In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500-word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background

2. Problem statement

3. Purpose of the change proposal


5. Literature search strategy employed

6. Evaluation of the literature

7. Applicable change or nursing theory utilized

8. Proposed implementation plan with outcome measures

9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, you are required to retrieve and assess a minimum of 8 peer-reviewed articles. an abstract is not required, CITE WEBSITE SOURCE.

Topic: Childhood Obesity – PICOT Statement

P-I-C-O-T Statement

P- Obese children under the age of 12 with a BMI index of 30 or more.

I-Educational Nutrition programs involving Proper diet and engaging in physical activity

C- Children who will be involved in the educational program versus those who will not be engaged.

O- Reduction in obesity among children below the age of 12 by increasing knowledge on nutrition education

T- A period not less than 1 year


It is evident that obesity and overweight in general have become worldwide epidemics as illustrated by the widespread concerns. Moreover, this menace has been associated with other life-threatening complications such diabetes, cancers, cardiovascular complications and a wide range of health problems, making it an even complicated case that needs to be attended to (Reilly, & Kelly, 2011). For children below the age of 12, obesity has not only resulted to the mentioned health problems, but also forms a basis for ridicule and overall loss of the self-esteem that is vital in development into adulthood. Due to this continued prevalence, there is need for the involved stakeholders such as the government and other policy makers in the healthcare system to have in place research-based interventions that will ensure a drop-in number of children affected. It is further crucial to understand the implications of obesity go beyond affecting the individual directly and affect both the individual and the nation through the high cost of treatment. All these can be addressed in a nutrition education program that is suggested by this paper. The following is a PICOT statement intends to find lasting solutions to this problem; Comment by Melissa Reedy: You actually want to include your PICOT statement here as well


Despite recording some decline in the prevalence of obesity among children below the age of 12, the numbers are still too high, and something must be quickly done before we completely lose control of this problem. Statistics indicate that, 12.7 million children and adolescents are affected by obesity (Ogden, Carroll, Kit, & Flegal, 2012). The target population for this research is children below the age of 12.


All intended intervention procedures should be based on research evidence and they should primarily focus on preventing children from being overweight and treating those that are already affected. The intervention suggested here is having a nutritional education program that highlights dieting and exercising. Dieting as an intervention requires changing the general food environment and making available healthy choices. Intense physical activities on the other hand are meant to eradicate sedentary lifestyles and creating policies that seek to change the overall socioeconomic environment could impact positively on the health of the population (O’Reilly, Cook, Spruijt‐Metz, & Black, 2014).


Through research-based evidence, the caregiver is mandated to educate the entire community on the entire subject matter. This means conducting civil education and ensuring information is readily available in the community (Summerbell, 2011). For this to work, the evidence provided must be compared to the practice being opposed. In this case, the practitioner suggests comparing results from obese children involved in an education nutritional program vs those not involved in one.


The general outcome is to ensure research and evidence is used to guarantee a society that is working towards healthy living and is characterized by continued care for the affected and prevention measures (Puhl, & Heuer, 2010). At the end of the intervention process, there should be little risk of obesity in the United States and an overhaul of the entire system that has for a long time not dealt with the issue. One of the leading causes of previous interventions because modifications is targeted at the micro levels. Whereby targeting children individually, families, or schools make it harder to achieve positive outcomes or impacts on other influences on weight status that affect the general environment at the macro levels. Therefore, successful obesity control efforts must require a more macro-environmental strategy in addition to the micro level behavioral adjustments.


Since obesity is a problem that has affected the community for years, the intervention process can only last for at least a year before meaningful conclusions can be drawn. The time it takes to completely have an impact on the problem will also depend on the number of disciplines that work together to find a lasting solution. Since research evidence is based on multidisciplinary collaboration, coming up with a fool proof solution to obesity in children will take a considerable amount of time (Han, Lawlor, & Kimm, 2010).


Bonomi, A. G., & Westerterp, K. R. (2012). Advances in physical activity monitoring and lifestyle interventions in obesity: a review. International journal of obesity, 36(2), 167.

Han, J. C., Lawlor, D. A., & Kimm, S. Y. (2010). Childhood obesity. The Lancet, 375(9727), 1737-1748.

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Jama, 307(5), 483-490.

O’Reilly, G. A., Cook, L., Spruijt‐Metz, D., & Black, D. S. (2014). Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review. Obesity reviews, 15(6), 453-461.

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019-1028.

Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. International journal of obesity, 35(7), 891.

Wang, Y., Wu, Y., Wilson, R. F., Bleich, S., Cheskin, L., Weston, C., … & Segal, J. (2013). Childhood obesity prevention programs: comparative effectiveness review and meta-analysis.

Waters, E., de Silva‐Sanigorski, A., Burford, B. J., Brown, T., Campbell, K. J., Gao, Y., … & Summerbell, C. D. (2011). Interventions for preventing obesity in children. The Cochrane Library.


INSTRUCTOR COMMENT: Your recommendation for further research is really not present, THIS IS WEEK SIX.

Topic: Literature Review


Childhood Obesity: Literature Review


Obesity has for a long time been a subject of concern, not only for adults but also for children. Due to the serious health implications that obesity has, a lot of efforts have been made to devise ways to prevent it. This includes several studies that are aimed at understanding the prevalence of obesity across the ages. This review is specifically for eight studies conducted by different researchers to address the various aspects of childhood obesity for children less than 12 years, from its prevalence, causes and prevention efforts as part of a capstone project aimed at establishing guidelines to be followed when coming up with intervention measures.

Comparison of research questions

Although each of the eight studies covered childhood obesity as the main study subject, there were specific research questions that varied across the studies. Bleich, Segal, Wu, Wilson, & Wang (2013) conducted a systematic review of community-based childhood obesity prevention while Tester, Phan, Jared, Tucker, Leung, Gillette, Sweeney, Kirk, Tindall, Olivo-Marston, & Eneli (2018), focused on the characteristics of obese children between 2-5 years. Cunningham, Kramer & Narayan, (2014), differed with the first two since their study involved the identification of obesity prevalence in the United States at the national level. Lee, Scharf & DeBoer, (2018) also conducted a study that was concerned with the causes of childhood obesity and focused on the relationship between food insecurity and obesity and was trying to answer the question of whether food insecurity is an independent risk factor for obesity in the United States.

The other study under review was conducted by Fetter, Scherr, Linnell, Dharmar, Schaefer, & Zidenberg-Cherr (2018) and was aimed at determining whether physical activity patterns improved School-Based Nutrition intervention. This differed from the rest in that instead of focusing on the causes of obesity, it was more concerned with the intervention measures at school level. Lydecke, Riley, & Grilo. 2018, conducted another study in which they were trying to answer the question regarding the relationship between parenting, eating behavior and the contribution they made on weight gain. Another study by Marcum, Goldring, McBride, & Persky (2018), questioned the micro-level choices that people make in their daily lives and their effect on their dietary behavior as an intervention to obesity. The last study under review was conducted by Vollmer, (2018) and was aimed at understanding how parents and specifically fathers understand obesity in their preschool aged children.

Comparison of sample populations

Since the different studies addressed different research questions, the sample populations were also different. One notable aspect of the sample population in all the studies however, is that the main study subjects were either child under 12 years or parents. For instance, Tester et al. (2018) investigated 7028 children between 2 and 5 years while Cunningham, Kramer, & Narayan (2014) had 7738 participants who were in kindergarten in the year 1998 and 2007. Vollmer (2018) used 117 fathers with an average age of 35 years while Marcum, Goldring, McBride, & Persky, (2018) used 221 mothers. Another study that included parents is the one conducted by Lydecke, Riley, & Grilo (2018) who included a sample of 581 parents.

It is important to note that the selection of the samples was much targeted and involved relatively large samples selected systematically. The reason behind the large samples was to have representation form as many regions as possible, given that the focus was the United States and the more the samples the more the reliability of the findings.

Comparison of the limitations of the studies

Each of the eight studies provided valuable findings that would greatly aid in the process of formulating policies for intervention measures. However, there were various limitations of the studies. Generally, since they were all conducted at different times with different research questions, it would be somehow difficult to generalize all their findings to arrive at a single conclusion. This therefore means that each study should be looked at exclusively as they address different questions. Because the studies only focused on obesity in children less than 12 years, there could be a challenge when formulating intervention measures. This is partly because the studies somehow overlooked the fact that some cases of obesity occur even past 12 years. Therefore, coming up with intervention measures for childhood obesity and focusing only on those below 12 years would leave out a significant number of children who are obese but fall above 12 years.

Studies such as those conducted by Bleich et al, (2013) were restricted to the quality of studies and the rejection criteria used. Also, all the other studies were qualitative in nature and therefore meant that their results were only restricted to what they were told by the participants. For instance, if any questions were left out during an interview or while answering a questionnaire, then this would largely affect the outcome of the results.


The findings of the studies would no doubt add a lot of value and insights on ways in which to carry out the capstone project. By focusing on specific facets of childhood obesity and carrying out systematic studies, there is a high chance of having a successful project that would probably change the way intervention measures are always put in place and this could provide an invaluable guideline within which to combat the problem of childhood obesity and the associated health implications once and for all. Comment by Melissa Reedy: What recommendations do you make for further research?


Bleich, S. N., Segal, J., Wu, Y., Wilson, R., & Wang, Y. (2013). Systematic review of community-based childhood obesity prevention studies. Pediatrics, 132(1), e201-e210.

Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). Incidence of childhood obesity in the United States. New England Journal of Medicine, 370(5), 403-411.

Fetter, D. S., Scherr, R. E., Linnell, J. D., Dharmar, M., Schaefer, S. E., & Zidenberg-Cherr, S. (2018). Effect of the Shaping Healthy Choices Program, a Multicomponent, School-Based Nutrition Intervention, on Physical Activity Intensity. Journal of the American College of Nutrition, 1-7.

Lee, A. M., Scharf, R. J., & DeBoer, M. D. (2018). Association between kindergarten and first-grade food insecurity and weight status in US children. Nutrition, 51, 1-5.

Lydecker, J. A., Riley, K. E., & Grilo, C. M. (2018). Associations of parents’ self, child, and other “fat talk” with child eating behaviors and weight. International Journal of Eating Disorders, 1-5.

Marcum, C. S., Goldring, M. R., McBride, C. M., & Persky, S. (2018). Modeling Dynamic Food Choice Processes to Understand Dietary Intervention Effects. Annals of Behavioral Medicine, 52(3), 252-261.

Tester, J. M., Phan, T. L. T., Tucker, J. M., Leung, C. W., Gillette, M. L. D., Sweeney, B. R., … & Eneli, I. U. (2018). Characteristics of Children 2 to 5 Years of Age with Severe Obesity. Pediatrics, 141(3), e20173228.

Vollmer, R. L. (2018). An Exploration of How Fathers Attempt to Prevent Childhood Obesity in Their Families. Journal of nutrition education and behavior, 50(3), 283-288.

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