Free Custom «Evidence-Based Practice Part II: Obesity as a Health Issue» Sample Essay

«Evidence-Based Practice Part II: Obesity as a Health Issue»

With the increasing emphasis on the improvement of outcomes in patient care and clinical practice, an evidence-based practice has steadily gained popularity in the nursing profession. This approach dictates the integration of the nursing knowledge with the best available medical evidence obtained from systematic research. When the two are combined, they form an effective basis for making decisions regarding patient care and clinical practice. Since its inception, the approach has proved effective in combating some of the major global health issues. This research paper presents clinical evidence that may be used in reducing incidences of obesity among school-going children through a comprehensive examination of the existing literature on obesity as a health issue.

Part A

Obesity is a term that is employed to describe the condition of having an excess of body fat. It is an accumulation of fat in the human body to an extent that it poses potential hazards to the health of an individual. In the medical practice, persons suffering from this medical condition have a weight that is more than the optimal weight for their height. A person’s Body Mass Index (BMI), as well as their fat distribution around the body, determine that state of being obese (Bhadoria et al., 2015). The National Institutes of Health considers individuals who have a BMI of thirty and above to be obese.

Due to the fast epidemiological and nutritional changes that are mostly characterized by nutritional paucities, obesity is currently a persistent health issue. Up to date, there are no comprehensive mechanisms that have been developed to understand the condition fully because it is believed to be caused by a number of factors. However, current lifestyle preferences, as well the cultural and environmental factors, are mostly liable for the increased rates of obesity around the world. For this reason, obesity is currently considered an epidemic with an increased prevalence in both developing and developed countries.

Prevalence of the Health Issues

Despite the fact that obesity may affect any population of the society, its prevalence in children is expansive. Childhood obesity is considered a public health crisis in numerous countries, including the United States. Research also indicates that obese children are more likely to remain obese in their adulthood, which increases their level of susceptibility to other non-communicable diseases such as diabetes and cardiovascular diseases. In children, the condition is mostly attributed to high calories and fat intake, as well as the lack of physical activity. This does not only compromise their physical wellness but also poses a risk to their emotional and social well-being.

Significance to Nursing

Due to the increasing rates of childhood obesity, the nursing practice has taken a significant interest in it. Consequently, measures to obtain more knowledge of dealing with obesity have been evidenced. Today, obesity is considered a priority health issue that has forced nurses into research to enable them to position themselves as role educators and role models to the obesity susceptible population in the society.

An increased emphasis has been laid on the obesity prevalence among school going children within the community to undertake intervention strategies meant to combat the condition from its onset. Due to this reason, the nursing practice has adopted an evidence-based approach to gain a better understanding of the issue. It will aid in developing treatments and preventive measures that can facilitate the reduction of the incidences of obesity among young children.

Obesity in the United States

Obesity is considered a major health risk among families in the United States since the rate of incidences has been on the rise. For children in the United States, BMI is subject to age and sex due to the variations of the body composition of boys and girls as they grow. Research indicates that more than seventeen percent of children aged two to nineteen years in the nation were found to be obese between 2011 and 2012 (FRAC, 2015). This prevalence of obesity in the United States has been linked to unhealthy lifestyles, with the lack of physical activity being the major causative factor.

Obesity in China

The prevalence of obesity in China has largely increased over the years. In 1985, children and adults obesity affected less than one percent of the entire population (Whitten, 2016). As of 2014, nine percent of girls and more than seventeen percent of boys were found to be obese (Whitten, 2016). This increase has been attributed to the adoption of western diets such as fast food and other high-energy foods. The amount of time that Chinese children spend watching television has also contributed to the high obesity levels because such children often lack sufficient physical inactivity. In addition, Chinese surveys consider waist circumference as a more reliable index for obesity compared to the BMI (Whitten, 2016) because the majority of the Chinese population is prone to central body obesity. Research indicates that close to two-third of obesity cases in China would have been overlooked if waist circumference was not measure (Whitten, 2016).

Obesity in Switzerland

Until recently, obesity in Switzerland has long been associated with adults. However, childhood obesity has received much attention, especially from the media, mostly because the number of obesity incidences in children has begun to grow. Statistics now show that one in every five children in Switzerland is obese (OECD, 2014). In addition to age and gender, the geographical location is also considered a factor in determining the prevalence of obesity. The prevalence may also be attributed to a large amount of fast food consumed by the Swiss children. However, the major cause of obesity in Switzerland is due to the persistent motion deficit, which means limited physical exercise among children.

Part B

Examination of the currently existing evidence on obesity as a global health problem is important to comprehend the existing nursing practice. It is meant to measure the effectiveness of some of the existing treatment and preventive measures that have been adopted to counter the increased incidences of obesity in children. This review of literature will also serve as the foundation from which more productive intervention practices may be developed. In addition, the research provides evidence that may explain the increased prevalence of obesity among school-going children. Some of the concerns studied about obesity are discussed below.

Study 1: Nursing Research Study in the United States

Katz et al. (2010) conducted a longitudinal randomized control trial to evaluate the effects of a physical activity program in an elementary school classroom on the child’s health outcome. The sample of a population selected for the research included 1215 students of three elementary schools. The sample was sufficient because it covered pupils from all ethnic groups in the United States. The sample population of this research was also fitting as it involved elementary schools with children who are highly susceptible to the issue of obesity. The three major dependent variables used for this research included the level of fitness, abdominal and upper body strength, and academic performance. The measurement tools employed were reliable and included endurance and flexibility assessments, MAP score comparison, and weighing scale.

During the research, the researchers assigned an ABC (Activity Bursts in the Classroom) program to three elementary schools in Missouri, with two other schools serving as control groups. The program was conducted by the classroom teachers who piloted multiple short and structured physical activity sessions during a regular school day. The reference point data were recorded in September 2007 while the sequel data were collected in April 2008 (Katz et al., 2010). To analyze the data, t tests, Mann-Whitney tests, and Pearson’s χ2 tests were utilized (Katz et al., 2010).

The results revealed an increase in the upper body and abdominal strength of the children in the intervention group. Secondary reports also highlighted an improved level of fitness amongst the participants, as well as an improvement in their academic performance. Thus, these programs can significantly contribute to combating obesity among school going children. The learning centers can offer recess and physical education programs more effectively as compared to any other institution (Katz et al., 2010) chiefly because they have an incessant and intensive contact with children. This shows that classroom-based activities can proliferate in-school physical activity. They can be introduced without significant changes in the curriculum and can still be effective in reducing the incidences of obesity among children, which makes the study crucial for clinical practice.

Study 2: Nursing Research Study in Switzerland

Meyer et al. (2014) carried out a randomized control study to show the significance of long-term school-based physical activity on a child’s health. The sample population used in this research was derived from nine elementary schools in Switzerland totaling to sixteen classes. In addition, six more schools (twelve classes) served as the control group. A total number of people recruited in this research included five hundred and two children. Consequently, the sample population used in this research was sufficient because it offered a more precise result for the research.

The programs were multi-component, including daily physical education, short physical activity cessations during lessons, and physical activity homework. The program was run for a year. Three years after the intervention was halted, dependent variables – the level of aerobic fitness, body fat, and quality of life – were measured. They were compared to the baseline data that was collected at the beginning of the program. The same measurements were also obtained at the end of the one-year program. The tools used for measurement included Harpenden calipers, an accelerometer, and a child health questionnaire. The measurements were reliable because the variables were tested the same way during all stages of the study. The differences were then analyzed with the help of a multilevel linear or logistic regression model (Meyer et al., 2014).

The results obtaained at the end of the program revealed positive, beneficial effects in terms of physical and aerobic fitness. In addition, the level of body fat among the participants had significantly reduced. However, the results obtained three years following the halt of the intervention showed no sustenance of these benefits in exception of aerobic fitness. Given that physical fitness has been identified as an effective intervention, this research implicates long-term interventions as a preferred method of maintaining body fitness (Meyer et al., 2014). Through this method, the weight and body fat levels of school-going children will be kept in check until they are old enough to make that choice independently, which will help to reduce the incidences of obesity among children in the long term.

Study 3: Nursing Research Study in China

Li et al. (2014) conducted a non-randomized controlled trial study. Its purpose was to assess the effectiveness of physical activities as a school program on obesity and other health-associated outcomes. A sample population of nine hundred and fifty-one child between the ages of seven and fifteen in China participated in the research. The sample size of the population used in this research was appropriate since the age of all the children was between seven and fifteen. At this age, most children are highly susceptible to acquiring morbid obesity. During the research, three hundred and eighty-eight children participated in the intervention group while the rest continued with the normal daily practice. The intervention group was exposed to improved physical education and extracurricular activities. The major dependent variables considered during the research included BMI, adiposity, and waist circumference, which were measured the same way during two rounds of measurements, which makes them reliable. The differences were then analyzed using Χ2 test and t test.

The results showed that the physical activities conducted throughout the program were effective in reducing the level of skinfold thickness. A significant decrease in the BMI levels amongst the participants was also evident. Therefore, the development of viable school-based obesity intervention is evidenced by these findings because the multi-component program would diminish adiposity and improve health outcomes in school-going children, especially those who are considered to be overweight or obese. However, the need for such interventions in the long-term is warranted if the incidence of childhood obesity is to be significantly reduced.

Study 4: Nursing Research Study in the United States

Crouter et al. (2015) carried out a randomized controlled pilot study to measure the feasibility and short-term impact of an after-school physical education and nutrition program on the levels of activity in school-going children. In this research study, the sample population used was forty-two children from a city school in Boston, the United States. This population sample was appropriate, as it comprised children who are highly susceptible to obesity but are also exposed to a specified level of physical activities. The participants were exposed to an after-school nutrition education program and a supervised physical activity. There were four major dependent variables used in the research, including the percentage of fat, waist circumference, sedentary level, and the BMI. At the starting point, the levels of physical activity were gauged through accelerometer tests. Other measurement instruments used included PACER, anthropometric and laboratory measures, and self-report behavioral measures. Once the ten-week program ended, these measurements were recorded the same way as a follow-up to identify any changes. The results were analyzed with the help of the Fisher’s exact test.

The conclusions were made using the information obtained from thirty-six participants out of the forty-two, who successfully completed the program. Nineteen participants were subject to nutrition and physical activities while seventeen were subject to nutrition only. The results recorded a decrease in sedentary time and an increase in physical activity. However, the nutrition and physical activity group showed more positive results compared to the nutrition group. These changes highlighted the potential that these programs may have in the maintenance of body weight amongst elementary school children (Crouter et al., 2015). As such, the development of a physical activity program accompanied by nutritional education may be an effective intervention strategy for combating obesity in children when employed on a large scale.


In light of the above, the importance of an evidence-based approach in combating major health issues is evidenced. The depth of evidence obtained from studies conducted in different parts of the world provides a better understanding of the health issue. As such, numerous studies have been conducted with regards to obesity, its prevalence, and intervention practices, which can provide a foundation for developing more effective interventions. Through this literature, the level of physical activity has been portrayed as the main risk factor. When suitably manipulated and coupled with new research, it may lead to reduced incidents of childhood obesity and an effective treatment policy for those suffering from this medical condition.


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