NRS 493 Literature Review

NRS 493 Literature Review

NRS 493 Literature Review

Childhood obesity is a serious public health issue and one of the top chronic diseases that is developing at an alarming rate in the US and globally. Managing this condition is difficult. The current project seeks to address this condition through the adoption of lifestyle health education as the nursing intervention to mitigate obesity among children. The principle deliberation taken in the identification of the articles in this literature review was focused on articles that address childhood obesity.  The purpose of this paper is to perform a literature review to examine how the available research supports the PICOT question developed. This literature review will be anchored on the literature evaluation table and the PICOT question that had already been developed for this project. Specifically, the literature review will compare articles in various aspects including sample population, research questions, and study limitations.

A Comparison of Research Questions

The emphasis is on the articles used in the PICOT question paper and the literature evaluation table. These articles used varied research questions to achieve the goals of the study. The questions used were either direct, indirect, or hypothesis. None of the studies used direct questions. The articles that used indirect questions include Mastrocola et al., (2020), Martin et al., (2018), Pan et al., (2020), and Jacob et al., (2021). On the other hand, some studies used hypotheses to help in directing the perspective of the readers about the topic and to help in proving an explanation. They include Atkins et al., (2020), Salam et al., (2020), Pereira & Oliveira (2021), and Scott-Sheldon et al., (2020). All the research questions focused on childhood obesity. However, the type and nature of questions differed depending on the objectives of the study.

A Comparison of the Sample Population

Every article used in this project involved a different sample population and was conducted in different settings based on what the researchers intended to attain. While some studies utilized a precise sample population, other studies utilized a general population of the targeted population. The studies that deployed a precise sample population included Martin et al., (2018), and Pan et al., (2020). On the other hand, the study that used the general population included Atkins et al., (2020). This article utilized an unspecified number of children aged 6 to 12 years with a body mass index (BMI) greater than or equal to the 85th percentile. Many studies also employed systematic reviews of studies from trustworthy databases. The articles were taken through inclusion and exclusion criteria to attain relevant articles that met inclusion criteria, which were eventually used as the sample population. The articles that used systematic reviews included Pereira & Oliveira (2021), Scott-Sheldon et al., (2020), Salam et al., (2020), Martin et al., (2018), and Jacob et al., (2021). Some articles such as Atkins et al., (2020) only specified the setting, age of the participants, and qualification for participating in the study without specifying the precise number of the sample population used.

A Comparison of the Limitations of the Study

This project advanced the adoption of lifestyle health education as the nursing intervention to mitigate obesity among children. The articles used in the project are characterized by various differing limitations. The first limitation noted in the studies is an incongruity in compliance with the goals of the project. Although all the studies in the project highlighted childhood obesity, nearly all of them significantly differed on the aspects of childhood obesity depending on the study topic. Jacob et al., (2021), Pan et al., (2020), and Mastrocola et al., (2020) focused on school-based interventions in addressing childhood obesity. On the other hand, Pereira & Oliveira (2021) and Martin et al., (2018) focused on dietary interventions in managing childhood obesity, with Martin et al., (2018) adding physical activity and behavioral interventions alongside dietary intervention. Other studies focused on a new taxonomy of intervention components to improve weight status in children 2–5 years of age. Atkins et al., (2020) also focused on unmet social needs and adherence to pediatric weight management interventions. Based on the provided information, it is evident that all the articles focused on childhood obesity but differed in the interventions to address the condition.

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The other limitation of the study is evident in the population sample size of the studies employed. The

NRS 493 Literature Review
NRS 493 Literature Review

population sample size is always instrumental in determining the reliability and validity of the study. Therefore, researchers need to be careful when deciding on the appropriate sample size for the study. Virtually, all the articles used in this project used different population sample sizes. Some studies such as Atkins et al., (2020) used a general population of the target group, while other studies used small and big population sample sizes. Studies that used a larger sample size include Salam et al., (2020), which used 654 studies for meta-analysis, and Pan et al., (2020), which used 279 students. The studies that used a small population sample size includes Jacob et al., (2021), which reviewed 39 publications, and Mastrocola et al., (2020), which used 27 studies for review. Researchers should note that a large population sample size is important in realizing accurate mean values and also minimization of the error margin. Contrarily, a small population sample size possesses a risk of failing a reliability test due to a bigger variability, which is a possible cause of margin errors and bias. It can also compromise trust in the research.

Conclusion and Recommendation

The goal of this capstone change project is to address childhood obesity through the adoption of lifestyle health education as the nursing intervention to mitigate obesity among children. The articles used in this literature review point to the fact that childhood obesity is a grave healthcare issue and it is vital to address the condition. Some of the intervention that the educational program seeks to focus on includes dietary interventions, behavioral interventions, and physical activity.  The literature review has indicated that the articles used in the project differ fundamentally in crucial areas such as sample size, research questions, and differences in supporting the goals of the project. It is, therefore, recommended that future studies should strive for inventive approaches with higher potential for sustainability such as community-based collaboration and participatory approaches. The approaches should consider existing resources such as public health programs, governmental incentives, institutional support, community support, and support from other primary stakeholders to support the target population.



Atkins, M., Castro, I., Sharifi, M., Perkins, M., O’Connor, G., Luo, M., Sandel, M., Taveras, E. M., & Fiechtner, L. (2020). Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017–2019. American Journal of Public Health, 110(S2), S251-S257.

Jacob, C. M., Hardy-Johnson, P. L., Inskip, H. M., Morris, T., Parsons, C. M., Barrett, M., Hanson, M., Woods-Townsend, K., & Baird, J. (2021). A systematic review and meta-analysis of school-based interventions with health education to reduce body mass index in adolescents aged 10 to 19 years. International Journal of Behavioral Nutrition and Physical Activity, 18(1), 1-22.

Martin, A., Booth, J. N., Laird, Y., Sproule, J., Reilly, J. J., & Saunders, D. H. (2018). Physical activity, diet, and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database of Systematic Reviews, (1). DOI: 10.1002/14651858.CD009728.pub3

Mastrocola, M. R., Roque, S. S., Benning, L. V., & Stanford, F. C. (2020). Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review. International Journal of Obesity, 44(2), 269-279.

Pan, H. J., Hung, L. J., & Chen, C. Y. (2020). Effect of class-based lifestyle intervention on the management of childhood obesity. Obesity Research & Clinical Practice, 14(2), 184-190.

Pereira, A. R., & Oliveira, A. (2021). Dietary interventions to prevent childhood obesity: A literature review. Nutrients, 13(10), 3447.

Salam, R. A., Padhani, Z. A., Das, J. K., Shaikh, A. Y., Hoodbhoy, Z., Jeelani, S. M., Lassi, Z.S., & Bhutta, Z. A. (2020). Effects of lifestyle modification interventions to prevent and manage child and adolescent obesity: a systematic review and meta-analysis. Nutrients, 12(8), 2208. Doi: 10.3390/nu12082208

Scott-Sheldon, L. A., Hedges, L. V., Cyr, C., Young-Hyman, D., Khan, L. K., Magnus, M., King, H., Arteaga, S., Cawley, J., Economos, C. D., Haire-Joshu, D., Hunter, C. M., Lee, B. Y.,  Kumanyika, S. K., Ritchie, L. D., Robinson, T. N., & Schwartz, M. B. (2020). Childhood Obesity Evidence Base Project: A systematic review and meta-analysis of a new taxonomy of intervention components to improve weight status in children 2–5 years of age, 2005–2019. Childhood Obesity, 16(S2), S2-21.