Provide an outline of your paper. The purpose of this paper is to demonstrate your ability to review and summarize five (5) original research articles on a health Services Administration topic. Remember, use the five (5) research articles proposed in assignment #3 submission.
I. Introduction
II. Literature Review
III. Analysis Approach (What was done; describe the population/subjects, methods, type of research; statistics used, etc.)
IV. Results (What was found)
a. authors last name (Research article 1)b. authors last name (Research article 2)c. authors last name (Research article 3)d. authors last name (Research article 4)e. authors last name (Research article 5)
V. Discussion (how results contribute to knowledge in the field, e.g. compare results to literature)
VI. Conclusions
Health & Medical
1
Healthcare Inequalities Bibliography
Course Number
Student Name
Affiliated Institution
Date
Health & Medical
2
Healthcare Inequalities Bibliography
1.
Title: Racial/Ethnic Discrimination in Health Care: Impact on Perceived Quality of Care
Abstract: The present research examines perceived discrimination’s impact on healthcare
quality disparities among different racial groups. A cross-sectional examination of the 2003
California Health Interview Survey determined that African Americans and Asian/Pacific
Islanders reported inferior healthcare quality compared to non-Hispanic whites and Hispanics.
The study found a negative correlation between discrimination and healthcare quality ratings
among all racial and ethnic groups. The study findings indicate that the disparity in low-quality
care ratings between African Americans and whites can be entirely attributed to the perception of
discrimination. The results suggest that incorporating interventions to tackle patient perceptions
of discrimination may be pivotal to enhancing healthcare quality.
Authors: Sorkin D.H, Metzger Q.N, De Alba I (2010).
Journal: General Internal Medicine
DOI: 10.1007/s11606-010-1257-5
2.
Title: Investigating Health Equity and Healthcare Needs among Immigrant Women Using the
Association Rule Mining Method
Abstract: The present research investigates the correlation between socioeconomic attributes
and healthcare requirements among female immigrants residing in Taiwan. The 2008 “Survey of
Foreign and Chinese Spouses’ Living Requirements” yielded data indicating that the most
pressing healthcare requirements were medical allowances, child health checkups, and parental
Health & Medical
3
knowledge and pre- and post-natal guidance. The primary obstacle to fulfilling these
requirements was determined to be financial strain. The investigation further unveiled that
healthcare requirements were impacted by factors such as nationality, socioeconomic status, and
length of residency. The results emphasize the correlation between economic disparity and the
well-being of women, indicating the necessity of implementing policies that tackle these
concerns in order to avert additional health decline among female immigrants.
Authors: Tseng M.H, Wu H.C (2021).
Journal: Healthcare (Basel)
DOI: 10.3390/healthcare9020195
3.
Title: Measuring Racial/Ethnic Disparities in Health Care: Methods and Practical Issues
Abstract: The present study uses a systematic methodology to ascertain and quantify healthcare
inequalities based on race and ethnicity. The authors espouse the adoption of the Institute of
Medicine’s definition of disparities, which excludes variations attributable to clinical necessity
and personal preferences. This paper demonstrates the practical implementation of the
abovementioned definition through various empirical techniques. The analysis showcases how
discrepancies can be comprehended concerning mental healthcare services’ utilization and
financial outlay. The authors emphasize the significance of utilizing these techniques to
comprehend fundamental pathways of inequalities, which allows policymakers and healthcare
providers to tackle healthcare disparity more efficiently.
Authors: Le Cook B, McGuire T, Zaslavsky A (2012).
Journal: Health Service Research
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DOI: 10.1111/j.1475-6773.2012.01387.x
4.
Title: Income Inequality in Health at All Ages: A Comparison of the United States and England
Abstract: The present research investigates the inequities in health outcomes based on income
in the United States and England. The study encompasses a range of health conditions and risk
factors while accounting for diverse age groups and genders. Notwithstanding variations in
healthcare systems, substantial income disparities in health outcomes exist in both nations, which
remain unaltered by variables such as ethnicity, health-related conduct, or healthcare
accessibility. Notably, the gradient exhibits a greater degree of steepness for the female
population, thereby signifying a more pronounced influence of income on women’s health
outcomes. The findings emphasize the necessity of policy dialogues encompassing wider societal
concerns beyond healthcare and insurance to mitigate health disparities.
Authors: Martinson M (2012).
Journal: American Journal of Public Health
DOI: 10.1111/j.1475-6773.2012.01387.x
5.
Title: Inequalities in Health Care Experience of Patients with Chronic Conditions: Results from
a Population-Based Study
Abstract: The present research examines the discrepancies in healthcare encounters among
individuals with persistent ailments, contingent on sociodemographic and health-related factors.
The Basque Health Survey findings indicate that various factors, including gender, age,
Health & Medical
education level, comorbidities, specific chronic conditions, and quality of life, significantly
impact the healthcare experience. Women, individuals of advanced age, and those with lower
levels of education tend to report more negative experiences. The diverse backgrounds of
patients with multimorbidity highlight the necessity of tailored care approaches. The research
underscores the significance of comprehending these associations to enhance the caliber of
healthcare provision, particularly for individuals with persistent ailments.
Authors: Solinis R, Laresgoiti M, Lazaro E, Ponce S, Orueta J, Rodriguez M.E (2021).
Journal: Healthcare (Basel)
DOI: 10.3390/healthcare9081005
5
The Impact of TV Advertisements on Elementary School Children’s Food Behaviors
Assignment #4: Outline
Students Full Name
Panther ID #1234567
Florida International University
HSA 4700: Quality and Evidence- Based Healthcare Services; Section RVC
Dr. Carol Biggs
01/01/2021
The Impact of TV Advertisements on Elementary School Children’s Food Behaviors
I. Introduction
a. Motivation to study this topic
• Estimates suggest 37 percent of all school-age children are overweight or obese
(Harris, et al.)
• Longitudinal studies support television screen time is directly related to increased risk
for children being overweight or obese (Robinson, et al.)
• Unhealthy food advertising comprises a majority of television food advertisements
(Story, et al.)
• Review of current literature can provide an opportunity to better understand the
relationship between food television advertisements and obesity risks in elementary
school children to guide public health policies
b. Objectives
• To determine the public health implication of TV advertisements on elementary
school-age children’s food consumption behaviors
c. Organizational overview of paper
• Review of the current literature regarding television advertising and its effect on
children’s attitudes and behaviors regarding food consumption and its relationship to
obesity risk
• Review of five primary research articles concerning the subject of television
advertising and child food consumption effects
• Presentation of the results of the five primary research articles reviewed
• Discussion of results, noted gaps and limitations, and conclusions drawn from
Evidence
II. Literature Review
a. Background information on topic
• Childhood obesity represents a persistent public health crisis in the U.S. affecting
more than a third of elementary school-age children
• Causes of childhood obesity are multifactorial and involve physical activity
behaviors, food consumption behaviors, nutritional knowledge, parental and peer
influences, food access, and genetics
Excessive television viewing has been identified as a risk for child obesity both due to
its association with sedentary activity as well as food consumption behaviors
• Television food advertisements have been shown to affect food consumption attitudes
and behaviors
• Public health recommendations concerning television food advertising have not been
adequately defined to guide clear public policies
b. Specific information to assist the reader’s understanding
• Television food advertising includes ads promoting unhealthy foods, healthy foods,
and food education
• Potential impacts of television food advertising on children include effects on
nutritional knowledge, attitudes about food types, and food consumption behaviors
c. Key terms
• Body mass index is a measure of calculation based on height and weight used to
assess obesity
• Overweight children are defined as having a BMI greater than 25 kg/m2
• Obese children are defined as having a BMI greater than 30 kg/m2
III. Analysis Approach
•
•
Description of search methodologies, search databases, inclusion criteria, exclusion
criteria, and key words to be described.
a. Harris, et al.
• AIM: To assess the effect that watching food ads versus non-food ads had on
children’s eating behaviors while watching television
• SUBJECTS: A total of 118 children, ages 7-11 years, were randomized to an
experimental group and a control group
• METHODS: Children were randomized to an intervention group that watched a 14minute cartoon with food ads while the other control group watched a similar length
cartoon with non-food ads. Both groups were provided snacks and water for
consumption if they chose. Measures of snack consumption were assessed using
ANOVA statistical analysis.
• RESEARCH TYPE: Randomized controlled trial
b. Dixon, et al.
• AIM: To assess the impact of television viewing of various television ads on
children’s knowledge, attitudes, and behaviors concerning healthy and unhealthy
foods
• SUBJECTS: A total of 919 5th and 6th graders in Australia sampled by survey and
enrolled in experimental trial involving 3 treatment groups and one control group
• METHODS: Pre-test survey regarding television viewing habits and eating attitudes
and behavior was collected a week before the experiment. Children were then
randomized into one of four groups: (1) junk food ads, (2) junk food and healthy food
ads, (3) healthy food ads, and (4) no food ads (control). Pretest responses and posttest
responses were analyzed by AONVA statistics to determine variations in
responses based on existing knowledge and behaviors and the interventions
• RESEARCH TYPE: Cross-sectional survey and randomized controlled trial
c. Andreyeva, et al.
• AIM: To assess the impact of watching television ads promoting soft drinks, fast
food, and cereals on consumption of these food types in elementary school-age
children
• SUBJECTS: Large cross-sectional survey of 55 consumer markets involving
thousands of children in elementary school grades collected from the Early Childhood
Longitudinal Survey
• METHODS: Data from the ECLS was compared to Neilson Company data regarding
television viewing habits matched with television content involving ads related to fast
food, cereals and soft drinks. This data was then compared to body weight and food
consumption behaviors identified in the cross-sectional survey. Statistical analysis
using ANOVA was used to determine significance.
• RESEARCH TYPE: Cross-sectional surveys
d. Hanks, et al.
• AIM: To determine the impact of healthy food advertisements on healthy food
choices and behaviors among elementary school-age children
• SUBJECTS: Ten elementary schools participated in this experiment involving over
22,000 elementary school-age children.
• METHODS: Schools were divided into three groups with one displaying a banner
along its salad bar depicting vegetable cartoon characters. The second group provided
students with a short segment health education cartoon featuring vegetable characters.
The third group received both of the above interventions. Pre-intervention food
behaviors and post-intervention food behaviors were assessed and compared by
statistical analysis.
• RESEARCH TYPE: Pre-test, post-test research design with multiple interventions
e. Halford, et al.
• AIM: To determine if food ads increase food consumption behaviors in elementary
children
• SUBJECTS: A total of 42 children ages 9-11 years from Liverpool were recruited and
divided into three groups based on body mass index: lean, overweight, and obese.
• METHODS: Pre-experimental questionnaires were administered to determine food
consumption and television viewing patterns. Half of the participants watched cartoon
followed by 8 food ads while the other half were watched the same cartoon and 8
non-food ads. Participants were then assessed in a post-test format to determine
which ads they recalled watching. The participants were then invited back and
performed the same experiment but switched the ad content. Data was then collected
from all students and compared based on body weight and ad recognition.
• RESEARCH TYPE: Observational, crossover design
IV. Results
a. Harris, et al.
• Children watching food ads consumed 45 percent more than those viewing nonfood ads.
The children’s consumption behavioral changes were not related to
hunger. The authors concluded that food ads prime automated eating behaviors in
children and are unrelated to food brand being advertised.
b. Dixon, et al.
• Findings showed that increased television use and increased exposure to
television ds promoting junk foods were associated with a more positive attitude
about junk foods. Likewise, increased television use alone was linked to increased
junk food consumption. However, ads for healthy foods also increased attitudes
and beliefs for healthy foods. The authors concluded that varying television ad
content could be an effective way to promote healthy food attitudes and behaviors
in children and reduce junk food preferences.
c. Andreyeva, et al.
• Results demonstrated that for every 100 soft drink ads watched, consumption of
soft drinks increased by 9.4 percent. For every 100 fast food ads seen,
consumption increased 1.1 percent. No correlation existed between ad exposure
and overall body weight, but fast food ads were more commonly viewed in
children with BMI meeting overweight criteria. The authors concluded that
unhealth food ad viewing increasing consumption of unhealthy foods, and this
consumption is junk food group specific to an extent.
d. Hanks, et al.
• The researchers found that children exposed to the vegetable cartoon banners
increased vegetable food consumption by 90.5 percent. They also found that
children exposed to both interventions (group 3) increased vegetable consumption
by 239.2 percent. They concluded that healthy food ads involving age-appropriate
content was effective in improving healthy vegetable consumption in elementary
school0age children.
e. Halford, et al.
• Results of the final analysis showed that the obese group of children recognized
more of the food ads than lean children. Likewise, those children who recognized
food ads had higher food consumption behaviors. Finally, all groups increased
food consumption after seeing the food ads. The authors concluded that exposure
to food ads cues food intake behaviors, and also that some children have a
heightened alertness to these ads.
V. Discussion
a. Heading for discussion
• Relationship between television food advertisements and food consumption in
elementary school children
b. Gaps in the research reviewed
• Each of the five articles examined the relationship between food ads on television
and children’s attitudes and behaviors regarding food consumption. However,
variations exist regarding experimental designs, ad content, measures of
children’s behaviors and attitudes, and duration of interventions. Gaps therefore
exist regarding the degree of influence these ads have on children’s food
consumption behaviors.
c. Overall strengths and weaknesses of the research articles
• Of the five research experiments, strengths included large participant numbers,
sound experimental methodologies, positive associations in each between
television ad viewing and changes in food consumption behaviors, and detailed
statistical analyses
• Weaknesses of the studies demonstrated significant variance in measures in
assessing food consumption and attitude among participants, variations in the
content of television ads seen, and variations in the duration of the interventions
d. Needed future work in the field
• Greater consistency in metrics used to assess children’s attitudes and behaviors
regarding food consumption is needed
• Longer duration studies to assess long-term impacts of television ad changes would
be beneficial
• Additional studies to assess the impact of healthy food ads versus the impact of
unhealthy food ads would help identify weighted effects of each
• Studies are needed to better define the role television ads can serve in relation to other
anti-obesity interventions including cost assessments
VI. Conclusions
a. Summary of objectives and approach of this paper
• The review explored the effect that television advertisements have on food
consumption attitudes and behaviors among elementary school children by examining
five primary research studies
b. Major findings of this paper
• The research shows that television ads clearly affect children’s food consumption
attitudes and behaviors in both positive and negative ways and can serve as a strategy
to guide healthier behaviors. However, the degree of impact this has in reducing
overall obesity among children is not well defined
c. Important implications of this paper’s findings
• Further studies are needed to better define the role that food advertisement policies
may play in reducing childhood obesity among elementary school children. The
positive correlations noted in these five research studies support further investigation
into how such policies may be implemented and how their effect measured
d. Recommendations based upon the review of these 5 research articles
• The evidence supports practices among educators and parents to limit exposure to
unhealthy food television advertisements among elementary school children while
encouraging exposure to healthy food ads and those providing nutritional education.
Policymakers may also consider public health policies to place restrictions on
unhealthy food ads, but further evidence is likely needed before the public is
convinced of these approaches. Researchers, as such, should further explore the
degree of impact these policies could have by assessing effects over longer periods of
time and in combination with other interventions.
References
Harris, JL, Bargh, JA, & Brownell, KD. (2009). Priming effects of television food advertising on
eating behavior. Health Psychol. 2009; 28(4): 404-413. doi.org/10.1037/a0014399
Dixon HG, Scully ML, Wakefield MA, & White VM, Crawford DA. The effects of television
advertisements for junk food versus nutritious food on children’s food attitudes and
preferences. Soc Sci Med. 2007; 65(7): 1311-23.
doi.org/10.1016/j.socscimed.2007.05.011
Andreyeva T, Kelly IR, & Harris JL. Exposure to food advertising on television: associations
with children’s fast food and soft drink consumption and obesity. Econ Hum Biol. 2011;
9(3): 221-33. doi.org/10.1016/j.ehb.2011.02.004
Hanks AS, Just DR, & Brumberg A. Marketing vegetables in elementary school cafeterias to
increase uptake. Pediatrics. 2016; 138(2): e20151720. doi.org/10.1542/peds.2015-1720
Halford JC, Gillespie J, Brown V, Pontin EE, & Dovey TM. Effect of television advertisements
for foods on food consumption in children. Appetite. 2004; 42(2): 221-5.
doi:10.1016/j.appet.2003.11.006
Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, & Wartella E. Screen
media exposure and obesity in children and adolescents. Pediatrics. 2017;
140(Supplement 2): S97-101. doi:10.1542/peds.2016-1758K
Story M, & French S. Food advertising and marketing directed at children and adolescents in the
US. Int J Behav Nutri Phy. 2004; 1(1): 3. doi.org/10.1186/1479-5868-1-3
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