Adolescent AND OBESITY.

This week focus on finding the evidence for your project proposal guided by your PICOT question and critically appraising that evidence. There are many resources available to you and a few examples are provided below.
•    Cochrane Library (South’s Online Library)
•    CINAHL Plus with Full-Text (South’s Online Library)
•    Joanna Briggs Institute Library
•    AHRQ Evidence Reports
•    Guidelines Clearinghouse
As you identify literature you will use the Rapid Appraisal (RCA) Checklists to appraise the literature. The following checklists are available and can also be found in Appendix D of your text (Melnyk&Fineout-Overholt, 2011).
•    Rapid Critical Appraisal Checklist for Case-Control Studies
•    Rapid Critical Appraisal Checklist for Cohort Studies
•    Rapid Critical Appraisal Checklist for Randomized Clinical Trials
•    Rapid Critical Appraisal Checklist for Systematic Review of Clinical Intervention Studies
•    Rapid Critical Appraisal Checklist for Qualitative Evidence
•    Rapid Critical Appraisal Checklist for Evidence-Based Clinical Practice Guidelines
You will also find the Templates for the Evaluation and Synthesis Tables for Conducting an Evidence Review in Appendix E of your text.
The Evaluation table, the Synthesis Table of the RCAs and the Evaluation and Synthesis Tables are available below.
PICOT question using the format: In Adolescents (P) how does  significance of nurse practitioner’s  role which include teaching education and screening (I) compare to parents role in terms of food selection (C) affect the rise in Obesity (O) overt  3 to 6 months period (T)?
This is the evidence table to use

First Author
(Year)    Conceptual Framework    Design/Method    Sample & Setting    Major Variables Studied (and their Definitions)    Measurement    Data Analysis    Findings    Appraisal: Worth to Practice

Search Tracker

PICOT question organizer

P    Population    Adolescents
I    Intervention or
Issue of interest    Obesity
C    Comparison     Significance of nursing roles, and parents role
O    Outcome     Effective teaching, weight loss, self –efficacy; healthy food choice,  &improved physical activity.
T    Time frame    3 to 6 months,

Search Tracker to use

Search  #    Initial search terms    Database    And/Or?    Added search terms    Title (Ti)
Anywhere, etc.    # of articles found

Synthesis Table Templates

1    2    3    4    5    6    7    8    9    10    11    12
Level I: Systematic review or meta-analysis
Level II: Randomized controlled trial
Level III: Controlled trial without randomization
Level IV: Case-control or cohort study
Level V: Systematic review of qualitative or
descriptive studies
Level VI: Qualitative or descriptive study
(includes evidence implementation
Level VII: Expert opinion or consensus

1    2    3    4    5    6    7    8    9    10    11    12

Studies    Design    Sample    Outcome

Use 5 researched articles that is less than or 5 years old.
•    Evidence review and synthesis
o    List the names of the databases you searched and if limited to a span of time, i.e., less than 5 years old
o    Summarize “keeper” studies
o    Summarize the synthesis of the body of evidence
•    Purpose of the project – include intervention
•    Theoretical framework
•    Clinical questions
•    This week you will submit the completed Evaluation Table that includes  your “keeper” studies. This will be added to your final paper as an Appendix. You will also turn in the Search Tracker so faculty can see the steps you took to locate the evidence. This will not become a part of your paper, but it is for feedback only should faculty deem that necessary.
•    By Thursday, October 7, 2015, submit your paper for faculty feedback.
Assignment 1 Grading Criteria     Maximum Points
Search Tracker shows path for searches    10
Columns of the Evaluation Table contain appropriate information from which decisions can be made    15
Acronyms are explained below table    15
Table is neatly done and readable    10
Total:    50

Part 2 of your project proposal, the evidence review and synthesis section. This section consists of narrative descriptions of each study that forms the body of evidence. The length of this section will vary based on the number of studies that you include. The paper should be written in a scholarly fashion using APA format. For each article include in the narrative:
•    Authors’ names, date of publication (included in the citation).
•    Quality and level of evidence
•    How significant (or not) the evidence is and why you think so. How are these articles relevant to change practice or policy for your specific practice site and population? If a study is not significant and you have included it, mention how your clinical expertise was involved in this decision.
•    Your summary the synthesis section should clearly indicate the intervention you plan to use in your project proposal. You will discuss this in greater detail in the next section, but do leave the reader with the understanding of the intervention you chose.
You will also turn in your completed Synthesis Table(s) that will become part of your Appendix in your final paper.

Part  2 Grading Criteria     Maximum Points
Scholarly narrative descriptions of studies forming the body of evidence that included all the important elements: authors’ names, date of publication, and quality and level of evidence.    15
Significance of study or influence of clinical expertise    10
Brief description of the intervention chosen      5
Synthesis Table    15
Used current APA style for references and title page.    5
Total:    50

This week, the task is to formulate a plan to begin your literature search using words from your PICOT question as search terms, combining those terms with MESH terms to expand or contract your search, and tracking your search to avoid retracing your steps. Use the Search Tracker to keep a record of your steps. The goal at the end of this week is to have  articles appraised and added to the Evaluation Table, Next  complete your Evaluation Table that will contain only the “keeper” studies. “Keeper” studies are those you have appraised using the appropriate Rapid Critical Appraisal (RCA) checklist and have deemed potentially useful for your project proposal.
Locating evidence and appraising it can be approached in two ways. You can appraise each article as you read the abstract using the appropriate RCA checklist. Or, you can save a copy of all the articles you find and appraise them all later. From an article’s abstract alone, you can often determine if the study is pertinent, which makes the appraisal process faster. However, if the abstract does not provide adequate information, you may not want to take the time to appraise as you go.
Regardless of the approach you take, once you locate articles in your search you should save a copy. This process can be accomplished in several ways. Most databases allow you to save articles in a folder that you create within the database. Another approach is to save the articles to a folder you have created on your computer’s hard drive. As you are moving forward with your search, encountering the same articles over and over is an indication that your search has reached its limits.
Once you have critically appraised the studies you found, the next step is to add those that have merit to the Evaluation Table. If you are unsure about a study, add it to the table so that you will not have to go through the appraisal process again. You will have saved the pertinent information. You can always delete the study from your Evaluation Table later.

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