Summary of Clinical Issue

Literature Evaluation Table

Student Name: Christiana Bona.

Summary of Clinical Issue (200-250 words):

Childhood obesity is one of the problems that affect the United States and other developed economies.  Obesity among children and youths is widely recognized as an issue that generates a lot of adverse health impacts.  For instance, childhood obesity is a major indicator of future mental and physical health problems. In spite of the highest rates of childhood obesity in the country in the last three decades, obesity has been linked to other more serious health problems such as cardiovascular diseases and diabetes. As nurses and other health professionals continue to grapple with this problem, there are still no clear treatment approaches. Health professionals usually do not have a comprehensive guideline on where to manage the nearly one-third of their populations who present the medical care with obesity that coexists with other medical conditions and problems. Numerous treatment models have been proposed to address this rising public health concern. These approaches often include use of the traditional interventions such as pharmacological interventions. However, overemphasis on one treatment intervention may fail to generate the desired objectives. While the traditional strategies to obesity prevention and management have placed emphasis on medications, wider attention to other dimensions of treatment is necessary. Such treatment interventions may include the multi-tiered or holistic strategies that incorporate both pharmacological and non-pharmacological interventions. For instance, a wider focus should incorporate practices such as assessing the mental health impacts of obesity on the patients. Thus, a public health multi-tiered approach to obesity that emphasizes on promotion, prevention, and individualized interventions are recommended.

PICOT Question: Is the use of multi-tiered approach to the treatment and management of childhood obesity more effective than overreliance on only pharmacological interventions in reducing obesity prevalence rates?

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Cuda, S. E., & Censani, M. (2018). Pediatric Obesity Algorithm: A Practical Approach to Obesity Diagnosis and Management. Frontiers in pediatrics6.

 

Heerman, W. J., Schludnt, D., Harris, D., Teeters, L., Apple, R., & Barkin, S. L. (2018). Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation. BMC public health18(1), 498. Bazyk, S., & Winne, R. (2013). A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth. Occupational therapy in health care27(2), 84-98.
How Does the Article Relate to the PICOT Question? The article is relevant to the PICOT question because it proposes the use of algorithms and technological systems that have data on all aspects of a child’s obesity prevention and management strategies. The study recommends use of behavioral interventions in managing and treating childhood obesity and health issues, apart from the use of pharmacological interventions. The article is directly related to the PICOT question because it proposes the adoption of multi-tiered approaches to childhood obesity management, prevalence and prevention over decades.
Quantitative, Qualitative (How do you know?) The study uses quantitative designs because there are many quantitative indicators such as BMI, prevalence rates, and obesity comorbidities that have been used The research uses quantitative design because the researchers evaluate the outcomes of community based interventions quantitatively using pre-post survey, attendance rates, and reduction rates. The research provides obesity data on children between ages 0’ and 12 years. The study is mainly qualitative because it uses descriptive studies to explore the use of multi-tiered approach to obesity management and it involves 20 intervention.
Purpose Statement The study explores previous research done on pediatric algorithm diagnosis, evaluation, and management. The purpose of the study is to examine the adoption of the rigorously assessed healthier families programs by Parks and Recreation centers in three cities. The purpose of the study is to investigate the efficacy of obesity prevalence from 2013 – 2014 trend over the decade and public health multi-tiered approach to childhood obesity prevention and management.
Research Question What is the effectiveness of pediatric obesity algorithm in diagnosis and treating childhood obesity? Are community-based behavioral interventions effective in treating and managing childhood obesity? Is the multi-tiered approach to obesity management effective in reducing childhood obesity prevalence rates?
Outcome The study found that identifying and treating childhood obesity as early as possible is important as understanding comorbid conditions. The study outcomes indicate that the utilization of evidence-based childhood obesity interventions is a major aspect of combating obesity and its long-term health consequences. The outcome of the study showed that multi-tiered approach is more effective than the traditional models of managing childhood obesity.
Setting 

(Where did the study take place?) 

Hospital setting, USA Community setting, USA The research was undertaken in public healthcare settings.
Sample The researchers selected more than 100 articles on previous studies undertaken on pediatric obesity algorithms of which 1000 children aged 6 -12 years where sampled A total of 23 parent child pairs in three partner sites were selected. The study selected a total of 1000 children to participate in the research
Method The main data gathering method that was used  quantitative content analysis Interviews were used for data gathering Questionnaires were used as the main data gathering methods.
Key Findings of the Study The study found that pediatric obesity algorithm can help to guide health professionals with a practical and evidence-based approach  to diagnosis and management of childhood obesity The study found that the average attendance for the program was about 7.6 per session, with 71 percent attending. The study found that the utilization of  multi-tiered approach to obesity management is more effective than traditional models.
Recommendations of the Researcher The study recommends families to use algorithmic tools to manage and reduce childhood obesity. The study recommends the use of community-based obesity prevention and management strategies, which can help to significantly reduce BMIs and behavior change among obesity patients The study recommends future investigations into the significance of public health multi-tiered approach to obesity, emphasizing on health promotion, prevention, and individualized interactions.

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Rankin, A., Blood-Siegfried, J., Vorderstrasse, A., & Chlebowy, D. O. (2015). Implementation of childhood obesity identification and prevention strategies in primary care: A quality improvement project. International Journal of Pediatrics and Adolescent Medicine2(2), 59-63.

 

Styne, D. M., Arslanian, S. A., Connor, E. L., Farooqi, I. S., Murad, M. H., Silverstein, J. H., & Yanovski, J. A. (2017). Pediatric obesity—assessment, treatment, and prevention: an Endocrine Society Clinical Practice guideline. The Journal of Clinical Endocrinology & Metabolism102(3), 709-757. Wilfley, D. E., Staiano, A. E., Altman, M., Lindros, J., Lima, A., Hassink, S. G., … & Improving Access and Systems of Care for Evidence‐Based Childhood Obesity Treatment Conference Workgroup. (2017). Improving access and systems of care for evidence‐based childhood obesity treatment: Conference key findings and next steps. Obesity25(1), 16-29.
How Does the Article Relate to the PICOT Question? The study is related to the PICOT question because it seeks to explore culturally appropriate strategies of treating and managing childhood obesity The article explores recommended practices and standards for childhood obesity treatment and prevention. The study is relevant to the PICOT question because it seeks to explore ways of improving access to care for childhood obesity patients.
Quantitative, Qualitative (How do you know?) The study uses quantitative design because there are quantitative metrics such as BMI, rates of prevalence, and the rates of increase in childhood obesity The study uses mixed methods (both qualitative and quantitative approaches) Quantitative, design was used because the study explores changes that take place when children are provided referrals for six years for 26 contact hours comprehensive treatments.
Purpose Statement The purpose of the study was to implement childhood obesity identification and prevention guidelines from evidence-based recommendations into practice. The purpose of the research is to formulate clinical guidelines and standards for evaluation, treatment, as well as prevention of pediatric obesity. The purpose of the study was to advance the translation of USPSTF recommendations to design feasible, acceptable, and effective sustainable care for childhood obesity patients.
Research Question Does implementation of evidence-based guidelines and standards in healthcare settings help to reduce obesity prevalence rates among children? What are the necessary clinical guidelines that are needed for the assessment, treatment, and prevention of pediatric obesity? Can improved access and system of care reduce childhood obesity prevalence?
Outcome The outcomes of the study was to reduce morbidity and financial burdens associated with childhood obesity The outcome of the study was the development of an evidence-based guideline with the use of Grading of Recommendations, assessments, and development processes. The outcome of the study included the need to provide sustainable care delivery models for evidence-based treatment of childhood obesity.
Setting 

(Where did the study take place?) 

The research was done in pediatric primary care office settings The research was conducted within the premises of the Endocrine Society through an appointed Task Force. The study was undertaken in primary healthcare settings
Sample A total number of 80 patients were selected to participate in the study A total of 6 experts were selected to participate in the study 46 national leaders in the healthcare sector were selected to participate in the study
Method Questionnaires and other quality indicators were used for data gathering Both questionnaires and focus groups were used since it was a taskforce that comprised of 6 members who sat in a group to develop and assess standards Interviews were used in the study
Key Findings of the Study The study found that practice change including childhood obesity identification and familial prevention guidelines positively reduces obesity among children. The findings indicated that engaging experts from the Endocrine Society can help to develop effective methods of childhood obesity prevention and treatment. The survey indicated that there are multiple barriers that deter the implementation of the USPSTF recommendations. Such barriers include high operating costs, low availability, and quality of staff training.
Recommendations of the Researcher The study recommends the implementation of evidence-based guidelines and standards in increased identification of children at risk of children at risk for childhood obesity and enhanced familial obesity prevention The researchers recommend the need for future studies to focus on understanding ways of effecting systemic changes in food environments and total daily morbidity, including ways of sustaining healthy BMI. The study suggests the need for stakeholders in the healthcare sectors to convene intensive interactive conferences in order to develop holistic standards of care for pediatric obesity patients.