Integrating Evidence into Practice

This individually completed assignment is worth 30% of the marks for the subject. In order to complete the assignment, you are required to do the following:
a) Develop and refine, using a structured approach, a relevant and answerable practice-related question that can be used in developing a search strategy to find evidence that EITHER relates to the effects of a health-related intervention (as specified by your discipline) OR relates to the risk/causal factors for a disease or other health condition (as specified by your discipline). You are required to use the refined practice-related question to develop a search strategy, and to use this strategy in conducting complex and comprehensive searches of a database(s)/other repositories of evidence, (as specified by your discipline) to identify papers/articles, each of which reports: a research study that investigated the effect(s) of ahealth-related intervention (as specified by your discipline);OR a research study that investigated the risk/causal factors for a disease or other health condition (as specified by your discipline). The refined practice-related question; and the key words of the search strategy and the database tools/features that were utilised as part of the search strategy (e.g. MeSH headings; Boolean operators; truncations; wildcards; limits) are to be provided in section 1 of the template (see below), and the search output is to be included as an appendix to the template.
b) Select one paper/article from the list of papers/articlesposted on your discipline’s section of the La Trobe University Learning Management System (LMS)homepage for the subject. You are to search for and find the full text of theselected paper/article.An appraisal of this paper/article is to be conducted, and reported as per sections 2-4 of the template (see below).
This assignment is to be completed in 1,250 words (approximately), excluding: the details in the preface section of the template;all text that is part of the template;the reference list (of cited sources), if any; and the appendix.Any in-text citations (and the associated reference list) need to be in keeping with APA style. Note that, in the template, boxes, and cells in tables, will automatically expand in size as you enter text into them. You should scrutinise the template before commencing the task.The Subject Intended Learning Outcomes (SILO) being assessed by this assignment are selected aspects of SILO 1-4.
The due date and time for submission of the Assignment is Monday May 9 2016, 9am.Before submission, you must first subject your assignment to Turnitin, (via the Individual Assignment Turnitin link in the Assessment section of the LMS homepage for the subject). This version of the assignment should be a plain Word document of your own words only (i.e. without these instruction pages and the preface page;text that is part of the template;the reference list, if any;and the appendix.Once you receive a satisfactory Turnitin report, incorporate the text (from the document of your own words only) into the template, add the list of references (if applicable), and the appendix.
Submit a copy of your final version of the assignment, as a Word document,via the Individual Assignment Submission link in the Assessment section of the LMS homepage for the subject.
 

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1. Practice-related question and search strategy (5 marks)
In this section you should:
• Describe the development of your practice-related question using a structured approach, and provide the final wording of the question itself. (2 marks)
• Specify the key words of your search strategy, and the database tools/features that were utilised as part of the search strategy (e.g. MeSH headings; Boolean operators; truncations;wildcards; limits). (3 marks)
The search output should be attached to this template as an appendix.
To response the scenario and focus on the modifiable lifestyle habits that may contribute the development of overweight, which are diet and physical activity. Thence, intervention will be specifying as diet and physical activity in the structure approach.

The structure approach to develop the practice-related question:
Population:adults
Intervention:diet and physical activity
Comparison: not applicable
Outcome:weight reduction

Therefore, the developed practice-related question is “How effective diet and physical activity can cause weight reduction among obesity in adults?”

The keywords that narrow down the research for the practice-related question in different categories are:
Population: adults, women, men, female, male
Intervention: diet, physical exercise*, lifestyle
Comparison: N/A
Outcome: weight reduction, weight loss, lose weight, reduce body weight
Limitations: English language, last 5 years

Medline 1996 (OVID) will be used as a database tool to be part of the search strategy and the search history is attached as appendix. The searching technique such as limitations, truncations and wildcards were also applied to specify the search area.
And the final selected article is:
Christensen, J. R., Faber, A., Ekner, D., Overgaard, K., Holtermann, A., & Sogaard, K. (2011). Diet, physical exercise and cognitive behavioural training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers – a randomized controlled trial. BMC Public Health, 11:671 doi: 10.1186/1471-2458-11-671

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2. Study quality (10 marks)
(i) Evaluation of the methodological soundness of the study reported in the selected paper/article. This evaluation may be aided by, but not limited to, the use of a tool(s)/checklist(s)/other criteriaset(s) (as specified by your discipline). (4 marks)
The found article addresses the trial focusing on the intervention group, which is the health care workers. This study demands all participants working at least 15 hours per week in the project for the recruitment. Only 98 of 202 employees met the full criteria to enter the target group and 144 consenters passed the baseline test and became reference group.
98 female overweight health care workers were cluster-randomised and evaluated the effects in first 3 months. Anthropometrical measurement was used and estimated as the intervention focus during the study, such as body weight and musculoskeletal pain.The people participating the trial are randomly allocated to receive treatment equally, which can minimize the bias while in receiving treatment.
Standardised and validated scales questionnaires are used in single-blinded randomised control trial study method and they were possible consent to be returned in a sealed envelope.The questions in it were The patients were not aware that they were receiving the active treatment in single-blinded trials. Itcontrols the participants’ opinion are not being affected by any elements and ensure the validityof the treatment.

 

(ii) Bias that can potentially impact upon a study of the type reported in the selected paper/article (5 marks)
Use single line spacing when completing this table.
Type of bias Definition Answer the following questions with regard to the study reported in the selected paper/article.
• Has this type of bias affected the study (Yes/No) and, if so, how?
• Has this type of bias been avoided in the study (Yes/No)and, if so, how?
Attrition bias It is the systematic differences between the control and experimental groups in withdrawals from the study (Cochrane, 2011 ).
Selection Bias Allocation of subjects into groups by the interferences from researchers will results in unbalanced groups that introduce bias into the study (Abdelhamid, 2005).

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Is the quality of the study so poor that any observed effect(s) can be explained by the biases?
Yes 0 No 0

(iii)All things considered, is the studyof sufficient quality (i.e. sufficiently valid) to warrant its use to inform practice? (1 mark)
Yes 0 No 0

 

3. Study results(5 marks)
In this section you should outline the results of the study reported in the selected paper/article. This outline should include identification of statistically significant effects and, for each of these effects, identification of the values of the associated statistics (the population effect size estimate and the 95% confidence limits for this estimate; or the value of the statistic (e.g. the t value), and the applicable degrees of freedom and the p value).

 

4. Clinical/practical importance of the study findings(10 marks)
(i) With reference to one of the statistically significant effects reported in the selected paper/article, specify what could be considered to be a minimum clinically or practically significant or important effect size,for an effect of this type, and provide a rationale for what you specify. (4 marks)
(ii) Decide if the effect (as per (i) above) is clinically or practically significant or important, and provide a reason for this decision (based on what you have outlined for (i)above). (2 marks)
(iii) Provide a recommendation for practice and a rationale for this recommendation, which relates to and is based on your decision (and the reason for this decision)about the clinical or practical significance or importance of the effect(as per (ii) above). (4 marks)

 

References

Christensen, J. R., Faber, A., Ekner, D., Overgaard, K., Holtermann, A., & Sogaard, K. (2011). Diet, physical exercise and cognitive behavioural training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers – a randomized controlled trial. BMC Public Health, 11:671 doi: 10.1186/1471-2458-11-671

Appendix