Assignment 4: Planning for Evaluation
The research process is key in finding appropriate interventions to address a population health problem effectively. Central to the formulation of such interventions is data collection and analysis, which can inform the researcher if there is a need to undertake screening programs for a particular disease (LoBiondo-Wood & Haber, 2021). However, evaluation is critical for the data and results to be informative enough. Evaluation ensures that the data is sound and suitable as the basis for making such decisions. The implication is that in a case where a study’s result does not undergo an evaluation process, it cannot be applied to improve population health (Melnyk & Fineout-Overholt, 2019). Therefore, the purpose of this week’s assignment is to formulate an evaluation plan for the anticipated results of the population health intervention developed earlier; the chosen intervention to help address the problem of developing hypertension due to psychological stress is blood pressure self-monitoring with comprehensive education.
The Expected Outcomes
As indicated earlier, hypertension is one of the conditions that has been identified to be common among health workers, and one of the causes can be attributed to psychological stress. Therefore, it is hoped that the use of blood pressure self-monitoring and comprehensive education addressing various lifestyle activities can result in better outcomes (Mills et al.,2018). Therefore, various outcomes are expected. One of the outcomes expected is lower incidences of hypertension. With self-monitoring of blood pressure, the targeted patient population will be able to regularly check their blood pressure levels and note whether it is within the acceptable systolic and diastolic ranges. In the case of concerning figures, the patient can timeously seek medical attention, reducing the chances of worsening the condition.
The other expected outcome is acceptance and uptake of the use of blood pressure self-monitoring devices. The outcomes largely depend on how well the patients use the devices to monitor their blood pressure as directed. So if they agree to use the devices as directed, then the goal shall have been achieved. As part of the intervention, the patient group will be offered comprehensive education support that addresses the prevention and management of hypertension. Therefore, the next expected outcome is increased or improved knowledge on the facts about hypertension, such as causes, risk factors, adverse impacts or effects, prevention, treatment, and management.
The Data Collection Tools
Appropriate data collection tools should be used to collect the data relevant to the project. The project is focused on healthcare workers experiencing psychological stress and, therefore, at risk of developing hypertension. Therefore, one of the most important data collection tools to be used is the questionnaires (Hopp & Rittenmeyer, 2021). A self-administered questionnaire will be used in assessing the participants’ knowledge on hypertension so that the education material can appropriately be aligned for optimum content delivery and outcomes. Questionnaires will also be used in evaluating the knowledge after implementing the intervention. The patients will also be expected to submit self-reported blood pressure, which will then be integrated into the electronic health records. Therefore, electronic health records are another source that will be vital for data acquisition.
The Statistical Test
As part of determining the impact of the proposed intervention, data analysis will be conducted, and various statistical tests will be explored to help determine the efficacy of the proposed intervention (Suresh, 2018). It is important to note that the project aims to study the effect of the intervention on the development of hypertension and hypertension outcomes. Therefore, the healthcare workers exposed to psychological stress will be followed to determine whether they go on to develop hypertension, both in the intervention and control groups. The median will be used in the analysis of the number of individuals who went on to have hypertension. The multivariable regression analysis will also be used in controlling confounding variables (Grove & Cipher, 2019). A paired t-test will also be used in evaluating the knowledge change on incremental knowledge on hypertension among the research participants.
The Methods Applied in Data Collection
As earlier indicated, credible data is key in determining the effectiveness of the intervention; therefore, relevant data collection methods should be applied. In addition, the data has to be checked for completeness as questionnaires will be used for data credibility. Independent individuals will check the data for completeness and ensure that only complete questionnaires are considered during the analysis. Since data will be extracted from questionnaires and electronic health records, data curation will be vital to ensure that there is accuracy. The analysis will also be important in determining the impact of the intervention in terms of outcome and process measures (Melnyk & Fineout-Overholt, 2019). Whereas the outcome measures will show whether the expected results have been achieved, the process measures will indicate the effectiveness of the intervention.
Conclusion
Evaluation is one of the most important steps in the research process involving the implementation of an intervention to address a particular disease or population health. Evaluation offers valuable information regarding the intervention, such as the magnitude of success, whether the project is worth continuing or if it should be abandoned. Therefore this week’s assignment has presented an evaluation plan for the proposed intervention to help in addressing hypertension.
References
Grove, S. K., & Cipher, D. J. (2019). Statistics for nursing research-e-book: A workbook for evidence-based practice. Elsevier Health Sciences.
Hopp, L., & Rittenmeyer, L. (2021). Introduction to evidence-based practice: A practical guide for nursing. FA Davis.
LoBiondo-Wood, G., & Haber, J. (2021). Nursing Research E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing &Healthcare: A Guide to Best Practice. Wolters Kluwer.
Mills, K. T., Obst, K. M., Shen, W., Molina, S., Zhang, H. J., He, H., … & He, J. (2018). Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients: a systematic review and meta-analysis. Annals of internal medicine, 168(2), 110-120. https://doi.org/10.7326/M17-1805.
Suresh, S. (2018). Nursing research and statistics. Elsevier Health Sciences.
The opioid use disorder (OUD) is national public health issue that needs effective mitigation and efforts to tackle it from various sectors and stakeholders. The opioid epidemic has led to increased cost of health services and burden on the system, leads to mortality and morbidity, and exerts strain on limited healthcare resources (HRSA, 2021). Evaluation of such interventions and their effects is critical as it offers an opportunity to assess their effectiveness to the target population, particularly those affected by the opioid crisis. Evaluation approaches like outcome evaluation assess the effectiveness of health promotion programs in producing positive change to reduce the severity of the opioid crisis (Haley & Saitz, 2020). The purpose of this paper is to propose an evaluation plan based on the health outcome of the “Prevention for States” program by the Centers for Disease Control and Prevention in helping states to have sufficient resources and support to tackle the opioid crisis or epidemic.
Evaluation Planning
The overriding purpose of evidence-based practice (EBP) programs and initiatives is to create change in target populations by addressing the causative factors of a problem and raising awareness through health promotion. Evaluation is a critical and final step of an EBP initiative as it allows implementers and other stakeholders to assess the effectiveness of an intervention or initiative (Friis & Sellers, 2021). Outcome evaluation assesses the effectiveness of an initiative in producing the desired change. Outcome evaluations focus on change witnessed in program participants and the difference it has made to such populations. The focus of outcome evaluation comprises of changes in comprehension, attitudes, behaviors, and practices that lead to modifications among the targeted individuals and populations. Outcome evaluations are mainly summative in nature. Summative evaluation entails collecting information once a program has been fully implemented to assess its impact and outcomes for stakeholders to make effective decisions on whether to adopt the initiative, continue it, or modify for improvement. Summative evaluation is a systematic approach that allows implementers to collect and analyze data about the effects of an intervention, output, and outcomes during and after its implementation (Daoust et al., 2022). Summative evaluation would, therefore, assist in measuring and determining success, the efficacy and cost implications of evidence-based practice initiatives in health care settings and organizations.
In this case, the intervention program to tackle the opioid epidemic is CDC’s “Prevention for States” that allows states to get resources and support to fight the crisis. At the core of this intervention is the need for states to develop a host of programs and initiatives aimed at tackling the opioid crisis as a public health issue in the country (CDC, 2021). Studies demonstrate that state policy interventions to address the opioid crisis are essential as they have led to a decline in cases and prescription and opioid misuse. Therefore, the evaluation plan will focus on the current data about the various state interventions in different states that are getting CDC funding and support to tackle the issue (HRSA, 2021). The outcome evaluation plan will entail having sufficient data and information from state agencies and federal departments to assess the overall effectiveness of the “Prevention for States” program by CDC. State policy interventions’ evaluation will focus on both outcome and summative approaches where the assessment will seek to understand the efficacy of each program in different states. The evaluation will focus on assessment of behavioral change among users and abusers, initiation of legal frameworks to control prescription of different schedules of drugs, and ethical conduct among providers in different professional levels.
The evaluation will also consider a host of approaches, especially a multidisciplinary approach, comprising of many interventions through one program to reduce the prevalence of opioid crisis in states, especially those worst affected and under the CDC program. The initiative provides states with federal resources and support to use in developing appropriate interventions to tackle the opioid problem (Finley et al., 2017). Access to resources, technical assistance, and training are critical since they enable providers to incorporate behavioral health care services into their practice settings to improve interventions focused on dealing with the impacts of prescription drug overdose and misuse among various affected individuals and populations (Daoust et al., 2022; Fischer et al., 2019). The “Prevention for States” programs show through its funding element the role of inter-agency and inter-government collaboration and partnership in tackling the opioid use disorder through approaches like data collection and screening for stakeholders know new and effective policies (CDC, 2021). Therefore, the evaluation plan will focus on assessing the effectiveness of each component of the program during and after its implementation to ascertain positive effects on the target population. The evaluation will consider if these interventions lead to better approach to the problem or if states should improve the initiative by creating complementary models for target population.
Conclusion
Evaluation is an essential stage in EBP projects like the one to reduce the prevalence of opioid use disorder (OUD). The initiative by CDC to enhance efforts to reduce incidences of OUD in population as a national public health emergency will require evaluation using both outcome and summative approaches to ascertain its effectiveness. The evaluation will ensure that stakeholders have necessary tools and approaches to roll out the program and confer benefits to target population.
References
Centers for Disease Control and Prevention (CDC) (2021). Prevention for States.
https://www.cdc.gov/drugoverdose/states/state_prevention.html
Daoust, R., Paquet, J., Marquis, M., Chauny, J. M., Williamson, D., Huard, V., … & Cournoyer,
- (2022). Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged from the Emergency Department: A Systematic Review and Meta-analysis. JAMA Network Open, 5(1), e2143425-e2143425. doi:10.1001/jamanetworkopen.2021.43425
Emily, T., Madison, B. & Charlene, E. (2019). Health promotion International: Which
literacy for health promotion: health, food, nutrition or media? Vol 35, pp. 432-444,
doi.org/10/1093/heapro/daz007.
Fischer, B., Pang, M., & Jones, W. (2020). The opioid mortality epidemic in North America: do
we understand the supply side dynamics of this unprecedented crisis? Substance abuse treatment, prevention, and policy, 15(1), 1-8. DOI: https://doi.org/10.1186/s13011-020-0256-8
Finley, E. P., Garcia, A., Rosen, K., McGeary, D., Pugh, M. J., & Potter, J. S. (2017). Evaluating
the impact of prescription drug monitoring program implementation: a scoping review. BMC health services research, 17(1), 1-8. https://doi.org/10.1186/s12913-017-2354-5
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones &
Bartlett. Chapter 8, “Experimental Study Designs”
Haley, D. F., & Saitz, R. (2020). The opioid epidemic during the COVID-19 pandemic. JAMA,
324(16), 1615-1617. DOI:10.1001/jama.2020.18543
Health Resources and Services Administration (HRSA) (2021). Opioid Crisis.
Lee, B., Zhao, W., Yang, K. C., Ahn, Y. Y., & Perry, B. L. (2021). Systematic evaluation of state
policy interventions targeting the US opioid epidemic, 2007-2018. JAMA network open, 4(2), e2036687-e2036687. DOI:10.1001/jamanetworkopen.2020.36687