Research Critiques and PICOT Statement Final Draft

Christiana Bona

Grand Canyon University

October 10, 2019

Background of the Study

Authors of this research work utilized the method of pilot execution study to look at the implementation of the thoroughly assessed Healthier Families Program as well as the Recreation sites within three cities of the nation i.e. Michigan, Nevada, and Georgina which consists of people of different socio-cultural origins. There has been limited success in different healthcare outcomes even though there has been the expansion of the evidence-based behavioral interventions within the community organizations. This has been the case since the fidelity and the clinical interventions dosage are becoming diluted when they are utilized within the community settings.

There have been more than 300 randomized controlled trials to assist in preventin and treating childhood obesity. There are several trials which have been successful in enhacing che child body mass index, however, the generalizability of their outcome, as well as the sustainability of the programs, have become hard to evaluate. Attempts that have been made to replicate the programs in other healthcare facilities have not been fruitful. Therefore, due to the burden of childhood obesity, future studies must include rigorous methods to help in scaling out the effective research into the real world context and assessing their effects.

Methods of the Study

This study involved utlization of RE-AIM framework to assess the program through quantitative i.e. the pre and post-survey of the behavioral changes; attendance and fidelity. A qualitative approach was also used i.e. interviews using Parks and Recreation staff as well as participants of the program. Each participant site was used for the ten families coming from the local communities through the use of in-person, face to face, and email. The research was guided by the question: "are the community-based behavior interventions effective in the treatment and management of childhood obesity?"The inclusion criteria used by the researchers was based on the inclusion of parents of more than 18 years and children between 3to 5 years.

The participants were to commit themselves to participate in the study for three months program. The exclusion criteria, especially for the families, were no contact and sickness that would likely prevent them from actively participating in frequent exercise activities. The limitation of the study was that it was designed using a pilot study and it was hard to generalize the intervention effectiveness. Another weakness of the study is that the participants used were early adopters and they enrolled without using the targeted recruitment techniques. The assessment methods used by the authors for the health behaviors were restricted to the pre-post survey and this means that the project or research work can be subject to recall or social desirability biases.

Results of the Study

The outcome of this study shows that the use of evidence-based childhood obesity intervention is one of the most important approaches to dealing with obesity issues as well as the long-term impacts associated with the disorder. It is also important to contextualize the intervention of the successful scaling out while at the same time offering rigorous strategies to make sure that there is greater fidelity.

Ethical Considerations

The authors of this research work followed ethical requirements by meeting the ethics approval and consent of participation. The apporval of this study was done by the Vanderbilt University Medical Center Institutional Review Board. The participants who agreed to participate in the study signed the consent to confirmtheir willlngness to take part in the study.

Conclusion

The pilot study was amongst the first attempts made to help in ensuring that there is scaling out of the evidence-based childhood obesity intervention within the community Parks and Recreational institutions. The successful and sustained behavioral change amongst geographical and divese ethnic populations with greater attendance and fidelity is demonstrating the effective strategies to focus on the prospect large scale execution efforts to help in the reduction of childhood obesity in the community.

Bazyk, S., & Winnie, R. (2013). A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth. Occupational therapy in health care, 27 (2), 84-98.

Background

Childhoood and youth obesity cases is a major concern for the public healthcare sector which significantly affecting the physical and mental well-being. Even though the traditional methods of preventing obesity is based on diet and aerobic exercise at the individual level, focus need to change to the impacts of mental health in relation to obesity. People with obesity are living in a world where they faced stigmatization and are less accepted and this leads to social exclusion and discrimination. Therefore, this study aims at presenting a multi-tiered approach to the prevention of obesity which focuses on promotion of psychological well-being, prevention, and individualized interventions.

Methods of study

Authors of this study used descriptive studies to help in exploring multi-tiered approaches to obesity management which involved the use of 20 interventions. The authors used questionnaires to help in the collection of data. A total of a sample size of 1000 children were selected to participate in the study. The study was guided by the research questions i.e. "is the multi-tiered approach in the identification of the management of obesity effective in the reduction of childhood obesity and its prevalence rates."

Results of the Study

The key outcome of this study is that the use of the multi-tiered approach to obesity is effective and helps in the management of obesity. A multi-tiered approach is working more successfully than other traditional methods used in the management of obesity. Therefore, to reduce childhood obesity, the focus needs to be a shift from the traditional approaches of managing obesity to a more multi-tiered approach. This can help in the reduction of obesity cases among children.

Ethical Considerations

The authors of this article followed the ethical principle guiding research work. The first ethical requirement met is seeking consent from the participant who later signed the consent form to confirm their readiness to take part in the research work. The approval of this study was done by the Cleveland State University Institutional Review Board which allowed the authors to go ahead with the research.

Conclusion

The study concluded that even though the traditional approaches which focus on the watching diet and taking part in the exercise activity, little attention has been given to the mental issues that affect obese individuals due to the stigmatization issues. Therefore multi-tiered approach to obesity which focuses on the promotion of emtiional well-being, reducing the risks to obesity, and designing or improving individualized intervention needs to be adopted to help in fighting against childhood obesity which is becoming a major healthcare concern in the country.

Reference:

Heerman, W. J., Schludnt, D., Harris, D., Teeters, L., Appel, R., & Barkin, S. L. (2018). Scale

out of a community-based behavioral intervention for childhood obesity: pilot

implementation evaluation. BMC public health, 18 (1), 498.