1. HS499 Bachelor’s Capstone Week 6 Seminar Research Analysis on Community Health

2. Seminar Questions Discuss your status report on your progress with your research project. Include your impression of the availability of outside resources to include in your research. Indicate which areas you think you may be in need of further assistance in developing your project. Of the four assigned articles, select one and provide an assessment of the research performed, the type of methodology used and the findings and conclusion of the research. What did you like about the article? What recommendations do you have for the researcher to improve on the study?

3. Article 1

6. SPARC stands for Sickness Prevention Achieved through Regional Collaboration. The author notes that “instead of viewing the physician-patient encounter as the beginning and end of a delivery system, SPARC’s approach would regard the physician practice as one element of a communitywide network of activities.”

7. Article 1

8. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 Background: There is a continuing need to examine the relationship between diet quality and health in the population. The Healthy Eating Index (HEI) has been developed as a composite measure of diet quality by the US Department of Agriculture. Objectives: The first objective was to use the HEI to assess the diet quality of a representative sample of the US population and population groups. The second objective was to examine the association between HEI and obesity.

9. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 Design: Cross-sectional analysis of data from 10 930 adults who participated in the Third National Health and Nutrition Examination Survey. Sociodemographic, physical activity, dietary, and health data were used in the analysis. Diet quality was assessed with the HEI score, ranging from 0 to 100, based on 10 dietary criteria. A low HEI score indicates poor diet.

10. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 Results: A majority of survey participants had a low HEI score. The percentage of individuals classified as having a poor diet varied by age, gender, race/ethnicity, income, and education. A low HEI score was associated with overweight and obesity. There was a graded increase in the odds ratio of obesity across the HEI category after adjusting for age, gender, race/ethnicity,physical activity, smoking, alcohol use, income, and education.

11. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 Conclusions: An index of diet quality, such as HEI, may provide a comprehensive assessment of diet in the population. Since the HEI is based on the US Dietary Guidelines, the use of these guidelines as a way to improve health should be emphasized. However, the overall effectiveness of these guidelines in disease prevention needs to be studied further.

12. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 One of the US national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15%. However, research indicates that the situation is worsening rather than improving Two methods are commonly used in the study of diet quality and health. First, statistical techniques such as factor analysis and cluster analysis may be used to identify the common dietary patterns and then relate these patterns to the health outcome.

13. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 The second approach to assessing an individual’s diet is to score it with a set of criteria to produce a composite index of diet quality. The goal in undertaking a comprehensive analysis of dietary patterns in relation to overweight and obesity was to clarify some of the inconsistencies in the earlier studies. The Third National Health and Nutrition Examination survey (NHANES III) is a nationally representative survey of the US civilian population using a stratified, multistage, probability sample design. Study sample consisted of 10,930 individuals.

14. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 Data for analysis included anthropometric and dietary intake data. Additional data included Sociodemographic data (age, sex, race/ethnicity, household income, and education), physical activity, smoking status, and alcohol use. Body weight was measured using a beam balance scale and height was measured using a stadiometer. From these, BMI was calculated as weight in kilograms divided by height in meters squared (kg/m2).

15. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 They defined three weight categories using the following recommended criteria (National Institutes of Health (NIH), 1998): normal weight (BMI of 18.5–24.9 kg/m2), overweight (BMI of 25–29.9 kg/m2), and obesity (BMI of 30 kg/m2 or greater). They excluded underweight individuals with BMI of 18.4 kg/m2 or lower (n¼228) from the analysis.

16. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 The results show that the diet quality as assessed by HEI varied according to sociodemographic factors such as age, gender, race/ethnicity, income, and education as well as lifestyle factors, such as smoking, alcohol use, and physical activity. The mean HEI score was higher among the older individuals, women, other Hispanics, other non-Hispanics, and individuals with higher income and education. Conversely, more of the younger age groups, men, non- Hispanic blacks, and individuals with low income and education were classified as having poor diet.

17. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 The major limitation of the study is the use of crosssectional study design, which cannot provide evidence of a causal relationship between HEI and obesity. However, it is generally accepted that poor diet is associated with the subsequent development of several chronic diseases. In addition, they could not control for the genetic predisposition for obesity in their analyses.

18. Article 2 Healthy Eating Index and obesity HX Guo1*, BAWarden1, S Paeratakul2 and GA Bray2 In conclusion, results suggest that HEI is associated with obesity in the US population. Since the HEI is based on the Dietary Guidelines for American, the use of these guidelines as a way to improve health should be emphasized. However, the overall effectiveness of these guidelines in disease prevention needs to be investigated further in prospective studies and among different populations, especially populations outside the US.

19. Article 3

24. Article 4