Hello Dr Kyzar and Class· Does the research design answer the re

Hello Dr Kyzar and Class
· Does the research design answer the research question?
Explain your rationale.
Lloyd et al., 2018 focused at establishig whether the
school-based interventions for children of ages 9-10 years
would help in preventive excessive weight gain after 24 months.
The researchers used pragmatic cluster randomized controlled
trial of the Healthier Lifestyle Programme (HeLP) which is a
school-based obesity prevention intervention that was
performed in 32 schools found in the southwest England. This
method is revealing school as the ideal location for the
childhood obesity preventiuon programs due to the near-
universal reach f children in the socioeconomic spectrum. It
also shows the importance of the change in the diet and physical
activity behaviors and their impacts on the weight status (Lloyd,
et al., 2018). Were the study sample participants
representative? Why or why not?
The sample calculation assumed a mean of 35 children age
9-10 years in every school and this implies that a total of 1,120
samples were used. This is a good number that can represents
the problems at the 32 schools that were being targeted by the
researchers.
Compare and contrast the study limitations in this study.
The findings of the study shows that the effectiveness
of the school-based obesity prevention programmed is
inconclusive and contradictory. The interventions used are
highly heterogenous in the design and most of the studies used
for the research have some methodological weaknesses for
example the inadequate statistical power, greater levels of
attrition, differential uptake, follow-up, and the short-lived
follow-up.
· Based on this evidence summary, would you consider this
systematic review as support for your selected practice
problem? Explain your rationale.

Two themes were considered to be important i.e. energy in
and decision making and the responsibility. It is clear that
school hosts many children and can therefore be used as ideal
place to deliver the population-based interventions. Even
though it might not adequately intensed to affect both school
and the family environment hence wieght of the children, it
needs to be promoted since it helps in changing the health
behaviors of the children. This is important in addressing the
issue of childhood obesity sinnce it helps in promoting healthy
behaviors among children (Lloyd , et al., 2018).
References
Lloyd, J., CStat, C. S., Logan, S., Green, C., Dean, S., Hillsdon
, M., Abraham, C., Tomlinson, R., Pearson, V., Taylor, R.,
Ryan, E., Price, L., Streeter, A., Wyatt, K., & Wyatt, K. (2018).
Effectiveness of the Healthy Lifestyles Programme (HeLP) to
prevent obesity in UK primary-school children: a cluster
randomised controlled trial. The Lancet Child & Adolescent
Health, 2(1), 35-45. https://doi.org/10.1016/S2352-
4642(17)30151-7
2
Evidence Synthesis
Student’s Name
Department, Institutional Affiliation

Course Title
Tutor’s Name
Date
Hi Dr Kyzar and class
Whether the author identified the scope of evidence synthesis
The scope of the evidence synthesis is focused on the issue
of patient falls with injuries and the challenges related to the
prevention of falls within the acute cares settings. The author
has identified this scope by drawing pieces of evidence from
various authors. The evidence drawn from the previous studies
indicates that the issue of patient falls is a major adverse event
that interferes with the quality of healthcare services that are
being provided to the patients within the acute care settings for
example nursing homes and healthcare facilities. The study
reveals that the detrimental effects caused by the issues of
patients' falls are associated with serious bruises, trauma,
fractures, and death of the patients when it is not prevented at
the right time (Araujo, et al., 2017).
The evidence also supports the focus of the author by
revealing that the issue of falls is a common problem that is
being experienced by elderly patients. It shows that one in every
three individuals more than 65 years old suffer from at least one
fall every year. This is associated with either alone of combined
factors such as environmental factors, social factors,
psychological factors. Therefore, the author has managed to
gather the literature that helps in addressing the research area
that is to say the issue of patient falls. The author has managed
to synthesize the literature by comparing the literature studies
referenced in this work. The author has managed to assess and
interpret to help in concluding on the issue of patients' falls and
how it is becoming an issue within the acute care and to the
healthcare providers (Araujo, et al., 2017).
Whether stronger paraphrased sentences are included to help in
supporting the contemporary sources of research evidence
Through providing the description, summary, analysis,

and identification of the key concepts; there is successful
paraphrasing of the sentences to help in supporting the sources
of the research evidence. The evidence from one of the research
evidence used i.e. (Gygax Spicer, 2017) shows the issue of falls
to be a common problem amongst elderly individuals due to the
factors that are either combined or occurring singularly. These
factors include social, environmental, and psychological factors.
This evidence is supported by the paraphrased sentence which
states that the etiology of falls among their elderly patients is as
a result of attempting to get out of the bed without any form of
assistance from the team of healthcare providers such as nurses.
The issue is further increased by other causative factors such as
diseases, impulsiveness, urgency, medications, and lack of
knowledge about the hospital environment. Another issue that is
paraphrased to support the evidence from the research is the
turnover problem among healthcare providers. Due to the
inadequate number of healthcare providers such as nurses to
spend more time with the patients, these elderly remains to be
highly exposed to the risk of falls as a result of the low ratio of
nurse to the patient (Gygax, 2017).
Whether the facts presented are related to the practice problem
that has been presented in an objective way
The facts presented in the article through research
evidence and conclusion from the research findings have been
done objectively and they are based on the issue of patient falls
and injuries and fall prevention. One of these facts is that the
issue of patient falls is a common problem within acute care
facilities such as nursing homes and hospitals. They are linked
to some of the preventable factors related to the social,
environmental, and psychological factors. Due to the reduction
in the ability to perform most of the ADLs, elderly patients are
considered to be high-risk individuals who require help from the
nurses to overcome the issue of falls which increases the risks
of preventable injuries and deaths. These patients also
experience the side effects of the medications, illness,
impulsiveness, and urgency thus exposing them to a high risk of

falls when effective interventions are not developed (Araujo, et
al., 2017).
The other key fact linked to the issue of fall prevention is
the lack of adequate nurses to help patients with their needs
such as pottying and movement within the hospital. Due to the
lack of knowledge about the hospital environment as well as
lack of adequate to respond to their needs immediately, elderly
patients remain highly exposed to severe bruises, fractures,
traumas, and preventable deaths (Araujo, et al., 2017).
Whether the author uses sources to support the ideas and claims
The argument presented by the author is supported by the
evidence from past studies. According to the argument from the
author, the issue of falls among patients occurs as a result of
their attempts to get out of bed without any form of assistance
from the nurses. The author also argues that patients' falls is
also associated with the urgency, illness, medication being used
by the patients, impulsiveness, and unfamiliarity with the
hospital environment in addition to the increase in the turnover
of the nurse staffing which reduces the number of nurses in the
hospitals.
These arguments are supported by the research evidence
used by the author. According to Gygax Spicer (2017), one to
three persons of ages 65 years and above do suffer from at least
one fall every year as a result of multiple factors that are linked
to social, environmental, and psychological factors. The issue of
illness, impulsiveness, urgency, and medication as presented by
the author is the social and psychological factors that are
demonstrated in the research evidence. The issue of a low
number of patients is an environmental factor within the
hospital facility. This increases the level of exposure of these
patients to the risk of falls (Gygax, 2017). According to the
author, patients always attempt to get out of their bed without
any assistance from the nurses. Due to the lack of knowledge
about the environment of the hospitals, the majority of them
fall. De Medeiros Araujo et al (2015) shows that such falls
expose them to mild and severe bruises, fractures, traumas, and

even deaths. The few numbers of nurses in the facility imply
that there would be no nurses left to keep an eye on other
patients who might require help with pottying and bathing (de
Medeiros Araujo, et al., 2017).
Whether this exemplar is a true synthesis of the evidence
The exemplar presented is a true synthesis of the evidence
concerning the issue of patient falls and the complex nature of
preventing such falls. Even though the presentation is majorly
based on the arguments based on the research evidence, the
information presented is a true reflection of what is happening
in acute care settings. Even though efforts have been made to
help in addressing the issue of patient falls, the evidence
synthesis further confirms that addressing this issue is still
complicated as a result of the high turnover that leads to the low
number of nurses to care for the growing number of patients
who are seeking services for their chronic conditions. The low
number of nursing staff makes it impossible to implement the
nursing hourly rounds and this complicates the interventions of
efforts being made to ensure that there is the successful process
of implementing the nursing hourly rounds (Araujo, et al.,
2017).
The issue of patient falls is also associated with the
problems caused by the medication and the psychological issues
of the patients. The reduction in physical strength and mental
well-being results in the reduction of the ability of the patients
to perform their ADLs such as bathing. In acute care, these
patients require help from the patients with the roles such as
bathing and pottying. Due to the lack of adequate nurses, it
makes it hard for these patients to have their needs rendered at
the right time. Therefore, they are forced to get out of bed with
no form of help from the nurses. Due to their reduced physical
and mental ability as well as lack of knowledge about the
hospital environment, they find themselves falling on the
ground thus exposing them to mild to severe bruises, fractures,
trauma, and death. Therefore, the effective process of
addressing the issue of patients' falls requires the process of

dealing with the complications within the facility at first for
example addressing the issue of lower nurse-patient ratios and
improvement in the hospital environment by increasing the
number of caregivers within the wards while nurses are busy
caring for other patients (Araujo, et al., 2017).
References
Araujo, J. N., Fernandes, A. P., Moura, L. A., Santos, M. M.,
Ferreira Junior, M. A., & Vitor, A. F. (2017). Validation of
nursing outcome content Fall prevention behavior in a hospital
environment. http://www.repositorio.ufc.br/handle/riufc/23831
de Medeiros Araujo, C. X., de Lima Silva, V., Guerra, G. C.,
Ferreira, A. H., de Araujo Barbosa, S. J., & de Araujo Junior,
A. A. (2017). Quality of life, integrative community therapy,
family support, and satisfaction with health services among
elderly adults with and without symptoms of depression.
Psychiatric Quarterly, 88(2), 359-369.
https://doi.org/10.1007/s11126-016-9453-z
Gygax, S. J. (2017). The Got-A-Minute Campaign to Reduce
Patient Falls with Injury in an Acute Care Setting. MedSurg
Nursing, 26(5).
1
PICOT Formulation
Student's Name
Department, Institutional Affiliation
Course Title

Tutor's Name
Date
Hello Dr Kyzar and Class
According to Abbade et al (2016), PICOT format is used in
the comparative research studies on the relationship between the
exposure and the outcome. The exposure in this case can be
considered to be the newly developed intervention that is
targeted at addressing health issues. This discussion is therefore
focused on looking at the two-practice question based on the
PICOT format to help in driving the practice change (Abbade et
al., 2016).
Practice Question 1
Identification of the PICOT components
Population: children of ages between 5 to 19 years with a body
mass index (BMI) of more than
Intervention: the use of the motivational interviewing during a
regularly well-child scheduled visitation and its influence on
the BMI, BP, quality of life, and the daily physical exercise
Compared: Usual practice is compared to the intervention of
motivational interviewing in the regular well-child visitation.
Outcome: the implementation intervention i.e. motivational
interviewing influences improvement in the BMI, daily physical

exercise, and quality of life.
Time: 8-10 weeks
The keywords used in the identification of the practice question
The keywords or terms that guide the search process to
facilitate the process of responding to the practice questions
include the motivational interviewing, regular well-child
visitation, the BMI, the quality of life, the physical exercise,
blood pressure (BP), and the 8-10 weeks timeframe.
To respond to the practice question further, a researched-
based intervention focused is on the use of motivational
interviewing. One of the articles generated from the research
work is by Luque et al (2019) that involved the use of the
Obemat2.0 trial. The Obemat2.0 trial was used to assess the
effectiveness of multi-component motivational program to treat
childhood obesity that is linked between the primary care and
hospitals specialized services when compared to the usual
intervention that is carried out in the primary care (Luque, et
al., 2019).
The authors performed a cluster randomized clinical trial
through the use of the two intervention arms i.e. the
motivational intervention group and usual care group as the
control using 167 study subjects. In the motivational
intervention, there were motivational interviewing, learning
materials, the utilization of the electronic health physical
activity monitor and three group-based gatherings. Based on the
results from the study, the primary results show an increase in
the score of the body mass index before and after 12 or 12 plus
3 months implementation. The secondary results i.e. the pre and
post intervention included the compliance to the medication, the
waist circumference, fat mass index, the fat-free mass index, the
total body weight, and the mineral density of the borne (Luque,
et al., 2019).
The research-evidence based intervention being addressed
The research-evidence based intervention was the
motivational interventions such as motivational interviewing,
learning materials, the utilization of the electronic health

physical activity monitor, and the three group-based sessions
(Luque, et al., 2019).
The quantifiable outcomes and how they will be measures
The quantifiable outcomes from the article include body
mass index, compliance to the treatment, waist circumference,
fat mass index, fat-free mass index, the mineral density of the
bone, lipid profile of the blood, the glucose metabolism, the
psychological issues, and the total body weight. These are the
key components that are associated with obesity. The
assessment of the outcome is based on looking at whether there
is an increase or reduction in the BMI based on the z score after
the implementation period; whether there is an improvement in
the adherence process to the medication; and looking at the
changes in the score of other parameters mentioned above, for
example, the waist circumference, glucose metabolism and the
mineral density of the bone marrow (Luque, et al., 2019).
The valid measurements or tools
The measurement tool used for the measurement of the
quantifiable data was Obemat2.0. This tool was used to assess
the effectiveness of the multicomponent motivational program
to help in treating childhood obesity. The multicomponent
motivation program included the motivational interviewing, the
learning materials, and utilization of the electronic health
physical activity monitor (Luque, et al., 2019).
Whether the practice question can be answered within the
specified period
The 8 to 10 weeks period is inadequate to measure as well
as give accurate and reliable data that would reveal the true
picture on the impacts of the intervention. The generated data
would not be enough to implement the proposed intervention
since the reduction in the BMI, the improvement in the physical
activities, and the quality of life requires adequate time for the
assessment. The time is also limited concerning factors such as
resources required, making contact with the patients, and the
measurements of the outcomes (Luque, et al., 2019).
Practice Question 2

Identification of the PICOT elements
Population: the adult care patients
Intervention: the implementation of the research-based skincare
integrity bundle
Comparison: the implementation of the intervention that
involves the use of the researched-based skincare integrity
bundle is being compared to the standard care practice that does
not involve any intervention to impact the hospital-associated
pressure injuries.
Outcome: the implementation of the intervention will influence
the rates of the hospital-associated pressures injuries
Time: the 8 to 10 weeks of the implementation process of the
proposed intervention
The keywords used identified in practice question
Some of the key terms focused on in this research question
include the skincare integrity bundle, standard care, critical care
patients or population, hospital-acquired pressure injuries, the
incidence of the skincare integrity bundles, and the 8 to 10
weeks timeframe.
Based on the use of the above terms, the generated
research-based evidence is by Cruz (2020) that focused on the
impacts of using pressure preventive bundle within 2 months.
The author aimed at implementing the intervention involving
the use of the intervention for the reduction of the rates of the
pressure injuries amongst adult in the ICU. The author reports
that patient in the ICU units is at high risk of pressure injuries
as a result of the acuity diagnosis. Therefore, they need a longer
type of healthcare services, medical procedures, and the
application of various types of medical equipment (Cruz, 2020
).
The research-based evidence intervention
In this study, the evidence presented to help in addressing
the issue of pressure injuries among patients in the ICU is the
preventive bundles. According to the author, this evidence-
based intervention helps reduce the reported incidences of the
pressure injuries amongst adult patients within the ICU. The

author further reveals that the intervention can be used to
assess, examine, and to offer continuous bedside support and
positive feedback to the healthcare providers (Cruz, 2020).
The quantifiable outcomes, how to measure them, and the
potential tool to help in their measurements
According to the author, the successful implementation of
the intervention must be able to lead to the attainment of 10
percent or more in the reduction of the rate of pressure injury
cases. The author also indicates that the intervention must be
able to give about or more than 90 percent of the provider
compliance to the implementation of the preventive bundles.
The achievement of these expectation confirms the effectiveness
of the intervention program (Cruz, 2020 ).
The outcomes from the implementation of the preventive
bundles in the prevention of the pressure injuries are analyzed
or measured by assessing the changes. There is an expectation
that the implementation of the intervention will be improved
amongst healthcare providers. There is a need to be a
consistency in the process of implementing the bundle towards
the prevention of the pressure bundles (Cruz, 2020).
The valid measurement tool that can be used for the
quantification of the data to confirm the effectiveness of the
intervention is the compliance checklist tool. This tool is used
for the monitoring, auditing, and to offer continuous effective
feedback to the providers within the ICU units. The tool is
useful in providing information concerning adherence to the
implementation of the intervention (Cruz, 2020).
Whether the practice question would be answerable within 8 to
10 weeks
The effective implementation can't generate data that can
be relied on concerning the importance of the preventive
bundles within 8 to 10 weeks. This is a procedure that deals
with health, therefore, requires adequate time for preparation
and plan on the types of resources that will be required. It also
requires the training of the nurses and other healthcare
providers while at the same time allowing the team to ensure

that such proposed practices are implemented within the ICU
units (Cruz, 2020).
References
Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., &
Thabane, L. (2016). Framing of research question using the
PICOT format in randomised controlled trials of venous ulcer
disease: A protocol for a systematic survey of the literature.
BMJ Open, 6(11), e013175.
doi:https://doi.org/10.1136/bmjopen-2016-013175
Cruz, C. (2020 ). Reducing the Incidence of Pressure Injuries in
Adult ICU Patients at McAllen Medical Center with the
Implementation of a Pressure Injury Preventive Bundle: A
Quality Improvement Project.
Luque, V., Feliu, A., Escribano, J., Ferre, N., Flores, G.,
Monne, R., . . . Closa-Monasterolo, R. (2019). The Obemat2.0
Study: A Clinical Trial of a Motivational Intervention for
Childhood Obesity Treatment. Nutrients, 11(2), 419.
doi:https://doi.org/10.3390/nu11020419
Running head: PARAMETRIC STATISTICS 1
PARAMETRIC STATISTICS 2
Analyzing Parametric Statistics
Student’s name
Professor
Course title
Date

Hi Dr Kyzar and Class
1. When looking at the evidence, one notes that there is an
independent variable and that a spearman’s ranked correlation is
used in the analysis of the data. The spearman’s correlation can
be referred to as the nonparametric version of the Pearson
correlation. The correlation coefficient by Spearman’s measures
the direction and the strength of the association between two
variables which are ranked. For the use of this test, one requires
two variables which are either ratio, interval, or ordinal. The
spearman correlation is used when the assumptions of the
Pearson correlation have been violated. The spearman’s
correlation determines the direction and the strength of the
monotonic relationship between these two variables as opposed
to the strength and direction of the linear relationship (Schober
et al., 2018). The person correlation is the one which looks at
the linear relationship between the two variables. The
monotonic relationship refers to the relationship when either as
the value of one increases the other variable is increasing or as
the value of one of the variable is increasing, the other variable
is decreasing (Bakdash and Marusich, 2017). The spearman
correlation is used in measuring the direction and strength of
monotonic association between these two variables. The
monotonicity is considered to be less restrictive compared to
that of the linear relationship. When one normally picks the
measure of association, it is after looking at the pattern of the
data which is observed. When one looks at the scatterplot and it
shows a relationship which looks monotonic, then one would
use the spearman’s correlation (Akoglu, 2018). If there is a
liner relationship, then one uses a person’s correlation as it
shows the direction and strength of the linear relationship. The
correct level of correlation analysis which should have been
used in this case is Pearson’s correlation analysis. The data that
has been presented has a normal distribution and has therefore
met all assumptions of the Pearson’s correlation. There is
manipulation of the independent variable and the Pearson’s is

the better level.
2. Correlational analysis and association are sometimes used
interchangeably but they have slightly different meanings when
it comes to the technicality. Association refers to the presence
of any relationship between two variables but the correlation is
used to refer where there is existence of a linear relationship
between the variables. The terms are often used interchangeably
when it comes to various texts despite the differences. The
correlation analysis explores the association which is there
between two or more variables. The correlational analysis
makes an inference about the strength of the relationship
between the variables (Akoglu, 2018). There are several
differences which can be shown when it comes to association. A
scatter plot, for example, shows the association between two
variables. The scatter plot matrix indicates the pairwise scatter
plots for the various variables. When it comes to the majority of
books, correlated and associated all mean to the same thing. The
technical meaning which is there in correlation is that there is
strength of the association as measured by the correlation
coefficient. Correlation as it is used is mainly a technical term
while the association is not. The association simply means that
there is a relationship presence (Schober et al., 2018). The
association will mean that certain values of one variable tends
to co-occur with certain values of the other variable. There is no
dependent or independent variable when it comes to the
correlation. It’s a descriptive statistic which is bivariate. When
it comes to the technical side, one can note that there are
several measures of association but only some of them can be
referred to as correlations.
3. After the findings I have a different outlook on the decision
on whether to use the evidence to inform practice change. A
quasi-experimental research study involves the manipulation of
an independent variable so as to see how the dependent variable
will react. In this case the study sample size is large and the
data is normally distributed. I believe that this study makes an
error and should have instead used the Pearson’s correlation

coefficient to show the relationship. The Pearson’s correlation
coefficient fits the purpose and there is no need to use the
spearman’s ranked correlation.
References
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation
coefficients: appropriate use and interpretation. Anesthesia &
Analgesia, 126(5), 1763-1768.
Akoglu, H. (2018). User's guide to correlation
coefficients. Turkish journal of emergency medicine, 18(3), 91-
93.
Bakdash, J. Z., & Marusich, L. R. (2017). Repeated measures
correlation. Frontiers in psychology, 8, 456.
Analyzing Descriptive Statistics:
Students Name:
Institutional Affiliation:
Professors Name:
Date:
Hi Dr Kyzar and classmates

What statistical procedure is needed to determine an
effective sample size to make a reasonable conclusion?
Main objective of having or developing an effective sample size
is trying to get both clinically and statistical significant result
as this also tries to maximize the use of the resources
efficiently. A determinant of sample size may include the size
in question, homogeneity of the sample the anticipated attrition,
and sometimes the risk of errors which have been considered as
being appropriate depending on the research question being
studied. In determining the sample size of the given sample, one
would have to accurately define the outcome which is the
objective being measured. Another determinant is the
homogeneity of the sample which shows the similarity of the
study units and the best way that this sample would be
representing the entire population (Burmeister and Aitken,
2017).
At some point, this also includes determining the different
parameters including the standard deviation. It’s important to
note the essence of level of significance as this helps in
identifying whether some effect may be existing. Power of a test
is also important as this includes the probability of not
detecting the effect in the event when there is an effect. In that
note, I may argue that the sample size determination procedure
may include pinpointing the outcome or a given hypothesis
which in this case it includes a null and alternative hypothesis,
then one selects the smallest effective size then one may specify
the significance of the test, estimate the different parameter
values that may be required in calculating the sample size and
specifying the intended power. In some cases, the sample size
may also be dependent on the design and the different
parameters that are being measured.
Reading through the study, you observe that the
researcher used a chi-square analysis to analyze nominal and
ordinal data. Is this the appropriate level of statistical analysis
to answer the research question? Explain your rationale.

Chi square analysis is the efficient statistical test that can be
incorporated in answering different research questions. From
the different study readings, we may denote that chi-square
analysis is one of the many statistical tests that may be useful in
describing the data as this statistical test does not provide the
casual relationship between these two variables. The chi-square
analysis may be incorporated in describing and outlining he
differences in the nominal and the ordinal variables. Also, it’s
worthwhile noting that the study description may also show that
the given data was not normally distributed. In that note, we
may conclude that chi-square may also be used in the data
which may not be depending on normal distribution in
interpreting the findings of the study. This makes it a non-
parametric test that can be used in checking association among
the different categorical variables (McHugh, 2018).
A chi square is essential, just as stated, its can be used in
analyzing nominal and categorical data as when the chi -square
helps in analyzing both the ordinal and the nominal data, the
different statistical tests are incorporated inn finding different
problems by approaching the problems of ordinal variables. For
instance the Mann-Whitney test is appropriate in evaluating the
differences that exists between different populations that are
using a given data from an independent measure design. On the
other hand, other tests also tries in evaluating the differences
between different populations by incorporating the different
samples for a given treatment condition.
Reading further, the researcher reports that the p-level
led her to conclude that the null hypothesis was rejected. In
your critique of the study, you determine that the null
hypothesis is true. Do these findings impact your decision about
whether to use this evidence to inform practice change? Why or
why not?
From the critique, the said findings would have an effect on the
decision as I would have to evaluate whether I can incorporate
this evidence in informing some practice change. The reason for

this is because the researcher committed type 1 error which is
likely to lead to inefficient change that may help in adopting
newer things or even may lead to erroneous results as there are
constant errors in the practice. In trying to avoid such and
related errors and sort of mistakes, in my case, I would try
controlling for type 1 error as this would help me in correcting
the errors that are likely to result to making wrong conclusions
and adopt the best change practice that would help in attaining
the stipulated results (Weiss and Weiss, 2017).
Statistical errors may legitimate data as this at some point may
lead to getting incorrect conclusion. In the study, it’s always
crucial to determine if the given results are correct because that
what matters most considering the objective of the study. In the
event when this results are incorrect, then it would not be
necessary to interpret the data any further. Which as stated the
fact that when I discover that the research made type 1 error, it
would be very hard for me to make any further conclusions on
the study. We have different statistics that helps us in getting
evidence which helps in determining if there is any relationship
that exists between some parameters. This statistics play an
important role in every aspect and it’s therefore important to
always take it into consideration as this may lead to different
series of events of implications irrespective of where a given
study was conducted.
References
McHugh, M. L. (2018). The chi-square test of independence.
Biochemia medica: Biochemia medica, 23(2), 143-149.
Weiss, N. A., & Weiss, C. A. (2017). Introductory statistics.
London: Pearson Education.
Burmeister, E., & Aitken, L. M. (2017). Sample size: How many
is enough? Australian Critical Care, 25(4), 271–274.
doi:10.1016/j.aucc.2012.07.002

1
Whether the research design answer the research question
In Ash et al (2017), the researchers were aiming at
profiling the current family-based childhood obesity prevention
as an intervention through the employment of the systematic
review and the quantitative content evaluation techniques to
help in the identification of the present gaps in the awareness.
The method employed by the authors was a wide-ranging search
approach using the databases PubMed, PsycINFO, and CINAHL.
This was done to guide on the identification of the eligible
interventions that can help in the prevention of childhood
obesity accompanied with lively family component that was
developed between 2008 and 2015. The search results reveal
that the existence in the few numbers of interventions that
target the diverse population and the obesity risk habits beyond
the diet and the physical exercises inhibiting the process of
developing a all-inclusive, custom-made intervention (Ash et
al., 2017).
Whether the study sample participants were representatives
In Ash et al (2017), a total of 84 samples from the
underserved population and non-traditional families and as well
as the racial or ethnic composition were used. Even though this
is a smaller sample, it gives a clear picture of the role played by
family-based childhood obesity prevention interventions (Ash et
al., 2017).
The limitation of the study
The limitation showed by the researcher in Ash et al
(2017) is that the focus was on the articles that were published
over relatively narrow time-period. The researchers also failed
to evaluate the effectiveness or the quality of the intervention
thus limiting the potential of the review. The outcome of the
study can be influenced by the number as well as the choice of
the databases searched thus subjecting it to the publication bias
(Ash et al., 2017).

Whether this quantitative research study would be considered as
a support to the selected problem
The key themes identified by the researchers included
intervention characteristics, article characteristics, and the
sample characteristics. The rise in childhood obesity is a burden
to the nation. Therefore, efforts are being made to have an
effective intervention. The researchers showed the need of
having intervention effort, especially in the low- and middle-
income nations. Ash et al (2017) study is therefore revealing the
importance of family-based childhood obesity intervention that
can be used to tackle the issue of obesity among children (Ash
et al., 2017).
References
Ash, T., Agaronov, A., Aftosmes-Tobio, A., & Davidson, K. K.
(2017). Family-based childhood obesity prevention
interventions: a systematic review and quantitative content
analysis. International Journal of Behavioral Nutrition and
Physical Activity, 14(1), 113. https://doi:10.1186/s12966-017-
0571-2
2
Does the research design answer the research question?
The research questions of the article by Lidgate &
Lindenmeyer (2018) seek to look at the experiences of the
parents and the informal caregivers in receiving and providing
informal childcare for the British children of ages 0-5 years; the
perceptions about the relationship existing between the informal
childcare and the childhood obesity; and the proposed

intervention thoughts and the delivery approaches in preventing
obesity amongst children who are receiving informal care
(Lidgate & Lindenmeyer 2018).
Through adopting the in-depth focus groups of 14
participants, the researchers managed to offer answers to the
research questions. Based on the outcome of the study, the
informal carers were identified to be offering both practical and
the emotional support roles for the parents. There was a
perception that informal care is contributing to childhood
obesity through cross generation conflicts that prevents the
adoption of the healthy practices; the trade-off for the parents
between the receiving childcare and the maintenance of the
control; reduction of the energy capacity of the carers; and
increase in the snacking. The findings is supporting the idea of
and informing the development towards an information based
and the cheaper intervention that is being provided through the
present primary care platforms (Lidgate & Lindenmeyer 2018).
Tremblay et al. (2017) was focused on the Canadian 24-
Hour movement Guidelines for the early (0-4 years) that
involves the integration of the physical, sedentary, behaviors,
and the sleep. This study involved a systematic review that
examined the physical activity, sedentary behavior, sleep, and
the combined behaviors that looks into the relationship within
among the movement behaviors and several health indicators
that were completed usign the Guideline Development Panel.
This study method helped in the generation of the evidence-
informed proposals that invlved the combinations of the light,
moderate, and the vigorous-intensity physical activity, the
sedentary behaviors, and the sleep among individuals from ages
1 to 4 years in the achievement of the healthy day. This
guideline is offering a public health guideline where there is
maximization of the health that is based on the balance of
movement (Tremblay et al., 2017).
Lloyd et al., 2018 focused at establishig whether the
school-based interventions for children of ages 9-10 years
would help in preventive excessive weight gain after 24 months.

The researchers used pragmatic cluster randomized controlled
trial of the Healthier Lifestyle Programme (HeLP) which is a
school-based obesity prevention intervention that was
performed in 32 schools found in the southwest England. This
method is revealing school as the ideal location for the
childhood obesity preventiuon programs due to the near-
universal reach f children in the socioeconomic spectrum. It
also shows the importance of the change in the diet and physical
activity behaviors and their impacts on the weight status (Lloyd,
et al., 2018).
Were the study sample participants representative
The sample size used by the Lidgate & Lindenmeyer
(2018) were few, therefore, it makes it hard for the outcome of
the study to be used to represent or generalized what is
happening in other cities. Even though researchers made an
effort to recruit both parents and the carers in the study, only 14
participants were involved in the study to ensure that it meets
the limited timeframe. Therefore, it is recommended that the
interpretation of the study outcome have to be done with some
limitations (Lidgate & Lindenmeyer 2018).
In the study by Tremblay et al. (2017), a total of 552
Canadian preschool-aged children from CHMS were used. The
sample used in the research work are adequate enough to reveal
the events related to the link of the time being used during
sleep, sedentary behavior, LPA, and the MVPA (Tremblay et
al., 2017).
In a study by Lloyd et al. (2018), the sample calculation
assumed a mean of 35 children age 9-10 years in every school
and this implies that a total of 1,120 samples were used. This is
a good number that can represents the problems at the 32
schools that were being targeted by the researchers.
Comparing the study limitations
The limitation of the study by Lidgate & Lindenmeyer
(2018) is linked to the few number of the study participants who
took part in the study. The researchers only managed to recruit
14 participants to ensure that the limited timeframe of the

project is met. This therefore makes it essential to make an
interpretation of the data with some limitations (Lidgate &
Lindenmeyer 2018).
The limitation of the research work by Tremblay et al.
(2017) is that there was an incomplete evidence-based for the
guidelines with low quality. The study is not representing the
best available evidence collected through the systematic review
and the original research. The research work is lacking adequate
research to form specific aspects of guideliens for example the
dose-response research studies.
In the article by Lloyd et al. (2018), the findings of the
study shows that the effectiveness of the school-based obesity
prevention programmed is inconclusive and contradictory. The
interventions used are highly heterogenous in the design and
most of the studies used for the research have some
methodological weaknesses for example the inadequate
statistical power, greater levels of attrition, differential uptake,
follow-up, and the short-lived follow-up.
Whether the selected qualitative study is supporting the practice
problem
The problem in this case is related to the obesity especially
on children. There is an increase concern about the rise in the
reported cases of obesity among children. Based on the findings
by Lidgate & Lindenmeyer (2018), there are four themes that
emerged. The most important two themes include the
importance of the informal care to families and the society and
the potential explanations for the link between childhood
obesity and the informal care. These themes are important since
they reveal the relationship between the childhood obesity and
the informal care as well as revealing the role played by the
families and the society when it comes to the implementation of
the informal care (Lidgate & Lindenmeyer 2018).
The study by Lidgate & Lindenmeyer (2018) is important
since it reveals that obesity in children is associated with the
informal childcare and the rising risk factors of the childhood
obesity for children of ages 0-5 years. The study reveal that

informal education to the carers is important in supporting
parents and helping in the prevention of obesity amongst
children. The intervention that targets the primary care is
helping in the reduction of the risk of childhood obesity
(Lidgate & Lindenmeyer 2018).
The study by Tremblay et al. (2017) is based on the proces
as well as the outcomes for the development of the Canamdian
24-hour movement guidelines for the early years (0-4 years)
which involves the integration of the physical activity, sleep,
and the sedentary behavior. The two importance themese
emerged from the stufy findings i.e. physical activity and health
indicators and the sedentary health behaviors and indicators.
The researchers focused on the development of the guidelines
that involves the integration of the movement behaviors which
followes a shift towards whole-day strategy to the
conceptualization of the movement behavior supported by the
Canadian 24-hour movement guidelines. It helps in ensuring
that the problem of childhood obesity is addressed through
promotion of active health lifestyles (Tremblay et al., 2017).
In the research work by Lloyd et al. (2018), two themes
were considered to be important i.e. energy in and decision
making and the responsibility. It is clear that school hosts many
children and can therefore be used as ideal place to deliver the
population-based interventions. Even though it might not
adequately intensed to affect both school and the family
environment hence wieght of the children, it needs to be
promoted since it helps in changing the health behaviors of the
children. This is important in addressing the issue of childhood
obesity sinnce it helps in promoting healthy behaviors among
children (Lloyd , et al., 2018).
References
Lidgate , E. D., & Lindenmeyer, A. (2018). A qualitative insight
into informal childcare and childhood obesity in children aged
0–5 years in the UK. BMC Public Health, 18, 1229.
https://doi.org/10.1186/s12889-018-6131-0
Lloyd, J., CStat, C. S., Logan, S., Green, C., Dean, S., Hillsdon

, M., Abraham, C., Tomlinson, R., Pearson, V., Taylor, R.,
Ryan, E., Price, L., Streeter, A., Wyatt, K., & Wyatt, K. (2018).
Effectiveness of the Healthy Lifestyles Programme (HeLP) to
prevent obesity in UK primary-school children: a cluster
randomised controlled trial. The Lancet Child & Adolescent
Health, 2(1), 35-45. https://doi.org/10.1016/S2352-
4642(17)30151-7
Tremblay, M. S., Chaput , J.-P., & Carson, V. (2017). Canadian
24-Hour Movement Guidelines for the Early Years (0–4 years):
An Integration of Physical Activity, Sedentary Behaviour, and
Sleep. BMC Public Health, 17, 874.
https://doi.org/10.1186/s12889-017-4859-6
Lidgate & Lindenmeyer., 2018; Permalink:
https://doi.org/10.1186/s12889-018-6131-0
Tremblay et al., 2017; Permalink:
https://doi.org/10.1186/s12889-017-4859-6
Lloyd et al., 2018; Permalink: https://doi.org/10.1016/S2352-
4642(17)30151-7

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