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State of the Science Quality Improvement Paper


The paper focuses on the problem of people’s insufficient physical activity and its adverse impact on health. The proposed plan draws attention to children, adolescents, adults, and older people to identify whether they can benefit from regular physical exercises. These participants will be found among the number of outpatient clinic patients, but the plan will be based on their self-care. Numerous research-based articles reveal the benefits of physical activity, but a gap exists concerning how to increase people’s motivation and what specific exercises it is better to use. In addition to the participants above, the key stakeholders include healthcare practitioners, nurses, physicians, and policymakers. The paper explains that the quality improvement plan aims to make people involved in regular physical activity to improve their well-being and health. Consequently, outcome measurement will consider the time spent on physical activity and rates of hypertension, diabetes, and cardiovascular disease.

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Keywords: physical activity, hypertension, diabetes, health.

State of the Science Quality Improvement Paper

Sufficient physical activity is a significant factor that contributes to the better health of the population. It is so because regular exercises reduce the risk of developing elevated blood pressure and chronic health conditions among adults and adolescents. Physical activity is also of importance for overweight individuals since it allows them to strengthen their health, reach high levels of well-being, and avoid adverse health outcomes. Irrespective of this, approximately 80% of the US population is involved in the insufficient activity because of various reasons, including the lack of time, desire, and opportunities (Piercy et al., 2018, p. 2020). Consequently, there should be specific guidelines and recommendations that people can use to adhere to healthy lifestyles. Thus, the given paper attempts to review the current literature on the topic, identify its strengths and limitations, and offer a quality improvement plan that addresses those limitations.

State-of-the-Science Review of the Literature

A significant bulk of research focuses on the issue of physical activity and its meaning for individuals. That is why it is possible to find a few current studies that consider the topic under consideration. Even though the sources in this paper address the issue under analysis from different points of view, all of them are research-based, which brings more credibility to the given project. The following information will present a critical review and synthesis of the articles selected, and three significant aspects will be addressed.

To begin with, one should state that most articles explain the benefits that can be caused by physical exercise. Thus, Marzetti et al. (2017) admit that regular physical activity reduces the risk of stroke, diabetes, cardiovascular disease, and some types of cancer. Furthermore, this approach has the potential to improve energy balance and functional health (Marzetti et al., 2017). According to Lewis and Hennekens (2016), regular exercise minimizes the risk of developing hypertension and enhances muscle, bone, and joint health. These researchers admit that physical activity is a useful way to strengthen the US population’s overall health.

In addition to that, Lewis and Hennekens (2016) argue that a greater emphasis on physical activity can lead to a significant reduction of US healthcare expenditures. It is so because when the rates of the disease above are lower, the US healthcare industry will have to provide care to fewer patients. Then, Mishu et al. (2019) stipulate that adherence to physical exercises improves the individual quality of life, body composition, and others. Finally, the studies by Marzetti et al. (2017), and Mishu et al. (2019) demonstrate that people who lead sedentary lifestyles cannot achieve the positive outcomes above, which proves the advantages of the behavior under consideration.

The second synthesized aspect relates to the population under consideration. Since insufficient physical exercise is a typical problem for older people, it is not a surprise that the research article by Marzetti et al. (2017) focuses on the representatives of this age group. The scientists indicate that when the older population engages in regular physical activity, it is a useful “remedy against physical frailty and sarcopenia” (p. 35). In addition to that, Mishu et al. (2019) identify that regular exercise is also useful for older people with severe mental ill health. Dozier, Schroeder, Lee, Fulkerson, and Kubik (2020), however, understand that adults and children are also subject to less active lifestyles. That is why these researchers have designed their study and identified that the younger population is also subject to problems that are caused by insufficient physical activity. Consequently, children also need specific guidelines to increase their physical activity and enhance their health.

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Since the articles above have demonstrated the importance of physical activity, it is also rational to consider how to promote it among the US population. Even though DiPietro et al. (2019) emphasize the reduction of type 2 diabetes and hypertension rates, the researchers also admit that there is not much evidence that this behavior is more requested. For example, DiPietro et al. (2019) explain that proposed solutions work well with motivated volunteers but “break down under real-life conditions at the community or population level” (p. 200). At the same time, Cheung, Talley, McMahon, Schorr, and Wyman (2020) argue that knowledge of physical activity guidelines is insufficient to promote this behavior and contribute to the better physical health of the population. The information above stipulates that the current evidence has a gap concerning these details. Consequently, it is necessary to take specific measures to improve individuals’ adherence to healthy lifestyles, which will lead to their improved well-being.

Strengths and Limitations of Current Evidence

The information above makes it possible to identify significant strengths of current research on the topic under consideration. On the one hand, a majority of articles focuses on the potential positive outcomes of leading a healthy lifestyle (Marzetti et al., 2017; Mishu et al., 2019; Lewis & Hennekens, 2016; Dozier et al., 2020). It relates to the fact that regular physical exercise has a positive influence on mental and physical health of people. It is so because physical activity strengthens bones and joints as well as minimizes the risk of developing hypertension, type 2 diabetes, various kinds of cancer, sarcopenia, and others.

On the other hand, another positive feature of the current evidence refers to the fact that the articles attempt to analyze the effect of sufficient activity or lack thereof on various layers of the population. For example, the studies under analysis make it possible to identify that physical exercise can be beneficial for people of all ages, including children, adults, and older individuals. That is why one can conclude that the strengths of the current evidence manifest themselves in the overwhelming coverage of the benefits of a healthy lifestyle for the population. This literature demonstrates that it is reasonable to invest in promoting the behavior under consideration.

The literature review also makes it impossible to state that the topic under analysis does not imply any weaknesses. The first of them relates to the fact that none of the articles has mentioned what specific kinds of physical activity can result in the benefits above. In addition to that, the pieces of research have not explained whether there should be any differences in the choice of physical activity kinds depending on the age of the population. The second weakness manifests itself in the fact that the current evidence presents the advantages of physical activity but does not explain how to promote this behavior among the population. Since there are no specific strategies, it becomes challenging to make people benefit from healthy lifestyles in real-life conditions. In other words, knowledge of the physical activity advantages and guidelines only is not sufficient to contribute to better health outcomes. That is why the description of the weaknesses reveals that a quality enhancement plan is necessary to ensure that physical activity is helpful for individuals.

Quality Improvement Plan

The given plan should be based on a specific model to ensure that all efforts lead to positive outcomes, and the Plan/Do/Study/Act (PDSA) model seems suitable. According to Magnuson, Kras, Aleandro, Rudes, and Taxman (2020), this model is useful because it focuses on both research and practice, meaning that there exist high chances that the desired results will be achieved. When it comes to the present plan, the investigation of possible ways to promote physical activity among the population will precede any actions.

The plan under consideration will imply a few key stakeholders. Firstly, children, adolescents, adults, and older people are the most significant of them because the project aims to improve their health outcomes. Secondly, healthcare practitioners, nurses, and physicians should also be included. It is so because they should provide the individuals above with the necessary knowledge and guidelines to promote physical activity. Thirdly, policymakers and social workers are among the stakeholders because it is essential to implement a comprehensive approach to improve population health. Furthermore, politicians will also be under impact because it has been described that the promotion of healthy lifestyles can reduce US healthcare expenditures. Consequently, the medical professionals, social workers, and policymakers should be members of an appropriate interdisciplinary team that will make individuals involve in physical activity.

The proposed plan stipulates that it is necessary to make people regularly spend time walking, running, or bicycling since these are essential physical activities. Children and older people should involve in moderate activities, while adolescents and adults can benefit from vigorous exercises (Piercy et al., 2018). As has been stated above, it is a challenging task that requires a comprehensive approach. That is why King et al. (2019) explain that there should be individual and community-level strategies. Individual plans consider the necessity to develop and distribute guidelines for specific layers of the target population. Community-level strategies, in turn, draw attention to the fact that it is necessary to popularize a healthy lifestyle. Useful measures include school learning programs, mobile phone interventions, and creating an environment that would promote physical activity (King et al., 2019).

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It is also necessary to comment on a plan for outcome analysis. The independent variables include school learning programs, mobile phone interventions, and an exercise-friendly environment. These phenomena have the potential to change the quality of people’s health. Consequently, the dependent variables include the time of physical activity and health data, including decreased rates of hypertension, type 2 diabetes, and obesity. The change plan will be considered successful if its participants will regularly involve in physical activity and have a lower prevalence of the health conditions above compared to individuals compared to the individuals outside the intervention. It will be necessary to compare that prevalence to an average value throughout the United States. Consequently, it will not be challenging to measure the outcomes of the proposed quality improvement plan.

In addition to that, it is rational to draw attention to ethical considerations. Firstly, it refers to the fact that participation in the quality enhancement plan will be voluntary. No individual will be forced to involve in physical activities if they do not want to do it. Secondly, participation in the present quality improvement project will be anonymous. This aspect is necessary to ensure that the participants’ personal information will be protected from unauthorized use. Furthermore, one can suppose that some individuals will not agree to participate in the intervention if their personal information is not secured. Finally, the quality improvement plan will be designed to protect human subjects and their health. It relates to the fact that no participant will be subject to heavy physical exercises if they feel bad or if they do not want to be members of the intervention.


The lack of physical activity is a severe problem in the modern world. Multiple phenomena prevent individuals from engaging in regular exercises, but this sedentary lifestyle leads to significant adverse outcomes. It refers to being overweight, elevated blood pressures, and other health issues. That is why the given paper attempts to identify whether sufficient physical activity can minimize the risk of developing the health problems above. The identified studies demonstrate that regular physical exercises can lead to better health outcomes since they reduce the rates of developing hypertension, diabetes, cardiovascular disease, and others. However, the articles do not explain how to involve individuals in physical activity and what specific kinds of exercises are more useful. Consequently, this literature review indicates that there is a gap in knowledge, and that is why a quality improvement plan is necessary to address the issue under consideration.

The plan stipulates that the most effective kinds of physical activity are walking, running, and bicycling because they do not require much equipment and are suitable for everyone. The key stakeholders of the plan include individuals of all ages, healthcare practitioners, nurses, physicians, and policymakers. The project addresses the issue that it is essential to increase people’s motivation and provide them with more opportunities to lead healthy lifestyles. That is why the proposal is to apply school learning programs, mobile phone interventions, and creating an activity-friendly environment. Furthermore, the plan addresses possible ethical considerations, which are necessary to protect human subjects. Finally, the quality improvement plan explains how it will be possible to evaluate the outcomes. Significant attention will be drawn to whether participants are involved in physical activity and have lower rates of hypertension, type 2 diabetes, and obesity than those who do not get involved in regular physical activity.


Cheung, C., Talley, K. M., McMahon, S., Schorr, E., & Wyman, J. F. (2020). Knowledge of physical activity guidelines and its association with physical activity and physical function in older adults. Activities, Adaptation, & Aging, 44(2), 106-118.

DiPietro, L., Buchner, D. M., Marquez, D. X., Pate, R. R., Pescatello, L. S., & Whitt-Glover, M. C. (2019). New scientific basis for the 2018 US Physical Activity Guidelines. Journal of Sport and Health Science, 8(3), 197-200.

Dozier, S. G. H., Schroeder, K., Lee, J., Fulkerson, J. A., & Kubik, M. Y. (2020). The association between parents and children meeting physical activity guidelines. Journal of Pediatric Nursing, 52, 70-75.

King, A. C., Whitt-Glover, M. C., Marquez, D. X., Buman, M. P., Napolitano, M. A., Jakicic, J., … Tennant, B. L. (2019). Physical activity promotion: Highlights from the 2018 Physical Activity Guidelines Advisory Committee systematic review. Medicine & Science in Sports & Exercise, 51(6), 1340-1353.

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Lewis, S. F., & Hennekens, C. H. (2016). Regular physical activity: Forgotten benefits. The American Journal of Medicine, 129(2), 137-138.

Magnuson, S., Kras, K. R., Aleandro, H., Rudes, D. S., & Taxman, F. S. (2020). Using plan-do-study-act and participatory action research to improve use of risk needs assessments. Corrections: Policy, Practice, and Research, 5(1), 44-63.

Marzetti, E., Calvani, R., Tosato, M., Cesari, M., Bari, M. D., Cherubini, A., … Landi, F. (2017). Physical activity and exercise as countermeasures to physical frailty and sarcopenia. Aging Clinical and Experimental Research, 29(1), 35-42.

Mishu, M. P., Peckham, E. J., Heron, P. N., Tew, G. A., Stubbs, B., & Gilbody, S. (2019). Factors associated with regular physical activity participation among people with severe mental ill health. Social Psychiatry and Psychiatric Epidemiology, 54, 887-895.

Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., … Olson, R. D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020-2028.

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