[100 to 150 words]

·         State your clinical question or topic for your capstone project proposal.

·         What issue is the question/topic addressing?

·         What are the reasons you selected this question/topic?

Q1. State your clinical question or topic for your capstone project proposal

Will obese children from the community benefit from dietary and physical activity guidance compared to having no nutritional or physical activity education, in a manner that will reduce weight and health-related concerns over the next 5 years?

Q2. What issue is the question/topic addressing?

The primary focus of this capstone project is to explore the benefits of dietary and physical activity in reducing weight and health-related concerns associated with childhood obesity. Also, the capstone project proposal emphasizes comparing dietary and physical activity guidance and the absence of nutritional or physical activity education in alleviating the effects and complications associated with childhood obesity.

Q3. What are the reasons you selected this question/topic?

Childhood obesity is a risk factor for life-threatening health conditions such as hypertension, high cholesterol, type 2 diabetes mellitus (T2DM), asthma, and multiple psychological complications, including anxiety, depression, low self-esteem, and stress (Centers for Disease Control and Prevention, 2022). Dietary and physical activity education are among recommended evidence-based practices for addressing childhood obesity and its complications. As a result, it is essential to explore the effectiveness of these interventions in addressing childhood obesity.

[200 to 250 words]

Address the following questions/bullets in completing this section:

·         Start at the starting point – What, Where, When, Why, and How?

·         What is known about this topic or what is the evidence on this topic (Scoping Search)?

·         What is the outcome of interest?

·         What are the gaps in our understanding or knowing related to this topic?

The proposed project focuses on testing the impacts and effectiveness of dietary and physical activity guidance in preventing childhood obesity and related complications. The target population is school-aged children from (enter the local community). The estimated time for assessing the project’s desired outcome is 5 years. The intervention group will participate in personalized dietary and physical activity guidance, including education programs. The primary reason for implementing this project is to prevent childhood obesity and related health complications, including asthma, type 2 diabetes, high cholesterol, hypertension, and psychological complications like depression and low self-esteem.

Q2. What is known about this topic or what is the evidence on this topic?

Plenty of scientific studies provide insights into the risk factors for childhood obesity, its epidemiology, complications, and preventive interventions. According to Pereira & Oliveira (2021), the major risk factors for childhood obesity include genetics and a permissive obesogenic environment, including access to fast food outlets. Also, socioeconomic determinants such as poverty, limited access to physical exercise infrastructure, and food insecurity increase the prevalence of childhood obesity (Pereira & Oliveira, 2021). This study recommends personal-based educational approaches like nutrition/diet education sessions, promotion of physical activity, and advertising restrictions for fast food as ideal strategies for preventing childhood obesity.

Q3. What is the outcome of interest?

The desired outcome of the project proposal is the post-intervention reduction of weight and the alleviation of health-related concerns associated with childhood obesity. The project targets to reduce childhood obesity-related health concerns like type 2 diabetes mellitus (T2DM), asthma, high cholesterol, and psychological issues, such as depression, anxiety, and low self-esteem.

Q4. what are the gaps in our understanding or knowledge related to this topic?

This proposed project focuses on investigating and addressing knowledge gaps regarding the effectiveness of dietary and physical guidance (education) to in addressing childhood obesity and related health complications. The current literature reports mixed findings on the effects of the proposed interventions. Therefore, it is essential to address the knowledge gap in the current research by implementing the project.

[150 to 200 words]

Provide details of your exhaustive search process. Be certain to list:

Databases searched.

·         PubMed

·         BMC Public Health

·         European Journal of Clinical Nutrition (EJCN)

·         Multidisciplinary Digital Publishing Institute (MDPI)

·         Google scholar

·         Elsevier

All the keywords or search phrases used.

·         Childhood obesity

·         Physical activity and childhood obesity

·         Nutritional education and childhood obesity

·         School-based nutritional programs

·         Childhood obesity prevention

How many articles in total that were found?

·         The search yielded 24 journal articles

List the inclusion/exclusion criteria.

·         Publication date (2018-2023)

·         Complete articles (journals with abstract only were excluded)

·         Consistency with the PICOT question

·         Peer-review

·         Focus on the study variables

Provide the number of articles that were retained and a description on why those articles were retained.

5 journal articles were retained because they fulfilled the inclusion criteria. For instance, they were published within the last five years (2018-2023), were complete articles, and focused on the study’s variables, primarily the effectiveness of physical activity and nutritional education in addressing childhood obesity.

·         Consider using a flowchart to outline the search process.

[500 to 1000 words]

Conduct a review of the literature. Include at least five (5) research articles and/or evidence-based guidelines. Address the following questions/bullets in completing this section:

·         Conduct a review of the literature.

·         Provide the highlights from the research.

·         Synthesize the literature on the topic.

·         Summarize how the project will contribute to knowledge by filling in gaps, validating, or testing knowledge.

·         Cite references in this section per APA and list the reference in the References section at the end of the form.

Many qualitative, quantitative, and mixed-methods studies explore the effectiveness of physical activity promotion and dietary guidance in preventing childhood obesity and alleviating the associated complications. The major themes in the current scholarly literature consistent with the topic include school-based nutritional programs, the role of parents in preventing childhood overweight and obesity, and the contribution of an integrated approach in combatting childhood obesity.

Physical Activity Promotion and Childhood Obesity

In a comprehensive literature review, Wyszynska et al. (2020) present the role of physical activity in preventing excessive body weight and provide evidence-based, age-appropriate recommendations for physical activity (PA). According to Wyszynska et al. (2020), physical activity refers to “any bodily movement produced by the contraction of skeletal muscles that raise energy expenditure above the metabolic rate” (p. 2). The characteristics of physical activity include its modality, frequency, intensity, duration, and context of practice (Wyszynska et al., 2020). Exercise is a profound example of planned physical activity since its structured, repetitive, and favors physical fitness, development, and maintenance.

The contribution of physical activity in the prevention of childhood obesity obtains backing from the reviewed scholarly articles. According to Wyszynska et al. (2020), obesity is a complex, multifaceted health problem prevalent due to various risks, including individual, sociocultural, and environmental factors. Environmental factors encompass school facilities and exercise opportunities central to healthy weight management practices. Children can utilize physical environments in homes and schools to promote healthy behaviors. Wyszynska et al. (2020) argue that walkable neighborhoods, access to parks, and recreational facilities are essential resources in preventing childhood obesity. However, these resources can only guarantee favorable outcomes with input from teachers and parents. Wyszynska et al. (2020) recommend strategies for promoting physical activity in schools and homes. These recommendations include encouraging children to be active during break times, increasing the number of mandatory hours of physical education classes, limiting or discouraging sedentary behaviors, developing an active lifestyle-supportive environment, and creating a safe indoor living environment with stimulating physical activity toys.

These recommendations obtain support from a study by Juric et al. (2023). In this study, the researchers examine the effectiveness of a real-world, population-scaled, school-based physical activity (PA) intervention in preventing childhood obesity. The study involved more than 34000 participants from over 200 schools in Slovenia and compared the intervention group with a similar number of nonparticipants from the same schools. The study revealed a significant difference in BMI (Body Mass Index) between the intervention and the control group, confirming the effectiveness of school-based physical activity intervention in preventing and treating childhood obesity.

Dietary Guidance and Childhood Obesity

Like physical activity, many scholarly studies explore the importance of a healthy diet in preventing and treating childhood obesity. In a quasi-experimental study conducted in primary schools in Gujarat, India, Raval & Soni (2022) investigated how physiotherapy interventions and dietary awareness can help manage childhood obesity. The researchers exposed the Intervention group (n=15) to physical activity alongside diet awareness programs for three months. The study revealed a significant difference in waist circumferences and waist height ratio in the experimental and control group (p< 0.005) (Raval & Soni, 2022). This finding supported the conclusion that three months of physical activity and diet awareness programs profoundly prevent and treat childhood obesity.

Early awareness of healthy behaviors and lifestyle choices can be essential in preventing childhood obesity. Navidad, Padial-Ruz & Gonzalez (2021) state that dietary choices are the primary risk factors for childhood obesity and overweight. For instance, children consume ultra-processed food products with refined sugars and a high content of fats instead of the recommended constituents of a healthy diet, including vegetables, legumes, and cereals. These unhealthy foods expose children to obesity and increased risk of cardiovascular diseases, depression, cerebrovascular conditions, and premature mortality (Navidad, Padial-Ruz & Gonzalez, 2021). Educating parents on healthy diet choices and the potential consequences of unhealthy foods is a practical intervention for modifying behavior and preventing childhood obesity (Verduci et al., 2022). The effectiveness of diet assistance programs relies massively upon an integrated approach by governments, community-based organizations (schools), teachers, healthcare professionals, and parents.

How the project will contribute to knowledge by filling gaps, validating, or testing knowledge

Although the current scholarly literature explores the impacts of various interventions in preventing and treating childhood obesity and related complications, only a few strategies yield positive outcomes (Lambrinou et al., 2020). Physical activity (PA) promotion and diet assistance are among the most explored approaches for addressing childhood obesity, considering the linkage between sedentary lifestyles and unhealthy diets and an increased risk of obesity and overweight. The effectiveness of these interventions is consistent with contextual factors like the collaboration between healthcare professionals, teachers, school management, and parents. Also, contextual aspects, such as social determinants of health (SDOH), influence the outcomes of these preventive measures. As a result, this project focuses on addressing knowledge gaps regarding the importance of physical activity and nutritional assistance in preventing and treating childhood obesity by exploring contextual factors and issues that affect the success of these approaches. Secondly, it seeks to build on an exhaustive literature review to inform recommendations for practice improvement and the conclusion that physical activity and nutritional assistance can prevent childhood obesity.

PICOt Question

State your PICOt question here. Use the elements of the PICOt in separate sections below to describe each component.

·         Population – Provide the description of the targeted population.

·         Intervention – Describe your evidence-based intervention.

·         Comparison – What is currently happening?

·         Outcomes – List at least two (2) measurable outcomes.

·         time – What duration of the study for the project? (e.g., usually 6 months or 3 months)

Clinical question: Will obese children from the community benefit from dietary and physical activity guidance compared to having no nutritional or physical activity education, in a manner that will reduce weight and health-related concerns over the next 5 years?

Population(P): Obese children from the community

Intervention (I): Dietary and physical activity guidance

Comparison (C): The absence of nutritional or physical activity education

Outcomes (O): (I) Weight reduction

(II) Prevention of obesity-related health complications

time (t): 5 years

[75 to 100 words]

Address the following questions/bullets in completing this section:

·         Who is your target population?

·         Describe your population, i.e., age, ethnicity, gender, condition/diagnosis, etc.?

·         Describe the setting where this project be implemented?

The target population for the project is school-aged children

Description of the Population

The proposed project targets school-aged children (6-12 years) living in Jacksonville, Florida. The inclusion criteria for the potential participants include a diagnosis of obesity and overweight, age (6-12 years), and ethnicity (Black and Latino children).

Description of the setting

The project will take place in Jacksonville, Florida. Jacksonville is the seat of Duval County and is ideal for the project, considering the need to promote healthy behaviors. According to County Health Ranking & Roadmaps (2023), about 28% of people in Duval County embrace sedentary lifestyles, while 10% of the population grapples with limited access to healthy foods. These factors predispose people to an increased risk of overweight and obesity. Therefore, implementing this project in this setting would result in positive health outcomes for children struggling with overweight and obesity.

[100 to 200 words]

Address the following questions/bullets in completing this section:

·         What are you planning to investigate or implement as a policy/process or program?

·         What are you doing that is different than what is currently happening?

·         List 2-3 potential actions that will be applied in this practice change.

NOTE: Be very specific in your description.

The purpose of the proposed project is to investigate the effectiveness/benefits of dietary and physical activity in reducing overweight and health-related concerns associated with childhood obesity, including an increased risk of chronic conditions like high blood pressure, heart disease, type 2 diabetes mellitus (T2DM), and respiratory complications.

What are you doing that is different from what is currently happening?

It is essential to note that many scholarly studies and current practices emphasize physical activity and nutritional guidance as profound evidence-based strategies for preventing overweight and averting health issues associated with childhood obesity. Therefore, the proposed project will also explore the role of parents’ dietary choices and lifestyle changes in contributing to childhood obesity.

List 2-3 potential actions that will be applied in this practice change

The implementation phase of the proposed project will include various activities, including;

• Explaining and disclosing information regarding the project to parents and young participants to obtain consent and establish a rapport.
• Distributing surveys and questionnaires
• Interviewing parents and obtaining transcripts to inform data analysis instruments

*For purposes of this Proposal Project Form the assumption will be that the C (Comparison Group) is ‘traditional care or current care’

[100 to 150 words]

(1). Achievement of thresholds for appropriate body weight

(2). Enhanced knowledge of healthy dietary choices for parents

(3). Prevention of obesity-related health complications.

What outcomes will be measured?

• Weight management
• Parental awareness of healthy dietary choices
• Long-term prevention of obesity and related health complications.
• Maintenance of appropriate variables, including participants’ blood pressure and sugar levels.

How do you plan to do this?

Formative and summative evaluations will enable adequate assessment of pre-and-post intervention effectiveness. Formative assessments will occur during the initiative’s implementation, while summative evaluations will occur at the end of the intervention.

What tools will you be using to measure your outcomes?

Surveys, interviews, and pre-and post-intervention changes in body mass index (BMI) will provide qualitative and quantitative data necessary for measuring the project’s outcomes.

What data will be used to validate the success of the project?

Qualitative data regarding improved parental awareness of physical activity and nutritional guidelines for children, alongside quantitative data on the post-intervention reduction of body mass Index will validate the project’s success.

How will you know if your intervention resulted in change?

The post-intervention achievement of the recommended threshold for body mass index (BMI) for children (16-22) and improved parental awareness and implementation of healthy diet choices will signify that the intervention resulted in change. Also, effective obesity and overweight management will render the project successful.

[200 to 250 words]

·         Provide a summary for your MSN Capstone Project.

·         Select and provide the rationale for three (3) competencies or specialty standards that you would expect to use in implementing this project [List of your specialty competencies are listed in the Week 9 Reflection Post]

9. 2 References

[Minimal of 5 research articles and references are paged on the last page.]

·         Add your references in APA formats on the last page.

The proposed MSN capstone project aims to explore the effectiveness of dietary and physical activity guidance in reducing childhood overweight/obesity and health-related concerns. The project derives inspiration from the overarching need to prevent co-morbidities associated with childhood obesity, including hypertension, type 2 diabetes mellitus, depression, stress, asthma, and low self-esteem. If these complications are not appropriately addressed, they may exacerbate more adverse outcomes, including premature mortalities, poor quality of life, disability-adjusted life years (DALYs), and massive economic burdens on families, communities, and healthcare systems. Dietary interventions and physical activity are profound non-medical interventions that significantly improve the health outcomes of at-risk populations.

By implementing this project, I would apply various competencies and specialty standards, including competency 1, which entails scientific foundations of analyzing and applying data to assess, enhance, and improve healthcare delivery. Secondly, competency 4 (practice inquiry) requires MSN-prepared nurses to provide leadership in translating new knowledge into practice, generate knowledge from clinical practice, and apply clinical investigative skills to improve health outcomes. Finally, I would apply Competency 6, which encompasses policy objectives and expectations. MSN-prepared nurses should understand the relationship between policy and practice, advocate for policies that improve care quality, and utilize external evidence to support policy development. These competencies are consistent with various standards of professional practice, including Standard 1 (Assessment), standard 2 (Diagnosis, Problems, and issues identification), Standard 3 (outcomes identification), standard 9 (Evidence-based Practice and Research), and Standard 10 (quality of Practice).