Academic and Practice Enquiry
RQ: What are the challenges due to lack of physical activity among children with obesity?
Researching this question reflects the following aspects:
Population: Children of 10-11 years
Exposure: Physical activity
Outcomes: Challenges or obesity consequences
Introduction
The rising prevalence of childhood obesity has come up as a serious concern in the developed countries and increasingly in different parts of the developing world (1). Hence, nowadays childhood obesity has become a complex health concern (2). It occurs when a child is well above a normal or healthy weighty for her/his age with height. All these facts reflect that obesity to be researched on seems to be an interesting topic as it has become one of the major concerns for not only the children’s parents but also the entire healthcare sector. This topic is important from the nursing practice because nurse sees children in various settings including primary care offices, hospitals and schools, their contribution towards identifying children at risk to becoming overweight or obese is effective. Furthermore, the nurse plays a major role in ensuring families well-educated regarding health promotional strategies for preventing the progression of obesity into adulthood for example indulging in physical activity. The significance of physical activity may refer to the management of childhood obesity or/and the prevention of obesity (3).
Thus, the importance of physical activity delivered by a nurse to the children’s parents would be explored here by taking a systematic review. Furthermore, the benefits delivered by physical activity to a child with obesity would be explored by carrying out a systematic review. Obesity rates have been increasing among children irrespective of their ages, and reduced physical activity seems to likely be a contributor to this trend (4).
Search Strategy
To carry out the integrative Literature review, the e-healthcare databases being searched for are PubMed, Medline, BMJ (British Medical Journal), JMIR (Journal of Medical Internet Research), European Journal of Clinical Science and HHS (Human and Health Service) Public Access. While searching the database, exclusion criteria are “pre-publication databases such as before the 2006 year published articles are excluded, other than specific research design such as if systematic review, purely qualitative, cohort or other research design is found then the articles would be excluded, and if the article’s findings are based on adolescents or infants, then the articles would be excluded again. However, the inclusion criteria are based on post-published articles after the year 2006, which means only those articles would be included that are published after 2006. Strengths of this research study are the authenticity of selecting articles and databases, checking the reliability and validity of the papers and investigating in-depth or descriptive findings. Weaknesses could be lengthy or time-consuming, not following a systematic review and documentation of the observations of six articles would be a challenging task.
Study Selection
The reason to include such inclusion criteria, specifically the research design, is that data would be collected at a defined time and this design would purely be based on descriptive aimed at accessing the challenges experienced by a definite population, children. The reason to include articles getting published after 2006 years because the recent data could give more descriptive, in-depth and intense based as nowadays obesity has come up as a huge challenge for the entire world, specifically when the population is children. This is the reason for which only children is targeted because obesity in children has been increasing all over the world, specifically in the UK. The reason is to include exclusion criteria such as before the year 2006 because before 2006 children obesity had not become one of the major concerns.
Critical Appraisal
To critically appraise the selected six papers, the following aspects need to be maintained for each study:
Article 1:
Title: The title is moderate clear because it indulges metrics accessing the physical activity to be carried out by obese children, although it would be more accurate if the types of physical activity would be mentioned to decrease the long-term consequences of obesity.
The title is completely clear as the title meet the research question because the title aims at identifying the association between the practices of childcare educator and PA and dietary intake of children; if this association would result in ineffective then challenges could be identified.
This title is completely clear when associated with the RQ. The title describes the association of sedentary behaviour, PA, body composition, and cardio-respiratory fitness with the risk of sleep-related breathing in obese children.
This title has huge relevancy with this paper’s RQ because this reflects that there is a strong relationship between video games, obesity and children. Videogames make the children obese because it restricts the children from PA by indulging in this sedentary behaviour of being sat in front of the screen.
This title also maintains high relevancy with the RQ since the article identified that PA is an additional risk factor affecting bone mineral accretion leading a child to obesity.
This title reflects that there is limited attention provided by parents towards their preschool-aged children regarding indulgence in PA session. This lack of attention by the parents increases the rate of obesity risks among the children.
Abstract: Yes, the article has provided some of the relevant information directing the researcher to answer the research question. The article has focused on step-metrics to identify the intervention of PA in obese children, and the RQ aims at identifying the challenges due to PA faced by obese children.
The article offers huge relevant information regarding the RQ because the study reflects the role of childcare educators to promote PA and healthy eating behaviour among obese children. This study offers information about the lack of PA and other activities that lead an overweight child to experience risks related to sleep.
This article reveals the reasons from the children’s end that restrict them to get engaged in PA and that reason is video games. This article reveals that how video games contribute to increasing weight in a child and making that child obese.
This article offers a scope to get knowledge about bone density among obese children, which is a major factor of lack of PA. This lack of PA becomes an additional factor affecting the accretion of bone mineral, thus RQ based on challenges due to lack of PA among the respective population can be met by this article.
This article provides huge scope to the link between a parent’s attention and obesity rate among the children. Since the RQ aims at identifying the challenges due to PA among obese children and this article gives information to this RQ by emphasizing home physical environment characteristics set by the parents of the obese children.
The rationale gets lacked in this study, however, a few objectives are set aimed at identifying the indicators based on set metrics of PA. Thus, based on the objectives set in this study, the reasons sound comparatively less convincing because the study is carried out with the motive of public health recommendations to be provided to obese children and their health. On the other hand, this research study aims at focusing on the challenges that obese children experience due to lack of physical activity. The study does not indulge a critical overview of any similar research being carried out, where this study is completely based on its findings of qualitative research. However, the article offers primary sources and the references are given date.
The rationale defined to conduct this study is based on the increased rate of obesity during the childhood period. However, the approach of the author to convince the reason does not sound interesting enough because the author emphasises majorly the role of educator instead of public health concern, which the respective study at the initial stage had focused on. This research study has not indulged a critical review of any other research study. The author gave primary sources, however, the references are not given date.
The rationale is based on examining the association between lack of PA, presence of sedentary behaviour, unproductive body composition and risks associated with sleep. The reasons provided in this study are convincing because the author considered “PA” as a concern for increasing sleep-related risks among obese children. This research does not use any other systematic review. This study indulges primary sources and the references are given dated.
The rationale behind conducting this study reflects that the parents also contribute to making their kids uninterested in physical activity. There is so much additional use of the screen in a child’s daily life that started linking to higher obesity prevalence among children. The reasons behind the rationale are convincing enough to link the study’s rationale and the RQ of this assignment. The study indulged a critical review of around 26 studies among all 25 were cross-sectional and only 1 was longitudinal. This article gave secondary sources by carrying out a systematic review.
The reason behind this study is based on a fact that the prevalence of obesity among children has reached an epidemic proportion, where concerns about a child’s bone density increase the rate of bone fracture. The reasons are convincing enough because bond density is a challenge because of lack of PA followed by nutritional factors. The researcher gives secondary sources and the references are given date.
The reason behind this study was to examine the clustering of the obesity-associated risk behaviours among the pre-school children’s mother. The reason offered by the author was not as convincing as other articles’ reasons were because this article rarely focused on the factors driven by PA that would result in increasing the rates of obesity among children. This study emphasises the parent’s attention towards the obesity-related risk behaviours by considering the eating behaviour as a major risk. The author includes a rich dataset of secondary sources regarding the socio-ecological factors associated with the obesogenic home environment of a mother having children of 2-5 years of age. The researcher uses secondary sources only based on that secondary analysis was carried out.
It is a mixed study, where the parents of 105 numbers of children were interviewed and descriptive research was carried out and the childrens PA endurance was recorded. However, there was a lack of hypothesis and research questions, only the objectives were defined. A cross-sectional research design was used, however, the selected design seems to be inappropriate for the phenomena reported such as step-based metrics being used for assessing the time of PA among the obese children. Data was collected for this study through interviewing the parents or legal guardian of the obese children. Active Brain Project collected the data for this study, which got the approval of the Human Research Ethics Committee of the University of Granada. Since it is a self-reported data collection method, thus the data were collected on the ground of the respective university. The sample was recruited by communicating the obese children’s parents and legal guardians over the phone and email as it consisted of a smaller sample size. The response rate seems to comparatively be less productive as the children need to perform on the tasks, where their physical activity endurance was observed. The data were analysed through a descriptive study.
This is a quantitative study, the study formulated a hypothesis reflecting that educators influence positively the healthy behaviour of preschoolers. This study utilized a cross-sectional research study and was appropriate for the phenomena reported that is the role of educators in encouraging the children’s healthy behaviour in terms of PA and diet. The data was collected by including 723 preschoolers from 50 randomly selected childcare centres. These data were collected by weighing the lunch plate of these children and readings of an accelerometer for 5 consecutive days were noted. The research assistants have collected the data, which was collected in two provinces of Canada, the sample was recruited by contacting the childcare centres and it was a big sample size. The response rate was 95% and the data were analysed by carrying out statistical analyses, where normality tests were used for determining the distribution of each outcome based variable.
This is a quantitative study and stated a clear hypothesis reflecting that excess fat is a major predictor of SRBD (Sleep-related breathing disorder) only when the lean mass of a child is low. Fats can only be reduced if the child carries out intense vigorous PA. A cross-Sectional research design is applied and this design is entirely applicable to the phenomena stated here that is lack of PA contributes to increasing the risks of breathing during sleeping by an obese child. The data was collected by including 109 children of 10.1 years with obesity and overweight and by distributing the questionnaire based on different aspects such as Paediatric Sleep questionnaire filled by parents and other PA related questionnaire was filled by the children. The ActiveBrain Project collected the data for this study and the data collection was done at the Unit of Paediatrics of the San Cecilio and Virgen de las Nieves University hospitals along with healthcare centres of Granada (Spain). The sample was recruited by contacting the parents of the obese childcare through parental written informed consent. The sample size was small. The response rate was high, where the parents and children had answered all the questions in the questionnaire. Statistical analysis was done by including the descriptive characteristics as means and standard deviations for the continuous variables and categorical variables.
This is a qualitative study, where the reasons questions reflect the recent state of observational studies, extent of videogames being considered as an effective intervention tool for healthy weight in a child, and gaps existing in understanding the association between obesity and videogames, are mentioned. The research design was non-observational by involving a qualitative study or a systematic review. Data was collected by keeping a scoping review of twenty-six studies that are published in-between 2013-2018. Data was collected by the respective researcher of this study, where no mentioning of the authority can be seen. Since it is a qualitative or systematic review type study, thus data was collected online or by using electronic databases. The sample was recruited by considering the publication dates of the articles, having some association between videogames and obesity either direct or indirect and the sample size was moderate as compared to a qualitative study. The response rate varies because some of the articles reflect an indirect relationship between the variables, and some reflect that videogame can affect the sleeping pattern of a child negatively. The data were analysed by applying the meta-analysis technique along with a cross-sectional examination to compare the findings of all the articles being systematically reviewed.
This is a qualitative study, where the questions, objectives and hypothesis are not mentioned or stated. The design used here is a cohort study, which is relevant enough for the phenomena reported here, for example, being a cohort study, this researcher aims at investigating the causes of bone density among obese children. The data was collected by carrying out an investigation about what the additional factors are, which lead the children to experience bone density concern and obesity. The data was collected by the researcher of this paper, who belongs to the PhD department of the Children’s Hospital of Philadelphia. The data was collected in the university, University of Pennsylvania Perelman School of Medicine. Since the author is a novice and the type of this study is qualitative, thus a small sample size was recruited. Since it is a cohort research paper, thus there is no response rate identified in the paper. The data were analysed by applying a systematic review technique.
This is a qualitative study, where the researcher clearly states the objective that is to identify the clustering risk factors driven by the socio-ecological home environment that a child’s mother maintains. The research design here is the cross-sectional design, which is appropriate to identify the interrelationship between health risks and risks associated in the home environment for a child prone to obesity. The data were collected by following the administration of the online format that involved the maternal participants for the survey session. The author being a member of the Rutgers University collected information from the maternal participants of the children with obesity. The data was collected over the online platform using an online HOMES survey. The sample was recruited by sending the recruitment notices to the participants by asking them to participate in the survey for helping the researchers learn more about the families having young kids. A total of 280 moms was recruited for this survey and the sample size was small. The response rate of these participants is more than expected reflecting that all questions of the survey were accomplished by each participant. The data were analysed by performing cluster analysis with independent t-tests with chi-square analysis for validating the findings.
The ethical issues are not acknowledged and considered by the researcher. For example, the reliability, validity and data collection guidelines are not mentioned in the article.
This research discussed the ethical considerations, which get approval from the University of Saskatchewan and Health Canada ethics boards.
This study has well discussed the ethics it follows, for example, the study protocols it maintains, get approved by the Ethics Committee on HR of the Granada University and was even registered in the ClinicalTrials.gov.
The study did not clearly state anything about the ethical considerations because it was secondary qualitative research applying for systematic review. Thus, no ethics to be discussed in this research study.
The respective study does not mention the ethical considerations this paper has gone through. There is a lack of ethics identified in this paper.
This paper has ensured protocols to score of scale were correct and accurate. Furthermore, this research has thoroughly followed protocol on the development and content of the survey.
The study utilized statistical tests to observe how much time a child spends in carrying out PA, however, the author has not mentioned the results, although indicated that around 40% of 10.1 year age of children spend time in LMVPA (Low-Moderate Vigorous PA). It is a mixed approach of research, where the researcher involved the parents for consent and children to perform the test, however, no themes were framed.
The respective study used statistical tests and not clearly explained the result because the study reflected its statistical results only on dietary intake instead of PA, 95% of children intake fibre, sugar and calorie-based diets.
The study has used statistical tests and the author has explained the results reflecting that body composition and PA are positively related to SRBD among obese children.
The study utilized a systematic review and has effectively explained the findings, however it is yet not clear from this study that whether there is a positive association between videogame and obesity. The pattern of carrying out this research seems to be effective, however lack of reliability and validity proof regarding the findings of this research. However, there is no theme generated in this study although it was a qualitative study.
The research has applied cohort study, thus no statistical analysis has been carried out. Since it was a qualitative analysis, thus themes were needed to be presented, although the author has not identified the themes.
It is a qualitative method, thus statistical analyses have been performed, where the researcher clearly stated the percents and frequencies of clustering variables that are examined for describing the sample regarding the mothers meeting defining PA level behaviours of their children.
The researcher indicated that a large sample size could give a clearer result, the author did not emphasize comparing this study with other studies. The author reflected that the utility of public health strategy varies as per the children’s involvement in physical activity whether MVPA or LMPVA. The article discusses its limitations such as carrying out multiple testing would have incorrectly rejected its null hypothesis, as a result, false statistically key results are seen. The results are compared to other studies. The author explained the clinical importance of the study findings reflecting that there need to be effective interventions aiming to increase PA and decrease sedentary time in the childcare centre.
The limitation of this study says that since it is a cross-sectional study, thus it did not allow the researcher for inferring casualty for any of the associations studied such as PA, sedentary behaviour, body composition and SRBD. There is no comparison of this study with other study results. There is one recommendation only, however not related to clinical study reflecting that studies based on randomized controlled trials are further needed for corroborating or contrasting the findings of this research.
There is a major limitation regarding this study reflecting that there is a lack of prospective trials, for example, among 26 articles only 12 reported the significant association between obesity and videogame. The results of this study are compared with the other 26 studies’ findings and there are different results proposed, it reflects positive association and others reflect a negative association or even no association. The author did not explain any clinical significance of this study findings because the findings of this study are ambiguous evidence-based with no accurate justification of whether there is an association between videogame and obesity or not. Interventional and prospective trials are the major recommendations here.
The author represented the technical limitation that might divert the results of whether the bone healths of obese children are paramount towards improving the clinical health assessment. The result of this study was not compared with other research findings as it was based on an investigation aimed at reflecting that low bone density is because of lack of PA. Clinical significance reflects that clinical concerns for bone health among children with technical challenges in densitometry are to be considered.
There are limitations identified in this study such as obscuring the interrelationships between health behaviours, the complexity of this behaviour specifically while developing prevention intervention. Furthermore, following the cross-sectional design limited the ability for making interferences of the casualty from their observed associations and there are reporting errors in the findings of this study. The results of this study have not been compared with any other study, thus no explanations for any different results proposed from this comparison. However, this study has recommended some clinical observations from the mothers end that is PA level of children needs to be increased, sedentary screen-time among the children needs to be lowered and many others.
| Author, year and Title | Study Aim | Study design | Data collection | Strengths and weakness | Main outcome |
| Migueles et al., 2020, “ | To determine the early intervention for increasing PA among obese children | Primary research with quantitative
The researcher applied a cross-sectional protocol |
Random
110 children (8 -11 years) were recruited from Granada Spain Observational method |
Cross-Sectional; Focuses on such a population getting benefitted from ambulatory PA
The involvement of accelerometer was a weakness |
Ambulatory activity is the major source of PA among obese children
74% moderate-vigorous PA |
| Ward et al., 2017 | To identify the role of childcare educators in encouraging obese children for PA | Primary research with quantitative; cross-sectional is the research design | Random; 723 preschoolers from 50 childcare centres
Canada provinces are the area Surveys |
Cross-Sectional; Using an objective method to assess PA, direct observations of the educators
Weakness: false statistically key outcomes |
Healthy eating is positively related to obesity
PA practices of educators cannot affect children for PA |
| Torres-Lopez et al., 2020, “ | To examine the relationships between PA, Sedentary Behaviour, and, obesity | Primary sources, quantitative with cross-sectional approach | Random; 109 children of age 10 +/-1 years, 45 girls and64 boys, recruited from Granada, Spain
Questionnaire |
Cross-Sectional
Including objectivity measured, accelerometer for PA, valid reliable and relevant health-related tests; The sample size was its limitation |
PA levels are positively associated with SRBD (Sleep-related breathing disorder) |
| Kracht et al., 2020, “ | To determine the relationships between obesity and videogames | Secondary sources; systematic review by using already published articles | Random sampling; 26 samples; 25cross-sectional and 1 longitudinal; qualitative data collection; Diary entries | Systematic review; Literature body of the articles used as a sample;
Lack of a prospective trial, no comment on areas of improvement Ambiguous findings |
There is no association between obesity and videogame |
| Kelley et al., 2017 | To identify whether “PA” is an additional factor of bone density leading to obesity | Secondary sources; qualitative; Investigation; self-reported | No sampling technique; Self-reported | Systematic; Analysis of finite number
The limitation is technical limitation hampering the productivity of the outcome |
Moderate to low vigorous PA can decrease the long-term consequences of obesity |
| Virginia, 2018 “ | To identify the obesity-related risks driven by the family specifically the mom of an obese child | Primary; quantitative | Random; Mothers of 2-5 years children
496 maternal participants; quantitative; questionnaire or survey |
Cross-sectional; socio-ecological home environment
Online HOMES Survey Limiting the interferences of a casualty from its association being observed |
Targeting mother to promote PA among children with obesity can decrease the possible consequences |
APEC Part 2
| Research Results | Grouped Results | Themes |
| The steps-based metric is a good predictor to know about obese children getting indulged in PA; this would reflect how much they would spend in stepping and other PA
Thus, indulging in PA can lessen the effects of obesity among the children |
The result reflects that PA is one of the key factors that can only reduce the possible risks of obesity with long term consequences in their adulthood. This challenge can be reduced by indulging the pre-schooler educators assessing the step-based metrics to encourage the students for involving in PA activities | Contribution of educators to measure the physical health endurance of obese children: A quick step to adopt Steps-based metrics |
| The role of educator is influential in encouraging obese children, however not in PA, although in dietary intake
It also reveals that there is a huge collaboration of PA resulting in long-term adolescent consequences getting mitigated |
||
| Sedentary behaviour driven by lack of PA among obese children results in increasing the risks related to sleep-risk breathing disorder. Thus, lack of PA increases sedentary behaviour result in SRBD | Lack of physical activity enhances the sedentary behaviour among obese children, where playing the videogame instead of outdoor games is an example of sedentary behaviour. This behaviour can lead the children to face long-term effects in their adolescent phases, which further would result in ADS | An association between PA and activities are driven by sedentary behaviour: A result fostering or reducing SRBD |
| The videogame is one of the major reasons resisting the children to participate in PA, which increases obesity among the children | ||
| PA is the risk factor that hampers the bone density among children with obesity, PA is one of the additional factors with nutritional diet | Lack of PA that seeks for parent’s attentions leads the children with obesity to experience low bone density. Thus, mother’s socio-ecological home environment rather than PA attention may be a risk factor for bone fracture in their obese children | Maternal Parents role towards encouraging obese children for PA: A step towards lessening the risk of low bone density |
| Parental attention in a socio-ecological home environment is one of the challenges that obese children face when it comes to PA |
Comparing the findings with the First theme reflects that the role of educators usually is found to be not as effective as it needs to be, thus the theme sounds conflicting about how the children can consider their educators as a role model. Furthermore, the educators need to be well trained to use the step-metric predictor to analyse whether the children are investing enough time in playing or getting engaged in PA. However, comparing the findings with the Second Theme states that there are some children, who do not indulge in sedentary behaviour, although found to be obese. Thus, providing a strong link between these two would result in ambiguous findings. Furthermore, sleep-related breathing disorders are increased by other additional factors like nutritional intake, cardio-respiratory fitness and many others, thus only PA cannot contribute hugely in reducing the risks related to SRBD. Lastly, comparing the findings with the Third Theme showcases that sometimes parents are not so educated that they could define their limits of feeding their children specifically if it maternal parent. Thus, less active/healthy moms with a higher BMI (Body Mass Index) with waist circumstances may lead to negative results in decreasing the obesity consequences among the children.
It is the time for recalling the nurse to perform her duty of encouraging various personnel related to the obese children. Here, the nurse needs to adopt a brand new practice innovation that could lead her to be highly convincing, appealing and deliverable personality to influence the preschool educators, parents and legal guardians to make their children physically fit. Thus, NPs working in family practice or even a general paediatric practice setting need to be consistent using the “BMI-for-age” index for screening for childhood obesity, which the AAP (American Academy of Paediatric) always recommends. There needs to be an amendment of an EBD approach that is the nurse needs to think and act beyond a teaching parent for promoting food choices and PA among the children and their families. Now, NPs and FNPs need to work in a paediatric practice setting, where NPs need to be aware of prevention guidelines, thus they could perform particular prevention strategies for obese children. Hence, it is suggesting the abolition of an existing clinical practice that is to behave like a teaching parent instead; they need to use BMI (Body Mass Index) for age and monitoring the children at increased risk of obesity.
The evidence from the above results reflects that PA is an additional risk factor that contributes to bringing major complications to the life of a child dealing with obesity. For example, lack of PA decreases the bone density among obese children, which results in bone fracture, thus nursing practice needs to monitor the BMI of the children. Apart from this, the steps-based metric is also a useful tool to evaluate the physical health endurance among obese children, which needs to be practised by the nurses being available at paediatric setting or family care setting. This is the recommendation for nursing as a new practice that needs to be integrated into evidence-based practice. This recommendation for nursing practice may affect the role of educators indulging in step-based metric to observe obese children PA involvement. Furthermore, it may affect the patient once they get encouraged of participating in PA, thus they would not adversely be affected by the long-term consequences of obesity in their adulthood.
After summarising the major points of this assignment, it can be concluded that lack of PA or physical activity is one of the major reasons obese children experiencing long-term consequences in their adolescent stages. Furthermore, the strengths of the literature review are based on the tools and techniques that the researcher would be used for data collection, however, this strength for some other articles becomes a weakness. For example, the strength of using cross-sectional analysis becomes a weakness because it limits the inferences casualty regarding the observed findings. Recommendation for clinical practice reflects that a nurse needs to bring some new changes in their evidence-based practice by consistently using the BMI for different age groups in the setting where they are now working.
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The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
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Read moreEach paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.
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