Childhood Obesity Evidence-Based Practice

Childhood Obesity Evidence-Based Practice

Childhood Obesity Evidence-Based Practice

Evidence-Based Practice and Applied Nursing Research

PICO Table Example

Evidence Matrix

Evidence-Based Practice and Applied Nursing Research

Evidence Table

Task 2 Articles: These articles must be published within the last 5 years. All seven articles should focus on a single intervention.

Note:

Please upload the full text version of all articles used in these two tasks with your submission. You do not need to run the Turnitin report for the articles you selected since they will match 100% to the published article. Please do run Turnitin on your own work in your paper and matrix.

How do I run the Turnitin report?

Please view the library video found in Module 3. Please use the library video examples to select the 7 articles for this task. Remember you can use primary research, secondary research (systematic and integrative reviews), quantitative, and qualitative studies as research in this task. Use the task instruction headings to set up your paper. Use the email tool in the library to set up your reference page (see using email tool in the library video).

We are happy to review article selection concepts for this course with you. Please schedule a call with your assigned CI. You need 5 research articles (level 1-3) and 2 non-research articles (level 4-5) that support a single intervention. See toolkits below to help you with levels and types. For example, if your topic is falls, and your intervention is “patient education on fall risk”, then all your articles have to support education on fall risks. See example search terms for research and non-research articles below.

Here is a list of topics to consider.

Here are some search words that will focus on a single intervention for each topic. You should consider trying these exact search words to begin the search.

• hand hygiene education
• patient education on fall risk
• patient education on smoking cessation
• patient education to prevent heart failure readmission
• non-pharmacological behavioral interventions to reduce pain
• non-pharmacological behavioral interventions to reduce anxiety
• pet assisted therapy
• palliative care education
• patient education to prevent elective C-section
• skin to skin to improve breastfeeding compliance
• prophylactic dressings to prevent pressure ulcer
• assessment for early removal of urinary catheter
• bundles to prevent urinary tract infection

Articles with the word review in the title are good for task 2 research articles as long as they review research studies (Systematic or Integrative reviews), see chapter 6 & 7. The sample size for a review article is the number of studies reviewed. Always start from the home page of the library to begin your search:

For the non-research studies add a second search term to the second row of the search tab as shown below. You may want to begin by searching for the non-research articles as they can be a bit more challenging to review, and remember not to select an article with the words Systematic review or Integrative review in the title as a non-research study (see chapter 6 & 7). Try to select articles for consideration that have the non-research search terms shown below in the title and/or subjects.

• quality improvement
• practice guideline
• consensus panel
• CNE
• Commentary
• expert opinion

After you have selected your 5 research articles, consider using each of the non-research search words above in the second row as shown here:

See suggestions below for each section of the task

A1. Healthcare Problem/ A2. Significance of Problem/ A3. Current Practice / A4. Impact on Background

Write 1-2 paragraphs for each response. You may want to include in text citations to support these sections. The A section should only discuss the problem without any mention of the intervention. The current practice should relate to the C in the PICO. Discussion on how the problem impacts either the workplace culture OR the patient’s culture is required in A4.

B. PICO Table (Chapter 4) Download the table from Taskstream or just include a 4 row by 2 column table in the paper and use the PICO toolkit as a guide (Module Video 2 and Toolkit, Appendix B).

B1. PICO Question (Chapter 4) Construct the question that relates to the PICO elements in the table using the PICO Question Development toolkit as a guide (Module Video 2.4 and Toolkit, Appendix B).

Here is a question template:

Among (population), does (intervention) lower (problem) as compared to the current practice?

C1. Keywords. This is just a list of the search terms used.

C2. Number and Types of Articles. Describe the number and research types/subtypes of the articles you find in your search. They may include research articles, quality improvement, practice guidelines, pieces written to educate/inform, expert opinion, and more. This is a bare-bones description of the number and types of articles you find. For example, you might begin by stating the number of articles that came up (10,000) and the number you reviewed (20) then give a breakdown of the types you reviewed (5 RCT, 5 Reviews, 5 Quality Improvement projects, 5 Qualitative). (1 paragraph)

C2a. Research and Non-Research Evidence. (Chapters 6 & 7). You can use 2 of your five research articles here to represent the 2 research studies. Be sure to state if the publication is a research or non-research evidence. Do not use an article with the words systematic review or integrative review in the title as an example of non-research evidence. This will be 4 paragraphs describing the 2 research (Level I-III) and 2 non-research (Level IV-V) studies found during the search. Each paragraph should include the in-text citation for that article, for example:

The first research study found … (Smith & Jones, 2014).

Then write a few sentences about that research study and do the same for the other 3 articles. Review the research evidence appraisal toolkit and Chapter 6 for the research evidence articles.

Review the non-research evidence appraisal toolkit and Chapter 7 for the non-research evidence articles.

D. Evidence Matrix. Download the matrix from Taskstream. Enter the 5 research articles (Level I – III) in the table using the level and quality guide toolkit to determine the correct level. The research design/type should be quantitative, qualitative, or mixed methods. Remember, level 1 are randomized controlled trials only, level 2 are quasi-experimental only, and everything else is level 3. For systematic and integrative reviews, read the level 1-3 definitions in Appendix C. The sample size for review studies are the number of articles reviewed. Please read chapter 6 & 7 and be sure not to include non research evidence such as quality improvement projects in the table (Module Video 3 Toolkit, Appendix C:Level and quality guide).

E. Recommended Practice Change. This section should be a minimum of 6 sentences. The first sentence names the single intervention that all the articles in the matrix support. Then write one sentence each for the 5 studies in the matrix on how each article used the intervention to decrease the stated problem. Each of the five sentences must include an in text citation for that research study. For example, Intentional rounding was shown to decrease falls by 20% over 3 months (Smith, Rogers, & Stein, 2014). (1-2 paragraphs)

References Video for help with in text citations (2 minutes)

F1. Key Stakeholders. (Chapter 3, p. 41 & Chapter 8, p. 155) A stakeholder is anyone who has something to win or lose from this change. Also, think about those whom you need to engage in the process to make it a lasting change by involving them in the decision to make the change. They can be floor nurses, nurse educators, nurse managers, nurse administrators, etc. You will need to mention at least 3 different key stakeholders. For each stakeholder, name a strategy to involve them in the decision to change the practice. (1-2 paragraphs)

F2. Barriers. (Chapter 9, p. 177) This section is a discussion of the barriers to change. You may want to talk about change, delegation of tasks, training/education, funding, and attitude toward research as these are areas that cause barriers to initiation and continuing compliance with a practice change. Mention one barrier related to change and one barrier related to translation of research into practice. (1 paragraph)

F3. Strategies for Barriers. (Chapter 9, p. 180) This section will discuss 2 strategies to overcome the identified barriers in section F2. (1 paragraph)

F4. Indicator to Measure Outcome. (Chapter 1, p. 9 & Chapter 8, p. 154 – 155) An indicator is something that can be measured. For example, if the I in the PICO is “hourly rounding to prevent falls” the outcome measure would be the number of falls. Describe how you would measure an improvement after the practice change. (1 paragraph)

G Sources. Remember to include 5 in-text citations in section E from the 5 research studies in the Evidence Matrix. Also, remember that the reference page should include all 7 studies mentioned in the paper, assuming that the 2 research studies in C2a are also included in the 5 research studies in the Evidence Matrix.

For reference page and in text citations: References rules

EVIDENCE-BASED PRACTICE ON CHILDHOOD OBESITY COMPLETED SAMPLE PAPER

Evidence-Based Practice on Childhood Obesity

Melanie Mejia

Western Governors University

Evidence-Based Practice on Childhood Obesity

SECTION A: SUMMARY AND BACKGROUND OF THE PROBLEM

a. Health problem

Childhood obesity is a condition affecting children as a result of excess weight that hinders them from engaging in normal life activities. Childhood obesity has become a major health challenge that affects children across the globe. The World Health Organization have declared obesity an global epidemic that needs to be addressed after medical research that proved over 5 million children below five years are obese Gaffney et al., (2014). A 2012 WHO report claimed that the childhood obesity trend is changing whereby it is a condition that is affecting even developing countries unlike before when it was predominant in developed countries.

As a result of the condition, many children are subject to live a life that they should not live as children. The reason is that obesity restrains children from engaging in massive physical exercises that they should play including playing (Gaffney, et al., (2014). It is sad to see that the health condition is also hindering the rate of children growth, for instance, obese children take a longer time to learn how to walk or even feed themselves as different body organs are not responding the way they should. The condition has made children from as early as one years old to start developing other comorbidities that by significant margins are lowering life expectancy, a situation that is calling for massive resolution strategies to save the life of children.

b. The significance of the problem

Childhood obesity is a preventable condition that is caused by an unhealthy lifestyle. For instance, children were fed on unhealthy junk foods which possess excess oil, wheat, and artificial sugar. Also, children suffering from obesity lack proper engagement in activities that help burn calories and the excess fat and sugars are converted into fat and stored in the body leading to weight increment. The absurd reality is that obesity is a major life-threatening condition that promotes the development of many other chronic diseases. According to the WHO, obesity by itself has not been said to cause death, but it creates a positive environment that makes other health conditions that causes death in children to develop and become hard to control.

For instance, obese children become vulnerable to ailments like diabetes, coronary heart diseases, respiratory diseases, stroke, and cancer among many others. The latter is in the sense that childhood obesity weakens body organs to the extent that it does not produce enough antibodies that strengthen the immune system. The reason is that the food consumed leading to the development of obesity does not have the right nutrients that boost immune system development. The child despite appearing healthy and fat from the outside is frail internally and becomes exposed to different health conditions. Because of childhood obesity, the rate of childhood mortality has increased as well as the number of children suffering from chronic ailments.

c. Current practice

Adopting a healthier lifestyle is the best current practice that can help address the childhood obesity health problem. It is a practice that entails parents feeding children with natural organic foods and green juices instead of packed and fast foods. It also entails making sure that children eat fruits so that their bodies can have a well-balanced nutrients supply which helps in making the body strong and also avoid instances of having fat in the body. It is also a practice that requires children to be involved in physical exercises in efforts to promote the healthy operation of body organs like the heart.

d. Impact on background

Childhood obesity negatively impacts the life of a child. The reason is that the child is restrained from engaging in activities that he/she would love to do. Activities or games that require extensive body activity prevents an obese child from performing to their full potential due to excess body weight placing limitations in which the child cannot bend, walk, jump, or even run. This means that obesity prevents even the most talented children from engaging in activities they find interesting. Obesity also predisposes children to constant ailments due to a weak immune system, poses a child to develop at a slower pace, including the mind development which determines the levels of intelligence that the child would have. Childhood obesity also affects the social life of a child because an obese child finds fun while indoors watching television or playing video games and hence interpersonal and social skills are not developed.

SECTION B: PICO TABLE

Pico Question:

Can childhood obesity be entirely reduced as a result of engaging in physical exercises or adopting a healthy feeding is the overall effective strategy?

SECTION C: RESEARCH STRATEGY

C1. Keywords

Childhood obesity, overweight-related behaviors, parenting, body weight, prevention, intervention, lifestyle, physical exercises, parenting, obesity triggered ailments

C2. Number and types of articles

During research, articles to be used were sought over 5000 articles that were found. However, the research only chose five peer-reviewed articles that proved to have relevant and accurate information that would meet the research set threshold. From the five selected articles, three are reviewed articles under the category of level 1-3 and two articles under the non-research category of level 4-5. All articles are about childhood obesity though they differ in the area of childhood obesity focus. For instance, one article talks about how childhood obesity develops and the factors that promote for instance parenting. Another article provides a medical view of childhood obesity and how it affects the health of children. There is also another article that talks about the right steps to take to prevent childhood obesity. In overall, the articles cover the issue of childhood obesity in all aspects thereby creating an overall picture.

C3. Research and non-research evidence

Research evidence articles used are; An, Ji, & Zhang (2017); and the authors of this article provides a review and meta-analysis of the effectiveness of social media-based interventions on weight-related behaviors and body weight status. The article authors provide details and insights from past literature and authors. An article by Hutchens, & Lee, (2018); is another research evidence talking about parenting Practices and Children’s Physical Activity. The article is an integrative Review that provides detailed findings from other professionals about childhood obesity. The last chosen research evidence article is authored by Nigg et al., (2016) which is a review that focuses on different childhood obesity invention strategies. The article provides researched information about children already enrolled in a healthy program on how they can overcome obesity health challenge.

Non-research evidence use is that of is that of Gaffney et al., (2014). In this article, the authors provide views, opinions, and guidelines about the steps parents or caregivers should take during infancy in order to preven childhood obesity. An article by Vittrup, & McClure, (2018); is the second non-research evidence in this assignment. The article talks about different barriers that hinder successful childhood obesity prevention concerning parental knowledge and attitudes.

SECTION D: EVIDENCE MATRIX

Evidence Matrix

SECTION E: RECOMMENDATION

Childhood obesity is a highly preventable condition when healthy living conditions and styles are embraced and taught to children. According to Hutchens, & Lee, (2018); physical exercises can help reduce but not entirely address childhood obesity, and this means it is only through feeding properly with organic balanced foods, eating the right portions, and engaging in physical exercises that can eliminate childhood obesity and other ailments triggered by it. However, parents must be fully involved as they determine the meals and products that their children feed on the most. According to An, Ji, & Zhang, (2017); lack of knowledge is a major challenge, and social media can be used as a suitable tool for childhood obesity information sharing. Through the tool, people can share the causes, symptoms, and treatment options available.

Further, Gaffeny et al., (2016) also state that there are specific obesity prevention strategies every parent or guardian should know that help in preventing childhood obesity during infancy. Knowing these obesity prevention strategies such as avoiding the introduction of solid foods until after 6 months of age, understanding an infant’s satiety cues, and increasing physical play helps parents raise healthier and stronger children and prevent obesity at an early age. According to Nigg et al., (2016); the environment also contributes to childhood obesity. Members of the society should embrace programs to help parents and children overcome the health problem. Lastly, Vittrup, & McClure, (2018) provides vital insights that parents should be cautious of because they hinder the success of childhood obesity prevention strategies. These are parental knowledge and attitude and emphasizes that parents should put effort to gather the right knowledge and develop the right attitude.

SECTION F: RECOMMENDATION IMPLEMENTATION

F1. Key stakeholders

To implement the recommendation, three stakeholders must be involved; the government, parents, and members of the community. The government needs to be aware of the different strategies that childhood obesity information should be shared with parents and provide a suitable environment. The parents need to understand the vital role they play and attitude they should develop towards children with and those developing obesity. The members of the community need to understand the childhood obesity programs that they should endorse together along with the kind of support they should offer to parents with obese children.

F2. Barriers

Funding is the major barrier because the program is costly as well as the changes needed and hence might be hard for some stakeholders. The attitude might be another hindrance because some stakeholders are not bothered by the childhood obesity issue. Another reason is that lack of proper attitude would make it hard for the change to be successfully introduced and implemented.

F3. Strategies for barrier

Training and counseling is the overall and most effective strategy that can be used to address the barriers. The reason is that human beings naturally resist changes that they are not familiar with. By familiarizing the stakeholders first before making any move would create a positive and suitable environment for effective and collaborative change implementation. Another effective strategy is using motivational strategies to attract attention and interest of the stakeholders. For instance, using obese children in society and taking them through the recommendations and they become a living example.

F4. Indicators to measure the outcome

The reduction of childhood obesity rate would be the overall indicator to measure the outcome. The reason is that the main issue being addressed is the increasing rate of childhood obesity as well as an increase in mortality rate due to other conditions triggered by childhood obesity. The application of the recommendation and within a set timeframe with the number of childhood obesity rates starting to fall is an indication that the program was a success.

References

An, R., Ji, M., & Zhang, S. (2017). The effectiveness of social media-based interventions on weight-related behaviors and body weight status: review and meta-analysis. American journal of health behavior, 41(6), 670-682.

Gaffney, K. F., Kitsantas, P., Brito, A., & Kastello, J. (2014). Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice. Journal of pediatric nursing, 29(2), 108-113.

Hutchens, A., & Lee, R. E. (2018). Parenting Practices and Children’s Physical Activity: An Integrative Review. The Journal of School Nursing, 34(1), 68-85.

Nigg, C. R., Anwar, M. M. U., Braun, K. L., Mercado, J., Kainoa Fialkowski, M., Areta, R., … & DeBaryshe, B. (2016). A Review of Promising Multicomponent Environmental Child Obesity Prevention Intervention Strategies by the Children’s Healthy Living Program. Journal of environmental health, 79(3).

Vittrup, B., & McClure, D. (2018). Barriers to childhood obesity prevention: Parental knowledge and attitudes. Pediatric Nursing, 44(2), 81-94.

EBP Synopsis of Articles

Can add to intro? :

Childhood obesity rates are rising quickly and pose a major risk factor for comorbidities such as cardiovascular disease and the early development of type II Diabetes in children. Parents are the primary role model for children being that children are more likely to follow their parent’s eating behaviors. Parents are also responsible for creating the environment of food the children are surrounded by when choosing the types of food that are available in the home. However, parents may lack the knowledge about health and obesity and physical activity recommendations and are contributing causes that may lead to obesity in childhood. Several studies have shown a link with children who spend a lot of time watching television or playing video games and obesity.

Synopsis of Baby Steps in the prevention of Childhood obesity; IOM guidelines for Pediatric Practice

Studies have been done which show a positive correlation between infants with excess weight gain during infancy and later childhood obesity. Due to the obesity epidemic in children, the Institute of Medicine, 2011, has created guidelines to prevent childhood obesity. The IOM infancy-related guidelines focus on infant growth monitoring, sleep, physical activity, and healthy feeding. In order to prevent infant excess weight gain the IOM has created measurement tools which are used in clinical assessments to help identify parents/caregivers who practice non-responsive infant feeding styles. Studies have shown that mothers believe that feeding their fussy baby will help soothe him/her. Interventions such as education for parents/caregivers on identifying infant behaviors of satiety have helped parents differentiate these from other causes such as anger, boredom, or a soiled diaper. Intervention techniques include providing content on soothing/calming techniques that comforted the infant without being fed. Studies have also shown that breastfeeding until at least 6 months of age and the delayed introduction of solid foods after the age of six months led to lower weight to length ratios. The IOM (2011) guidelines call for increased physical activity of infants in order to prevent childhood obesity which in turn also leads to gross motor developmental delays.

Brief synopsis of Barriers to Childhood Obesity Prevention:

Parental Knowledge and Attitudes: might need to add more about intervention programs ?

Parents may lack the knowledge about health and obesity and physical activity recommendations and are contributing causes that may lead to obesity in childhood. Several studies have shown a link with children who spend a lot of time watching television or playing video games and obesity. Majority of the parents in this study seemed unsure of correct physical activity recommendations for children. This study has shown that majority of the parents in the study performed do not know the meaning of overweight and obesity and may not consider their overweight or obese child to be so. Only 6% of the 40% percent of the children who were overweight or obese in this study were actually diagnosed by a doctor. The study done also has shown that parents with a higher BMI score had a child with a higher weight percentile, showing that obesity runs in the family. Parents play a primary role model for children being that children are more likely to follow their parent’s eating behaviors. Parents are also responsible for creating the environment of food the children are surrounded by when choosing the types of food that are available in the home. Approximately 46% of the parents in the study stated they buy a fast food meal for their children at least once per week. This study also revealed that majority of the parents/caregivers lack the knowledge of correct portion sizes. Majority of the parents in the study stated they either did not know how to govern appropriate portion sizes or simply judge by how much they think their child might eat.

This study revealed that parents face many barriers to help prevent obesity in their children. Many parents revealed the cost of healthy foods, parents’ busy schedules, and finding time to prepare healthy meals are major barriers faced. In order to implement a childhood obesity prevention program, it is important to consider the barriers and help parents find ways to implement healthy eating and exercise habits. It is important to educate families about the specifics of healthy eating, correct serving and portion sizes, what is considered physical activity and the recommended amount, and how to recognize when your child is overweight or obese. Educational handouts can be given out at pre-schools, schools and medical clinics.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

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For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

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The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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