Community Medicine 2 - Output 3 (Research Desisgn) Community Medicine15-B Members: Matel, Maria Carolina Nazareno, Christine Panghulan, AldeeRay

Parao, Angelo Reyes,Kevin Sampelo, Ma. CarmelaA. Tee, Jan Raemon

I. II.

GROUP15-B, JOSEPHINE M. CARNATE,MD, MPH RESEARCH QUESTION AND OBJECTIVES A. Research Question Is the prevalence of malnutrition higher in street children compared to institutionalized children in orphanages located in Paco, Manila during the year 2011? B. Objectives

i.

General Objectives

To be able to compare the prevalence of malnutrition among street children and institutionalized children in orphanages located in Paco, Manila during the year 2011. ii. Specific Objectives

1.To determine the body

mass index (BMI) of street children and

institutionalized children living in orphanages. 2.To compare the Body Mass Index (BMI) of street children and institutionalized children living in orphanages. 3.To correlate the absence or presence of biological parents to the frequency of malnutrition among street children and institutionalized children in orphanages.

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III.

BACKGROUND A. Research Hypothesis

The prevalence of malnutrition is generally higher in street children compared to institutionalized children. There is a direct relationship between the children’s environment (socio-economic and demographic factors such as location and condition of household,

presence or absence of biological parents) and their nutrition status.

B. Conceptual Framework

(Dependent Variable) (Independent Variable)

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IV.

DESIGN

Operational definition of variables:

Dependent variable

In this study, the prevalence of malnutrition would be the dependent variable. This variable would be determined using BMI. Values less than 18.5 is regarded as underweight while a BMI value greater than 25 is considered overweight and above 30 is considered obese. as set by WHO.

Independent variables

The independent variables in this particular study would be either being an institutionalized child or being a street child. Institutionalized children for this matter will be defined as those living in the orphanages for at least 6 months. Street children are further classified as “Children on the Streets” described as children working on the streets but have homes to return to and “Children of the Streets” described as children living on the street.

Confounding variables

Confounding variables include age, sex and physical activity.
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Research Design:

Type of study to be employed

A cross-sectional type of study will be utilized to identify the relationship between being in an orphanage and/or being in the street and the prevalence of malnutrition. Definition of study population/study groups and source of subjects

Children, both male and female, ages 6 to 10 would be the target subjects of this study. They will be randomly selected from a study population which will come from an orphanage in Paco, Manila (for the representatives of the Institutionalized children). To represent street children, the areas within the vicinity of the orphanage will be surveyed to build the sample population. This is done to eliminate any factors and variables which may affect the outcome of the study like the availability of certain food groups, environmental hazards, degree of pollution et cetera.

Steps to be undertaken/ Procedure to be followed

The samples from the aforementioned locations would be randomly numbered and
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selected using a randomizer (table of random numbers or automated random number generator) to eliminate selection bias. The heights and weights would be determined using a standard balance and height meter respectively. Survey questionnaires would also be given out to the parents and care takers of the orphanages. The data gathered from the questionnaires would be sorted, analyzed and by statistics association of the risk factors involved in acquiring malnutrition for the institutionalized and street children would be done.

Schematic Diagram of the Research Design
Street Child (+) malnutrition

Institutionalized Children and Street Children

Street Child (-) malnutrition

Randomly selected children ages 6-10

Institutionalized Child (+) malnutrition Institutionalized Child (-) malnutrition

Biases/Limitations

Much consideration had been given to the selection of the ages from 6 to 10 primarily which is the facilitation of the measuring of the heights and weights to determine accurate Body-mass indices. This range has also the advantage of being able to confirm and validate certain information from the survey questionnaires which in most cases will be answered by the parents or care takers of the orphanage. Likewise, the degree of cooperation tends to increase from ages 6 and up. Therefore the study was decided to be limited to this age range. Another limitation to this study is the inability of the researchers to determine and eliminate
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confounders like inherent defects in metabolism which may significantly affect the outcome of the study. Likewise, the difficulty of defining and determining factors such as “crowding” limits the study to some extent. Other quantitative determinants of malnutrition will also not be included in this study which will solely rely on BMI data to report malnutrition. The extent of association between the availability of some food groups, presence of pollution and other variables would not be discussed intensively but their individual possible contribution to malnutrition would be thoroughly discussed. Selection bias may follow the tendency of the researchers to opt for malnourish-looking individuals in hopes of generating a large sample population with a very high percentage of positive malnutrition. This will be circumvented by using random selection of samples from the representative population.

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