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Title of critique: "Getting the balance right: Qualitative evaluation of a holistic weight management intervention to address childhood obesity"
Childhood obesity is a major health as well as a social concern that interferes with normal health and wellbeing of children. The weight management program is widely applicable in the UK, which aims to improve the overall body weight of children and enhance their self-esteem. Evidence base report suggests many researches have been taken place to provide insight on the importance of weight management intervention in terms of reducing body weight thereby reducing the vulnerability of children towards obesity. In relation to this background, a qualitative evaluation study has been conducted by S Visram, T.D. Hall and L. Geddes to evaluate the usefulness of a weight management intervention program in terms of addressing childhood obesity. This critical study starts by representing the background information that is followed by the ethical consideration section, in which it will be discussed how research ethics have been maintained by researchers while conducting the evaluation study. After that, this overall discussion will present the critical analysis of qualitative design that is used by the researcher in the study. Thereafter the critical overview of the sampling and data collection process will be discussed. Then there will be discussed the evaluation reporting standard in which it will be analysed critically whether the study has successfully achieved a good reporting standard. This discussion will be followed by a conclusion section which will summarise the underlying aspects of the overall discussion.
This section will discuss how all ethical issues are addressed in the evaluation study by researchers from the time of seeking approval from NHS Research Ethics Review Service to the process in which ethics are followed in the study.
As mentioned by Ryen (2016) research ethics are considered as the moral values, professional codes and moral rules that are needed to be applied by the researcher in terms of conducting data collection process, data analysis, data reporting process and publication of research findings. While conducting any research, researchers need to consider the subject’s rights to the confidentiality, privacy and informed consent in terms of maintaining the validity and authenticity of the entire research study.
In maintaining research ethics in any research study, the first thing that researchers need to do is getting approval from the relevant Ethics Committee and Review Ethics Board in order to involve human subjects into the data collection process. In this context, Osborne and Luoma (2018) mentioned that the Ethics Review Board is assigned to consider the risk factors and harms that are associated with involving human subject into the research study. Before granting the permission, the Ethics Review Board and committee want researchers to prove that no harm or risk will be caused to the participants before, during and after the research and highly effective safeguarding techniques will be used by researcher to protect each participant from any associated risk factors. In the evaluation study, it is mentioned that ethical approval for conducting this research has been approved by the NHS Research Ethics Service. From this statement, it is clear that the researchers were able to assure that the entire research will be conducted ethically which would not make any harm to any participant.
After receiving ethical approval from concerned ethical committee or board the next step that researchers need to follow while conducting a research study is to take informed consent from each participant. In this evaluation study, the quotes of participants are used while discussing the themes points out the fact that confidentiality is not mentioned as well as an addressed by the researchers in proper manner. In this context, Tauri (2018) mentioned that researchers need to take informed consent from each participant in terms of assuring that each participant in will take part in the research study voluntarily and there are no forces applied on them for participating in the data collection process. Informed consent is also important for researchers to assure that participants are aware of objectives as well as the purpose of the research study before participating in it. In the evaluation study, it is mentioned that during recruitment of participants study information packs were send to participants in which there was an information letter for parents and guardians which contain information about the purpose of conducting ‘Balance It!’ programme. Additionally, there was a separate information letter for young people and children mentioning the purpose, objectives and aim of this program. This ensured that the researcher has addressed research ethics in terms of seeking informed consent from each participant.
As stated by Battiste (2016), the researcher has the responsibility to assure that the research study would cause no harm to participants by providing additional safeguarding process to the vulnerable people. In this context, the evaluation study mentioned that while conducting the interview, researchers interviewed the participants in their preferable places where they feel safe, for example in case of children, they are interviewed along with their parents as they feel safer with them. Therefore, it can be stated that this evaluation study successfully addressed the concept of non-maleficence in this research study. On the contrary, it can be stated that although the study can provide a safe environment to each participant while conducting the interview, most of the children who participated in this data collection already had obesity and overweight. In this context, there is no mentioned regarding understanding the issues, choices and preferences of these children while taking their interview along with their parents which interfere with the concept of maintaining participants’ autonomy. On the other hand, the evaluation study acknowledged that there are some drawbacks in this study such as poor communication with many children and the families that can be considered as the potential barriers for researchers to understand the psychology, preference, choices and interest of each participant that are important to respects participants autonomy.
This section will represent a critical analysis of the research design that has been used in the evaluation study. The evaluation study has used a qualitative research method to evaluate as well as express the views, perspectives and experience of stakeholders about weight management and childhood obesity.
Qualitative research design is the process of a comprehensive discussion of database that assists the researcher to interpret and discuss the research objectives by using valid as well as detailed information in terms of meeting them accordingly (Creswell, 1998). This research design is based on the social constructivism perspectives, in which interpretation is generally based on the combination of useful research perspectives and the database that are collected from participants. As mentioned by Finch and Lewis (2004), qualitative research design consists of three data collection process such as in-depth interview, observation and focus group discussion. Unstructured or in-depth interview is one of the most important methods of collecting qualitative data. Carter and Henderson (2007) defines an in-depth interview as the process of interaction of research participants and researcher in terms of gaining valid as well as practical information that is related to research objectives. While it comes to use qualitative research design researchers need to be aware of the advantages and limitation of using this research method. As mentioned by Carter and Henderson (2007) one of the major advantages of using unstructured interview is allowing researchers to explore the factors that underpin participant’s answers such as their opinion, reasons, feeling and beliefs. Many authors have mentioned that one of the major advantages of the interview is it assists the researcher to make face to face conversation with research participants that is helpful for the researcher to observe the body movements, approaches, behaviour and facial expression of each participant, that are important for developing an in-depth understanding about their response. On the other hand, Finch and Lewis (2004) stated that there are some limitations associated with conducting an in-depth interview that researches need to consider while using the qualitative research method in their study. Firstly, the entire process of conducting an interview is time-consuming. Secondly, the researcher needs to have a high patience level to listen to the response of each participant carefully. Third, people who always try to establish their viewpoint only rather than listening to other people, they cannot achieve the desired outcomes through the in-depth interview process. As mentioned by Carter and Henderson (2007), a focus group can be described as discussion that is organised to explore the specific set of different research issues. On the other hand, observation is the process in which researcher participates into a community setting in terms of observing the activities, events and interaction that occur there.
Based on the context and nature of the topic of this evaluation study that provides the new insight on social perspectives regarding the importance of weight management intervention for reducing childhood obesity, it can be stated that the use of qualitative research method is highly relevant as well as suitable. As the qualitative research design is based on social constructivism philosophy, it helps researchers of this evaluation study to analyse the social views, opinion and perspectives regarding how useful is the weight management program, “Balance it, Getting the right balance” for improving weight and enhancing the overall self-esteem in children. As stated by Ishtiaq (2019), the qualitative research design is useful for researchers while they need to observe the events, interaction and action in a community or organisational setting or a study population, that can represent the phenomena as well as perspectives of the entre society regarding the research issue. In this evaluation study, the qualitative research design is highly useful as well as relevant that assisted researchers to gather responses from participants belonging to different age groups, occupation and organisation. In the evaluation study, children, NHS and local community staffs and parents of children are included in the data collection process, that assisted researchers to gather different kinds of views and opinion regarding childhood obesity. As mentioned by Glesne (2016), the qualitative research design is helpful for the researcher to observe the behaviour, activities, facial expression and body movement of each participant that is crucial in analysing the finding. On this note, the qualitative research design is useful in this evaluation study to analyse how affected society views childhood obesity in a comprehensive manner thereby explaining behavioural, social, historic and cultural factors that are associated with developing childhood obesity.
Although qualitative research method is proved to be highly relevant to this evaluation study there are some backdrops that could have been improved during using the qualitative method. Service users and staffs involved in this evaluation study have acknowledged the fact that overall interview and data collection process can be more cohesive and structured to provide flexibility to each research participant on meeting their individual needs. As mentioned by Ishtiaq (2019), while conducting qualitative research design, the researcher needs to maintain clear and comprehensive communication with research participants that is helpful to analyse the perception, viewpoint and behaviour of participants in relation to the research topic. On this note, it is acknowledged in the evaluation study that during the interview process the communication between the research participants and researchers can be improved through involving participant into the decision-making process. Despite these backdrops, the study has conducted the interview successfully in terms of gathering detailed information about the experiences that research participants gathered through the “Balance it” programs. As mentioned by Glesne (2016), qualitative research is suitable for the types of researches that needs to analyse the opinion and viewpoints of different people about the research issue. Qualitative research assists this evaluation study to involve a range of age groups to analyse the variation in decisions, understanding and views of NHS and local authority staffs, young people and children regarding the adverse impact on childhood obesity. Additionally, researchers have used verbal and visual methods while using qualitative research method to observe the overall activities of children and NHS staffs in ongoing “Balance it” program, that is useful to evaluate their roles in expressing their experience and views regarding the usefulness of this weight management intervention program to address childhood obesity.
In this evaluation study, 16 professional stakeholders had been selected from NHS acute trust (4 staff), primary care trust (9 staffs) and local authority (3 staffs). 28 families had been approaches for taking part in this study, but only 20 families consented to involve in this process. Here researchers used purposive sampling in terms of recruiting local authority and NHS staffs. As mentioned by Campbell et al. (2020) purposive sampling is the nonprobability sampling process that aims to select a sample that is logically considered to be the representative of the entire population. On this note, the evaluation study has successfully conducted the purposive sampling process that is highly convenient to select staffs by ensuring the sample population that is recruited best fitted to the criteria of the target population. On the other hand, it is not mentioned in the evaluation study that which sampling techniques has been used to select 20 families, which raise the questions of the convenience, relevance and criteria of this sampling process to select children and the family members. As stated by Setia (2016), during selecting the sample population, researchers need to ensure that the sample population will be informed about the purpose, objectives and the associated risk of the research study. On this note, the evaluation study mentioned that, during the sampling process, study information packs have been sent to the NHS and local authority staffs which they distributed to 20 families by post. In this information packs, there were information for children, young people and parents regarding the purpose of “Balance it” program, objectives of this study and ethical criteria associated with this research process. This process ensures the peer researchers have successful comply with the ethics that are associated with sample selection. On the other hand, the evaluation study mentioned that research follows the data protection legislation while providing the detailed information about the “Balance it” program through sending the information pack to the authorised NHS and local authority staffs.
As mentioned by Carter and Henderson (2007) in-depth interview is the process interaction between the research participants and researchers to elicit useful information. In this evaluation study, the researcher has conducted an individual interview for each research participants to gain detailed as well as comprehensive information regarding the viewpoint of the affected community toward childhood obesity and weight management intervention. As mentioned by Wilson et al. (2016), in-depth interview assists researchers to explore the different factors that underpin participants answers, such as reasons, beliefs, opinion, and feeling. In the evaluation study, the interview format was highly flexible with the intention of promoting comfort and enhancing the openness of participants so that they can have the freedom of sharing their actual experiences and views. Additionally, participants were given the freedom to share any additional issues that they encounter professional and personal context. As stated by Cridland et al. (2016), individual in-depth interview assists researchers to observe the body movement, facial expression, approaches and attitude of each participant that are crucial in developing an in-depth understanding on their psychology, feeling, thoughts and opinion. On this note, it is not mentioned that in the evaluation study whether researchers are benefitted through using the individual interview to observe the behaviour, facial expression and body movement of participants, but it is clear in this study that in-depth interview assists the researcher to gain information regarding the social and cultural perspectives about childhood obesity and weight management programs. This points out that, the in-depth interview is best suited and relevant for this study to analyse the perspectives, viewpoint and experience of participants regarding the importance of weight management intervention to address childhood obesity. As mentioned by Simoni et al. (2019), a successful in-depth interview is that in which the interview is taken conveniently to make participants feel relax and comfortable which is important to share their issues, pain, experience through which they went.
On this note, in the evaluation study, researchers tried to maintain a flexible and supporting environment in which participant can be interviewed comfortably. In this purpose, the NHS staffs and local authority are interviewed in their workplace that assists them to feel relax and flexible to share their views regarding childhood obesity and usefulness of “Balance it” program. On the other hand, while it comes to interview children, researchers in the evaluation study have interviewed them with parents as children feel safer only when they are with their parents. From this note, it can be stated that in this evaluation study researchers have successfully met all the criteria that are needed to be followed to conduct a useful in-depth interview in terms of grabbing useful information in relation to research topic. As mentioned by Carter and Henderson (2007), an in-depth interview is useful as it involves diverse participants with different characteristics that act as a social representative in relation to express their perspectives regarding the research topic. The evaluation study involves a range of ages of participants in the interview process such as four stakeholder groups of different age groups are interviewed including guardian and parents, young people and children, NHS staffs and local authority staffs. This process assists researchers to analyse perspectives and experience of different age group people that are helpful to the study to evaluate how the different communities view the importance of weight management program on improving weight in children and reduce their vulnerability to childhood obesity. According to Finch and Lewis (2004), while conducting an in-depth interview, researches need to assure that the entire discussion is recorded properly without any involvement of bias and manipulation of data. In this note, the researchers in this evaluation have successfully recorded the audio of the entire interview and transcribed verbatim. Additionally, all the field notes are written up in a proper manner to gather the contextual data. Therefore, it can be stated that the evaluation study has successfully conducted an in-depth interview that assisted researcher to fulfil research objectives.
From the overall analysis, it can be stated that the evaluation study could not meet the good reporting standard, hence it achieved an average reporting standard. Although the study has a research methodology section, there is no mentioned about the research design and approaches that are important for gaining a good reporting standard. Although the process used in conducting the interview is elaborately discussed in this study, there is confusion regarding the types of in-depth interview used by researchers as the study mentioned that researchers had interviewed staffs both in individually and in groups. On the other hand, in data collection section, only age groups are mentioned as the characterises used by researchers for participants, but there is no mention about the other characters such as ethnicity, social factors and cultural factors that also have an important impact on participant's perspective about childhood obesity. As stated by Ishtiaq (2019), in the data analysis section of a good report the evaluation of findings needs to be mentioned in a detailed manner. On this note, the evaluation study lacks any detailed as well as comprehensive discussion of methods or techniques that are used for evaluating the finding gathered from interview. On a positive note, it can be stated that researchers have successfully followed the ethical aspects while conducting the research. Additionally, the study also mentioned the areas of improvement and backdrops of this study that could have been improved to enhance the standard of the research study.
From the overall discussion, it can be concluded that critical analysis of any study is the process of comparing the findings and information of that study with other resources to analyse the validity of this information. Qualitative research method is the process in which spoken or written data are collected from research participants by using different methods such as focus group, interview, documents, case studies and participatory action researches. In-depth interview is the most preferred way of qualitative data collection, in which there is structured interaction between the researcher participants and researcher to gather useful information. While it comes to analyse the reporting standard of any study, the study must meet all the criteria associated with gaining a good reporting standard such as well-defined research objectives, clear research methodology, research design, comprehensive data collection and analysis and detailed description of research findings.
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