Understanding and Using Evidence for Public Health

This report discusses evidence-informed public health, search strategy, primary research study analysis, and literature review of primary research article. It also covers the impact of physical exercise on adolescents and children obesity. Subject: Public Health, Course Code: N/A, Course Name: N/A, College/University: N/A

: UNDERSTANDING AND USING
EVIDENCE FOR PUBLIC HEALTH
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TABLE OF CONTENTS
INTRODUCTION.........................................................................................................................4
BACKGROUND Evidence-informed public health and it’s important...................................4
SEARCH STRATEGY..................................................................................................................5
One database used and why.........................................................................................................5
PICO framework and why it is used............................................................................................5
Main and alternative search keywords........................................................................................6
Boolean operators used in primary research study article and contribute in refining the search
keywords......................................................................................................................................6
Limiters (filters) were used and why...........................................................................................7
How many search results were identified and the way they have been narrow done..................7
The way one primary research study article and literature review journal article has been
selected........................................................................................................................................7
Strengths and limitations of your search strategy........................................................................8
PRIMARY RESEARCH STUDY ARTICLE.............................................................................8
Aim (and objectives) of the research study.................................................................................8
Kind of study...............................................................................................................................8
Where and when was it done.......................................................................................................8
Ethical approval and informed consent.......................................................................................8
Kind of participants were involved..............................................................................................8
Method of data collection and done in research..........................................................................9
Key finding in abstract and discussion session............................................................................9
Strengths and limitations (weaknesses) of the study...................................................................9
Value of the research and recommend for future research or public health policy.....................9
Literature review article.............................................................................................................10
Answer of focussed question.....................................................................................................10
Comparison of the finding of primary research with the finding of literature review..............10
Summarization of theme of literature review............................................................................10
Usefulness of literature article over primary.............................................................................11
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CONCLUSION............................................................................................................................11
REFERENCES..............................................................................................................................12
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INTRODUCTION
Public health refers to the protection and promotion health status of people as well communities
in which they live, play, work and learn. Physical activities such as exercise/ workouts have been
proven as the powerful treatments for preventing obesity and to improve obesity risk factors in
adolescents and children as well (Shelton, Cooper and Stirman, 2018). The report will aim to
analyse the background of public health, search strategy of chosen article, primary research study
analysis of research study article and the literature review of the primary research article.
BACKGROUND
Evidence-informed public health and it’s important
Evidence informed public health refers to the process of refining and distribution of best
evidence available from the research, experience and context. This evidence is used for
informing and improving the public health practices and policies. These benefits involve the
access to a higher quality and better access to information and knowledge on best practices. They
also enhances the likelihood of successful policies and programs as well as the greater workforce
productivity (Brownson, Fielding and Green, 2018).
Literature review
Literature review refers to the piece of academic writing which demonstrate the understanding
and knowledge of literature on a certain topic or subject. The literature review involves a critical
evaluation of the topic. A literature review provides the researcher to the users a general image
or review of knowledge which is previously published by other authors on the question which is
under research (Kowalski and et.al., 2020). This provides a theoretical framework by a research
methodology as well as also ensures that a proper research question has been asked. It can be a
form of review article which presents the existing knowledge, methodological contributions,
theoretical contributions as well as the substantive findings. They are the basis of every research
in every academic field (Norcross and Lambert, eds., 2019).
Main sources and types of evidence
Evidence refers to the procedure of
systematic appraisal, identification as well as the evidence based care e contemporary research
finding as a framework for decision making. The evidence based research in healthcare refers to
the use of research evidence as well with other factors for making clinical decisions. The
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evidence based research in healthcare is the integration of best staff skills, training, experience
and the research evidence. It is published across a number of resources which includes academic
journals, websites, news reports, books and conference proceedings etc. (Albarqouni and et.al.,
2018). There are various evidence based research such as peer reviewed publications such as
PubMed, CINAHL, search engines such as Google scholar, NICE evidence search and the
specific evidence etc. The main sources of evidence involves books, journals and newspapers
etc.
Impact of physical exercise on adolescents and children obesity is a significant topic as obesity
is the leading decease which involves an excessive amount of body fat. As obesity us a major
concern which is not limited to cosmetics only as it can it can enhance the risk of other diseases
such as diabetes, high blood pressure and other some concerns.
SEARCH STRATEGY
One database used and why
Cinahal databases is one of the database that has been used to
gathered information related to the study as it is indexes for availability of top
nursing and allied health literature. Likewise nursing journals as well as articles in relation with
the physical activity along with its impact towards the obesity. It is principle resources for
literature search in nursing and considered good source to search in context of review of
qualitative evidence
PICO framework and why it is used
PICO framework is evidence-based practice that is mainly used to frame and answer
clinical or health care related questions. It contribute in development of literature search
strategies for instance in systematic review (Woo Chook Yu and et al. (2004). On the basis, of
four elements, such as problems, interventions, comparisons and outcomes, question is being
framed. Likewise, in context of our study it is:
P (Population) Children and Adolescents
I (Intervention) Exercise and Physical activity
C (Comparison) No comparison
O (health Outcome) Fitness and reduce obesity
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Main and alternative search keywords
The alternative search keywords that have been used to complete the study related to
“impact of physical exercise on obesity in Adolescents and Children are:
Search terms Synonyms used
Adolescents Teenagers, younger people
Physical activity and exercise Work out
Obesity Fatness, chubbiness
Intervention Strategies or action to overcome health issue
Outcome Results
Therefore, it can be stated all these were good key words that has been used to gathered
sufficient information about the topic because our study has been based on impact of physical
exercise on obesity in Adolescents and children.
Boolean operators used in primary research study article and contribute in refining the search
keywords
Boolean operator has also been used in primary research study such as AND, OR, NOT
or AND NOT) are being utilised to either exclude keywords in a search ort conjunctions to
combine. With an motivate to get more focused and productive results. Likewise the article of
“Changes in physical fitness of a home-based physical exercise program in childhood obesity: A
quasi-experimental uncontrolled study”. It has been gained through making use of impact of
physical activity or exercise program on childhood obesity, this has widen the search as all
article that were either related to physical activity or exercise program are extracted (Woo Chook
P, CW, et al. (2004). While, and has narrow down the search such as impact of physical activity
and exercise program on childhood obesity has only presented article that have information
related to the both keywords. Hence the Boolean operators keywords have contribute in refining
the search.
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Limiters (filters) were used and why
Inclusive and exclusive are filters or limitation has been used to gather only useful
search pertaining to the topic, thus it has eliminated unnecessary information or article being
study.
Inclusive Exclusive
The article that has been published after 2011
are included.
While, before 2011 published article are
excluded to have recent year information only.
Study present in English is being included. On the other hand, other language used in
study is excluded for better understanding.
While article that are related to impact of
physical exercise on obesity of children are
included.
But, the study which are not pertaining to
adolescent.
How many search results were identified and the way they have been narrow done
In order to pursue the search that is related with the Primary search the Boolean
operators have been used. When the related search term has been inserted then it presents 1000
search result which has been lowered down with the use of And Boolean operator which narrow
down the research to 800. Later with the use of relevant inclusion and exclusion criteria the
research has again shortened that gives 600 articles. This process continues with further search
result in terms of applying of filter in terms of date of publication and language, obesity terms
and others that gives the result as 33.
In case of secondary research with the application of search terms initially 1264 search in
total has been made, out of which 889 has been selected after screening. Out of which 753 has
been excluded as they did not include overweight and obese adolescent. Later with an exclusion
of 112 articles because of not showing the result in relation to impact of PA towards
cardiovascular risk, gives a total of 24 selected articles.
The way one primary research study article and literature review journal article has been selected
Cinahal databases is one way that has been mainly used to gathered
both primary research study article and literature review journal article for achievement of set
objective.
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Strengths and limitations of your search strategy
Strength of search strategy as it has make use of Cinahal databases, appropriate
keywords to have necessary information. But weakness is that it has
included article that has been published even 8-10 years before this
information are not much recent.
PRIMARY RESEARCH STUDY ARTICLE
Aim (and objectives) of the research study
The main aim and objective of the research study to evaluate the changes in PF and body
composition (BC) of a home-based physical exercise for treating childhood obesity.
Kind of study
It is a randomised control trail research under which the group evaluated the effect of
combined home base physical exercise program in respect to BC of overweight adults and
children. Thus, as it involves the grouping of participants followed with the implementation of
intervention on one while the other group will be treated with other treatment.
Where and when was it done
The study has been conducted within the Hospital General of the University of Valencia in
which all the individual belonging to 8 years to 16 years of both sexes were participated in the
study. It has been published in 2017 (Lisón and et.al., 2017).
Ethical approval and informed consent
Yes, ethical approval as well as informed consent has been taken by the researcher in
primary study as it has been signed by participating subjects and their parents. Furthermore, the
study has been completed as per the Second Helsinki Declaration, and is also being approved by
ethics committee of the hospital. Thus, it ensures its validity and reliability (Lisón, and et.al.,
2017).
Kind of participants were involved
In the study there are around Thirty-three overweight/obese children and adolescents
participated for six month in home-based intervention. This intervention included muscular
strength exercises and aerobics that are being done by children to reduce their overweight for
good health and well being.
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Method of data collection and done in research
In the research an intervention of physical exercise has been applied to the participants
followed with the measurement of results before and after the intervention. This will lead to
determine the impact of intervention over the group. The information was gathered from
participants of Hospital General of the University of Valencia by collecting crucial information
pertaining to the study, statistical analysis has been, such as Kolmogorov–Smirnov test.
Likewise, the t-tests of related samples have been done to make comparison of pre and post
intervention value of Anthropometric variables. Wilcoxon test for comparing pre and post for
lower body explosive is another method that has been used to complete the study (Lisón, and
et.al., 2017).
Key finding in abstract and discussion session
As per abstract session the key finding support the effectiveness of this program that
make improvement not only BC but the PF also. However, the results have been interpreted with
caution because of the lack of control group.
As per discussion session the finding shows that physical exercise can make
improvement in terms of CRF and MuS. Likewise, an implication of home based intervention
will prove to be useful for the families with low cost and time. The results suggest that an
ambulatory self-administer physical exercise program would be effective for the improvement of
BC and PF of obese and adolescent children. In the same way it shows that it is applicable at the
large scale without considerable time and cost.
Strengths and limitations (weaknesses) of the study
Strength of the study is that it have make use of making use of randomised control trail
study which will assist the research in terms of testing of intervention. Thus, the information has
been gathered in minimum cost possible. The first and foremost limitation of the study was that
it lack of a concurrent control group it has lead issue in interpreting the presented PF results
(Lisón, and et.al., 2017).
Value of the research and recommend for future research or public health policy
The research is valuable as it has helped in finding out that the self-administer physical
exercise program is effective for effective for improving BC and PF of obese children and
adolescents. Hence, it is suggested that this intervention can also be implemented on large scale
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as it does not considered both economic cost and time and personnel. While, future research
must focus on long-term effectiveness of such program through an RCT (Lisón, and et.al., 2017).
Literature review article
Answer of focussed question
Yes, the literature has answered the focussed question i.e. the aspect of physical fitness
has a direct impact towards the cardiovascular risk. This can be justified with the results of the
review which shows that physical activity leads to a change towards the fat percentage, systolic
blood pressure, waist circumstances, cholesterol and various other related aspect of
cardiovascular risk factor reduction.
Inclusion of relevant studies
Yes the relevant studies has been included in the review. This is because all the study are
considered with the effect of PA intervention towards the composition of body, physical fitness
components, biochemical markers, endothelial function among the obese and overweight
adolescent (Vasconcellos, and et.al., 2014). Likewise, the study is highly focussed towards one
relationship and thus bear effective outcome. This will also lead to reduce the chances of
biasness. This can also be supported with the inclusion and exclusion criteria under which
relevant study has been included and other repeated and non-useful studies has been excluded.
Comparison of the finding of primary research with the finding of literature review
The finding with respect to primary research as well literature review match with each
other. This can be justified with respect to the finding of both the research. This is because the
primary research also shows that the physical exercise has a direct impact towards the obesity
and overweight childhood (Vasconcellos, and et.al., 2014). On the same way the aspect of
systematic review or secondary research also shows the same result that physical exercise lead to
directly impact towards the obesity and reduction of cardiovascular risks.
Summarization of theme of literature review
Effect of physical activity on Body Mass Index and Physical Fitness Variable
With the analysis of twenty-two studies, majority i.e. 15 studies show that physical
activities have a direct impact towards the reduction of BMI. In the same way with respect to the
performance of physical activities the waist measurement as well as BMI would be reduced
(Vasconcellos, and et.al., 2014).
Effect of physical activity on Biochemical Markers:
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The physical activities also have a direct impact towards the biochemical makers in terms
of varying the proportion of insulin. Six study shows that insulin will reduce while 5 did not said
anything. However, on an overall 12 studies suggest that the change will occur.
Usefulness of literature article over primary
Findings of literature review article are more useful than the findings of one primary
research article because they provide a comprehensive background as well as analysis of
available research on a topic.
CONCLUSION
It can be concluded that the public health are the activities related to protection and
promotion as well as the status of certain communities. The evidence based public health is
critical and provides benefits such as recognition of best practices and better planning and
implementation of resources. The literature review answers the questions which describe the
authenticity and validity of research articles. Cinahal database is used for gathering information
and PICO framework was used as an evidence based practice. In the articles inclusive and
exclusive filters/ limiters were used for gathering appropriate search. For primary research study
the aim focused on evaluating changes in physical fitness and body composition of a home based
physical exercise. Thirty three overweight children were involved in study.
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REFERENCES
Books and Journals
Albarqouni, L. and et.al., 2018. Core competencies in evidence-based practice for health
professionals: consensus statement based on a systematic review and Delphi survey. JAMA
network open. 1(2). pp.e180281-e180281.
Brownson, R.C., Fielding, J.E. and Green, L.W., 2018. Building capacity for evidence-based
public health: reconciling the pulls of practice and the push of research. Annual review
of public health. 39. p.27.
Eisenmann JC (2007) Aerobic fitness, fatness and the metabolic syndrome in children and
adolescents. Acta Paediatrica (Oslo, Norway: 1992). Supplement 96(12): 1723–1729.
Eisenmann JC (2007) Aerobic fitness, fatness and the metabolic syndrome in children and
adolescents. Acta Paediatrica (Oslo, Norway: 1992). Supplement 96(12): 1723–1729.
Kowalski, L.P. and et.al., 2020. COVID‐19 pandemic: effects and evidence‐based
recommendations for otolaryngology and head and neck surgery practice. Head &
neck. 42(6). pp.1259-1267.
Lisón, and et.al., 2017. Changes in physical fitness of a home-based physical exercise program in
childhood obesity: A quasi-experimental uncontrolled study. Journal of Child Health
Care. 21(2). pp.153-161.
Melnyk, B.M. and et.al 2018. The first US study on nurses’ evidence‐based practice
competencies indicates major deficits that threaten healthcare quality, safety, and patient
outcomes. Worldviews on Evidence‐Based Nursing. 15(1). pp.16-25.
Norcross, J.C. and Lambert, M.J. eds., 2019. Psychotherapy relationships that work: Volume 1:
Evidence-based therapist contributions. Oxford University Press.
Ortega FB, Ruiz JR and Castillo MJ (2013) Physical activity, physical fitness, and overweight in
children and adolescents: evidence from epidemiologic studies. Endocrinologı´a y
Nutricio´n 60(8): 458–649.
Shelton, R.C., Cooper, B.R. and Stirman, S.W., 2018. The sustainability of evidence-based
interventions and practices in public health and health care. Annual review of public
health. 39. pp.55-76.
Vasconcellos, and et.al., 2014. Physical activity in overweight and obese adolescents: systematic
review of the effects on physical fitness components and cardiovascular risk
factors. Sports medicine. 44(8). pp.1139-1152.
Woo KS, Chook P, Yu CW, et al. (2004) Effects of diet and exercise on obesity-related vascular
dysfunction in children. Circulation 109(16): 1981–1986.
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