SCENARIO: In an outpatient clinic, a nurse practitioner observes a high prevalen
ID: 3176720 • Letter: S
Question
SCENARIO: In an outpatient clinic, a nurse practitioner observes a high prevalence of obesity in young female patients. The nurse practitioner further observes that there appears to be an association between the economic status of the patient and their obesity. The nurse practitioner reviews the related literature but does not find a study that directly relates obesity and economic status. The nurse practitioner decides to conduct a study to determine if a relationship exists between obesity in younger females, ages 15 to 18 years, and their economic status. The nurse practitioner elicits help from four outpatient clinics and receives data on the Body Mass Index (BMI) for all female patients from age 15 to 18 years. The nurse practitioner also attains information concerning if the patient is above or below the federal poverty line for their respective family. The nurse practitioner uses a bivariate correlation between BMI and the dichotomous variable of economic status. The results did not reflect a statistically significant relationship.
Questions:
a)What kind of study is this according to the methodology used? Justify your choice.
b)Write a research hypothesis/hypotheses or question(s) for this study and identify the variables in the study.
c)Critique the internal and external validity of the study as it is designed.
d)Critique the data analyses used in the study.
e)If you were going to conduct this study, how would you redesign to enhance its validity and at the same time make it reasonable to conduct in a outpatient clinical setting? In your redesign be sure to address the appropriateness of the tests used to measure the outcomes of the study and the statistical procedure(s) that you would use to analyze data.
Explanation / Answer
a) This is an example of observational study as it records the information about subjects without applying any treatment to subjects.
b) Here the Null hypothesis = H0 = Relationship does not exists between obesity and their economic status in younger females, aged 15 to 18 years
Alternative or Research hypothesis = HA = Relationship exists between obesity and economic status in younger females, aged 15 to 18 years
Variables in the study are BMI(continuous variable) and Economic status(dichotomous variable)
c) Internal Validity - this study can not infer the cause and effect relationship, as for that we need an experimental setting i.e. study will not be able to determine that economic status caused high or low BMI. External Validity - If the practitioner randomly selected the 4 outpatient clinics for collecting the BMI and economic status data, then we can say that results can generalise to population. But in the question, the random keyword is not mentioned.
d) The practitioner used bivariate correlation between the BMI and the dichotomous variable of economic status.
e) If i were going to conduct the study, i would randomly select the the outpatient clinics to collect BMI and economic status data. If no. of clinics can be increased that would be good for the statistics. The t-test procedure can be used to measure of the outcome of the study as here we need to determine whether the 2 groups based on dichotomous economic status are different.
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