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FINAL PROJECT TIMELINE

Item 1:Research Topic, Dataset, Stakeholder Assessment, & Academic Deliverable

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You will submit a document that describes: 1) your proposed research topic and a draft specific research question; 2) the data set you will use, with details concerning which variables/questions will be used to operationalize which constructs; 3) which stakeholders will be affected by the research project; and, 4) the type of academic deliverable that will be produced. Note that if the product will be a proposal, then #2 above is not required.

Item 2:Final Project DRAFT #1: Significance/Background for peer review

You will submit a document that describes: 1) revised research questions and hypotheses; 2) a significance section, which clarifies the theoretical and/or methodologicalgaps in the literature that will be addressed by students’ proposed project; and 3) an innovation section, which highlights the project’s unique contribution to the literature, as well as future research, practice, and community engagement that will become possible due to the findings of students’ proposed project. You will participate in a peer review of these sections, in which you and one peer from class will provide each other with feedback on clarity and on strength of arguments. Your timely and complete submission of Draft #1 is counted towards a separate peer review grade (see syllabus). However, the material you prepare for this draft (and your peer’s feedback on this material) will be integrated into your final deliverable for your final project.

Item 3:Methods: Analytic Plan

You will submit a document that describes your analytic plan (e.g., hypotheses and corresponding planned analyses and descriptive/inferential statistics; relationships of interest).

Item 4:Final Project DRAFT #2 Methods:Design, Procedures, & Measures for peer review

You will submit a document that describes the: 1) sampling method, including the target population, sampling frame, and sample; and 2) study design and procedures, including assignment and the timing of data collection.Your timely and complete submission of Draft #2is counted towards a separate grade (see syllabus). However, the material you prepare for this draft (and your peer’s feedback on this material) will be integrated into your final deliverable for your final project.

Item 5: Final deliverable. Your final product is due on or before Thursday, May4 and should be submitted electronically via Blackboard . Late papers will not be accepted. You will submit a final revised academic deliverable, in which you will integrate all sections above and in which you must address all input from instructors and peer reviewers. In addition to the sections already submitted as drafts, this final deliverable will also include an additional section (either a “Results andDiscussion” section for students completing a poster or manuscript; or an “Implications for Public Health” section for students completing a proposal).

Your final product should be approximately 8-10 pages (typed, double spaced, 1-inch margins) if a manuscript or proposal. Length may vary if your final product is a poster. (Please submit posters in poster format –i.e., as a single PowerPoint slide – and as a text-only Word document for easy reading.)

APA format.

Section 1: Background (i.e., lit review), Research Question(s),and Hypotheses

· Clear and compelling review of background literature

· The review should focus on previous research most related to your research question(s), population and measures

· Should incorporate a review of at least 15 peer-reviewed empirical or theoretical articles relevant to your research question

· The review should demonstrate what is known about your area of interest as well as what is not known

· The review should clearly lead the reader to understand the need for and importance of your research question(s) and your study

· You must identify AT LEAST one way your study will uniquely contribute to the literature by improving upon or modifying (in an interesting way) some aspect of previous studies on this topic

· Clear research question(s) and hypotheses

· Include a research question for each relationship you will test (as specified via email), and a hypothesis for each question. In some cases you will be able to specify a directional hypothesis based on the results of previous research. In other cases, especially if few people have explored the research question before or previous research has found mixed results, you can included a non-directional hypothesis.

· For example if you are interested in whether ethnic identity is related to self-esteem and depression among diverse adolescents you should have two research questions:

1. What is the relationship between ethnic identity and self-esteem among Black, Latino, Asian and White adolescents? I hypothesize that ethnic identity will be positively related to self-esteem among Black, Latino and Asian adolescents. However, I hypothesize that there will be no relationship between ethnic identity and self-esteem for White adolescents.

2. What is the relationship between ethnic identity and depression among Black, Latino and Asian adolescents? Previous research has not yet explored the relationship between ethnic identity and depression, thus this is an exploratory research question.

· Section 1 of this paper should follow the same ordering as required for Paper Draft 1: first, discuss and cite the literature on your topic and use it to illustrate what is and is NOT known in the literature; second , identify a way your study will add something unique that is not already known to this literature by improving upon some aspect of existing studies; finally , end by stating both your specific research questions AND your hypotheses ( separately ).

Section 2: Methods section –

· Study design: Clearly articulate (identify and describe) a study design that is able to answer the research question(s) posed.

· Participants: Provide clear information about how (from where, using what recruitment mechanisms and what sampling design) the sample will be recruited and selected for the study and who will be targeted for inclusion; and give basic demographic information about participants: age, gender, race/ethnicity, any characteristics that are relevant to your study.

· Procedures: Give clear and detailed information about how the study will be conducted. This includes how participants will be assigned to groups (if applicable), how materials will be distributed and introduced and collected, etc. This section will be longer and more detailed for experimental studies, which will include information about how participants will be assigned to groups and how the independent variable(s) will be manipulated. It will be even longer for intervention studies, as the goals of the intervention and details of how the it will be implemented must be described.

· Measures: Provide clear and specific info provided about all study measures, including the independent (or predictor) variable(s), the dependent (or outcome) variable(s) and any variables that are included as covariates ( including confounds) . For each measure, you should provide information about the number of items, the response scale, reliability and validity.

· You should first research what measures previous studies have used to measure the constructs in your study. Information about the number of items, response scale, reliability and validity may come from these studies.

· However, if the sample in your study is very different (in age, race/ethnicity, gender or some other important way) from the samples used by previous research, or if no reliability or validity information is available in previous studies, you should describe what steps you will take analytically to check the reliability and validity of your proposed measure for your sample.

· If you cannot find adequate measures (measures which match your constructs exactly) of some or all of the constructs in your study, you can propose that you will develop your own. In this case, describe what steps you will take analytically to check the reliability and validity of your proposed measure and provide sample items.

· POTENTIAL CONFOUNDS : You must identify and measure at least 2-3 potentially important confound variables. This means that you must also describe the measures you will use to assess these confound variables.

Section 3: Data Analytic Plan

· Data analytic plan: give a clear description of how you will analyze the data to answer each of your research question(s) and demonstrate your understanding of your analyses. This includes (a)a description of the statistical methods you will use for each question, (b) what statistics (e.g., coefficients, R Square, t, F, etc.) you will look at to determine whether there is a significant result for each question and (c) what statistical information you will use to interpret your result.

· Here is an example of language that conveys your understanding of statistics and how they will be able to answer your research question:

· “A t-test will be used to determine whether participants assigned to the counseling intervention had lower depression scores than those assigned to the control group. A significant t-test (p< .05) indicates that the means of the two groups differ more than would be expected due to chance alone. The means of each group will then be inspected to see which group had the lower mean. If participants in the counseling intervention group have the lower mean, we can conclude that the counseling intervention has significantly decreased depression, as hypothesized.”

· The data analytic procedures you choose need to be well-suited to answer each research question and must be suitable for use with the measures you have proposed to use. (For example, if you are using a continuous measure of ethnic identity – say an average of 5 items which tap ethnic identity – to predict self-esteem, it is not appropriate to use ANOVA, which assumes that you have a categorical predictor.)

· Remember that you must include your 2-3 confounds in your analysis!!! (because otherwise there isn’t much point in measuring them!)

Section 4: Discussion and Conclusions

a. For students completing a manuscript or poster: Results and Discussion

· Present the results of your analyses. Include tables as appropriate, and include text describing your primary statistical findings. Text descriptions are required. Tables are likely necessary, but are not sufficient (on their own) for this section.

· Discuss your findings vis a vis the extant literature you described in your Significance/ Background section. Start by restating the gap that your study is filling in the extant literature. Then discuss whether or not your results are consistent with what you expected, based on the extant literature.

· Discuss next steps for this line of research (i.e., what else does the field need to know or what kind of study should be done next to build on yours) and implications for intervention (i.e., explain how the findings can inform and shape the design and development of new interventions and what kind of interventions they might be).

a. For students completing a proposal: Discussion of Importance to Public Health

· Reiterate how the proposed study will innovate upon the extant research, and restate what gaps it will fill in the literature.

· Explicitly state, and discuss at length, the benefits the proposed research will have for public health. Be sure to include both direct benefits to participants in your own proposed sample, as well as indirect benefits to public health, epidemiology, communities, etc. that are implications of the research.

· If your proposed study is not an intervention, discuss implications for future interventions (i.e., explain how the findings can inform and shape the design and development of new interventions and what kind of interventions they might be).

b. ALL Products should include: Strengths and Limitations –

· What does your study add to previous literature? Briefly reiterate this (i.e., say it again).

· Thorough and thoughtful consideration of the strengths and weaknesses of your study’s design. The strengths and weaknesses should be framed in terms of internal andexternal validity.

· Internal validity: can your study establish cause and effect relationships? What confounds are there and how will you address them? Are there any you will not be able to address? What factors do you not have control over that could be a threat to internal validity?

· External validity: how generalizable are the results of your study? To what types of people would the results be applicable? What about the way you will measure your constructs and the procedures you used in your study? How generalizable are these? How biased or representative is your sampling design

c. ALL products should include: Ethical considerations

· Information about how ethical considerations are dealt with in the study. This includes:

· What are the potential risks and benefits?

· Consenting procedures

· Debriefing procedures (for experiments, especially)

· Steps you will take to ensure confidentiality

· Steps you will take to reduce potential for coercion

· In some cases, more information should be provided about how other ethical considerations will be addressed. For example, if you plan to study how different therapies affect depression and you find that one of the therapies is worsening depression, how will this be handled? If you are studying a sensitive issue such as abuse, how will risks to participants be minimized (i.e., will you refer them to services to help them handle any painful or traumatic emotions or memories that arise as a result of participation in your study)? If I mentioned ethical concerns in your feedback email, you must address what I asked you about or discussed with you.

Obesity and Dental Caries among Elementary School Student

Introduction

Obesity is one of the easiest medical conditions to recognize but most difficult to treat. Unhealthy weight gain as a result of a poor diet and lack of exercise is responsible for over 300,000 deaths each year (American Academy of Child and Adolescent Psychiatry, 2016). Overweight and obesity are a global epidemic among children of all ages. According to the World Health Organization (WHO), the prevalence of combined overweight and obesity in children rose by 47.1% between 1980 and 2013. In the U.S, childhood obesity is a serious problem as the prevalence of obesity was estimated at 17% in 2011-2014; extreme obesity was 5.8% (Williams and Greene, 2018).

Dental caries is infections caused by plaque, which is a sticky film of bacteria that forms on your teeth (U.S. Department of Health and Human Service, 2017). Dental caries are prevalent among youth aged 6–19 years. Untreated caries can cause pain and infections. In 2015–2016, the prevalence of total caries (untreated and treated) was 45.8% and untreated caries was 13.0% among youth aged 2–19 years in the U.S (Center for Disease and Control, 2018)

Pre- and primary school children who are overweight and obese are more likely to continue to be obese as adolescents and adults. They are also at an increased risk for poor health outcomes associated with being overweight (Williams and Greene, 2018). Also, dental caries can lead to cavities which can cause pain and infections that may lead to problems like eating, speaking, playing, and even low self-esteem for kids (CDC, 2021). The different development of obesity-related complications and dental caries among children has significant consequences on kids as this might impacts their ability to perform a certain task (Ng et al., 2014).

The product will be a proposal to implement school-based health promotion in the classroom and its association with a healthy outcome to reduce the risk of obesity and dental caries for elementary school children. Research has demonstrated that an increased level of sugary food consumption will be positively significantly associated with dental caries and obesity among elementary school children. The proposal will provide the key concept of past works of literature and unique contribution that can be used in the continued practice of implementing healthy options programs in elementary schools.

This study will aim to answer the following question:

1. Is having a nutrition health class in a school associated with healthy outcomes like shaping student food choices, reducing the risk of obesity and dental caries for elementary school children?

This study examines the existing literature on the importance of providing nutrition classes and healthy food options to elementary school students. Previous studies have shown that nutrition education in elementary schools plays an important role in shaping students’ food choices and ultimately health and performance (Perera and Frei, et al., 2015). Also, it is evident that not only will a school nutrition program impact the lives of children for their future health needs, but also their current status (USDA, n.d.). Many children also lack the knowledge of how and why eating healthy is so important and it is important to provide nutrition education and healthy option to the elementary student (Henzel, 2007).

The author’s Steward and Wang emphasize the importance of early learning of nutrition-related knowledge, attitudes, and behaviors in schools as it is evident that the school plays a huge role in influencing children’s diet. A student who attends schools that promotes healthy eating options through teaching and by providing healthy snacks and meals in schools is likely to request healthy options at home as healthy food provided in schools and the influence of peers become more important than their parent’s diet influence at home (Wang and Stewart, 2012). Promoting these behaviors might create a healthy environment that assists children to make healthy food choices that might reduce the risk of obesity among children (Wang and Stewart, 2012).

School-based promotions in classrooms have been proven to be an effective factor to reduce dental caries and obesity among elementary school students. A research study reported by Barnett, Henderson, et al., identified three distinct school environments where type 1 and 2 schools had healthy eating programs in school while type 3 schools had weak eating programs in the school. Adjusting for potential confounders, children attending type 1 and 2 schools had 21% (incidence rate ratio=0.79, 95% CI=0.68, 0.90) and 6% (incidence rate ratio=0.94, 95% CI=0.83, 1.07). The report statically proved that type 1 and 2 students had a lower 2-year incidence of dental caries and obesity respectively, compared with type 3 schools (Barnett and Henderson et, al., 2017)

Significance

We aim to work with policymakers by presenting past and recent research on the effect of obesity on kids to enable to them pass and implement policies that will mandate all elementary schools in the U.S to include nutrition education in their curriculum that will become an integral part of a normal school day for elementary-aged kids and will entail discussion, education, and activities that promote an increased knowledge of nutrition and expanded healthy options at home and school for kids (Guenther, Marc, et al., n.d).

Another unique contribution is organizing workshops to educate and create awareness to parents on the benefits of eating healthy. These workshops will also provide information and resources to parents on how to access healthy options in their neighborhood. Also, working with stakeholders like community partners and policymakers to implement healthy options programs in elementary schools in underserved communities will help reduce the risk of dental caries and obesity among children.

Due to many recent changes in the past years in the area of kids eating habits studies will still need to be done in the future on children who participated in the healthy diet programs where fruits and vegetables were served and how their diets have changed upon completion of K-12.

Another gap identified in the studies is the concerns about the lack of knowledge available on perceptions of healthy eating. More data are needed on the perceptions of healthy eating in general, on the influence on perceptions of messages from diverse sources such as food companies, and, most important, on the role of perceptions of healthy eating as a determinant of food choice.

Innovation Section

The approach of working with policymakers is innovative because it creates awareness on the effect of obesity and dental caries to policymakers which might help make policymakers reach an agreement of passing bills that might help reduce the risk of obesity and dental caries. Also, the approach of organizing educational workshops is innovative because these workshops might be resourceful to parents as this will better inform them on how to choose and access healthy food options for their children.

Methods

Study Design

The study is a quasi study using mothers and children in Chicago public schools between the ages of 6-12 to explore the association between nutrition, health class, obesity, and dental caries. Both quantitative and qualitative methods will be used to answer the research questions. All participants will complete a survey questionnaire with the help of a research assistant or community health worker.

Study Setting

The study will be conducted in Chicago Illinois where few schools will be randomly selected to participate in the study. The study will randomly select ten elementary schools in underserved communities in Chicago where there are fewer educational resources for students and access to healthy food options. The study will specifically select schools in the Southside and Southwest of Chicago.

Sampling Design

The sampling frame of the study is mothers and children in selected elementary schools in the Southside and Southwest of Chicago. The goal of the study is to access mothers and children in underserved communities with limited educational resources, educational background for parents, socio-economic status for parents, and access to healthy options for parents and kids.

Recruitment and Eligibility Procedures

The Researchers for the study will collaborate with not-for-profit organizations in Chicago like the Consortium to Lower Obesity in Chicago Children (CLOCC) whose goal is to confront the childhood obesity epidemic by promoting healthy and active lifestyles for children throughout the Chicago metropolitan area. The first step in the study will involve writing a short letter to parents through the teachers in school. The letter will contain a brief overview of the study. The letter will request parents who will be interested in the study to provide their contact phone number to enable the research assistant to put a call to them and explain in detail about the study. Participants will be screened for eligibility through a series of questions. A parent who are interested in the study and provides their contact information will be contacted and a detailed overview of the study will be provided to them. Written informed consent will be obtained from the parents or guardians before the start of data collection. A training program will be conducted by the PI where all participants and data collectors will be trained. The study will get approval for the protection of research subjects from the Institutional Review Board (IRBs) of the Illinois Department of Public Health

Data Collection Procedures

The study staff will consist of a community health worker, a research assistant, and the principal investigator (PI). Data will be collected by a community health worker and research assistant through a questionnaire that will be given to participants to fill out. The questionnaire will contain questions about obesity and dental caries awareness, demographic questions, and visual prompt pictures will be used to illustrate healthy food and unhealthy food options in the questionnaire to parents and kids. These questionnaires will be handled and filled out by the research assistant and community health worker based on participants’ responses. The questionnaire will also have a Spanish version where an interpreter will be available to translate to Spanish-speaking parents and kids.

Specific Measure

Socio-demographic and characteristic data

Demographics of the participant will be obtained by administering a socio-demographic behavioral questionnaire (SDBAQ) which will be modified by researchers. Participants (both parents and children) will be asked to self-report data like age, gender, education, the location where they live, socioeconomic status, and educational background.

Data Analysis Plan

Linear regression will be used to determine whether having a nutrition health class in a school is associated with health outcomes like shaping student food choices, reducing the risk of obesity, and dental caries for elementary school children?. To explore the association between having a nutrition health class in school with obesity and dental caries, I aim to test the null hypothesis of linearity against alternative regression functions and select the best fitting model. In doing so, I will use fractional polynomial regression models to evaluate whether the effect of a continuous variable (i.e. obesity rate) on the outcome (i.e. prevalence of dental caries) is better modeled by a nonlinear fractional polynomial (FP) function.

References

1. American Academy of Child and Adolescent Psychiatry (2016). Obesity In Children and Teen. Retrieved From https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Obesity-In-Children-And-Teens-079.aspx

2. CDC. (2020) Water Access in Schools. Retrieved from Water Access | Healthy Schools | CDC

3. CDC. (2018) Prevalence of Total and Untreated Dental Caries Among Youth: United Stated, 2015-2016. Retrieved From Products – Data Briefs – Number 307 – April 2018 (cdc.gov)

4. CD. (2021). Children’s Orall Health. Retrieved From Children’s Oral Health | Basics | Children’s Oral Health | Division of Oral Health | CDC

5. Edasseri, A., Barnett, T. A., Kâ, K., Henderson, M., &Nicolau, B. (2017). Oral health–promoting school environments and dental caries in Québec children. American journal of preventive medicine53(5), 697-704.

6 Green Schools National Network. (2018). Safe Water in Schools: What do we know? What can we do?Retrieved fromSafe Water in Schools: What do we know? What can we do?

7.Guenther, Marc, et al., (n.d). Incorporating Nutrient Education In Minneapolis School. Retrieved from school-nutr-brief.pdf (umn.edu)

8. Henzel, T. (2017). The Importance of Incorporating Nutrition Education Programs In Elementary Schools. Retrieved from The Importance Of Incorporating Nutrition Education Programs In Elementary Schools (regis.edu)

9.    Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., Abraham, J. P., Abu-Rmeileh, N. M., Achoki, T., AlBuhairan, F. S., Alemu, Z. A., Alfonso, R., Ali, M. K., Ali, R., Guzman, N. A., Ammar, W., … Gakidou, E. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England), 384(9945), 766–781. https://doi.org/10.1016/S0140-6736(14)60460-8

10.    Perera, T., Frei, S., Frei, B., Wong, S. S., &Bobe, G. (2015). Improving Nutrition Education in US Elementary Schools: Challenges and Opportunities. Journal of Education and Practice6(30), 41-50. Retrieved from Microsoft Word – JEP-Vol.6 No.30 2015.docx (ed.gov)

11. Wang, D., & Stewart, D. (2013). The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: a systematic review. Public health nutrition16(6), 1082-1100.

12. Walls, H. L., Peeters, A., Proietto, J., & McNeil, J. J. (2011). Public health campaigns and obesity-a critique. BMC public health11(1), 1-7.

13. Williams, S. E., & Greene, J. L. (2018). Childhood overweight and obesity: affecting factors, education and intervention. Journal of Childhood Obesity2(3), 1-7.

14. United States Department of Agriculture. (n.d.). Study Shows Strong Nutrition Education Can Lead to Healthier Food Choices by SNAP Recipients. Retrieved From https://www.fns.usda.gov/pressrelease/2013/fns-001313

15. U.S. Department of Health and Human Services.  (2017).Oral Health. Retrieved from:gov/a-z-topics/oral-health“> https://www.womenshealth.gov/a-z-topics/oral-health

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