Benchmark – Capstone Project Change Proposal 

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Problem statement
3. Purpose of the change proposal
4. PICOT
5. Literature search strategy employed
6. Evaluation of the literature
7. Applicable change or nursing theory utilized
8. Proposed implementation plan with outcome measures
9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

RUBRIC

Attempt Start Date: 03-Feb-2020 at 12:00:00 AM

Due Date: 09-Feb-2020 at 11:59:59 PM

Maximum Points: 300.0

Benchmark – Capstone Project Change Proposal – Rubric

No of Criteria: 16 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory 0-71%0.00 %Less Than Satisfactory 72-75%75.00 %Satisfactory 76-79%79.00 %Good 80-89%89.00 %Excellent 90-100%100.00 %Content60.0     Background5.0Background section is not present.Background section is present, but incomplete or otherwise lacking in required detail.Background section is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Background section is present and complete. The submission provides the basic information required.Background section is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Problem Statement5.0Problem statement is not present.Problem statement is present, but incomplete or otherwise lacking in required detail.Problem statement is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Problem statement is present and complete. The submission provides the basic information required.Problem statement is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Change Proposal Purpose5.0Purpose of change proposal is not present.Purpose of change proposal is present, but incomplete or otherwise lacking in required detail.Purpose of change proposal is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Purpose of change proposal is present and complete. The submission provides the basic information required.Purpose of change proposal is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.PICOT5.0PICOT is not present.PICOT is present, but incomplete or otherwise lacking in required detail.PICOT is present. Some minor details or elements are missing but the omission(s) do not impede understanding.PICOT is present and complete. The submission provides the basic information required.PICOT is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Literature Search Strategy5.0Literature search strategy is not present.Literature search strategy is present, but incomplete or otherwise lacking in required detail.Literature search strategy is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Literature search strategy is present and complete. The submission provides the basic information required.Literature search strategy is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Literature Evaluation5.0Literature evaluation is not present.Literature evaluation is present, but incomplete or otherwise lacking in required detail.Literature evaluation is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Literature evaluation is present and complete. The submission provides the basic information required.Literature evaluation is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Utilization of Change or Nursing Theory (2.2)5.0Theory utilization is not present.Theory utilization content is present, but incomplete or otherwise lacking in required detail.Theory utilization content is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Theory utilization content is present and complete. The submission provides the basic information required.Theory utilization content is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Proposed Implementation Plan with Outcome Measures (3.2)5.0Implementation plan is not present.Implementation plan is present, but incomplete or otherwise lacking in required detail.Implementation plan is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Implementation plan is present and complete. The submission provides the basic information required.Implementation plan is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Identification of potential barriers to plan implementation, and a discussion of how these could be overcome (2.3)5.0Identification of potential barriers to plan implementation and /or discussion component is not present.Identification of potential barriers to plan implementation with a discussion component is present, but is incomplete or otherwise lacking in required detail.Identification of potential barriers to plan implementation with a discussion component is present. Some minor details or elements are missing but the omission(s) do not impede understanding.Identification of potential barriers to plan implementation with a discussion component is present and complete. The submission provides the basic information required.Identification of potential barriers to plan implementation with a discussion component is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Appendices Inclusive of Practice Immersion Clinical Documentation (1.2)5.0Appendices are not present.Appendices are present, but incomplete or otherwise lacking in required detail.Appendices are present with minor elements missing that do not impede understanding.Appendices are present and complete. The submission provides the basic information required.Appendices are present, complete, and incorporates additional relevant details and critical thinking to engage the reader.Evidence of Revision 10.0Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.Incorporation of research critique feedback or evidence of revision is incomplete.Incorporation of research critique feedback and evidence of revision are present.Evidence of incorporation of research critique feedback and revision is clearly provided.Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.Organization and Effectiveness30.0     Thesis Development and Purpose10.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction10.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)10.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.Format10.0     Paper Format (use of appropriate style for the major and assignment)5.0Template is not used appropriately, or documentation format is rarely followed correctly.Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

Running head: LITERATURE REVIEW

LITERATURE REVIEW

Literature Review

Avery Bryan

Professor Tammy Grey

NRS-490

01/19/2020

The proposed capstone project aims to recommend effective measures that will assist in reducing the prevalence of obesity among African American children. The findings of various research studies have shown that there are an increasing number of African American children who are obese and overweight. Obesity is, therefore, one of the major health concerns. Many research studies have been carried out to determine measures that can be put in place to curb the prevalence of obesity. Most of the researchers have been able to recommend effective interventions to check this particular trend of an increasing number of obese children. Obese children are prone to getting various serious health complications that impact negatively on their health and reduce their life expectancy. The conditions that are associated with obesity have been attributed to high mortality rates among African American children. The capstone project will, therefore, recommend interventions such as educating families on practicing healthy lifestyles. This will help in reducing the prevalence of obesity among African American children. 

The research questions of studies that have examined the issue of childhood obesity have been similar. For instance, the research questions contained in the article by (Amini et al., 2014) addressed issues concerning barriers to losing weight and interventions that are effective in losing weight among children. The research questions that were asked by (Chircop et al., 2015) addressed the environmental influences on childhood obesity. Generally, the research questions that were asked by various researchers attempted to come up with the answer of several aspects of childhood obesity from causes to interventions. Most of the research questions led to the discovery of new aspects surrounding childhood obesity. 

The researchers examining the issue of childhood obesity used a different set of sample populations. This largely depended on the nature of the study. For example, a sample population of twenty-seven obese/overweight primary school-students was used in the study that was carried out by (Amini et al., 2014). A sample population of forty-seven families was used by (Chircop et al., 2015). A sample population of seventy-four obese/overweight children was used in the research study that was conducted by (Ranucci et al., 2017). In the study carried out by (Danford et al., 2015), a sample population of 286 low‐income mothers with children aged 4–8 years was involved in the study. After reviewing various studies, it is apparent that most of the researchers used a convenient sample size. The convenient sample population enabled the researchers to better determine the average values of their data and avoid errors when making inferences concerning various aspects of childhood obesity. They were, therefore, able to obtain accurate results and come up with correct recommendations. 

The research studies that were reviewed had different limitations. For instance, the study by (Amini et al., 2014) was conducted in public schools, so the inferences and conclusion may not necessarily be generalizable to private schools. There are several limitations of the research study that was carried out by (Chircop et al., 2015). First, the data presented was collected from purposively sampled diverse contexts. The findings generated were therefore not generalizable. Secondly, only one school neighborhood of each type (high/low SES; urban/rural/suburban) was represented in the data and there is much variation within each of these categories in terms of opportunities for physical activity and healthy eating. There are various limitations to the study carried out by (Danford et al., 2015). First, results may only be generalizable to low‐income families. Secondly, the semi‐structured interview did not allow for detailed probing to gain a greater understanding of the perceptions of the mothers. Thirdly, the research questions were answered in a socially desirable manner. Finally, parents who participated in the study may have had a greater interest in strategies for feeding children or a willingness to participate in research than those who did not participate. It is, however, good to note that these limitations did not impact negatively the outcomes of the research studies. 

There are several implications of the findings of the research studies that were reviewed. First, implementing factual content about healthy eating and activity alone may not be an effective strategy for reducing the prevalence of childhood overweight/obesity. This is because most parents that were interviewed were already aware of these health messages. Clinicians should consider focusing on the delivery of information concerning obesity prevention strategies. The results of most of the research studies that were reviewed suggest that while most parents are very knowledgeable about obesity prevention strategies; there may be obstacles to their ability to implement these strategies in their homes. Clinicians should also consider focusing on developing strategies with the parents to support behavioral change. Novel strategies that effectively support behavior change are required. The implications for further research include the need to move beyond the socio-ecological model, by integrating critical dimensions such as ‘time’ to allow for a more nuanced understanding of contemporary healthy living. Policy-makers should take several lessons from the findings of the reviewed studies. Health promotion campaigns should be designed. These campaigns should concern healthy eating practices and advertisements for physical activity. The researchers also ascertain that childhood obesity prevention efforts aimed at both physical activity and healthy eating should be consistent with health. 

References

Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M. H., Sadrzadeh-Yeganeh, H., & Eslami-Amirabadi, M. (2014). Children with obesity prioritize social support against stigma: a qualitative study for development of an obesity prevention intervention. International Journal of Preventive Medicine, 5(8), 960.

Chircop, A., Shearer, C., Pitter, R., Sim, M., Rehman, L., Flannery, M., & Kirk, S. (2013). Privileging physical activity over healthy eating:‘Time’to Choose?. Health Promotion International, 30(3), 418-426.

Danford, C. A., Schultz, C. M., Rosenblum, K., Miller, A. L., & Lumeng, J. C. (2015). Perceptions of low‐income mothers about the causes and ways to prevent overweight in children. Child: Care, Health and Development, 41(6), 865-872.

Ranucci, C., Pippi, R., Buratta, L., Aiello, C., Gianfredi, V., Piana, N., … & Gili, A. (2017). Effects of an intensive lifestyle intervention to treat overweight/obese children and adolescents. BioMed Research International, 2017.

Running head: CAPSTONE PROJECT TOPIC 1

Obesity Among African American Children

2

Obesity Among African American Children

Avery Bryan

Professor Tammy Gray

NRS-490

December 8th, 2019

The project will focus on reducing the prevalence of obesity among African American children. There have been an increasing number of African American children with obesity over the past few years. Obesity is a major health concern. This is because children who have obesity, compared to those with normal weight are at high risk of getting many serious health complications. These health complications include high blood pressure, type 2 diabetes, low quality of life and stroke and low. Generally, obesity is a growing health concern in the US not only among the African American children but also among the adults and adolescents of all races. Individuals in the low income bracket are mostly affected. The project will therefore focus on educating families on practicing healthy lifestyle in order to reduce the prevalence of obesity among the African American children. Comment by Tammy Gray: When you state facts in academic papers you must use a reference Comment by Tammy Gray: Spacing must be consistently double spaced through the entire paper

APA papers require the use of headings. Use the assignment requirements as headings

Obesity is prevalent among the African American children. Most of the African American families are low income earners. This results to them not to be able to purchase healthy foods. There is a perception that healthy foods are expensive. Their food consumption to a large extent consists of proteins from genetically modified organisms (GMOs), larger amounts of refined grains and sugars and high level of fructose corn syrup. They consume junky foods that are cheaper to buy. The African American children who consume these foods end up becoming obese.

Obesity is not a disease in itself. However, it leads to an increased risk of individuals to develop other illnesses that are chronic. These chronic diseases include some types of cancer, coronary heart disease, stroke, osteoarthritis, type 2 diabetes and other complicated health conditions. A myriad of social and physical negative consequences are associated with obesity. The conditions associated with obesity carry both short term and long term negative consequences that are extremely expensive to treat both at individual and societal level. It is less expensive to prevent obesity than to cure it. It is therefore important to address the problem of obesity by implementing effective preventive measures.

Obesity has several impacts on the work environment, the quality of care provided by the staff and patient outcomes. Obesity has a negative impact on work environment and the quality of care offered by the staff in that obese staff may not be able to undertake their duties as required. This can lead undesired patient outcomes.

Addressing the issue of obesity among is significant. This is because it will lead to a reduction in prevalence of illnesses and conditions associated with childhood obesity. It will also contribute to improved quality of life among the African American children. The issue of addressing the prevalence of obesity has implications on nursing in that it will lead to implementation of new EBP practices that are going to prevent the prevalence of obesity.

The proposed solution to addressing the prevalence of obesity is to educate the African American families on the importance of consuming healthy foods and practicing healthy living. This can go a long way in reducing the prevalence of obesity among the African Americans. The proposed EBP project aims at reducing the prevalence of childhood obesity among the African Americans by 10%.

References Comment by Tammy Gray: Start references on separate page

Andrews, K. R., Silk, K. S., & Eneli, I. U. (2010). Parents as health promoters: A theory of planned behavior perspective on the prevention of childhood obesity. Journal of health communication, 15(1), 95-107. Comment by Tammy Gray: Journal titles are iltalized

Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015). Addressing childhood obesity: opportunities for prevention. Pediatric Clinics, 62(5), 1241-1261.

Gunnarsdottir, T., Njardvik, U., Olafsdottir, A. S., Craighead, L. W., & Bjarnason, R. (2011). The Role of parental motivation in family‐based treatment for childhood obesity. Obesity, 19(8), 1654-1662.

Hesketh, K., Waters, E., Green, J., Salmon, L., & Williams, J. (2005). Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health promotion international, 20(1), 19-26. Comment by Tammy Gray: Capitalize all words except prepositions in journal titles

A minimum of 8 articles is required

Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. L. (2006). The role of parents in preventing childhood obesity. The Future of children, 16(1), 169-186.

Natale, R. A., Messiah, S. E., Asfour, L., Uhlhorn, S. B., Delamater, A., & Arheart, K. L. (2014). Role modeling as an early childhood obesity prevention strategy: effect of parents and teachers on preschool children’s healthy lifestyle habits. Journal of Developmental & Behavioral Pediatrics, 35(6), 378-387.

Skouteris, H., McCabe, M., Swinburn, B., Newgreen, V., Sacher, P., & Chadwick, P. (2011). Parental influence and obesity prevention in pre‐schoolers: a systematic review of interventions. Obesity reviews, 12(5), 315-328.

Running head: CAPSTONE PROJECT TOPIC 1

Obesity Among African American Children

2

Obesity Among African American Children

Avery Bryan

Professor Tammy Gray

NRS-490

December 8th, 2019

The project will focus on reducing the prevalence of obesity among African American children. There have been an increasing number of African American children with obesity over the past few years. Obesity is a major health concern. This is because children who have obesity, compared to those with normal weight are at high risk of getting many serious health complications. These health complications include high blood pressure, type 2 diabetes, low quality of life and stroke and low. Generally, obesity is a growing health concern in the US not only among the African American children but also among the adults and adolescents of all races. Individuals in the low income bracket are mostly affected. The project will therefore focus on educating families on practicing healthy lifestyle in order to reduce the prevalence of obesity among the African American children. Comment by Tammy Gray: When you state facts in academic papers you must use a reference Comment by Tammy Gray: Spacing must be consistently double spaced through the entire paper

APA papers require the use of headings. Use the assignment requirements as headings

Obesity is prevalent among the African American children. Most of the African American families are low income earners. This results to them not to be able to purchase healthy foods. There is a perception that healthy foods are expensive. Their food consumption to a large extent consists of proteins from genetically modified organisms (GMOs), larger amounts of refined grains and sugars and high level of fructose corn syrup. They consume junky foods that are cheaper to buy. The African American children who consume these foods end up becoming obese.

Obesity is not a disease in itself. However, it leads to an increased risk of individuals to develop other illnesses that are chronic. These chronic diseases include some types of cancer, coronary heart disease, stroke, osteoarthritis, type 2 diabetes and other complicated health conditions. A myriad of social and physical negative consequences are associated with obesity. The conditions associated with obesity carry both short term and long term negative consequences that are extremely expensive to treat both at individual and societal level. It is less expensive to prevent obesity than to cure it. It is therefore important to address the problem of obesity by implementing effective preventive measures.

Obesity has several impacts on the work environment, the quality of care provided by the staff and patient outcomes. Obesity has a negative impact on work environment and the quality of care offered by the staff in that obese staff may not be able to undertake their duties as required. This can lead undesired patient outcomes.

Addressing the issue of obesity among is significant. This is because it will lead to a reduction in prevalence of illnesses and conditions associated with childhood obesity. It will also contribute to improved quality of life among the African American children. The issue of addressing the prevalence of obesity has implications on nursing in that it will lead to implementation of new EBP practices that are going to prevent the prevalence of obesity.

The proposed solution to addressing the prevalence of obesity is to educate the African American families on the importance of consuming healthy foods and practicing healthy living. This can go a long way in reducing the prevalence of obesity among the African Americans. The proposed EBP project aims at reducing the prevalence of childhood obesity among the African Americans by 10%.

References Comment by Tammy Gray: Start references on separate page

Andrews, K. R., Silk, K. S., & Eneli, I. U. (2010). Parents as health promoters: A theory of planned behavior perspective on the prevention of childhood obesity. Journal of health communication, 15(1), 95-107. Comment by Tammy Gray: Journal titles are iltalized

Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015). Addressing childhood obesity: opportunities for prevention. Pediatric Clinics, 62(5), 1241-1261.

Gunnarsdottir, T., Njardvik, U., Olafsdottir, A. S., Craighead, L. W., & Bjarnason, R. (2011). The Role of parental motivation in family‐based treatment for childhood obesity. Obesity, 19(8), 1654-1662.

Hesketh, K., Waters, E., Green, J., Salmon, L., & Williams, J. (2005). Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health promotion international, 20(1), 19-26. Comment by Tammy Gray: Capitalize all words except prepositions in journal titles

A minimum of 8 articles is required

Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. L. (2006). The role of parents in preventing childhood obesity. The Future of children, 16(1), 169-186.

Natale, R. A., Messiah, S. E., Asfour, L., Uhlhorn, S. B., Delamater, A., & Arheart, K. L. (2014). Role modeling as an early childhood obesity prevention strategy: effect of parents and teachers on preschool children’s healthy lifestyle habits. Journal of Developmental & Behavioral Pediatrics, 35(6), 378-387.

Skouteris, H., McCabe, M., Swinburn, B., Newgreen, V., Sacher, P., & Chadwick, P. (2011). Parental influence and obesity prevention in pre‐schoolers: a systematic review of interventions. Obesity reviews, 12(5), 315-328.

LiteratureEvaluation Table

Student Name: Avery Bryan

Change Topic (2-3 sentences): Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school going African American children in the US. Physical activity and healthy eating are the key interventions that are used to tackle the problem of obesity.

	Criteria	Article 1	Article 2	Article 3	Article 4
	Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Amini et al., International Journal of Preventive Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258668/	Chircop et al., Health Promotion International, https://doi.org/10.1093/heapro/dat056	Danford et al., Child: Care, Health & Development, https://doi.org/10.1111/cch.12256	Ranucci et al., BioMed Research International, https://doi.org/10.1155/2017/8573725
	Article Title and Year Published	Children with Obesity Prioritize Social Support against Stigma: A Qualitative Study for Development of an Obesity Prevention Intervention. 2014.	Privileging physical activity over healthy eating: ‘Time’ to Choose? 2015.	Perceptions of low-income mothers about the causes and ways to prevent Overweight in children. 2015.	Effects of an Intensive Lifestyle Intervention to Treat Overweight/Obese Children and Adolescents. 2017.
	Research Questions (Qualitative)/Hypothesis ( Quantitative ), and Purposes/Aim of Study	The aim of the research was to complete the understanding of ideas, attitudes, beliefs, and preferences of obese primary school children.	The purpose of the research was to examine environmental influences on youth obesity.	The aim of the research was to examine what low-income mothers perceive to be the causes of and the ways to prevent children from becoming overweight.	The aim of the study was to examine the effects of a multidisciplinary lifestyle intervention to treat overweight/obese children and adolescents.
	Design (Type of Quantitative, or Type of Qualitative)	Qualitative study	Mixed methods study	Qualitative			Quantitative
	Setting/Sample	Twenty-seven obese/overweight primary school-students	Forty seven families	286 Low‐income mothers with children aged 4–8 years	Seventy four overweight/obese children or adolescents
	Methods: Intervention/Instruments		Focused Group Discussions	Interviews	Semi‐structured interviews	Multidisciplinary interventions
	Analysis	All FGD notes were analyzed to find the main themes.	Interviews were transcribed verbatim and imported into NVIVO qualitative data analysis software version 8 (2008) to organize and code the data and initial codes were further analyzed into emerging concepts and major themes by an interdisciplinary team.	The semi structured interviews were first transcribed verbatim and imported into qualitative data analysis software.	Analysis of cardio metabolic risk based on the waist-to-height ratio (WHTR) measurement.
	Key Findings	Children mentioned nutrition and physical improvement, social support, and education as the main elements of an effective intervention.	A perceived lack of time to meet the demands of youth’ scheduled physical activities was the dominant theme across interviews from all neighborhoods	The majority of mothers (77.1%) reported that they carried out their suggestions to prevent their children from becoming overweight.	Both children and adolescents showed a significant reduction in body weight, BMI, waist circumference, fat mass, and WHTR index and an improvement of fat-free mass, adherence to the Mediterranean diet, and physical fitness performance.
	Recommendations	Obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community.	Healthy eating should receive the same priority that was exacerbated in suburban and rural environments.	Increased physical activity should be encouraged as a way to prevent children from becoming overweight.	A family-based multidisciplinary approach should be encouraged since it is effective in ameliorating the health status, the nutrition habits, and physical performance in children and adolescents.
Explanation of How the Article Supports EBP/Capstone Project	The article supports the EBP/Capstone Project since it highlights ways in which children with obesity prioritize social support against stigma.	The article supports the EBP/Capstone Project in that it lays emphasis on physical activity and healthy eating as strategies to tackle childhood obesity.	The article supports the EBP/Capstone Project in that it examines the perceptions of low-income mothers about the causes and ways to prevent obesity in children.	The article supports the EBP/Capstone Project in that it examines the impacts of an intensive lifestyle intervention to treat overweight/obese children.

Criteria

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Article Title and Year Published

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

Design (Type of Quantitative, or Type of Qualitative)

Quantitative

Qualitative

Quantitative

Setting/Sample

Methods: Intervention/Instruments

Focused Group Discussions

Analysis

Key Findings

Recommendations

Article 5	Article 6	Article 7	Article 8
Sylvetsky et al., Journal of Obesity, https://dx.doi.org/10.1155/2013/670295	Xu et al., Journal of Obesity, https://doi.org/10.1155/2017/2746595	Lutfiyya et al., Journal of the American Board of Family Medicine, https://doi.org/10.3122/jabfm.2008.03.070207	LaShun, ABNF Journal, https://search.proquest.com/openview/9790b951685f186cffb071e9099c2cc8/1?pq-origsite=gscholar&cbl=32975
Youth Understanding of Healthy Eating and Obesity: A Focus Group Study. 2014.	A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers. 2017.	Overweight and obese prevalence rates in African American and Hispanic children. 2014.	Parental depression, family functioning, and obesity among African American children. 2015.
The aim of the study was to investigate youth’s understanding of obesity and to investigate gaps between their nutritional knowledge, dietary habits, and perceived susceptibly to obesity and its co-morbidities.	The purpose of the research was to find out whether collaborative community-based programs designed for children and their caregivers are effective in reducing obesity rates.	The purpose of the study was to examine the prevalence of overweight and obesity in African-American and Hispanic children compared with white children.	The research aimed at examining issues concerning Parental depression, family functioning, and obesity among African American children.
	Qualitative
Sample ads for the development of an obesity awareness campaign	Collaborative community-based setting	Obese African American children	African American setting: 44 parent-child dyads
A Community-Based Nutrition and Physical Activity Intervention	Examining the prevalence of overweight and obesity in African-American and Hispanic children compared with white children	Demographic questionnaire and instruments that measured family functioning, parental psychopathology, child behavior and cardiovascular risks
Inductive thematic coding to identify key themes related to youth reports of family eating habits, perceived facilitators and barriers of healthy diet, and knowledge about obesity and its complications.	Analysis of the 16-week intervention including weekly group nutrition and physical activity sessions.	Multivariate analyses were performed on cross-sectional data from the National Survey of Children’s Health collected in 2003 to 2004.	The collected data were statistically analyzed using the relevant software.
Mixed attitudes about healthy eating, low perceived risk of being or becoming obese, and limited knowledge about the health consequences of obesity may contribute to the rising prevalence of obesity among youth in Georgia.	Participants decreased their fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention.	Overweight children were more likely to be African American and Hispanic than white.	Parental factors such as depression play a significant role in childhood obesity.
There should be a need for education to connect lifestyle behaviors to development of obesity.	South County Food, Fitness and Fun (SCFFF) program is recommended since it is effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese.	Policymakers concerned with issues of childhood obesity should pursue the creation of school-based health clinics in schools where at least 50% of the student body live in households with incomes less than 150% of the Federal poverty level.	Effective parenting is essential for controlling childhood obesity.
Explanation of How the Article Supports EBP/Capstone	The article supports the EBP/Capstone Project in that analyze the youth’s understanding of obesity.	The article supports the EBP/Capstone Project in that it determines the effectiveness collaborative community-based programs designed in reducing obesity rates.	The article supports the EBP/Capstone Project in that it examines the prevalence of overweight and obesity in African-American.	The article supports the EBP/Capstone Project in that it examines how parental factors such as depression influences obesity among children.

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Avery Bryan

Benchmark – Capstone Project x

Summary

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Benchmark – Capstone Project

Avery Bryan

Professor Tammy Gray

NRS-490

02/09/20

Benchmark – Capstone Project

Obesity is prevalent among the African American children. Most of the African

American families fall in the low income groups. This results to them not being able to purchase

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healthy foods. There is a perception that healthy foods are very expensive to purchase. Their

food consumption to a large extent consists of proteins from genetically modified organisms

(GMOs), larger amounts of refined grains and sugars and high level of fructose corn syrup. They

consume junky foods that are cheaper to buy. These foods contribute a lot to childhood obesity

among the African American children who consume them.

Obesity is not a disease in itself. However, it leads to an increased risk of individuals to

develop other diseases that may be considered to be chronic. These chronic diseases include

some types of cancer, coronary heart disease, stroke, osteoarthritis, type 2 diabetes and other

complicated health conditions. A myriad of social and physical negative consequences are

associated with obesity. The conditions associated with obesity carry both short term and long

term negative outcomes that are extremely expensive to treat both at individual and societal

level. It is less expensive to prevent obesity than to cure it. It is therefore important to address the

problem of obesity by implementing effective preventive measures.

Childhood obesity is a world-wide health problem and development of interventions to

prevent or control it should be a priority (Amini et al, (2014). Obesity is prevalent and on the

increase among many school going African American children in the US. Physical activity and

healthy diet are the key preventive interventions that can be implemented to tackle the challenge

of childhood obesity (Chircop et al., (2015).

Obesity is a major health concern. This is because children who have obesity, compared

to those with normal weight are at high risk of getting many serious health complications. These

health complications include high blood pressure, type 2 diabetes, low quality of life and stroke

and low. Generally, obesity is a growing health concern in the US not only among the African

American children but also among the adults and adolescents of all races. Individuals in the low

income bracket are mostly affected.

The key purpose of this particular change proposal is to reduce the prevalence of obesity

among the African American children. Addressing the issue of childhood obesity among the

African American children is very significant. This is because it will lead to a reduction in the

prevalence of illnesses and conditions that are associated with childhood obesity. It will also

result in improved quality of life among the African American children.

The proposed PICOT question is, Among the African American children (P), does

implementing childhood obesity prevention measures (I) results to reduction in the prevalence of

childhood obesity (O) compared to those children who have not been educated on obesity

prevention (C) within two years (T)?

Addressing the prevalence of obesity has implications on nursing in that it will lead to

discovery of new evidence-based practices that are going to prevent the prevalence of obesity.

A comprehensive literature search was employed. An electronic search was conducted

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randomized controlled trials. The literature search results revealed about 100 publications. The

abstracts were screened and eight studies were relevant to the PICOT question. These studies

included four quantitative studies and four qualitative studies.

Several studies have been done concerning the PICOT question. The results of various

research studies have shown that there are an increasing number of African American children

who are obese and overweight. Obesity is, therefore, one of the major health concerns. Many

research studies have been carried out to determine interventions that can be implemented to

reduce the prevalence of childhood obesity. Most of the researchers have recommended

implementation of effective interventions to check this particular trend of an increasing number

of obese African American children. Obese children are prone to getting various serious health

complications that negatively affect their health and reduce their life expectancy. The conditions

that are associated with obesity have been attributed to high mortality rates among African

American children.

Most of the empirical studies have established a link between childhood obesity and

parental obesity. The studies conclude that children that are raised by obese parents are more

likely to be obese as compared to children who are raised by parents who are not obese.

(Huffman, Kanikireddy & Patel, (2010) attempted to find out ways in which parenthood

contributes to childhood obesity. They established that several parenthood factors contribute to

obesity. These factors include obese parents raising children. (Parrino et al, (2016) examined the

Influence of early-life and parental factors on childhood overweight and obesity. These authors

also found out that obese parent raising children contribute to early childhood obesity. Their

findings also indicated that early childhood obesity is not caused by parents who are not obese

raising their children.

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using several databases that include Cochrane Database of Systematic Reviews and Cochrane

Central Register of Controlled Trials. The search included English-only published articles

between 2009 and 2019. The keywords that were searched include obesity, obese children, obese

parents, children’s risk of being obese, parents who are not obese, systematic reviews, and

The research study conducted by (Sahoo et al, (2015) examined the causes and

consequences of childhood obesity. Their empirical results showed that food preferences of

parents can influence the foods that children eat. Obese parents may prefer to take foods such as

sugary beverages and snacks. This will influence children to take such kind of foods. These types

of foods have high chances causing obesity.

The study carried out by (Santangeli, Sattar & Huda, (2015) found out that there is an

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association between maternal obesity and childhood development with increased risks of obesity.

It can, therefore, be concluded that maternal obesity is likely to contribute to early childhood

obesity. The research carried out by (Yeung et al, (2017) analyzed how parental obesity impacts

early childhood development. It can therefore be concluded that there are high chances of

children raised by obese parents to be exposed to obesity risk factors.

The studies that were reviewed have their strengths and weaknesses. A strength that is

common with all these studies that have been reviewed is that it establishes a cause and effect

relationship between parental obesity and childhood obesity. Other studies also attempt to

examine childhood prevention measures are effective or not. These studies therefore support the

claim in my PICOT question to a greater extent.

The change theory that was applicable or utilized is the Iowa theory. This particular

theory incorporates use of research and other types of evidence. The Iowa model has been used

extensively in many nursing research programs. There are seven major steps that have to be

followed in the Iowa model. These steps that are followed in the Iowa model include identifying

the problem that require change, establishing a team to assess the problem, gathering and

analyzing research studies related to the problem at hand, grading the evidence found, coming up

with an evidence-based standards, implementing changes, and finally evaluating the changes.

The interventions that are required to reduce the prevalence of childhood obesity among

the African American children will be implemented at the three levels. These levels include,

individual, family and community levels. One of the interventions is to educate the African

Americans concerning the importance of consuming healthy foods and practicing healthy living.

This can go a long way in reducing the prevalence of obesity among the African Americans. The

outcome measure associated with this particular intervention is the reduction of the prevalence of

childhood obesity among the African American children by 10%.

Childhood obesity prevention interventions are implemented at the family level because

parents play a unique role in the prevention of obesity (Andrews, Silk & Eneli, (2010). Parents

are supposed to provide anticipatory guidance and counseling that can influence families’

nutrition and physical activity habits (Andrews, Silk & Eneli, (2010).

Parents are supposed to be keen and hence being able to recognize obesity risk factors

early in a child’s life. They will then be able to help their children to make positive changes that

will improve their weight trajectory. Another outcome measure is the full adoption of measures

that are aimed at reducing excess weight among the African American children. These measures

include healthy diet, regular physical and assessing weight (Andrews, Silk & Eneli, (2010).

These interventions will go a long way in preventing childhood obesity. Parents should monitor

and model their children as they raise them. Parents should also encourage their children to

engage in regular physical exercises (Andrews, Silk & Eneli, (2010).

According to (Brown et al, 2015), the most efficient and cost-effective technique of

reducing the risk of obesity among young children is parental guidance as they raise them.

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in reducing the risk of childhood obesity (Gunnarsdottir et al, (2011). (Lindsay et al, (2006) laid

emphasis on the role played by parents in preventing childhood obesity. Several evidence-based

practices also support this particular claim (Natale et al, (2014).

Implementing an evidence-based practice change is always faced with many obstacles.

Often the use of research in clinical settings is a common barrier. According to (Mathieson,

Grande & Luker, (2018) this barrier is linked to the support provided by the institution in which

physicians work, healthcare workers’ skills and values, quality of research and distribution of

information. From this standpoint potential barriers to the proposed capstone project are

insufficient time, failure to pay attention to statistics and lack of time gather enough information

about childhood obesity. In light of the above barriers, it is recommended to adopt a viable

approach that can sustain the evidence-based approach. The critical integration is to create an

environment that is supportive. Communication methods must be enhanced to ensure effective

communication between the interdisciplinary members. Simply by enhancing collaborative work

in the evidence-based practice and research, the clinical setting will build rapport and credibility.

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References

Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M. H., Sadrzadeh-Yeganeh, H., & Eslami-

Amirabadi, M. (2014). Children with obesity prioritize social support against stigma: a

qualitative study for development of an obesity prevention intervention. International

journal of preventive medicine, 5(8), 960.

Chircop, A., Shearer, C., Pitter, R., Sim, M., Rehman, L., Flannery, M., & Kirk, S. (2013).

Privileging physical activity over healthy eating:‘Time’to Choose?. Health promotion

international, 30(3), 418-426.

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Parents ought to guide their children on the best nutritional practices. Parents have to implement

practices that reduce the risk of childhood obesity. Parental interventions are therefore effective

Huffman, F. G., Kanikireddy, S., & Patel, M. (2010). Parenthood—a contributing factor to
childhood obesity. International journal of environmental research and public

health, 7(7), 2800-2810.

Mathieson, A., Grande, G., & Luker, K. (2018). Strategies, facilitators and barriers to

implementation of evidence-based practice in community nursing: a systematic mixed-

studies review and qualitative synthesis. Primary health care research &

development, 20.

Parrino, C., Vinciguerra, F., La Spina, N., Romeo, L., Tumminia, A., Baratta, R., … & Frittitta,

L. (2016). Influence of early-life and parental factors on childhood overweight and

obesity. Journal of endocrinological investigation, 39(11), 1315-1321.

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.

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Santangeli, L., Sattar, N., & Huda, S. S. (2015). Impact of maternal obesity on perinatal and

childhood outcomes. Best Practice & Research Clinical Obstetrics &

Gynaecology, 29(3), 438-448.

Yeung, E. H., Sundaram, R., Ghassabian, A., Xie, Y., & Louis, G. B. (2017). Parental obesity

and early childhood development. Pediatrics, 139(2), e20161459.