534352551720755343525619188553435257373620Evidence Level and Quality:

Article Title:

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan Number: nu12010194

Author(s): Hong-jie Yu 1, Fang Li 2, Yong-feng Hu 3, Chang-feng Li 2, Shuai Yuan 4 , Yong Song 1,

Miaobing Zheng 5, Jie Gong 2 and Qi-qiang He 1,6,*Publication Date: 10 January 2020

Journal: Nutrients

Setting: Wuhan, China

Sample 1340 students in

the third and fourth grades.

Does this evidence address my EBP question? Yes No

Do not proceed with appraisal of this evidence

Level of Evidence (Study Design)

A. Is this a report of a single research study? If No, go to B. Yes No

Was there manipulation of an independent variable?

Was there a control group?

Were study participants randomly assigned to the intervention and control groups? Yes

Yes No

No

Yes No

If Yes to all three, this is a Randomized Controlled Trial (RCT) or Experimental Study LEVEL I If Yes to #1 and #2 and No to #3, OR Yes to #1 and No to #2 and #3, this is Quasi Experimental (some degree of investigator control, some manipulation of

an independent variable, lacks random assignment to groups, may have a control group) LEVEL II If No to #1, #2, and #3, this is Non-Experimental (no manipulation of independent variable, can be descriptive, comparative, or correlational, often uses secondary data) or Qualitative (exploratory in nature such as interviews or focus groups, a starting point for studies for which little research currently exists, has small

sample sizes, may use results to design empirical studies) LEVEL III NEXT, COMPLETE THE BOTTOM SECTION ON THE FOLLOWING PAGE, “STUDY FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION” 53232053658235532447540633655314950451294553244754809490

Is this a summary of multiple research studies? If No, go to Non-Research Evidence Appraisal Form.

Does it employ a comprehensive search strategy and rigorous appraisal method (Systematic Review)? If No, use Non-Research Evidence Appraisal Tool; if Yes:

Does it combine and analyze results from the studies to generate a new statistic (effect size)? (Systematic review with meta-analysis)

Does it analyze and synthesize concepts from qualitative studies? (Systematic review with meta-synthesis)

If Yes to either a or b, go to #2B below.

For Systematic Reviews and Systematic Reviews with meta-analysis or meta- synthesis:

Are all studies included RCTs?

Are the studies a combination of RCTs and quasi-experimental or quasi-experimental only?

Are the studies a combination of RCTs, quasi-experimental and non-experimental or non-experimental only?

Are any or all of the included studies qualitative?

COMPLETE THE NEXT SECTION, “STUDY FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION” LEVEL I

LEVEL II

LEVEL IIlLEVEL IIlYes

Yes

Yes

Yes No

No

No

No

STUDY FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION:

The methods used in this article adequately adhered to the rules and policies of medical research practice. The study’s findings indicated that although most children studied had higher heights, there was no significant difference in sex ratio, age, weight, and household income level between the two selected groups.

NOW COMPLETE THE FOLLOWING PAGE, “QUALITY APPRAISAL OF RESEARCH STUDIES”, AND ASSIGN A QUALITY SCORE TO YOUR ARTICLE

Johns Hopkins Nursing Evidence-Based Practice Appendix E: Research Evidence Appraisal Tool

Quality Appraisal of Research Studies

Does the researcher identify what is known and not known about the problem and how the study will address any gaps in knowledge?

Was the purpose of the study clearly presented?

Was the literature review current (most sources within last 5 years or classic)?

Was sample size sufficient based on study design and rationale?

If there is a control group:

Were the characteristics and/or demographics similar in both the control and intervention groups?

If multiple settings were used, were the settings similar?

Were all groups equally treated except for the intervention group(s)?

Are data collection methods described clearly?

Were the instruments reliable (Cronbach’s α [alpha] > 0.70)?

Was instrument validity discussed?

If surveys/questionnaires were used, was the response rate > 25%?

Were the results presented clearly?

If tables were presented, was the narrative consistent with the table content?

Were study limitations identified and addressed?

Were conclusions based on results? Yes No NA

Yes No Yes No Yes No Yes No Yes No NA

Yes No NA

Yes No Yes No NA

Yes No NA

Yes No NA

Yes No Yes No NA

Yes No Yes No Quality Appraisal of Systematic Review with or without Meta-Analysis or Meta-Synthesis

Was the purpose of the systematic review clearly stated?

Were reports comprehensive, with reproducible search strategy?

Key search terms stated

Multiple databases searched and identified

Inclusion and exclusion criteria stated

Was there a flow diagram showing the number of studies eliminated at each level of review?

Were details of included studies presented (design, sample, methods, results, outcomes, strengths and limitations)?

Were methods for appraising the strength of evidence (level and quality) described?

Were conclusions based on results?

Results were interpreted

Conclusions flowed logically from the interpretation and systematic review question

Did the systematic review include both a section addressing limitations and how they were addressed? Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

QUALITY RATING BASED ON QUALITY APPRAISAL

High quality: consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference to scientific evidence

Good quality: reasonably consistent results; sufficient sample size for the study design; some control, and fairly definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence

Low quality or major flaws: little evidence with inconsistent results; insufficient sample size for the study design; conclusions cannot be drawn