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Research Article Critique Paper and Critique Tool Assignment

Research Article Critique Paper and Critique Tool AssignmentResearch Article Critique Paper and Critique Tool AssignmentPart 1: Write a two-page critique on the article Telecoaching plus a portion control plate for weight care management: a randomized trialPart 2: Complete the Johns Hopkins Quantitative Research Appraisal Tool (Links to an external site.).Content of critique should include at a minimum:1. Participant sampling,2. Questionnaires/tools,3. Ethics,4. Analysis of findings,5. Limitations,6. Discussion section,7. Summary: Application (translation) to practice specialty, and future implications.Preparing the Assignment:1. APA Format According to 6th edition.2. Word Doc per assignment requirements3. Word Doc Format:Research Article Critique Paper and Critique Tool AssignmentCover page, no abstract, introduction (no heading per APA), body of the paper/review, reference list, appendix with Johns Hopkins appraisal doc. For review sections refer to your readings and the Johns Hopkins Research Appraisal Tool.ORDER A PLAGIARISM-FREE PAPER HERE· Article title, author, journal, publication date· Evidence level and quality· Analysis of the study methodology (specific to study type, e.g., qualitative versus quantitative versus non-research)Reference List should include the chosen article and other resources used to construct the review, such as course textbook, Johns Hopkins Evidence Based Practice: Model and Guidelines (2018), and How to Read a Paper by Greenhalgh (2014).Research Article Critique Paper and Critique Tool AssignmentRubricNR505NP WK4,5,6 Article Critique_SEPT19NR505NP WK4,5,6 Article Critique_SEPT19Criteria Ratings PtsThis criterion is linked to a Learning OutcomeIntroductionRequired content for this section includes: • Introduction to chosen article • Succinct overview of assignment focus. 10.0 ptsExcellentContent includes well-written, succinct, information that includes: Article topic/focus, authors and specific aim of assignment.Research Article Critique Paper and Critique Tool Assignment 9.0 ptsV. GoodContent is well-written but omits or is thin in one area. 8.0 ptsSatisfactorySection content is basic in its explanation of the article (overview) and the purpose of the assignment but lacks specific detail and depth. 5.0 ptsNeeds ImprovementAll content is included but difficult to piece together in its explanation of the article (overview) and the purpose of the assignment OR a piece of the content is missing, for example, overview of assignment focus, yet what is written is well stated.Research Article Critique Paper and Critique Tool Assignment 0.0 ptsUnsatisfactoryMissing OR Section content is vague in its introduction of the article (overview) and the purpose of the assignment is missing OR article overview is missing, and purpose of the assignment is vague.)  10.0 ptsThis criterion is linked to a Learning OutcomeCritique of ArticleRequired content for this section includes: • Methodological review specific to type (non-research versus research): (use text and resources) • Ethical review (not always present with guidelines or systematic reviews) • Analysis of findings • Limitations • Discussion • Application to practice (translation) • Future implications 50.0 ptsExcellentAll content is included in the critique with comprehensive definitions, examples and with in-text citations that support the article evaluation with depth.Research Article Critique Paper and Critique Tool Assignment 46.0 ptsV. GoodAll content is included in the critique. One or two sections may be included without depth: For example, Definitions, examples and with in-text citations that support the article evaluation with depth. Or: All content has explanatory depth of analysis including definitions, examples and in-text citations supporting the analysis, however, a content area may be missing (such as ethical review or limitations) 42.0 ptsSatisfactoryTwo or three content areas are missing, or all content areas are included but there is inconsistent depth/ integration of definitions, examples and in-text citations that support the article evaluation with depth 25.0 ptsNeeds ImprovementFour or more content areas are missing, or all content areas are included but there is little to no depth/ integration of definitions, examples and in-text citations that support the article evaluation with depth.Research Article Critique Paper and Critique Tool Assignment 0.0 ptsUnsatisfactoryCritique is vague, without structure, without discernible integration of definitions, examples, and in-text citations that support the writing.Research Article Critique Paper and Critique Tool Assignment  50.0 ptsThis criterion is linked to a Learning OutcomeJohns Hopkins Appraisal Tool 50.0 ptsExcellentAll sections of the Appraisal Tool are completed for the correct article review (for example, the non-research tool is used for guidelines, the qualitative tool is used for qualitative review).Research Article Critique Paper and Critique Tool Assignment 46.0 ptsV. GoodTool is included, is the correct tool, and is missing: A. Non-Evidence Tool: 1 of the 6 sections B. Evidence Tool: 1 section missing 42.0 ptsSatisfactoryTool is included, is the correct tool, and is missing: A. Non-Evidence Tool 2 or 3 of the 6 sections B. Evidence Tool: 2 sections missing 25.0 ptsNeeds ImprovementTool is included and is missing: A. Non-Evidence Tool 4 or more of the 6 sections B. Evidence Tool – 3 more sections missing.Research Article Critique Paper and Critique Tool Assignment 0.0 ptsUnsatisfactoryTool is missing or the wrong tool is used.Research Article Critique Paper and Critique Tool Assignment  50.0 ptsThis criterion is linked to a Learning OutcomeOrganization & FormatRequirements: • Cover (title) page • No abstract • Introduction • Body of paper and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.Research Article Critique Paper and Critique Tool Assignment 15.0 ptsExcellentAll aspects of paper follow APA guidelines (cover, no abstract, introduction, headings (not on introduction), body of paper and reference page 14.0 ptsV. Good1-3 APA errors 12.0 ptsSatisfactory4-5 APA errors 8.0 ptsNeeds Improvement6-9 APA errors 0.0 ptsUnsatisfactory10 or greater APA errors  15.0 ptsThis criterion is linked to a Learning OutcomeSyntax, grammar, spellingRules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the 6th edition of the APA manual. 5.0 ptsExcellentThere are no grammatical, spelling, word usage or punctuation errors.Research Article Critique Paper and Critique Tool Assignment 4.0 ptsV. Good1-3 grammatical, spelling, word usage or punctuation errors. 3.0 ptsSatisfactory4-5 grammatical, spelling, word usage or punctuation errors.Research Article Critique Paper and Critique Tool Assignment 2.0 ptsNeeds Improvement6-9 grammatical, spelling, word usage or punctuation errors. 0.0 ptsUnsatisfactory10 or greater grammatical, spelling, word usage or punctuation errors.  5.0 ptsTotal Points: 130.0Evidence level and quality rating:    Article title: Number:Author(s): Publication date:Journal:Research Article Critique Paper and Critique Tool AssignmentSetting: Sample (composition and size):Does this evidence address my EBP question?YesNo- Do not proceed with appraisal of this evidenceResearch Article Critique Paper and Critique Tool Assignment· Clinical Practice Guidelines LEVEL IVSystematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel· Consensus or Position Statement LEVEL IVSystematically developed recommendations, based on research and nationally recognized expert opinion, that guide members of a professional organization in decision-making for an issue of concern· Are the types of evidence included identified? · Yes · No· Were appropriate stakeholders involved in the development of recommendations? · Yes · No· Are groups to which recommendations apply and do not apply clearly stated?Research Article Critique Paper and Critique Tool Assignment · Yes · No· Have potential biases been eliminated? · Yes · No· Does each recommendation have an identified level of evidence stated? · Yes · No· Are recommendations clear? · Yes · NoFindings That Help Answer the EBP QuestionComplete the corresponding quality rating section.  Research Article Critique Paper and Critique Tool Assignment  Johns Hopkins Nursing Evidence-Based PracticeAppendix F: Non-Research Evidence Appraisal Tool  Johns Hopkins Nursing Evidence-Based PracticeAppendix FNon-Research Evidence Appraisal   1 · Literature review LEVEL VSummary of selected published literature including scientific and nonscientific such as reports of organizational experience and opinions of experts· Integrative review LEVEL VSummary of research evidence and theoretical literature; analyzes, compares themes, notes gaps in the selected literature· Is subject matter to be reviewed clearly stated? · Yes · No· Is literature relevant and up-to-date (most sources are within the past five years or classic)? · Yes · No· Of the literature reviewed, is there a meaningful analysis of the conclusions across the articles included in the review? · Yes · No· Are gaps in the literature identified? · Yes · No· Are recommendations made for future practice or study? · Yes · NoFindings That Help Answer the EBP QuestionComplete the corresponding quality rating section. Research Article Critique Paper and Critique Tool Assignment· Expert opinion LEVEL VOpinion of one or more individuals based on clinical expertise· Has the individual published or presented on the topic? · Yes · No· Is the author’s opinion based on scientific evidence? · Yes · No· Is the author’s opinion clearly stated? · Yes · No· Are potential biases acknowledged? · Yes · NoFindings That Help Answer the EBP QuestionComplete the corresponding quality rating section.  Organizational Experience· Quality improvement LEVEL VCyclical method to examine workflows, processes, or systems with a specific organization· Financial evaluation LEVEL VEconomic evaluation that applies analytic techniques to identify, measure, and compare the cost and outcomes of two or more alternative programs or interventions· Program evaluation LEVEL VSystematic assessment of the processes and/or outcomes of a program; can involve both quaNtitative and quaLitative methodsSetting:Research Article Critique Paper and Critique Tool Assignment Sample Size/Composition:· Was the aim of the project clearly stated? · Yes · No  · Was the method fully described? · Yes · No  · Were process or outcome measures identified? · Yes · No  · Were results fully described? · Yes · No  · Was interpretation clear and appropriate? · Yes · No  · Are components of cost/benefit or cost effectiveness analysis described? · Yes · No · N/AFindings That Help Answer the EBP QuestionComplete the corresponding quality rating section. Research Article Critique Paper and Critique Tool Assignment    · Case report LEVEL VIn-depth look at a person or group or another social unit· Is the purpose of the case report clearly stated? · Yes · No· Is the case report clearly presented? · Yes · No· Are the findings of the case report supported by relevant theory or research? · Yes · No· Are the recommendations clearly stated and linked to the findings? · Yes · NoFindings That Help Answer the EBP QuestionComplete the corresponding quality rating.      Community standard, clinician experience, or consumer preference LEVEL V· Community standard: Current practice for comparable settings in the community· Clinician experience: Knowledge gained through practice experience· Consumer preference: Knowledge gained through life experienceInformation Source(s) Number of Sources· Source of information has credible experience · Yes · No · N/A· Opinions are clearly stated · Yes · No · N/A· Evidence obtained is consistent · Yes · No · N/AFindings That Help You Answer the EBP QuestionComplete the corresponding quality rating section. Research Article Critique Paper and Critique Tool Assignment Quality Rating for Clinical Practice Guidelines, Consensus, or Position Statements (Level IV)A High qualityMaterial officially sponsored by a professional, public, or private organization or a government agency; documentation of a systematic literature search strategy; consistent results with sufficient numbers of well-designed studies; criteria-based evaluation of overall scientific strength and quality of included studies and definitive conclusions; national expertise clearly evident; developed or revised within the past five years.B Good qualityMaterial officially sponsored by a professional, public, or private organization or a government agency; reasonably thorough and appropriate systematic literature search strategy; reasonably consistent results, sufficient numbers of well-designed studies; evaluation of strengths and limitations of included studies with fairly definitive conclusions; national expertise clearly evident; developed or revised within the past five years.C Low quality or major flawMaterial not sponsored by an official organization or agency; undefined, poorly defined, or limited literature search strategy; no evaluation of strengths and limitations of included studies; insufficient evidence with inconsistent results; conclusions cannot be drawn; not revised within the past five years.Research Article Critique Paper and Critique Tool AssignmentQuality Rating for Organizational Experience (Level V)A High qualityClear aims and objectives; consistent results across multiple settings; formal quality improvement or financial evaluation methods used; definitive conclusions; consistent recommendations with thorough reference to scientific evidence.B Good qualityClear aims and objectives; formal quality improvement or financial evaluation methods used; consistent results in a single setting; reasonably consistent recommendations with some reference to scientific evidence.C Low quality or major flawsUnclear or missing aims and objectives; inconsistent results; poorly defined quality; improvement/financial analysis method; recommendations cannot be made.Quality Rating for Case Report, Integrative Review, Literature Review, Expert Opinion, Community Standard, Clinician Experience, Consumer Preference (Level V)A High qualityExpertise is clearly evident, draws definitive conclusions, and provides scientific rationale; thought leader in the field.B Good qualityExpertise appears to be credible, draws fairly definitive conclusions, and provides logical argument for opinions.C Low quality or major flawsExpertise is not discernable or is dubious; conclusions cannot be drawn.Research Article Critique Paper and Critique Tool AssignmentRESEARCH Open AccessTelecoaching plus a portion control plate for weight care management: a randomized trial Jill M. Huber1, Joshua S. Shapiro2, Mark L. Wieland1, Ivana T. Croghan1, Kristen S. Vickers Douglas3, Darrell R. Schroeder4, Julie C. Hathaway5 and Jon O. Ebbert1,6*AbstractBackground: Obesity is a leading preventable cause of death and disability and is associated with a lower health- related quality of life. We evaluated the impact of telecoaching conducted by a counselor trained in motivational interviewing paired with a portion control plate for obese patients in a primary care setting.Methods: We conducted a randomized, clinical trial among patients in a primary care practice in the midwestern United States. Patients were randomized to either usual care or an intervention including telecoaching with a portion control plate. The intervention was provided during a 3-month period with follow-up of all patients through 6 months after randomization. The primary outcomes were weight, body mass index (BMI),waist circumference, and waist to hip ratio measured at baseline, 6, 12, 18, and 24 weeks. Secondary outcomes included measures assessing eating behaviors, self-efficacy, and physical activity at baseline and at 12 and 24 weeks.Research Article Critique Paper and Critique Tool AssignmentResults: A total of 1,101 subjects were pre-screened, and 90 were randomly assigned to telecoaching plus portion control plate (n = 45) or usual care (n = 45). Using last-value carried forward without adjustment for baseline demographics, significant reductions in BMI (estimated treatment effect -0.4 kg/m2, P = .038) and waist to hip ratio (estimated treatment effect -.02, P = .037) at 3 months were observed in the telecoaching plus portion control plate group compared to usual care. These differences were not statistically significant at 6 months. In females, the telecoaching plus portion control plate intervention was associated with significant reductions in weight and BMI at both 3 months (estimated treatment effect -1.6 kg, P = .016 and -0.6 kg/m2, P = .020) and 6 months (estimated treatment effect -2.3 kg, P = .013 and -0.8 kg/m2, P = .025). In males, the telecoaching plus portion control intervention was associated with a significant reduction in waist to hip ratio at 3 months (estimated treatment effect -0.04, P = .017), but failed to show a significant difference in weight and BMI.Research Article Critique Paper and Critique Tool AssignmentConclusion: Telecoaching with a portion control plate can produce positive change in body habitus among obese primary care patients; however, changes depend upon sex.Trial registration: ClinicalTrials.gov NCT02373878, 13 February 2015. https://clinicaltrials.gov/ct2/show/ NCT02373878.Keywords: Obesity, Telecoaching, Portion control plate, Primary care, Patient-centered medical home* Correspondence: Ebbert.Jon@mayo.edu 1Division of Primary Care Internal Medicine, Department of Medicine, Rochester, MN 55905, USA 6Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA Full list of author information is available at the end of the articleTRIALS© 2015 Huber et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Research Article Critique Paper and Critique Tool AssignmentHuber et al. Trials (2015) 16:323 DOI 10.1186/s13063-015-0880-1 http://crossmark.crossref.org/dialog/?doi=10.1186/s13063-015-0880-1&domain=pdfhttps://clinicaltrials.gov/ct2/show/NCT02373878https://clinicaltrials.gov/ct2/show/NCT02373878mailto:Ebbert.Jon@mayo.eduhttp://creativecommons.org/licenses/by/4.0http://creativecommons.org/publicdomain/zero/1.0/http://creativecommons.org/publicdomain/zero/1.0/Research Article Critique Paper and Critique Tool AssignmentBackground Obesity is a leading cause of preventable death and dis- ability in the United States [1], a lower health-related qual- ity of life [2], and contributes to chronic disease burdens of hypertension, hyperlipidemia, osteoarthritis, cancer, diabetes mellitus, and sleep apnea. Medical costs for people who are obese are $1429 higher per year than those of normal weight and total $147 billion annually [3]. The American Medical Association, American Collegeof Physicians, and the United States Preventive Services Task Forces have published guidelines that define obesity as a disease and recommend intensive physician-patient behavioral modification for obese patients [1, 2, 4–7]. However, lack of physician disease recognition, time, and skills make implementation of these recommendations unlikely [8–10]. Furthermore, existing trials of obesity counseling by primary care physicians have demon- strated mixed results [11–13]. A large meta-analysis of primary care diet and physical activity interventions re- cently showed that the most effective interventions utilize a combined lifestyle approach and require inten- sive patient contact spread over several months [14]Research Article Critique Paper and Critique Tool Assignment. This intensive patient contact may be best achieved by utilizing allied healthcare providers as has been demon- strated with successful clinical weight loss interventions administered by a registered dietician [15, 16], a medical assistant [17], or by a counselor using motivational inter- view techniques [18]. Recently, there has also been an increased interest inmaintaining patient contact via information technology such as email, telephone, and online messaging [19, 20]. Telephone counseling has been associated with positive behavior changes such as increasing physical activity and improving nutrition [21] while also being associated with significant weight loss [16]. Additionally, group tele- phone counseling via conference calls conducted by counselors has also demonstrated promising results [22]. Although telecoaching has proven efficacious, it remains poorly understood how it lends itself to a combined life- style approach in weight loss interventions. We conducted a pilot study of a weight loss interven-tion utilizing telecoaching conducted by a counselor trained in motivational interviewing for obese patients in a primary care setting. Additionally, patients received a portion control plate, which previously had been shown to be helpful for monitoring food portions [23]. We hypothesized that an intervention utilizing a combined lifestyle approach to weight management would be feas- ible and result in significant weight loss.Research Article Critique Paper and Critique Tool AssignmentMethods Study overview We conducted a randomized clinical trial evaluating the effectiveness of telecoaching combined with a portioncontrol plate. Telecoaching was provided during a 3-month intervention period with follow-up through 6 months after randomization. The primary study out- comes were weight reduction, BMI, waist circumference, and waist to hip ratio, measured at 6, 12, 18, and 24 weeks. Secondary outcomes included measures assessing eating behaviors, self-efficacy, and physical activity collected at 12 and 24 weeks. Enrollment took place between May 2011 and June 2012. This trial was performed in accord- ance with the CONSORT guidelines for randomized con- trolled trials (see Additional file 1 and 2 for details).Research Article Critique Paper and Critique Tool AssignmentSetting The study was conducted at a large academic primary care practice in the Midwestern United States. The practice provides primary care to approximately 130,000 patients.Study participants Participants were eligible for the study if they were be- tween the ages of 18 and 55 years with a body mass index ≥30 and ≤39.9 kg/m2 (obesity class I and II) and were motivated to pursue weight loss. We selected the upper age limit of 55 years because we were most inter- ested in determining if the intervention was effective in a population at risk for complications related to over- weight and obesity who may not yet be suffering these consequences. Participants were excluded if they had a significant health condition (for example, recent myocar- dial infarction, untreated hypertension, bipolar disorder, etcetera), had undergone bariatric surgery, were preg- nant, or were utilizing an investigational weight loss medication. This study was approved by the Institutional Review Board of Mayo Clinic prior to patient contact: reference number 11-001395.Research Article Critique Paper and Critique Tool AssignmentStudy enrollment Study personnel performed a limited chart review based on BMI and age eligibility criteria to identify primary care patients eligible for the study. For potentially eli- gible participants who had an upcoming appointment, their primary care providers were alerted of their eligibil- ity. The study was then introduced at the clinic visit with referral of those interested to study personnel for con- sideration of enrollment. For eligible participants who did not have an upcoming appointment in primary care, a recruitment letter was sent with instructions on how to contact study personnel for enrollment. All interested eligible patients underwent initial pre-screening via tele- phone by study personnel. Potential subjects then met with study personnel to review the study protocol in de- tail. Informed consent was obtained from all participants (or next of kin) prior to enrolment in the trial.Research Article Critique Paper and Critique Tool AssignmentHuber et al. Trials (2015) 16:323 Page 2 of 9  Randomization A computer generated randomization schedule was cre- ated using blocks of size 4 to ensure that treatment as- signment was balanced across groups over the course of the enrollment period. Using this randomization sched- ule, individuals who did not have any subject contact for the present study prepared randomization envelopes, which were labeled according to subject ID number and contained an index card indicating the treatment assign- ment for the given subject. At the time of enrollment, a subject was assigned the next sequential subject ID number, and the appropriate sealed envelope was opened to reveal the subject’s randomized treatment as- signment. The authors were blinded to randomization. The interventionist was not blinded to study assignment given the nature of the intervention Additional files 3.Research Article Critique Paper and Critique Tool AssignmentIntervention In the intervention group, participants received a por- tion control plate with instructions on use along with telecoaching. Telecoaching involved telephone counsel- ing on lifestyle modification from a single master’s level female counselor trained in motivational interviewing and wellness coaching. The wellness coach proactively contacted the partici-pants every 2 weeks for 3 months for a total of seven phone calls. Motivational interviewing was the frame- work for intervention delivery. Motivational interviewing is a directive, patient-centered counseling style for elicit- ing behavior change by helping patients to explore and resolve ambivalence [24]Research Article Critique Paper and Critique Tool Assignment, with efficacy data for weight loss in face-to-face clinical settings [25]. The focus of the discussion was an improvement in lifestyle by identi- fying barriers to incorporating healthy behaviors and problem solving to overcome these, collaborative goal setting, and progress toward patient-identified behavior change goals. Specific strategies were utilized to focus on improving diet and physical activity. These included, giving information about the “500 calorie challenge,” which is a strategy for reducing daily caloric intake by 500 calories. Additionally, recommendations were given for incorporating routine self-weighing, tools for moni- toring and documenting intake, and regular physical activity with a goal of 150 min of moderate intensity exercise per week. Average phone call duration was approximately 20 mi-nutes with the first and final calls being slightly longer. The format of the coaching session was a “check in,” fo- cusing on progress towards behavior change goals from the previous call, discussion around successes and bar- riers, problem solving, and collaboratively setting an ac- tion plan for the upcoming 2 weeks. The usual care group received institutional pamphlets on healthy eating and exercise habits.Research Article Critique Paper and Critique Tool AssignmentStudy measures Participants in both groups were evaluated in the clinic at baseline and at 6, 12, 18, and 24 weeks to obtain weight, BMI, waist circumference, and waist to hip ratio. Participants also completed measures assessing eating behaviors and physical activity at baseline and at 12 and 24 weeks. The primary outcomes included body weight, BMI,Research Article Critique Paper and Critique Tool Assignmentwaist circumference, and waist to hip ratio. Body weight was measured by a digital scale calibrated on a regular basis using certified weights. Participants were measured with their shoes and heavy outer garments removed and pockets emptied. The BMI was calculated from mea- sured height and weight (kg/height [meters]2). Waist circumference measurement was standardized utilizing a measuring tape held in the horizontal plane around the abdomen at the iliac crest and taken at the end of a nor- mal expiration with the tape snug and not compressing the skin. Waist to hip ratio was calculated by dividing the waist circumference measurement by the measure- ment obtained at the narrowest part of the hips. Secondary outcomes included physical activity level,dietary changes, self-efficacy, social support, and con- structs of behavioral change. Physical activity was mea- sured via two separate surveys. The Seven-Day Physical Activity Recall [26] is a five-item assessment of physical activity over the previous 7 days that characterizes sleep, light, moderately hard, hard, and very hard activity. Results are reported as total daily energy expenditure (kcal/day)Research Article Critique Paper and Critique Tool Assignment. The International Physical Activity Question- naire (IPAQ) [27] is a seven-question self-report meas- ure of physical activity that has been shown valid and repeatable in very diverse settings throughout 12 dif- ferent countries. The questionnaire assesses frequency and duration of walking, moderate-intensity activity, and vigorous-intensity activity over a 1-week period, with results reported in total Metabolic Equivalents (METs) per week. Dietary changes were measured via the Food FrequencyQuestionnaire (FFQ), which is a self-administered food questionnaire that asks the participant to report frequency of consumption and portion size of 125 common food items over a given time [28, 29]. This was administered electronically. The Eating Inventory [30] measured dietary restraint,disinhibition, and hunger. Research has demonstrated that scores can improve following obesity treatment, and that scores predict outcome to obesity treatment [31]. Additionally, we utilized the Weight Efficacy Life-Style Questionnaire (WEL) [32], which is a 20-item eating self-efficacy scale consisting of a total score and five situ- ational factors: negative emotions, availability, social pressure, physical discomfort, and positive activities. Participants rated their confidence in being able toHuber et al. Trials (2015) 16:323 Page 3 of 9Research Article Critique Paper and Critique Tool Assignment successfully resist the urge to eat using a 10-point scale ranging from 0 (not confident) to 9 (very confident) [33]. Improvements in eating self-efficacy have been associated with both greater weight loss as well as im- proved performance in weight control behaviors during intensive treatments [34]. We measured social support with the Weight Management Support Inventory (WMSI) [35], which assesses four dimensions of social support (emotional, instrumental, informational, and ap- praisal). The WMSI allows measurement of baseline levels of support for weight management and verifies changes in support via intervention. Finally, we mea- sured commonly accepted constructs of behavioral change with the Neis Behavior Change Scale (NEIS), which is a 16-item questionnaire that evaluates three theoretical constructs: (a) goal setting, (b) restructuring plans, and (c) relapse prevention and maintenance. These constructs have previously been identified as im- portant aspects of interventions, and this scale has been shown to have both internal and test-retest reliability in assessing these [36].Research Article Critique Paper and Critique Tool AssignmentSample size and statistical analysis This randomized trial was a pilot study, and a power analysis to determine number of subjects needed for statistical significance was not performed. Data are pre- sented as mean ± SD or median (25th, 75th) for continu- ous variables and frequency percentages for nominal variables. Body size measurements at 3 and 6 months were compared between groups using analysis of covari- ance. For these models, the follow-up measurement was the dependent variable, treatment group was the inde- pendent variable and the baseline value of the measure- ment was included as the covariate. These analyses were performed using only subjects with complete data, and using the approach of last value carried forward. For these analyses, the results are summarized by presenting the estimated treatment effect and corresponding 95 % confidence interval. From initial comparisons of baseline characteristics, the distribution of males and females was found to differ significantly between treatment groups. For this reason, post-hoc analyses were performed which included sex as a covariate, and supplemental analyses were performed separately for males and fe- males. Due to skewed distributions, the change from baseline to 3 months for secondary outcomes was compared between groups using the rank sum test. In all cases, two-sided tests were performed with P values ≤ .05 considered statistically significant.Research Article Critique Paper and Critique Tool AssignmentResults Enrollment and follow-Up Of the 1101 subjects screened, 106 passed a telephone pre-screen. Of these 106, 92 attended a consent/screenvisit, and 90 were randomly assigned to telecoaching plus portion control plate (n = 45) or usual care (n = 45) (Table 1). Although the majority of both treatment groups were female, the percentage of males in the tele- coaching plus portion control group was significantly lower than that for the usual care group (16 % versus 36 %; P = .030). Other baseline characteristics were simi- lar between groups. Fourteen subjects discontinued the study, as they were not present for the 6-month follow- up visit resulting in an overall study completion rate of 84 % (82 % for telecoaching plus portion control, 87 % for usual care).Research Article Critique Paper and Critique Tool AssignmentBody measurement outcomes In the primary analysis using last-value carried forward without adjustment for baseline demographics, significant reductions in BMI (estimated treatment effect -0.4 kg/m2, P = .038) and waist to hip ratio (estimated treatment effect -.02, P = .037) at 3 months were observed in the telecoaching plus portion control plate group com- pared to usual care (Table 2). These differences were not statistically significant at 6 months. Because the distribution of males and females was foundto differ significantly between treatment groups, post-hoc analyses with last-value carried forward were performed with sex included as a covariate. For the endpoints of weight and BMI, significant sex-by-treatment interaction effects were detected at both 3 months (P = .027 and P = .049) and 6 months (P = .020 and P = .044)Research Article Critique Paper and Critique Tool Assignment. Given these significant sex-by-treatment interaction effects, add- itional analyses were performed to assess all endpoints separately for males and females. For females, the tele- coaching plus portion control intervention was associated with significant reductions in weight and BMI at both 3 (estimated treatment effect -1.6 kg, P = .016 and- 0.6 kg/m2, P = .020) and 6 months (estimated treat- ment effect -2.3 kg, P = .013 and -0.8 kg/m2, P = .025). For males, the telecoaching plus portion control inter- vention was associated with a significant reduction in waist to hip ratio at 3-months (estimated treatment effect -0.04, P = .017).Changes in activity, diet and theory-based measures We observed no significant overall difference in physical activity, dietary quality, or theory-based measures be- tween the intervention and usual care groups. Among women, significant differences were observed for the change in METs per week based on the IPAQ (median change from baseline +778 versus -257 for telecoaching plus portion control versus usual care, respectively; P = .011), change in WEL total score (+12.5 versus -1.5, P = .041) and change in NEIS restructuring plans (+1.0 versus -1.0, P = .012) (Table 3).Huber et al. Trials (2015) 16:323 Page 4 of 9 Research Article Critique Paper and Critique Tool AssignmentDiscussion We observed that use of telecoaching with a portion con- trol plate among obese primary care patients can produce positive change in body habitus and that changes depended upon sex. For women, the intervention was as- sociated with weight loss maintained at 6 months as well as corresponding positive behavioral changes as assessed by the secondary outcome measures. We observed an improvement in the waist to hip ratioat 3 months among the men in our study. Among men, waist to hip ratio may actually be a better predictor of mortality risk than weight loss [37, 38]. Interventions such as ours that have a clinically significant beneficial impact on waist to hip ratio may therefore potentially have a clin- ically significant impact on mortality risk in men. A number of studies have recently highlighted possibledifferences between males and females in weight loss tri- als. Historically, men have been underrepresented in weight loss trials and many trials have enrolled females exclusively [39]. In the past, this has made it difficult to compare accurately the magnitude of effect in men ver- sus women. A recent systematic review comparing weight loss interventions through diet and exercise found that men are generally more successful than women in weight-loss trials, but found no evidence that men and women should adopt different weight loss strategies [40]. To our knowledge, specific sex-based determinantsinfluencing response to lifestyle intervention by motiv- ational interviewing and setting behavior change goals have not been well characterized. However, our findings imply that telephone-based, motivational interview- based interventions in a primary care practice may be more successful among women. The positive change in the NEIS and the WEL scoresamong the female participants who received telecoach- ing plus a portion control plate could indicate that these participants experienced improvements in eating self- efficacy as well as improvements in some constructs ofTable 1 Baseline demographic characteristicsTelecoaching + portion controlUsual care(N = 45) (N = 45)Research Article Critique Paper and Critique Tool AssignmentAge, yearsmean ± SD 48.3 ± 12.3 47.4 ± 14.1range 20 to 65 18 to 70Sex, no. (%)Male 7 (16) 16 (36)Female 38 (84) 29 (64)Race/ethnicity, no. (%)White, non-Hispanic 43 (96) 41 (91)Other 2 (4) 4 (9)Marital status, no. (%)Married/living as married 26 (58) 34 (76)Separated/divorced 2 (4) 4 (9)Never married 13 (29) 7 (16)Widowed 4 (9) 0 (0)Number of people in household, no. (%)1 11 (24) 7 (16)2 13 (29) 21 (47)3 7 (16) 6 (13)4 or more 14 (31) 11 (24)Education, no. (%)Less than high school 1 (2) 0 (0)High school graduate 8 (18) 3 (7)Some college 17 (38) 17 (38)4-year college degree or more19 (42) 25 (56)Work status, no. (%)Full time 34 (76) 29 (66)Part time 6 (13) 7 (16)Unemployed 2 (4) 0 (0)Retired 1 (2) 8 (18)Current tobacco use, no. (%) 4 (9) 1 (2)Diabetes, no. (%) 3 (7) 4 (9)Prior treatment fordepression, no. (%)14 (31) 13 (29)Prior treatment for alcoholism, no. (%)Research Article Critique Paper and Critique Tool Assignment2 (4) 2 (4)Weight,, mean ± SD, kg 99.6 ± 14.0 103.6 ± 18.9BMI, mean ± SD 36.5 ± 4.2 36.1 ± 3.9Waist, mean ± SD, cm 108.6 ± 9.3 112.4 ± 13.3Waist-hip ratio, mean ± SD 0.88 ± 0.10 0.91 ± 0.11FFQ, total calories,median (25th, 75th) 2271 (1531, 3054) 2366 (1865, 3725)Table 1 Baseline demographic characteristics (Continued)IPAQ, total METs,median (25th, 75th) 1760 (998, 4666) 1440 (680, 4596)WEL, total score,median (25th, 75th) 129 (110, 139) 116 (95, 136.5)Nies Behavior Change, median (25th, 75th)Goal setting 20.0 (17.5, 23.0) 20.0 (17.5, 24.0)Restructuring plans 14.0 (13.0, 15.0) 14.0 (13.0, 16.0)Relapse prevention 18.0 (16.0, 21.0) 18.5 (15.0, 21.0)BMI body mass index (calculated as weight in kilograms divided by height in meters squared), FFQ Food Frequency Questionnaire, IPAQ International Physical Activity Questionnaire, WEL Weight Efficacy Life-Style QuestionnaireHuber et al. Trials (2015) 16:323 Page 5 of 9 Research Article Critique Paper and Critique Tool Assignmentbehavioral change. Specifically, the significantly increased scores of the NEIS behavior change construct of restruc- turing indicates that these participants would be more comfortable restructuring their weight loss plan if success is not immediately achieved. Setting weight loss goals can have both positive as well as negative effects, and an increase in the construct of restructuring in behavioral change indicates a necessary skill in overcoming setbacksin behavioral change. Although the telecoaching interven- tion was not primarily focused on eating self-efficacy or restructuring, these appeared to be positive changes related to the overall effects of the intervention. The strengths of this study include a randomized de-sign and assessment of an intervention that is feasible in a primary care clinic. Telecoaching allows the behavioral interventions and frequent patient contact necessary toTable 2 Body size change from baseline to 3 and 6 months, overall and according to sexChange from baselineTelecoaching + portion controlUsual care Complete case estimated treatment effectLast value carried forward estimated treatment effectN Mean ± SD N Mean ± SD Est (95 % C.I.) P* Est (95 % C.I.) P value*Research Article Critique Paper and Critique Tool AssignmentAll Subjects3-monthsWeight, kg 38 −2.2 ± 3.1 40 −1.0 ± 2.0 −1.2 (-2.4, -0.1) 0.045 −0.9 (-1.9, +0.1) 0.091BMI, kg/m2 38 −0.9 ± 1.2 40 −0.3 ± 0.7 −0.5 (-1.0, -0.1) 0.020 −0.4 (-0.8, -0.0) 0.038Waist, cm 38 −3.2 ± 3.6 39 −1.9 ± 2.6 −1.3 (-2.7, +0.1) 0.072 −0.9 (-2.2, +0.4) 0.180Waist-hip ratio 38 −0.02 ± 0.05 39 −0.00 ± 0.03 −0.02 (-0.04, -0.00) 0.037 −0.02 (-0.04, -0.00) 0.0376-monthsWeight, kg 37 −2.6 ± 4.4 39 −1.1 ± 3.7 −1.5 (-3.3, +0.4) 0.118 −1.0 (-2.6, +0.6) 0.225BMI, kg/m2 37 −1.0 ± 1.7 39 −0.4 ± 1.3 −0.7 (-1.4, -0.1) 0.038 −0.5 (-1.1, +0.1) 0.093Waist, cm 36 −4.1 ± 6.1 39 −2.8 ± 4.1 −1.4 (-3.8, +0.9) 0.240 −1.1 (-3.2, +0.9) 0.282Waist-hip ratio 36 −0.02 ± 0.07 39 −0.00 ± 0.05 −0.02 (-0.05, +0.00) 0.083 −0.02 (-0.05, +0.00) 0.083Women3-monthsWeight, kg 33 −2.5 ± 3.1 26 −0.7 ± 2.1 −1.9 (-3.2, -0.6) 0.007 −1.6 (-2.8, -0.3) 0.016BMI, kg/m2 33 −1.0 ± 1.2 26 −0.3 ± 0.8 −0.7 (-1.2, -0.2) 0.012 −0.6 (-1.1, -0.1) 0.020Waist, cm 33 −3.5 ± 3.6 25 −1.9 ± 2.9 −1.6 (-3.4, +0.1) 0.074 −1.4 (-3.0, +0.2) 0.083Waist-hip ratio 33 −0.01 ± 0.05 25 0.00 ± 0.03 −0.01 (-0.03, +0.01) 0.350 −0.01 (-0.03, +0.01) 0.2956-monthsWeight, kg 33 −2.9 ± 4.5 25 −0.3 ± 3.4 −2.9 (-4.8, -1.0) 0.004 −2.3 (-4.0, -0.5) 0.013Research Article Critique Paper and Critique Tool AssignmentBMI, kg/m2 33 −1.1 ± 1.7 25 −0.2 ± 1.4 −1.0 (-1.8, -0.2) 0.014 −0.8 (-1.5, -0.1) 0.025Waist, cm 33 −4.0 ± 6.2 25 −2.0 ± 4.1 −2.0 (-4.8, +0.8) 0.172 −1.7 (-4.2, +0.8) 0.199Waist-hip ratio 33 −0.02 ± 0.07 25 0.00 ± 0.05 −0.01 (-0.04, +0.02) 0.428 −0.01 (-0.04, +0.01) 0.371Men3-monthsWeight, kg 5 −0.0 ± 2.4 14 −1.4 ± 1.8 +1.4 (-0.6, +3.3) 0.190 +1.3 (-0.3, +2.8) 0.135BMI, kg/m2 5 −0.0 ± .08 14 −0.4 ± 0.6 +0.4 (-0.2, +0.9) 0.206 +0.4 (-0.1, +0.9) 0.102Waist, cm 5 −1.5 ± 3.2 14 −2.0 ± 2.1 +0.3 (-2.0, +2.7) 0.785 +0.9 (-1.6, +3.4) 0.501Waist-hip ratio 5 −0.04 ± 0.05 14 −0.00 ± 0.04 −0.04 (-0.07, -0.00) 0.037 −0.04 (-0.07, -0.01) 0.0176-monthsWeight, kg 4 −0.2 ± 3.5 14 −2.4 ± 4.0 +2.4 (-1.3, +6.1) 0.227 +2.3 (-0.5, +5.1) 0.122BMI, kg/m2 4 −0.1 ± 1.1 14 −0.7 ± 1.1 +0.6 (-0.5, +1.7) 0.281 +0.7 (-0.1, +1.5) 0.098Waist, cm 3 −6.2 ± 3.6 14 −4.0 ± 4.0 −2.4 (-6.6, +1.8) 0.286 −0.2 (-3.8, +3.4) 0.902Waist-hip ratio 3 −0.03 ± 0.06 14 0.00 ± 0.06 −0.03 (-0.09, +0.03) 0.338 −0.04 (-0.08, +0.00) 0.077*Treatment effects were estimated using analysis of covariance (ANCOVA). For these analyses, the follow-up measurement was the dependent variable, treatment group was the independent variable and the baseline value of the measurement was included as the covariateHuber et al. Trials (2015) 16:323 Page 6 of 9 Research Article Critique Paper and Critique Tool Assignmentguide weight loss, and may utilize resources more effi- ciently than frequent clinic visits. The collaborative care model engages nonphysician members of the medical team. Minimal exclusion criteria of participants show that the intervention is successful primarily for obese women representative of those patients routinely seen in primary care clinics in regards to age, comorbidities, and baseline nutrition and physical activity status; however, generalizability is limited in regards to ethnicity, as a majority of participants was Caucasian. Our study has limitations. First, we were limited by arelatively small sample size, low enrollment of males, and a random imbalance of males. We anticipated randomization would result in an even balance and did not stratify in anticipation of an imbalance. In addition, our study is limited by underrepresentation of minority populations who have higher rates of obesity [7]. Differences in patient contact time of the interventionexisted between the two groups. Differences in contact time may potentially confound the assessment of efficacy of the telecoaching plus portion control plate interven- tion compared to a control intervention if contact timeinfluenced outcome. Our study was not designed to assess the influence of contact time on our outcomes. Furthermore, we did not record the counseling sessions, nor did we require the counselors to follow a predefined script. This may hinder reproducibility but may increase generalizability. Available evidence suggests that average weight lossesof 2.5 kg to 5.5 kg at ≥2 years achieved with lifestyle intervention reduces the risk of diabetes by 30 % to 60 % [41]. Among women, we observed a significant weight loss of 2.9 kg in the complete case analysis at 6 months. We did not examine weight maintenance beyond this interval. Measures of physical activity and exercise inten- sity included the Seven Day Physical Activity Recall and the IPAQ. Although we did observe a significant differ- ence in METS/week in the intervention group, these self-reporting tools are not the most reliable measures of physical activity. Finally, while the portion control plate was used as a tool to facilitate discussion with the tele- coach, the study was not designed to isolate the relative impact of the plate versus the telecoaching intervention components.Research Article Critique Paper and Critique Tool AssignmentTable 3 Secondary outcomes change from baseline to 3 months, overall, and according to sexTelecoaching + portion control Usual careN median (25th, 75th) N median (25th, 27th) P value*All SubjectsFFQ, total calories 38 −796, (-1303, -196) 41 −694 (-1371, –303) 0.662IPAQ, total METs/week 39 +757 (-720, +2104) 40 +61 (-1071, +790) 0.090WEL, total score 39 +12.0 (-4.0, +21.0) 40 +1.0 (-18.5, +16.25) 0.070NEIS: Goal setting 39 +1.0 (-1.0, +3.0) 40 −1.0 (-2.0, +1.0) 0.027NEIS: Restructuring plans 37 +1.0 (0.0, +1.0) 40 −1.0 (-2.0, +0.75) 0.006NEIS: Relapse prevention 39 +2.0 (0.0, +3.0) 39 0.0 (-1.0, +3.0) 0.066WomenFFQ, total calories 33 −745 (-1233, -177) 26 −471 (-1224, -241) 0.598IPAQ, total METs/week 34 +778 (-479, +2158) 26 −257 (-2690, +565) 0.011WEL, total score 34 +12.5 (-4.0, +21.0) 26 −1.5 (-17.5, +14.0) 0.041NEIS: Goal setting 34 +1.0 (-0.25, +3.0) 26 0.0 (-2.0, +0.25) 0.104NEIS: Restructuring plans 32 +1.0 (0.0, +1.0) 26 −1.0 (-2.0, +0.25) 0.012NEIS: Relapse prevention 34 +2.0 (+0.75, +3.75) 25 0.0 (-1.5, +3.5) 0.125MenFFQ, total calories 5 −1316 (-2512, -607) 15 −707 (-1864, -342) 0.485IPAQ, total METs/week 5 −5280 (-8611, +3598) 14 +480 (-248, +1248) 0.431WEL, total score 5 +2.0 (-15.0, +31.0) 14 +6.5 (-23.0, +22.0) 0.963NEIS: Goal setting 5 +1.0 (-3.5, +2.5) 14 −1.5 (-2.0, +1.0) 0.811NEIS: Restructuring plans 5 +1.0 (−2.5, +15.0) 14 0.0 (−1.0, +1.0) 0.317Research Article Critique Paper and Critique Tool AssignmentNEIS: Relapse prevention 5 −2.0 (−2.5, +1.5) 14 0.0 (−1.25, +1.25) 0.543FFQ Food Frequency Questionnaire, IPAQ International Physical Activity Questionnaire, NEIS Neis Behavior Change Scale, WEL Weight Efficacy Life-Style Questionnaire *Wilcoxon rank sum testHuber et al. Trials (2015) 16:323 Page 7 of 9  Conclusion The recent AHA/ACC Obesity guidelines support the use of electronically delivered, including telephone, primary care weight loss programs focused on lifestyle interventions facilitated by a trained interventionist. This study supports telecoaching plus a portion con- trol plate as a promising weight management strategy for obese women in primary care. Future research should evaluate whether this weight loss is maintained over time in these programsAdditional filesAdditional file 1: CONSORT Checklist. (DOC 217 kb)Additional file 2: TIDieR Checklist. (DOC 62 kb)Additional file 3: CONSORT Diagram. (JPEG 187 kb)Abbreviations BMI: body mass index; IPAQ: The International Physical Activity Questionnaire; METs: metabolic equivalents; FFQ: Food Frequency Questionnaire; WEL: Weight Efficacy Life-Style Questionnaire; WMSI: Weight Management Support Inventory; NEIS: Neis Behavior Change Scale..Competing interests The authors declare that they have no competing interests.Research Article Critique Paper and Critique Tool AssignmentAuthors’ contributions JMH designed the trial, obtained funding, oversaw the conduct of the study, and drafted the initial draft of the manuscript. JSS interpreted the data and provided critical revisions of the manuscript. MLW helped with study design, interpretation of results, and writing. ITC coordinated the study, helped draft the initial draft of the manuscript, and provided critical revisions of the manuscript. KSV interpreted the data and provided critical revisions of the manuscript. DRS helped with data acquisition, analyzed the data and provided critical revisions of the manuscript. JCH provided the study interventions and provided critical revisions of the manuscript. JOE helped design the trial, helped secure resources to fund the study, oversaw the conduct of the study, mentored the principal investigator, helped draft the manuscript, interpreted the data, and provided critical revisions of the manuscript. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.Research Article Critique Paper and Critique Tool AssignmentFunding/support This study was funded by the Mayo Clinic in Rochester, MN.Author details 1Division of Primary Care Internal Medicine, Department of Medicine, Rochester, MN 55905, USA. 2Division of Internal Medicine, Department of Medicine, Rochester, MN 55905, USA. 3Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. 4Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA. 5Patient Education and Consulting Services, Mayo Clinic, Rochester, MN 55905, USA. 6Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.Received: 27 April 2015 Accepted: 21 July 2015References 1. US Burden of Disease Collaborators. The state of US health, 1990–2010:burden of diseases, injuries, and risk factors. JAMA. 2013;310:591–608. 2. 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Effectiveness of weight loss interventions – is there a difference between men and women: a systematic review. Obes Rev. 2015;16:171–86.Research Article Critique Paper and Critique Tool Assignment41. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63:2985–3023.Submit your next manuscript to BioMed Central and take full advantage of:• Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitHuber et al. Trials (2015) 16:323 Page 9 of 9Research Article Critique Paper and Critique Tool Assignment BioMed Central publishes under the Creative Commons Attribution License (CCAL). Under the CCAL, authors retain copyright to the article but users are allowed to download, reprint, distribute and /or copy articles in BioMed Central journals, as long as the original work is properly cited. Research Article Critique Paper and Critique Tool Assignment

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