A Critique of the article Self-Efficacy Program to Prevent Osteoporosis among Chinese Immigrants
Abstract
The journal talks about a research conducted on the Chinese immigrants’ particularly older ones of forty five years and above. The research indicates that the immigrants are at a high risk of contracting Osteoporosis compared to other population in the United States. The critique of a quantitative study is helpful in that it provides a wider review of the researchers’ strategies to write his article characterized by both strengths and limitations. Critique studies are important in rating an article or a journal and also to be able to determine whether it supports the subject topic. In this critique of Self-Efficacy Program to Prevent Osteoporosis among Chinese Immigrants, I will cover the title, the problem, and purpose, Research design, Population and sample, Data collection and measurement, procedures used, Data Analysis, Findings and the researchers’ summary assessment.
The researchers have met the criteria by using Self-Efficacy program to prevent Osteoporosis among Chinese immigrants as the title. It Cleary represents the overall content in this article. From the title, the researchers have systematically laid out a perfect system from the introduction to the purpose and procedure all the way to the summary. The researchers have been able to bring up the idea and even explain key words that give a reader a clear view of the journal. However, the researchers fail to include applications part and the expected outcome in the title.
Problem and Purpose
The researchers in this journal have been able to identify the problem statement that leads to the employment of Self efficacy program that aims to prevent the osteoporosis problem among Chinese immigrants. The recent forty five years old Chinese immigrants to the US have been found to be at a greater risk of contracting osteoporosis because of their low bone mineral density. The researchers have gone ahead to identify the lack of information which worsens the already risky situation among the Chinese immigrants. However, the researchers did not elaborate and expand the problem in detail thus omitting some of the information required in stating the problem in a quantitative study. For example, the researchers fail to state the age bracket at which the Chinese people are affected by this disease.
The researchers only have mentioned the age of the participants used in their research but have not specified whether it is possible for the young generation to contract Osteoporosis (Qi et al., 2011). The researchers have also highlighted on the purpose of this journal. They have insisted on the need to provide education to the Chinese immigrants about the higher risks they face of contracting Osteoporosis compared to other groups found in the United States. Furthermore, they have stated the reasons for the risks and also aim to provide information on how the immigrants can reduce the risk of contracting Osteoporosis. Although the researchers have failed to explain further about how safe the Chinese immigrants below the age of 45 years are, they have provided the age bracket for the targeted audience.
Nevertheless, the researcher have not fully laid out the purpose of this journal as required. The researchers should have stated their aim to identify barriers as well as discussing strategies for the recruitment of the Chinese immigrants into clinical research studies. The aim to fill gaps in the current research involving recruitment of American Chinese immigrants of over forty-five years into clinical trials should also have been their purpose (Dong et al., 2011). Another goal the researchers should have considered in their research is the need to review published reports of recruited Chinese immigrants and expose the recruitment barriers as well as discussing strategies to overcome these obstacles. Finally, the researchers should have identified the other non-Chinese groups that the journal intends to employ as a comparison to the older Chinese immigrants.
The researchers have also accommodated the use of both independent and dependent variables. While using the age as an independent variable, the researchers have also included measures to curb and reduce the risk of Osteoporosis as dependent variables. Finally, this journal’s purpose coincides with the nursing discipline as it aims to research, explain and provide information as well as a long lasting solution to the imminent risk of Osteoporosis amongst the elder Chinese immigrants.
Research Design
The researchers used a randomized controlled trial. Foreign-born Mandarin speaking Asians were recruited in this trial with a total mean age of 64.08 years (Tufts Qi et al., 2011). Two groups were employed that is the intervention group, and n control the attention group. Sixty-three women and twenty men took part in this program. This is a good method to use in a case like the one in this journal although the researchers have not effectively carried out the research using this method. Considering that this disease affects both men and women, and before the research, it is not known who are at a higher risk, the researchers should identify both the male and female participants in equal measure (Qi et al., 2011). The researchers of this case, on the contrary, have included more representatives in one gender group than the other which could have produced inaccurate and biased results. From my point of view, the researchers would have used the PRISMA method to carry out this research. This method involved revision and exposition of quality reporting of meta-analyses statements and was developed recently by a renowned group of scholars.
According to Tufts Qi et al., (2011), this approach has been endorsed widely by medical journals with up to one hundred and forty-six medical journals supporting it. It has been described highly as a standard for reporting systematic reviews and meta-analysis. Tufts Qi et al., (2011), show that the use of PRISMA method improves the quality of a review article compared to the Randomized Controlled Trial. There are three processes involved in this process that is searching for previous medical journals and keywords for example Chinese immigrants. PubMed, Web of Science and the Cochrane Central Register of Controlled Trials would have been useful to the researchers during the searching process (Tufts Qi et al., 2011). Second is to identify the strategies to be used and finally screening which involves testing the strategies so that the criteria will be met and excluding the ones that do not fulfill the criteria.
The researchers did not appropriately use the comparison criteria required in research. First, many researchers have used more women in number than that of men in the study which otherwise should be equal since Osteoporosis poses a threat to both men and women (Wieland et al., 2012). The researchers should also have considered including non-Chinese groups to prove the journal’s agenda for example by comparing the results obtained from the Chinese immigrants to those derived from the Caucasian counterparts. Also, according to this journal, it seems the research was conducted once and has not been related to other research attempts maybe from previous years. However, the researchers have been accurate in dealing with the data analysis in the journal. The data has been laid out well since the start of this research when personnel’s were recruited up to the point when results were obtained and analyzed. Another factor used and observed by the researchers in this journal is the blinding form. During the program, the data obtained from them was not released to them and hence all that was needed of them was the tests. Nevertheless, there is no case of attrition bias observed in this article. The researchers have used a systematic Literature Review design. This is because the journal is characterized by a rigorous and well-defined approach, it is comprehensive, has provided the actual time this study was carried out, it has also provided details of the methods that the researchers used to evaluate and synthesize findings of the journal.
Population and Sample
The researchers of this journal have identified the Mandarin speaking Asians as the target audience of this journal. The audiences are the recently settled immigrants in the United States of the age 45 years and above (Tufts Qi et al., 2011). Both men and women have been included in this study. The recent Chinese immigrants have been described as having a low bone mineral density and thus are at a significant risk of developing Osteoporosis. Although having provided the full details of the target audience, the researchers ought to have added another different group from the Chinese immigrant group so as to compare and contrast the results and also be able to understand the reason why one group is more at risk than the other one.
Since the target population for the study is the Chinese immigrants who live amidst other members of the community, finding them for the study requires several sampling methods (Tufts Qi et al., 2011). The most efficient in the case of targeting a conspicuous group on the population is often stratified sampling. This way, the researcher has a fast way of reaching respondents than it would be in the case of snowballing, for example. Recruiting the participants started with advertising the project through posting in grocery stores, retirement community center, churches, apartments, and the Chinese newspaper. Those that qualified for the study had to be above the age of 45 and healthy. In other words, they had to be free from any condition that may affect their hearing, sight, or even the functions of the heart. The number of those who volunteered to participate was 111 who were then assigned to the treatment or attention control group randomly using sealed envelopes.
Considering the fact that the number of respondents was 110 and that there were relatives and members of the same family from the number, it is only fair to say that the effort to enhance representativeness was not successful. The biases may have been minimized through randomly assigning people to different control groups, but it is nonetheless clear that there was bias. Of the 110 respondents, the researcher states that 52 of them came in pairs. This means that they were family and that they would not provide an accurate representation of the Chinese immigrant community. Other than that, the number of respondents was only 110 and came to the study voluntarily. This simply means that hundreds of others chose not to come despite meeting the requirements. Since it was voluntary, the researcher was sure that few people would come. A hundred people, in this case, shows that there was a small number of participants. An informed study would have worked on having at least 200 respondents. That way, it would be possible to acquire unbiased results.
Data Collection and Measurement
After coming up with the respondents, proper data collection methods have to be in place so that the researcher can obtain all the information he/she needs. Since the population targeted was often made up of low-income earners, the possibility of some or most of these people being illiterate was high. For that reason, it was data collection methods that required them to read English would not have worked so well (Tufts Qi et al., 2011). Since all the respondents were supposed to be fluent in Mandarin, the researcher used interviews conducted in the language so as to acquire them most out of the interaction with the respondents. Still, the primary data collection method was the questionnaire, which was used to gather background information of the participants. Questions asked revolved around their age, gender, and marital status, the number of children, acculturation, osteoporosis preventive behaviors, osteoporosis risk, and knowledge of the condition (Tufts Qi et al., 2011). The outcome measures were translated from and back to English to establish reliability and validity with Caucasians. Nonetheless, the study was limited by the small sample size which means there was insufficient power for the researchers to support their hypothesis. For this reason, factors such validity and reliability in the research requires that more research is done so as to develop more understanding of the issues.
Procedures
The intervention in the researcher was based on the idea that self-efficacy improved knowledge and behaviors relate to bone health among the Chinese immigrants. The intervention received by the randomly selected participants showed tremendous improvement after just 2 weeks of receiving the intervention. This was concerning the knowledge they had on osteoporosis, self-efficacy for exercise, and adherence to the medication used to treat the condition. The intervention was allocated and implemented properly as it took notice of issues such as language, culture, and specific needs for reducing the racial, ethnic, and socioeconomic disparities in health. After the interventions, the results among the respondents indicated that they were changing their behavior and attitude toward the control and combating of the condition. Moreover, one of the components of the self-efficacy theory is to help the participants set small individual goals for exercises that they can master in the long run and experience more success. In the research, the inventions that were laid down by the researched worked and they were, in fact, available for every participant in the group to receive them. While reliability and validity are difficult concepts to cover due to the limitation of time and sample size in this particular research, the use of SPSS in the research encouraged validity to a large extent by reducing bias in the study.
Data Analysis
The study employed descriptive statistics as the data analysis method for the demographic variables. Nonetheless, there were also independent-sample tests conducted for the continuous variables. Most importantly, the researchers employed the use of chi-square for testing both the dichotomous and categorical variables so as to examine the baseline equivalent for the attention control group and the treatment groups. The process of the data analysis used a 2 (time) X 2 (treatment) as a one-way repeated-measure that would help highlight any deviation from the typical path that treatment results occurred. Looking at the data analysis method used, the research indicates the use of appropriate statistical methods as the procedure would guide the development of informed conclusions on the study. There were many variables in the research. Osteoporosis risks, knowledge and efficacy measures, health information of osteoporosis preventive behaviors, demographics, and self-efficacy and outcome expectations for exercise are some of these variables. An informed data collection procedure must, therefore, account for these variables in order to control the confounding variables. While the data collection took notice of these variables, the most significant factor in the research was time which was important in this particular researcher. It also enabled the researchers to support their hypothesis on self-efficacy.
Findings
The characteristics of the sample indicated that the majority of the participants had a high risk of developing osteoporosis. Interestingly, most of these people lacked proper preventive measures and, therefore, would have remained at risk. The researcher has no doubt taken care of almost every area of research in this particular study. For example, the information about statistical significance is well presented in that it was set at <.05. In fact, most of the research revolves around this particular number. For instance, the findings indicate that concerning behaviors and attitudes toward health, an increase occurred in terms of time spent in exercises showing that more intervention and information available increased positive attitude toward promoting good health and preventive osteoporosis. The two significant groups in the researcher were those that received treatment and those that did not. Those that did show enormous improvement in health and their attitudes toward exercise as an effective way of preventing contracting osteoporosis. The selection of participants was done in a way that it would help measure a broad range of events. After dividing the group into two, the results obtained for those that received the intervention indicated that there was progress among the respondents. The percentage of those that underwent treatment was 38.18. This means that only 42 of the total 110 people that were eligible for participation was included in the research. Such is a low number for study. It any case, the validity of the study would have been improved had the number been higher.
Summary Assessment
Undoubtedly, there were many limitations for the research. To begin with, time and sample size were the main limiting factors that tended to affect the validity and the reliability of data. Nonetheless, the hypothesis developed by the researchers was supported by this study since there was proof from the findings that the osteoporosis was affected by self-efficacy. The respondents, who are the Mandarin-speaking immigrants, as seen in the study, can be used in self-efficacy interventions to show the importance of exercise and adherence to medication. Before the intervention, this group of Chinese immigrants had limited knowledge on the control and prevention of the condition. After the intervention, however, the knowledge impacted on the participants indicated positive attitudes toward exercise and the preventive measures for osteoporosis. The results of the research study add to the knowledge that self-efficacy interventions are effective in improving the knowledge and behaviors of Asians in regard to bone health. After careful consideration of the research, deductions can be drawn to highlight the issue of reliability and validity. For example, the number of participants and the time to conduct the study were quite limited. This indicates that it would be almost impossible to ascertain that the results are valid and reliable. Still, the information obtained can be used by nurses in their practice in regard to promoting self-efficacy among the members of the public concerning the prevention of several health conditions.
References
Dong, X., Chang, E. S., Wong, E., & Simon, M. (2011). Working with culture: lessons learned from a community-engaged project in a Chinese aging population. Aging Health, 7(4), 529-537.
Qi, B. B., Resnick, B., Smeltzer, S. C., & Bausell, B. (2011). Self-efficacy program to prevent osteoporosis among Chinese immigrants: A randomized controlled trial. Nursing research, 60(6), 393-404.
Tufts Qi, B. B., Resnick, B., Smeltzer, S. C., & Bausell, B. (2011). Self-efficacy program to prevent osteoporosis among Chinese immigrants: A randomized controlled trial. Nursing Research, 60(6), 393-404.
Wieland, M. L., Weis, J. A., Palmer, T., Goodson, M., Loth, S., Omer, F., & Sia, I. G. (2012). Physical activity and nutrition among immigrant and refugee women: a community-based participatory research approach. Women’s Health Issues, 22(2), e225-e232.
