Using what you have learned from Modules 1-6 create a report including an annotated bibliography based on the topic selected in Assessment 2.

Assessment Description

Using what you have learned from Modules 1-6 create a report including an annotated bibliography based on the topic selected in Assessment 2.

Assessment Instructions

Write a report which includes:

1. Introduction/background

2. Annotated bibliography (four x relevant and current research articles)

3. Literature evaluation (based on the four articles)

4. Conclusion

You will need to address the following elements:

Use APA 7th referencing

Was the research detailed in the article qualitative or quantitative?

What was the aim of the research?

How was the study conducted?

What were the results of the study, and do they answer the study question/aim?

What are the strengths and limitations of the study?

Overall statement on the applicability of the research to clinical practice.

Length: 2500 words

Due date: November 12, 2022

Format Font:

Plain font, size 12 (eg: Calibri, Times New Roman, Ariel)

Line Spacing: 1.5

Referencing: APA 7th Submission: Turnitin via Learnline

Header of document: Student number and Unit Code

Footer of document: Word count, page number and referencing system (APA 7 th)

criteria

Knowledge of the underpinning principles and theories of research

Demonstrate an ability to locate and select appropriate literature to answer a healthcare question Show critical thinking related to the selected articles and develop a coherent argument for how they address the specified research question

Apply academic convention to develop a clear and logical argument within the word limit (+/-10%)>

NOTE:

You helped me do the research topic on: TO FOCUS ON THE ATTRIBUTES TO MANAGE ANXIETY DISORDER AMONG TEENAGERS.

Please based on that assignment we did previously we will do thus one too using the above criteria.

Please the following is an example from the lecturer:

Example:

RESEARCH QUESTION - Are IDF recommended lifestyle modifications as effective as pharmaceutical interventions in avoiding progression to a diagnosis of T2DM for patients diagnosed as pre-diabetic?

BACKGROUND - According to the International Diabetes Federation (IDF, 2021), there are 537 million T2DM cases globally. This is predicted to rise to 784 million in 2045. Since 2001 cases have tripled; making it the worlds fastest growing, non contagious health challenge. A T2DM diagnosis has a significant impact on both individual health and life expectancy (World Health Organisation [WHO], 2016). Whilst some of the factors contributing to this surge are unmodifiable, there is also evidence that modifiable risk factors include diet, obesity and a sedentary lifestyle (IDF, 2021).

INRODUCTION - This paper contains four annotated bibliographical entries which address this topic. Broadly, each entry supports the health benefits of the IDF recommended interventions. The first selected study by Davies et al., (2016) demonstrates the benefits of community support, personal empowerment and dietary education, in avoiding disease progression. The second study by Marsden et al., (2022) demonstrates that an online approach, can provide effective and wide-reaching interventions. The third entry by the Diabetes Prevention Program Research Group (2015) focuses on the long term difference between available treatment options, disease progression and complications. In the fourth study Sun et al., (2017) addresses costs. Seeking to ensure a balance between expenditure and effectiveness, the authors inform and benefit key stakeholders to balance modifications with pharmaceutical interventions and avoid a T2DM diagnosis.

ANNOTATED BIBLIOGRAPHY

Davies, M., Gray, L. & Troughton, J. (2016). A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: The Let's Prevent Diabetes cluster randomised controlled trial. Preventive Medicine. 2016 Mar; 84:48-56. DOI: 10.1016/j.ypmed.2015.12.012. PMID: 26740346.

AIM - This randomised controlled trial takes a quantitative approach to its primary aim of researching the efficacy of recommended lifestyle and dietary interventions in preventing progression to a T2DM diagnosis. Davies et al., (2016) use a community based primary diabetes prevention program. Enrolling hyperglycaemic participants, considered to be at high risk of disease progression, the authors take a collaborative, longitudinal approach to the research topic. The purpose of this study was to investigate how to effectively implement the existing preventative research in a primary health care setting for participants with an existing pre-diabetes diagnosis. This information could then inform the efficacy of targeting dietary choices and activity levels and preventing disease progression, when compared to standard pharmaceutical interventions. METHOD - A meta-analysis of 44 general medical practices were chosen at random to either implement a 6 hour structured educational program, supported by regular telephone contact and a yearly refresher course or the provision of standard pre-diabetes medical care. Participants were over the age of 18, not pregnant, hyperglycaemic and considered to be at high risk of disease progression. Data in this randomised controlled trial was gathered for a period of 3 years. The measurable outcome was disease progression, crossing the threshold from persistent hyperglycaemia to a T2DM diagnosis. RESULTS There was a total of eight hundred and eighty participants. This was comprised of 36% female, with a mean age of 64 years and 16% representing an ethnic minority. From this cohort 131 participants went on to develop T2DM during the allocated time frame and showed an insignificant reduction in the risk of disease progression in comparison to standard pharmaceutical care. EVALUATION - This study is relevant, valid, current and unlikely to be effected by bias. The strength of this study lies in the size of its cohort and its ability to address the hypothesis. It is also strengthened by its use of electronic medical records to research and activist practices to provide insight, generate new knowledge and simultaneously engage relevant stakeholders as a means of generating fundamental societal change. The allocation to treatment groups was concealed, the participants were similar at baseline and the outcome was standardised. This type of research aims to improve outcomes of pre-diabetic participants through empowering strategies and information to improve individual health. A weakness lies in its restricted scope of participation and the lack of direct, individual monitoring of participants for adherence. The study also did not account for the various socioeconomic and other demographic influences in the participants. The study ultimately concluded that incorporating education is an effective means of providing improved outcomes, reducing disease progression through a specific and low cost, preventative approach whilst simultaneously empowering the studys participants. CONCLUSION -This study has significant implications for further research and for clinical practice. The authors show that although low cost, community based diabetes prevention programs may result in modest benefits to biomedical, lifestyle and psychosocial outcomes, the reduction of the risk of a T2DM diagnosis does not reach significance. The results still illustrate the importance of diabetes prevention as participation in the program was associated with reduced levels of hyperglycemia, clinically significant weight loss and improved HbA1c results. This result supports the importance of diabetes prevention. Outcomes were assessed based on either the development of a T2DM diagnosis and / or the presence of microvascular disease, comprising neuropathy, retinopathy and nephropathy. These findings have important implications for guiding and informing future T2DM and primary care research.

Marsden, A.M., Bower, P. & Howarth, E.et al.Finishing the race a cohort study of weight and blood glucose change among the first 36,000 patients in a large-scale diabetes prevention programme.Int J Behav Nutr Phys Act19,7 (2022). https://doi.org/10.1186/s12966-022-01249-5

AIM The authors primary aim is to quantify and analyse the impact of the program on participants weight and blood glucose levels. Marsden et al., (2022) examine and report upon both the physical changes and reasons that correlate with the recorded changes, measuring both weight, fasting plasma glucose and HbA1c (haemoglobin A1c) levels to monitor the status of the 36,000 participants in the 'Healthier You' program. Healthier You was an intensive, diet and exercise behavioral intervention aimed at preventing progression to T2DM carried out in the United Kingdom (UK) between 2016 and 2019. METHOD Patient level data was continuously gathered and analysed for deviations from the initial data which formed the statistical baseline. This data was then used to demonstrate the programs effectiveness and levels of engagement, with a quantitative, longitudinal, pre and post test design and a mixed method approach to the research question. RESULTS - The results were grouped into three specific areas; the uptake, the use of and the impact of the interventions. At the annual follow up, the data showed an average weight loss of between 2.8 and 3.4 kg and a reduction of between 1.4 to 1.8 mmol for HbA1c. Regular access to peer, website and telephone support was associated with considerably higher reductions in both HbA1c and weight loss. EVALUATION This study is relevant, valid, current and unlikely to be effected by bias. This study addresses the question, with its size supporting the accuracy of the resulting data. The interventions aim provided strong parameters, but it doesnt acknowledge variables such as age and employment status and the size of the cohort reduced the capacity for the direct monitoring of participants. CONCLUSION This study demonstrates that a digital approach can provide an effective and wide-reaching, population-based contribution to T2DM prevention. It focused on adherence to the recommended diet and activity guidelines and resulted in a clinically significant reduction in two of the variables; HbA1c and body weight. An outcome which supports the health benefits of the recommended diabetes prevention lifestyle modifications. This online success is however, qualified by the minimum of 16 hours of direct contact over the 13 sessions available within the programs timeframe. Revealing the specific nature of the studys additional requirements, informs future T2DM primary care research. Ultimately, showing that lifestyle interventions can significantly reduce diabetes development through a low cost, high impact, preventative approach to disease progression.

Diabetes Prevention Program Research Group (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: The Diabetes Prevention Program Outcomes Study.The Lancet. Diabetes & endocrinology,3(11), 866875. https://doi.org/10.1016/S2213-8587(15)00291-0

AIM This study takes a quantitative approach to the research and the primary aim is to compare the recommended intensive lifestyle interventions, with masked metformin and a placebo in a group of pre-diabetic participants at high risk of disease progression. The authors seek to determine whether the intensive application of the recommended lifestyle interventions results in comparable control of hyperglycaemia when compared with standard pharmaceutical care. METHOD This program was a randomised, controlled, clinical trial conducted through 27 randomly selected medical centres across the United States of of America (US). All participants were offered recommended lifestyle intervention support semi-annually, with the pharmaceutical group receiving unmasked metformin. RESULTS During the 15 year follow up period, transition to a T2DM diagnosis was reduced by 27%in the lifestyle intervention group and by 18% in the standard pharmaceutical care group, in comparison to the placebo group. These differences reduced over the studys timeframe. EVALUATION This study is relevant, valid, current and unlikely to be effected by bias. This study specifically addresses the hypothesis. It was concluded a full year before the scheduled completion date because the independent data safety monitoring board deemed the question had been fully addressed. The use of comparators and randomisation strengthens the resulting data and ensures that altered outcomes are able to more accurately be assigned to the interventions. The allocations were anonymous and all participants were treated identically, apart from the interventions pertaining to the study. There was however, a lack of very direct monitoring of the participants in order to verify stated adherence levels. CONCLUSION At the conclusion of the study the instance of microvascular complications did not vary significantly between the participants in any of the treatment groups. The recommended lifestyle intervention group had a T2DM incidence of 55%. It was 56% in the pharmaceutical group and 62% for those participants who received a placebo. This study demonstrates that both the recommended lifestyle intervention group and the standard pharmaceutical care group experienced a significant reduction in disease progression.

Sun, Y., You, W., Almeida, F., Estabrooks, P., & Davy, B. (2017). The effectiveness and cost of lifestyle interventions including nutrition education for diabetes prevention: a systematic review and meta-analysis.Journal of the Academy of Nutrition and Dietetics,117(3), 404-421.

AIM - This study takes a quantitative approach to testing both the effectiveness and the costs associated with the recommended lifestyle and dietary modifications. The authors aim to assess and quantify the results from diabetes prevention programs through a systematic review and meta-analysis. Data from between 2000 and 2015 was used to synthesise the costs, benefits and efficacy of the recommended lifestyle modifications and then compared against alternative sources. For example; face to face versus online or homemade versus dietician prepared meals. The authors then sought to test the effectiveness of lifestyle interventions. Aiming to determine which specific aspects of the programs correlate with the successful implementation of the recommended modifications and delay or avoid progression to a T2DM diagnosis. METHOD - A systematic review of the relevant literature researching the efficacy of recommended diet and lifestyle modification programs, designed to prevent disease progression for participants with persistent hyperglycaemia. The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (PRISMA, 2021). The measurable outcome was disease progression, crossing the threshold from persistent hyperglycaemia to a T2DM diagnosis. RESULTS - Study participants were anonymously divided into either the intervention group or the control group. Health scores included data such as; Body Mass Index (BMI), waist circumference, medical and family history were compiled at both baseline and again 6 months later in order to analyse for clinical variables and assess the efficacy of the interventions. The subsequent analysis was moderated through the separate use of both intervention and control practices in order to reveal the most practical, accurate and usable data. For example; participants getting the nutritional education intervention revealed varying degrees of weight loss over the following 12 months, whereas participants in the dietician prepared intervention although revealing a relatively larger weight loss also incurred higher costs associated with the intervention. EVALUATION - This study is relevant, valid, current and unlikely to be effected by bias. The strength of this study lies in its ability to address the most practical aspect of the hypothesis and in that way guide and inform practice, provide additional insight for future research and engage the relevant stakeholders. Also, being conscious of any associated costs incurred during the implementation of the lifestyle interventions means that the nature of the data gathered for this study provides real world valid and informative data for future research in this area. An area of weakness that could be found in the study was the lack of a comparator, only using publications written in English. There was also a lack of specifics regarding costing and further to this the authors did not address the more specific socio-economic circumstances, specific preferences or special interests related to diet and nutrition. CONCLUSION - This study indicated that participation in a digital diabetes prevention program that focused on adherence to recommended diet and activity guidelines resulted in a clinically significant reduction in two of the variables; HbA1c and body weight and is a lost cost, high impact, specific and accessible element of an entire population approach to preventing those with a pre-diabetic diagnosis progressing to a T2DM diagnosis.

LITERATURE EVALUATION

A search for relevant articles was carried out through the Charles Darwin University (CDU) library database. Each of the 4 articles selected was deemed to be relevant to the research question, valid and peer reviewed, current to within a timeframe of the previous 10 years and unlikely to be effected by bias. The selected articles all declared any conflicts of interest and contained both a clearly stated methodology and specified inclusion and exclusion criteria. Each of the studies provided purposeful sampling, quantitative and explanatory outcomes and also addressed aspects of empowering and informing stakeholders, targeting hyperglycaemia and avoiding disease progression. Differences exist in areas such as the research methodology, strengths and weaknesses, the trajectory it offers for further research and its relevance for future clinical practice (Greenhalgh, 2020).

CONCLUSION

The entries in this annotated bibliography address various aspects of the research question, and present high quality evidence to identify risk factors, empower participants and inform future research in the quest to prevent disease progression. The benefits of community support, the scale of intervention made possible through an online approach, the long term health benefits and the cost effectiveness of prevention are all addressed. Through these papers, the authors have made a small but significant contribution to combatting the worlds fastest growing, non-infectious health challenge.

References

Davies, M., Gray, L. & Troughton, J. (2016). A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: The Let's Prevent Diabetes cluster randomised controlled trial. Preventive Medicine. 2016 Mar; 84:48-56. DOI: 10.1016/j.ypmed.2015.12.012. PMID: 26740346.

Diabetes Prevention Program Research Group (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: The Diabetes Prevention Program Outcomes Study.The Lancet. Diabetes & endocrinology,3(11), 866875. https://doi.org/10.1016/S2213-8587(15)00291-0

Greenhalgh, T., M. (2020).Understanding research methods for evidence-based practice in health. (2nd ed.). Wiley, Australia. https://ebookcentral.proquest.com/lib/cdu/reader.action?docID=6488129

International Diabetes Federation (2021).Diabetes Atlas-10th Edition. https://diabetesatlas.org/

Marsden, A.M., Bower, P. & Howarth, E.et al.Finishing the race a cohort study of weight and blood glucose change among the first 36,000 patients in a large-scale diabetes prevention programme.Int J Behav Nutr Phys Act19,7 (2022). https://doi.org/10.1186/s12966-022-01249-5

Sun, Y., You, W., Almeida, F., Estabrooks, P., & Davy, B. (2017). The effectiveness and cost of lifestyle interventions including nutrition education for diabetes prevention: a systematic review and meta-analysis.Journal of the Academy of Nutrition and Dietetics,117(3), 404-421.

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ2021;372doi:https://doi.org/10.1136/bmj.n71

World Health Organisation. Global report on diabetes. Geneva: World Health Organisation; 2016.