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Extraneous Variables
There are four main extraneous variables in the proposed study. First of all, parents health literacy might affect the success of education on lifestyle changes. Secondly, differences in medications used to manage childhood obesity could also influence the outcomes of the intervention. Lastly, the childrens lifestyle, such as diet and activity levels could contribute to the results of the study. The first two extraneous variables can be controlled by establishing inclusion and exclusion criteria (Grove, Gray, & Burns, 2015).
Prior to beginning the intervention, parents of potential participants should be given a health literacy test, and only the children of those with a specific level of health literacy would be included in the study. Similarly, medical intervention should focus on one medicine rather than on children who receive any medication for obesity management. Physical activity and exercise levels should be recorded, as they will contribute to the scope of the study. As it is anticipated that parental education will result in lifestyle changes, there is no need to control these two variables.
Instruments
The first instrument that will be used in data collection is body mass index (BMI). The BMI is measured by dividing a patients weight in kilograms by height in meters squared. This instrument is considered to have very high reliability (95%) and validity (84%), which allows using this measure in nursing research (Leatherdale & Laxer, 2013). Another instrument that will be used prior to data collection is the Health Literacy Questionnaire (HLQ), which is also widely used in health research. However, according to Hawkins, Gill, Batterham, Elsworth, and Osborne (2017), the validity of this instrument is rather low because it relies on the participants perceptions (56.5%).
The reliability of the HLQ is moderate and is estimated to be 65-70%. It would be possible to replace the HLQ with an original questionnaire targeting knowledge about lifestyle and obesity prevention specifically. In this case, it would be best to use Q-Sorting to determine the construct convergent and the construct discriminant validity, as well as Chronbachs test to determine the internal consistency of the tool (Taherdoost, 2016). These measures will help to test the validity and reliability of the new instrument.
Description of the Intervention
The research will seek to compare two different interventions: medical treatment of childhood obesity and the education of parents in healthy lifestyle and obesity prevention. The first intervention will include children using medications prescribed by a qualified physician to control obesity. The second intervention will consist of three one-hour education seminars and additional reading materials. Parental education will focus on the topics such as diet, physical activity, obesity risks and consequences, and calorie intake restriction for obese children. Supporting materials will also offer links to websites and contact information of local community resources that could help parents to educate children on healthy lifestyle and weight management.
Data Collection Procedures
Before the intervention, parents of potential participants will fill out a health literacy questionnaire, and the participants medical treatment information will be accessed using electronic health records. Children of parents with average health literacy scores will be included in the educational intervention group, whereas those using the same obesity medication will be included in the medical intervention group. The height, weight, and body mass index of all participating children will be recorded before the intervention and at monthly intervals for three months after the intervention. The researchers will use the same scales and stadiometers for each participant throughout the study to avoid measurement errors. The change in BMI before and after the intervention will be calculated for individual participants and for the two intervention groups.
References
Grove, S. K., Gray, J. R., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). St. Louis, MO: Elsevier.
Hawkins, M., Gill, S. D., Batterham, R., Elsworth, G. R., & Osborne, R. H. (2017). The health literacy questionnaire (HLQ) at the patient-clinician interface: A qualitative study of what patients and clinicians mean by their HLQ scores. BMC Health Services research, 17(1), 309-323.
Leatherdale, S. T., & Laxer, R. E. (2013). Reliability and validity of the weight status and dietary intake measures in the COMPASS questionnaire: Are the self-reported measures of body mass index (BMI) and Canadas food guide servings robust? International Journal of Behavioral Nutrition and Physical Activity, 10(1), 42-52.
Taherdoost, H. (2016). Validity and reliability of the research instrument: How to test the validation of a questionnaire/survey in a research. International Journal of Academic Research in Management, 5(3), 28-36.
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