Evidence-Based Practice Faith MS, Van

Evidence-Based Practice

Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TVE, Odoms-Young a, Wansink B,

Wylie-

Rosett J (2012). Parents as Agents of Change for Obese Children. Retrieved Sepetmeber 5, 20120 from:

http://my.americanheart.org/professional/General/Parents-as-Agents-of-Lifestyle-Change-for-Obese-Children-a-Call-to-Action_UCM_436920_Article.jsp

Date (year)

Review of the Literature

Specific data analysis

Suggested Conclusions

Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TVE, Odoms-Young a, Wansink B, Wylie-Rosett J

Official Journal of the American Heart Association

Environment as an important influence on a child's health and whether or not the child becomes obese: parents has a huge influence on that environment.

Consults a range of literature which support the idea that the family unit has a tremendous impact on whether or not a child becomes obese

Gathers and deconstructs information regarding childhood obesity

Examines a range of gathered data according to caregiver impact

Parents need to be called to action to exert a healthier influence on their children's health nutritional habits.

3. The evidence presented in the report absolutely supports the conclusion reached by the team of authors. The researchers go to great lengths to determine how "Families play a critical role in the development and maintenance of eating and activity behaviors in youth, and parents have considerable influence over what, when, where and how children eat. As parent involvement2 and modeling of healthy behaviors3 have been identified as crucial components of effective interventions, most child weight control programs are family-based. Moreover, parent weight loss predicts child weight loss,4 suggesting that adult behavior change favorably affects child outcomes" (Faith et al., 2012). Faith and colleagues conclude that the American Heart Association is wise to treat parents and guardians as agents of change when it comes to bringing children to a healthy weight. The researchers have concluded that weight control is largely a behavioral issue and that basic mediators of body weight such as what one eats, when one eats, how often one eats and how much one eats are acquired behaviors that can be influenced by altering environment cue that revolve around them and the results that follow (Faith et al., 2012). Faith and associates find that the most effective way to change behavior is via behavioral interventions encompass a range of activities and skills that allow people to engage in lifestyle changes (2012). Parents are at the crux of making behavioral interventions effective when it comes to child hood obesity. For example Faith and colleagues demonstrate that when a parent loses weight, children generally follow in the same pattern.

4. When children are the subject of a research article, a range of ethical issues generally come into play. However, the ethical issues at play, helping children to healthfully lose weight in a manner that is constructive and beneficial, without starving children or chipping away at their self-esteem. The authors of the study reflect these needs by making parents, guardians and other adult caregivers the people who bear the brunt of the responsibility for this matter. In certain respects one could treat this as a reaction to the ethical issues inherent in the study, and on the other hand, one can treat this as a reaction to evidence and research presented. While the researchers do point out the older-aged children can be more responsible for making behavioral changes, the brunt of the burden of responsibility belongs foremost to the parents.

5. The type of research used for the study were previously conducted qualitative and quantitative research studies which strictly examined the roles that parents had in helping children to abandon unsatisfactory behavior. For example, the study demonstrated how "Parent-only treatments have been used for child behavioral issues such as tantrums, self-destructive behaviors, verbal aggression, excessive crying, thumb sucking, school phobia, and oppositional behavior.15 Parent-only interventions also have been utilized for child weight control13, and provide for more flexibility, and less burden and cost, relative to a model targeting both parents and children" (Faith et al., 2012). This demonstrates how parental influence has always been a successful factor in assisting children in the abandonment of a range of unsatisfactory traits and was one of the motivating forces for examining the impact of parents and guardians on childhood weight loss and healthy eating habits.

a. it's certainly possible that other types of research would have been effective for this subject matter, however the researchers in this case did such an eloquent job of examining evidence and taking into consideration a range of past studies, that question seems insignificant.

Section B

Problem Identified: Childhood Obesity

Author(s)

Source

Date (year)

Research Type (experimental, quasi-experimental, case series, ethnographic, etc.)

Population/

sample size

Outcome measures

Pertinent data from results

Suggested Conclusions

Toruner EK, Savaser S.

Journal of School Nursing

2010

Experimental: Quantitative

81

Body Mass Indices

Exercise training reduced weight in the intervention group of school children

Weight training and nutritional training can positively impact childhood obesity.

Lee G, Ha Y, Vann JJ, Choi E.

Journal of School Nursing

2009

Experimental Quantitative

3,400 students

Students' accurate or inaccurate weight status perception

Male students underestimated their weight; female students generally overestimated their weight.

Interventions need to be made to teach accurate body image to students

Moore JB, Pawloski LR, Goldberg P, Kyeung MO, Stoehr a, Baghi H.

Journal of School Nursing

2009

Experimental quantitative

126 students

Students' nutritional knowledge

Students' nutritional knowledge increased, but there was no real change in BMI.

"Color my pyramid" can be a useful tool in combating childhood obesity.

Resnick EA, Bishop M, O'Connell a, Hugo B, Isern G, Timm a, Ozonoff a, Geller AC.

Journal of School Nursing

2009

Experimental quantitative

46 parents

Child BMI

Children all dropped in BMI.

Parental education can be effective in reducing the BMI of children.

Stalter AM, Chaudry RV, Polivka BJ.

Journal of School Nursing

2011

Experimental Quantitative

25 Ohio School Nurses

School nurse knowledge base

Collaborating with other teachers leads to better health outcomes

Nurses should collaborate with physical education teachers

Stuart WP, Broome ME, Smith BA, Weaver M.

Journal of School Nursing

2005

Intervention review

17 weight loss studies

Adolescent body mass index or weight

Studies need more focus on ethnic minorities and on parental intervention

More research needs to be done before any conclusions are reached.

Tsai PY, Boonpleng W, McElmurry BJ, Park CG, McCreary L.

Journal of School Nursing

2009

Experimental Quantitative

1 public school predominantly hispanic

Children's body mass index

Strategic interventions like Take 10!

Reduce children's BMI

Take 10! The health and exercise program is effective in fighting childhood obesity.

Jennifer Yost1*, Barbara Krainovich-Miller2, Wendy Budin3 and Robert Norman4

BMC Public Health

2010

Comparative secondary analysis design

Body mass index, weight perception, and weight perception accuracy.

"Age, Black or African-American race, body-mass index, weight perception, and weight perceptions accuracy were consistently associated with the likeliness of trying to lose weight among U.S. female adolescents" (Yost et al., 2010).

Factors that can impact weight loss efforts such as age, race and socioeconomic class need to be adequately considered when making weight loss interventions.

Frank M. Sacks, M.D.,1,2 George a. Bray, M.D.,5 Vincent J. Carey, Ph.D.,2 Steven R. Smith, M.D.,5 Donna H. Ryan et al.

New England Journal of Medicine

2009

Quantitative

BMI and weight loss reduction in adults

All participants lost around 6kg

Diets which emphasize a reduction in calories are effective in weight loss.

JM Jurkowski, LL Green Mills, HA Lawson

Journal of Community Health

2012

Quantitative

200 parents

Reduction of weight in obese kids

Majority of children lost weight and became more active.

Parents play a major role in getting kids to eat healthy and fighting childhood obesity.

Annotated Bibliography

Toruner, E.K., & Savaser, S. (2010). A controlled evaluation of a school-based obesity prevention in Turkish school children. Journal of School Nursing, 26(6), 473-82.

Researchers scrutinize and determine the efficiency of a weight management program for elementary aged school children. The sample included two groups of approximately 40 students each. Students in one group got work out sessions for two and a half months. The parents of all the kids in both groups got training and consultancy sessions. The BMI index of the students in the intervention group decreased. Findings indicate that starting at the elementary school age is a good time for to change kids' eating habits.

This data demonstrates the necessity of targeting kids while their young in order to impact necessary changes on to habits that they'll have for life. Researchers have found this with foreign languages; the younger a child is when the foreign language is learned the better the child will absorb it. Thus, it should not be such a surprise that the same is true for the "language" of healthy eating.

Lee, G., Ha, Y., Vann, J.J., & Choi, E. (2009). Weight perception and dieting behavior among Korean adolescents. Journal of School

Nursing, 25(6), 427-435.

In this study, researchers attempted to find the connection between elements like weight status, weight perceptions and dieting behaviors in South Korean teenagers, particularly because South Korean standards of aesthetic ideals have adapted over time and school nurses need to be aware of these changes. The study involved giving adolescents a questionnaire to determine if they perceived their weight and appearance with accuracy; most females overestimated their weight and most males underestimated their weights. However, this was just 35% of the participants. The bulk of the participants (65%) were able to assess their body weight accurately. On the other hand, the results of the study indicate the need for interventions to help develop health body images and healthy assessments of body weight.

This study was conducted in a thorough and comprehensive manner as the details of the study reflect. The researchers were wise to engage a large sample, so as to create a comprehensive amount of feedback and findings and to be able to look for trends with accuracy. The findings of this actual study point to the need for parents and authority figures to be better connected to the body image ideals of their children so that they can best meet the needs of these young adults.

Moore, J.B., Pawloski, L.R., Goldberg, P., & Kyeung, M.O. (2009). Childhood obesity study: a pilot study of the effect of the nutrition education program color my pyramid. Journal of School Nursing, 25(3), 230-9.

In this study, researchers assess the effectiveness of a particular educational intervention referred to as "Color My Pyramid" which is a children's nutritional program that is designed to influence kids early on to becoming more nutritionally educated. The design of the research was quasi-experimental, using 126 elementary school aged children as a sample. The findings demonstrated that educational interventions at the elementary level were wise practices that could have a positive impact on young children's BMIs.

Color My Pyramid is not the only program of this nature which exists and it would be worth conducting more research to determine if comparable programs would be equally beneficial in reducing weight for children. Furthermore, Color My Pyramid orbits around the food pyramid drafted by the USDA; this pyramid has often come under seige by nutritionists as not being the healthiest for kids. Thus, it would be also interesting to see if other food pyramids -- such as ones which emphasized less grains and more protein -- proved more effective. However, the study demonstrates yet again, the effectiveness in engaging children in nutritional interventions at a young age in order to form good habits for adulthood.

Resnick, E.A., Bishop, M., O'Connell, a., & Hugo, B. (2009). The cheer study to reduce BMI in elementary school students: a school-based, parent-directed study in Framingham, Massachusetts. Journal of School Nursing, 25(5), 361-72.

Resnick and colleagues attempted to ascertain the overall effectiveness and long-standing impact of parent-centered interventions on childhood obesity by engaging 46 parents over overweight kids from two public schools in Massachusetts. The researchers attempted to test the best ways in which educational materials should be taught to parents: via self-instructed methods or through one on one teaching methods with community health workers. At the end of the study, parents completed surveys and all their kids had their BMIs measured once more. All the children experiences lower BMIs, generally moving from 94 to 90.1. This demonstrates that educating adults can have a profound and immediate impact on their children in a clearly positive way.

The overall message of importance regarding this study is that it doesn't really matter in what way parents are educated, just that they are. Giving parents the proper knowledge and tools to make their kids healthy is what is most important of all. This study showcases that parents can have a profound impact on the habits and behavior of their young, and that researchers should never discount that but capitalize on it as a means for reducing the obesity epidemic.

Stalter, a.M., Chaudry, R.V., & Polivka, B.J. (2011). Regional differences as barriers to body mass index screening described by Ohio school nurses. Journal of School Health, 81(8), 437 -- 448.

Stalter and colleagues attempted to determine what the barriers were in BMI screening in schools and if there were any facilitating factors. The study involved 25 school nurses in three areas of Ohio. The tools used were simple, a tweaked version of Healthy People 2010 as a model as a means for uncovering reasons and motivations for the choices made by these nurses in a group format. The tools were reasonably adequate, turning out results which showed things like the nurses' background, school policy, and access to quality healthcare as all factors in whether or not the nurses took BMI measurements. Different tools would probably have turned up the same results as this study was just an attempt to uncover such information and how it works as a motivating factor.

Stuart, W.P., Broome, M.E., & Smith, B.A. (2005). An integrative review of interventions for adolescent weight loss. Journal of School Nursing, 21(2), 77-85.

Researchers wanted to determine the effectiveness of a range of weight-loss interventions with overweight teenagers by comparing and contrasting 17 studies which addressed this issue. The results of the study found that there weren't enough representations of minority groups and that a more precise conceptual framework is needed to best guide the study. The tools used were efficient enough; similar results would have been gleaned even if the researchers used highly efficient tools.

Tsai, P.Y., Boonpleng, W., McElmurry, B.J., Park, C.G., & McCreary, L. (2009). Lessons learned in using Take 10! with Hispanic children. The Journal of School Nursing, 25(2), 163-172.

Researchers were aware of how poor diet and a lack of physical activity could attribute to childhood obesity; TAKE 10! Was a program implemented in public schools to address this issue. Tsai and colleagues used questionnaires, observations, teacher surveys and one on one interviews to determine the effectiveness of the program and whether or not it needs to be tweaked. Tsai and associated made some discoveries which point to changes the TAKE 10! regime could implement. The tools used to reach these results were reasonably thorough, however, it's noticeable that the researchers at no point weighed the children or calculated their BMIs something which would have given them clear results as to the efficacy of the program.

Yost, J., Krainovich-Miller, B., Budin, W., & Norman, R. (2010). Assessing weight perception accuracy to promote weight loss among U.S. female adolescents: A secondary analysis. BMC Public Health, 10, 465.

Researchers acknowledge that obesity has become a global epidemic and that concerted immediate effort is necessary. Yost and colleagues engaged in a non-experimental, descriptive, comparative secondary analysis design using data from a National Longitudinal study of adolescent health. The tools used were statistical software which assessed the range of variables. These tools were highly effective and eventually led researchers to the conclusion that things like age, race, body-mass index and weight perception along with accuracy needs to be engaged into weight loss interventions for American teenage girls. The statistical data analysis tools used were so precise and successful, there's no doubt that another tool would only provide different results if it was inferior.