Research Article Critique
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Research Article Critique
Evidence-based practice (EBP) has become the cornerstone of modern medical and nursing practice. The central tenet in the application of EBP is that a critical and objective review of published scientific literature can be employed to isolate effective ideas and interventions while still considering the distinct preferences and requirements of the patient. As such, critiquing published literature is a skill that all medical personnel should develop and practice. The article under review is Breland et al. (2013) ‘Challenges to Healthy Eating for People with Diabetes in a Low-Income, Minority Neighbourhood.’ The qualitative research article included interviews with African American and Latina participants with diabetes to understand the type of foods consumed, food preparation, source of foods and impact of race and ethnicity on eating habits for the selected population. The results of the analysis, including the capture of strengths and limitations in the report, make up the remainder of the paper. While the article is unclear about the rationale behind the study, the research design and methods deliver reliable, replicable and credible insight into the relationship between race, household income and eating habits.
The title of the research article provides a clear indication of the report’s content. The title highlights the population of interest (people with diabetes, low-income earners in a minority neighbourhood) and the study’s broad aim (challenges to healthy eating). According to O’Brien et al. (2014), the title of a scientific/academic article should be concise and follow the format of outlining the population of interest, type of intervention, comparison and potential outcomes. A review of the subject article shows it followed this format to the letter. Moreover, the authors responsible for the research have a solid publication history and are active participants in nursing education. For instance, Jessica Breland has over ten published research articles with the National Library of Medicine. The authors’ academic qualifications and years of professional experience add to the credibility of the report. The article offers a detailed opening that draws the reader further into the report for further reading.
The title is not the only element in a report designed to offer readers a brief insight into an academic paper. Abstracts are short statements concerning a scientific report that give the reader a concise understanding of the paper’s research and findings (Grove et al. 2012). The abstract covers the findings’ aim, design, results and consequences. Breland and his co-authors employ a structured abstract. The opening of the paper contains sub-headings that provide information regarding the paper’s objectives, research design and methods, results and conclusion. The structured approach improved clarity in interpreting the major aspects of the academic report. Moreover, the authors successfully provide appropriate justifications for the methodology and a summary of key processes used to implement the research. However, the report fails to expound on the implications of the findings. The reader is left to have open interpretations of the many ways the research can be applied in practice. The approach is a good way to inspire readers to reflect on the findings.
EBP practice outlines that scientific research must have a philosophical underpinning. The subject research report conveys that the authors used the grounded theory. However, according to Rieger (2019), with all the available grounded theory approaches, it is challenging for researchers to discern and decide on the best approach. While it is suitable that the report has a grounded theory, the authors do not provide information on why the philosophy was selected. In addition, the report does not clarify which type of grounded theory is applied. The lack of information implies the possibility that the research approach is not congruent with the desired knowledge or the research’s purpose (Rieger, 2019). There is also the possibility the researchers did not engage in a thoughtful reflection on their personal philosophical beliefs. Research has to also be consistent with the researcher’s philosophical values. The review of the report’s philosophical underpinnings negates its reliability as they raise questions concerning the paper’s worldview and how it impacts its findings.
Researchers are often recommended to disclose their participant selection and recruitment strategies. Participants must have access to information concerning the study’s purpose, setting and timeframe to better understand the boundaries of the research (Taherdoost, 2016). The article provides comprehensive information regarding the people involved, method of recruitment, time taken and location. A close analysis of the selection process indicates all participants were chosen based on the fulfilment of the study’s criteria (have diabetes, be aged, come from a low-income, minority neighbourhood). The approach is termed as ‘purposive sampling,’ and it is a well-documented sampling method that ensures researchers collect data from populations whose experiences are relevant to the study (Taherdoost, 2016). There is a reduced possibility of bias as selected patients do not have extreme views as their feeding habits are based on routine and behaviour. In this instance, purposive sampling is suitable because people suffering from diabetes represent a distinct group. The population size applied in the study is big enough to justify the generalization of findings.
The report shows strict adherence to the ethical guidelines used in publishing scientific research. Scientists, including research clinicians, are expected to disseminate information clearly and unambiguously, tailoring the presentation of the information to meet the recipient’s capacities (Nusbaum et al. 2017). Apart from using a suitable sampling method, the researchers inform that all selected participants provided informed consent. Volunteers were required to go through a written digital document that provided basic information regarding the study. The completion of a short survey and the provision of a digital signature acted as proof that the participants understood the purpose of the research, its structure, processes and the right to withdraw. The researchers also had to acquire pre-approval from Mount Sinai’s Institutional Review Board (IRB) (Breland et al. 2013). The professional body helps ensure the research did not breach any policies or standards during the data collection process. Including the IRB and collecting informed consent enhance the credibility of the researchers and the report’s trustworthiness. The process indicates a dependable academic institution supports the study.
Including information on how informed consent was delivered, acquired and used in the study would have increased the credibility of the research article. There is no data on how the participants were informed about the study. It is a requirement for participants to be given enough information about the study before participating to know what should be expected and be aware of their rights. Educating participants on the study provides them with a basis for giving informed consent and evading passive deception. Often, researchers are deceived by researchers by omitting crucial information about the research. According to Israel and Hay (2006), omission in ethics holds the same punitive value as cheating. Half-truths are equally considered lies. In another scenario, the research could have followed up with the participants to provide information on the results of the project. The approach also offers the volunteers an opportunity to raise issues that might have come up during the implementation of the study. Research is intended to contribute to scientific knowledge and the safety and well-being of human beings.
The report employs an appropriate data collection method that helps meet its purpose. In the article, the researchers disclose the setting in which the data is collected. They provided information on why they selected focus groups and why each member had to complete a survey. Providing information on the setting is vital because it can influence the participant’s emotions, degree of comfort and willingness to participate (Melnyk & Fineout-Overholt, 2011). While the article clarifies that participants engage in focus groups, it does not indicate the role of the researcher. It is unclear who within the focus groups is responsible for recording data and which methods they apply. The authors simply state that surveys were used. Subsequently, a professional translator was integrated to convert the data from Spanish without distorting the information. Failure to disclose how the data was recorded impedes its replicability and confirmability (Rieger, 2019). The reader cannot determine whether there was theoretical saturation in the grounded theory to ensure the research did not miss any teachable aspects related to the topic.
The lack of a moderator within the focus groups implies a gap in the data collection process. Focus groups must be steered by a skilled and experienced moderator to prevent the loss of focus due to internal and external distractions (Melnyk & Fineout-Overholt, 2011). The research fails to provide an overview of the role of the moderator, marking one limitation in the paper. For instance, it is unclear whether the right questions were asked in the focus groups due to the gap. It can be noted that the researchers wanted to minimize the influence they had on the study by not being in direct contact with the participants. A positive point in the paper is the inclusion of Table 1 in the data collection section. The graphic shows that all focus groups were covering the same topic. The approach improves the comparability of data in the subsequent thematic analysis section.
There is the sense that the report does not comprehensively consider the relationship between the researchers and the volunteers. Research articles have to highlight the relationship between participants and researchers (Melnyk & Fineout-Overholt, 2011). The report could have been more credible if the researchers acted as moderators because that would allow them to leverage rapport in empathetic moments to derive more information from the participants. By not acting as moderators, there is no evidence of how the study questioned the interests, assumptions and inspirations of the participants. Therefore, a reflexive approach might not have been applied to improve the quality of the data collection process much further. People might have their influences and potential biases that might impact the quality of information they give in focus groups (Melnyk & Fineout-Overholt, 2011). There is also no information in the study if there were any other events requested for the focus groups. For instance, events designed to give responses to participants of the project. Respondent validation via sending the results of the research to the participants could have highlighted a more considerate and respectful perception of the relationship between the researcher and the participants.
The research article is sufficient and comprehensively assessed using thematic analysis. The data analysis method is advantageous when dealing with large amounts of data or where knowledge is inductive (Sundler et al. 2019). The study focuses on the eating habits of diabetes patients in low-income communities. The researchers had to use a method that allowed them to dig into data without any preconceptions. A thematic analysis facilitates this feat by generating codes of data that highlight emerging themes or occurrences (Sundler et al. 2019). Therefore, the researchers can emphasize recurrent patterns, feelings or ideas. By using the coding process, the article could compare data from the different focus groups. Categorizing the responses into nodes ensures data consistency through the amalgamation of similar concepts (Sundler et al. 2019). Credibility is evident in the paper as the thematic analysis did not result in any contradictory responses. However, the integration of an independent third party to validate the nodes and themes would have enhanced the reliability and credibility of the research.
Apart from being effective, the thematic analysis is also appropriate. Researchers assessing human behaviour have to employ qualitative methods that can illuminate the subjective experiences of people sampled within the study (Sundler et al. 2019). The thematic analysis does not alter any of the responses given by the participants, meaning the researchers are only working with primary data. Moreover, leaving responses unaltered reduces the possibility of bias or coercion in the report. The thematic analysis was the right methodology for addressing the goals of the study based on subjective experiences. Sundler et al. (2019) inform that research designs have to be justified by social constructivist, epistemological stances. The basis allows reports to gather ‘what is real’ for individuals as expressed in surveys and interpreted in findings. Judging from the results of the thematic analysis, it is apparent that the use of focus groups facilitated the collection of in-depth primary data for the exploration of the health topic. If the authors had used the Q-Sort methodology before the focus groups, the approach could have influenced how participants expressed their views.
The data analysis shows sufficiency of rigor. The authors ensure the section is described in detail to ensure transparency. For instance, the views of the participants on their eating habits are compared in a back-to-back manner to increase visibility. However, it is common to observe researchers undertaking the data comparison in tabular form. Organizing the responses in tables would have heightened visibility, readability and understanding. Before the coding process, the authors inform that they went through the data to familiarize themselves with it, identifying areas of interest and emerging themes (Breland et al. 2013). The discussion that followed added to the rigour of the data analysis process. The main strength of the data analysis is that it followed a framework agreed upon by the researchers. The framework guaranteed that all survey responses were considered and contextualized in the identification of potential themes. The verbatim quotes included in the discussion sufficiently indicate the robust generation of themes. The quotes equally facilitate the integration of a theme of trust in the article as responses remain unaltered.
The discussion section is well presented to provide an overview of findings within the larger context of diabetes management and prevention. One highly noticeable element is the many citations included in the discussion. The authors made use of contemporary sources to support points emerging from the analysis. According to Caldwell et al. (2011), scientific studies have to be richly referenced to indicate the researchers considered their findings in relation to previous knowledge. The approach guarantees that the research article contributes to present knowledge gaps. Such a feat is accomplished when the authors discuss how the report can be the basis for the future development of diabetes intervention. The researchers illuminate the need for more research on public health, which is centered on marginalized, minority communities (Breland et al. 2013). Another positive point in the article is how the discussion reflects the external validity of the findings. For instance, the findings are portrayed as limited due to the small sample population. The organization of the findings was a strong point for the article, improving its readability and ease of understanding.
The results are conveyed in distinct themes in prose and are supported by verbatim quotes. The article’s conclusion section offers a clear statement of findings. The results are explicit because the generalizations are consistent with the quoted statements the researchers used per theme. Poole et al. (2018) debate the credibility of findings by evaluating the strengths and limitations of a study. According to the authors, the arguments in a thematic analysis should be discussed in light of their strengths and weaknesses. Breland et al. (2013) include a discussion of the assumptions and weaknesses probably present in their arguments in the conclusion section. The discussion includes an exploration of the limitations of the study. The deliberation aligns with Poole et al.’s (2018) assertions, supporting the credibility of the article. Nevertheless, triangulation in the article, specifically multiple researchers going over the arguments, would have increased the strength of the arguments. The involvement of independent analysts is an approach constantly cited to reduce bias in qualitative research. The highlighted weakness, however, did not impede the findings from fulfilling the aims of the study.
The article is highly applicable because there is a local application of the results. The study’s findings are consistent with public health recommendations on the management of obesity, diabetes and feeding habits. For instance, the views expressed in the article concerning the relationship between household income and healthy diet are consistent with the recommended feeding policies for public schools in low-income neighbourhoods. The views express the official policy position of the U.S. government on the prevention of diabetes among young children through healthy diets (Breland et al. 2013). Therefore, optimizing access to food and healthcare for diabetes patients in low-income neighbourhoods might not be as costly since they are consistent with other public health interventions. Nevertheless, the article does highlight areas where further education, resources, training and support are required to address the social health issue. The approach facilitates the transferability of findings to research articles that cover areas nearly similar to the research topic.
The conclusion of the paper provides a good overview of the implications of the study on public health and future research. Rieger (2019) reiterates the importance of researchers conveying the value of their research in interpreting the experiences of patients. As a result, the final report acts as limited guiding service in the development of future interventions. Highlighting the implications is a process often associated with the generation of hypotheses and not practical measures for improving health services. Nevertheless, the suggestions and summations provided by the researchers are reasonable and realistic. The implied future research directions build on the results of the current study, facilitating the exposure of knowledge gaps and needs of this specific type of study and its population. It is not questionable where the authors claim the study adds unique information on the particular mechanism of responses to patients to diabetes and also provides a CSM-based framework that can be used to understand how stated barriers collaborate to impact eating habits.
Overall, Breland et al.’s study is well designed with meaning and useful findings. The study is presented skillfully with a well-structured introduction, objectives, research methodology and design, results, and conclusion. The qualitative methodology has been well implemented, enabling the researcher to gain subjective experience. Researchers have not utilized the grounded theory appropriately because they do not form a theory. However, it can build on existing theory to formulate a new theory. Original objectives have been adhered to throughout the research. Findings have also been presented clearly, enabling the reader to follow and understand them. Throughout the research, direct quotes from the interview have been employed to reinforce the findings. However, there are some shortcomings of the research as not providing justification for the grounded theory, data presentation, and collection and not briefing the participants before involving them in the research. The implications are discussed in light of the limitations and analysis of other comprehensive studies. Such an article is recommendable in dealing with diabetes in marginalized minority communities in developed economies.
References
Breland, J. Y., McAndrew, L. M., Gross, R. L., Leventhal, H., & Horowitz, C. R. (2013). Challenges to healthy eating for people with diabetes in a low-income, minority neighbourhood. Diabetes Care, 36(10), 2895–2901. https://doi.org/10.2337/dc12-1632
Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal, synthesis, and generation of evidence. Elsevier Health Sciences.
Israel, M., & Hay, I. (2006). Research ethics for social scientists. Sage.
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Nusbaum, L., Douglas, B., Damus, K., Paasche-Orlow, M., & Estrella-Luna, N. (2017). Communicating risks and benefits in informed consent for research: A qualitative study. Global Qualitative Nursing Research, 4, 2333393617732017. https://doi.org/10.1177/2333393617732017
O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine, 89(9), 1245-1251.
Poole, M., Bamford, C., McLellan, E., Lee, R.P., Exley, C., Hughes, J.C., Harrison-Dening, K. and Robinson, L., (2018). End-of-life care: a qualitative study comparing the views of people with dementia and family carers. Palliative Medicine, 32(3), 631-642.
Rieger K. L. (2019). Discriminating among grounded theory approaches. Nursing Inquiry, 26(1), e12261. https://doi.org/10.1111/nin.12261
Sundler, A. J., Lindberg, E., Nilsson, C., & Palmér, L. (2019). Qualitative thematic analysis based on descriptive phenomenology. Nursing Open, 6(3), 733–739. https://doi.org/10.1002/nop2.275
Taherdoost, H. (2016). Sampling methods in research methodology; how to choose a sampling technique for research. SSRN Papers, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3205035