Running head: USING THE DATA INFORMATION KNOWLEDGE WISDOM 1

Using the Data Information Knowledge Wisdom Continuum

Lori Dixon
Walden University
Transforming Nursing & Healthcare Through Information Technology
NURS-6051-12

June 29, 2014

USING THE DATA INFORMATION KNOWLEDGE WISDOM 2



Using the Data/Information/Knowledge/Wisdom Continuum
Obesity has reached epidemic levels in the United States, and it is passed down from the
parents to their children. Lifetime changes to create healthy lifestyles in families need to be
addressed, and teach them to maintain healthier lives. The purpose of this paper is to use the
framework of the Data, Information, Knowledge, and Wisdom (DIKW) Continuum. Data is
distinct fields of information; such as a weight is 200 lbs. Information is the organization of data
that is interpreted and organized. Knowledge is finding the relationships between the
information that has been obtained. Wisdom is using the knowledge that is obtained to solve
health problems (Bickford, 2008).
Clinical Question
The United States spends over $147 million a year on treating obesity and related diseases.
There are 78 million obese adults and 12.5 million obese children, and the number of obese
individuals is increasing by 10-20% over the next 20 years (Zamosky, 2013). Children learn
from their parents bad nutritional habits and lack of activity. How do we teach parents and
children to live a healthy lifestyle, and then maintain that lifestyle? I chose this questions
because I have lived it all of my life. My parents are not overweight, but I was overweight from
the time I was a toddler. I see others all around me that struggle with their weight, and have not
found a solution to being healthy. We measure obesity by BMI and weight, but the more
important issues are eating healthy and active lifestyle. My goal in researching data on this topic
is to find treatment programs where patients will make changes in their habits for a lifetime.
Data to Information
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To find data concerning my research question, I used the Walden Library and Internet. I
searched for articles based on the topic. The Nursing Databases - CINAHL & MEDLINE
Simultaneous Search was used with the keywords of obesity and nursing. I filtered this search
by searching the period of 2010 to 2014. I reviewed the titles of articles and the abstracts to find
articles I wanted to read, and I thought applied to my research question. Once I found the
articles to read, I would download them and read each article highlighting the data points that
applied. In addition, information within the articles would interest me, I would use a Google
scholar search to find articles not included in my initial search.
Data becomes information when it is interpreted and organized. Data being entered into
an electronic health record (EHR) should be organized across health systems to interpret the data
gathered to improve population health. In 2009, the Pediatric EHR Data Sharing Network
(PEDSNet) formed a consortium with six hospitals and one university system. Four of the six
hospitals used EPIC, one used Cerner Millennium, and one used Allscripts (Bailey et al., 2013).
The ability to aggregate data across several hospitals provides a large sample to monitor and
research childhood obesity. These systems are also used for adults, and the same data could be
extracted and organized to understand obesity better obesity in adults. The hospitals extracted
information from all outpatient visits, except surgery and emergency. The data extracted
included; height and weight, sex and age, visit date and department specialty and all diagnoses
(Bailey et al., 2013). This type of project could be expanded to develop questions regarding
characteristics or data elements of obese families. Data elements that could be included would
be family members and relationship to each other, weight and height of each member, and diet
and activity.
Information to Knowledge
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Knowledge is finding the relationships between the data elements that have been
organized into information. In the PEDSNet study, the information about height and weight was
calculated to find the body mass index (BMI). Children with a BMI in the 95 percentile only
20% had any diagnosis recorded (Bailey et al., 2013). By looking at this information in a large
sample, they were able to identify deficits in diagnosing pediatric patients. In an obese
population, it would be expected to see comorbidities such as hypertension and diabetes. In this
population of children it was found that there was a relationship between obesity and acute
leukemia, multiple sclerosis, and chromosomal anomalies (Bailey et al., 2013).
Knowledge to Wisdom
Once the characteristics of the obese population are identified as knowledge, the next step is
taking that knowledge and finding the treatments that will answer the research question. This
lead to another article search for obesity and mobile applications and the result was five articles
that I reviewed. Children love playing video games, and a review was done on mobile
applications to treat obesity in children. HyperAnt was the top application after the review, it
provided information about activity and food choices. It did not allow any user entry of data,
and the child could not set personal goals. Overall the use of applications engaged children
about their health, but they lacked evidence-based information, and the author suggested the app
developers work with clinical experts (Schoffman, Turner-McGrievy, & Wilcox, 2013).
A research study was done in Australia on a mobile app called TXT2BFiT for young
adults. The program combined self-report, coaching calls, and text messages with education for
the participant. The article did not include any final outcomes and is still in process (Hebden et
al., 2013). Due to the research study being ongoing, this did not appear to be the solution to my
question.
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The final article was about obesity rehabilitation and using mobile technology. The
treatment was long-term with an inpatient and outpatient combination. The patient was admitted
for 30 days to a multi-disciplinary team, and the treatment focus was on changing dysfunctional
behaviors. After inpatient discharge, the patient was admitted to outpatient, and to sustain
weight-loss long-term, extensive psychotherapeutic intervention and is multidisciplinary. The
program uses mobile devices, video conferencing with clinicians the patient worked in the
hospital, and call coaching. There are five components that need to be included in a mobile
application; self-monitoring, counselor feedback and communication, social support, structured
program, and individually tailored program (Castelnuovo et al., 2014).
Conclusion
The increasing use of the EHR provides the data that nursing informatics can access to
research patient information related to a disease process. By organizing the data into a structured
format, researchers are able to collate data to find new treatments. For example, the PEDSNet
study pulled together the information to monitor obesity in children. Reviewing the common
data elements in the population the research has an understanding of cause, and can work on
solutions to create health changes. To create solutions to change the health behavior of obese
children and adults, the treatment must be long-term and multidisciplinary. The use of video
conferencing and mobile technology will also decrease the cost of healthcare by decreasing the
comorbidities of obesity.

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References
Bailey, L. C., Milov, D. E., Kelleher, K., Kahn, M. G., Del Beccaro, M., Yu, F., ... Forrest,
C. B. (2013, June). Multi-institutional sharing of electronic health record data to
assess childhood obesity. PLOS ONE , 8(6), 1-8. doi:
10.1371/journal.pone.0066192
Bickford, C. J. (Ed.). (2008). Nursing informatics: Scope and standards of practice.
Silver Spring, MD: Nursesbooks.org.
Castelnuovo, G., Mauro Manzoni, G., Pietrabissa, G., Corti, S., Giusti, E., Molinari, E., &
Simpson, S. (2014, May 20). Obesity and outpatient rehabilitation using mobile
technologies: the potential mHealth approach. Frontiers in Psychology, 5, 1-11.
doi:10.3389/fpsyg.2014.00559
Hebden, L., Balestracci, K., McGeechan, K., Denney-Wilson, E., Harris, M., Bauman,
A., & Allman-Farinelli, M. (2013). TXT2BFiT a mobile phone-based healthy
lifestyle program for preventing unhealthy weight gain in young adults: study
protocol for a randomized controlled trial. Trials, 14, 1-9. Retrieved from
http://www.trialsjournal.com/content/14/1/75
Schoffman, D. E., Turner-McGrievy, G., & Wilcox, S. (2013, September). Mobile apps
for pediatric obesity prevention and treatment, healthy eating, and physical
activity promotion: just fun and games? Transl Behav Med, 3, 320325. doi:
10.1007/s13142-013-0206-3
Zamosky, L. (2013, February 25th). The obesity epidemic. MEDICAL ECONOMICS, 14-
17. Retrieved from MedicalEconomics.com