Management Program for Prepubertal Children Effective Appraisal

Question: Describe about the Management Program for Prepubertal Children for Effective Appraisal. Answer: As per Edmunds et al., the predominant impact of obesity in age groups prior to puberty has been noticed in major research work prior to the provided paper of Dr. Golley. The study in the research paper is characterized by the analysis of parenting skills and their impact on the modification of child behavior according to their age. The parents have to apprehend the necessity of behavioral modifications in different methods (Edmunds et al., 2014). The exposure or intervention observed in the research paper directs towards the randomized control trial of 111 overweight children in age group of 6-9 years. The intervention comprised of two weight management strategies including the delivery of parenting skills training and the provision of parental skills training complemented with comprehensive lifestyle training. As per Friend et al the control group was assumed in the form of waitlisted group awaiting intervention and was subject to observation for 12 months (Friend et al., 2015). Th e parents involved in each intervention group were administered with distinct levels of parental training modules which reflected on the individual needs of social modeling for tackling the issue of obesity in children especially in age groups prior to puberty. The outcome of the study was found in the background noted in the social issues with the distinct blocks stratified according to the recruitment site and gender. The study design could be observed as a 3-block strategy primarily designed through computer applications. According to Golley et al, the different responsibilities of the research activity such as data collection, recruitment, intervention delivery, participant allocation and randomization were assigned to specific individuals (Golley et al., 2007). The study population could be clearly observed in the families which were selected through different recruitment methods such as newsletters in schools and media publicity over the course of a year. As per the research o f Gillette et al., the impact of distinct behavioral traits on the capability of parents to assist in curbing the obesity in children among 6 to 9 years of age could be apprehended as the outcome of the research paper. Exposure in case of the research assumes application in form of a three distinct layered strategy which is implemented through the different parental skills training, waitlisted group and intensive lifestyle education (Gillette et al., 2014). The prominent resources implied in the research include the triple P resources which indicates positive parenting program. The intensive education for parents was complemented with additional sessions for lifestyle support. According to Hughes et al, the outcomes of the study indicated that the impact of the training in parenting skills alongside intensive education was reliable in moderating the BMI, weight and metabolic quotients (Hughes et al., 2015). Parenting skills training alone also contributed to feasible development in the treatment of children and the reduction in BMI scores in three groups over the years as observed in different intervention groups. The reduction in BMI scores by 45% in the personal skills training and intensive education intervention group is a profound indicator of intervention outcome. The research findings could be evaluated from a non-casual perspective citing the requirement of identifying ambiguity, chance variation and bias due to measurement or selection. The critical explanation of the distinct outcomes in context of ambiguity could be found in the observation of similar outcomes in case of intervention groups with parenting skills training as well as those with parenting skills training and intensive lifestyle education. As per Jasik et al, outcome suggests that the provision of additional lifestyle support education did not have any formidable impact on the reduction in BMI scores or metabolic health profiles of the participants (Jasik et al., 2015). The impacts of chance variation have to be considered as the necessary ingredient for the research as the data implemented for monitoring the BMI and metabolism index are collected with a substantial degree of error observed in each variable. The impact of other hormonal effects, medication and psychological e ffects also requires an evaluation in context of the research issue for illustrating a lucid impression of the chance variation prospects. Furthermore, the measurement and selection bias could be reviewed as a profound aspect of the research study which suggests uniform weight and body measurement standards for prevention of chance variations and the intervention is also associated with relaxing messages assuring lack of gender stereotyping. As per Nguye, the issues of measurement bias could be observed in the errors which are imperatively found in the data measured especially the body weight, age, height, BMI and waist circumference (Nguye, 2015). The cumulative evaluation of data could create various ambiguities in terms of measurement bias. Selection bias could be observed in the research topic as per a casual explanation as the selection of participants for the study could be contradicted on the basis of involvement of distinct personnel. The randomization of base line measureme nts could also be subjected to the impact of facets such as socioeconomic status and the anthropometry or measurement of physical traits across different anthropological sects. According to O'Connor et al, the evaluation for the program could be considered as a monitoring initiative responsible for adaptations and appropriate attendance at the sessions was considered as explanation of an outcome exposure relationship from a non-causal perspective (O'Connor et al., 2015). The participants also created issues which led to chance variation alongside confounding since some participants withdrew from the training program. The increase in height was also a prominent characteristic outcome of the research. However, the impact of intervention on groups and waitlisted groups indicate different implications suggesting the underlying effect of factors such as age and behavioral adaptations. The research outcomes are hence found to be characterized by a prominent association with the chances of ambiguity, selection bias, chance variation and measurement bias. As per the research of Santa Maria, the prominent confounding observed in the research is also related to selection bias as 64% of the participants are female and it is also seen that 44% parents were obese and 34 percent are considered overweight which suggests a formidable confusion in the flexibility of outcomes (Santa Maria et al., 2014). The baseline measurement and the stratified period of time utilized for the execution of research activity and the improvement of body statistics of the participants i.e. the children. According to Skelton, Martin Irby, while the control group is established in the form of a section of the participants waitlisted for intervention for 12 months, it is not necessarily determined that they showed no signs of improvement (Skelton, Martin Irby, 2016). The only prominent assumption which could be presented in the context is the relatively higher impact of P+DA training. The differen t factors which are also concerned with the non-causal explanation of research outcomes further refer to the distinct variables such as total cholesterol, gender, blood pressure, BMI, posthoc analysis and the utilization of SPSS for analyzing the research inputs. The test for causal explanation could be derived only through association with response which is one of the significant indicators. The dose-response association is determined through the determination of outcome following the intervention in a specific context. As per Twiddy et al, the participants selected in the research were subjected to distinct interventions and hence could be considered as responsive to a certain amount of moderation. The distinct activities noted for the validation of dose-response relationship in the exposure and outcome could be seen as the change in the strategy of tackling prepubertal obesity (Twiddy et al., 2012). Rather than emphasizing on the child for decreasing weight, parents were divided into groups and were consulted for specific intervention sessions. The dose response relationship between the exposure and the outcome is effective for the research activity since the association determines the feasibility of outcomes derived from a particular doma in of study. The sample size obtained for the research was 28 for each groups and the application of the sample sizes for deriving depreciation in BMI mean values from the baseline of 0.26+-0.49 and the significance level is assumed to be 0.05 obtained from a 2-sided perspective. The dropout rate has also been considered for determining the requirement of considering dropout rates essentially at 20 to 50 percent and therefore selection of sample sizes are enough for obtaining relevant research outcomes. The baseline variables included age, parental weight, growth potential, socioeconomic status, weight description, ethnicity and gender. Secondary analysis is executed for resolving the ambiguity pertaining to gender and analysis of families having greater than 75% attendance in the training sessions (Skelton, Martin Irby, 2016). The establishment of the relationship between exposure and outcome has to be critically reviewed with the references to findings of the research. Sixty four percent of the sample population was found out to be above 8 years of age and obesity was also clearly anticipated in the findings. Around 82 individuals were obese and the dual parent families alongside the demographic information indicating majority of white ancestry. The share of parents associated with overweight problems and obesity issues include 34% and 44% respectively and the prominent differences related to the family characteristics and child behavioral traits. The dose-response relationship could be estimated in the prominent effect of the three intervention groups noticed differently in context of BMI status, metabolic profiles, waist circumference and height. The reductions in the BMI scores over the course of 12 months suggest an almost similar range of results observed in the different intervention groups such as P, P+DA and WLC group. As per Jasik et al, the growth in BMI was observed predominantly in the WLC group at a rate of 45% as compared to 24% and 19% in the P+DA and P groups and therefore, indicates that the intervention or the exposure has presented a formidable impact through the administration of the intervention in measured proportions and thus obtain relevant responses (Jasik et al., 2015). The research results also nee d to be evaluated for relevancy to the topic of study. The findings in terms of variables such as waist circumference and BMI are considered as relevant to the study and the relevancy could be tested against the objectives of the research paper. As per the research of Gillette et al, First of all, the research objectives to find the impact of parenting skills and training on the reduction of obesity in children within the age group of pre puberty primarily range from 6 to 11 years (Gillette et al., 2014). The intervention groups were specifically designed to monitor the varying levels of impact of the parenting skills training and alternative support education for lifestyle improvement. Hence the research findings could provide a basic impression of the directions in which the research variables affect the outcome. Furthermore, the establishment of a control group serves as a precedent for the research activity as it illustrated the impact of non intervention groups on obesity manag ement. The findings observed in case of the WLC groups helped to obtain a frame of reference for comparing the findings of the P+DA and P groups. The findings obtained in the research paper were also indicative of references to the other influencing factors such as gender disparity, weight status, parental weight status and socioeconomic standing. However, the association of the research outcomes with evidence from earlier studies also deserves a profound mention as they help in reviewing the authenticity of the research findings in case of the present research topic. The ambiguities in precedents could also lead to several superfluous pitfalls in research findings which could be limited with the moderation of distinct facets such as methods for data collection, establishment of supervision standards and enhancing the data analysis methods (Golley et al., 2007). The correspondence of research outcomes with the exiting evidence from other studies could be helpful in determining the areas of insufficiency in the research activity and thereby impose remedial measures. The association of the selected research paper with other prof ound evidence refers to the research findings based in Israel. The evidences from the research also suggests the significance of parenting as a potential resource for managing issues of excessive weight in children prior to the age of puberty. The study was carried out on a sample population of 50 individuals comprising largely of children within the age group of six to eleven years. The reports from the research findings indicated that if parents assumed responsibility for managing weight issues of children prior to puberty, then the consistent follow up till a period of 8 years leads to induction of a formidable lifestyle modification. The participants i.e. children implemented major transformations in their lifestyles through the implementation of strategies by parents such as initiation and sustenance of recommended and healthy dietary habits. The other evidence acquired from the studies which are relevant to the selected research paper includes the reference to impression of pa rents that they have adequate information pertaining to child nutrition and therefore they are completely aware of the requirements of their children. This perception is also noticed in context of the selected research paper as the distinct intervention groups are designed with parenting skills training as the primary aspect of intervention alongside the improved and intensive training on lifestyle support. These factors are perceived as foremost influences on the parenting skills training and reduction in obesity of children and therefore relate to evidences in other studies and models. The implications of plausibility of the outcomes in context of a biological mechanism can be evaluated from the viewpoint of the physiological indicators determined from the research outcome. The metabolic health outcomes serve as the platform for validating the plausibility of research outcomes as biological mechanism and in this case, the differences were minimal and the impact of the intervention groups could be barely observed in context of the biological mechanism indicators. However, the findings were slightly altered in the first six months which indicate reduction in diastolic blood pressure and with limited variations at the end of 12 months. The comparative reduction in the six month duration could be validated by the impact of drastic changes in lifestyle (Friend et al., 2015). Generalisability can be perceived as the representation of external validity and it indicates the relevancy of application of research outcomes in case of the source population. The source population could be defined as the sample population subjected to study. The result findings indicate that the generalisability of the research outcomes can be verified from two distinct perspectives. First of all, the research outcomes have to applicable in the case of selected sample only and the second perspective refers to the overall population. Therefore, the study findings could be considered externally valid since the outcomes of the intervention applied for the research indicate profound association with changes in weight management strategies due to the improvement of parenting skills training. Furthermore, the individual research findings refer to the reduction in BMI scores of different intervention groups alongside the metabolic health profiles could be applicable in the case of presen t population. The evidences from the different case studies in the past such as in an Israeli research study indicate the feasibility of the outcomes in diverse contexts of population and thereby realize the prospects of external validation (Hughes et al., 2015). Apart from the minimal instances of critical gaps, the research findings are also applicable in a wider population context since the outcomes of the research indicate modification of lifestyle as well as behavioral traits of parents rather than embarking on management of the individual or the child for weight management. The application of the research outcomes for designing strategies incorporated with measures through which parents can initiate healthy and recommended diet practices for their children. The implications of socioeconomic and demographic factors have been minimal only with the exception of gender in the research outcomes and hence the outcomes could be considered as generalisable in context of the global pop ulation also. References Edmunds, L.D., Rennie, K.L., King, S. and Mayhew, H., 2014. Experiences of those Taking Part in the BeeZee Bodies Family-Based Weight Management Intervention: A Qualitative Evaluation.International Journal of Child Health and Nutrition,3(4), pp.163-169. Friend, S., Fulkerson, J., Flattum, C., Horning, M., Olson, C., Barlow, T. and Neumark-Sztainer, D., 2015. Cooking With Kids in Rural Minnesota: Family Meals and Interest in Family-Focused, Community-Based, Healthful-Eating Programs.Journal of Nutrition Education and Behavior,47(4), p.S9. Golley, R.K., Magarey, A.M., Baur, L.A., Steinbeck, K.S. and Daniels, L.A., 2007. Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children: a randomized, controlled trial. Pediatrics,119(3), pp.517-525. Gillette, M.L.D., Stough, C.O., Beck, A.R., Maliszewski, G., Best, C.M., Gerling, J.K. and Summar, S., 2014. Outcomes of a Weight Management Clinic for Children with Special Needs.Journal of Developmental Behavioral Pediatrics,35(4), pp.266-273. 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A longitudinal investigation of overweight children's body perception and satisfaction during a weight management program.Appetite,85, pp.48-51. Santa Maria, D., Swartz, M.C., Markham, C., Chandra, J., McCurdy, S. and Basen-Engquist, K., 2014. Exploring Parental Factors Related to Weight Management in Survivors of Childhood Central Nervous System Tumors. Journal of Pediatric Oncology Nursing,31(2), pp.84-94. Skelton, J.A., Martin, S. and Irby, M.B., 2016. Satisfaction and attrition in paediatric weight management.Clinical obesity. Twiddy, M., Wilson, I., Bryant, M. and Rudolf, M., 2012. Lessons learned from a family-focused weight management intervention for obese and overweight children.Public health nutrition,15(07), pp.1310-1317.