Community Medicine 2 Output 6 (Data Collection Tool) Community Medicine15-B Members: Matel, Maria Carolina Nazareno, Christine Panghulan,

, Aldee Ray Parao, Angelo I. II. Reyes, Kevin Sampelo, Ma. CarmelaA. Tee, Jan Raemon

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. 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 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

IV. VARIABLES/ DATA TO BE COLLECTED p1 The p1 variable is the estimate of the sample population for street children located within the vicinity of the subject orphanage who are malnourished. The value that will be used for this study is 73% as taken from the literature reviewed. p2 The p2 variable is the estimate of the sample population for orphans located within the vicinity of the subject orphanage who are malnourished. The value that will be used for this study is 54.8% as taken from the literature reviewed. Alpha Alpha () is the probability of committing Type I error in which the null hypothesis is rejected when it is true. In this study, is the probability of rejecting the claim stating that the percentage of malnutrition among the street children and orphans is the same, when in fact, it is true. A 90% confidence interval will be used, hence is 0.1. Beta Beta () is the probability of committing Type II error or failing to reject the null hypothesis. In this study, is the probability of failing to reject the claim that the percentage of malnutrition among street children is the same among orphans. The power of the study is 80%, therefore is 0.20.

Direction of the test The study is a two-tailed test. The critical region is split into two parts. The null hypothesis states that there is no association between being a street children and malnutrition if the value that will be obtained is greater or lesser than that of the alternative hypothesis. The alternative hypothesis states that there is an association between being a street children and malnutrition. VALUES OF THE VARIABLES FOR CALCULATIONS Variables p1 p2 Alpha Beta Values 73% 54.8% 0.10 0.20

The value for p1 was taken from International Centre for Diarrhoeal Disease Research, Bangladesh: Dissemination Seminar on: Health Needs and Health Seeking Behaviours of Street Dwellers in Dhaka City, wherein 73% of street children are found to be malnourished. The value for p2 was obtained from the journal Are Orphans At Increased Risk of Malnutrition in Malawi? by Annals of Tropical Paediatrics: International Child Health, Volume 19, Number 3, 1 September 1999, pp. 279-285(7), in which the statistical value is 54.8% in favour of institutionalized children. A confidence level of 90% and a power of 80% will be used. Weight Values

This set of data will be obtained using a standard balance and will be recorded with the KILOGRAM unit.

Height Values

This set of data will be obtained using a height meter and will be recorded with the METER unit.

BMI Values This set of data will be obtained by dividing the weight values obtained (in kg) over the square of the height values obtained (m2) and will have a final unit of kg/m2. Values less than 18.5 and greater than 25 will be considered as positive disease cases (malnutrition).

V. METHOD OF DATA COLLECTION

For the purpose of this study, Observation by making use of equipment and tools is the preferred method for data collection. Specifically, the use of standardized and calibrated balance and height meter will be used for taking weight and height measurements respectively. This method was chosen over other data collection methods primarily because the key element in this study is the determination of BODY MASS INDEX to determine the nutritional status of the subjects. This data is quantifiable and measurable by using the height and weight measurements of the subjects. While it can be argued that observing the physical appearance, behaviour and characteristics of the subject may be used as a method for nutritional status determination, it is very much prone to subjective bias from the observers and will not give

accurate results unlike the proposed method of data collection. The same reason holds true in justifying observation using equipment and tools as choice for data collection over Focus Group Discussion and Questionnaires/interview which will not give appropriate and quantified results.

VI. DATA COLLECTION TOOLS

1. Letter of Consent for the Participation of Institutionalized Children

DeLaSalleHealthScienceInstitute College of Medicine

Mrs. Esperanza C. Gutierrez President Associacion de Damas Filipinas, Inc. Settlement Homes Paco, Manila Maam/ Sir: Good day! We are medical students from De La Salle Health Sciences Institute, Dasmarinas City, Cavite. As part of our course requirement in Community Medicine 2, we are conducting a comparative study on the nutritional status among institutionalized and street children. For the former category, we will specifically be assessing those children living in the orphanages. In light of this, we would like to ask permission from your good office to allow us to conduct our study in your institution. Aside from the assessment of nutritional status, our study will also include analysis on the factors which affect the nutrition and health status of street and institutionalized children. We believe that this study would be able to provide you with valuable input during your general improvement planning for the institution and we would be very glad to share the results of our study with you. We also assure you that we will only use information necessary for the study and any sensitive and other data concerning the children and the institution will not be published. Likewise, we are very much open to discussing these important terms with you if you deem it necessary to do so. We are looking forward to meeting and working with you regarding this study and it is hoped and prayed for that you would grant us permission to do so. Thank you and may our good Lord

bless you more. Thank you for your kind consideration. Sincerely yours, Angelo Parao Noted by: Josephine M. Carnate, MD, MPH

2. Informed Consent for Parents/Guardians of Street Children

DeLaSalleHealthScienceInstitute College of Medicine Petsa: ______________ PAHINTULOT Ako si __________________ , nasa hustong gulang at ama/ina/kamaganak/gardyan ni ______________________, matapos mapaliwanagan ukol sa layunin, kabuluhan at posibleng benepisyo ng pag-aaral na ito ay nagbibigay pahitulot na ipagamit ang mga impormasyon ukol sa taas, timbang at body-mass index ni ____________________. Nauunawaan ko na ito ay boluntaryong pakikiisa sa pagaaral na ito at walang anumang kapalit na tulong pinansyal o anumang materyal na bagay.

LAGDA sa itaas ng Pangalan 3. Body-Mass Index Determination Sheet