Answered step-by-stepRead this article and answer the s belo
Answered step-by-stepRead this article and answer the s below. Muoz, R. F., Le,…Read this article and answer the s below.Muñoz, R. F., Le, H. N., Ippen, C. G., Diaz, M. A., Urizar, G. G., Soto, J., … & Lieberman, A. F. (2007). Prevention of postpartum depression in low-income women: Development of the mamás y bebés/mothers and babies course. Cognitive and Behavioral Practice, 14(1), 70-83. Finish and post the Johns Hopkins Research Evidence Appraisal Tool to both your Group’s Discussion Board and the assignment link by the first due date. To avoid unwanted formatting changes, indicate your responses to YES or NO s by highlighting your response. As you assess the quality of the studies using criteria in the appraisal tool, these criteria will help you identify limitations of the study. Limitations will be listed into your CA-ET (see #2 below) and should be described in your rationale for the strength of the evidence (see #3 below). Major limitations are often reported by the author’s in a “Discussion” or “Limitations” section of published studies. Submit your draft Appraisal Tool to group discussion board for feedback from group members by date on course syllabus. Use the Johns Hopkins Nursing EBP Evidence Level and Quality Guide (Appendix D on Blackboard) to identify the quality ratings. Read all of your group members’ Appraisal Tools and make recommendations for any improvements/corrections. You will want to make any improvements/corrections so that you accurately complete the group assignment below. Submit your final Appraisal Tool using the Individual Assignment link by the final due date. Key PImage transcription textSynthesis Process Recommendations Level and Quality of Applicability Consistency of Strength of overallIndividual Evidence Quantity (generalizable to of Findings Across evidence to guide Appraisal EvidenceEvidence population/setting practice of interest) recommendationsoints:Evidence synthesis is best done through group discussion. All team members share their perspectives, and the team uses critical thinking to arrive at a judgment based on consensus during the synthesis process. The synthesis process involves both subjective and objective reasoning by the full EBP team.Through reasoning, the team:Reviews the quality appraisal of the individual pieces of evidenceAssesses and assimilates consistencies in findingsEvaluates the meaning and relevance of the findingsMerges findings that may either enhance the team’s knowledge or generate new insights, perspectives, and understandingsHighlights inconsistencies in findingsMakes recommendations based on the synthesis processWhen evidence includes multiple studies of Level I and Level II evidence, there is a similar population or setting of interest, and there is consistency across findings, EBP teams can have greater confidence in recommending a practice change. However, with a majority of Level II and Level III evidence, the team should proceed cautiously in making practice changes. In this instance, recommendation(s) typically include completing a pilot before deciding to implement a full-scale change.Generally, practice changes are not made on Level IV or Level V evidence alone. Nonetheless, teams have a variety of options for actions that include, but are not limited to: creating awareness campaigns, conducting informational and educational updates, monitoring evidence sources for new information, and designing research studies.The quality rating (see Appendix D) is used to appraise both individual quality of evidence and overall quality of evidence. Read this entire document before proceeding. Johns Hopkins “Directions” for using this form are at the end of the document. Remember that your instructions on BB say to not answer the fit and feasibility s. * This is a synthesis! Your CA-ET lists each study individually and your JH Appraisal Tool summarizes findings for each study. In this synthesis document, within each level, create a synthesis of findings across studies. For the Overall Quality Rating, indicate the number of studies with high, good and low quality. Then, within each level decide on an overall rating. EBP : Among low income ethnic minority women in the perinatal period, how does cognitive-behavioral therapy compared to usual care affect perinatal depression? EBP : Among low income ethnic minority women in the perinatal period, how does cognitive-behavioral therapy compared to usual care affect perinatal depression? Category (Level Type) Total Number of Sources/Level Overall Quality Rating Synthesis of FindingsEvidence That Answers the EBP Level IExperimental studyRandomized controlled trial (RCT)Systematic review of RCTs with or without meta-analysisExplanatory mixed method design that includes onlya Level I quaNtitative study Author Last name (year) Author Last name (year) High # Good # Low # OVERALL: Level IIQuasi-experimental studiesSystematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysisExplanatory mixed method design that includes only a Level II quaNtitative study Author Last name (year) Author Last name (year) High # Good # Low # OVERALL: Level IIINonexperimental studySystematic review of a combination of RCTs, quasi-experimental and nonexperimental studies, or nonexperimental studies only, with or without meta- analysisQuaLitative study or meta- synthesisExploratory, convergent, or multiphasic mixed-methods studiesExplanatory mixed method design that includes only a level III QuaNtitative study Author Last name (year) Author Last name (year) High # Good # Low # OVERALL: Category (Level Type) Total Number of Sources/Level Overall Quality Rating Synthesis of FindingsEvidence That Answers the EBP Level IVOpinions of respected authorities and/or reports of nationally recognized expert committees or consensus panels based on scientific evidence Author Last name (year) Author Last name (year) High # Good # Low # OVERALL: Level VEvidence obtained from literature or integrative reviews, quality improvement, program evaluation, financial evaluation, or casereportsOpinion of nationally recognized expert(s) based on experiential evidence Author Last name (year) Author Last name (year) High # Good # Low # OVERALL: Based on your synthesis, which of the following four pathways to translation represents the overall strength of the evidence?Strong, compelling evidence, consistent results: Solid indication for a practice change is indicated.Good and consistent evidence: Consider pilot of change or further investigation.Good but conflicting evidence: Noindication for practice change; consider further investigation fornew evidence ordevelop a research study.Little or no evidence: No indication for practice change; consider further investigation for new evidence, develop a research study, or discontinue project.If youselected either thefirst option orthe second option, continue. If not,STOP, translation isnot indicated.Recommendations based on evidence synthesis and selected translation pathway Answer the PICO and state your recommendations. Include major methodological limitations across studies affecting the quality of the evidence. Include whether the evidence can be generalized to your clinic population, and if not, indicate who can the evidence be generalized to. Consider the following as you examine fit:Are the recommendations:Compatible with the unit/departmental/organizational cultural values or norms?Consistent with unit/departmental/organizational assumptions, structures, attitudes, beliefs, and/or practices?Consistent with the unit/departmental/organizational priorities?Consider the following as you examine feasibility:Can we do what they did in our work environment?Are the following supports available?ResourcesFundingApproval from administration and clinical leadersStakeholder supportIs it likely that the recommendations can be implemented within the unit/department/organization? Directions for Use of This FormPurpose of formUse this form to compile the results of the individual evidence appraisal to answer the EBP . The pertinent findingsfor each levelof evidence are synthesized, and a qualityrating is assignedto each level.Total number of sources per levelRecord the number of sources of evidence for each level.Overall quality ratingSummarize the overallquality of evidencefor each level.Use Appendix D to rate thequality of evidence.Synthesis of findings: evidence that answers the EBP Include only findings from evidence of A or B quality.Include only statements that directly answer the EBP .Summarize findings within each level of evidence.Record article number(s) from individual evidence summary in parentheses next to each statement so that the source of the finding is easy to identify.Develop recommendations based on evidence synthesis and the selected translation pathwayReview the synthesis of findings and determine which of the following four pathways to translation represents the overall strength of the evidence:Strong, compelling evidence, consistent results: Solid indication for a practice change.Good and consistent evidence: Consider pilot of change or further investigation.Good but conflicting evidence: No indication for practice change; consider further investigation for new evidence or develop a research study.Little or no evidence: No indication for practice change; consider further investigation for new evidence, develop a research study, or discontinue the project. Fit and feasibilityEven when evidence is strong and of high quality, it may not be appropriate to implement a change in practice. It is crucial to examine feasibility that considers the resources available, the readiness for change, and the balance between risk and benefit. Fit refers to the compatibility of the proposed change with the organization’s mission, goals, objectives, and priorities. A change that does not fit within the organizational priorities will be less likely to receive leadership and financial support, making success difficult. Implementing processes with a low likelihood of success wastes valuable time and resources on efforts that produce negligible benefits. Evidence level and quality rating: _____________ ARTICLE DESCRIPTION (1 point) Article title: Number:(STUDENTS: We will not use this for this course. This could be used when you have lots of articles in the review and you number them to keep track)Author(s): Publication date: Journal: Clinical Nursing ResearchSetting: Sample (composition and size): Does this evidence address my EBP ?Yes (STUDENTS: All of the studies in this course will answer the PICO). No-Do not proceed with appraisal of this evidence Is this study:QuaNtitative (collection, analysis, and reporting of numerical data)Measurable data (how many; how much; or how often) used to formulate facts, uncover patterns in research, and generalize results from a larger sample population; provides observed effects of a program, problem, or condition, measured precisely, rather than through researcher interpretation of data. Common methods are surveys, face-to-face structured interviews, observations, and reviews of records or documents. Statistical tests are used in data analysis. Go to Section I: QuaNtitativeQuaLitative (collection, analysis, and reporting of narrative data) Rich narrative documents are used for uncovering themes; describes a problem or condition from the point of view of those experiencing it. Common methods are focus groups, individual interviews (unstructured or semi structured), and participation/observations. Sample sizes are small and are determined when data saturation is achieved. Data saturation is reached when the researcher identifies that no new themes emerge and redundancy is occurring. Synthesis is used in data analysis. Often a starting point for studies when little research exists; may use results to design empirical studies. The researcher describes, analyzes, and interprets reports, descriptions, and observations from participants. Go to Section II: QuaLitativeMixed methods (results reported both numerically and narratively) Both quaNtitative and quaLitative methods are used in the study design. Using both approaches, in combination, provides a better understanding of research problems than using either approach alone. Sample sizes vary based on methods used. Data collection involves collecting and analyzing both quaNtitative and quaLitative data in a single study or series of studies. Interpretation is continual and can influence stages in the research process. Go to Section I for QuaNtitative components and Section II for QuaLitative components Section I: QuaNtitativeLevel of Evidence (Study Design) (1 point)Is this a report of a single research study? Yes No Go to B1. Was there manipulation of an independent variable? Yes No2. Was there a control group? Yes No3. Were study participants randomly assigned to the intervention and control groups? Yes NoIf Yes to s 1, 2, and 3, this is a randomized controlled trial (RCT) or experimental study. LEVEL IIf Yes to s 1 and 2 and No to3 or Yes to1 and No to s 2 and 3, this is quasi-experimental.(Some degree of investigator control, some manipulation of an independent variable, lacks random assignment to groups, and may have a control group). LEVEL IIIf No to s 1, 2, and 3, this is nonexperimental.(No manipulation of independent variable; can be descriptive, comparative, or correlational; often uses secondary data). LEVEL IIIStudy Findings That Help Answer the EBP (4 POINTS)This should be consistent with your Critical Appraisal-Evaluation Table (CA-ET). You do not need to include the statistical test from the Results column; this is a narrative summary of findings. For each depression outcome measure, state the findings. ***For example, in this RCT, post-menopausal women who attended zumba classes (n=50) three times per week over 12 months had a statistically significant greater reduction in abdominal skin fold thickness, but no reduction in BMI compared to women in the control group (n=50). Complete the Appraisal of QuaNtitative Research Studies section Is this a summary of multiple sources of research evidence? YesContinue NoUse Appendix F (non-research appraisal tool)1. Does it employ a comprehensive search strategy and rigorous appraisal method?If this study includes research, nonresearch, and experiential evidence, it is an integrative review (see Appendix F). YesContinue NoUse Appendix F (non-research appraisal tool)2. For systematic reviews and systematic reviews with meta-analysis(see descriptions below):Are all studies included RCTs? LEVEL IAre the studies a combination of RCTs and quasi-experimental, or quasi-experimental only? LEVEL IIAre the studies a combination of RCTs, quasi-experimental, and nonexperimental, or non- experimental only? LEVEL IIIA systematic review employs a search strategy and a rigorous appraisal method, but does not generate an effect size.A meta-analysis, or systematic review with meta-analysis, combines and analyzes results from studies to generate a new statistic: the effect size.Study Findings That Help Answer the EBP Complete the Appraisal of Systematic Review (With or Without a Meta-Analysis) section Appraisal of QuaNtitative Research Studies (2 points)Does the researcher identify what is known and not known about the problem and how the study will address any gaps in knowledge? Yes No Was the purpose of the study clearly presented? Yes No Was the literature review current (most sources within the past five years or a seminal study)? Yes No Was sample size sufficient based on study design and rationale?Briefly state why: Yes No If there is a control group:Were the characteristics and/or demographics similar in both the control and intervention groups? Yes No N/AIf multiple settings were used, were the settings similar? Yes No N/AWere all groups equally treated except for the intervention group(s)? Yes No N/AAre data collection methods described clearly? Yes No Was instrument reliability discussed (e.g., including source citations) or reported (e.g., Cronbach’s a > 0.70)? Yes No N/AWas instrument validity discussed (e.g., including source citations)? Yes No N/ADid the researchers report or discuss retention and/or attrition? Yes No N/AWere the results presented clearly? Yes No If tables were presented, was the narrative consistent with the table content? Yes No N/AWere other study limitations identified and addressed? “Other” limitations refers to threats to internal and external validity not found in this checklist. Major threats to internal and external validity should also be listed in the “Limitations” column of the CA-ET. Yes No Were conclusions based on results? Yes No Go to Quality Rating for QuaNtitative Studies section Appraisal of Systematic Review (With or Without Meta-Analysis)Were the variables of interest clearly identified? Yes NoWas the search comprehensive and reproducible?Key search terms stated Yes NoMultiple databases searched and identified Yes NoInclusion and exclusion criteria stated Yes NoWas there a flow diagram that included the number of studies eliminated at each level of review? Yes NoWere details of included studies presented (design, sample, methods, results, outcomes, strengths, and limitations)? Yes NoWere methods for appraising the strength of evidence (level and quality) described? Yes NoWere conclusions based on results? Yes NoResults were interpreted Yes NoConclusions flowed logically from the interpretation and systematic review Yes NoDid the systematic review include a section addressing limitations and how they were addressed? Yes NoComplete Quality Rating for QuaNtitative Studies section QQuality Rating for QuaNtitative Studies: (1 point) Highlight or circle the appropriate quality rating below:A High quality: Consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference to scientific evidence.B Good quality: Reasonably consistent results; sufficient sample size for the study design; some control, and fairly definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence.C Low quality or major flaws: Little evidence with inconsistent results; insufficient sample size for the study design; conclusions cannot be drawn. Section II: QuaLitativeLevel of Evidence (Study Design) A Is this a report of a single research study? (1 point) Yes go to Level III Nogo to II BWere data collected texts (e.g., individual or group interviews, diaries) or images? Yes NoDoes the researcher analyze words rather than numbers? Yes NoIs the role and/or potential influence of the researcher explained? Yes NoStudy Findings That Help Answer the EBP(4 Points) Complete Appraisal of Single QuaLitative Research Study section Appraisal of a Single QuaLitative Research StudyWas there a clearly identifiable and articulated:Purpose or research ? Yes NoJustification for method(s) used? Yes NoPhenomenon that is the focus of the research? Yes NoWere study sample participants representative of population of interest? Yes NoDid the investigators have knowledge of or experience with the research area? Yes NoWere participant characteristics described? Yes NoWas sampling adequate, as evidenced by achieving saturation of data? Yes NoData analysis:Is an audit trail (field notes, the researcher’s personal experiences with interviewees, or how coding decisions were made) mentioned?Faculty Note: mentioned field notes but does not describe coding decisions. Yes NoDid the researcher describe other strategies used to minimize or allow for the effects of researcher bias? Yes NoWas there a clear description of how data were analyzed (i.e., method)? Yes NoDid the researchers describe the use of trustworthiness criteria to ensure rigor in their study? (see Melnyk, Chapter 6, page 157) Yes NoDo the narrative data (participant quotations) support the findings (e.g., themes)? Yes NoDo findings flow from researchto data collected to analysis undertaken? Yes NoAre conclusions clearly explained? Yes NoGo to Quality Rating for QuaLitative Studies section For summaries of multiple quaLitative research studies (meta-synthesis), was a comprehensive search strategy and rigorous appraisal method used? YesLevel III Nogo to Appendix FStudy Findings That Help Answer the EBP Complete the Appraisal of Meta-Synthesis Studies section Appraisal of Meta-Synthesis StudiesWere the search strategy and criteria for selecting primary studies clearly defined? Yes NoWere findings appropriate and convincing? Yes NoWas a description of methods used to: Compare findings from each study? Yes NoInterpret data? Yes NoDid synthesis reflect: Yes NoNew insights? Yes NoDiscovery of essential features of phenomena? Yes NoA fuller understanding of the phenomena? Yes NoWas sufficient data presented to support the interpretations? Yes NoComplete the Quality Rating for QuaLititative Studies section Quality Rating for QuaLitative Studies Circle the appropriate quality rating below:No commonly agreed-on principles exist for judging the quality of quaLitative studies. It is a subjective process based on the extent to which study data contributes to synthesis and how much information is known about the researchers’ efforts to meet the appraisal criteria.For meta-synthesis, there is preliminary agreement that quality assessments should be made before synthesis to screen out poor-quality studies1.A High quality is used for single studies and meta-syntheses2.The report discusses efforts to enhance or evaluate the quality of the data and the overall inquiry in sufficient detail; and it describes the specific techniques used to enhance the quality of the inquiry. Evidence of all of the following is found in the report and is clearly described:Transparency: Describes how information was documented to justify decisions, how data were reviewed by others, and how themes and categories were formulated.Diligence: Reads and rereads data to check interpretations; seeks opportunity to find multiple sources to corroborate evidence.Verification: The process of checking, confirming, and ensuring methodologic coherence.Self-reflection and self-scrutiny: Being continuously aware of how a researcher’s experiences, background, or prejudices might shape and bias analysis and interpretations.Participant-driven inquiry: Participants shape the scope and breadth of s; analysis and interpretation give voice to those who participated.Insightful interpretation: Data and knowledge are linked in meaningful ways to relevant literature.B Good quality is used for single studies and meta-syntheses2.The report discusses efforts to enhance or evaluate the quality of the data and the overall inquiry in sufficient detail; and it describes the specific techniques used to enhance the quality of the inquiry. Evidence of some of the following is found in the report and/or lacks clarity:Transparency: Describes how information was documented to justify decisions, how data were reviewed by others, and how themes and categories were formulated.Diligence: Reads and rereads data to check interpretations; seeks opportunity to find multiple sources to corroborate evidence.Verification: The process of checking, confirming, and ensuring methodologic coherence.Self-reflection and self-scrutiny: Being continuously aware of how a researcher’s experiences, background, or prejudices might shape and bias analysis and interpretations.Participant-driven inquiry: Participants shape the scope and breadth of s; analysis and interpretation give voice to those who participated.Insightful interpretation: Data and knowledge are linked in meaningful ways to relevant literature.C Lower-quality studies contribute little to the overall review of findings and have few, if any, of the features listed for High/Good quality. 1 https://www.york.ac.uk/crd/SysRev/!SSL!/WebHelp/6_4_ASSESSMENT_OF_QUALITATIVE_RESEARCH.htm 2 Adapted from Polit & Beck (2017). Section III: Mixed MethodsLevel of Evidence (Study Design)You will need to appraise both the quaNtitative and quaLitative parts of the study independently, before appraising the study in its entirety.Evaluate the quaLitative part of the study using Section I. Level QualityInsert here the level of evidence and overall quality for this part: Evaluate the quaLitative part of the study using Section II. Level QualityInsert here the level of evidence and overall quality for this part: To determine the level of evidence, circle the appropriate study design:Explanatory sequential designs collect quaNtitative data first, followed by the quaLitative data; and their purpose is to explain quaNtitative results using quaLitative findings. The level is determined based on the level of the quaNtitative part.Exploratory sequential designs collect quaLitative data first, followed by the quaNtitative data; and their purpose is to explain quaLitative findings using the quaNtitative results. The level is determined based on the level of the quaLitative part, and it is always Level III.Convergent parallel designs collect the quaLitative and quaNtitative data concurrently for the purpose of providing a more complete understanding of a phenomenon by merging both datasets. These designs are Level III.Multiphasic designs collect quaLitative and quaNtitative data over more than one phase, with each phase informing the next phase. These designs are Level III.Study Findings That Help Answer the EBP Use the Appraisal of Mixed Methods Studiessection Appraisal of Mixed Methods Studies3Was the mixed-methods research design relevant to address the quaNtitative and quaLitative research s (or objectives)? Yes No N/AWas the research design relevant to address the quaNtitative and quaLitative aspects of the mixed-methods(or objective)? Yes No N/AFor convergent parallel designs, was the integration of quaNtitative and quaLitative data (or results) relevant to address the researchor objective? Yes No N/AFor convergent parallel designs, were the limitations associated with the integration (for example, the divergence of quaLitative and quaNtitative data or results) sufficiently addressed? Yes No N/AGo to Quality Rating for Mixed-Method Studies section 3 National Collaborating Centre for Methods and Tools. (2015). Appraising Qualitative, Quantitative, and Mixed Methods Studies included in Mixed Studies Reviews: The MMAT. Hamilton, ON: McMaster University. (Updated 20 July, 2015) Retrieved from http://www.nccmt.ca/ resources/search/232 Quality Rating for Mixed-Methods StudiesCircle the appropriate quality rating belowA High quality: Contains high-quality quaNtitative and quaLitative study components; highly relevant study design; relevant integration of data or results; and careful consideration of the limitations of the chosen approach.B Good quality: Contains good-quality quaNtitative and quaLitative study components; relevant study design; moderately relevant integration of data or results; and some discussion of limitations of integration.C Low quality or major flaws: Contains low quality quaNtitative and quaLitative study components; study design not relevant to research s or objectives; poorly integrated data or results; and no consideration of limits of integration. Health ScienceScienceNursingNURS 8103Share
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