Increased prevalence of childhood obesity, which is recognized as precursor to multiple chronic conditions and its attendant comorbidities, and the thrust from healthcare providers to combat this epidemic has given fillip to obesity related research that generated volumes of studies in variety of subjects associated with overweight and obesity. There are variety of methods and designs to generate knowledge and qualitative research is considered to be ideal for identifying the patient’s concerns, interests, and priorities and to reflect their lived in experiences.
Recent experiments in integrating research techniques produced, among other things, ‘qualitative meta-synthesis’ and meta-ethnography, which offers a means of fusing and enhancing the contribution of qualitative findings to the development of more “formalized knowledge” (Zimmer, 2006, & Arkins., et al, 2008).
The synthesis of primary qualitative studies is termed ‘meta-synthesis’ and rationale for synthesizing qualitative research is based on the concept that “synthesis of evidence can allow the construction of larger narratives and more general theories,” and “could overcome the problem of isolation associated with qualitative research” (Dixon-Woods, 2004, p.3). Review of obesity studies using meta-synthesis by Snethen et al (2006) shows that it is an effective technique for consolidating knowledge from variety of studies by qualitative researchers.
Snethen et al (2006) attempted to evaluate the effectiveness of weight-loss interventions for overweight or obese children aged 6 to 16 years. They searched MEDLINE, CINAHL, PsycINFO, Health STAR, ERIC, ProQuest Nursing Journals, Sociological abstracts, and Nursing/Academic Edition and Dissertation Abstracts, published between 1980 and 2002. The researchers selected controlled studies with at least sever participants in each group, and retrospective studies were not included.
Chosen studies reported multiple activities, behavioral trainings, dietary interventions, or exercise programs aimed to intervene in children’s weight loss with the active participation of overweight children alone or with their parents. Criteria of trials for inclusion in their meta-analysis were that it had to report means and standard deviations of weight loss for the intervention and control groups of school children with a mean age of 10.77 years. Based on a quality score ranging from 0 to 40 assigned by the authors, seven studies (n=694) were included in the review and trials with crossover or sequential designs were excluded.
The differences between studies were investigated using the Q statistic, the correlation between the effect size and program duration, and discussing the influence of the amount of structure of the intervention. Snethen and colleagues conclude that “there are effective methods for weight loss in children, but there was not enough data to support one intervention as being more effective than any other” (2006).
Analysis of the review reveals that researchers searched several sources, have stated a clear question and inclusion criteria, and assessed study validity. However, it is not clear whether any attempt has been made to minimize language bias, and study design and methods used to combine effect sizes has not been explained in detail. Incomplete reporting of review methods and inadequate reporting of validity assessment makes the conclusion unclear, though it reflects the strength of evidence presented in the review.
It is viewed that gathering the findings of ‘multiple primary qualitative studies using a systematic process may: help generate more comprehensive and generalisable theory’, expand existing systematic reviews , or provide insight into the success or failure of a particular research finding, and assuage anomalous findings emerging from quantitative research( Atkins et al, 2008). Although synthesizing research findings may benefit health care interventions, concerns have also been expressed regarding the loss of explanatory context when multiple study findings are combined.
Reference
Dixon-Woods, Mary., et al. (2004). Integrative Approaches to qualitative and quantitative analysis. Health Development Agency. Web.
Atkins, Salla., et al. (2008). Conducting a meta-ethnography of qualitative literature: Lessons learnt. BMC Research Notes. Web.
Zimmer, L. (2006). Qualitative meta-synthesis: a question of dialoguing with texts. NCBI. Web.
Snethen, J, A., Broome M, E., & Cashin, S, E. (2006). Effective weight loss for overweight children: a meta-analysis of intervention studies. Journal of Pediatric Nursing, 21(1):45-56. Web.