Benchmark – Capstone Project Change Proposal

Literature Review

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Literature Review

Childhood obesity is one of the leading public health issues facing the United States of America. This problem is characterized by children having a Body Mass Index (BMI) of more than 30. The rate of childhood obesity in the United States has been increasing significantly in the past decade. This has put many children at the risk of physical, social, and psychological issues; some of which are extended to their adulthood. Therefore, it is important to study this problem and develop interventions that can help reduce the rate of obesity in children. This study was designed to provide an evidence-based solution to obesity in children. The PICOT statement, “children with a BMI above 30 who are undergoing nutritional monitoring compared to not being monitored nutritionally can achieve significant weight loss in a period of a year” will be answered with help of a study aiming at evaluating how diet changes can be helpful in reducing the rates of obesity. This paper evaluates literature on childhood obesity, which helps to understand information on the public health issue that can be used to develop better interventions. Benchmark – Capstone Project Change Proposal

Comparison of Research Questions

The literature that has been included in this research mainly focuses on the causes and the effects of childhood obesity. Some of the studies evaluate the effects in childhood while others evaluate the adulthood effects. There are also studies on prevention and intervention methods for dealing with the public health issue. The study by GBD 2015 Obesity Collaborators (2017) has a different approach because it evaluates the trends in obesity across the world. This research is important because it helps to understand the extent of childhood obesity as a public health issue not only in America, but also in other countries.

Sahoo et al. (2015), evaluates the causes and effects of childhood obesity. The research takes an overall approach in evaluating all types of causes and effects of obesity in children. Xu and Xue (2016) also have a similar research question. This research also evaluates the causes and effects of obesity but is extended to evaluate the prevention strategies to avoid the occurrence of obesity in children. These two studies help to understand more about the factors that cause obesity in children, which is helpful in developing the intervention for this research. Other studies that have investigated the effects of childhood obesity pay attention to the possible effects in adulthood. Ayer et al. (2015) investigates the possible lifetime risks of cardiovascular disease because of childhood obesity. The authors hypothesize that a person has a higher lifetime risk of cardiovascular disease if they are overweight or obese as a child. Simmonds et al. (2016) investigates the risk of being obese as an adult when one is obese as a child. The study’s research question asks whether the risk of obesity in adulthood is increased by childhood obesity. Benchmark – Capstone Project Change Proposal

The remaining studies evaluated in the literature answer research questions aiming at understanding the dynamics of prevention and intervention techniques for childhood obesity. Oelscher et al. (2015) seeks to understand whether a system’s-based approach would work better than a primary based approach in preventing obesity in low income and ethnically diverse communities. Allender et al. (2016) evaluates how community action can influence childhood obesity prevention initiatives. Lastly, Davis et al. (2016) investigates whether mothers’ perceptions on obesity risk factors influence the rate of obesity in the communities. These three studies help to give an insight into the effective strategies of preventing and reducing obesity in children.

Comparison of Sample Populations

Half of the studies evaluated for this study were reviews of other studies done in the past either in the form of systematic literature reviews or meta-analyses. Sahoo et al. (2015) evaluated literature reviews but does not mention the methodological process; hence, the sample size is not clear. Similarly, Xu and Xue (2016) has a random evaluation of literature with no review of the methodology; hence, the exact sample is unknown. Ayer et al. (2015) sample is made up of primary cohort studies on cardiovascular disease and obesity. The study evaluates 8 research studies to with a total sample of over 300 participants. Lastly, Simmonds et al. (2016) conducted a meta-analysis that included 15 cohort studies with a total sample size of 200,777 participants.

The remaining literature includes primary studies. Oelscher et al. (2015) conducted a primary study with 576 children between 2 and 12 years as the participants. Allender et al. (2016) also did a primary study with a sample of 5050 children from 84 primary schools as the participants. GBD 2015 Obesity Collaborators (2017) performed a study of 67.8 million people in 175 countries across the world. Lastly, Davis et al. (2016) only had 40 Mexican American mothers as the participants of the research.

Comparison of the Limitations of the Studies

The most common limitation in the selected studies is in the sample size of the studies. Sahoo et al (2015) and Xu and Xue (2016) fail to mention the sample selection process. Therefore, the applicability of the information they present is limited. Davis et al (2016) only used 40 Mexican-American women in their study. This is a very small sample to apply the results to a wider community and includes the members of only one community. Therefore, cultural factors such as the beliefs and attitudes of Mexicans towards factors affecting obesity could affect the results. Oelscher et al. (2015) also has a very small sample of slightly above 500 kids; hence, the results may not be representative of the entire population. The limitation of GBD 2015 Obesity Collaborators (2017) study is that it is done in many countries but does not evaluate the unique cultural factors that affect obesity rates in each of the populations evaluated. It may be unwise to generalize the results for all populations.

Conclusion

Generally, there is consistency is the results of the studies evaluated in this literature review. All the studies show obesity as a serious public health issue regardless of the population within which the study has been conducted. The causes and effects of obesity are also similar in the studies that evaluate these factors. The prevention and intervention techniques that have been examined also revolve around diet and exercise in all studies. Benchmark – Capstone Project Change Proposal

 

References

Allender, S., Millar, L., Hovmand, P., Bell, C., Moodie, M., Carter, R., … & Orellana, L. (2016). Whole of systems trial of prevention strategies for childhood obesity: WHO STOPS childhood obesity. International journal of environmental research and public health, 13(11), 1143.

Ayer, J., Charakida, M., Deanfield, J. E., & Celermajer, D. S. (2015). Lifetime risk: childhood obesity and cardiovascular risk. European heart journal, 36(22), 1371-1376.

Davis, R. E., Cole, S. M., Blake, C. E., McKenney-Shubert, S. J., & Peterson, K. E. (2016). Eat, play, view, sleep: Exploring Mexican American mothers’ perceptions of decision making for four behaviors associated with childhood obesity risk. Appetite, 101, 104-113.

GBD 2015 Obesity Collaborators. (2017). Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine, 377(1), 13-27.

Oelscher, D. M., Butte, N. F., Barlow, S., Vandewater, E. A., Sharma, S. V., Huang, T., … & Oluyomi, A. O. (2015). Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Childhood obesity, 11(1), 71-91.

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.

Simmonds, M., Llewellyn, A., Owen, C. G., & Woolacott, N. (2016). Predicting adult obesity from childhood obesity: a systematic review and meta‐analysis. Obesity reviews, 17(2), 95-107.

Xu, S., & Xue, Y. (2016). Pediatric obesity: Causes, symptoms, prevention and treatment. Experimental and therapeutic medicine, 11(1), 15-20.

PICOT Statement

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PICOT Statement

Introduction

Childhood obesity poses a major public health threat to children in the United States. The rate of childhood obesity in the country has increased significantly in the past few decades. Although at different rates, children across different demographic groups in America struggle with weight issues which poses physical and psychological effects on them (Pulgaron, 2013; Sahoo et al., 2015). Therefore, it is important to develop an intervention to help in the reduction of this public health problem to protect children from its effects. This PICOT statement proposed an evidence-based solution that includes making sure that children have access to better diets. The following is an evaluation of the components of the PICOT statements and how they contribute to solving this issue.

PICOT Statement

Children with a BMI above 30 who are undergoing nutritional monitoring compared to not being monitored nutritionally can achieve significant weight loss in a period of a year.

P- Children with a BMI above 30

I-Undergoing nutritional monitoring

C- Compared to not being nutritionally monitored

O- Can achieve reduced weight

T- in a period of a year

Population

The population of focus for this intervention is the children in the United States with a BMI above 30 (Ogden et al., 2012). A BMI above 30 indicates that the children are suffering from obesity. The focus for the intervention will be children between 6 and 15 years because they are around the age groups with the highest risk of obesity in the country. Additionally, children within this age group tend to have the highest risk of engaging in unhealthy eating habits, especially when not being monitored (Ayer et al., 2013). Children below this age group are mainly under the care of their parents; hence, parents can easily control what they eat. On the other hand, the older children can understand obesity and be educated on ways they can change their eating habits; thus, there is no need to monitor them.

Intervention

The intervention is monitoring what the children eat. Each of the children in the selected age group needs to have an adult with an understanding of nutrition and its relationship with overweight and obesity issues. The adult with then develop the children’s meal plans, making sure that the foods they take in a day include those that will assist with weight loss but not suppress the required nutrients for a healthy lifestyle. The foods that have been determined to be high contributing factors to obesity include those with higher levels of sugar and excess fat. Many foods that fall into the category of ‘junk foods’ tend to contain these components. Therefore, these are the main foods that will be controlled in this intervention.

Comparison

The comparison to the intervention is failing to monitor the diets of the children. This implies that the children will be allowed to eat whatever they want regardless of the nutrition components of the food. Children tend to like the ‘junk foods’, which is part of the main reasons for the high rates of childhood obesity (Sabin & Kiess, 2015). Not monitoring the children and what they eat will mean that there will be a higher chance of maintaining or worsening their obesity. Benchmark – Capstone Project Change Proposal

Outcome

The expected outcome of this intervention is a significant reduction in the population’s weight. Two of the controllable contributing factors to childhood obesity are diet and physical activity. This intervention focuses on poor diet, which has been proven to lead to accumulation of excess fat leading to obesity in children (Roberto et al., 2015). Excess sugars and fat are some of the main causes of weight-related issues in children. Therefore, if these foods are controlled, it is expected that the children will experience a significant reduction of fat in their bodies. It is expected that after the intervention, the participating children will have a reduced body weight.

Time

Weight loss is a gradual process that occurs through consistency in the application of the intervention aiming at causing the weight loss. A period of one year has been assigned to this intervention program to ensure that the children are given enough time for their bodies to adapt to their new diets and for them to experience significant weight loss that can be recorded because of the intervention. The weights of the children will be measured at the beginning of the program and at the end of the intervention program to determine the significant change that has taken place after a year of monitoring the diets of the children and making sure that they only eat the right foods.

 

References

Ayer, J., Charakida, M., Deanfield, J. E., & Celermajer, D. S. (2015). Lifetime risk: childhood obesity and cardiovascular risk. European heart journal, 36(22), 1371-1376.

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Jama, 307(5), 483-490.

Pulgaron, E. R. (2013). Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clinical Therapeutics, 35(1), A18-A32.

Roberto, C. A., Swinburn, B., Hawkes, C., Huang, T. T., Costa, S. A., Ashe, M., … & Brownell, K. D. (2015). Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet, 385(9985), 2400-2409.

Sabin, M. A., & Kiess, W. (2015). Childhood obesity: current and novel approaches. Best Practice & Research Clinical Endocrinology & Metabolism, 29(3), 327-338.

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.