1Rough Draft Quantitative Research Critique And Ethical Consider.docx

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Rough Draft Quantitative Research Critique And Ethical
Considerations
Rough Draft Quantitative Research Critique And Ethical
Considerations 2
Quantitative Research Critique and Ethical Considerations
Christiana Bona
Grand Canyon University
October 16, 2019
Childhood Obesity
Picot Question: How do the new practical approaches in the
diagnosis and management help in the reduction of obesity
issues as compared to the lack of reliance on the traditional
approaches (diet and exercise)?
Background
Childhood obesity is considered to be a major international
growing problem. Even though there is a high rate of obesity
cases in the United States and other regions of the world for the
past 30 years, there is still a lack of clear treatment approaches
to be applied to reduce this incidence. Healthcare providers are
lacking ideas on where they should find approaches related to

the guidance and the process of managing the healthcare
services to about one-third of the population who are affected
by the healthcare issues associated with obesity. The Pediatric
Obesity Algorithm is now considered to be an evidence-based
approach in terms of diagnosing and managing childhood
obesity. The authors of this study aimed at providing a summary
of the topics from the Pediatric Obesity Algorithm related to the
diagnosis of pediatric obesity, assessment, and management.
Other tasks include the performance of differential diagnosis,
reviewing the systems, diagnosis of the workup, physical
examinations, management of age-specific, and the treatment of
the associated weight gain. The outcome of this study will,
therefore, help in the identification and treatment of children
with obesity through using the Pediatric Obesity Algorithm
which serves as a guide to healthcare providers with evidence-
based approaches to the diagnosis process and managing obesity
in children and offering families with the tools they require to
ensure that there is healthy future.
How the article is supporting the topic
The article above is talking about some of the present gaps
concerning the management and treatment of obesity among
children. Through identifying that there is an absence of clear
treatment approaches that can be relied on the treat and manage
obesity among children, the authors of this article proposed that
the Pediatric Obesity Algorithm can be successful in providing
evidence-based approaches for diagnosing and amanging
childhood obesity. Therefore, Pediatric Obesity Algorithm can
be considered as a new approach in managing and diagnosisng
obesity among children as compared to the traditional methods
that involve watching the diet and exercise which is sometimes
not followed by children. Pediatric Obesity Algorithm approach
is helping in ensuring that there is a proper physical
examination, age-specific management, use of medication and
surgery, and performance of differential diagnosis among other
procedures that are performed in this approach.
Method of Study

The method used by the authors is based on the qualitative
content analysis using research samples (100) articles from the
previous studies. The studies were those which were undertaken
to study the pediatric obesity algorithm. The setting of the study
was mainly the healthcare facilities within the United States.
This method of study cannot be relied on since it is mostly
associated with errors from the previous studies.
Results
Based on the findings of this study, a pediatric algorithm
is important since it helps in guiding healthcare providers with
practical evidence-based approaches required to diagnose and
manage childhood obesity. The process of identifying and
treatment of patients is an important aspect and it needs to be
done earlier enough. A comprehensive process of management
through using the Pediatric Obesity Algorithm is guiding the
healthcare providers with some practical and evidence-based
approaches needed for the diagnosis and management of obesity
among children. This study is important to future scholars who
wish to study the role played by the Pediatric Obesity
Algorithm in the prevention of obesity among children as
compared to the future proposed intervention. This study is also
important to the healthcare providers since it informs about the
effectiveness of the Pediatric Obesity Algorithm in the
prevention of childhood obesity.
Outcomes
The anticipated outcome from the PICOT question is that
new effective practical approaches such as Pediatric Obesity
Algorithm in the diagnosis and management are helping in the
early detection and management of childhood obesity. The
outcomes of this article reveal that the Pediatric Obesity
Algorithm helps healthcare providers to use the practical
approaches needed to diagnose and manage childhood obesity.
The similarity between the expected outcome of the PICOT
question and the new approach from the study is that there will
be an improvement in the procedure of diagnosing and
management of obesity in children thus reduces the reported

cases of obesity.
Rankin, A., Blood-Siegfried, J., Vorderstrasse, A., & Chlebowy,
D. (2015). Implementation of childhood obesity identification
and prevention strategies in primary care: A quality
improvement project. International Journal of Pediatrics and
Adolescent Medicine, 2 (2), 59-63.
Background
According to this study, the increase incidences of
childhood obesity combined with the increased cases of
morbidity and financial burden needs the process of identifying
and implementing helpful pediatric obesity prevention
approaches in primary care. The solution proposed by the
authors of this study is that there is a need to have evidence-
based clinical course of actions to provide brief, culturally
suitable information related to measures of identifying and
preventing childhood obesity within primary care. The study
was aimed at implementing the childhood obesity process of
identifying and offering the prevention guidelines using
evidence-based recommendations and tracking form.
How the article support the nurse practice issue chosen
This study is related to the PICOT question since it also
seeks to explore some of the cultural suitable approaches
needed to helping in the process of managing and treating
obesity among children. The article is providing an answer to
the PICOT question by providing the best practice approaches
which are necessary towards the diagnosis and management of
childhood obesity. Through using evidence-based
recommendations and tracking forms as the best practices, it
becomes easier to manage and treat obesity among children.
Methodology
The setting for this study was in the pediatric primary care
offices which serves the rural and semi-rural regions. The
practice staffs included in the study were physicians, nurses,
physician assistants, front office staff, and medical assistants.
The patients were age between four years to adult and they were
mostly from the underserved group of people with 42 percent of

the population being the beneficiaries of the Medicaid. The
population consisted of 33 percent of individuals from the
Hispanic community. The benefit of this study is that it was
only based on a single setting as opposed to two like the
previous article thus suggesting that the responses that will be
provided by the study participants will be somehow similar.
Nevertheless, the authors of this study failed to provide
exhaustively detailed on how data were collected.
Results of the study
The key outcome of the study is that there was an increase
in the practice in identifying and documenting measures of
preventing obesity through the motivational interviewing, there
was a positive outcome in the pediatric population following
practice change which involved the inclusion of identifying
childhood obesity and familial prevention approaches. The
implementation of the evidence-based guidelines is important in
increasing the process of identifying the risk of childhood
obesity and improved familial education on the prevention of
obesity.
Concerning the implication of this study, the incorporation
of the Motivational interviewing on the tracking tool is
providing an evidence-based strategies for motivating the
clients as well as their families to choose to live healthy lives.
This allows nurses to improve the well-being of their patients.
It also increases awareness among nurses and educating them on
the means of ensuring that healthy lifestyles are developed and
reduction of the risk factors in the population.
The outcome comparison
The outcome of this article is to ensure that there is a
reduction in the morbidity and the financial burden associated
with the increased cases of childhood obesity. The anticipated
outcome of the PICOT question is to ensure that there is an
reduction in the rate of childhood obesity by using effective
practices of diagnosing and management. This will help in
reducing the morbidity and death of childhood deaths as a result
of obesity. Both PICOT and outcomes from the study are aimed

at ensuring the there are best practices to help in reducing the
incidences of obesity and deaths associated with this disorder.
Reference:
Cuda, S., & Censani, M. (2018). Pediatric Obesity Algorithm: A
Practical Approach to Obesity
Diagnosis and Management. Frontiers in pediatrics, 6.
“My Brother Calls Me ‘Bug Eyes’”: A Case Study on the
Endocrine System
Nineteen-year-old Krista waited impatiently as Dr. Weisman
scribbled in his chart. She hoped he was scribbling an
explanation of what was wrong with her. She was tired of not
feeling like herself and tired of being so stressed about it. She
was particularly tired of how her eyes seemed to bulge outward,
so much that her 10-year-old brother had started calling her
“Bug Eyes.”
Dr. Weisman finally put down his pen and looked at Krista.
“Well, your blood pressure and pulse are elevated. You’ve lost
weight without trying, you have difficulty sleeping, you
perspire more than usual and you’ve had continuing bouts of
diarrhea. Those things, combined with the swelling in the front
of your neck, suggest that you may be suffering from more than
the stress of college life. I think we need to run some blood
tests to check your thyroid function.”
Krista blinked in surprise. “All of those things can be caused by
a problem with my thyroid? Even the way my eyes look?”
Dr. Weisman nodded. “Your thyroid secretes several hormones
that have widespread and varied effects. The protrusion of your
eyes is a condition called exophthalmos – it is an inflammatory
response to abnormal levels of thyroid hormones. The fact that
you have this condition in addition to your other symptoms

makes me fairly certain this is a thyroid problem.”
Krista hoped Dr. Weisman was right. Having a medical
explanation for her symptoms would mean that she wasn’t
losing her mind.
Several days later, Krista met again with Dr. Weisman.
“Let’s talk about your test results,” he said. “Your thyroid
hormone levels are elevated, but your level of thyroid-
stimulating hormone (TSH) is lower than it should be. Those
results suggest that you probably have Graves’ disease, which
means that your thyroid is overactive. But there’s good news
too—this is a condition that we can treat relatively easily.”
Krista felt a twinge of relief at the doctor’s words, but a flurry
of questions poured out of her mouth. “What made my thyroid
go crazy? And what is TSH? If it’s a thyroid hormone, why is it
low instead of high like everything else? And what kind of
treatment do I need? Will it fix my thyroid? Will I…”
Dr. Weisman laughed and held up his hand to stop the barrage
of questions. “Hold on, Krista. I’ll explain everything, and with
the right treatment, your brother may not be able to call you
‘Bug Eyes’ much longer.”Short Answer Questions
1. Name the two hormones commonly referred to as “thyroid
hormone” and describe their general actions.
2. Why would an overactive thyroid cause Krista’s weight loss,
sweating, and elevated heart rate?
3. Krista wonders if TSH is a “thyroid hormone,” and Dr.
Weisman explains that it is not. State the action of thyroid-
stimulating hormone (TSH) and name the gland that secretes it.
4. How is the secretion of TSH regulated under normal
conditions?
5. In Graves’ disease, the immune system makes antibodies that
stimulate TSH receptors on the thyroid gland. What effect does
this have on Krista’s thyroid?

6. Why is Krista’s TSH level low instead of high?
7. If Krista had been diagnosed with hypothyroidism, what
would happen to her levels of TSH and thyroid hormone?
8. A common treatment for Graves’ disease involves ingesting a
dose of radioactive iodine, which slowly destroys the thyroid
gland. Why are other tissues unaffected?
1
Rough Draft Qualitative Research Critique and Ethical
Considerations
2
Considerations
Considerations
Christiana Bona
Grand Canyon University
October 10, 2019
Background of the Study
Authors of this research work utilized the method of pilot
execution study to look at the implementation of the thoroughly
assessed Healthier Families Program as well as the Recreation
sites within three cities of the nation i.e. Michigan, Nevada, and
Georgina which consists of people of different socio-cultural

origins. There has been limited success in different healthcare
outcomes even though there has been the expansion of the
evidence-based behavioral interventions within the community
organizations. This has been the case since the fidelity and the
clinical interventions dosage are becoming diluted when they
are utilized within the community settings.
There have been more than 300 randomized controlled
trials to assist in preventin and treating childhood obesity.
There are several trials which have been successful in enhacing
che child body mass index, however, the generalizability of
their outcome, as well as the sustainability of the programs,
have become hard to evaluate. Attempts that have been made to
replicate the programs in other healthcare facilities have not
been fruitful. Therefore, due to the burden of childhood obesity,
future studies must include rigorous methods to help in scaling
out the effective research into the real world context and
assessing their effects.
Methods of the Study
This study involved utlization of RE-AIM framework to
assess the program through quantitative i.e. the pre and post-
survey of the behavioral changes; attendance and fidelity. A
qualitative approach was also used i.e. interviews using Parks
and Recreation staff as well as participants of the program.
Each participant site was used for the ten families coming from
the local communities through the use of in-person, face to face,
and email. The research was guided by the question: "are the
community-based behavior interventions effective in the
treatment and management of childhood obesity?"The inclusion
criteria used by the researchers was based on the inclusion of
parents of more than 18 years and children between 3to 5 years.
The participants were to commit themselves to participate
in the study for three months program. The exclusion criteria,
especially for the families, were no contact and sickness that
would likely prevent them from actively participating in
frequent exercise activities. The limitation of the study was
that it was designed using a pilot study and it was hard to

generalize the intervention effectiveness. Another weakness of
the study is that the participants used were early adopters and
they enrolled without using the targeted recruitment techniques.
The assessment methods used by the authors for the health
behaviors were restricted to the pre-post survey and this means
that the project or research work can be subject to recall or
social desirability biases.
Results of the Study
The outcome of this study shows that the use of evidence-
based childhood obesity intervention is one of the most
important approaches to dealing with obesity issues as well as
the long-term impacts associated with the disorder. It is also
important to contextualize the intervention of the successful
scaling out while at the same time offering rigorous strategies
to make sure that there is greater fidelity.
Ethical Considerations
The authors of this research work followed ethical
requirements by meeting the ethics approval and consent of
participation. The apporval of this study was done by the
Vanderbilt University Medical Center Institutional Review
Board. The participants who agreed to participate in the study
signed the consent to confirmtheir willlngness to take part in
the study.
Conclusion
The pilot study was amongst the first attempts made to
help in ensuring that there is scaling out of the evidence-based
childhood obesity intervention within the community Parks and
Recreational institutions. The successful and sustained
behavioral change amongst geographical and divese ethnic
populations with greater attendance and fidelity is
demonstrating the effective strategies to focus on the prospect
large scale execution efforts to help in the reduction of
childhood obesity in the community.
Bazyk, S., & Winnie, R. (2013). A multi-tiered approach to
addressing the mental health issues surrounding obesity in
children and youth. Occupational therapy in health care, 27 (2),

84-98.
Background
Childhoood and youth obesity cases is a major concern for
the public healthcare sector which significantly affecting the
physical and mental well-being. Even though the traditional
methods of preventing obesity is based on diet and aerobic
exercise at the individual level, focus need to change to the
impacts of mental health in relation to obesity. People with
obesity are living in a world where they faced stigmatization
and are less accepted and this leads to social exclusion and
discrimination. Therefore, this study aims at presenting a multi-
tiered approach to the prevention of obesity which focuses on
promotion of psychological well-being, prevention, and
individualized interventions.
Methods of study
Authors of this study used descriptive studies to help in
exploring multi-tiered approaches to obesity management which
involved the use of 20 interventions. The authors used
questionnaires to help in the collection of data. A total of a
sample size of 1000 children were selected to participate in the
study. The study was guided by the research questions i.e. "is
the multi-tiered approach in the identification of the
management of obesity effective in the reduction of childhood
obesity and its prevalence rates."
Results of the Study
The key outcome of this study is that the use of the multi-
tiered approach to obesity is effective and helps in the
management of obesity. A multi-tiered approach is working
more successfully than other traditional methods used in the
management of obesity. Therefore, to reduce childhood obesity,
the focus needs to be a shift from the traditional approaches of
managing obesity to a more multi-tiered approach. This can help
in the reduction of obesity cases among children.
The authors of this article followed the ethical principle
guiding research work. The first ethical requirement met is

seeking consent from the participant who later signed the
consent form to confirm their readiness to take part in the
research work. The approval of this study was done by the
Cleveland State University Institutional Review Board which
allowed the authors to go ahead with the research.
Conclusion
The study concluded that even though the traditional
approaches which focus on the watching diet and taking part in
the exercise activity, little attention has been given to the
mental issues that affect obese individuals due to the
stigmatization issues. Therefore multi-tiered approach to
obesity which focuses on the promotion of emtiional well-being,
reducing the risks to obesity, and designing or improving
individualized intervention needs to be adopted to help in
fighting against childhood obesity which is becoming a major
healthcare concern in the country.
Reference:
Heerman, W. J., Schludnt, D., Harris, D., Teeters, L., Appel, R.,
& Barkin, S. L. (2018). Scale
out of a community-based behavioral intervention for childhood
obesity: pilot
implementation evaluation. BMC public health, 18 (1), 498.
Research Critique Guidelines
To write a critical appraisal that demonstrates comprehension of
the research study conducted, address each component below
for qualitative study in the Topic 2 assignment and the
quantitative study in the Topic 3 assignment.

Successful completion of this assignment requires that you
provide a rationale, include examples, or reference content from
the study in your responses.
Qualitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research
problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the
number of people affected by the clinical problem.
· Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?
Method of Study:
· Were qualitative methods appropriate to answer the research
questions?
· Did the author identify a specific perspective from which the
study was developed? If so, what was it?
· Did the author cite quantitative and qualitative studies
relevant to the focus of the study? What other types of literature
did the author include?
· Are the references current? For qualitative studies, the author
may have included studies older than the 5-year limit typically
used for quantitative studies. Findings of older qualitative
studies may be relevant to a qualitative study.
· Did the author evaluate or indicate the weaknesses of the
available studies?

· Did the literature review include adequate information to build
a logical argument?
· When a researcher uses the grounded theory method of
qualitative inquiry, the researcher may develop a framework or
diagram as part of the findings of the study. Was a framework
developed from the study findings?
Results of Study
· What were the study findings?
· What are the implications to nursing?
· Explain how the findings contribute to nursing
knowledge/science. Would this impact practice, education,
administration, or all areas of nursing?
· Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Quantitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research

problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the
number of people affected by the clinical problem.
· Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?
Methods of Study
· Identify the benefits and risks of participation addressed by
the authors. Were there benefits or risks the authors do not
identify?
· Was informed consent obtained from the subjects or
participants?
· Did it seem that the subjects participated voluntarily in the
study?
· Was institutional review board approval obtained from the
agency in which the study was conducted?
· Are the major variables (independent and dependent variables)
identified and defined? What were these variables?
· How were data collected in this study?
· What rationale did the author provide for using this data
collection method?
· Identify the time period for data collection of the study.
· Describe the sequence of data collection events for a
participant.
· Describe the data management and analysis methods used in
the study.
· Did the author discuss how the rigor of the process was
assured? For example, does the author describe maintaining a
paper trail of critical decisions that were made during the

analysis of the data? Was statistical software used to ensure
accuracy of the analysis?
· What measures were used to minimize the effects of researcher
bias (their experiences and perspectives)? For example, did two
researchers independently analyze the data and compare their
analyses?
Results of Study
· What is the researcher's interpretation of findings?
· Are the findings valid or an accurate reflection of reality? Do
you have confidence in the findings?
· What limitations of the study were identified by researchers?
· Was there a coherent logic to the presentation of findings?
· What implications do the findings have for nursing practice?
For example, can the findings of the study be applied to general
nursing practice, to a specific population, or to a specific area
of nursing?
· What suggestions are made for further studies?
· Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Reference
Burns, N., & Grove, S. (2011). Understanding nursing research
(5th ed.). St. Louis, MO: Elsevier.
© 2016. Grand Canyon University. All Rights Reserved.

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