Summary
The hypothesis of this randomized controlled trial study is, does the neighbourhood environment directly influences obesity development. Factors influencing diabetes has remained unresolved. This study sought to determine if neighbourhood environment is directly contributing to obesity development. Therefore, this hypothesis is important so at to establish the relationship between obesity, diabetes and the neighborhoods. This hypothesis is important in directing the study to focus on the influence of neighborhoods on obesity and diabetes. To ensure success of the study, data obtained from social experiment assessing the relationship of assigned variation in a random manner within neighborhood conditions of obesity as well as diabetes. The geographical location where this randomized controlled trial study was undertaken was in Los Angeles, Baltimore, New York, Chicago and Boston in areas with high poverty rates. A number of methods were used in this study. Since 1994 up to 1998, Housing and Urban Development department assigned 4498 women having children who live in public houses characterized by high poverty in a random manner whereby less than ten percent of them were poor as well as counseling to move; however 1312 got assigned to obtain unrestricted, customary vouchers, lacking extraordinary counseling about moving, as well as 1398 got assigned into a control group which was not offered any of these opportunities. Since 2008 up to 2010 being part of the follow-up survey, the researcher measured data showing health effects, encompassing weight, glycated haemoglobin levels and height.
One of their major findings was that the opportunity to move out of a neighborhood characterized by prevalent poverty levels into a neighborhood characterized by minimal poverty levels was allied to the modest though potentially significant reductions within the pervasiveness of the thrilling diabetes as well as obesity. In essence, the mechanisms attributed to these associations are still not clear and calls for further research, due to their capacity of guiding the community intervention design meant to focus on improving health.
Method, strengths & limitation
This randomized controlled trial study’s strengths were based on how the participants in the study were assigned to take part in the study. The participants of the study were selected randomly to take part in the study. This is important since it minimizes biasness in the study and as well makes the study effective. The study has efficiently exploited the use of Hills criteria such as the strength of the association. To demonstrate how neighborhood influences obesity and diabetes, the researchers sought to level of association or connection between these aspects. Also, specificity has been applied to specify and indicate the precise factors attributed to the neighborhood that causes diabetes and obesity. Additionally, consistency has been applied in the study in monitoring and evaluating the study group and the control group.
Strength in the study is in the manner in which the response rate was calculated. The response rate was calculated according to the two phases set as the calculation was made based on the total population of participants with data as well as those missing data. This study followed systematic progress that was quite fair and unbiased. The weakness in this study is the inability of the study to establish a distinct difference between the participating groups in the study with the comparison group. In statistical analysis of the findings, it did not effectively use the logistic regression in analyzing the data.
Bias
There are some biases in the manner in which the randomized controlled trial study was conducted. when analyzing the control group and participating group on their opportunity to utilize voucher in order to move to a neighborhood characterized with low poverty rate, the biasness is evident in the participating group as some of the participants were given the opportunity to obtain the low poverty vouchers while the rest were not given this opportunity. All participants in the group ought to have been given equal opportunity to use these vouchers in order of the study to be effective and unbiased.
Recommendations
To ensure that the randomized controlled trial study is effective, it is important to ensure that biasness in the study is avoided. All the participants in the participating group needs to be given equal opportunity to vouchers so as to get correct results. When analyzing data obtained in the study, data analysis should be taken seriously and down in two phases and different. Data analysis for the participating group and the control group should be done separately. All in all, further research needs to be done to determine how cultures influence obesity and diabetes. This is research is necessary to demonstrate the relationship between neighborhood, culture and their possible influence to cause diabetes and diabetes.