Chamberlain University: EBP Change Project Proposal

This project proposal addresses the nursing practice concern of childhood obesity, focusing on elementary-aged children. It poses a PICOT question investigating the effectiveness of nutritional education in reducing BMI over eight weeks. The proposal identifies key stakeholders like teachers and parents, and employs the Social Cognitive Theory as a theoretical framework. A literature review synthesizes relevant studies on nutritional education interventions. The project outlines data collection methods, including anthropometric measurements and questionnaires, and specifies data analysis techniques using SPSS. Expected outcomes include a positive impact on BMI and dietary habits. The proposal also includes a detailed reference list of relevant research papers.

Running head: EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 1
Evidence-based Practice Project Proposal
Student Name
Chamberlain University
Date

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 2
Nursing Practice Concern/Problem
Kindergarten years are significant phases of growth and development in children and they
affect the entire life of the child in the future. Multiple factors influence the health of a child. The
influence of the western lifestyle such as the life of inactivity and the consumption of high-calorie-
dense foods have been found to impact the health of elementary school-aged children. Obesity is a
lifestyle disease that is wholly preventable but requires early intervention through effective
intervention and prevention programs to minimize the negative consequences of the condition in later
life. Nutrition education has been proposed as the most effective intervention for the prevention of
childhood obesity.
PICOT Question
(P) In obese elementary-aged children (I) Does nutritional education, compared to having (C) no
nutritional education, in a way that will (O) reduce BMI over the next (T) 8 weeks
Key Stakeholders
The major stakeholders in this project will include elementary school teachers, parents,
elementary students, hospitals, gynecologists, and nutrition and dietetics officers. The elementary
school teachers are key stakeholders in this project because they are the potential implementers of
nutritional education programs. Additionally, studies have indicated that school-going children spend
most of their time at school than in any other place (Stage et al., 2018; Hall et al., 2016b). Thus, the
teachers are the most effective stakeholders in the implementation of the project. Similarly, the
students’ parents and the children themselves are key stakeholders because the parents must give their
consent and the children have to actively participate in the intervention. Other key stakeholders such
as hospitals, nutritional experts and gynecologists are significant in the design and development of the
nutritional education program
Theoretical Framework

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 3
The Social Cognitive Theory has been developed, customized, and adapted to care for the
health of the participants by aiming at behavioral changes towards a healthful diet and lifestyle. The
theory emphasizes that human conduct relies on the mutual interaction of individual, behavioral, and
ecological factors 4. Multiple health-promoting interventions for elementary children and based on the
social cognitive theory are more effective in creating substantial changes in healthy eating and living
an active life 5 (Mead et al., 2017).
Literature Review
Several studies have addressed the subject of this paper from different angles. Yin et al. (2019)
conducted a study that was aimed at assessing the effectiveness of prevention programs for early
childhood obesity among school-aged children. The randomized controlled study involved 444
children between two and nineteen years. The scholars found out that the use of face to face sessions
focused on nutritional education plays a key role in improving BMI by motivating the parents and
children to adhere to recommended practices. By recruiting trained professionals with extensive
experience also enhances the effectiveness of the education sessions and subsequent outcomes.
Studies by Stage et al. (2018), Hall et al. (2016b), and Suiraoka et al. (2017) have also shown a related
trend in their findings.
Jarper-Ratner et al. (2016) also investigated the impact of education-based nutritional programs
as well as community-centered experimental cooking to improve knowledge, encouraging the
consumption of vegetables, and reducing obesity. The scholars used a quasi-experimental design to
assess data from the underserved elementary schools in Chicago. According to the findings, based on
T-test analysis, experimental cooking, as well as nutritional education programs, improve the
knowledge of learners regarding their dietary and food consumption behaviors. Although there was
selection bias in the study, it showed how nutritional education is central to positive dietary behaviors.
Additionally, Graziose et al. (2017) examined the aspect of cost-effectiveness and how it
relates to nutritional education. The research focused on the long-term cost impacts of nutrition-based

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 4
obesity prevention programs as a component of the curriculum. The research focused on New York’s
fifth-grade learners in public schools. The use of a cluster-randomized controlled trial research design
enabled the scholar to collect and analyzed data from 20 public schools. The findings showed that
nutritional education programs are effective and efficient in the long-term in terms of cost-
effectiveness. Graziose et al. (2017) also ascertained that the findings are also depicted in elementary
school when restricted to physical activity. Other scholars such as Blistein et al. (2016), Hall et al.
(2016a), and Jia et al. (2019) have shown the efficacy associated with educational nutritional
programs on childhood obesity, healthy behavior motivation, and dietary change.
Data Collection Methods
Baseline data will be collected after and before the recruitment of children into the study. All
the interviews and measurements will be carried out within the school compound. The following data
collection tools will be used to collect data:
a) Anthropometry
i. A height meter for obtaining height
ii. Waist circumference tape for obtaining the waist circumference to approximate the
abdominal adiposity
iii. Bathroom scale for ascertaining the weight
iv. The thickness of the skin (subcutaneous fat) will be measured using skinfold calipers
b) Questionnaire
Different sections will be included in the questionnaire:
i. Family-based characteristics
ii. Socio-demographic features
iii. Physical activity and sedentary recreation
iv. Dietary practices and food consumption
Analysis

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 5
Data cleaning and verification will be carried out using Excel 2013 software package. SPSS
version 21 will be used to analyze data. The demographic features of the participants will be assessed
using descriptive statistics whereas the variation between the placebo and experimental groups will be
established using inferential statistics. Inferential statistics will be used to assess the existing
variations. Other tests that will be performed include non-parametric tests, Odds Ratios, and Chi-
Square test to determine the nature of relationships between the variables of the study.
Expected Outcomes
Socio-demographic and economic factors are likely to be positively linked to overweight.
Examples might include the profession or occupation of the mother, absence of other siblings,
accessibility to computer games, type of transportation, and ownership of cellphones. Dietary factors
among obese children are likely to include the intake of high-calorie foods such as sweetened
beverages etc. The intervention is likely to result in a significant increase in the involvement in
physical education and a decline in the intake of high-calorie foods. Additionally, it is expected that
after the designated eight weeks, the experimental group, who are the obese elementary-aged children,
will depict a positive change in BMI to depict the effectiveness of a nutritional education program. The
researcher expects to see no change among those participants who did not receive any nutritional
education interventions within the same period.

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 6
References
Blitstein, J. L., Cates, S. C., Hersey, J., Montgomery, D., Shelley, M., Hradek, C., ... & Olson, S. (2016).
Adding a social marketing campaign to a school-based nutrition education program improves
children’s dietary intake: a quasi-experimental study. Journal of the Academy of Nutrition and
Dietetics, 116(8), 1285-1294.
Graziose, M. M., Koch, P. A., Wang, Y. C., Gray, H. L., & Contento, I. R. (2017). Cost-effectiveness of
a nutrition education curriculum intervention in elementary schools. Journal of nutrition
education and behavior, 49(8), 684-691.
Hall, E., Chai, W., & Albrecht, J. A. (2016a). A qualitative phenomenological exploration of teachers'
experience with nutrition education. American journal of health education, 47(3), 136-148.
Hall, E., Chai, W., & Albrecht, J. A. (2016b). Evaluation of a K-2 Elementary Nutrition Education
Program. Health Behavior and Policy Review, 3(1), 70-80.
Jarpe-Ratner, E., Folkens, S., Sharma, S., Daro, D., & Edens, N. K. (2016). An experiential cooking and
nutrition education program increase cooking self-efficacy and vegetable consumption in
children in grades 3–8. Journal of nutrition education and behavior, 48(10), 697-705.
Jia, P., Xue, H., Cheng, X., & Wang, Y. (2019). Effects of school neighborhood food environments on
childhood obesity at multiple scales: a longitudinal kindergarten cohort study in the USA. BMC
medicine, 17(1), 99.
Mead, E., Brown, T., Rees, K., Azevedo, L. B., Whittaker, V., Jones, D., Olajide, J., Mainardi, G. M.,
Corpeleijn, E., O'Malley, C., Beardsmore, E., Al-Khudairy, L., Baur, L., Metzendorf, M. I.,
Demaio, A., & Ells, L. J. (2017). Diet, physical activity and behavioral interventions for the

EVIDENCE-BASED PRACTICE CHANGE PROJECT PROPOSAL 7
treatment of overweight or obese children from the age of 6 to 11 years. The Cochrane database
of systematic reviews, 6(6), CD012651.
Stage, V. C., Wilkerson, K., Hegde, A., Lisson, S., Babatunde, O. T., & Goodell, L. S. (2018). Head
Start administrator and teacher perceptions of parental influence on preschool children’s
nutrition education. Journal of Early Childhood Research, 16(2), 160-175.
Suiraoka, I. P., Duarsa, D. P. P., Wirawan, I. D. N., & Bakta, I. M. (2017). Perception of parents,
teachers, and nutritionists on childhood obesity and barriers to healthy behavior: a
phenomenological study. International journal of health sciences, 1(2), 1-11.
Treu, J. A., Doughty, K., Reynolds, J. S., Njike, V. Y., & Katz, D. L. (2017). Advancing School and
Community Engagement Now for Disease Prevention (ASCEND) a quasi-experimental trial of
school-based interventions to prevent childhood obesity. American Journal of Health
Promotion, 31(2), 143-152.
Yin, Z., Ullevig, S. L., Sosa, E., Liang, Y., Olmstead, T., Howard, J. T., ... & Small, S. (2019). Study
protocol for a cluster randomized controlled trial to test “¡ Míranos! Look at Us, We Are
Healthy!”–an early childhood obesity prevention program. BMC pediatrics, 19(1), 190.