Childhood obesity is a prevalent health issue in developed countries defined as the excess of body fat and creates a high risk for the general population to develop a range of adverse problems and co-morbidities as demographics evolve. Numerous efforts have been made to address the rise of childhood obesity, but its alarmingly growing rates with an estimated 41 million affected children worldwide, particularly prevalent in the United States suggest systemic failures and the need for change in medical practice and interventions. The formulated PICOT question is: In school-age children (P), does 30 minutes of school-based physical activity (I), compared with no physical activity (C), decrease BMI and childhood obesity risks (O), within a one-year period (T)?
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A quantitative approach by Hall, Butte, Swinburn, & Chow (2014) analyzes the dynamics of childhood obesity and presents a numerical model approach on how a child’s organism and BMI will respond to various obesity interventions. This model is based on calorie consumption and energy balance that considers healthy growth levels while allowing for quantitative predictions regarding weight management and interventions. This is directly related to the PICOT question by presenting an approach to calculating energy balance. While the study is more focused on nutrition, caloric calculations determined by the researchers of 1200 kcal for boys and 900 kcal for girls in children are a net sum of food intake and energy expenditure from exercise. Potentially, this numeric determination can be used to develop the school-based physical activity intervention, which allows calculating the caloric expenditure based on duration and type of exercise. In turn, this would reflect on the identified outcome of decreased childhood obesity risks and BMI.
A qualitative approach by Verbeken et al. (2018) examines a model of Approach Avoidance Training (AAT) used alongside motivational game elements in an inpatient childhood obesity program. This approach is meant to manage food stimuli, and affect implicit attitudes, attentional bias, craving control, and weight-loss maintenance. The game elements contributed to the therapeutic process with children and the qualitative approach is aimed at addressing the underlying behaviors of childhood obesity rather than reactionary management. This research is relevant in the context of the PICOT question specifically due to the setting and practicality of using the AAT and game elements with children. The elements can be incorporated into the intervention of physical activity and contribute to a multimodal approach to childhood obesity management in schools beyond simple exercise or nutritional routines. The study offers an exemplary approach to adopting the intervention with children in a real-life setting, beyond a theoretical approach.
The research, both quantitative and qualitative, in its association with the PICOT question, demonstrates the highly complex conceptualization of childhood obesity interventions. Through this, the systemic failures to prevent the rise of childhood obesity are highlighted, suggesting the need for change in practice and policy. Although the nursing practice is not directly associated with such interventions, nurses can serve as school nurses, advocates, public health officials, and consultants to school boards and local governments that would oversee such school-wide programs to reduce childhood obesity. Taking into account the research in the context of the PICOT questions, it is evident that nurses must take a comprehensive, highly rigorous, and multimodal approach to developing interventions as well as working with children and families to address the root causes and behaviors of childhood obesity. While simple educational interventions are fundamental, basic exercise or nutrition programs have a little long-term impact. Only with an approach that considers the quantitative aspects of numerical caloric balance models and a qualitative approach to motivate the children to stick with healthy lifestyles and behaviors, that potential progress can be made on the childhood obesity epidemic.
Hall, K. D., Butte, N. F., Swinburn, B. A., & Chow, C. C. (2014). Dynamics of childhood growth and obesity: Development and validation of a quantitative mathematical model. Lancet Diabetes Endocrinol, 1, 97-105. Web.
Verbeken, S., Boendermaker, W. J., Loeys, T., Moens, E., Goossens, L., Latomme, J., & Braet, C. (2018). Feasibility and effectiveness of adding an approach avoidance training with game elements to a residential childhood obesity treatment – A pilot study. Behavior Change, 35(2), 91-107. Web.