Discussion: Observational Study Designs

NURS 8310 Discussion: Observational Study Designs

Discussion: Observational Study Designs

Analytic Epidemiological Designs: Observational

An observational study is one of the first steps in epidemiology for establishing a link between exposure and a result. Cohort studies typically follow large groups of people throughout time, both retrospectively or prospectively establishing a cohort and looking ahead. Clinical trials cannot give crucial descriptive data and information on long-term efficacy and safety, but observational studies may, and at a lower cost. Case reports and case series, ecological studies, cross-sectional studies, case-control studies, and cohort studies are all examples of this type of research. Participants in observational studies are those who are not subjected to any forced changes in their circumstances, i.e., they are not subjected to any intervention. Observational studies aim to explore the ‘natural’ condition of risk factors, diseases, or outcomes, despite the fact that participants’ behavior may change while they are being observed. Those that are sick, who have a disease, are often compared to people who aren’t sick, who don’t have the disease, in analytic investigations (McGrath et al., 2010).

Risk Factor and Health Outcome

The usage of Cannabis in relation to psychosis is the risk factor and health result covered in this discussion. In young people, cannabis usage is linked to psychosis-related consequences. According to some studies, at the 21-year follow-up, cannabis usage and three psychosis-related outcomes were examined; including non-affective psychosis, hallucinations, and the Peters et al Delusions Inventory score (Sarvet et al., 2018). The use of sibling pairs minimizes the chance that unmeasured confounding is to blame for the results. This study adds to the growing body of evidence that early cannabis usage in young adults is a the risk-modifying factor for psychosis-related outcomes (Sarvet et al., 2018)

Observational Design, strength and Limitation

In relation to design, sibling pair analysis nested within a prospective birth cohort was involved. At the 21-year follow-up, cannabis usage and three psychosis-related outcomes were examined. At the 14-year follow-up, associations between time since first cannabis use and psychosis-related outcomes were investigated using logistic regression adjusted for sex, age, parental mental illness, and hallucinations. With general linear modeling, the relationship between within-pair differences in duration since initial cannabis use and Peters et al Delusions Inventory score was investigated in 228 sibling pairs. (Sarvet et al., 2018). Nevertheless, there are worries that the link could be due to methodological limitations or unmeasured residual confounding. The inclusion of sibling pairings also minimizes the chance that unmeasured confounding could create a bias or result in questionable results. Another aspect of limitation is that all cohort members couldn’t receive the CIDI, due to insufficient funding (Najman, & Williams, 2010).

Improving Population Health

Self-medication should be screened for among youths presenting with mood/anxiety disorder, and gold standard concurrent therapy should be provided to address both the self-medication behavior and the mood/anxiety problem at the same time. Also, therapies such as Dialectical Behavior Therapy, which focuses on fostering self-acceptance while acknowledging the need to change, should be incorporated in their treatment plan. Improving health outcomes with better patient understanding and education is key. It is better to catch them young to prevent kids from growing up with bad habits with bad health outcome

An expanded role for educated consumers interacting with responsive health care teams is a major component of health care reform to support the people. Individuals especially the youths must, however, be highly engaged in order to reap the benefits of health

Discussion Observational Study Designs
Discussion Observational Study Designs

education. The gap between expectations and actual performance of behaviors related to health care and prevention has been documented in population studies. Improvement in self-efficacy, an important component of self-management, has been the most constant positive consequence of interventions to promote self-care. Although the focus has tended to be on short-term outcomes rather than long-term impacts, most studies of self-management programs have found gains in patient satisfaction, coping abilities, and feelings of social support. A review of the social determinants of health is beyond the scope of this review, as there are several factors that influence behavior. Parents and school teachers should pay attention to the behavior of students and be able to identify negative changes and when to refer kids to therapists or psychologists (Adams, 2010)


Sarvet, A. L., Wall, M. M., Keyes, K. M., Olfson, M., Cerdá, M., & Hasin, D. S. (2018). Self-medication of mood and anxiety disorders with marijuana: Higher in states with medical marijuana laws. Drug and alcohol dependence, 186, 10–15.

McGrath, J., Welham, J., Scott, J., Varghese, D., Degenhardt, L., Hayatbakhsh, M. R., … & Najman, J. M. (2010). Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Archives of general psychiatry67(5), 440-447.

Najman, J., & Williams, G. (2010). Association Between Cannabis Use and Psychosis-Related Outcomes Using Sibling Pair Analysis in a Cohort of Young… Arch Gen Psychiatry67(5).

Adams, R. J. (2010). Improving health outcomes with better patient understanding and education. Risk management and healthcare policy3, 61

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Childhood obesity is a growing international health problem affecting over one third of United States’ school-aged children (Wang et al., 2021).  School-based programs, such as not offering sugar-based beverages are popular, as well as activity programs (Wang et al., 2021).  The strongest motivator for obese children has been shown to be empowerment (Wang et al., 2021).  Empowerment-based health interventions help the child make healthier decisions (Wang et al., 2021).  Childhood obesity can lead to adult obesity along with comorbidities (Krupsky et al., 2021). Alleviating childhood obesity will help create healthier adults.

Wang et al., 2021, utilized Empowerment Theory for youths ages 9-12 to allow them to make healthier, conscious decisions.  Three components or processes were used:  intrapersonal, interactional and behavioral (Wang et al., 2021).  By empowering the youths to make conscious decisions against drinking sugar-based drinks, their intake of water improved and healthier choices were made (Wang et al., 2021).

Observational Study Design

            Observation study designs are rather simple to apply and take into account time, person or place (Friis & Sellers, 2021).  The designs differ in six areas:  number of observations made, directionality of exposure, data collection methods, timing of data collection, unit of observation, and availability of subjects (Friis & Sellers, 2021).  Selecting the appropriate design starts with a good question to answer.  Research into causes of disease often rely on cross-sectional studies and often indicate what is achieved (Elm et al., 2007).

            I would like to ask the question:  Do parents of children ages 9-12, understand healthy food choices, such as no sugar-based drinks?  A descriptive, cross-sectional survey would be used with the survey being sent home to the parents of children that fall within the range of 9-12 years of age.  The survey would be retrospective, asking how many sugar-based drinks their child intakes vs how many water beverages the child intakes.  A 2×2 table could be used to determine disease status vs. exposure status and help to build the survey (Friis & Sellers, 2021).

Strength & Limitations

            Strengths of the study would be that the questions would be clearly asked with categories of the amount or number of sugar-based drinks vs water.  The child’s weight would be asked.  This would allow the results to be broken down into person.  STROBE guidelines could also be used to be sure the study is inclusive of important variables and information (Von Elm et al., 2007).

            On weakness is that some parents will not complete the survey and return it.  Another is that you are relying on the parent’s recollection of data, and not the child’s direct answers.  Reliance on accurate data would be crucial.

Improvement in Population Health

            Understanding availability of unhealthy food choices would allow opportunity to possibly provide educational sessions to the children’ parents.  One could also be sure that the school is offering healthy beverage choices.


Friis, R. H., & Sellers, T. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett Learning, LLC.

Krupsky, K. L., Parrott, A., Andridge, R., Zvara, B. J., Keim, S. A., & Anderson, S. E. (2021). A mixed methods analysis of environmental and household chaos: Considerations for early-childhood obesity research. BMC Public Health, 21(1).

Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies. Annals of Internal Medicine, 147(8), 573–577.

Wang, M. L., Sprague Martinez, L. S., Weinberg, J., Alatorre, S., Lemon, S. C., & Rosal, M. C. (2021). A youth empowerment intervention to prevent childhood obesity: Design and methods for a cluster randomized trial of the h2go! program. BMC Public Health, 21(1).