Discussion 2: Epidemiologic Designs
As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As a DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.
For this Discussion, you will consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for investigating the population health problem you selected for Assignment 1. In addition, you will consider which epidemiologic data sources you would use to examine your health problem.
To prepare:
- Reflect on the population health problem you identified in Assignment 1, which you will use for Major Assessment 7, and your early review of the literature.
- Identify a question for your study; this will help you select an appropriate design.
- Consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for addressing your selected health problem based upon the assumptions and basic tenets of each design.
- Determine which epidemiological design(s) would not be appropriate for your study and why.
- Also, explore the various health data resources that were presented in Chapter 5 of the course text, Epidemiology for Public Health Practice. Consider which data resources you could use for your study, assessing the strengths and limitations of those resources.
By Day 5
Post a cohesive scholarly response that addresses the following:
- Briefly summarize the population health problem you selected for Major Assessment 7, and state the study question you want to answer.
- Explain which epidemiologic study design is most appropriate for your study, as well as the assumptions and tenets that support its application.
- Analyze the strengths and the limitations of the potential data sources you might use for your study.
Read a selection of your colleagues’ responses.
By Day 7
Respond to at least two of your colleagues providing feedback on the appropriateness of the study question for the health problem, the selected epidemiologic study design, and whether another design might also fit the population and population health problem. In addition, provide any further insights on the strengths and limitations of the selected data sources, and suggestions of other data sources that might be appropriate.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Week 4: Analytic Epidemiology Designs: Experimental
In the fall of 2011, the FDA announced a shortage of important chemotherapy drugs; this shortage, in turn, disrupted clinical trials and led to potential challenges in assessing data from those studies. Experimental research, which includes clinical trials, plays a pivotal role in the advancement of disease prevention and treatment. Once a risk factor has been established, the next step is testing an intervention through experimental research methods. Does this drug actually prevent or ameliorate symptoms?
In Week 3, you examined observational study designs, an important form of analytic epidemiology. This week, the focus turns to experimental studies. As you explore this topic, think about why experimental research is considered the “gold standard” of epidemiology. You will also begin developing Assignment 2 (Sections 1 and 2 of Major Assessment 7) and consider which research design will best address your selected population health problem.
Learning Objectives
Students will:
- Analyze a randomized controlled trial research study
- Analyze ethical issues with a randomized control trial study
- Evaluate epidemiologic study designs to answer a population health study question
- Evaluate the strengths and limitations of health data sources to answer a population health study question
- Determine primary data collection methods for a specific population health problem
Learning Resources
Required Readings
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.
- Chapter 8, “Experimental Study Designs”
This chapter examines experimental and quasi-experimental study designs.
This article examines programs that integrate substance abuse treatment and pregnancy, parenting, or child services. The authors conclude that there is a need for funding of high-quality randomized control trial and improved reporting practices. This article also demonstrates the application of analytic research designs to explore a population health problem.
The authors examine how both behavioral support and pharmacotherapies can be effective in helping people to stop smoking. By adopting a randomized or quasi-randomized controlled trial, the authors are able to evaluate whether such combinations of pharmacotherapy and behavioral support compared to receiving usual care or brief advice assists individuals in smoking cessation.
Physicians’ Health Study (2010). Retrieved from http://phs.bwh.harvard.edu/
Required Media
Laureate Education (Producer). (2012). Epidemiology and population health: Experimental studies [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 5 minutes.
In this program, the presenters discuss experimental studies, including the effect of randomization and blinding on study results.
Accessible player
Optional Resources
Groopman, J. (2006, December 18) Medical dispatch—The right to a trial: Should dying patients have access to experimental drugs? New Yorker, 82(42), 40–47.
Name: NURS_8310_ Week4_Discussion2_Rubric
| Excellent | Good | Fair | Poor | |
| RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. |
Points Range:8 (26.66666%) – 8 (26.66666%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*. |
Points Range:7 (23.33333%) – 7 (23.33333%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*. |
Points Range:6 (20.00%) – 6 (20.00%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*. |
Points Range:0 (0.00%) – 5 (16.66666%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*. |
| CONTENT KNOWLEDGE | Points Range:8 (26.66666%) – 8 (26.66666%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course. |
Points Range:7 (23.33333%) – 7 (23.33333%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course. |
Points Range:6 (20.00%) – 6 (20.00%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course |
Points Range:0 (0.00%) – 5 (16.66666%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course. |
| CONTRIBUTION TO THE DISCUSSION | Points Range:8 (26.66666%) – 8 (26.66666%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature. |
Points Range:7 (23.33333%) – 7 (23.33333%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature |
Points Range:6 (20.00%) – 6 (20.00%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas. |
Points Range:0 (0.00%) – 5 (16.66666%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas |
| QUALITY OF WRITING | Points Range:6 (20.00%) – 6 (20.00%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints. |
Points Range:5 (16.66666%) – 5 (16.66666%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;. |
Points Range:4 (13.33333%) – 4 (13.33333%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints. |
Points Range:0 (0.00%) – 3 (10.00%)
Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints. |
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Solution
The population health problem selected in Major Assessment 7 is prescription drug overdose, commonly called the opioid crisis. Clinically referred to as the Opioid Use Disorder (OUD) the opioid problem is a critical population health issue affecting millions of individuals across the United States. Initially, the opioids were meant to help patients with chronic and terminal conditions to relieve pain (Liang & Shi, 2019). However, these drugs have an addictive effect that has led to their abuse by other people who find them having similar benefits like the hard abused substances like heroin and cocaine.
The study question is “What is the efficacy of the Centers for Disease Control and Prevention’s “Prevention of State” program in lowering the prevalence of prescription drug overdose?”
Knowing the risk factors associated with the high prevalence of OUD in the population needs a comprehensive analysis. Therefore, the most appropriate epidemiological design is cohort study design. The tenet of this design is that it makes follow ups of research subjects that have similar features over time (Friis & Sellers, 2021). Based on this approach, researchers can understand the risk factors that lead to an increase or a decline in the prevalence of health problems like the opioid epidemic. The third tenet of the cohort study design is that it establishes cause and effect perspectives in research (Alexander et al., 2018). The other assumption that supports cohort approach is that it entails large samples and enables researchers to identify potential risk factors that contribute to disease over time.
Potential sources of data in cohort studies include observations from the participants, and use of past records comprising of similar research findings (Barrett & Noble, 2019). The advantages of these source include ability to interact with participants and get first-hand information, takes time to include large representative samples for varied outcomes. However, the sources of data require time and resources to gather comprehensive information.
References
Alexander, L., Lopes, B., Ricchetti-Masterson, K., & Yeatts, K. B. (2018). Randomized
controlled trials. ERIC Notebook Periodical Second Edition No. 10. Retrieved from https://nciph.sph.unc.edu/tws/HEP_ERIC10/certificate.php
Barrett, D., & Noble, H. (2019). What are cohort studies? Evidence-Based Nursing, 22, 95-96.
doi: 10.1136/ebnurs-2019-103183
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones &
Bartlett. Chapter 8, “Experimental Study Designs”
Liang, D., & Shi, Y. (2019). Prescription drug monitoring programs and drug overdose deaths
involving benzodiazepines and prescription opioids. Drug and alcohol review, 38(5), 494-502. DOI: 10.1111/dar.12959.