Weight Loss Using Three Methods in Premenopausal Women - Research Proposal Example

HSC 501 Qualitative Research Proposal I. The Research Plan A. An Assessment of the Willingness, Readiness and Awareness of Pre-menopausalWomen regarding Weight Loss Interventions and the Barriers to their Successful Weight Management B. Abstract: Using qualitative hypothesis generating methodology, the study will venture to investigate the willingness, readiness and awareness of pre-menopausal women regarding weight management and identify barriers which deter them from making the most out of weight loss programs. A total of 102 women aged 45 to 49 will be recruited as participants in this study by randomized sampling. The main instruments to be utilized in the study will be an interview guide and a self-report questionnaire on menopausal status and demographic profile. Data will be analyzed using theoretical coding as specified in Auerbach and Silverstein (2003). Based on the coding, findings will be collated and summarized. Conclusions will be drawn, thereafter, and appropriate hypotheses will be generated. Recommendations will be suggested to enhance the positive experiences and benefits of pre-menopausal women engaged in weight management programs. C. Statement of the Research Problem: The study will attempt to qualitatively examine the willingness, readiness and awareness of pre-menopausal women regarding weight management and identify barriers which deter them from making the most out of weight loss programs. Specifically, the proposed study will address the following objectives: 1. Describe the willingness of the research participants to engage in weight management schemes. 2. Assess the readiness of the participants to undergo weight management and compare this with their willingness. 3. Evaluate the awareness of the participants regarding the importance and health benefits of weight management for women approaching the stage of menopause. 4. Identify the barriers which prevent women from engaging in successful and fruitful weight management program. D. Hypothesis: The study will be designed using qualitative methodology, hence, it will be a qualitative hypothesis-generating research. As defined in Auerbach and Silverstein (2003), this type of research collects interview data from the respondents regarding a particular field of interest and then based on the data collected, hypotheses will be developed at the end of the study. No hypothesis will, therefore, be formulated and tested prior to data collection. E. Background of the Study Obesity as a global health problem is already widely recognized (World Health Organization, 2000; James, 2003; Haslam, Sattar and Lean, 2007; Lovejoy, 2009). It was, however, noted by Lovejoy (2009) that while the world sees the significance of obesity as a global epidemic, there seem to be less recognition that the prevalence of obesity is higher among women around the world and that obesity presents differential health risks in women. Cooper, Fairburn and Hawker (2003) identified the main health risks of obesity as hypertension (which is associated with risk of stroke), cardiovascular disease (such as coronary artery disease, peripheral vascular disease, and heart failure), abnormal cholesterol levels (associated with risk of heart disease), diabetes, sleep apnea, osteoarthritis, and gall bladder disease. Women who are overweight, however, face greater risks for postmenopausal breast cander, endometrial cancer and pre-menopausal ovarian cancer. Moreover, women who are obese face greater risks for polycystic ovarian syndrome (PCOS) and PCOS-related infertility (Lovejoy, 2009). To counteract the risks associated with weight gain during the menopausal stage, there should be conscious efforts on the part of healthcare practitioners to emphasize that weight gain is among the modifiable risk factors which may be controlled through weight management, fat restriction, and increased physical activity. There are many barriers which restrain a lot of women in the pre-menopausal stage from engaging in successful weight management programs. Clark (1999) identified common barriers as perceived ability, social discomforts and bodily pain or fear of pain. In two more recent studies, Napolitano and Borradaile (in Cree, 2008) revealed mental obstacles such as self-consciousness, fear of failure, fear of injury, perceived poor health, having minor aches or pains and feeling too overweight to exercise were the most common concerns, while Ali, Bernsen and Baynouna (2009) uncovered healthcare system – related, social and physical barriers to weight loss intervention programs. Meanwhile, the inspiration for the present study was derived from the findings of DiBonaventura and Chapman (2008), who revealed the effect of barrier under-estimation on weight management and exercise which results in the discrepancy between the respondents’ intention to lose weight and the behavioral change pattern necessary for successful weight management intervention. Edelman and Mandle (2006) maintained that in more general terms, people are tend to initiate and maintain physical activity when they perceive a net benefit, choose an enjoyable activity, feel competent doing such activity, feel confident in overcoming perceived barriers, feel safe doing the activity, able to access the activity regularly, perceive no substantial negative financial or social costs, able to address competing time demands and fit activity into the time schedule and able to balance labor-saving devices with other activities that involve physical exertion. Based on available knowledge about the conditions necessary for individuals to initiate and maintain physical activity and on the participants’ accounts of their own experiences, recommendations will be forwarded in the design of ideal programs targeted among pre-menopausal women to encourage them to enroll in weight management programs. The study is of paramount significance in the light of the findings of Brown, Kelly and Summerbell (2007) regarding the absence of any substantial evidence that managing weight gain during menopause through combined diet and activity can still prevent weight gain in this stage. F. Definitions The following terms are defined to guide layman readers in understanding the substance of the proposed study: Coding. As will be used in this study, coding, or theoretical coding refers to the deciphering or interpretation of the data from the interview. This procedure involves naming or identifying a concept or a theoretical construct, explaining and discussing these in sufficient detail. Explanations are reflected in the coding notes appended at the end of the study documentation. Perimenopause. This is the time period closer to menopause identified by the onset of such menopausal changes as hot flushes or bleeding. Pre-menopausal stage. This term refers to the reproductive period of a woman before menopause, or in other words, from menarche to menopause. The pre-menopausal stage includes the perimenopause. G. Method 1. Subjects: A random sample of 100 women aged 45 to 49 from Boston City, Massachussetts will be recruited as voluntary participants of the study. This number represents the probability sample of the proportion of women population in Boston City who are in their pre-menopausal stage. Data for the sample size computation was taken from the US Bureau of Census (2008) and from Varney, Kriebs, and Gegor (2004) who maintained that the range of menopause is between the ages of 48 and 55. Pre-menopause is estimated to be from 48-49 years of age. From the total population of women in Boston of 314,458, around 6.3 per cent of this number fall within the pre-menopausal age range of menopause or approximately 19,810. 2. Material: The main instruments of the proposed study will be a self-report questionnaire on menopausal status and demographic profile, and an interview guide. The self report questionnaire is exhibited as an attachment to this proposal. 3. Procedure: Using randomized sampling method, 102 women will be enjoined to participate in the study. Voluntary participants will be requested to sign informed consent forms, a draft of which is presented in the appendix. Participants will first be requested to fill in the self-report questionnaire which contains pertinent demographic profile such as age, occupation, and educational attainment, as well as the menopausal status of the respondents. Names of the respondents will not be required in the questionnaire. Instead, respondents will be identified using respondent codes. After the self-report questionnaires are completed, the participants will be given the option to continue with the interview or to have the interview scheduled for another time at their convenience. To facilitate theoretical coding and and maintain data accuracy, the interviews will be recorded using micro-casettes. Recorded interviews will be transcribed at the soonest possible time after they have been conducted and the experience is still fresh in the memory of the researcher. To complement the theoretical coding, coding notes will be exhibited as part of the appendix of the study findings. The findings will then be summarized and conclusion will be drawn. Based on the findings of the study, the hypotheses will be developed. Recommendations will be formulated based on the findings and conclusions to help enhance the positive experiences of pre-menopausal women in their weight loss programs. 4. Data Management: Data will be analyzed using the process of theoretical coding as explained under the definition section of this proposal. H. Literature Cited Ali, H. I., Bernsen, R. M. & Baynouna, L. M. (2009). Barriers to weight management among Emirati women: a qualitative investigation of health professionals’ perspectives. International Quarterly of Community Health Education, 29(2), pp. 142-159. Auerbach, C. F. & Silverstein, L. B. (2003). Qualitative data: an introduction to coding and analysis. New York: New York University Press. Brown, T., Kelly, S. & Summerbell, C. (2007). Prevention of obesity: a review of interventions. Obesity Reviews, 9(S1), pp. 127-130. Clark, D. O. (1999). Identifying psychological, physiological and environmental barriers and facilitators to exercise among older low income adults. Journal of Clinical Geropsychology, 5(1), pp. 51-62. Cooper, Z., Fairburn, C. G. & Hawker, D. M. (2003). Cognitive-behavioral treatment of obesity: a clinician’s guide. New York: The Guilford Press. Cree, R. (2008). Mental barriers hamper obese women’s effort to get exercise. Retrieved February 21, 2010 from http://www.temple.edu/newsroom/ 2008_2009/10/ stories/mentalbarriers.htm DiBonaventura, M. & Chapman, G. B. 2008). The effect of barrier under-estimation on weight management and exercise change. Psychology, Health & Medicine, 13(1), pp. 111-122. Edelman, C. L. & Mandle, C. L. (2006). Health promotion throughout the lifespan. 6th ed. St. Louis, MO: Elsevier/Mosby. Haslam, D. Sattar, N. & Lean, M. (2007). Obesity-time to wake up. In N. Sattar & M. Lean (Eds.), ABC of obesity (pp. 1-3). Malden, MA: Blackwell. James, P. (2003). Obesity: a global problem. In L. Voss & T. Wilkin (Eds.), Adult obesity: a paedriatric challenge (pp. 1-12). London: Taylor & Francis. Lovejoy, J. C. (2009). Pregnancy and menopause. In C. A. Nonas & G. D. Foster (Eds.), Managing obesity: a clinical guide. 2nd ed. (pp. 260-274). Chicago, IL: American Dietetic Association. Speller, M. L. (2004). The menopause answer book: treatments and solutions for your unique symptoms. Naperville, IL: Sourcebooks. US Bureau of Census (2008). Age and Sex: Boston City, Massachusetts. Retrieved February 19, 2010, from http://factfinder.census.gov/servlet/STTable?_bm=y&-geo_id=16000US2507000&-qr_name=ACS_2008_3YR_G00_S0101&-ds_name=ACS_2008_3YR_G00_&-redoLog=false Varney, H. Kriebs, J. M. & Gegor, C. L. (2004). Varney’s midwifery. 4th ed. Sudbury, MA: Jones & Bartlett. World Health Organization (2000). Obesity: preventing and managing the global epidemic. Geneva: World Health Organization I. Documentation of Informed Consent A draft of the informed consent form is shown next page. I. Documentation of Informed Consent INFORMED CONSENT An Assessment of the Willingness, Readiness and Awareness of Pre-menopausal Women regarding Weight Loss Interventions and the Barriers to their Successful Weight Management I am conducting research on the willingness, readiness and awareness of pre-menopausal women regarding weight loss interventions and the barriers which deter them from making the most out of weight management. I am investigating this because of the alarming statistics about obesity and being overweight in the United States and around the world. Without meaning to scare you, the World Health Organization already considers obesity as a global epidemic since the dawn of the new millennium. The experiments I am conducting will provide us with better chances to control weight gain and obesity among pre-menopausal women. When we successfully control our weight during the pre-menopausal period or as we age, we also take a stand against the health risks that obesity presents to the woman population. If you take part in this research project you will be asked to answer a short questionnaire regarding your menopausal status and pre-menopausal symptoms and a few demographics such as age, occupation and educational attainment. You will also be requested to participate in individual interviews regarding your experiences and perception about weight loss interventions. We do not expect you to feel any physical discomfort nor sustain an injury during the procedure since you will not be subjected to any physical tests or strength training.  You will not be required to write you name on any of the two questionnaires to protect your anonymity. Instead each participant be given a respondent code number which will be used to gather all data pertaining this research study. After you have completed the questionnaires, it will be collected and stored in a secure location to safeguard the confidentiality of your responses. After the study has been defended before a refutable panel of jurors and has passed rigorous academic standards, the questionnaires will be shredded and disposed by incineration. Taking part in this project is entirely up to you. No one will hold it against you if you decide not to participate in this study.  If you do take part, you may withdraw at any time.  In addition, if you change your mind about taking part in this study, you may ask to have your data withdrawn from the study after the research has been conducted. Should you feel you need to know more about this research experiment, please contact me at phone # or at my email address ______________. My advisers name is _____________ and his/her contact details are as follows, phone number ___________, and email address ______________. This research proposal has been approved by the name of university Research Ethics Committee. Complete information on the university policy, as well as the procedure for research involving humans can be obtained from name of person or office at telephone number _____________________. You will be furnished a photocopy of this signed consent form. Sincerely,    [Name of researcher, title] I agree to take part in this project.  I know what I will have to do and that I can stop at any time. ___________________________________    March XX, 2010   Signature  and Respondent Control Number                                                     II. Plan for Administrative Support A. Budget The estimated budget for the proposed study is $951.62. This amount will cover expenses for equipment, supplies, refreshments for the interviews, etc., plus 5% contingency allowance. The only personnel to be involved in the conduct of the study is the researcher. As to equipment, one laptop for the processing of interview data and documentation ($400.00), one micro-cassette recorder ($60.00) will be used and 102 blank micro cassettes (at $1.10 per box of 10s or $12.10), one printer ($30.00) and one printer ink cartridge black and colored ($32.00). As to supplies, a ream of bond papers ($6.00), notebook to serve as field book for note-taking during interview photocopies of the self-report questionnaires (408 sheets at 27 cents each or $110.16) . The researcher plans to offer refreshments (juice and sandwich) to the respondents during the interviews (at $1.50 for a 12 ounce glass of orange juice and $1.10 for a tuna sandwich or $2.60 times 102 = $256.20).906.30 III. Appendix A draft of the self-report questionnaire is shown below. An Assessment of the Willingness, Readiness and Awareness of Pre-menopausal Women regarding Weight Loss Interventions and the Barriers to their Successful Weight Management Self Report on Menopausal Status AND DEMOGRAPHIC PROFILE (Adapted from Speller, 2004) Part 1. Demographic Profile. Please check the appropriate box or indicate the information being requested: 1. Age :  45  46  47  48  49 2. Occupation : ________________________________ 3. Educational Attainment : ____________________________ Part 2. Menopausal Status. Kindly check the box corresponding to the symptoms you are currently experiencing. A. Menstrual period  I experience missing periods.  I experience regular cycles.  I experience periods which are closer/further apart.  I experience heavier/lighter bleeding than previously.  I experience spotting between periods.  I experience worsening PMS symptoms. B. Hot Flashes  I experience hot flashes once a day or less, and they’re manageable.  I experience hot flashes more than once a day, and they occasionally interfere with my life.  I experience hot flashes every fifteen minutes, and they’re driving me crazy. C. Night sweats, Insomnia  I experience throwing the covers off occasionally.  Most nights, I experience waking up drenched in sweat.  I experience not being able to sleep as I used to.  I experience not being able to function unless I get a full night’s sleep. D. Mood Swings  I experience being more irritable than I used to be.  I experience being fine one minute then suddenly getting angry or depressed and then fine again.  I experience being nervous.  I experience feeling depressed.  I experience crying over little things.  I experience feeling exhausted. E. Vaginal Dryness  I experience a little discomfort during intercourse, as my vagina is dry.  I feel discomfort during intercourse but fine otherwise.  I experience itching in the vaginal area.  I experience getting a lot of vaginal infections. F. Other Symptoms  I experience losing my interest in sex and that devastates me.  I experience fuzzy thinking.  I experience not being able to concentrate.  I experience having poor memory.  I experience having headaches.  I experience gaining weight.  I experience having dry and wrinkly skin.  I experience having heart palpitations and shortness of breath.  I experience feeling dizzy.  I experience aching joints. G. Early Stage  I experience having my period completely stop.  I experience not having a period in twelve months.  I experience having hot flashes and night sweats.  I experience being unable to fall asleep or stay asleep as I used to.  I experience being irritable and short-temprered.  I experience being depressed. H. Intermediate Stage  I experience not considering intercourse because of the pain/bleeding involved.  I experience having cystitis.  I experience urinating frequently.  I experience my urine leaking when I sneeze/cough/laugh/make love.  I experience wearing a pad to protect my underwear from urine spotting.  I experience wrinkled skin on my hands/face/neck.  I experience gaining weight I can’t lose.  I experience feeling physically weaker.  I experience deteriorating eyesight.  I experience thinning/graying hair.  I experience memory lapses which are disturbing to me.  I experience gum disease and tooth loss. I. Late Stage  I experience coronary heart disease.  I experience high blood pressure.  I experience Osteopenia/Osteoporosis  I experience thyroid disease.  I experience macular degeneration of the eye.  I experience Type II Diabetes  I experience Osteoarthritis  I experience breast/uterine/ovarian/colon cancer.  I experience Alzheimer’s disease.  I experience Hypercholesterolemia. Read More