WEEK 3 DISCUSSION: OBSERVATIONAL STUDY DESIGNS

A clinical pediatric nurse has noticed a rise in childhood asthma diagnoses among the Hispanic population served by the local clinic. The nurse is concerned about this increase in asthma incidence in the patient population and turns to the literature to explore current research on this topic. The nurse finds, through the reading, that there appears to be an association between parental smoking and childhood asthma and wonders if this could be the cause of the rise in cases.

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This type of suspected association between a risk factor (exposure) and a particular outcome (childhood asthma) can be evaluated using an observational study design. A relevant case-control study would match a group of controls (no asthma) with the case group (asthma diagnosis). Both groups would then be assessed on certain historical exposures like (a) family history; (b) early childhood respiratory infections; (c) secondhand smoke exposure; (d) urban residence (ozone); and (e) obesity. Measures might include interviews, surveys, and medical records. If results show the case group has a higher rate of exposure to a given risk factor, the researcher may conclude that exposure results in greater odds of asthma.

In any epidemiological study, the design and methodology used should be appropriate for that study and for the research question. It is important for researchers to understand the strengths and limitations of each of the study designs and methods. This gives them a better chance of correctly interpreting results and synthesizing them for use in developing and implementing evidence-based population health programs. For this Discussion, you will explore the strengths and limitations of various types of observational study designs and critique their appropriateness for specific studies.

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RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

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

Chapter 6, “Study Designs: Ecologic, Cross-Sectional, Case Control”

Chapter 7, “Study Designs: Cohort Studies”

Bahr, R., Clarsen, B., Derman, W., Dvorak, J., Emery, C. A., Finch, C. F., Hägglund, M., Junge, A., Kemp, S., Khan, K. M., Marshall, S. W., Meeuwisse, W., Mountjoy, M., Orchard, J. W., Pluim, B., Quarrie, K. L., Reider, B., Schwellnus, M., Soligard, T., Stokes, K. A., … Chamari, K. (2020). International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))Links to an external site.. British Journal of Sports Medicine, 54(7), 372–389. https://doi.org/10.1136/bjsports-2019-101969

Community Preventative Services Task Force. (n.d.). The community guideLinks to an external site.. https://www.thecommunityguide.org/

Framingham Heart Study. (n.d.). Epidemiological background and design: The Framingham heart studyLinks to an external site.. https://www.framinghamheartstudy.org/fhs-about/history/epidemiological-background/

STROBE. (2021). HomeLinks to an external site.. https://www.strobe-statement.org/

The STROBE Checklist is considered the gold-standard in assessing the quality of observational research studies.

U.S. Department of Health and Human Services. (n.d.). Healthy People 2030Links to an external site.. https://health.gov/healthypeople

ARTICLES FOR THIS WEEK’S DISCUSSION:
Note: By Day 1, your Instructor will assign you to a small group. Your group will be assigned two of the following articles to analyze.

Batty, G. D., & Hamer, M. (2020). Vascular risk factors, Framingham risk score, and COVID-19: Community-based cohort studyLinks to an external site.. Cardiovascular Research, 116(10), 16641665. https://doi.org/10.1093/cvr/cvaa178

Hillyer, G. C., Nazareth, M., Lima, S., Schmitt, K. M., Reyes, A., Fleck, E., Schwartz, G. K., & Terry, M. B. (2021). E-cigarette use among young adult patients: The opportunity to intervene on risky lifestyle behaviors to reduce cancer riskLinks to an external site.. Journal of Community Health. Advance online publication. https://doi.org/10.1007/s10900-021-01027-7

Kebede, E., Kekulawala, M. (2021).Risk factors for stillbirth and early neonatal death: A case-control study in tertiary hospitals in Addis Ababa, EthiopiaLinks to an external site.. BMC Pregnancy and Childbirth,21(1), Article 641. https://doi.org/10.1186/s12884-021-04025-8

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case control studyLinks to an external site.. International Journal of Health Policy and Management, (5), 300–306. https://doi.org/10.15171/ijhpm.2019.11

Whittle, R. S., Diaz-Artiles, A. (2020). An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York CityLinks to an external site.. BMC Medicine, 18(1),Article 271. https://doi.org/10.1186/s12916-020-01731-6

Spector, A. L., Quinn, K. G., McAuliffe, T. L., DiFranceisco, W., Bendixen, A., Dickson-Gomez, J. (2020). Health-related quality of life and related factors among chronically homeless adults living in different permanent supportive housing models: A cross-sectional studyLinks to an external site.. Quality of Life Research: An International Journal of Quality-of-Life Aspects of Treatment, Care and Rehabilitation, 29(8), 20512061. https://doi.org/10.1007/s11136-020-02482-w

Palència, L., Ferrando J., Marí-Dell’Olmo, M., Gotsens, M., Morrison, J., Dzurova, D., Lustigova, M., Costa, C., Rodríguez-Sanz, M., Bosakova, L, Santana, P., & Borrell, C. (2020). Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recessionLinks to an external site.. Cancer Epidemiology, 69, Article 101827. https://doi.org/10.1016/j.canep.2020.101827

Nguyen, L. H., Örtqvist, A. K., Cao, Y., Simon, T. G., Roelstraete, B., Song, M., Joshi, A. D., Staller, K., Chan, A. T., Khalili, H., Olén, O., & Ludvigsson, J. F. (2020). Antibiotic use and the development of inflammatory bowel disease: A national case-control study in SwedenLinks to an external site.. The Lancet. Gastroenterology & Hepatology, (11), 986–995. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034612/

Required Media

The Challenges of Conducting Trials

Time Estimate: 2 minutes

Let’s Learn Public Health. (2017, May 5). Epidemiological studies—made easy! [Video].Links to an external site. YouTube. https://www.youtube.com/watch?v=Jd3gFT0-C4s

Note: The approximate length of this media piece is 10 minutes.

TO PREPARE:

Review the different types of observational study designs presented in the Learning Resources: ecologic, cross-sectional, case-control, and cohort.

Carefully examine the characteristics, strengths, and limitations of each design.

Consider when it is appropriate to use each of the observational study designs.

Consider how using observational study designs can lead to improvements in population health.

By Day 1 of this week, you should have received a communication from your Instructor assigning you to a small group to review two specific articles. Review the two articles your group was assigned, with a critical eye toward the researchers’ use of study design and their selected methods. Although several students will be assigned the same articles, this is NOT a group project; please submit your Discussion posts individually. You will then have the opportunity to discuss and share your thoughts with your colleagues.

BY DAY 3 OF WEEK 3

In your assigned group area:

Post a brief description of the two studies you were assigned, with a particular focus on the study design and methods. Then:

Describe at least one strength and one limitation of each study’s design.

Identify the population, data sources, and epidemiologic measures of association that the authors used.

Finally, share your insights about the appropriateness of the design for the study. Do you agree with the researchers’ choice of design?

Do you agree with the researchers’ conclusions? Justify your reasoning.

BY DAY 5 OF WEEK 3

Post at least two substantive responses to peers in a different group who analyzed at least one different article in their initial post. Include information from the Learning Resources in your responses as appropriate. You may expand on each peer’s posting with additional insight and resources about study designs, ask a question to further the discussion, or offer polite disagreement or critique supported with evidence. You may also make a suggestion or comment that guides or facilitates the discussion. At least one of your response posts should address the applicability of observational studies for improving population health status.

BY DAY 7 OF WEEK 3

Respond to any questions you may have been asked by your peers in your assigned group area. Note what you have learned and/or any insights you have gained as a result of reading the comments your peers made.

NURS_8310_Week3_Discussion_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeRESPONSIVENESS TO DISCUSSION QUESTION (20 possible points) Discussion post minimum requirements: The original posting must be completed by Day 3 at 10:59 pm CT. Two response postings to two different peer original posts, on two different days, are required by Day 6 at 10:59 pm CT. Faculty member inquiries require responses, which are not included in the peer posts. Your Discussion Board postings should be written in Standard Academic English and follow APA 7 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 library and other credible online resources (guidelines, expert opinions etc.)

20 to >19.0 pts

Excellent

• Discussion postings and responses are responsive to and exceed the requirements of the Discussion instructions. • The student responds to the question/s being asked or the prompt/s provided. Goes beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated) • Demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Exceeds the minimum requirements for discussion posts.

19 to >15.0 pts

Good

• Discussion postings and responses are responsive to and meet the requirements of the Discussion instructions. • The student responds to the question/s being asked or the prompt/s provided. • Demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Meets the minimum requirements for discussion posts.

15 to >12.0 pts

Fair

• Discussion postings and responses are somewhat responsive to the requirements of the Discussion instructions. • The student may not clearly address the objectives of the discussion or the question/s or prompt/s. • Minimally demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Does not meet the minimum requirements for discussion posts; has not posted by the due date at least in part.

12 to >0 pts

Poor

• Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. • Does not clearly address the objectives of the discussion or the question/s or prompt/s. • Does not demonstrate that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Does not meet the requirements for discussion posts; has not posted by the due date and did not discuss late post timing with faculty.
20 pts

This criterion is linked to a Learning OutcomeCONTENT REFLECTION and MASTERY: Initial Post (30 possible points)

30 to >29.0 pts

Excellent

Initial Discussion posting: • Post demonstrates mastery and thoughtful/accurate application of content and/or strategies presented in the course. • Posts are substantive and reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. • Initial post is supported by 3 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings.

29 to >23.0 pts

Good

Initial Discussion posting: • Posts demonstrate some mastery and application of content, applicable skills, or strategies presented in the course. • Posts are substantive and reflective, with analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. • Initial post is supported by 3 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings.

23 to >18.0 pts

Fair

Initial Discussion posting: • Post may lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. • Posts demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors. • There is a lack of support from relevant scholarly research/evidence.

18 to >0 pts

Poor

Initial Discussion posting: • Post lacks in substance, reflection, analysis, or synthesis. • Posts do not generalize, extend thinking or evaluate concepts and issues within the topic or context of the discussion. • Relevant examples and scholarly resources are not provided.
30 pts

This criterion is linked to a Learning OutcomeCONTRIBUTION TO THE DISCUSSION: First Response (20 possible points)
20 to >19.0 pts

Excellent

Discussion response: • Significantly contributes to the quality of the discussion/interaction and thinking and learning. • Provides rich and relevant examples and thought-provoking ideas that demonstrates new perspectives, and synthesis of ideas supported by the literature. • Scholarly sources are correctly cited and formatted. • First response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Responds to questions posed by faculty.

19 to >15.0 pts

Good

Discussion response: • Contributes to the quality of the interaction/discussion and learning. • Provides relevant examples and/or thought-provoking ideas • Scholarly sources are correctly cited and formatted. • First response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Responds to questions posed by faculty.

15 to >12.0 pts

Fair

Discussion response: • Minimally contributes to the quality of the interaction/discussion and learning. • Provides few examples to support thoughts. • Information provided lacks evidence of critical thinking or synthesis of ideas. • There is a lack of support from relevant scholarly research/evidence. • No response to questions posed by faculty.

12 to >0 pts

Poor

Discussion response: • Does not contribute to the quality of the interaction/discussion and learning. • Lacks relevant examples or ideas. • There is a lack of support from relevant scholarly research/evidence. • No response to questions posed by faculty.

20 pts

This criterion is linked to a Learning OutcomeCONTRIBUTION TO THE DISCUSSION: Second Response (20 possible points)
20 to >19.0 pts

Excellent

Discussion response: • Significantly contributes to the quality of the discussion/interaction and thinking and learning. • Provides relevant examples and thought-provoking ideas that demonstrates new perspectives, and extensive synthesis of ideas supported by the literature. • Second response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Scholarly sources are correctly cited and formatted. • Responds to questions posed by faculty.

19 to >15.0 pts

Good

Discussion response: • Contributes to the quality of the interaction/discussion and learning. • Provides relevant examples and/or thought-provoking ideas • Second response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Scholarly sources are correctly cited and formatted. • Responds to questions posed by faculty.

15 to >12.0 pts

Fair

Discussion response: • Minimally contributes to the quality of the interaction/discussion and learning. • Provides few examples to support thoughts. • Information provided lacks evidence of critical thinking or synthesis of ideas. • Minimal scholarly sources provided to support post. • Does not respond to questions posed by faculty.

12 to >0 pts

Poor

Discussion response: • Does not contribute to the quality of the interaction/discussion and learning. • Lacks relevant examples or ideas. • No sources provided. • Does not respond to questions posed by faculty.
20 pts

This criterion is linked to a Learning OutcomeQUALITY OF WRITING (10 possible points)
10 to >9.0 pts

Excellent

Discussion postings and responses exceed doctoral level writing expectations: • Use Standard Academic English that is clear, concise, and appropriate to doctoral level writing. • Make few if any errors in spelling, grammar, that does not affect clear communication. • Uses correct APA 7 format as closely as possible given the constraints of the online platform. • Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

9 to >8.0 pts

Good

Discussion postings and responses meet doctoral level writing expectations: • Use Standard Academic English that is clear and appropriate to doctoral level writing • Makes a few errors in spelling, grammar, that does not affect clear communication. • Uses correct APA 7 format as closely as possible given the constraints of the online platform. • Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

8 to >6.0 pts

Fair

Discussion postings and responses are somewhat below doctoral level writing expectations: • Posts contains multiple spelling, grammar, and/or punctuation deviations from Standard Academic English that affect clear communication. • Numerous errors in APA 7 format • May be less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

6 to >0 pts

Poor

Discussion postings and responses are well below doctoral level writing expectations: • Posts contains multiple spelling, grammar, and/or punctuation deviations from Standard Academic English that affect clear communication. • Uses incorrect APA 7 format • Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

10 pts

Total Points: 100

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WEEK 3 DISCUSSION: OBSERVATIONAL STUDY DESIGNS

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WEEK 3 DISCUSSION: OBSERVATIONAL STUDY DESIGNS