Outline of Problem Context and Background
There are worldwide concerns over obesity and overweight largely to the high and ever growing prevalence rates in different parts of the world. The World Health Organization and other authorities in global public health expect prevalence rates to go even higher following the increase of unhealthy lifestyles in the current generation (Pulgarón, 2013). Indeed, the population of obese and overweight people has doubled since 1980 with the current numbers at around 1.9 billion people. Obesity and overweight both refer to the accumulation of excessive fats in the human body. Elsewhere, obesity is medically defined as having a Basal Metabolic Rate (BMR) that is greater than or equal to 30 while overweight generally connotes to BMR that is greater than or equal to 25 (O’dea, 2008). The BMR on its part is a mathematical expression of an individual’s weight in kilograms divided by the square of their height. It is consequently given in kg/m2.
Childhood obesity and overweight is a greater concern globally and in Australia because it predisposes children to cardiovascular disorders, type 2 diabetes, future obesity and other health problems. Global prevalence stands at 41 million children while 1 out of 4 (25%) are overweight and obese in Australia (Han, Lawlor, & Kimm, 2010). There are no apparent sex preferences for childhood obesity and overweight while developing countries are now exhibiting growing prevalence as their developed counterparts. Though prevalence appears to have entered a plateau phase after 2011, there is need to address the problem both globally and in Australia.
Childhood obesity is a global concern given the flurry of health problems that are associated with it. Muscoskeletal disorders, psychological problems and cardiovascular diseases have all been cited as possible health effects of childhood obesity (Han, Lawlor, & Kimm, 2010). In addition, children with obesity and overweight are likely to be obese later in their adult life. Management of obesity and related health problems poses a huge fiscal burden on the health budget, despite being preventable. In the Australian context, the problem is clearly on an even more serious dimension with childhood obesity and overweight rates standing at 25%. This is one of the highest rates in the world and requires urgent redress. Though the prevalence rates have plateaued since 2011 at around 26%, this is barely relieving as they remain above desirable limits and comparably higher than other parts of the world (Han, Lawlor, & Kimm, 2010). To address the problem, there is need for proper monitoring with updated statistics and elaborate strategies of prevention.
Research Questions and Aims
Research Question: What are some of the strategies that can be used to reduce childhood obesity and overweight in Australia?
Aim: To determine ways of reducing the prevalence rates of childhood obesity and overweight from published literature.
Research Question: What are the prevalence rates of childhood obesity and overweight among children between the ages 0-5?
Aim: To generate more statistics on childhood obesity and overweight in Australia for the purposes of monitoring prevalence and planning interventions.
The present paper argues that the stated research question is best addressed using the research question “What are the prevalence rates of childhood obesity and overweight among children between the ages 0-5?” and the positivist approach.
It is apparent that the search strategy was novel in investigating the research questions posed in the paper. No other research from the literature reviewed had followed a similar approach despite there being a plethora of papers that adopted an analysis of already published data. The study narrowed down on three authoritative databases, the Cochrane, Medline and Pubmed while in normal cases researchers adopt a broad spectrum approach getting articles from a diversity of sources some of which are not always medically aligned. An example in the review was Han, Lawlor, & Kimm (2010) whose research was drawn from random sources. This was a strong differentiation move in the paper that ensured very relevant and strong research findings were unearthed. The search words were also quite specific and were refined using Boolean operators that helped to narrow down the search into relevant, manageable papers. It started off with results in the tune of hundreds of thousands before refinement of search terms reduced the load to less than ten thousand. More importantly, a ten year time limit of publication period was introduced that reduced the articles to less than a thousand and ready for critique and analysis. Papers that had near similar search strategies such as Olds et al (2010) had a larger sample and used articles within a wider range of time (1985-2004). The same is evident in the case of Gill et al (2009), meaning that there are absolutely no papers that investigated the research questions quite in the same way.
The research questions drafted in this paper are relevant to existing research on childhood obesity and overweight. The research question for the qualitative research design that relates to determining strategies of reducing childhood obesity and overweight for instance relates to a number of articles found from the search strategy. O’dea (2008) is one such study that focused on the predisposing factors of childhood obesity and overweight finding that children from pacific islands, Caucasian and Asian females were more obese than others. This study does not directly engage ways of reducing obesity and overweight but presents findings that can guide control. De Silva-Sanigorski (2010) demonstrates a higher relevance of the research question as it investigates the effectiveness of Romp and Chomp, a community based intervention, in reducing childhood obesity and overweight. Other studies that demonstrate the relevance of reducing childhood obesity and overweight rates in research include Chen, Beydoun, & Wang (2008) that focuses on the effects of sleep duration. Similar relevance has been demonstrated by Gonzalez-Suarez et al (2009) who determined the effectiveness of school based programs in dealing with childhood obesity and overweight. It is therefore apparent that the qualitative research question has strong links to available research.
The research question can be used to investigate the effectiveness of various interventions and unearth hitherto untested ones. This is important in coming with the best ways of addressing the health problem. Clearly, the qualitative research question appears stronger than the quantitative one given that there are more articles addressing mitigation of childhood obesity and overweight in the generated results. Further, the articles are quite direct in addressing childhood obesity and overweight that forms the spine of the problem statement, with most of them specific on control measures. Tested strategies of addressing childhood obesity and overweight, for instance community and school based interventions, have been discussed.
In the same way, the quantitative research question focusing on prevalence rates among children 0-5 years of age has strong relationships with existing research. There are two articles that focus on prevalence rates for the purposes of monitoring the health problem in Australia, especially to reinforce or dispel the notion that the rates had entered a plateau phase since 2011. These include Olds et al (2011) which examined the trends in childhood obesity and overweight in nine countries including Australia. Their findings agreed with the idea that prevalence rates of childhood obesity and overweight had reached a plateau phase not just locally but in the entire sample. Gill et al (2009) also sought to establish the presence of a plateau phase in the prevalence of childhood obesity and overweight and came up with the same results.
The research question on the prevalence of childhood obesity and overweight amongst children 0-5 years can be used to refine the available statistics that currently focus on 0-18 years. This will help to determine if the plateau phase is even across board or some groups of children have been disproportionately affected. The question is however a bit weaker than the qualitative one given that the latter has more relevant research articles with respect to the problem of addressing childhood obesity and overweight in Australia. Additionally, the available research has addressed prevalence rates but not on children 0-5 years of age hence the results are less direct to the problem statement.
This section discusses the approaches, research designs and other methodological aspects of both the qualitative and the quantitative research question. Ultimately, there is a comparison and an argument over which approach was the best in addressing the problem statement.
The research approach for the qualitative research question “What are some of the strategies that can be used to reduce childhood obesity and overweight in Australia?” was interpretivist. This is a research paradigm where the subjective realities and the understanding of the subjects in the research are taken for the truth. The research often refrains from seeking clarifications from the participants and correcting any apparent misconceptions on their part. Instead, they attempt to draw inferences from the raw ideas from their sample and reveal their own perspectives in the research as they interpret it (Yilmaz, 2013). This was a suitable paradigm for addressing the issue of childhood obesity and overweight in the sense that those who have made contact with the problem were best suited to suggest mitigates. They have already experienced what works and what doesn’t and are best placed to narrate the effectiveness of different interventions.
Common assumptions in interpretivist frameworks are quite a number. First, there is an ontological presumption that there is no single truth or reality but rather multiple ones that are often socially built by individuals. This implies that what one thinks to be the reality is not necessarily wrong despite the fact that it may deviate from the reality of others. For instance, if in the current context a participant suggests a mitigation measure that is unorthodox or unsupported by evidence based practice, such will still be taken to be the truth. Another assumption is that knowledge is acquired through the subjective realities, experiences and explanations of people (Yilmaz, 2013). This is against the scientific method which relies on perception, and rather places its might on what people narrate from their own experiences. Thereby, understanding how to deal with childhood obesity and overweight can be drawn from the experiences of those who have tried that in the past. It is also assumed that researcher bias and intuition is necessary in interpretation of data. Thereby, it is not necessary to identify bias in the study and how it may have potentially affected the results. In terms of methodology, it is also assumed that qualitative methods of analysis and interpretation are the best methods as they highlight the actual experiences, feelings and standpoints of individuals.
The qualitative research design in question was critical review of available research. This entails an analysis of relevant articles published in reputable databases and drawing themes from them. The articles contain ideas about mitigation from other papers and a content analysis is carried out to determine the main ideas. Sampling was done on the basis of time and relevance, with only articles within a ten year period included. Additionally, the search was narrowed down to articles that address obesity and overweight in Australian children rather than a wider, global spectrum. There was no data collection as it was already made available by the articles that were derived from the various databases. Interpretation was made through determination of trends and themes that emerged from the data.
The research paradigm selected for the research question “What are the prevalence rates of childhood obesity and overweight among children between the ages 0-5?” was positivist. This is the dominant approach in the sciences which subscribes to the belief that a single truth can be established through a logical application of theory on facts. Facts in this case are observable phenomena, utilizing human perception (Creswell, 2012). The paradigm is highly applied in the scientific method that is based on observations, hypothesis formulation, testing of hypothesis and making successive itineration until there is no discordance between predictions and the outcomes. In application to the quantitative research question, it is believed that a single rate of prevalence can be established through observation of data. Unlike interpretivism, there can be no more than one reality, and objectivity is observed.
Several assumptions are made with respect to the positivist approach. First, it is assumed that the single reality can be measured, observed and is in a fixed state. This means does it does not vary depending on the researcher or other conditions and can be determined through repeated trials (Creswell, 2012). Additionally, it is assumed that knowledge can be quantified and be obtained in an objective manner. This is unlike in interpretivist approaches where knowledge is subjective and determined by the biases of both the observer and the participants. In this case, the determination of the truth must therefore be with acknowledgement to the effect of bias and making necessary adjustments to accommodate it. In terms of methodology, it is assumed that experimental, quasi-experimental, analytical and exploratory methods are the best in gaining scientific information. These are the dominant methods that appear in positivist approaches, defining phenomena in fixed and discrete terms.
The research design adopted in the study was analytical. This entails the descriptive analysis of articles drawn from Pubmed, Medline and the Cochrane library in line with the research question on prevalence rates of childhood obesity and overweight within ages 0-5. Descriptive statistics, specifically percentages were used to define prevalence rates of the health problem. In the context of data collection, such was not conducted given that the data was already available from the studies that were included in the analysis. However, sampling was done in line with the ten year timeline for inclusion and relevance to the aspect of prevalence rates of childhood obesity and overweight in Australia. Means, Medians, percentages and standard deviation were used to determine prevalence rates and characterize them.
Though both approaches are standardized and widely used in different domains of research, there was a relative difference in as far as their effectiveness was concerned with respect to the problem statement. The problem in the study concerns the reduction of childhood obesity and overweight in Australia, through determination of updated and refined prevalence rates and mitigation measures to the same. This is a problem that requires objectivity and definite
solutions, rather than subjective opinions and biases. This makes the positivist approach the most suitable for use. In the particular case of prevalence rates, there cannot be a subjective opinion to the same. Prevalence rates are used to plan expenditure, interventions and scope the health problem. This highlights the need to establish them discreetly and give them a mathematical value that can offer such grounding. The qualitative approach where themes are identified from existing research is not the best to take. On the other question on strategies of reducing childhood obesity and overweight, qualitative methods may apply because they lead to generation of more content. A qualitative study generates more content that can help to identify strategies, their effectiveness and other additional details. If the study was explorative, a qualitative design would be the most appropriate as it would generate more information for further studies (Yilmaz, 2013). However, the design selected was a critical review which aims to generate results that offer final deductions. Therefore, laying the basis for future research was not the primary interest but rather answering the research question. Unfortunately, this does not auger well with the presence of bias as it reduces the credibility of the findings and in essence limits generalizability. The results of the study would be soundly useful if they could be generalized to the Australian population with respect to controlling childhood obesity and overweight. This indicates that bias and the lack of a central idea of truth that is fixed and observable makes the qualitative approach less suitable for the research problem. This is profound in the sense that the results required in the paper were summative rather than meant for laying foundation for further research.
The purpose of this paper was to justify a research question and argue the best approach to address it. The problem statement outlined the global and local stakes on childhood obesity and overweight, detailing the high prevalence rates that currently stand at 25% in Australia. Such a trend indicates that 1 out of 4 children is either obese or overweight which is way above the global averages for the same health problem. Obesity and overweight are associated with cardiovascular disorders, muscoskeletal disorders, psychological problems and a number of other cormobidities. This explains the urgency of addressing them to their full extent and the relevance of the research questions. From the reviewed literature, it was apparent that no study had investigated both research questions in the manner that was adopted by the present paper. In addition, the issues raised in the research questions were relevant to existing research both with respect to prevalence rates and the strategies of dealing with obesity and overweight. There were quite a number of articles addressing the same, though the qualitative research question was stronger in this regard with more papers providing ways of dealing with childhood obesity and overweight.
Two approaches were provided to address the problem in the study. The interpretivist approach was fronted to address the qualitative research question on strategies of addressing childhood obesity and overweight. This method, though standard and largely employed in research domains, allows for both participant and researcher bias and is barely in providing definite answers to the research question. In addition, the subjectivity in the analysis suggests that the results cannot be generalized on the Australian children. This made it less preferable. The positivist approach on its part is objective and believes that a single reality exists in an observable, fixed and measurable form. The approach was thus found suitable for determining prevalence rates and offering general solutions to the research problem. Positivism agrees with the idea that the logical application of theory on facts can lead to common reality, that can be accepted as truth by all. This is the best approach for both research questions in the study and the general problem stated. It is therefore recommended that the approach is used for either questions rather than the interpretivist approach. Only the positivist method can offer findings for evidence based practice and health planning of interventions. Further recommendations:
Chen, X., Beydoun, M. A., & Wang, Y. (2008). Is sleep duration associated with childhood obesity? A systematic review and meta‐analysis. Obesity, 16(2), 265-274.
Creswell, J. W. (2012). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oaks, CA: Sage.
De Silva-Sanigorski, A. M., Bell, A. C., Kremer, P., Nichols, M., Crellin, M., Smith, M., …& Robertson, N. (2010). Reducing obesity in early childhood: results from Romp & Chomp, an Australian community-wide intervention program. The American journal of clinical nutrition, 91(4), 831-840.
Gill, T. P., Baur, L. A., Bauman, A. E., Steinbeck, K. S., Storlien, L. H., Fiatarone Singh, M. A., … &Caterson, I. D. (2009). Childhood obesity in Australia remains a widespread health concern that warrants population-wide prevention programs. Medical Journal of Australia, 190(3), 146.
Gonzalez-Suarez, C., Worley, A., Grimmer-Somers, K., &Dones, V. (2009). School-based interventions on childhood obesity: a meta-analysis. American journal of preventive medicine, 37(5), 418-427.
Han, J. C., Lawlor, D. A., & Kimm, S. Y. (2010). Childhood obesity. The Lancet, 375(9727), 1737-1748.
O’dea, J. A. (2008). Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: implications for treatment, prevention and community education. Health & social care in the community, 16(3), 282-290.
Olds, T. S., Tomkinson, G. R., Ferrar, K. E., & Maher, C. A. (2010). Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. International journal of obesity, 34(1), 57.
Olds, T., Maher, C., Zumin, S., Péneau, S., Lioret, S., Castetbon, K., …&Sjöberg, A. (2011). Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Pediatric Obesity, 6(5‐6), 342-360.
Pulgarón, E. R. (2013). Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clinical therapeutics, 35(1), A18-A32.
Yilmaz, K. (2013). Comparison of quantitative and qualitative research traditions: Epistemological, theoretical, and methodological differences. European Journal of Education, 48(2), 311-325.
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