Importance Of Research In Nursing And Promoting Physical Fitness Among Aboriginals

Definition of Research

The main clinical issue that will be highlighted in this evidence-based nursing report is physical inactivity leading to obesity among the aboriginals. According to the PHN Darling Downs and West Moreton, an Australian Government Initiative (2018), there is no or little exercise among the people who are aged 18 years and above. The Darling Downs and West Moreton PHN secure the first position in Australia for the highest rate of the physical inactivity. As per the reports of the Australian Burden of Disease Study, high body mass index (BMI) is the single leading risks factors for increasing the disease burden by 7%. Increase in the trend of obesity increases the disease burden for endocrine disorders, cardiovascular disease, kidney or renal complication, urinary disease and cancer. This disease cumulates the overall disease burden by 31%. The trend of obesity is higher among the aboriginals. According to Health Assessment Needs (2018) Darling Downs and West Moreton have highest population of aboriginals with more than 500 residents in comparison to the entire state (Queensland). The majority of the aboriginals who resides in Darling Downs and West Moreton are obese and the main reason highlight behind this is lack of physical activity. As per the evidence-based practice it is the role of the nursing professional to educate the youth for indigenous and non-indigenous population among the importance of physical fitness and combating obesity.

How the evidence-based practice of education from nurses helps to increase the health awareness among the aboriginals about the physical fitness and thereby helping to decrease obesity?

Population (P)	Aboriginals
Intervention (I) Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper	Health-education about the physical fitness and awareness about physical health
Comparison (C)	No health-education
Outcome (O)	Increase in physical fitness and decrease in vulnerability of developing chronic disease

PICO elements	Keywords	Search terms	Search strategies
P (Patient or Population)	Aboriginals	Aboriginals	Aboriginals OR Indigenous population OR Torres Strait Islanders
I (Intervention)	Education and awareness	Community education	Community based education OR Community Awareness
C (Comparison)	No education and awareness programs
O (Outcome)	Increase health awareness	Health Awareness OR Physical Fitness	Physical fitness OR Decrease chronic Disease

The evidence based search strategy will deal with search of the literary articles through online databases. According to Gopalakrishnan and Ganeshkumar (2013), the search of the research articles in the online databases, help to filter relevant source of information on any given topic. The sources gather through the online search of the databases help will help to frame a meta-analysis or systematic review of literature. Gopalakrishnan and Ganeshkumar (2013) are of the opinion that narrative review or the meta-analysis are considered as an important source of information under the healthcare settings.

According to Aveyard (2014) having a clean plan for conducting electronic search of the databases is important in order to save significant amount of time. Plan for conduction of literary search and to narrow the data was done with inclusion and exclusion criteria. Polit and Beck (2014) stated that inclusion and exclusion criteria are important to set boundaries of research and to shorten the available bibliographic resources.

Inclusion Criteria	Exclusion Criteria
Primary and secondary research	Case studies and clinical guidelines
Language: English	Other than English
Country: NA
Year of publication: 2014 to 2019	Published before 2014
Peered reviewed journals
Qualitative and Quantitative research

Differences between Qualitative and Quantitative Research

In order to narrow the search results while focusing on most recent source of information, the year filter was set within the last 5 years. The articles published before 2014 were excluded from the search in order to highlight the evolution of the public health education and awareness towards promotion of the healthy lifestyles. Both qualitative and quantitative studies were included. However, in the selection of the research paper, hierarchy of evidence were taken into consideration. First priority was given to systematic review conducted over the randomised control trial. According to Mai (2016), this falls under the level one of the evidence of the research forward. It helps to provide authentic and biased source of information.

Figure: Level of Evidence

(Source: Mai 2016)

Keywords, which were used for the search of the databases, are highlighted below in the table. Alternative search terms were used in order to broaden the overall search results. Boolean search operators were used in order to make numerous combinations of keywords. Boolean operators are used to establish relationships with the keywords used (Robb & Shellenbarger, 2014). Here, ON/AND are used as Boolean operators.

The research conducted by Passmore et al. (2017), aimed towards identifying effective healthy lifestyle program in order to address the risk factors behind the development of chronic diseases among the Aboriginal people like physical inactivity of consumption of unhealthy food. Passmore et al. (2017) mainly implemented Knockout Health Challenger, a community based healthy lifestyle program and targeted it towards the aboriginal communities residing in New South Wales, Australia. The community based intervention mainly attempted to study the effect of health awareness program for the promotion of healthy lifestyle and thereby helping to prevent the development of the chronic diseases. The analysis of the results highlighted that health related interventions is helpful in promoting healthy lifestyle among the aboriginals. This awareness of the healthy lifestyle is reflected by the promotion of the physical activity and reduction in the weight of the aboriginal individuals. This community-based intervention also had potential in closing the gap of health inequality.

One of the strength of the study is its sample size 586 people who are registered under 22 different teams. Marshall et al. (2013) are of the opinion that the having a large sample size helps to reduce the chances of getting biased results. High sample size increases the overall effectiveness of the results. The study also had a perfect focus over a stringent aim, the target group of population and a proposed intervention in order to achieve the outcome and thus increasing the feasibility of the study over other sample population. One of the limitation of the study is, it uses self-reported physical activity rate and diet plan in order to access the success of the community-based intervention. Subar et al. (2015) stated that self-reported data might lead to the generation of the observational bia and thus decreasing the appropriateness and meaningfulness of the study.

Evidence-based Practice to Increase Physical Fitness Awareness Among Aboriginals

Thurber et al. (2018) conducted a study in order to evaluate the factors, which are causing increase in the risk of obesity among the aboriginal population in Australia and intervention in order to reduce the risk factor. Thurber et al. (2018) performed a cross-sectional study among 1515 aboriginal and 213301 non-aboriginals residing in the New South Wales. The BMI (Basal Metabolic Index) was used to study the level of obesity and as an intervention; socio-economic determinants were considered. The analysis of the results highlighted that prevalence of obesity was high among the aboriginals in comparison to the non-aboriginals and the main-risk factor behind obesity is physical inactivity. The increase in the level of physical activity can be promoted via increase in the improvement in the socio-economic condition. Thurber et al. (2018) are of the opinion that this can be achieved by increase in education about healthy lifestyles and education about the disease awareness. One of the limitations of the study is its uneven sample size between the comparative groups which might lead to the generation of biased results (Marshall et al., 2013). Moreover, dependence on the self-reported data, mainly the self-reported BMI is the main limitation study as it might lead to the over and the under-estimation of the BMI and thereby hampering the appropriateness of the study. Consideration of the wide range of socio-economic data can be regarded as the strength of the study and thereby helping to improve the effectiveness of the study (Subar et al., 2015). However, use of the BMI in order to record the obesity help to increase the feasibility of the study. The overall interpretation of the data and its association with the socio-economic factors help to increase the meaningfulness of the study in the evidence based approach.

Conclusion across the evidence

From the above two papers, the evidences highlighted that improvement of the socio-economic factors in the domain of proper education and awareness is helpful promoting healthy lifestyle among the aboriginals and this in turn will help to promote physical activity.

The papers, which were selected for the critical analysis, stringently abided the main ethical considerations of the research. The authors of both the research followed the guidelines as proposed by the Human Research Ethics Committee of the Aboriginal Health. This can be considered as strength of the study.

The key recommendation in order to increase the overall physical activity and physical fitness among the aboriginals will include increase in the provision for the community health interventions and awareness with a detailed focus on the health-related reduction and vulnerability towards the chronic or non-communicable diseases (Passmore et al., 2017). The community health education will mainly be undertaken by the community health nurses. In health interventions and awareness program, the family members or the direct carers will also be involved in order to increase its overall health outcome (Barr?Anderson et al., 2013). The main clinical expertise that will be important in such community based intervention will include a detailed knowledge about basal metabolic rate and variance of weight on a basis of height, gender, bone-density and age and amount of calorific required in the body. The main barriers include absenteeism during the follow-up period. This barrier can be overcome by the implementation of the financial incentives (Krause, Collen & Nicholas, 2013). The main ethical considerations that must be taken into consideration in such community based initiative include culturally sensitivity and respect towards the autonomy of the service users. The outcomes will evaluated by the decrease in the weight or the body mass of the participants after one month participation in the community education program (Carroll-Scott et al., 2013).

Community-Based Interventions for Promoting Healthy Lifestyles

References

Australian Institute of Health and Welfare. (2011). Risk factors to health. Access date: 27^th of December 2018. Retrieved from: https://www.aihw.gov.au/reports/biomedical-risk-factors/risk-factors-to-health/contents/risk-factors-and-disease-burden

Aveyard, H. (2014). Doing a literature review in health and social care: A practical guide. McGraw-Hill Education (UK).

Barr?Anderson, D. J., Adams?Wynn, A. W., DiSantis, K. I., & Kumanyika, S. (2013). Family?focused physical activity, diet and obesity interventions in A frican–A merican girls: a systematic review. Obesity Reviews, 14(1), 29-51.

Carroll-Scott, A., Gilstad-Hayden, K., Rosenthal, L., Peters, S. M., McCaslin, C., Joyce, R., & Ickovics, J. R. (2013). Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments. Social Science & Medicine, 95, 106-114.

Gopalakrishnan, S., & Ganeshkumar, P. (2013). Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare. Journal of family medicine and primary care, 2(1), 9.

Krause, T., Collen, W., & Nicholas, K. A. (2013). Evaluating safeguards in a conservation incentive program: participation, consent, and benefit sharing in indigenous communities of the Ecuadorian Amazon. Ecology and Society, 18(4).

Mai, J. E. (2016). Looking for information: A survey of research on information seeking, needs, and behavior. Emerald Group Publishing.

Marshall, B., Cardon, P., Poddar, A., & Fontenot, R. (2013). Does sample size matter in qualitative research?: A review of qualitative interviews in IS research. Journal of Computer Information Systems, 54(1), 11-22.

Passmore, E., Shepherd, B., Milat, A., Maher, L., Hennessey, K., Havrlant, R., … & Mitchell, J. (2017). The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: the New South Wales Knockout Health Challenge. BMC public health, 17(1), 951.

PHN Darling Downs and West Moreton, an Australian Government Initiative., (2018).  Health Needs Assessment Description of health service use, workforce and consumer need. Access date: 27^th of December 2018. Retrieved from: https://www.ddwmphn.com.au/attachments/DDWMPHN-Health-Needs-Assessment.pdf

Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.

Robb, M., & Shellenbarger, T. (2014). Influential factors and perceptions of eHealth literacy among undergraduate college students. On-Line Journal of Nursing Informatics, 18(3).

Subar, A. F., Freedman, L. S., Tooze, J. A., Kirkpatrick, S. I., Boushey, C., Neuhouser, M. L., … & Reedy, J. (2015). Addressing Current Criticism Regarding the Value of Self-Report Dietary Data, 2. The Journal of nutrition, 145(12), 2639-2645.

Thurber, K. A., Joshy, G., Korda, R., Eades, S. J., Wade, V., Bambrick, H., … & Banks, E. (2018). Obesity and its association with sociodemographic factors, health behaviours and health status among Aboriginal and non-Aboriginal adults in New South Wales, Australia. J Epidemiol Community Health, jech-2017.