nutrition evaluation and management

nutrition evaluation and management

Running head: PICOT STATEMENT 1










PICOT Statement: Childhood Obesity





P-I-C-O-T Statement

P- Patients who suffer from obesity (BMI of more than 30)

I- Undertaking nutritional education, diet, and exercise

C- Comparison to nutritional education, endoscopic bariatric surgical intervention

O- Improved health outcomes in terms of overall weight

T – A year’s time limit

PICOT Statement: Childhood Obesity


Childhood obesity poses serious health problems in the US as the number of overweight and obese population increases at a rapid pace every year. The effects of this problem have arrested the attention of policymakers, societal members, and government agencies. This has resulted in ranking childhood obesity as a national health concern. The adverse impacts of this disease go beyond the health realms to include economic burden on both personal and national budgets. While there are numerous risk factors and various evidence-based interventions to address this challenge, no single approach is consistently efficacious in curbing the disease. Consequently, it is imperative that efficacious initiatives and policies be developed to address the never-ending problem of childhood obesity. Multidisciplinary approaches are often broad and cut across all dimensions of personal health problems. Instead of placing emphasis solely on biomedical models, health care professionals should also seek to promote behavior change among obesity patients and their family members. A PICOT statement can be utilized as an effective tool to seek interventions of addressing childhood obesity.

PICOT Statement


In the US, obesity prevalence is highest among children aged from 6 to 11 years (Cheung et al. 2016). The disease has tripled among this age group from 4.2 percent to 15.3 percent from 1963 to 2012. In the last three decades, increased cases of obesity prevalence have been noted among children of all ages, although the differences in obesity prevalence have been recorded in terms of age, race, ethnicity, and gender (Cheung et al. 2016). In this respect, children from socioeconomically disadvantaged families and some racial and ethnic minorities experience the higher median score on obesity than the dominant white population. Higher obesity rates are often recorded among blacks and Hispanics compared to whites. For instance, a survey on girls in the Southwest revealed that the yearly cases of obesity stood at 4.5 percent among Blacks, 2 percent among Hispanics, and 0.7 percent among white girls aged from 13 to 17 years (Cheung et al. 2016). For low-income earners, American Indians rank highest at 6.3 percent, followed closely by Hispanics at 5.5 percent.


Evidence-based interventions that seek to reduce childhood obesity incidences in the country should target two major areas: prevention and treatment. High-quality RCT has been proven as one of the most effective preventative intervention, especially in schools (Reilly, 2006). Such interventions involve making changes on the school curriculum by introducing and improving physical education, changing school meal provisions, and reducing the television viewing hours. Schools should also engage in promotional campaigns that encourage walking form home to school (Ickes, McMullen, Haider & Sharma, 2014). This intervention has been successful in most cases involving girls in the sense that the risks of becoming obese are significantly lowered. Treatment interventions should be limited to motivated families and communities, in which the child and parents perceive obesity as a problem. From a theoretical perspective, treatments should be continued for longer periods such as months to years. Diets should be modified, especially with the use of regimen such as traffic light diet. Television viewing habits should also be reduced (Ickes et al. 2014). Furthermore, treatment should be aimed at encouraging families to self-monitor their lifestyle. Finally, more time should be offered for consulting with family members.


Being a member of a multidisciplinary team, the nurse practitioner performs the task of offering standardized care and advocacy support for healthy community environments. In addition, the nurse helps to ensures that there is proper coverage, access to, and incentives for regular obesity prevention, screening, diagnosis and treatment (Vine et al. 2013). There is also need to promote active living and healthy eating at work. Finally, focus should be on promoting healthy living during weight gain. There is also need to expand the role of health care providers, in childhood obesity prevention.


When a nurse is involved as one of the primary members in the multidisciplinary team approach, the child should be guaranteed of better continuity of care. The outcomes of interventions should include reduced obesity risks and curriculum adjustments for sustainable change to make it cost-effective (Ross et al. 2010). The curriculum modifications should be generalizable. One of the leading causes of failure of previous interventions is that they targeted modifications at the micro levels. This means that targeting individual children, families, or schools make it harder to have positive outcomes or impacts on the many other influences on weight status that affect the environment at the macro levels. Obesity control efforts that are successful should require a more macro-environmental strategy in addition to the micro level behavioral adjustments.


Obesity treatment and management should be a process that takes months to years. This is because the focus should not just be on the individual level, but also on the general behavioral patterns of a person’s family, friends, and society at large (Ross et al. 2010). Therefore, interventions should be multidisciplinary and aim at changing the behavior of the patient by promoting long term positive outcomes. Precautions to monitor blood pressure can be done every two weeks or on a monthly basis. Medications such as sibutramine can be utilized for periods of up to one year. However, its use should be discontinued in patients whose weight loss stabilizes at less than five percent of their initial body weight.



Cheung, P. C., Cunningham, S. A., Narayan, K. V., & Kramer, M. R. (2016). Childhood obesity

incidence in the United States: a systematic review. Childhood Obesity12(1), 1-11.

Ickes, M. J., McMullen, J., Haider, T., & Sharma, M. (2014). Global school-based childhood

obesity interventions: a review. International journal of environmental research and

public health11(9), 8940-8961.

McGrath, S. M. (2017). Childhood Obesity Comorbitities Awareness Hospital-based Education

(Doctoral Dissertation), Walden University, Minneapolis, Washington.

Reilly, J. J. (2006). Obesity in childhood and adolescence: evidence based clinical and public

health perspectives. Postgraduate medical journal82(969), 429-437.

Ross, M. M., Kolbash, S., Cohen, G. M., & Skelton, J. A. (2010). Multidisciplinary treatment of

pediatric obesity: nutrition evaluation and management. Nutrition in Clinical

Practice25(4), 327-334.

Vine, M., Hargreaves, M. B., Briefel, R. R., & Orfield, C. (2013). Expanding the role of primary

care in the prevention and treatment of childhood obesity: a review of clinic-and

community-based recommendations and interventions. Journal of obesity2013.

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