school-based interventions to control childhood obesity











Qualitative Research Critique and Ethical Considerations





Qualitative Research Critique and Ethical Considerations

Summary of the Study

In an article titled “Effect of school-based interventions to control childhood obesity: a review of reviews”, Amini et al. (2015) investigate the efficacy of school-based interventions in the prevention and management of overweight and obesity among school-going children for an eleven-year duration. Using systemic assessments, meta-analyses, reviews of reviews, and policy briefs, the researchers examine school-based obesity management programs that target children and young adolescents, including interventional studies that have control groups and sought to prevent or manage overweight and obesity within school contexts. Amini et al. (2015) found four systematic assessments and four meta-analyses that met the legibility and were incorporated into their review process. The results revealed that the implementation of multi-tiered interventions did not necessarily result in positive anthropometric outcomes. While the program durations serve as a crucial factor in influencing the efficacy of these interventions, there is a paucity of studies that sought to investigate the length of time needed for effective outcomes of these programs.

In view of the current variations between girls and boys in reacting to the aspects of the programs in tailoring school-based interventions, the dissimilarities should be taken into account, particularly aiming at children. These interventions can be more efficacious for vulnerable children populations. School-based initiatives for students should be able to report any unwanted or unexpected mental or physical negative impacts that stem from administering them to target populations. Body mass index was identified as one of the most widely utilized indicators for assessing the childhood obesity prevention or treatment trials. However, the researchers observe that overreliance on this metric as the only index for adiposity outcomes might prove misguiding. Moreover, there are very few studies that identify the mental theories and models of behavior change employed in school-based interventions. Therefore, Amini et al. (2015) propose for more studies that take into account psychological impacts of school-based interventions.

Method of Study

The main methods that were used to undertake the study included systemic reviews and meta-analyses. A meta-analysis can be defined as a form of survey in which previously prepared study reports, not humans, are subjects of the evaluation (McNabb, 2015). In this case, the meta-analysis has been used quantitatively by selecting a total of 61 materials for research. The meta-analyses method is an efficacious way of establishing the state of research findings on a specific subject, since it offers the researcher with the bigger picture as opposed to merely a simple discussion of a single or few parts of the issue or problem under investigation. In order to realize this objective, the researchers conducted a comprehensive literature search of previous works that were done from January 2001 to December 2011.

The main research databases that were utilized to select studies for research include PubMed, Cochraine, ProQuest, as well as Health Information Research Unit. Other sources of research materials to be evaluated included policy briefs and reports that are widely used both locally and internationally (Amini et al. 2015). A total of 61 research materials were selected for comprehensive analysis. In order to identify appropriate studies, all titles and abstracts generated from the searches were evaluated by a reviewer. This was meant to determine the extent to which they met eligibility standards. Therefore, an assessment of the full textual contents was done by a team of reviewers. Any discrepancy or disagreements were addressed by constructive discussions until a consensus was attained. All the 61 articles selected were assessed against new selection criteria in separate ways. One of the main benefits of this methodology is that it provides a holistic procedure for establishing a coding scheme and criteria for selecting studies. This may include reading study reports, coding the materials, and ensuring that they are subjected to a rigid statistical analysis (McNabb, 2015). This can impose a discipline on the research team that is normally missing in qualitative summarizations and comparative evaluations.

Results of the Study

In total one hundred and six papers were systematically evaluated. They included four systematic reviews and four-meta-analyses. During the first stage of the selection, three reports described as report were screened, which were filtered in the second stage of the selection process. Out of these reports, the researchers did not find any policy brief. Out of the our meta-analyses that were undertaken, one did not find the age ranges of participants incorporated in the studies., In some situations, some studies only took into account single strategies like physical activities or nutritional education for assessment of the studies. Further, others only sought to understand combined or multi-tiered strategies (Amini et al. 2015). A significant fraction of the reviews had quality assessments or a scoring system. The searches span for incorporated evaluations and meta-analyses ranged from 1966 to 2010. The systemic reviews and meta-analyses found that most studies were mainly undertaken in the United States and European nations. The outcomes of the reviews suggested that implementation of multi-component interventions did not necessarily improve the health outcomes. While implementation durations are a critical determinant of effectiveness, researches to examine the length of time needed were lacking. The researchers also found that more than half of the studies that were evaluated utilized body mass index as the measurement method for determining the outcomes of the interventions. Therefore, Amini et al. (2015) cautioned against overdependence on BMI as the sole method of assessing the efficacy of school-based interventions. Depending on it as the only metric for assessing adiposity outcomes can prove to be misleading. Most significantly, the researchers suggest the need to incorporate psychological impacts of interventions that seek to prevent and manage obesity among school-going children. Comment by Melissa Petrick: Consider spell check here. Comment by Melissa Petrick: Correct punctuation here.

How the Findings can Be Used in nursing Practice

For nursing practice, the study identifies school settings as some of the most powerful levels of interventions at which the problem of childhood obesity can be addressed. The study gives insights into how nurses can employ different strategies to curb childhood obesity. One of the issues that have been raised by the article is failure by previous studies to utilize multi-disciplinary and multi-tiered approaches to curb childhood obesity. For instance, most studies that have been evaluated by the research have only used few or single approaches, which generate minimal fruits. However, the article sheds light on the need for school-based interventions to move beyond use of only physical education to include dietary education and other practices. Comment by Melissa Petrick: Include in-text citations at the end of paragraphs where you’ve paraphrased information.

Ethical Considerations

All efforts that seek to reduce childhood obesity prevalence in schools must never overlook the potential ethical challenges that might emerge. One of the most commonly mentioned ethical issue is stigma. Health care professionals such as nurses and physicians must provide interventions that do not negatively brand overweight and obese people in negative ways (Garbarino & Sigman, 2010).  Instead, advocacy campaigns must be launched to discourage acts of bullying, verbal abuses, and discrimination against children who are overweight and obese. In some cases, nurses should embrace the best interest doctrine by examining strategies that work best for overweight and obese children. This may require engaging in extensive consultations with school heads, families, as well as the children themselves. The best interest policy is directly associated with the ethical premise of beneficence (Garbarino & Sigman, 2010).  Although conflicts may emerge when there are cases of disagreements on what works best for the child, there is need to take the most effective approach that has minimal potential risks to the patient.


Childhood obesity is one of the problems that continue to affect the United States and other developed countries. School-based interventions have proven to be some of the most effective strategies to eradicate this public health concern. However, this study suggests that the efficacy of school-based programs strongly depends on approaches that are used. Therefore, use of multi-tiered approaches that take into account elements such as physical education, dietary plans and education, and family-centered strategies promise to generate the desired health outcomes as opposed to using only a single strategy such as physical education alone. Comment by Melissa Petrick: This is an interesting article on an important topic. I want you to think through the specific implications this will have on nurses. What interventions will a school nurse do differently due to this research? Collaboration with a school psychologist? Screening? Specific education?



Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M. H., & Jazayeri, S. (2015). Effect of

school-based interventions to control childhood obesity: a review of

reviews. International Journal of Preventive Medicine6. Comment by Melissa Petrick: Page numbers? URL?

Garbarino, J., & Sigman, G. (Eds.). (2010). A child’s right to a healthy environment (Vol. 1).

New York: Springer Science & Business Media.

McNabb, D. E. (2015). Research methods in public administration and nonprofit management.

London: Routledge.

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