Title

Role of social determinants and lifestyle factors in developing

childhood obesity Pakistan, India and China

Chapter 3

Methodology

Keywords searched for the current study

A broad search was conducted using the keyword ‘social determinants’,

Lifestyle factors, Childhood Obesity, Pakistan, China and India. As a result of
this preliminary search, the final keywords utilized for the investigation were
socio-cultural, Health-related social problems, social risk factors, SDOH/
Social causal factors, Childhood obesity, Child BMI >age, living behaviors,
Way of living life, Living habits, Pakistan, India and China.

Table 1

Main Keywords

Social Childhood
determinants obesity Lifestyle factors Countries

Associated Keywords

Social risk Childhood

factors obesity Living behaviors Pakistan

Health-related Child BMI

social problems >age Way of living life India

SDOH/ Social Child weight >

causal factors age Living habits China
2.5 Inclusion and exclusion criteria
The subject, "What is the function of lifestyle variables and socioeconomic
determinants in childhood obesity in India, Pakistan, and India?" served as
the basis for the inclusion criteria for this review. Based on geography
relevance, papers on childhood obesity from the previous 15 years, journal
articles in English, scientific journals based on qualitative research, and
journal are some of the criteria that have been taken into consideration.
Other criteria that are frequently used include the year of publishing,
language of the study, type of article (such as conceptual, RCT etc.), and
journal. Choosing inclusion and exclusion criteria is one of the most crucial
aspects in performing your review in terms of study quality (Snyder, 2019).
And the same inclusion criteria are used or this research that is mentioned
below

A clear and concise description of the criteria used to determine which

papers are eligible for the study are described following

 The study has to be primary research, and the paper must be published
in a peer-reviewed journal with a high worldwide reputation.
 The objectives of the chosen study must be consistent with the research
topic.
 The research must be published between 2005 and 2022

The exclusion criteria designed for this research are listed as

follows:

A clear and concise description of the criteria used to determine which

papers are ineligible for the study are described following

 The article does not comply with the inclusion criteria.

  A dialect other than English was used to write the study.
 The study does not examine how socioeconomic variables, lifestyle
factors, and childhood obesity are related.
 The study uses no objective methodology to investigate how
socioeconomic determinants and lifestyle factors contribute to
childhood obesity.

2.6 Data evaluation process

Throughout the database evaluation stage, experts evaluate every
publication to determine which articles will be utilized in this project. The
examination will be conducted concurrently by academics from several
institutions. The following actions will be taken in data analysis. The
approach that will be employed by the PRISMA analytical system to assess
the data is shown in Figure 1. Using an initial search to evaluate data for a
study is a good method because it allows researchers to quickly and
efficiently identify relevant information without having to wade through an
overwhelming amount of data. Initial searches can also help researchers
narrow down their focus, allowing them to hone in on specific topics or
questions that need to be addressed. Additionally, initial searches can help
researchers identify any potential biases or errors in the data that need to be
addressed before the study can begin. PRIMSA can assist with the shifting of
data by providing an automated system for managing and storing data. This
can enable you to quickly access and analyze the data that is relevant to
your research on the role of lifestyle factors and social determinants in
developing child obesity in India, Pakistan and China. By having an
automated system, you can quickly create and store data sets, access data
from multiple sources, and analyze the data in a timely manner.
Additionally, PRIMSA can also help with creating visualizations of data and
creating reports that provide further insights into the data.
a) Title Analysis
Using the title, the examiner will determine if the paper is pertinent to the
main topic. Then, the examiner will use keywords from article headlines
to carry out the research that are pertinent to our main purpose or query.
The examiner will decide if to move toward the next stage of assessment
after reviewing the proposal. Prior to actually proceeding to the following
stage of the research, there should be a procedure to exclude
unnecessary materials.This title analysis focuses on the role of lifestyle
factors and social determinants in developing child obesity in India,
Pakistan, and China. The research aims to explore how lifestyle and social
factors contribute to the development of childhood obesity in these three
countries. Specifically, the research will look at the influence of diet and
physical activity on the development of obesity, as well as the role of
parental influence and education, and the influence of the social
environment on childhood obesity in these countries. Furthermore, the
research will focus on the differences in the prevalence of childhood
obesity in India, Pakistan, and China, and the factors that may contribute
to these differences. Finally, the research will examine potential
interventions to reduce the prevalence of childhood obesity in these
countries.

b) Abstract assessment
It is necessary to determine whether the filtered papers effectively
addressed the important question posed in the study at this level. Each full-
text report was then inspected for qualitative evaluation and data gathering
after the reviewer had evaluated the abstract for inclusion criteria. The study
was excluded if at least one of the aforementioned criteria wasn't met. In
cases where it wasn't clear, the entire manuscript was evaluated according
to the same standards. The research into the role of lifestyle factors and
social determinants in developing child obesity in India, Pakistan, and China
requires an application of theory to gather the necessary information. In
order to understand the underlying implications of this research, it is
important to analyze the role of lifestyle factors and social determinants, and
how they relate to the development of obesity in children. Additionally, it is
necessary to identify the potential implications of the research and how this
knowledge can be used to create policies and initiatives that can address the
issue of childhood obesity in the region. By applying theory to the data
gathered, a more holistic understanding of the research can be obtained,
which can be used to inform the development of effective solutions.

c) Diagonal reading
Overviews, annotations for graphs and tables, and findings will all be
scrutinized in publications that advance to this level. It is the duty of the
examiners to judge if either or not the following research questions posed fit
the SLR's objectives and contribute to the clarification of the main subject.
In order to confirm that the library research phrases are adequate, they will
also review the results.Such as Tackling child obesity in India, Pakistan, and
China requires an in-depth examination of the role of lifestyle factors and
social determinants. These include dietary patterns, physical activity, socio-
economic status, access to healthcare, and cultural influences. Research
suggests that unhealthy diets, physical inactivity, and sedentary lifestyles
are major contributors to the rising childhood obesity rates in these
countries. Studies have also highlighted the importance of socio-economic
factors, such as poverty, in contributing to the prevalence of obesity among
children. Additionally, research indicates that cultural norms, such as food
preferences, can also play a role in influencing dietary habits and physical
activity levels, thereby affecting the development of obesity in children.
Finally, access to quality healthcare and nutrition services is critical for the
prevention and management of obesity among children.
d) Full-script review
The authors read the full document in the last stage of the process, after
which they evaluate it using a pre-established criterion. Each paper
includes certain questions that should be answered by all assessors. In
other words, dependent on how effectively every question is answered,
the examiners will assign the research a (2) or a (1). If any of the
following three objectives is not satisfied, a rating of 0 is awarded. This
assessment is regarded as empirical because it is based on the author's
expertise and knowledge in the subject. The publication will be listed in
the SLR with a rating of Six or above on a scale of 10. (60
percent).Prisma (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses) is an evidence-based methodology that can be used to
conduct systematic reviews of the literature on any given research topic.
This methodology uses a set of guidelines to ensure that all relevant
studies are included and that the quality of the research is assessed. In
the context of the research on the role of lifestyle factors and social
determinants in developing child obesity in India, Pakistan and China,
Prisma can be used to ensure that all existing studies on the topic are
included in the review. This would allow researchers to understand the
current state of knowledge on the topic, and to identify any gaps in the
literature. Additionally, Prisma can be used to assess the quality of the
studies included in the review, ensuring that the findings from the review
are based on reliable evidence. This is especially important when looking
at the role of lifestyle factors and social determinants in developing child
obesity, as there are many aspects to consider, and it is important to
ensure that the evidence used to inform conclusions is of the highest
quality.
Figure 1: PRISMA flowchart

Data based searched and records identified (n=810)

PubMed(n=50), NCBI (n=124), Google Scholar(n=636)

Records screened Records excluded with reasons

(n=810) Titles/Abstract/ Duplicate studies
screened for Off topics
inclusion /exclusion Studies that did not include
criteria Pakistan, India and China
Studies that do not include children

Full text articles

Full text articles excluded with
assessed for eligibility
reasons (n=)
(n=)
Repeated data
No reports on prevalence and
statistically significant associations
Not have data on included
countries Pakistan, India and
China
Studies included in
literature review(n=)
2.7 Critical appraisal tool for limiting biasness risks
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-
Analyses) is an evidence-based tool used to assess the risk of bias in
systematic reviews. PRISMA is applicable to any type of systematic review
and can be used to assess the quality of the evidence on the role of lifestyle
factors and social determinants in developing child obesity in India, Pakistan,
and China. PRISMA is comprised of a checklist and flow diagram, which are
used to assess the risk of bias in systematic reviews. The checklist is
designed to assess the risk of selection bias, information bias, and
confounding bias. The flow diagram is used to assess the risk of publication
bias. In addition, PRISMA provides guidance on how to conduct a
comprehensive search and includes a checklist to ensure that all relevant
studies are identified and included in the review. Finally, PRISMA also
provides guidance on how to assess the quality of the evidence and how to
interpret the results of the review. By using PRISMA, researchers can ensure
that their systematic review is free from bias and is of high quality .

2.8 Venn diagram:

Utilizing a Venn Diagram (Figure 3) allowed a graphic display of study
inclusion and guaranteed that almost all relevant literature was obtained
(Rudestam and Newton, 2015, p.79). The one of the parameters denoted by
the particular words is represented by each circle. The research results were
evaluated based on the variety of parameters utilized in each research that
was located, with a "1" signifying the relevant topics that was used in the
research, a "2" signifying the research providing source material, and a "3"
signifying data on the topic.
 social
determinants
/lifestyle factors

obesity

Pakistan,India
childhood
and China
Caption: Lifestyle Factors, Social Determinants, and Child Obesity in India,
Pakistan, and China

This Venn Diagram illustrates the potential relationship between lifestyle

factors, social determinants, and child obesity in India, Pakistan, and China.
In the center of the diagram, the three countries are shown to have a shared
risk factor; lifestyle factors. These include physical inactivity, unhealthy diet,
and sedentary behavior, which are all potential contributors to the
development of child obesity. The outer circles represent the individual social
determinants of each country that could be influencing the prevalence of
child obesity. These include socio-economic status, cultural influences,
health care services and access to food. By analyzing the shared and
individual factors between the countries, researchers can gain a better
understanding of the role of lifestyle factors and social determinants in
developing child obesity in India, Pakistan, and China.

2.9 Ethical considerations:

Working with secondary data means the researcher does not come into
direct contact with study participants, so there is not any requirement of
ethical consideration.
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