A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the time frame needed to implement the change process.
Formulate a PICOT statement. (CHILDWOOD OBESITY). The PICOT statement will provide a framework for your capstone project.
In a paper of 750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.
Make sure to address the following on the PICOT statement:
- Evidence-Based Solution
- Nursing Intervention
- Patient Care
- Health Care Agency
- Nursing Practice
Prepare this assignment according to the guidelines found in the APA Style.
Running head: CHILDHOOD OBESITY 1
CHILDHOOD OBESITY 6
Capstone Project Topic Selection and Approval: Childhood Obesity
Capstone Project Topic Selection and Approval: Childhood Obesity
Obesity is one of the major public health issues that affect many societies today. Reducing the prevalence of obesity is one of the objectives of America’s Healthy people 2020 initiative as this has been determined to be a significant cause of many health issues in the society. While obesity affects all demographics, there has been a significant increase in the prevalence of this public health issue among children. Many children are emerging with Body Mass Index (BMI) that are above the 95th percentile, which is an indication of a higher risk of many lifestyle-related illnesses (Hoelscher et al., 2015). Children are part of the vulnerable members of the population; hence, a lot of strategies need to be put in place to ensure that they are protected from public health issues by their guardians and other people responsible in their lives. This project aims at evaluating the problem of childhood obesity in America, its extent, impact, and possible solution.
Childhood Obesity in America
The rate of childhood obesity has increased significantly during the past few decades. America has one of the highest rates of childhood obesity in the world, a figure that has tripled over the past three decades (Karnik & Kanekar, 2012). One out of every six children in the United States is obese while one out of every three is overweight. The rate of overall obesity in children has been steady since 2008, but there have been significant changes within different demographic groups. Some groups have a higher rate compared to others. Among socio-economic groups, the high income earning groups including families living 400% above the poverty level have the lowest rate of childhood obesity with 11.9% (Ogden et al., 2012). The groups living under the poverty rate has the highest rate of 21%. In terms of racial/ethnic characteristics, the Asian, non-Hispanic population has the lowest rate of obesity with a 9.8% rate (Ogden et al., 2012). Hispanics have the highest rate at 23.6% followed by the blacks at 20.7% and whites at 14.7% (Ogden et al., 2012). Although at different rates, all population groups in the U.S. have a significantly high risk of childhood obesity, which makes this a major public health issue in the country.
Impact of Childhood Obesity
The most significant impact of childhood obesity is the numerous health risks that it exposes children to. Obese children have a higher risk of being affected by the following health issues. The risk of Type 2 Diabetes is increased significantly when a child is overweight (Sahoo et al., 2015). They are exposed to cardiovascular problems such as heart disease and stroke (Ayer et al. 2015). They may develop issues with their respiratory systems such as sleep apnea and asthma. Obesity is also associated with musculoskeletal discomfort and joint issues.
Aside from the health issues, obesity is also associated with psychological, social, and emotional issues in children. Children may develop low self-esteem as a result of their bigger body type, which is generally perceived as less desirable in the society today (Sabin & Kiess, 2015). They may also experience bullying and issues in the social environment. These issues lead to problems such as depression and anxiety at a young age, problems which are sometimes maintained until adulthood (Pulgaron, 2013).
The significance of the Problem
Childhood obesity has been established to be a serious problem for children. Studying this topic has positive implications because it helps to determine the extent of the issue in America, establish the patterns of the problem between groups, and the causes of the patterns. Therefore, this topic is important because it helps to develop strategies for dealing with this issues and helping to improve the health of many children in America. This can be helpful for both public health professionals and parents in dealing with the major issue of obesity that continues to affect a large percentage of children.
Proposed Solution for Childhood Obesity
The proposed solution for reducing childhood obesity is exercising more government control over the fast foods and snacks industry. One of the main cause of childhood obesity is the quality of food that children have access to (Roberto et al., 2015). Fast foods and most of the snacks on the market today supply children with the excess sugars and fats, which cause their weight issues. Control over this market will reduce access to these products for the children. The best control for this market is an increase in taxes for companies in the industry so that their products can be more expensive, and hence, less accessible to people in the market. When fewer people can access unhealthy foods then there will be a reduction in the rate of obesity.
Ayer, J., Charakida, M., Deanfield, J. E., & Celermajer, D. S. (2015). Lifetime risk: childhood obesity and cardiovascular risk. European heart journal, 36(22), 1371-1376.
Hoelscher, D. M., Butte, N. F., Barlow, S., Vandewater, E. A., Sharma, S. V., Huang, T., … & Oluyomi, A. O. (2015). Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Childhood obesity, 11(1), 71-91.
Karnik, S., & Kanekar, A. (2012). Childhood obesity: a global public health crisis. Int J Prev Med, 3(1), 1-7.
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Jama, 307(5), 483-490.
Pulgaron, E. R. (2013). Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clinical Therapeutics, 35(1), A18-A32.
Roberto, C. A., Swinburn, B., Hawkes, C., Huang, T. T., Costa, S. A., Ashe, M., … & Brownell, K. D. (2015). Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet, 385(9985), 2400-2409.
Sabin, M. A., & Kiess, W. (2015). Childhood obesity: current and novel approaches. Best Practice & Research Clinical Endocrinology & Metabolism, 29(3), 327-338.
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.
Running head: PICOT STATEMENT 1
PICOT STATEMENT 2
PICOT Statement: Childhood Obesity
P- Patients who suffer from obesity (BMI of more than 30)
I- Undertaking nutritional education, diet, and exercise
C- Comparison to nutritional education, endoscopic bariatric surgical intervention
O- Improved health outcomes in terms of overall weight
T – A year’s time limit
PICOT Statement: Childhood Obesity
Childhood obesity poses serious health problems in the US as the number of overweight and obese population increases at a rapid pace every year. The effects of this problem have arrested the attention of policymakers, societal members, and government agencies. This has resulted in ranking childhood obesity as a national health concern. The adverse impacts of this disease go beyond the health realms to include economic burden on both personal and national budgets. While there are numerous risk factors and various evidence-based interventions to address this challenge, no single approach is consistently efficacious in curbing the disease. Consequently, it is imperative that efficacious initiatives and policies be developed to address the never-ending problem of childhood obesity. Multidisciplinary approaches are often broad and cut across all dimensions of personal health problems. Instead of placing emphasis solely on biomedical models, health care professionals should also seek to promote behavior change among obesity patients and their family members. A PICOT statement can be utilized as an effective tool to seek interventions of addressing childhood obesity.
In the US, obesity prevalence is highest among children aged from 6 to 11 years (Cheung et al. 2016). The disease has tripled among this age group from 4.2 percent to 15.3 percent from 1963 to 2012. In the last three decades, increased cases of obesity prevalence have been noted among children of all ages, although the differences in obesity prevalence have been recorded in terms of age, race, ethnicity, and gender (Cheung et al. 2016). In this respect, children from socioeconomically disadvantaged families and some racial and ethnic minorities experience the higher median score on obesity than the dominant white population. Higher obesity rates are often recorded among blacks and Hispanics compared to whites. For instance, a survey on girls in the Southwest revealed that the yearly cases of obesity stood at 4.5 percent among Blacks, 2 percent among Hispanics, and 0.7 percent among white girls aged from 13 to 17 years (Cheung et al. 2016). For low-income earners, American Indians rank highest at 6.3 percent, followed closely by Hispanics at 5.5 percent.
Evidence-based interventions that seek to reduce childhood obesity incidences in the country should target two major areas: prevention and treatment. High-quality RCT has been proven as one of the most effective preventative intervention, especially in schools (Reilly, 2006). Such interventions involve making changes on the school curriculum by introducing and improving physical education, changing school meal provisions, and reducing the television viewing hours. Schools should also engage in promotional campaigns that encourage walking form home to school (Ickes, McMullen, Haider & Sharma, 2014). This intervention has been successful in most cases involving girls in the sense that the risks of becoming obese are significantly lowered. Treatment interventions should be limited to motivated families and communities, in which the child and parents perceive obesity as a problem. From a theoretical perspective, treatments should be continued for longer periods such as months to years. Diets should be modified, especially with the use of regimen such as traffic light diet. Television viewing habits should also be reduced (Ickes et al. 2014). Furthermore, treatment should be aimed at encouraging families to self-monitor their lifestyle. Finally, more time should be offered for consulting with family members.
Being a member of a multidisciplinary team, the nurse practitioner performs the task of offering standardized care and advocacy support for healthy community environments. In addition, the nurse helps to ensures that there is proper coverage, access to, and incentives for regular obesity prevention, screening, diagnosis and treatment (Vine et al. 2013). There is also need to promote active living and healthy eating at work. Finally, focus should be on promoting healthy living during weight gain. There is also need to expand the role of health care providers, in childhood obesity prevention.
When a nurse is involved as one of the primary members in the multidisciplinary team approach, the child should be guaranteed of better continuity of care. The outcomes of interventions should include reduced obesity risks and curriculum adjustments for sustainable change to make it cost-effective (Ross et al. 2010). The curriculum modifications should be generalizable. One of the leading causes of failure of previous interventions is that they targeted modifications at the micro levels. This means that targeting individual children, families, or schools make it harder to have positive outcomes or impacts on the many other influences on weight status that affect the environment at the macro levels. Obesity control efforts that are successful should require a more macro-environmental strategy in addition to the micro level behavioral adjustments.
Obesity treatment and management should be a process that takes months to years. This is because the focus should not just be on the individual level, but also on the general behavioral patterns of a person’s family, friends, and society at large (Ross et al. 2010). Therefore, interventions should be multidisciplinary and aim at changing the behavior of the patient by promoting long term positive outcomes. Precautions to monitor blood pressure can be done every two weeks or on a monthly basis. Medications such as sibutramine can be utilized for periods of up to one year. However, its use should be discontinued in patients whose weight loss stabilizes at less than five percent of their initial body weight.
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McGrath, S. M. (2017). Childhood Obesity Comorbitities Awareness Hospital-based Education
(Doctoral Dissertation), Walden University, Minneapolis, Washington.
Reilly, J. J. (2006). Obesity in childhood and adolescence: evidence based clinical and public
health perspectives. Postgraduate medical journal, 82(969), 429-437.
Ross, M. M., Kolbash, S., Cohen, G. M., & Skelton, J. A. (2010). Multidisciplinary treatment of
pediatric obesity: nutrition evaluation and management. Nutrition in Clinical
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Vine, M., Hargreaves, M. B., Briefel, R. R., & Orfield, C. (2013). Expanding the role of primary
care in the prevention and treatment of childhood obesity: a review of clinic-and
community-based recommendations and interventions. Journal of obesity, 2013.