Research Literature, Design Approach and Sampling Guidelines

NR505 Week 4: Research Literature, Design Approach and Sampling Guidelines

Student Name

Instructor

NR505 Advanced Research Methods: Evidence-Based Practice

Chamberlin College of Nursing

Date

Applicable Elements of Research studies

The research article by titled ‘the outcomes of health promoting communities: Being active eating well initiative – a community-based obesity prevention intervention in Victoria, Australia’ describes research carried out with an aim to evaluate the practical impact of Health promoting communities: Being Active Eating Well initiative. The research design included both cross-sectional and longitudinal was a mixed method and multilevel quasi-experimental. The sample included children, adolescents and adults, with data collection done pre and post-intervention. The research incorporated multi-component interventions aimed at promoting healthy eating, physical activity and stronger healthier communities. The results from the study indicate gains in community capacity with few impacts on environments, policy or individual knowledge, skills, beliefs and perceptions. The strengths of the study include the ability to access a heterogeneous sample population and ability to conduct pre and post intervention assessment of the target population. The limitations of this study was the possibility of loss to follow-up due to the complex nature of the study population in terms of age and chances of emigration from their residents before the end of the study period. This literature supports the Pico question since it examines whether exercise alone or exercise combined with diet in reducing weight. The solution description is that it is important to use a systems approach that employs a modification of existing systems in implementation of strategies aimed at reducing obesity.

A study by was conductedwith variouspurposes including: to describe the obesity prevention practices that nurse practitioners (NPs) could employ to children and adolescents and to compare the identified practices of nurse practitioners by practice setting, specialty, and awareness of the prevention guidelines of childhood obesity. Other objectives were to identify the relationships between prevention practices and demographic variables of nurse practitioners, and to examine the resources for and barriers to implementing prevention practices. The research design was cross-sectional in nature and sampling method was convenience sampling of family and pediatric nurse practitioners. The intervention utilized in this study is the implementation of obesity prevention through direct contact between family and nurse practitioners with the target population. The findings from this study indicate that nurse practitioners in family and general pediatric settings did not consistently use the body mass index (BMI)-for-age index to screen for childhood obesity but were involved in teaching parents to promote healthy eating and physical activity. The strengths of the study include the ability to reach a large target population through conducting the study in family and general pediatric practice settings. The limitation of the study includes the inability of the researcher to get in direct contact with the target population. This study directly relates to the Pico question for this study in that it identifies the role of the nurse practitioners in prevention and management of childhood obesity. The solution description is that there is a role of the nurse practitioner in the practice setting in the prevention of childhood obesity.

Conducted a review of the literature with the purpose to identify effective or early treatment or interventions that can be used in pediatric primary care settings, with children who are overweight, obese, or high risk for later life obesity. This will facilitate the reduction of the trajectory of child weight gain, promote height weight attainment and decrease the incidence of chronic co morbidities associated with overweight and obesity. The research design was cross sectional in nature and involved review of six intervention studies. Each of the studies reviewed utilized various interventions. Purposive sampling of the studies to be reviewed was based on the nature of the study to test intervention strategies to prevent obesity. The studies reviewed employed various interventions including dietary intervention, school-based interventions and community-based interventions. The study findings indicate that pediatric healthcare providers experience a chronic problem in practice settings with adolescents and their families concerning obesity. The strengths of this study include the ability to come up with substantial evidence that explores various interventions to prevent obesity among children and obesity. This research article supports the Pico question for this study in that it focuses on the effects of early treatment or prevention interventions as opposed to comparison or control interventions on weight loss or healthy weight maintenance. The solution description is thatearly treatment and prevention of childhood obesity is important in reduction in the rates of childhood obesity and in the reduction of co-morbidities associated with childhood obesity.

Theoretical Framework and Change Model

The theoretical framework for this project is the social cognitive theory with the incorporation of its concepts including modelling, reinforcement, goal setting, self-regulation and self-efficacy. The pathway for obesity prevention based on this theory starts from parent or guardian education to parent behavior and attitude change to influence on the child by the parent in terms of family behaviors relative to nutrition, body image and physical activity. The change model for this study is the change theory by Kurt Lewin. This change model is in three stages namely, unfreezing-change-refreeze and explains ways to get rid of old patterns that are counterproductive.

Utilization of the social cognitive theory in this project will promote success and sustainability of the intervention aimed at prevention of childhood obesity. This theory supports cognitive and behavioral assessment in various domains including physical activity and dietary adjustments especially in terms of keeping track of weight changes based on exercise and dietary changes. Using the change model by Lewin promotes the success and sustainability of this projectas it promotes change in old patterns to adopting new patterns through change in thoughts, feelings, behavior or all three. The use of the social cognitive theory as a theoretical framework and the change model by Lewin, both promote changes in behavior leading to obesity prevention and control among children and adolescents.

Research Approach and Design

The research approach for this project is qualitative with the type of design focus under this larger research approach being a systematic review of randomized control trials conducted to establish the effectiveness of exercise only as compared to a combination of exercise and diet in the prevention and treatment of childhood and adolescent obesity. The Pico question for this research project is :In obese or overweight adolescents (P), is exercise and diet (I) more effective in reducing weight (O) compared to using exercise alone (C) in treatment?. The design approach is qualitative and involves review of various randomized control trials carried out to investigate the effect of exercise and dietary adjustments in early treatment and prevention of childhood and adolescent obesity.

The rationale for the design approach selected is that it provides the opportunity to compare the impact of exercise and diet on reduction of obesity with the utilization of available resources and a smaller period as compared to conducting a randomized control trial from scratch. The advantage of the selected design approach is that it makes the research project easier to conduct and the results acceptable since only peer reviewed randomized control trials will be used. The disadvantage of this design approach is the generalizability of the findings to populations of interest since the randomized control trials are likely to have been conducted in different settings.

Sampling Method

The target population is children and adolescents who are overweight, obese or at risk for overweight. The project will use non-probability sampling since not all studies on obesity prevention will get a chance to be included in the study. Randomized control trials on prevention and management of childhood obesity will be the only trials that will be considered. The sampling procedure will be purposive and will include review of randomized control trials and their findings in relation to prevention and management of childhood and adolescent obesity. The number of research articles included in the systematic review will be determined after several research articles related to childhood obesity prevention have been examined and screened for suitability for inclusion in the research project.

Oneadvantage of the sampling procedure is that only the best peer reviewed articles will be included in the systematic review of literature.Another advantage is that it enables the researcher to stick to the subject of interest and therefore will yield valuable results. The disadvantage of the sampling procedure is that it may lead to exclusion of research articles with findings valuable in obesity prevention, especially if obesity prevention is investigated in the context of adults. Protection of participant rights in this research project is ensured through the screening of articles to be reviewed to ensure that they are IRB approved and that research projects included consent from participants prior to research by the researchers in the randomized control trials.

References

Barone, D. F., Maddux, J. E., & Snyder, C. R. (2012). Social Cognitive Psychology: History and Current Domains. Springer Science & Business Media.

Bolton, K. A., Kremer, P., Gibbs, L., Waters, E., Swinburn , B., & De Silva, A. (2017). The Outcomes of Health Promoting Communities:Being Active Eating Well Initiative- a Community-Based Obesity Prevention in Victoria, Australia. International Journal of Obesity. doi:10.1038/ijo.2017.73

Creswell, J. W. (2014). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. SAGE.

Larsen, L., Mandleco, B., Williams, M., & Tiedeman, M. (2016). Childhood Obesity: Prevention practices of Nurse Practitioners. Journal of the American Academy of Nurse Practitioners, 70-79. doi:10.1111/j.1745-7599.2016.00105

Small, L., Anderson, D., & Melnyk, B. M. (2007). Prevention and Early Treatment of Overweight and Obesity in Young Children : A Critical Review and Appraisal of the Evidence. PediatrNurs, 149-161.