Harkness2e chap08 ppt

Chapter 8: Gathering Evidence for Public

Health Practice

Chapter Highlights • Epidemiologic/public health research

defined• Observational studies: Descriptive

versus analytical research• Strengths and limitations of

epidemiologic research methodology• Applying epidemiologic research to

public health nursing practice

QuestionIs the following statement true or false?In descriptive studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem.

AnswerFalseRationale: In analytical studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem. In descriptive studies, the researcher collects information to characterize and summarize the health event or problem.

Epidemiologic Research• Epidemiologic/public health research

can be descriptive or analytical. Study designs are based on the problem under study and range in strength on a continuum, with the weakest design being the retrospective design and the strongest being the experimental design.

Descriptive Studies• Descriptive studies are most frequently

used in public health research. They may be observational or analytical.

Observational Studies • In descriptive studies, the researcher

collects information to characterize and summarize the health event or problem.

• In analytical studies, the researcher relies on comparisons between groups to determine the role of various risk factors in causing the problem.

Case-Control Studies• Case–control studies retrospectively

compare subjects (cases) with a condition (disease) and matched subjects/control without the condition/disease.

Cohort Studies• Cohort studies, also called longitudinal

studies, examine phenomena prospectively to observe presumed effects over time.

Cross-Sectional Studies• Cross-sectional studies examine the

relationship of health-related characteristics and other variables of interest in a defined population at a particular point in time.

QuestionIs the following statement true or false?Cohort studies involve an in-depth analysis of an individual, group, or social institution.

AnswerFalseRationale: Case studies involve an in-depth analysis of an individual, group, or social institution. Cohort studies, sometimes referred to as prospective studies, are longitudinal studies, which monitor subjects over time to find associations between risk factors and health outcomes.

Descriptive Studies • Findings from descriptive epidemiologic studies lead to

hypotheses for future research.

QuestionIs the following statement true or false?Case–control studies, also known as prospective studies, work backward from the effect to the suspected cause.

AnswerFalseRationale: Case–control studies, also known as retrospective studies, work backward from the effect to the suspected cause. Cohort studies, sometimes referred to as prospective studies, are longitudinal studies, which monitor subjects over time to find associations between risk factors and health outcomes.

Advantages of Case-Control Studies• Allow for the examination of multiple

exposures for a single outcome• Are suitable for studying rare diseases

and those with long latency periods• Require fewer case-subjects• Are generally quicker and less

expensive to conduct than are cohort studies, making them well suited for an outbreak investigation

Disadvantages of Case-Control Studies

• They are not appropriate for studying rare exposures.

• They are subject to bias because of the method used to select controls.

• They do not allow the direct measure of the incidence of disease.

QuestionIs the following statement true or false?Intervention study is the epidemiologic investigation designed to test a hypothesized relationship by modifying an identified factor in a population. The study is preventive.

AnswerFalseRationale: Intervention study is the epidemiologic investigation designed to test a hypothesized relationship by modifying an identified factor in a population. Studies may be therapeutic (clinical) or preventive.

Quasi-experimental and Experimental Design

• Quasi-experimental and experimental designs are used to examine causality.

• The “gold standard” for research design is the randomized, control group design.

QuestionIs the following statement true or false?The “gold standard” for research design is the randomized, experimental group design.

AnswerFalseRationale: The “gold standard” for research design is the randomized, control group design.

Trials• Preventive trials focus on primary

prevention to reduce the incidence of disease.

• Therapeutic trials are based on secondary prevention, which focuses on limiting the spread of disease.

Community Health Nurses• Community health nurses are the

consumers of health-related research, which is the foundation of evidence-based practice and is also used to inform and educate the public.

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