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Research Proposal: Obesity-Reduction Program for Teenagers

Dana Weisbrot

Chamberlain College of Nursing

NR505: Advanced Research Methods

August 2019

Research Proposal: Obesity-Reduction Program for Teenagers

Data Collection

PICO Question

Can adiposity among teenagers be reduced significantly or managed through physical activity program and sports after a period of six months after the program’s implementation?

The type of data to be collected is mainly ordinal, ratios, and nominal data, which will be collected through observations and interviews. Nominal data places variables in main discreet categories that do not overlap such as the number of obese male teenagers, whereas ordinal data places variables in some type of order (Merriam & Grenier, 2019). For example, ordinal data can be used to categorize the causes of obesity among male, female, and different races of the teenage participants. On the other hand, ratios help to draw comparisons and relationship between variables such as the ratio of Latinos with obesity to that of Caucasian Whites. All the 200 participants will be interviewed privately on an individual basis to increase privacy and their degree of cooperation (Creswell & Creswell, 2017). Obesity is a health concern that can lower the victims’ self-esteem to the extent that they can feel embarrassed answering questions in front of a large group of people, which makes private interviews a good approach of obtaining data.

There are different methods through which interviews can be conducted, which include: face to face interviews involving individual participants and researchers; telephone interviews; and questionnaires that can be delivered by papers or through emails. The best approaches to conduct interviews are face to face and questionnaires. The questionnaire approach will be semi-structured so that a mixture of both closed and open-ended questions will be used. The mix of both closed and open-ended questions is appropriate because it will give the researchers the opportunity to obtain both necessary and additional information that respondents would like to elaborate more on (Merriam & Grenier, 2019). Another approach that is convenient for obtaining data for the qualitative research is through observations. Observations will aid in obtaining nominal data such as the number of obese participants who are male and female, and the race of the obese participants.

Data-Collection Process

Before the data-collection process begins, 200 obese teenagers will be selected through the purposeful sampling approach in which the specific qualifications for the participants will be determined by age of between 12-19 years, and they should not be suffering from conditions that can induce overweight or obesity. The participants should also be obese. After the 200 participants have been selected, the researchers will work directly with the participants. The first step is to plan the whole interview process including booking the right venue(s) that the participants are comfortable with. After the participants have been selected and oriented on the interview process, they will be informed to maintain high level of privacy in that they will be discouraged from sharing or discussing the information they provided with those who are yet to be interviewed. Furthermore, they will be informed about how to; build a rapport, ask or avoid questions, starting and finishing of interviews, and ways of managing difficult questions (King, Horrocks & Brooks, 2018). A quiet environment will be selected to minimize the possibility of distractions from the environment. It will be necessary to record all the interview sessions so as to have a back-up, or to refer to the recordings for future research-related tasks.  

During the interview, researchers will be required to present themselves professionally by dressing in a simple and neat manner in order to avoid distracting the participants. Furthermore, interviewers will be put on friendly and respectful visages in order to make the respondents feel free with them. Body language, tone, and the manners of the interviewers should be welcoming and friendly so as to build rapport with the respondents (King, Horrocks & Brooks, 2018). It will be necessary for the researchers to choose their words wisely, and ask questions in manners that reflect calmness and comfort to prevent giving the interviewees anxiety and making them curious concerning the impression that the interviewer get from their responses. Furthermore, interviewers should avoid manners that compel interviewees to answer in a certain manner such as leading questions, and multiple complex and irrelevant questions since such may discourage interviewees (King, Horrocks & Brooks, 2018). Moreover, the interviewers are expected to avoid being judgmental but should instead empathize with the respondents since being judgmental can emotionally and psychologically hurt the respondents as they will get the impression that the interviewers dislike them or their behaviors.

Interviewers ought to familiarize themselves with teenagers’ language such as slang in order not to be confused just in case the teenagers decide to use slang. Besides, Interviewers ought to avoid jargons and difficult expressions that can confuse the respondents and should explain any term that they believe can confuse the respondents (King, Horrocks & Brooks, 2018). When starting interviews, it is crucial to avoid questions and expressions that appear as threats and instead simple questions that mainly inquire about descriptive data about the participant in relation to the issue of obesity. Similarly, it would be best for interviewers to avoid questions that can psychologically and emotionally charge the respondents. As such, interviewers will select questions that ease the interviewees out of the interview session smoothly and happily. Therefore, interviewers can ask questions that are not connected to the interview theme but are related, so as to help the participants get out of the meeting without feeling stressed, depressed, or annoyed with the interview processes, the questions, or the interviewer.

Data will be collected at different venues that will be set according to the position of the schools in the community. Since the participants are teenagers of school-going age, from elementary to high school, interviews will be conducted in schools. Suitable venues in the schools will be selected so that the each participant will be interviewed in the schools that they go to. For example, researchers will contact the school administrators in advance to make arrangements to be allowed to use two or three classrooms in which the interviews will be conducted. The preferred classrooms will be those that are located away from sources of noise, and items that can distract participants during the interview process such as charts will be removed. Prior to beginning the interviews, audio recorders will be installed so as to capture all the responses, which will be used later after the interviews for comprehensive analysis. The whole data-collection process will take no more than two days since the interviews will be conducted in the weekend, both on Saturday and Sunday. Weekends are the most convenient time since children do not attend lessons, and selecting both Saturday and Sunday is to ensure religious flexibility for participants who worship on either of the days. The interview session for each participant will take about thirty minutes with an allowance of no more than twenty minutes for slow respondents.

Data saturation can be achieved in different ways, including formation of indicators or codes that will indicate that all information is exhausted. Although the sample size is big enough to establish data saturation, it is necessary to establish in-depth quiz that can be analyzed to determine if the data collected is of high quality and quantity (Ness, 2015). Data quantity indicates the information obtained is sufficiently voluminous. On the other hand, data quality implies that the information obtained is intricate, nuanced, and multi-layered so that it contains almost all information relevant for the study purpose without leaving gaps (Ness, 2015). When researchers have reached a point at which no new information or themes emerge, then data saturation will have been achieved. The researchers can form several categories of questions under which responses can be classified so that if all the categories have been filled, then saturation will also have been achieved. Data quality can be enhanced through testing for contradicting responses and excluding them from the collected information. This integrity analysis can be done through inductive and logical tests respectively. Inductive tests involve organizing the data in different themes to look for contradictions whereas logical testing involves checking alternative patterns to check if there are contradictions (Walliman, 2017). Another method to test data quality is through testing for negative cases. This approach involves an examination of the data to check for information that do not fit well with established patterns and themes (Walliman, 2017). Such anomalous data can be discarded to increase the quality of the data.

Analysis

Organization

Data analysis involves a systematic search and ordering of the gathered information to increase the level at which the data can clearly be understood. The collected information will be arranged in different categories and themes. For example, there will be different categories such as sedentary lifestyle, unhealthy diet such as junk food, and hereditary conditions based on other family members’ body size. This type of ordering will make the data more organized and easy to understand. Tables or charts will be used to make the data appear organized and easy to interpret. The data will then be coded, and suitable data-analysis software such as NVivo will be used to calculate important values such as standard deviation or mode, which will be used in the interpretation stage. The data-organization process will be guided by the research objectives and questions.

Themes

Different themes will be developed from the responses, which will help in the organization of the data into categories that can easily be understood. Themes will be developed from the respondents’ subjective meanings drawn from their social reality, which will be conveyed in categorical ordering and subdivisions to accommodate variations in the collected data (Vaismoradi, Jones, Turunen & Snelgrove, 2016). The main themes that will be applied in the research will be of different categories. They include: reasons why teenagers do not eat healthy diets; factors that contribute to sedentary lifestyle among the youth; and the reasons why obese and overweight teenagers do not engage in physical activities sufficiently. The themes that emerge from these categories include but not limited to: engagement in indoor leisure activities, spending most of the time in the internet and watching movies; eating to relieve stress; eating junk food because it tastes better than vegetable and fruits; and lack of enough supplies of vegetable products due to few or no grocery stores in the neighborhood. Such themes will aid both in organizing the data in different categories, and coding the data to enable common patterns to emerge for easy analysis. The process of thematic development for thematic analysis will consist of; initialization, construction, rectification or correction of errors, and finalization (Vaismoradi, Jones, Turunen & Snelgrove, 2016). The initialization stage will involve going through the interview transcripts and extracting useful information that is then coded to look for abstractions. The construction stage involves classification, comparison, labeling, and translation as well as transliteration of the data, followed by a comprehensive description of the different categories of the data (Vaismoradi, Jones, Turunen & Snelgrove, 2016). Rectification process involves immersion and relating different themes with the aim of establishing similarities and differences between the themes, and stabilizing the data set; and finalization involves the interpretation of the thematic data.

Coding

The codes will have common reference points for each of emerging themes. Coding aids in reducing the bulk of and organizing data. There are different types of coding processes that can be used in qualitative research, which include: conceptual, relationship, and respondents’ perspective coding respectively (Vaismoradi, Jones, Turunen & Snelgrove, 2016). For conceptual code, different dimensions, elements, and domains are identified. For the research, conceptual coding will involve categorizing responses into ignorance concerning the dangers of obesity or overweight, misconception that adiposity makes people look majestic, insufficient guidance from parents. Other codes include: high appeal for junk food, lack of enough recreational space in the neighborhood, laziness, genetic factors, laziness, overeating, and love for sedentary recreational activities such as watching movies while taking snacks. Relationship coding involves associating some trends with other dimensions and element (Vaismoradi, Jones, Turunen & Snelgrove, 2016). For this study, relationship coding will involve categorizing the responses based on the direct link between certain behaviors and obesity, such as negative attitude towards physical exercises.

Further afield, respondents’ perspective coding involves the respondents’ positive or negative comments about an experience or aspect under study (Vaismoradi, Jones, Turunen & Snelgrove, 2016). For this research, respondents’ perspective coding will involve categorizing the responses based on the positive, negative, or indifferent comments concerning the causes of and being obese. An example is negative attitude towards physical activities, or pride in the huge size of obese teenagers. Other possible coding approaches are: respondents’ characteristics coding that classify responses based on their demographics, and settings code that is based on respondents’ general characteristics (Saldaña, 2015). These two coding approaches can be applied to categorize respondents based on their demographics such as race, age group, surrounding environment of residence, and genetic factors. All of the coding approaches will be used in the final research so as to eliminate the possibility of lacking a category under which responses can be classified.

Triangulation

Triangulation is an approach in which researchers combine more than one qualitative research methods, or a combination of both qualitative and quantitative research approaches. It is done mainly to strengthen the validity and to increase the credibility of researches. Although triangulation involves a combination of different approaches to form a single case, the constituent approaches remain autonomous so that they still operate alongside the other main research approach (Lune & Berg, 2016). The meeting point or intersection of the combination of approaches is taken as the case under study. No one of the combination of the approaches is applied in a superior or inferior manner. In a case involving a combination of both qualitative and quantitative research approaches, interviews are done for the two approaches with the same respondents and the responses later compared, compiled and referred in the analysis and interpretation (Lune & Berg, 2016). In triangulation, the sampling process is conducted in two steps in that the same respondents take part in both sections of the study. However, in the second stage, researchers decide the participants that are to take part in interviews. Links are established between in data-set levels, and the questionnaire responses are analyzed to determine frequency and distribution for the whole sample of respondents (Lune & Berg, 2016). Similarly, answers to questionnaires are also analyzed and comparison made between the two data sets and typology developed from that point. After this, distribution of the questionnaire responses and the typology are joined and comparisons made.

There are four common methods through which triangulation can be conducted, which include: triangulation based on data source, analyst, perspective or theory, and methodology-based triangulation respectively. In qualitative research, methodology-based and data-source triangulation are the most effective triangulation methods that have higher potential to strengthen the validity of the data and findings of the research (Flick, 2018). Method-based triangulation strengthens the validity of a mixed method research that has combined both qualitative and quantitative study approaches. Data triangulation relates to people, time and space; analyst-based triangulation involves the many analysts analyzing and interpreting the data, then combining their views; theory-based triangulation involves the use of more than one theoretical framework to interpret and analyze data (Flick, 2018). Further, methodological triangulation is the application of more than one data-gathering approach such as questionnaires and observations, and the use of more than one research methodology to increase the accuracy and validity of the results and the research itself.

The relevance of triangulation to this research is that it will be applied to increase the validity and credibility of the results and the research design. The research will utilize a combination of triangulation methods to further increase the credibility of the results. The triangulation approaches that will be applied are: data-source, theory or perspective, and method-based triangulation. Data-source triangulation will basically involve obtaining data from different races of respondents and genders in different locations, and different levels of socioeconomic caliber to increase the likelihood of achieving data-saturation and to reduce bias and redundancy (Flick, 2018). Further afield, theory or perspective-based triangulation will be applied through incorporating more than one theoretical or concept-based framework to increase the degree to which the results and the study design are aligned to research objectives, purpose, and hypotheses. For example, the concept that physical activity is associated with high degrees of cardiovascular health and a reduction of the fat content in the body can be combined with other concepts such as healthy diets consisting of grains, fruits, and vegetable are associated with minimal accumulation of fats (Swisher et al., 2015). Methodological triangulation can be applied by combining both the grounded theory qualitative research approach with the phenomenological quantitative research approach since they both seek to provide explanation for a specific phenomenon under study (Smith, 2015). Therefore, it would be appropriate to combine these triangulation methods to increase the accuracy and validity of the results.

Evaluation

The obesity-reduction method that involves physical activities and a healthy diet will make the obese teenagers healthier than before. The main stakeholders in this research are: parents, obese teenagers, teachers, and the healthcare fraternity. The obese teenagers will be the direct beneficiaries of the physical exercise program since they are the main targets. After successfully engaging in physical activities for a period of six months, they will be able to notice the difference in terms of weight and size, mobility, and general health. Progress will be determined by measuring body mass index (BMI) of the participants. If their BMI will be 18.5 to 24.9, they will have attained normal healthy weight and size (Locke et al., 2015). The teenagers will be out of danger regarding high possibilities of acquiring obesity-related diseases such as type 2 diabetes. This will also relieve parents from anxiety, and unavoidable medical expenditure. Teachers will benefit since the teenagers will be more active in sports and in the class than before. All stakeholders can emulate and participate in the program to stay healthy. The first improvement that can be experienced in my nursing practice if the program is implemented is a reduction in cases of obesity-associated health disorders such as cardiovascular diseases. The second improvement that can be achieved in nursing practice is that since the program will have proved to be successful, nurses can use the same intervention in projects related to public health and apply it in other communities or geographical locations where there are many overweight and obese people.

Dissemination of Results

The results of this EBP project can be shared through traditional and modern methods of information broadcasting. Teachers and parents can be contacted directly through their contact information that was noted earlier on during participant selection. The information can be sent to them through hand delivery or sent to their emails. When it comes to other community stakeholders, the information can be printed in local magazines, brochures and posters in summary form and distributed to them in churches, healthcare facilities, or in community meetings and during healthcare campaigns (Vian, Kohler, Forte & Dimancesco, 2017). Concerning members of my future practice, the information can be kept in soft copies and sent to my peers directly in their emails. The information can also be sent to organizations and other individuals directly to their websites, and it will also be available in my institution’s website for free access so that community members or any person can access it from the website and make use of the information.

Conclusion

For this research, ordinal, nominal, and ratio data will be collected from a sample of 200 obese respondents through observations, questionnaires, and interviews. Interviews will be conducted in classrooms with suitable conditions such as minimal sources of distractions, and the interview sessions will take 30-50 minutes for each respondent. The process of data analysis will involve an arrangement of the interview responses in an organized manner through establishment of themes. Coding will then be done and the results analyzed. The results of the research will be disseminated to all stakeholders using online and traditional methods of communication. The program can be applied later for the benefit of other members of the community. This project will improve the healthcare fraternity since its implementation in different populations will reduce obesity-related disorders such as cardiovascular diseases and diabetes type 2. The program can also be implemented in future healthcare campaigns.

References

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. London: Sage publications.

Flick, U. (2018). An introduction to qualitative research. London: Sage Publications Limited.

King, N., Horrocks, C., & Brooks, J. (2018). Interviews in qualitative research (2nd ed.). New York: SAGE Publications Limited.

Locke, A. E., Kahali, B., Berndt, S. I., Justice, A. E., Pers, T. H., Day, F. R., ... & Croteau- Chonka, D. C. (2015). Genetic studies of body mass index yield new insights for obesity biology. Nature, 518(7538), 197-206.

Lune, H., & Berg, B. L. (2016). Qualitative research methods for the social sciences (9th ed.). London: Pearson Higher Ed.

Merriam, S. B., & Grenier, R. S. (Eds.). (2019). Qualitative research in practice: Examples for discussion and analysis (2nd ed.). New Jersey: John Wiley & Sons.

Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report. 20(9), 14508-1416.

Saldaña, J. (2015). The coding manual for qualitative researchers (2nd ed.). London: Sage.

Smith, J. A. (Ed.). (2015). Qualitative psychology: A practical guide to research methods. London: Sage.

Swisher, A. K., Abraham, J., Bonner, D., Gilleland, D., Hobbs, G., Kurian, S., ... & Vona-Davis, L. (2015). Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile. Supportive Care in Cancer, 23(10), 2995-3003.

Vaismoradi, M., Jones, J., Turunen, H., & Snelgrove, S. (2016). Theme development in qualitative content analysis and thematic analysis. Journal of Nursing Education and Practice, 6(5), 100-111.

Vian, T., Kohler, J. C., Forte, G., & Dimancesco, D. (2017). Promoting transparency, accountability, and access through a multi-stakeholder initiative: lessons from the medicines transparency alliance. Journal of pharmaceutical policy and practice, 10(1), 18-29.

Walliman, N. (2017). Research methods: The basics. New York: Routledge.

OBESITY AND PHYSICAL ACTIVITY

Running head: OBESITY-REDUCTION PROGRAM FOR TEENEAGERS

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