta, Rahman, and Haque (2017) conducted a descriptive
quantitative cross sectional study where a hundred mothers participated, and
knowledge, attitude, and practices were assessed as well as their relationship
to childhood obesity. The results indicated that mothers had the moderate
knowledge, attitude, and practices on childhood obesity. The findings reveal
that programs and strategies used in preventing and intervention of childhood
obesity can be used in informing a practice aimed at enhancing the health
outcomes for children with obesity. In a descriptive study by LeBlanc (2016),
total sedentary time and screen time was assessed for children with physical
inactivity and sedentary behavior. The results indicated that majority of
children are unaware of the guidelines involved in the measurement of the total
sedentary time. From the findings, there is a need for combined effort both at
school and at home to ensure that children do not adopt a sedentary lifestyle
which is associated with negative health outcomes.
In summary, the reviewed studies for use in the project
attribute positive health outcomes for obese children to certain factors which
include adequate knowledge, education on the essence of physical activity,
child-centered and family based programs on healthy weight and behavior, and
avoiding sedentary lifestyle choices.
Purpose
of the project
The proposed project has a specific aim of promoting
healthy body weight outcomes for children diagnosed with childhood obesity
which will be assessed by calculating their BMI before, during, and after the
intervention period. Thus, the purpose of the project is to determine the
difference in the body mass index for obese elementary school children whose
parents receive training on reducing childhood obesity and those who do not.
The proposed clinical question for the project is: “Is there a significant difference
in body mass index (BMI) for elementary school children who are obese whose
parents received educational training on reducing childhood obesity versus
elementary school children whose parents do not receive educational training?” The intervention plan in the project proposal
will involve grouping the participants in two groups; control and an
intervention group. The intervention group will have participants who will be
provided with educational programs on how to deal with childhood obesity through
proper nutrition, physical exercises and adopting a healthy lifestyle. It is
expected that there will be a significant difference in the outcomes of the
children of the parents in the two groups regarding promoting healthy body
weights as determined by the BMI results.
Methods
The evidence based project will be experimental and will
adopt randomized controlled design. It has been found to be appropriate in
assessing the difference in the outcomes of body mass index for children with
childhood obesity before and after the intervention as compared to the control
group. Campbell and Stanley (2015) reports that pretest and post test
measurements of the body mass index values are necessary for experimental
studies.
Project
setting and sample
The project will be based in a community set up with a
nearby health care facility where parents can take their children for
assessment. The choice of the participating parents will be based on an
inclusion criterion where they ought to have children with childhood obesity
and that they should not be receiving any additional assistance on how to take
care of their children. The other demographic factors such as age and sex ought
to be well distributed alongside others such as social, economic status, and
level of education. Random sampling will be used based on the inclusion
criteria to eliminate the likelihood of bias.
Confidentiality
The confidentiality of the information shared by the
participants will be protected in such a way that, all the data gathered from
the participants will be labeled using unique codes alongside their files. Only
the primary investigators will be allowed to use and manipulate the data for
the research purposes only and will have secure storage mechanisms for it. The
data that will be stored in a computer hardware system will also be safeguarded
by having a backup in cloud storage mechanisms and secured with strong
passwords. The access to the information will be limited only to the
investigators, and the data will be securely discarded six months after the end
of the project.
Procedures
and Intervention
Education programs on how to promote health outcomes of
children with childhood obesity will be provided to parents whose children are
obese. The programs will be community-based and will focus on teaching on the need
for proper nutrition and what constitutes proper nutrition for children,
adopting a healthy lifestyle, and the need for physical exercises for children.
The participating parents will be expected to practice them with the children
suffering from childhood obesity. Before and after the intervention period,
measurements of the height and weight will be done, and the BMI calculated in
consideration of the age and gender of children.
Instruments/
Scales and measurement of Outcomes
The BMI calculated for the participating children is a
reliable scale for use in computing data on height and weight for comparison
purposes. T-tests analysis will be used to test the difference between the
calculated BMIs before and after the intervention to identify whether there is
any significant difference between them. The test is quantitative only to show
the differences, but much emphasis will on the description of the outcomes and
reasons influencing them. The use of t-test in showing the statistical
difference between the gathered data has been used previously in research and
has high reliability and validity levels (Campbell & Stanley, 2015). It has
consistent measurements on the variables in question and also reports a true
account of the collected data. Hence, it is reliable in a study that seeks to
identify differences in outcomes after an intervention.
Data
Collection
Data collection will be facilitated through short
questionnaires for the participant demographics, but the data on weight and
height of the participating children will be gathered using the BMI scales. The
questionnaires will have questions on the age of the child, the gender of the
child, the level of education of the parent and the social, economic status as
for whether rich or poor. The researcher will measure the height and weight of
the children (for use in calculating BMI) and record in a paper format having
the demographic details as filled by the participants.
Data
Analysis
The expected outcomes of the project will be increased
levels of healthy weights for the participating children with childhood
obesity. The outcomes will be reported through measuring the BMI values after
the intervention period and compared to the pre-test results of the BMI values.
The comparison of the data obtained from the different tests will help to
identify the differences before and after the intervention. Data analysis will
be based on the obtained findings from the compared results in which any
perceived impact on promoting healthy weights for the children will be
identified.
For the
intervention group, paired sample T-test will be appropriate in comparing the
pre test, and post-test results for the BMI values obtained and assessed
whether they have a statistical difference. For the comparison of the control
and the intervention group, basic T-test will be used to identify the
difference between the means of the data sets at the end of the project period.
T-tests help to determine whether there is a statistically significant
difference between the data sets of independent groups of participants
(Campbell & Stanley, 2015). For the paired sample T-test, the data used has
to be related in some way and is most appropriate for the comparison of the
pre-test and post-test scores (De Winter, 2013). For this project, the
paired-sample T-test will be applicable for the comparison of the BMI data
obtained before and after the intervention. The statistical analysis procedures
will be crucial in determining whether the intervention will have any
significant impact on promoting healthy weights for elementary age group
children with childhood obesity.
The participants will have various demographic factors
which are important considerations in the study findings. The demographic data
that will be reported by the participants include the age and sex of the
participating children, social, economic status, and the level of education of
the participating parents. Sex and age are crucial predictors of the
appropriate and healthy BMI levels for children since they have varying growth
rates which cannot have standard values for all children but varies based on
the age and gender. The social, economic status and the level of education of
the participating parents will be necessary to consider since parents with high
levels of education and with a high social, economic status are likely to have
increased access to education on how to promote the health outcomes of their
children in comparison to those with a low education level and economic status.
The two factors will be considered to ascertain that the outcomes obtained are
large as a result of the intervention programs rolled out throughout the
project duration. The participating parents will fill in their demographic
details in the questionnaires that will be provided at the start of the
project. The demographic data will be reported alongside the identified
differences in the body mass index values for both the intervention and the
control group participants.
After the implementation of this project, the expected
outcomes will be enhanced health outcomes for the children with childhood
obesity identified through healthy weights. It is likely that the participating
children who receive the intervention will be at reduced risk of developing
other complications associated with childhood obesity in comparison to those in
the control group. A health promotion program will be rolled out in the
community to reduce the risk levels of developing the complications associated
with childhood obesity.
The involvement of stakeholders provides an effective way
of conducting evidence based project since they have various inputs that
enhance its relevance in solving the identified problem (Laycock, Bailie,
Matthews &Bailie, 2016). The participation of the stakeholders is crucial
to the project since each has a specific role they play in ensuring successful
completion and implementation. The stakeholders incorporated in the project
include the community (parents and their children), community health care
practitioners, and health care center superintendent, sponsoring agency
representative, policy makers working in various levels of the health care
system, researchers, and other health service support organizations.
In every project implementation, there are potential
barriers that every researcher ought to address to limit their effects on the
effectiveness of the intended outcomes (Wallis, 2012). For this project, there
are several barriers to its implementation that stakeholders have to deal with.
The barriers include challenges in handling a complex research; difficulties in
developing evidence based clinical policy, challenges in applying evidence in
practice, and organizational barriers. The difficulties in creating an evidence
based clinical policy will be addressed by having guidelines on how to develop
clinical studies based on evidence and using information systems that integrate
evidence with patient care. The care providers and practitioners require
comprehensive training on how to apply the guidelines and recommendations of
evidence based research studies to their practice (DiCenso, Guyatt&Ciliska,
2014). It would be ineffective to have evidence based studies completed and not
implemented by the care practitioners who have a key role in it.
Conclusion
This evidence based project proposal was designed with
the aim of ensuring that the increased cases of childhood obesity are reduced.
It is a randomized controlled trial and found to be effective in comparing the
outcomes from control and an intervention group. The proposed intervention entails
the provision of education and training programs to parents whose children have
obesity and are expected to implement them for a particular duration for
comparison of the BMI values between the control and the intervention groups as
well as pre-and post-test results. Previous research studies have shown likely
enhancement of health outcomes if the proposed intervention is adhered to. The
study will be applicable in designing community health programs aimed at
improving the health outcomes of children with childhood obesity.
References
Burns,
P. B., Rohrich, R. J., & Chung, K. C. (2011). The Levels of Evidence and
their role in Evidence-Based Medicine: Plastic and Reconstructive Surgery,
128(1), 305–310.
Campbell,
D. T., & Stanley, J. C. (2015) Experimental and quasi-experimental designs
for research: Ravenio Books
Centers
for Disease Control and Prevention (CDC) (2015) Healthy Weight: About Child and
Teen BMI,
Chen,
J., Weiss, S., Heyman, M., &Lustig, R. (2012). Efficacy of a child-centred
and family-based program in promoting healthy weight and healthy behaviors in
Chinese American children: a randomized controlled study. Journal Of Public
Health, 32(2), 219-229. doi: PubMed/fdp105
Cody,
W. K. (Ed.). (2013). Philosophical and theoretical perspectives for advanced
nursing practice (5th ed). Burlington, MA: Jones & Bartlett Learning.
World
Health Organization (2015). Facts and Figures on Childhood Obesity.
Search Tracker
PICOT
question organizer
|
PICOT
|
|
For the elementary
age group children with childhood obesity, does the provision of parent education
compared to taking no action for the duration of one year promote healthy
weights for the children?
|
|
P
|
Population
|
Elementary
age group children with childhood obesity
|
|
I
|
Intervention
or
Issue
of interest
|
Provision
of parent education
|
|
C
|
Comparison
|
Taking
no action
|
|
O
|
Outcome
|
Promoting
healthy weights
|
|
T
|
Time
frame
|
One
year
|
Search
Tracker
|
Search #
|
Initial search terms
|
Database
|
And/Or?
|
Added search terms
|
Title
(Ti)
Anywhere,
etc.
|
# of
articles found
|
|
1
|
Childhood
Obesity,
Provision
of parent education,
promoting
healthy weights for the children
|
Cochrane
Database of Systematic Reviews
|
OR
|
Anywhere
|
Anywhere
|
13
(1)
|
|
2
|
Childhood
Obesity, Promotion of Healthy weights
|
CINAHL
Plus with Full Text
|
AND
|
Anywhere
|
Anywhere
|
1
|
|
3
|
Childhood
obesity, Providing parent education,
promoting
healthy weights for the children
|
CINAHL
Plus with Full Text
|
AND,OR
|
Anywhere
|
Anywhere
|
25
(2)
|
|
4
|
Childhood
obesity,
Parent
Education,
Improving
healthy weights
|
CINAHL
& MEDLINE simultaneous search
|
OR,AND
|
Anywhere
|
Anywhere
|
13,855
|
|
5
|
Children
with Obesity,
Providing
parent education,
Promoting
healthy weights
|
ProQuest
Central
|
AND,AND
|
Abstract
|
Abstract
|
2 (1)
|
Anywhere- means that there was no specific section of
the articles that the search terms could be identified for inclusion.
Ab- (Abstract)- It means that the articles
obtained were evaluated based on their Abstracts and thus the articles obtained
contained the key terms in the abstract section.
OR/ AND - shows that the search of articles included
all the articles with any of the search terms used and ‘AND’ showed that the
search terms had to be found in each of the articles obtained.
The initial search terms were used as stated
using the AND/OR terms for specificity in identification of results. The search
criteria used was the advanced search where the terms were typed in the search
bars and separated by the choice of the AND/OR stated. The type of databases
was also specified to ensure that the search criteria were fully described as
required.
No comments:
Post a Comment