Implementing Evidence Based Practice

This document discusses the process of implementing evidence based practice in healthcare settings. It focuses on the impact of physical activity in preventing obesity among people with learning disabilities. The document includes a literature review, methodology, and evidence summary table.

Implementing Evidence Based
Practice

Table of Contents
Introduction......................................................................................................................................1
Research question............................................................................................................................1
Rationale.................................................................................................................................1
PICO question........................................................................................................................2
Aim.........................................................................................................................................2
Objectives...............................................................................................................................2
Literature review....................................................................................................................2
Methodology....................................................................................................................................4
Search strategy........................................................................................................................4
Search terms...........................................................................................................................4
Inclusion criterion...................................................................................................................4
Exclusion criteria....................................................................................................................4
Ethical considerations.............................................................................................................5
Result of the search strategy............................................................................................................5
Evidence summary table.........................................................................................................5
Quality appraisal..............................................................................................................................8
Summary and synthesis of the papers............................................................................................10
Issues of implementation...............................................................................................................10
Ottawa model of implementation.........................................................................................10
Conclusion.....................................................................................................................................10
References......................................................................................................................................12

Introduction
Evidence based practice refers to clinical procedures having proven of their effectiveness via
carried out appropriate investigations by specialised researchers. It includes number of clinical
activities which has approval from authorised organisation to be used in treatment for welfare of
an individual. However, the evidence based practice has several elements such as best external
evidence, individual practitioner’s clinical expertise and patient’s preference (Foster and et. al.,
2018). It involves the number of steps including identify the question, find relevant information,
critically appraise the data, integrate appraised evidence with own clinical expertise and then
evaluate the sane. In context of this project, it is based on the research aim of analysing effects of
physical activity in order to prevent the obesity among patients having problem of learning
disability. It includes the criterion of gathering information about given intervention which
facilitates to assess the impact of physical activities for reducing the risk of obesity. This
assignment will focus on use of PICO question in terms of collecting relevant information with
the help of using secondary data sources to analyse the respective facts about the topic. It will
include inclusion and exclusion criterion of the research and implementation of the results by
explaining its applicability in healthcare settings.
Research question
Rationale
In rest of this project, it has a rationale to evaluate the impact of physical activity to prevent the
occurrence of obesity. It includes the criterion the studying use of including some of physical
activities in order to avoid the extra fat gain among people having learning disabilities.
Meanwhile, it is necessary for investigator to analyse the actual impact of physical activity in
human body in order to ensure its effects to be used for improving condition of patient suffering
from learning disabilities. It is required for care professionals to only use evidence based practice
due to which study to evaluate impact of physical activity is favourable for improving patient
condition (Bertapelli and et. al., 2016). This research is important for learning about actual
metabolic effects on human body which will facilitates to gain evidence of using physical
activities in order to make patients feel better and comfortable respectively. However, it is
required to ensure the positive effects of this intervention so that physicians and nurse can use
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the same for patient wellness. It is very important to carry out this investigation for enhancing
effectiveness of treatment process.
PICO question
How effective is physical activity in preventing obesity in people with learning disability?
Population or patient People with learning disability
Intervention Physical activity
Comparison Balanced diet
Outcome Prevent obesity
Aim
“To analyse the impact of physical activity to prevent obesity among people with
learning disability.”
Objectives
 To identify the basic understanding about learning disabilities.
 To evaluate the cause of occurring obesity among people with learning disabilities.
 To analyse the impact of physical activity to prevent among people with learning
disability.
Literature review
The basic understanding about learning disabilities
Learning disability can be defined as a health condition in which the ability of an individual to
process nay kind of information get interrupted. It includes the condition when a person is not
able to learn and remember anything due to issues developed in their brain. Meanwhile, it
involves the criterion of main disabilities related to writing, reading and language. It includes the
several relevant disorder such as dyslexia, ADHD, dyscalculia, dysgraphia and processing
deficits (Spruijt-Metz and Saelens, 2016). However, it has been analysed that learning disability
can be caused by several factors including family history & genetics, prenatal & neonatal risks,
psychological trauma and environmental exposure which are responsible for developing
disruption in learning ability of an individual. It consist the criterion of gaining knowledge about
actual cause of learning disability in order to treat the same for improving their condition of
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patients. Moreover, it is necessary to diagnose relevant health problems causing learning
disability to treat it which facilitate to make an individual healthy and wellbeing.
The cause of occurring obesity among people with learning disabilities
The people with learning disability has limited physical movements and activities due to which
the metabolic rate slowed down that is responsible for increasing risk of occurring obesity. It
includes that learning disability is a negative factor due to which they were unable to intake
balanced diet and medications on time due to which risk of being overweight and obese will be
increased the metabolic rate reduction is mainly for developing condition of obesity (Yeo and et.
al., 2017). However, it has been evaluated that it is observed that several medical cause obesity
among people with learning disability involves irregular eating patterns, sedentary behaviour and
sitting behaviour which reduces the metabolic rate that will results into extra gain of fat that
facilitates to develop problem of obesity. It is required for medical practitioners to work on
actual cause of obesity to prevent the same in effective manner.
The impact of physical activity to prevent among people with learning disability
The physical activity plays an important role to burn extra fat deposited in the body tissues which
is helpful to reduce the weight for maintaining it to normal rage. It includes the fact that people
who regular prefer to use physical work out or relevant activities including dancing, aerobics
etc., them they can prevent occurrence of obesity among them. However, it has been analysed
that physical work is helpful to maintain normal amount of fat in body along with improving
cholesterol level in human body. It is necessary for care professionals to involve use of physical
activities among patients with learning disability for improving their health condition
(Vandelanotte and et. al., 2016). It will also provide support to prevent the occurrence of obesity
among these patients. Moreover, the physical activity has several benefits which are mentioned
here. Initially, it includes reducing the risk of heart attack, managing weight better and
facilitating to have lower blood cholesterol level. Secondly, it consist the benefit of reducing risk
of occurring type 2 diabetes and some type of cancers and have lower blood pressure among
patient suffering from learning disabilities. Thirdly, it is favourable to patient for gaining
stronger bones, muscles and joints along with reducing the risk of creating osteoporosis. It is also
helpful in order to decrease risk of falls and control blood sugar levels to maintain its normal
concentration. Moreover, it will facilitate to maintain better health of arteries and veins by
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avoiding risk of heart diseases. Additionally, it is observed that physical activity has positive
impact on people with learning disability for preventing occurrence of obesity.
Methodology
Search strategy
The qualitative research method is used in this investigation which facilitate to gain detailed
knowledge to study actual facts of given research problem. It includes the analyse the recorded
attitudes, feelings and behaviours which facilitate to again accurate findings respectively.
However, it is observed that descriptive research design will be focussed which is favourable to
gain detailed information and facilitate to study about behaviour as well as opinions of people
which helps to achieve desired research outcomes. In addition to this, the inductive research
approach will be used which is favourable to carry out investigation on effects of physical
activity to prevent obesity among patients suffering from learning disabilities. Moreover, this
project will going to utilise the philosophy of interpretivism for analysing respective data
effectively which will provide support to attain appropriate findings.
Search terms
The search terms includes number of phrases such as learning disability, cause of obesity,
strategies to prevent obesity, benefits of physical activities and obesity treatment. It involves the
use of several websites like CINAHL, mentalhelath.org, chidlrenhospital.org, healthgrades.com,
nichd.nih.gov, mayoclinic.org, webmd.com, betterhealth.vic.gov, healthline.com etc. The use of
secondary sources including research articles were used to gather relevant information which are
published in recent years for maintaining accuracy of the respective findings.
Inclusion criterion
In context of this project, it includes to focus on use of only secondary sources including articles
which are published from the year range of 2012 to 2020 which are helpful to gain accurate
information in order to achieve effective findings. It includes use of articles having specific topic
of physical activities for preventing the occurrence of obesity among people who were suffering
from learning disabilities. However, it consist the inclusion criterion of using article which are
based on effects of physical activities on body which is helpful to analyse the benefits of the
same for prevention of obesity.
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Exclusion criteria
The exclusion of criterion of given research is all about to avoid the research articles published
before the year of 2012. It includes the fact that various articles are available related to the topic
in which some of them are accurately based on the selected topic but published in the previous
years due to which they were not used. However, it has been analysed that the previous years of
articles were strictly avoided because it impact negatively on the accuracy of findings. It will
facilitate to reduce the authenticity of research findings which cannot be used in future
perspectives for human welfare.
Ethical considerations
The ethical principles are required to be used in in process of carrying out investigation as they
facilitate to direct the entire study in correct direction. It is favourable to encourage researcher to
conduct entire study in more effective as well as efficiency manner. Basically, the ethical
principles include number of factors such as informed consent, beneficence, honesty,
confidentiality, justice, trustworthiness and many more. It is very important for investigator to
follow these factors otherwise the authenticity of findings will reduced and they will not be
considered for future practices in healthcare settings.
Result of the search strategy
Evidence summary table
How effective is physical activity in preventing obesity in people with learning disability?
Author, date Study
Design/
Evidence
type
Setting Sample size Evidence
level rating
Study
Findings
that help
answer the
question
Craig A. Melville.,
2020. An open
study of the
effectiveness of a
multi-component
weight-loss
An open and
controlled
study
Adults with
intellectual
disabilities
and obesity
in hospital
Group of
adults with
intellectual
disabilities
and obesity
3 and 4
rating
It has been
founded that
physical
activity can
be considered
as an
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intervention for
adults with
intellectual
disabilities and
obesity.
effective
intervention
for prevent
the obesity.
Rachel
Russell, Verity
Chester, James
Watson, Canisius
Nyakunuwa, Lucy
Child, Mary
McDermott, Sharon
Drake and Regi T.
Alexander., 2020.
The prevalence
of overweight
and obesity
levels among
forensic
inpatients with
learning
disability.
The
controlled
study
The specific
forensic
service
46
inpatients
(15
women
and 31
men)
within a
specialist
learning
disability
forensic
service
2 and 3
rating
It has been
evaluated
that gender
sensitive
weight
management
strategies are
effective for
maintaining
body weight
and prevent
overweight
condition
Guillermo R. Oviedo,
Noémie Travier and
Myriam Guerra-
Balic., 2020.
Sedentary and
Physical Activity
Patterns in Adults
with Intellectual
A controlled
study
The adults in
general
hospital
Forty-two
adults and 42
older adults
2,3 and 4
rating
It has been
identified
that
sedentary
behaviour
should be
avoided to
avoid the
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Disability overweight
and obese
condition.
Stephanie M.
McCoy, John M.
Jakicic &
Bethany Barone
Gibbs., 2020.
Comparison of
Obesity, Physical
Activity, and
Sedentary
Behaviors Between
Adolescents With
Autism Spectrum
Disorders and
Without
A case study National
Survey of
Children’s
Health
The group of
42,747
adolescents
(ASD,
n = 915)
from the
2011–2012
3 and 5
ratings
It has been
determined
that
adolescents
need specific
target
program for
reducing
obesity along
with
increasing
physical
obesity.
Sean Healy,
Justin A. Haegele,
Michelle
Grenier and
Jeanette M.
Garcia., 2020.
Physical Activity,
Screen-Time
Behavior, and
Obesity Among 13-
Year Olds in
Ireland with and
without Autism
Spectrum Disorder
A random
trial study
Childcare
settings
Irish children
with and
without
autism
spectrum
disorder
(ASD)
4 and 5
ratings
It has been
examined
that
overweight
status is more
prevalent
among
children with
autism.
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S. Koritsas and
T. Iacono., 2020.
Weight, nutrition,
food choice, and
physical activity in
adults with
intellectual
disability
A controlled
study
adults
with
intellectua
l disability
(ID) in
Victoria
51
disability
workers
(11 men,
40
women)
and 68
(47 men,
21
women)
adults
3 and 4
ratings
It has been
founded that
people
should be
encourage to
get involved
in physical
activity and
adopt healthy
eating habits
for
maintaining
body weight
in
appropriate
manner.
Quality appraisal
Article 1: An open study of the effectiveness of a multi-component weight-loss intervention for
adults with intellectual disabilities and obesity
Considering the selected article, it has been analysed that adults suffering from intellectual
disabilities have high rates of obesity among them. it will focus on study of effectiveness of take
5 multi components weight loss intervention which will provide support to improve the weight
condition of them. it is required for physicians to consider utilisation of physical activity is
examined to be more effective as well as efficient in order to the problem of obesity among adult
having intellectual disabilities it has been founded that physical activity involvement is helpful to
avoid the obese condition among them in appropriate manner.
Article 2: The prevalence of overweight and obesity levels among forensic inpatients with
learning disability
As mentioned in given research article, it has been evaluated that overweight and obese
condition is prevalent among the inpatient of forensic service having the problem of learning
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disability. It includes the group of participants selected from forensic unit to gain knowledge
about their learning disabilities with obese condition. However, it is observed that these patients
has obese condition due to several components such as psychotropic medication, high‐
calorie food provision, restricted physical activity and sedentary lifestyles.
Moreover, it has been identified that requirement of efficient as well as
gender sensitive weight management intervention should be used for
maintaining normal weight of body.
Article 3: Sedentary and Physical Activity Patterns in Adults with Intellectual Disability
With the help of selected research article, it has been analysed that it will focus on reason of
sedentary behaviour which is responsible for development of obesity. It is observed that people
with sedentary behaviour acquire the metabolic issues due to which extra fat deposition get
started in body tissues which facilitates into obese condition. This project will use 42 adult older
patients with intellectual disability to study their physical activity and sedentary behaviours.
Meanwhile, it is observed that selected participants indicates about low levels of physical activity
and high rate of sedentary behaviour that results into overweight condition. It has been founded
that strategies are required to increase physical activities along with reducing sedentary
behaviour for maintaining normal weight.
Article 4: Comparison of Obesity, Physical Activity, and Sedentary Behaviors Between
Adolescents With Autism Spectrum Disorders and Without
From the given data, it has been examined that study will be carried out the comparison between
physical activity and sedentary behaviour among adolescents having problem of ASD (autism
spectrum disorder). It includes to consider around 42747 respondents from the National survey
from 2011 to 2012 for evaluating obese an overweight condition of adolescents. Meanwhile, it is
observed that to increase physical activity among them for overweight and obese individuals for
improving their body mass index. It has been founded that adolescents suffering from ASD
needs specific target programs in order to increase physical activities to reduce the risk of
occurring obesity.
Article 5: Physical Activity, Screen-Time Behavior, and Obesity Among 13-Year Olds in Ireland
with and without Autism Spectrum Disorder
Considering the selected article, it is based on the purpose of studying the comparison between
physical activity participation with screen time habit for obesity and reported reasons for lack of
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participation in sports among Irish children with and without autism spectrum disorder. It
includes the use of moderate vigorous activity, light activity and sports is observed to be
significantly reduced among group with ASD. However, it is observed that children with ASD
has more time which is spent to watch television that is accountable for occurrence of
overweight and obese condition among them. It has been identified that physical activities are
required to be increase among children with ASD for maintaining their normal weight along with
avoiding continue watching television. It is observed that around (34.4 vs. 24.7 %) were problem
of obesity among children with and without Autism spectrum disorder which is reduced by
engaging them in physical activities in regular basis.
Article 6: Weight, nutrition, food choice, and physical activity in adults with intellectual
disability
As mentioned above, it has been identified that it is based on the aim of define nutrition, food
choice, physical activity and weight status among adults having intellectual disability in Victoria.
It includes to consider group of 51 disability workers as respondents in which 11 men and 40
women were included to gather information for gaining better outcomes. However, it has been
founded that patient with intellectual disability were at high risk of diseases related to obesity,
inactivity and poor nutrition for effective strategies to maintain better health condition of the,
properly.
Summary and synthesis of the papers
Considering the above research papers, it has been evaluated that physical activities is must for
patient having learning disability otherwise they will at risk of obesity. It is necessary for care
professionals to provide effective care by involving patient with learning disabilities along with
involving them in regular physical activities like sports for maintaining their normal weight of
body. However, it is required to establish strategies for removing sedentary behaviour and
physical inactivity from their routine to avoid obesity.
Issues of implementation
Ottawa model of implementation
The effective strategies can be applied including number of physical activities, like walking,
sports, running, jumping and many more. It is helpful to use Ottawa model to implement these
strategies among patient suffering from learning disability. However, it is required to implement
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effective practices for reducing sedentary behaviour and make physical activities interested to
encourage people for involving them to maintain normal body weight.
Conclusion
From the above assignment, it has been concluded that physical activity is known as effective
strategy for improving health condition. It includes the use practices to avoid sedentary and
inactive behaviour among them for maintain normal weight of body which facilitate to avoid risk
of occurring obesity.
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References
Books and journals
Foster, C. and et. al., 2018. Physical activity and family‐based obesity treatment: a review of
expert recommendations on physical activity in youth. Clinical obesity, 8(1), pp.68-79.
Bertapelli, F. and et. al., 2016. Overweight and obesity in children and adolescents with Down
syndrome—prevalence, determinants, consequences, and interventions: a literature
review. Research in Developmental Disabilities, 57, pp.181-192.
Spruijt-Metz, D. and Saelens, B.E., 2016. 14 Behavioral Aspects of Physical Activity in
Childhood and Adolescence. Handbook of pediatric obesity: Etiology, pathophysiology, and
prevention, p.227.
Yeo, S. and et. al., 2017. What characteristics of nutrition and physical activity interventions are
key to effectively reducing weight gain in obese or overweight pregnant women? A systematic
review and meta‐analysis. Obesity Reviews, 18(4), pp.385-399.
Vandelanotte, C. and et. al., 2016. Past, present, and future of eHealth and mHealth research to
improve physical activity and dietary behaviors. Journal of nutrition education and
behavior, 48(3), pp.219-228.
Online
An open study of the effectiveness of a multi-component weight-loss intervention for adults with
intellectual disabilities and obesity. 2020. [Online]. Available through:<
https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/an-open-study-of-
the-effectiveness-of-a-multicomponent-weightloss-intervention-for-adults-with-intellectual-
disabilities-and-obesity/1C1F90C56584C50F6B00162616164AF2>
The prevalence of overweight and obesity levels among forensic inpatients with learning
disability. 2020. [Online]. Available through:<
https://onlinelibrary.wiley.com/doi/abs/10.1111/bld.12220>
Sedentary and Physical Activity Patterns in Adults with Intellectual Disability. 2020. [Online].
Available through:< https://doaj.org/article/23b8213d5dcc4858b7f3d2a11691b0bf>
Comparison of Obesity, Physical Activity, and Sedentary Behaviors Between Adolescents With
Autism Spectrum Disorders and Without. 2020. [Online]. Available through:<
https://link.springer.com/article/10.1007/s10803-016-2762-0>
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Physical Activity, Screen-Time Behavior, and Obesity Among 13-Year Olds in Ireland with and
without Autism Spectrum Disorder. 2020. [Online]. Available through:<
https://link.springer.com/article/10.1007/s10803-016-2920-4>
Weight, nutrition, food choice, and physical activity in adults with intellectual disability. 2020.
[Online]. Available through:< https://onlinelibrary.wiley.com/doi/abs/10.1111/jir.12254>
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