The incidence and prevalence of overweight has been increasing rapidly; today the problem has become a major health concern. The following paper outlines a plan for a family-based intervention to reduce obesity. The rationale for the preference is backed by current research. For example, a study by Sung-Chan, Sung, and Bronson (2013) found that family-based interventions that are rooted in behavior change are more effective in tackling the issue of obesity.
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Change Model Overview
The John Hopkins Nursing Evidence-Based Practice Process Model is a problem-solving approach that is used in decision-making. It includes three-step processes that are practice question, use of evidence, and translation. The main goal of the model is to encourage nurses to apply the latest research findings in care delivery to enhance efficiency and effectiveness.
In school-aged children, what is the impact of family-based interventions on maintaining healthy weight and reduction of obesity instances compared with school-based interventions within a six-month period?
Recruit Inter-professional Team
The inter-professional team to be included in the study will include nutritionists, pharmacists, pediatricians, nurse in charge and social workers. The leader of the team will be the in-charge nurse.
Develop and Refine the EBP Question
In school-aged children, what is the impact of family-based interventions on maintaining healthy weight and reduction of obesity instance compared with school-based interventions within a six-month period? Concerning PICO, the first element that is population will be the school-aged children. The second element is the intervention. It will be family-based and focused on behavioral change. The third element that is comparison is the school-based interventions that are based on specialized diet plans and group exercises. The fourth PICO element is the outcome. Desired outcome is the reduction in the incidence and prevalence rate of overweight and obesity among the schoolchildren.
Define the Scope of the EBP
The prevalence of obesity among the youth in the U.S. as per 2011-2014 data was 17%; the children aged between 6 and 11 years had a prevalence rate of 17.5% while for those aged between 12 and 19 years it was 20.5% (CDC, 2016). CDC (2016) has pointed out that in a population-based sample of young people aged between 5 and 17 years, 70% of those who were overweight and obese had at least one risk factor for cardiovascular diseases.
Determine Responsibility of Team Members
The social workers will assist the other health professionals in identification of families to be involved in the program. Nutritionists will be involved in diet formulations and nutrition advice for the participants. The pharmacist and pediatricians will work together in handling cases that may require medical intervention and drug use.
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Conduct Internal/ External Search for Evidence and Appraisal of Evidence
Studies by Amini, Djazayery, Majdzadeh, Taghdisi and Jaayeri (2015), Davidson, Jurkowski, Li, Kranz, and Lawson (2012), Kothandan (2014), and Sung-Chap et al. (2012) have established existence of qualitative and quantitative evidence to support the effectiveness of family-based interventions. For instance, the listed studies have used scientific methods to establish the feasibility and effectiveness of the interventions. Also, the randomized controlled studies by Kothandan (2014) and Sung-Chap et al. (2012) applied methodological approach of intervention and control groups. This enabled the researchers to determine the differences in the outcome. The intervention groups showed positive results in the reduction of overweight and obesity among the school-aged children.
Summarize the Evidence
Sung-Chap et al. (2012) reviewed 15 randomized controlled trials of family-based intervention for young people aged 2-19 years to evaluate methodological rigor of the intervention effectiveness. It was established that family-based interventions that were based on behavioral change were effective. Similar findings are supported by the studies by Amini et al. (2015), Davidson et al. (2012) and Kothandan (2014) which have shown that effective lifestyle interventions include individualized diet plans and increased physical activity.
Develop Recommendations for Change Based on Evidence
According to Sung-Chap et al. (2012), methodological interventions that are based on behavioral change have high effectiveness in the prevention and control of obesity. This is also supported by interventions carried out at school level. Therefore, it is important to implement projects that will bring change at family level in order to develop positive health habits for the children.
The project will run for six months. It will start by a consultative meeting with the key stakeholders to establish the key components of the plan. The second day will entail gathering the required equipment and resources needed for the project. The third day, the overall strategic plan will be drawn with details about all the undertakings. The selecting criteria for the children will be formulated and implemented by the social workers. This activity is expected to take three weeks. The first day of the project’s second month, after all resources and families are identified, evaluation criteria will be developed. The plan will be evaluated using formative and summative evaluation; the formative assessment will involve monthly monitoring of the project while the summative one will be undertaken after the completion of the plan. Table 1 below is the evaluation plan to be used.
Table 1: Evaluation Plan.
|Are project implementations processes being met?||In-charge nurse|
|Have all the required resources been assembled?||In-charge nurse|
|Is the strategic plan in place and are all stakeholders involved?||In-charge nurse|
|Are there behavioral changes among the study participants? |
(parameters: physical activity, diet, perception)
|Weight changes for the children||Nutritionist|
Evaluating Outcomes and Reporting Outcomes
The desired outcomes for the project include increased physical exercise, adherence to the specialized diet programs and weight reduction for the overweight and obese children.
The physical exercise will be measured by recording the number of times the children engage in physical exercise while the specialized diet will be established by providing children and parents with checklist to tick whenever the child adheres to the prescribed meal. Finally, the overweight and obese status will be established by continuous monitoring of the children’s weight. The results will be reported by use of tables and charts that will be presented to stakeholders during monthly seminars.
Identify Next Steps
In order to implement the plan on a larger scale, there will be a lobby for policy changes at the state government level. Therefore, not-for-profit organizations, department of health, and legislators concerned with health will be included as stakeholders. Their work will be to lobby for policy changes to ensure the program is incorporated as one of the health programs funded by the government.
Findings will be disseminated internally by use of consultative meetings that will be held on weekly basis to discuss the progress of the plan. This will help in identification of successes and gaps and necessary measures taken. Externally, there will be health seminars held on monthly basis to present the findings.
The increasing prevalence and incidence rate of overweight among children presents a great health and economic problem to the society. A family-based intervention is necessary in which the school-aged children are introduced to healthy living though programs that focus on increased exercise, reduction of fast food consumption and adoption of balanced meals.
Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M-H., & Jaayeri, S. (2015). Effect of school-based interventions to control childhood obesity: A review of reviews. International Journal of Preventive Medicine, 6, 1-8.
Davidson, K., Jurkowski, J., Li, K., Kranz, S., & Lawson, H. (2012). A childhood obesity intervention developed by families for families: Results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity, 10(3), 1-11.
Kothandan, S. (2014). School based interventions versus family based interventions in the treatment of childhood obesity – a systematic review. Archives of Public Health, 72(1), 1-17.
Sung-Chan, P., Sung, Y., & Bronson, R. (2013). Family-based models for childhood obesity intervention: a systematic review of randomized control trials. Obesity Review, 14(4), 265-278.
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