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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

Question #1

Is 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.

Answer to Question #1

False

Rationale: 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.

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.

Descriptive Studies

Descriptive studies are most frequently used in public health research. They may be observational or analytical

Case studies

Survey research

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

Analytical Studies

Cohort studies, also called longitudinal studies, examine phenomena prospectively to observe presumed effects over time.

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

Advantages: Allow for the examination of multiple exposures for a single outcome, suitable for studying rare diseases and those with long latency periods, require fewer case subjects, generally quicker, less expensive, and well suited for outbreak investigation

Disadvantages: Not appropriate for rare exposures, subject to bias because of the method used to select controls, do not allow direct measure of incidence

Question #2

Is the following statement true or false?

Cohort studies involve an in-depth analysis of an individual, group, or social institution.

Answer to Question #2

False

Rationale: 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.

Question #3

Is the following statement true or false?

Case–control studies, also known as prospective studies, work backward from the effect to the suspected cause.

Answer to Question #3

False

Rationale: 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.

Intervention (Experimental) Studies

Preventive trials

Therapeutic trials

Question #4

Is 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.

Answer to Question #4

False

Rationale: 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.

Question #5

Is the following statement true or false?

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

Answer to Question #5

False

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