This research paper illustrates ways in which a clinical nursing problem is addressed by various researchers in the medical field. In this research, a PICO question will be used as a tool that will help in developing a clinical question; does exercise vs. diet education reduce obesity in school children? Overweight and obesity are increasing in children and this has become a global concern. The reason behind this is the children’s low levels of physical activity, in concert with the rise in their inactive behaviors, jointly impelling research programs and strategies. The research and strategies are to enhance their levels of PA, in order to improve on reducing obesity increase amongst children.
Through the school settings and environment, there are many PA opportunities, considered to be intervention programs aiming at younger pupils (Lau, 2006, p. 2). It has been observed that, children tend to spend large proportions of day time within the school, with probable occasions to enable healthy lifestyle behavior development. Hence, PA gets to be allied with school through Physical education, in addition to PA in recess periods calling for the nursing profession intervention.
Reasons for topic selection
Having childhood and adolescence as an opportunity to address obesity, habitual PA helps to uphold a healthy body and weight, a link, to positive and healthy musculoskeletal development, cardiovascular systems, including neuromuscular awareness. The development is through promoting objectives meant for prevention of disease (Bluford, 2007, p. 8). PA could be taken outside school, through supervision by guardians alongside a nurse’s advice.
Through efforts to prevent childhood obesity globally, a range of proposed school based intervention that call for implementation, paved way for selection of this topic. Through study on heterogeneity, there is a rent difficult, towards drawing of generalizations on interventions that get to be most effective.
Diversities in methodologies as well as climatic, geographic, conceptual, ethnic, and regional characteristics, in association with a mixture of PA interventions, could be implemented in diverse countries. As a result, making it possible to outline effective intervention features to decrease levels of obesity in primary school children. In an example, this could be through combinations of increase in PA that is meant to decrease sedentary behaviors, so that to make appropriate diet that is more effective to reduce obesity, than the increase in PA or diet considered appropriate.
Further, as a contributor to this topic selection, the fact that there is no worldwide common intervention to demonstrate a long-term increase in PA, children whilst concurrently reduce their levels of obesity. This is through research on strategies to increase PA and obesity alleviation in children, greatly being observed (Heller, 2007, p. 14). Whilst according to Rodgers and Stratton, 2010, longitudinal research, of children who are school-aged, is meant to assess reduced obesity through increasing of the school based Physical Activity, have to some level been implemented.
In the sampling out of comprehensive search terms, which basically included child, health promotion, obesity, overweight, school nursing and diet, techniques used yielded a number of terms. However, for the better understanding of the topic two key ones that included diet and obesity were a subject of discussion that link the review of literature to population, intervention, control mechanisms and expected outcomes.
Qualitative search method use was recommended that provided supplementary insight. The understanding of the need for nurses’ intervention and relevance in tackling child obesity was crucial. Furthermore, the recommended subjects of choice would in the future benefit children through objective measure inclusions for the sake of reducing child obesity and overweight.
Therefore, the sampled search terms assist in exploration of factors influencing obesity in children. Through schools selection a sample of randomly selected five in every twenty children of the age between 6 to 12 years gets to be effected. Age favorite foods in these children, gets to be significant variables to use in studying them (Boutenko, 2007, p. 122). Further, findings get to indicate that consumption of junk foods by children of this age is high with minimal physical exercise, as their modern ways of playing do not include physical body including Play Stations, X-Box and other similar stationed games.
Longitudinal studies, with repeated monitoring using objective measures of Physical Activities in 6-12-year old children are rare. This is in spite of the evidence concerning the PA interventions, effective in the guide towards planning. This paper, therefore, tends to bridge this gap, by assessing school-based PA influence on obesity and overweight levels in children, through linking the gap, as an effort to prevent childhood obesity. This is through school-based interventions implementation that involves nurses.
The study through assessing the augment that physical activity (PA) in the school setting as a comparative background, through nurses, sets diet and exercise education requirements. This requirements lead into a decrease in obesity levels in children aged 6-12 year old, a double edged, question validating exercise and diet education, in tackling child obesity as an expected outcome.
This study assesses the effectiveness of school-based Physical Activities intervention, significant towards overweight and obesity, reducing in children, through describing and comparing control groups of boys and girls, all through the intervention. Also, this tends to bring on board a comparison of the weekends and school day levels of PA intercession and control boys and girls.
In school days, this tends to compare leisure time and school based PA levels of intervention to control boys and girls. Therefore, this is to assist in the describing and comparing of the overweight proportions in obese children to enhance intervention, and control of boys and girls throughout the intervention. This will, therefore, articulate the participation effect in the Physical Activities as interventions on levels of obesity and overweight in children.
Methods linking literature review to population, interventions, control and outcomes
Participants and settings
Through the review of literature discussed; population, intercessions, control, with no limit to outcomes get to be highlighted. This gets to be through voluntary participation by the study expanding the lead on research on longitudinal changes in PA in first-grade children and pre-scholars according (Hartwig, 2012, p. 312). This study is to highlight on the considerable dwindle of school time PA, past the shift of kindergarten children to first grade primary school. Additionally, with the look into the changes of body weight and PA of children, all through their transition in the 9 to 12 year old age in primary school, building and extending the chronological span of research.
Participants’ selection and intervention in this case, have to meet some criteria; an example through having a contest on poetry reading, school trips, competitions in sports and singing, and PA programs. Both interventions place schools to have similar Physical Activities conducive environments, comprising of grass, playground, a gymnasium, sports field, a yard, and other facilities to facilitate sporting (Hartwig, 2012, p. 222).
Standard and PA intervention program
The standard program on PA comprises of mandatory physical education (PE) lessons actively undertaken, focusing on overall development physically. This is through movement games, gymnastic exercises that are simple, and equipment exercises, skipping rope, hoop, or benches. In the control schools, additional PA could be undertaken by children in recess periods and after nursery school at wish. Mostly, this is subject to school equipment availability and teacher’s choice, with alternatives that, there could be choice of other desk-bound activities (Branca, 2007, p. 40).
Additionally, the program brings about PA intervention comprising of PA content recess for PA undertaken during and after-school and average short breaks daily. They should be inclusive of those that are; in between PA lessons and corridors, through playing around corners and movements that are close to classes.
Discussion of the research significance in Nursing Practice
As a clinical research in the practice of nursing, there is a significant assessment of the effectiveness of a school-based PA intervention, developing new nursing strategies. Hence, building the nurses capacity according. Therefore, there is need to have a two-year continuous study, to assist in proposing suitable measures to reduce overweight and obesity in 6 to12 year old children (Jensen, 2006, p. 82). As such, the study tends to bridge the gap flanked by school aged children, longitudinal studies, to obesity reduction focus of increased school based PA.
Capacity building is a significant clinical research intended, which as an objective, is needed to describe and compare various control and PA levels intervention according to Jensen, 2006. Prior to the PA intervention, differences get not to be notable in PA levels, amid the intervention and controls on weekends and on school days.
Notably, PA design might reduce the differences and step count between girls and boys. This is a long-term and increased PA implementation intervention, within the school environment, thereby, positively impacting on PA levels daily. Additionally, it is an intervention to girls, in reverting to high PA levels exhibited at kindergarten, and as a significant link to clinical research, that capacitates the field of nursing.
As an autonomous topic, to the nurses, it assists in developing their capacity, assisting in ensuring knowledge and understanding of the field, in a better manner according to Tudor-Locke. Intervention through the daily mean step count in school-based PA, despite the increase in intervention through girls and boys, there has been a lagging behind of the levels for girls and boys. This has been due to repeated monitoring of the controls, boys’ and girls’ levels of PA continuously decreased (Cronau, 2010, p. 72). Cronau 2010, continues to state that the decrease has seen the recording of low daily steps mean, after the observance of values at the ultimate monitoring, with an observation of low levels of school PA controls. Extensively, low weekend PA is insufficient for maintaining health, a step meant to be understood by nurses.
Comparing of PA control weekends and school days as intervention for girls and boys Weekends needs nurses understanding, for the sake of having a significantly lower PA than school days according to Tudor-Locke. Further, these finding highlights the alarming weekend levels of PA in both intervention and control of children, in relation to PA level’s threshold considered necessary for health maintenance.
In comparing of leisure time and school-based PA intervention levels of and control for school days in girls and boys, the step of leisure time counts. The reason gets to be that, guidelines on basic health for children and youth tend to be independent of the PA level, they engage in (Cronau, 2010, p. 34). It assists them to increase the time they spend on moderate to vigorous PA per day, therefore, counting in their daily step, during school days, by boys and girls achievement of intervention guidelines.
In the step counts during School time that includes achieved steps during and after school, nursery comprises of school days steps in children intervention, and controls. These levels tend to be modest by comparison to the previous study’s findings, an impact of assignments increase and homework that could decrease leisure time and Physical Activity level.
General Overview of Obesity Interventions
To ensure a balance; between exercise and diet, a number of interventions can be put in place. These interventions are with no limitation to; nurses designing a proper diet for their clients, education and awareness, designing proper exercise procedures, parental capacity building for the case of children and conducting of regular research, on exercise and diet education in the nursing field and blood sample analysis (Lustig, 2013, p. 44).
Assessment of the children physical health is one of the key interventions according to Lustig 2013. The description and comparison of the proportion of obese and overweight children in the need of control obesity, gets needed, for observing girls and boys all through the intervention process. The intervention, enables recommending of the participation effect in PA intervention, to children who are overweight and obese.
Exercise Programming is a critical expected intervention. In concluding the meta-analyses, a longer-term and content specific program, meant for girls and boys, tend to have a higher of obesity reduction chance than shorter-term programs that have a non-gender specific interventions (Branca, 2007, p. 111). This is through activity friendly and school support programs that are environmental friendly. Additionally, they play as effective implementation prerequisites, crucial for PA interventions.
Analysis of Diet is another intervention expected according to Hartwig, 2012. In the population of the schooling children of the age between 6 to 12 years, proper balancing of their diet may assist to cut down the obesity cases. This should have the consideration of Food brands, type, ingredients, and details on food preparation. This assists to cut down obesity in children, and further, family diet and activity balancing, needs to be reviewed, to assist cut down obesity a study by Hartwig, 2011.
Regular statistical body composition analysis could be an appropriate obesity intervention. In conducting this study, there is need to have the consideration of the possible limitations, that are not bound to a PA environment, considered to be a point contributing to the observed findings. This findings may include; non-representativeness of children to the wider child population requiring cautious exercise, when drawing generalizations (Jensen, 2009, p. 67). Additionally, when assessing the level of body weight using age-differentiated percentile, body composition does not need consideration.
The case for future research therefore, requires the recruitment of more population, and access to more school environment, which will bring on board a proper PA program in relation to children, so as to produce a fine-grained study picture.
Health interventions, which combine programs with diet and exercise focusing on progressive increase in high-intensity exercise duration was found to be achievable and valuable tools for changing obesity and overweight in children. This research presents insight on how increased high-intensity of exercise affects body composition in children. Increase duration of exercise, corresponded with energy expenditure that was greater and the overall increase in time had high-intensity versus low to moderate intensity exercise.
Based on this study, progressive high-intensity exercise as a tool should be considered to prevent future childhood obesity. Further, improving nurses’ nutritional knowledge may enhance their skills, enabling children’s resources. The improvement is by providing school nurses with opportunities to counteract obesity through collaboration with other professionals. Inadequate explanations bring about process shortcomings in the mobilizing of resources in children. Accordingly, suggestions get to be that improvement of knowledge on nutrition among nurses enhances person-centered counseling.
Additional difficulties in the enabling process information and differing food culture, give the complexity of childhood obesity. School nurses therefore, need to be given opportunities to cooperate with other professions in counteracting the obesity challenge alongside overweight.
Bluford, D. A., Sherry, B., & Scanlon, K. S. (2007). Interventions to prevent or treat obesity in preschool children: a review of evaluated programs. Obesity, 15(6), 1356-1372.
Boutenko, V. (2007). 12 steps to raw foods: How to end your dependency on cooked food. Berkeley, Calif: North Atlantic Books.
Branca, F., Nikogosian, H., Lobstein, T., & World Health Organization. (2007). The challenge of obesity in the WHO European Region and the strategies for response. Copenhagen, Denmark: WHO Regional Office for Europe.
Cronau, C. (2010). Great health is a piece of cake: Recipies for fast, healthy food. Moggill, Qld: Purple Lotus Publishing.
Hartwig, D., & Hartwig, M. (2012). It starts with food. Las Vegas: Victory Belt Pub.
Heller, M. (2007). The DASH diet action plan: Proven to lower blood pressure and cholesterol without medication. Deerfield, IL: Amidon Press.
Jensen, E. (2009). Teaching with poverty in mind: What being poor does to kids’ brains and what schools can do about it. Alexandria, Va: ASCD.
Lau, D. C., Douketis, J. D., Morrison, K. M., Hramiak, I. M., Sharma, A. M., & Ur, E. (2007). 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. Canadian Medical Association Journal, 176(8), S1-S13.
Lustig, R. H. (2013). Fat chance: The bitter truth about sugar. London: Fourth Estate.