Project Change Proposal


Project Change Proposal

Project Change Proposal

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Project Change Proposal


Students will develop a 1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

  1. Background
  2. Problem statement
  3. Purpose of the change proposal
  4. PICOT
  5. Literature search strategy employed
  6. Evaluation of the literature
  7. Applicable change or nursing theory utilized
  8. Proposed implementation plan with outcome measures
  9. Identification of potential barriers to plan implementation, and a discussion of how these could be      overcome
  10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide.


  • attachmentLiteratureReview_to_use.docx
  • attachmentPICOT_to_use.docx
  • attachmentsample_to-use.docx



Literature Review




Literature Review

Childhood obesity is one of the leading public health issues facing the United States of America. This problem is characterized by children having a Body Mass Index (BMI) of more than 30. The rate of childhood obesity in the United States has been increasing significantly in the past decade. This has put many children at the risk of physical, social, and psychological issues; some of which are extended to their adulthood. Therefore, it is important to study this problem and develop interventions that can help reduce the rate of obesity in children. This study was designed to provide an evidence-based solution to obesity in children. The PICOT statement, “children with a BMI above 30 who are undergoing nutritional monitoring compared to not being monitored nutritionally can achieve significant weight loss in a period of a year” will be answered with help of a study aiming at evaluating how diet changes can be helpful in reducing the rates of obesity. This paper evaluates literature on childhood obesity, which helps to understand information on the public health issue that can be used to develop better interventions. Project Change Proposal

Comparison of Research Questions

The literature that has been included in this research mainly focuses on the causes and the effects of childhood obesity. Some of the studies evaluate the effects in childhood while others evaluate the adulthood effects. There are also studies on prevention and intervention methods for dealing with the public health issue. The study by GBD 2015 Obesity Collaborators (2017) has a different approach because it evaluates the trends in obesity across the world. This research is important because it helps to understand the extent of childhood obesity as a public health issue not only in America, but also in other countries. Project Change Proposal

Sahoo et al. (2015), evaluates the causes and effects of childhood obesity. The research takes an overall approach in evaluating all types of causes and effects of obesity in children. Xu and Xue (2016) also have a similar research question. This research also evaluates the causes and effects of obesity but is extended to evaluate the prevention strategies to avoid the occurrence of obesity in children. These two studies help to understand more about the factors that cause obesity in children, which is helpful in developing the intervention for this research. Other studies that have investigated the effects of childhood obesity pay attention to the possible effects in adulthood. Ayer et al. (2015) investigates the possible lifetime risks of cardiovascular disease because of childhood obesity. The authors hypothesize that a person has a higher lifetime risk of cardiovascular disease if they are overweight or obese as a child. Simmonds et al. (2016) investigates the risk of being obese as an adult when one is obese as a child. The study’s research question asks whether the risk of obesity in adulthood is increased by childhood obesity.

The remaining studies evaluated in the literature answer research questions aiming at understanding the dynamics of prevention and intervention techniques for childhood obesity. Oelscher et al. (2015) seeks to understand whether a system’s-based approach would work better than a primary based approach in preventing obesity in low income and ethnically diverse communities. Allender et al. (2016) evaluates how community action can influence childhood obesity prevention initiatives. Lastly, Davis et al. (2016) investigates whether mothers’ perceptions on obesity risk factors influence the rate of obesity in the communities. These three studies help to give an insight into the effective strategies of preventing and reducing obesity in children.

Comparison of Sample Populations

Half of the studies evaluated for this study were reviews of other studies done in the past either in the form of systematic literature reviews or meta-analyses. Sahoo et al. (2015) evaluated literature reviews but does not mention the methodological process; hence, the sample size is not clear. Similarly, Xu and Xue (2016) has a random evaluation of literature with no review of the methodology; hence, the exact sample is unknown. Ayer et al. (2015) sample is made up of primary cohort studies on cardiovascular disease and obesity. The study evaluates 8 research studies to with a total sample of over 300 participants. Lastly, Simmonds et al. (2016) conducted a meta-analysis that included 15 cohort studies with a total sample size of 200,777 participants.

The remaining literature includes primary studies. Oelscher et al. (2015) conducted a primary study with 576 children between 2 and 12 years as the participants. Allender et al. (2016) also did a primary study with a sample of 5050 children from 84 primary schools as the participants. GBD 2015 Obesity Collaborators (2017) performed a study of 67.8 million people in 175 countries across the world. Lastly, Davis et al. (2016) only had 40 Mexican American mothers as the participants of the research.

Comparison of the Limitations of the Studies

The most common limitation in the selected studies is in the sample size of the studies. Sahoo et al (2015) and Xu and Xue (2016) fail to mention the sample selection process. Therefore, the applicability of the information they present is limited. Davis et al (2016) only used 40 Mexican-American women in their study. This is a very small sample to apply the results to a wider community and includes the members of only one community. Therefore, cultural factors such as the beliefs and attitudes of Mexicans towards factors affecting obesity could affect the results. Oelscher et al. (2015) also has a very small sample of slightly above 500 kids; hence, the results may not be representative of the entire population. The limitation of GBD 2015 Obesity Collaborators (2017) study is that it is done in many countries but does not evaluate the unique cultural factors that affect obesity rates in each of the populations evaluated. It may be unwise to generalize the results for all populations.


Generally, there is consistency is the results of the studies evaluated in this literature review. All the studies show obesity as a serious public health issue regardless of the population within which the study has been conducted. The causes and effects of obesity are also similar in the studies that evaluate these factors. The prevention and intervention techniques that have been examined also revolve around diet and exercise in all studies.


Allender, S., Millar, L., Hovmand, P., Bell, C., Moodie, M., Carter, R., … & Orellana, L. (2016). Whole of systems trial of prevention strategies for childhood obesity: WHO STOPS childhood obesity. International journal of environmental research and public health13(11), 1143.

Ayer, J., Charakida, M., Deanfield, J. E., & Celermajer, D. S. (2015). Lifetime risk: childhood obesity and cardiovascular risk. European heart journal36(22), 1371-1376.

Davis, R. E., Cole, S. M., Blake, C. E., McKenney-Shubert, S. J., & Peterson, K. E. (2016). Eat, play, view, sleep: Exploring Mexican American mothers’ perceptions of decision making for four behaviors associated with childhood obesity risk. Appetite101, 104-113.

GBD 2015 Obesity Collaborators. (2017). Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine377(1), 13-27.

Oelscher, D. M., Butte, N. F., Barlow, S., Vandewater, E. A., Sharma, S. V., Huang, T., … & Oluyomi, A. O. (2015). Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Childhood obesity11(1), 71-91.

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care4(2), 187.

Simmonds, M., Llewellyn, A., Owen, C. G., & Woolacott, N. (2016). Predicting adult obesity from childhood obesity: a systematic review and meta‐analysis. Obesity reviews17(2), 95-107.

Xu, S., & Xue, Y. (2016). Pediatric obesity: Causes, symptoms, prevention and treatment. Experimental and therapeutic medicine11(1), 15-20.

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