In Part A, you described the population and quality initiative related to your PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process.
Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles. Translational Research and Population Health Management Essay Paper
In a paper of 1,250-1,500 words, synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following:
Introduction: Describe the clinical issue or problem you are addressing.
Methods: Describe the criteria you used in choosing your articles
Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies.
Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Translational Research and Population Health Management
The clinical problem of adolescent obesity is a major public health issue in the United States. There is a rising number of adolescents aged between 13 and 19 years who are either overweight or obese. But what is interesting is that this problem of obesity among adolescents does not affect all ethnic or racial entities equally. It has been observed and shown by studies that those adolescents that are mostly affected by the problem of overweight and obesity are from poor backgrounds. Low socioeconomic status is therefore directly linked to teenage obesity. This means that there are factors associated with purchasing power that are at play in teenage obesity. These factors relate to diet specifically but also the ability to live in a decent neighborhood with recreational amenities. Because of systemic marginalization, it so happen that an overwhelming majority of these adolescents from poor backgrounds affected by obesity are from the minority marginalized communities. These are usually Hispanics and African American teenagers. They are a demographic that is affected by quite unfavorable social determinants of health. The same social determinants of health also affect their parents. These are low socioeconomic status, poor living conditions, low educational achievement, and lack of access to quality healthcare services. The parents cannot afford to regularly purchase fresh fruits and vegetables and so the teenagers mostly feed on junk foods and highly processed diets. They also drink a lot of the cheap sweetened sugary beverages that are high in calories both at home and at school. While at home, these teenagers only watch television from morning to evening without engaging in recreational activities. The reasons for this are many but include insecurity and lack of open playing fields that the children can use. This is the clinical issue of interest that this evidence-based project seeks to solve by searching for scholarly peer-reviewed research evidence for efficacious interventions. The purpose of this paper is therefore to present the clinical issue of adolescent obesity among marginalized communities in the United States, outline the evidence search for studies, and present a literature review of five of those studies that answer the PICOT question earlier set.
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Methods: The Criteria Used in Choosing the Articles
The method used to obtain the articles that answer the PICOT question was that of using keywords and Boolean operators to search research databases. The keywords were taken from the PICOT statement to ensure that the studies that would be generated would be answering the PICOT question. The research databases used for searching the scholarly evidence were CINAHL, ProQuest, Cochrane, and PubMed. From the earlier module, the PICOT question that was formulated was as follows: In adolescent children aged 13 to 19 years from poor marginalized backgrounds (P), does the bundled intervention of parent and school authorities education (I) compared to the current status of little or no intervention (C) result in a significant reduction in teenage obesity in the population demographic of interest (O) within a period of 12 months (T)? From this, the key words chosen for the search were ‘adolescent,’ ‘obesity,’ ‘overweight,’ ‘prevention,’ ‘marginalized communities,’ and ‘low socio-economic status.’ These were variously combined with the Boolean operator ‘AND’ to generate the search results. The initial result generated a total of 7,564 full text studies and abstracts. By using specific filters that removed systematic reviews and meta-analyses, it was possible to remain with only primary studies. Systematic reviews and meta-analyses are not primary studies and that is the reason they were excluded from the search. The remaining studies were 2,431. Further filters were then applied to only leave full text articles that were published within the last five years. This left a total number of 86 articles. The articles were then analyzed to see if they specifically answered the PICOT question. This last filtering resulted in 32 articles remaining. These were more specific in answering the PICOT question above. Out of these, five have been chosen for literature review on the problem of adolescent overweight and obesity among teenagers from poor marginalized communities. The following is the literature review on the methodology, results, and limitations of those studies. Translational Research and Population Health Management Essay Paper
Part A: Subjects, Methods, and Key Findings
Jelalian and Evans (2017) carried out a study in Mexico that aimed at finding what behavioral interventions were effective in preventing teenage obesity among Hispanic children. The subjects were Hispanic teenagers aged between 13 and 19 years and who were at risk of developing obesity. The study used a quantitative methodology to come u with findings that showed that adolescent children responded well to educational interventions offered from an early age. The educational message on behavioral change involved engaging in physical activity, eating fresh fruits and vegetables as much as possible, and watching less television.
Ogden et al. (2018) looked at the household incomes and educational achievements of families in the US and determined that there was a positive correlation between teenage obesity and household income. There was also a positive relationship between teenage obesity and level of education of both the parents and the teenager. Higher educational achievement made the parents and the teenager aware of the risks of obesity. This was an observational study or survey and the subjects were households with teenagers.
Partridge and Redfern (2018) on their part sought to find out the best digital strategies that may be used to facilitate prevention of teenage obesity. This is in realization of the fact that teenagers are the demographic that most uses technology in the form of smartphones. They found that mobile applications can be effectively used to enable the teenagers monitor their weight and take corrective action before becoming obese. The subjects were teenagers aged between 13 and 19 and the methodology adopted was quantitative.
Sweating et al. (2016) and Yoshinaga et al. (2018) are the other studies that were selected from the search results. The former researchers studied how teenagers are able to manage their weight as they transition into adulthood. The subjects were teenagers transitioning to college around the age of 19 years. They found that because of bullying and stigma, these teenagers were motivated to check their weight and make sure that they adopted interventions to cut their weight. This was a qualitative survey of a particular demographic population. Lastly, the latter researchers offer insight into the use of exercise as an intervention to prevent teenage obesity. This was a randomized controlled trial using teenagers as subjects and assessing their response to isotonic aerobic exercise (walking) with regard to obesity prevention. They found that walking was effective in reducing the chances of a teenager becoming obese.
Part B: Limitations, Controversies, Similarities/ Differences
The major limitations in all the studies include insufficient sample sizes in some cases and the lack of control of confounding variables such as availability of fresh fruits and vegetables. All the studies are similar in their results in that they are concentrating on finding interventions that will be evidence-based and that will be effective and efficacious in preventing obesity among teenagers from marginalized communities in the US. The main difference is in the study methodologies. Some of the studies are qualitative in nature while others are quantitative in nature. Of the quantitative ones, some are more robust and experimental in the form of randomized controlled trials or RCTs.
Areas for Further Study
According to the findings from these studies, what is known is that overweight and obesity affects disproportionately populations of teenagers from minority communities like Hispanics and African Americans. What is not known is whether there is a genetic component that plays a part in the epidemiology of obesity in teenagers from marginalized communities. The areas for further research should therefore focus on the possibility of heredity in the etiology of overweight and obesity among teenagers from minority communities.
Conclusion
Teenage obesity is a major concern for public health authorities in developed and developing countries. In the US, the problem affects more those teenagers from poor communities. These are mainly from minority communities. There is however enough evidence to support interventions that are efficacious in preventing the problem. They include exercise (walking) and the use of mobile applications.
References
Jelalian, E., & Evans, E.W. (2017).Behavioral intervention in the treatment of obesity in children and adolescents: Implications for Mexico. Nutrition Reviews, 75(S1), 79-84. Doi: https://doi.org/10.1093/nutrit/nuw035
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Ogden, C.L., Carroll, M.D., Fakhouri, T.H., Hales, C.M., Fryer, C.D., Li, X., & Freedman, D.S. (2018). Prevalence of obesity among youths by household income and education level of head of household – United States 2011-2014. MMWR Morbidity and Mortality Report, 67(6), 186-189. http://dx.doi.org/10.15585/mmwr.mm6706a3
Partridge, S.R., & Redfern, J. (2018). Strategies to engage adolescents in digital health interventions for obesity prevention and management. Healthcare, 6(3), 1-10. Doi: https://doi.org/10.3390/healthcare6030070
Sweeting, H., Smith, E., Neary, J., & Wright, C. (2016). ‘Now I care’: A qualitative study of how overweight adolescents managed their weight in the transition to adulthood. BMJ Open, 6(e010774), 1-9. https://doi.org/10.1136/bmjopen-2015- 010774
Yoshinaga, M., Seki, S., Ogata, H., Ito, Y., Aoki, M., Miyazaki, A., Tokuda, M., Lin, L., Horigome, H., & Nagashima, M. (2018). Treating childhood obesity by walking: A randomised controlled trial. Circulation, 136(Suppl. 1). https://www.ahajournals.org/doi/10.1161/circ.136.suppl_1.19734 Translational Research and Population Health Management Essay Paper