Diabetes

Critique
The article by Lynch et al. (2019) is entitled “Randomized Trial of a Lifestyle Intervention for Urban Low-Income African Americans with Type 2 Diabetes” and appeared in JGIM: Journal of General Internal Medicine. The article by Protheroe et al. (2016) is entitled “The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial” and appeared in Journal of Diabetes Research. This paper will critique the two articles by evaluating information pertaining to their titles, abstracts, introductions, background sections and the authors’ discussion of their respective studies’ significance. Information pertaining to the studies’ statement of problem, research questions or hypotheses, literature review, theoretical framework, ethical considerations and research design will be evaluated as well. The criteria used to critique the articles come from that provided by Polit and Beck (2017).
Title
According to Polit and Beck’s (2017) criteria for a well-written title, neither article had a sufficiently formulated title. The title by Protheroe et al. (2016) contained the primary concept of the study—namely, feasibility of health trainer improved patient self-management, and it also identified the population and design of the study—but it did not define the length of the study. Lynch et al. (2019) also failed to identify the length of the study in their title; however, like Protheroe et al. (2016), they did include the primary concept of lifestyle intervention for urban low-income African Americans with type 2 diabetes, and they did identify the population and design of the study.
Abstract
Protheroe et al. (2016) provided an unstructured abstract in fewer than 250 words. Sufficient information was given for the reader to decipher whether the article would be applicable or relevant. As Polit and Beck (2017) note, an abstract should be fewer than 250 words and contain a brief description of the study. It should also include the research questions, what methods were used, and the researcher found, and the abstract given by Protheroe et al. (2016) met all those conditions. The same goes for the one given by Lynch et al. (2019). Sufficient keywords were provided by Lynch et al. (2019) to search their article on databases. However, no keywords were provided by Protheroe et al. (2016).
Introduction, Background and Significance
Funding was provided for both articles. The National Institute for Health Research (NIHR) under its Research for Patient Benefit Programme (Grant Reference no. PB-PG-0110-20033) provided funding for the study by Protheroe et al. (2016). The National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number R01DK092271 and the National Institute for Heart Lung and Blood (NHLBI), grant number 1P50HL105189-01, provided funding for the study by Lynch et al. (2019). Both sources appeared to be reputable.
Background and significance were only slightly provided and merely suggested in each article. Both introductions contained literature reviews, which were not separated by heading but rather were incorporated directly into the introductions. The introduction for the article by Lynch et al. (2019) was roughly the same length as the introduction for the article by Protheroe et al. (2016). Approximately 20 sources were cited in the introduction by Protheroe et al. (2016), and the vast majority of these sources were current and primary. The authors picked sources that were well rounded for the current topic of discussion in this research article. In the study by Lynch et al. (2019), only nine sources were cited in the introduction, and the vast majority of these sources were current and primary. Lynch et al. (2019) also chose sources that were well rounded for the topic of discussion. According to Polit and Beck (2017), literature reviews provide a foundation for new research to be done and can tell researchers what the current status of a problem is and existing practice guidelines. While the authors meet some of these criteria, they do not meet all: neither explicitly discusses the gap in research that is being addressed, though they both suggest the need for the study they have conducted by alluding to what prior research has shown and how their research adds to it.
Statement of Problem
The problems in both articles are not explicitly defined but are only suggested. Lynch et al. (2019) state that African-Americans are more likely to have Type 2 diabetes, and this is assumed to be the problem since it is the opening statement. It is less clear what the problem is in the study by Protheroe et al. (2016).
Research Questions/Hypotheses
The study by Protheroe et al. (2016) was exploratory in nature and thus aimed to achieve three goals: to develop an intervention, explore feasibility of recruiting patients to a trial of the intervention, and collecting data to inform the design of the intervention. Neither research questions nor hypotheses were provided.
The study by Lynch et al. (2019) did contain a hypothesis, namely “that intervention participants would show a greater A1c reduction at 12 months than comparison participants and that the difference would be sustained 6 months after the conclusion of the intervention (at 18 months)” (p. 1175). There were no research questions provided, however.
Theoretical Framework
Protheroe et al. (2016) identified theoretical framework for the research question of this article. The theoretical framework is presented within the introduction and provides the rationale for conducting the research. According to Polit and Beck (2017) theoretical frameworks should include information to help to guide the study method, and specifies key variables that influence a phenomenon and why those variables might differ with proposed research. Lynch et al. (2019) also provided a framework: the Lifestyle Improvement through Food and Exercise (LIFE) intervention. It, too, was presented in the introduction and provided the rationale for conducting the research.
Ethical Considerations
Protheroe et al. (2016) did not disclose if the study was reviewed by an Institutional Review Board or Ethics Committee for approval. Their study was conducted in England, however, and they do, however, disclose how the patients were chosen to participate in the randomized control trail and the process for selection that took place. They state that all participants were consenting adults. Polit and Beck (2017) describe criteria for a description of ethical considerations as 1) the study should be reviewed by IRB, 2) it should be designed to minimize risks and maximize benefits, and 3) appropriate procedures should be used to safeguard the rights of the participants in the study. Protheroe et al. (2016) meet most of these conditions, saving the one regarding the IRB. The study by Lynch et al. (2019) was approved by the Rush University Medical Center and Cook County Health and Hospitals System (CCHHS) Institutional Review Boards. Participants gave written informed consent. Lynch et al. (2019) did not describe how they minimized risks and maximized benefits, however; aside from that condition they met the rest of Polit and Beck’s (2017) criteria.
Research Design
Protheroe et al. (2016) used a randomized control trial for their research design. Lynch et al. (2019) did the same. According to Polit and Beck (2017), “a control group is a key part of large trials, randomization helps to ensure that no bias affects the selection of people for the control group, and a study will publish baseline measurements for both groups to allow the reader direct comparison” (p. 10). Protheroe et al. (2016) abided by the same criteria: their randomized control trial was comparing a group of patients that had a lay health trainer (LHT) with a group of patients that received the usual care for diabetes education. The control group in their study received usual medical care provided to patients with their condition.
Lynch et al. (2019) also abided by the criteria described by Polit and Beck (2017): the randomized control trial they conducted was comparing a group of African American patients that would receive Lifestyle Improvement through Food and Exercise (LIFE) intervention. The control group received conventional Type 2 diabetes education which consisted of two group educational classes.
Both studies thus used a sufficiently non-biased research design (level II) with a randomized control trial in which they could conduct a test and obtain data. The study could be judged to be valid and reliable: they both measure what they purport to measure, and each provides sufficient design description that it could be duplicated by other researchers.
References
Lynch, E. B., Mack, L., Avery, E., Wang, Y., Dawar, R., Richardson, D., … Fogelfeld, L. (2019). Randomized Trial of a Lifestyle Intervention for Urban Low-Income African Americans with Type 2 Diabetes. JGIM: Journal of General Internal Medicine, 34(7), 1174–1183. https://doi-org.ezproxy.loyno.edu/10.1007/s11606-019-04894-y
Protheroe, J., Rathod, T., Bartlam, B., Rowlands, G., Richardson, G., & Reeves, D. (2016). The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial. Journal of Diabetes Research, 1–11. https://doi.org/10.1155/2016/6903245