Sample Paper on Section B: Problem Description


For the last few years, the number of obese children and adults in USA has increased dramatically (Babey et al., 2011). The World Health Organization (WHO) puts this figure at 30 percent (Bonnet, Dubois, & Orozco, 2014). California has not been left out in this worrisome trend because about half of the counties have recorded high rates of obesity among children (Babey et al., 2012). Although the number of obese children and adolescents in San Francisco is not as high as in other parts of the state, it is obvious that obese children and adolescents become obese adults when they grow up. Therefore, they pose a challenge to the county and state governments that offer medical care to obese citizens (Peebles, 2008).

A study that was conducted in 2013 by CDC revealed that 21 percent of obese high school students in San Francisco did not engage in physical activities for at least sixty minutes on daily basis. The study also revealed that 21 percent of these students spent most of their time watching television programs and 41 percent of them spent most of their time playing computer games and reading online. As it is evident from this study, majority of obese adolescents do not participate in physical activities or sports, as they should do. With regard to eating habits, the study revealed that 5 percent of these students did not drink fruit juices or eat fruits a week before the study. The study also revealed that 5 percent of these students did not take vegetables a week before the study. Furthermore, the study revealed that 21 percent of these students did not drink milk and 12 percent of them did not take breakfast a week before the study (CDC, 2015).

Current studies show that in the future obese children and adolescents are likely to develop coronary heart diseases, high cholesterol, various types of cancer and hypertension among other diseases (Babey et al., 2012). Studies also show that a lot of money will be spent treating obesity related diseases if the current obesity trend in the USA persists. Apart from spending a lot of money treating these diseases, current figures demonstrate that U.S. federal government spends a lot of money offering medical care to obese people than it spends offering care to smokers (Bonnet, Dubois & Orozco, 2014). This shows that if state governments in USA do not do something about obesity, then federal government will spend even more money in the future given the current rate of obese children and adolescents (Macpherson-Sanchez, 2015). In realization of this fact, the proposed study will help San Francisco county government to develop various methods for reducing obesity among adolescents aged between ten and nineteen years.

Stakeholders/change agents

In order to achieve the objectives of the proposed study, the main stakeholders, as well as the change agents for the study, will be the parents and schools. These two change agents will be critical because they will change the way adolescents in question eat and participate in physical exercises. On one hand, the parents will reduce the amount of fat that adolescents take in their food. On the other hand, the school will ensure that adolescents participate in physical exercises and take food with low fat (Babey et al., 2012). If the two change agents collaborate on this issue, then the county government and state government will benefit significantly from reduced cost of offering medical care to obese adolescents. In terms of interest, the county government, parents and schools may be interested in the proposed study because it has significant effect on each of them. The county government would reduce the amount of money it spends taking care of obese adolescents, parents as well would reduce such medical expenses while schools would enjoy having healthy students (Franzini et al, 2009).

Refined PICOT question

In adolescents ages 10-19 years old with obesity (P) how does school-based intervention of 30-60 minutes of physical activity (I) for 3-5 days per week and good nutrition (C) compared to no school based intervention for physical activity (sedentary lifestyle) (O) and decreased access to good nutrition affect the prevalence of the disease over a 10 month period (T). The results would be measured based on pre and post body mass index (BMI) results.

Purpose and objective of the project

The purpose of the proposed study will be to evaluate the effectiveness of physical exercises and good nutrition in reducing obesity among adolescents living in San Francisco. In this regard, the weight and height of all research participants will be recorded before and after the study to help in calculating respective BMIs. In terms of objective, it is expected that at the end of the study, the BMIs of the students in the two sets of schools (one with intervention and the other one without intervention) will be significantly different. For this reason, the post and pre BMIs for the students from schools with interventions are expected to be statistically different from each other at the end of the study. On the other hand, the post and pre BMIs for the students from schools without interventions are expected to show no significant difference at the end of the study.

Literature search method

With regard to literature search, a comprehensive electronic search method was done using ProQuest, ebsco and CINAHL as well as Medline databases. An additional search was done using the general Google search. The search included materials published between 2004 and 2015 and the key words used during the search were obesity, physical activities/exercises and good nutrition. After a thorough search was done, fifty-five articles were obtained. Their abstracts were reviewed and after careful review, only nine articles were found to be relevant to the proposed study. The articles included one cross-sectional study, three general studies from various institutions, one cohort descriptive study, two randomized control trials and two systematic reviews.

Importance of the study in nursing

From a clinical viewpoint, the proposed study will be an important one because it will help establish whether good nutrition and physical activities are important ingredients in reducing obesity among adolescents (Swinburn et al., 2004). If the two factors will be important in reducing obesity among adolescents living in San Francisco, then the study will advance the current literature. On the other hand, if the two factors will not be important in reducing obesity, the proposed study will form the basis of future studies (Kratz, Baars & Guyenet, 2012). From either perspective, the proposed study will be of great significance in nursing because either it will advance current literature, set the basis of future studies or do both.


Babey, S. et al. (2012). Overweight and obesity among children by California cities – 2010. UCLA Center for Health Policy Research and California Center for Public Health Advocacy.

Babey, S. et al. (2011). Changes in overweight and obesity among California 5th, 7th and 9th graders, 2005-2010. A patch of progress: UCLA Center for Health Policy Research and California Center for Public Health Advocacy.

Bonnet, C., Dubois, P., & Orozco, V. (2014). Household food consumption, individual caloric intake and obesity in France. Empir econ, 46; 1143-1166.

CDC. (2015). The obesity epidemic and San Francisco students. Retrieved on June 30, 2015 from

Franzini, L. et al. (2009). Influences of physical and social neighborhood environments on children’s physical activity and obesity. American journal of public health, 99(2); 271-278.

Kratz, M., Baars, T., & Guyenet, S. (2012). The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J nutr.

Macpherson-Sanchez, A. (2015). Integrating fundamental concepts of obesity and eating disorders: implications for the obesity epidemic. American Journal of Public Health, 105(4); 71-85.

Peebles, R. (2008). Adolescent obesity: etiology, office evaluation, and treatment. Adolesc Med, 19; 1-26.

Swinburn, B. et al. (2004). Diet, nutrition and the prevention of excess weight gain and obesity. Public health nutrition, 7(1A), 123-146.