Research Design
An RCT was conducted in a pediatric hospital under the supervision of pediatricians and inexperienced researchers. The RCT focused on early screening for obesity and the implementation of USPSTF standards. The authors experimented to determine whether doctors are following the USPSTF standards that are universally recommended for doctors. The authors call their study a project, and investigators and doctors randomly selected a group of children for it. Physicians were challenged to carefully screen these children when they visited the hospital, whether for routine or emergency visits. The study’s design is considered quasi-experimental, as the authors included the results of a survey of physicians in the conclusions of the study. Completing this survey was the last step in the study.
Doctors had to measure the body weight and height of the child carefully; this data must be documented. The single-case design was that each child in a group of 60 children presented to the doctor for screening. After screening, the child received no advice unless the physician found obese. If a child was overweight or obese, doctors immediately gave recommendations to him, and doctors could communicate with his family on this topic. The group of 60 children received much more suggestions and more careful supervision from the study than before. The authors conducted qualitative research, which first ascertained screening quality in a pediatric hospital before the intervention. Secondly, the authors aimed to improve the quality of screening in the hospital and increase the likelihood of detecting a tendency to obesity in children. The study involved 60 children from six to 16 years old (boys and girls); their electronic medical records were selected by physicians and subjected to careful screening.
The study’s design is similar to the authors’ goals and differs from the more theorized studies of Umer et al. (2017) and Ward et al. (2017). An extensive literature review was not necessary for the authors; however, they gave a vivid introduction about childhood obesity at the beginning of the article, in general, citing statistical data. If the authors had expanded the sample, the design would have changed accordingly, and perhaps they would have chosen a more mathematical strategy.
Data Collection Type
The authors developed a questionnaire for physicians participating in the intervention. The questionnaire was supposed to record the successes or failures of the study, in the opinion of pediatricians. The authors suggested that doctors complete the questionnaire once; the survey consisted of five questions, and it can be assumed that it was easy to complete. The authors were interested in whether the results achieved will help improve patients’ lives later. Questions in the questionnaire were closed and required an affirmative or non-affirmative answer. Sometimes it was necessary to show a degree of agreement or a degree of denial, as, for example, in the options where the authors suggested the answer ‘completely effective’ or ‘hardly did.’
Physicians answered the questionnaire in paper form, but instead of interviews, the authors conducted instructions with physicians before the intervention; this interview was conducted in a hospital by investigators. Nurses, doctors, and assistants were alerted to the importance of following rules and standards to improve public health. The authors identified no specific surveillance tools; researchers are public health professionals and physicians; the data are mainly presented on an ordinal scale, where respondents had to mark the degree of agreement. The verification tool, such as electronic health records and their information, is reliable. However, the authors acknowledge that this reliability is limited; the data obtained was not retested.
Comparing this study with others, one can highlight its originality since questionnaires were not demonstrated in any examples. Fenin et al.’s (2021) research is eminently practice-oriented, in contrast to Umer et al.’s (2017) theoretical analysis. All researchers work with similar statistics on obesity among children in the United States and do not contradict each other anywhere. Some researchers (Mǎrginean et al., 2018, Ward et al., 2017) expressed concern about the lack of early childhood screening.
Descriptive Stats
Data on the height weight of patients are available in the chart. The study showed two charts: before and after the intervention. The authors did not provide measures of central tendency, but only approximately one in three children in the cohort (36.7%) were screened before the intervention; after their intervention, this result was more than 90%. Standard deviations were also not reported, and this is because there were only 60 patients. The authors note the smallness of the study and suggest that if the study involved perhaps more than 100 children, the results would be more varied. The authors also did not demonstrate the correlation coefficient (r), this is also because the data they collected did not concern mainly mathematical data. Neither information from nurses and doctors nor data from patients were calculated mathematically. The only thing the doctors were looking for was the baby’s body mass index, which investigators also put on the schedule. However, the study was not devoted to identifying body mass index.
In studies of theoretical focus, data were collected in a very different way, despite similar results. Ward et al. (2017) and Mǎrginean et al.’s (2018) studies similarly collected data but did not have a supervised group of children. Ward et al.’s (2017) studies are cross-sectional, making them identical to Fenin et al.’s (2021) studies under consideration. All of the compared studies uniquely collect materials and data. Kumar and Kelly’s (2017) research is essentially a review and consists of well-organized data.
Data Analysis and Interference
Studies do not assume probabilistic data as the authors do not calculate probabilities. Confidence intervals were not indicated before the publication of the final results. The final results amounted to 91.7% of all children (55 children out of 60). Researchers did not explicitly state the hypothesis, but the authors argued that following USPSTF standards should improve screening among children. Readers can consider that the researchers checked how carefully doctors and nurses usually follow the USPSTF standards. After testing, they implemented the USPSTF system, first proving its usefulness. Statistical programs, software, were not used, with the exception of Excel.
The effects size used was not mentioned; power analysis was not necessary. The data was collected using a medical database of electronic medical records. The authors checked how carefully doctors fill out documentation, including electronic documentation, about the condition of patients. Encoding of data were carried out in the standard form of hospitals, and the authors did not pay much attention to this. All the used programs are also related primarily to medicine and hospital equipment.
The reviewed study does not contain a rich qualitative analysis, in contrast to the studies of Kumar and Kelly (2017) and Umer et al. (2017). Fenin et al.’s (2021) team had only the children’s medical records and the examinations that followed the initial analysis. These data need to be analyzed and decisions made regarding medical recommendations. Later, these recommendations were to develop into interventions by doctors in the families of young patients.
Evaluation
Although the hypothesis was presented unacceptably, it was understandable, the same as the desired results of the authors; these results were achievable and not overly theorized. The authors well matched the instrument to a sample of 60 children. Considered article could have been more precise, but the authors deliberately did not set themselves such a goal. The research participants, physicians, were hospital employees where the authors chose to perform the intervention. The participants were not specifically recruited for the intervention. The authors did not raise the topic of compensation for participation. It is probably because, during the intervention, doctors and nurses were not supposed to do what was not part of their duties. All medical work was tied only to the requirements of medical organizations and their daily responsibilities.
Investigators did not obtain IRB approval as it was not required. The authors received an IRB exemption from the University of Alabama in Huntsville. There are ethical constraints on research: patients’ personal information and how much it should be visible to study directors. The study has, of course, medical significance. Young patients took part in the screening, allowing doctors to know their current state of health. As shown by this study and investigations by Mǎrginean et al. (2018) and Ward et al. (2017), neglect of screening affects the fixation of the tendency to obesity in children. Future research on this topic is needed, and the authors prove it. They explain the large and complex problem of childhood obesity as an epidemic, and this is traced verbatim in other works (Kumar & Kelly, 2017). It is helpful to conduct such studies with different samples, dividing children into subgroups by age.
The authors successfully investigated the local problem of obesity in one hospital and achieved the desired results. They increased the number of patients under screening from 22 to 55, thus finding more children prone to obesity or weight gain. For eight weeks, patients followed the recommendations given by doctors. It can be generalized from this that the health status of the sample of patients has increased.
References
Fenin I.A., Norris, C.L., Barnby, E., & Hammock, M.B. (2021). Adoption of clinical guidelines to improve childhood obesity screening. Pediatric Nursing, 47(3), 114-123.
Kumar, S., & Kelly, A. S. (2017). Review of childhood obesity. Mayo Clinic Proceedings, 92(2), 251–265. Web.
Mǎrginean, C. O., Mǎrginean, C., & Meliţ, L. E. (2018). New insights regarding genetic aspects of childhood obesity: A minireview.Frontiers in Pediatrics, 6. Web.
Umer, A., Kelley, G. A., Cottrell, L. E., Giacobbi, P., Innes, K. E., & Lilly, C. L. (2017). Childhood obesity and adult cardiovascular disease risk factors: A systematic review with meta-analysis.BMC Public Health, 17(1). Web.
Ward, Z. J., Long, M. W., Resch, S. C., Giles, C. M., Cradock, A. L., & Gortmaker, S. L. (2017). Simulation of growth trajectories of childhood obesity into adulthood. New England Journal of Medicine, 377(22), 2145–2153. Web.