Evidence-Based Practice (EBP) PDF

**QUIZZ PREPARATION** **[Book chapter (1-7-10)]** I. **Chapter 1: Critically Appraising Experiments: Overview of Experimental Designs** - **Importance in Evidence-Based Practice (EBP)** - Random assignment is critical for assessing the effectiveness of interventions. -...

**QUIZZ PREPARATION** **[Book chapter (1-7-10)]** I. **Chapter 1: Critically Appraising Experiments: Overview of Experimental Designs** - **Importance in Evidence-Based Practice (EBP)** - Random assignment is critical for assessing the effectiveness of interventions. - Various experimental designs are employed depending on the nature of the study. - **Types of Experimental Designs:** 1. **Classic Pretest--Posttest Control Group Design** - Involves random assignment to experimental and control groups. - Pretest and posttest scores are compared to assess the intervention\'s impact. - Example: A study measuring therapeutic effects on self-esteem. 2. **Posttest-Only Control Group Design** - Does not include a pretest due to impracticality. - Focuses solely on comparisons of posttest outcomes. - Example: Evaluating a rearrest prevention program for inmates post-release. 3. **Solomon Four-Group Design** - Combines both pretest and posttest groups to control for testing effects. - Enables differentiation between testing effects and true intervention effects. 4. **Alternative Treatment Designs** - Compares two or more competing interventions without a control group. - Effective if both treatments yield significant improvements. 5. **Dismantling Designs** - Examines which components of a multifaceted intervention are effective by randomizing combinations of components. - Useful in assessing the necessity of specific treatment features. 6. **Placebo Control Group Designs** - Controls for placebo effects and other forms of reactivity that might confound results. - Involves a placebo group that receives an inactive or alternative intervention. - **Threats to Internal Validity** - **Experimenter Expectancies**: Researcher bias can influence participant responses. - **Obtrusive vs. Unobtrusive Observation** - Obtrusive: Participants are aware they are being observed, possibly affecting behavior. - Unobtrusive: Measurement occurs without participant awareness, providing more accurate data. - **Introduction to Evidence-Based Practice: Emergence of Evidence-Based Practice** - **Historical Background** - The concept of evidence-based practice (EBP) is not new; its roots can be traced back to the early 20th century. - In 1917, Mary Richmond highlighted the use of research to guide clinical services and social reform in social casework. - **Evolution and Growing Importance** - The EBP movement gained momentum in response to accumulated scientific evidence indicating that some interventions are more effective than others. - Practitioners are now increasingly expected to make decisions based on rigorous research evidence. **Defining Evidence-Based Practice** - **Core Definition** - EBP is defined as a decision-making process where practitioners integrate the best available research evidence with their expertise and the values, preferences, and circumstances of clients. - **Common Misconceptions** - A prevalent misconception is viewing EBP as a cookbook approach, where interventions are rigidly prescribed without considering practitioner judgment or client needs. - **Comprehensive Perspective** - EBP should not be viewed as merely adhering to a fixed list of interventions but involves a dynamic process of integrating evidence with unique client characteristics. - **Types of EBP Questions** - **Practitioners may seek evidence to address a variety of questions, categorized as follows:** 1. **Predictive Factors**: What factors best predict desirable or undesirable outcomes? - Example: In mentoring programs, identifying characteristics related to long-lasting mentor-mentee matches. 2. **Learning from Experience**: What can I learn about clients and service delivery from others\' experiences? - Example: Investigating clients\' perspectives on service quality in shelters. 3. **Assessment Tools**: What assessment tool should be used? - Focusing on reliability, validity, sensitivity, feasibility, and cultural sensitivity of the chosen tool. 4. **Effectiveness of Interventions**: What intervention, program, or policy has the best effects? - Selection should be backed by rigorous research evidence. 5. **Cost Analysis**: What are the costs of interventions, policies, and tools? - Finding a balance between effectiveness and affordability in program selection. 6. **Harmful Effects**: What are the potential harmful effects of interventions, policies, and tools? - Evaluating known risks and contraindications related to specific interventions. - **EBP is Not Restricted to Clinical Decisions** - EBP applies not only in clinical contexts but also in administrative and policy-making decisions. - Example: Decision analysis in community health interventions and social service funding. **Developing an Evidence-Based Practice Process Outlook** - Implementing EBP requires a shift in mindset and approach: - **Critical Thinking** - EBP fosters critical thinking, where practitioners evaluate the merit of testimonials versus research evidence. - **Client-Centered, Compassionate Approach** - EBP promotes understanding clients as individuals and tailoring interventions to their specific needs. - **Ethical Implications** - Practicing EBP aligns with ethical obligations to provide informed consent and make evidence-based decisions in the best interest of clients. **Challenges in Implementing EBP** - **Time and Resource Constraints** - Finding and assessing relevant research can be time-consuming and might not be feasible in every practice context. - **Conflicting Evidence** - Occasional inconsistencies in research findings may complicate decision-making. - **Generalizability of Findings** - There may be a lack of evidence relevant to specific populations, prompting the need for adaptive strategies in implementation. **Key Chapter Concepts** - EBP integrates research evidence with practitioner expertise and client values. - Misunderstandings of EBP as a cookbook approach neglect the complexity of practice. - The importance of practitioner-client relationships in the effectiveness of interventions can\'t be overstated. - Evidence-based questions guide practice and decision-making beyond intervention efficacy. - Critical thinking is essential in challenging authority-based assumptions in practice. - EBP is rooted in ethical imperatives aiming for compassionate, client-centric service delivery. II. **Chapter 2: Steps in the Evidence-Based Practice (EBP) Process** - **Step 1: Question Formulation** - **Definition and Importance** - Formulating a clear, precise question is crucial for guiding the evidence search process. - Questions often relate to the effectiveness of interventions, programs, or policies. - **Common EBP Questions** - Examples include inquiries about which treatment modalities are most effective for specific populations (e.g., physically or sexually abused girls). - **Using the PICO Framework** - **P**atient/Population/Problem: Identify the characteristics of your clients and the issues being addressed. - **I**ntervention: Specify the intervention being considered or compared. - **C**omparison: Note the intervention to which you are comparing. - **O**utcome: Define the desired changes or results from the intervention. - **Developing Synonyms and Related Terms** - Consider different terms that may describe the same concepts (e.g., children may be referred to as youth or young adolescents) to ensure a thorough literature search. - **Step 2: Evidence Search** - **Literature Search Methods** - Conduct literature searches through scholarly databases, Google Scholar, or other internet sources. - Be aware of the limitations of freely available resources compared to academic databases. - **Search Techniques** - Use specific terms that relate to your EBP question (e.g., PTSD, exposure therapy). - Implement Boolean operators (AND, OR, NOT) to refine or broaden your search criteria. - **Example for Searches:** - A search for \"PTSD AND exposure therapy\" is more targeted than a search for \"PTSD,\" which may yield overwhelming results. - **Evaluating Evidence Sources** - Use objective databases like: - Cochrane Collaboration (health care interventions) - Campbell Collaboration (social welfare and justice) - American Psychological Association (Empirically Supported Treatments) - **Filtering Results** - Understand when to use advanced features in databases or to review abstracts to identify relevant studies. - Keep track of search terms used to avoid redundancy and to refine the search process. **Step 3: Critically Appraising Studies and Reviews** - **Evaluating Quality** - Rigor of studies must be assessed; look for peer-reviewed articles with strong methodologies. - Beware of studies with conflicts of interest or significant flaws that may affect their findings. - **Key Concepts in Appraisal** - Differentiate between studies that are fundamentally flawed and those with minor limitations. - Prioritize stronger studies over numerous weak studies to make evidence-based decisions. - **Example Criteria for Quality Assessment** - Participant selection, data collection methods, and analysis run the gamut from very strong to very weak; understanding this is crucial for appraisal. - **Step 4: Selecting and Implementing the Intervention** - **Typical Misinterpretations of EBP** - It is a misconception that one must automatically choose the best-supported intervention without considering client circumstances and practice context. - **Importance of Context in Implementation** - Implementing evidence-based interventions requires consideration of client demographics, available training, and other practical factors. - Collect data on the intervention\'s effectiveness regularly and adjust the approach as needed. - **Client Informed Consent** - Engage clients in the decision-making process by discussing the evidence surrounding interventions and possible side effects. - **Step 5: Monitor Client Progress** - **Establishing Evaluation Metrics** - Develop measurable goals collaboratively with the client to track the effectiveness of the intervention. - **Importance of Monitoring** - Regularly assess whether the chosen intervention is beneficial, adjusting tactics if necessary based on feedback and documented progress. - **Client Engagement** - Sharing progress data with clients can enhance their commitment to treatment and provide meaningful discussions on adjustments needed. - **Feasibility Constraints** - **Challenges in Real-World Application** - Practitioners may face time constraints and access barriers that hinder the ideal implementation of EBP. - **Strategies to Overcome Constraints** - Leverage teamwork to distribute the workload and access various evidence-research strategies collectively. - Utilize existing materials such as practice guidelines from established organizations for efficient reference. - **Key Chapter Concepts** - EBP involves critical thinking about practice decisions based on systematic evaluation of current evidence. - The process is iterative; practitioners must be willing to re-evaluate practices as new evidence emerges or as client needs shift. **Review Exercises** Encourage practical application of the discussed concepts: 1. Discover two electronic search engines and review their functionalities. 2. Formulate a targeted EBP question and explore diverse search results based on variations in search terms. 3. Analyze how client diversity may influence the applicability of found studies to inform practice. III. **Chapter 3: Research Hierarchies: Which Types of Research Are Best for Which Questions?** - **Overview of Evidence-Based Practice (EBP)** - **Importance of EBP**: Understanding how to critically appraise research quality. - **Appraisal Objective**: Distinguish between evidence with minor limitations and flawed evidence. - **Shades of Gray**: Accept that studies fall on a continuum between exemplary and flawed. - **Influential Factors**: Practice expertise and client preferences may sway decision-making. - **Research Hierarchy for EBP Questions** - **Types of Research Hierarchies** - **Multiple Hierarchies**: Recognizes that various EBP questions require different types of research. - **Controversy Around EBP**: - Misconceptions about EBP being rigid. - Recognition of qualitative research value. **Experimental vs. Non-experimental Designs** - **Experimental Designs**: - Viewed as the gold standard for establishing causation. - Involves random assignment of participants to treatment/control groups. - **Limitations**: - Not all EBP questions necessitate causal inference; some are exploratory or descriptive. - **Qualitative and Quantitative Studies** - **Key Characteristics**: - **Qualitative Studies**: - Employ flexible designs, subjective methods, often with small samples. - Aim to cultivate deep insights and theoretical richness. - **Quantitative Studies**: - Focus on objective, statistical findings that can generalize. - Designed to test specific hypotheses about causal relationships. - **Mixed-Method Studies**: Some research combines qualitative and quantitative methods. - **Types of EBP Questions and Corresponding Research Designs** 1. **Predicting Outcomes** - **Good Predictors**: - Correlational studies may rank higher for predicting undesirable/desired outcomes. - Use multivariate procedures to identify significant factors. - **Example**: Correlational studies in foster care to determine success predictors. 2. **Client and Practitioner Experiences** - **Importance of Understanding**: - High-ranking qualitative research can provide deeper insights into client experiences. - **Research Examples**: - In-depth interviews with parents of mentally ill children to gauge treatment perceptions. 3. **Assessment Tools Selection** - **Considerations**: - Research on reliability, validity, and cultural sensitivity often employs correlational designs. 4. **Intervention and Program Effects** - **Hierarchy**: - Experiments rank highest for identifying effective interventions and controlling for extraneous variables. - **Research Example**: - Randomized controlled trials for trauma therapy in disaster survivors. - **Ranking Different Research Designs** - **Research Design Hierarchy** - **Level 1**: Systematic reviews and meta-analyses - **Level 2**: Multisite replications of randomized experiments - **Level 3**: Randomized experiments - **Level 4**: Quasi-experiments with low vulnerabilities - **Level 5**: Single-case studies - **Level 6**: Correlational studies - **Level 7**: Other Designs (anecdotal reports, qualitative descriptions) - **Philosophical Considerations** - **Critique of Traditional Science**: Some argue traditional methods are biased and dismiss objectivity. - **Response to Criticism**: - Importance of striving for objectivity, even if it's unattainable. - Failing to assess social reality may empower those in power against the disenfranchised. - **Key Chapter Concepts** - **Contradictions About EBP**: It is not merely experimental-focused; varied methodologies can serve different questions. - **Emergence of Nuanced Views**: Distinction between qualitative and quantitative studies, recognizing each has a rightful place in research. IV. **Chapter 4: In-Depth Study Guide: Criteria for Inferring Effectiveness in Research Studies** **1. Criteria for Evaluating Intervention Effectiveness** - **Key Questions for Critical Appraisal** - What are the four fundamental questions to evaluate the effectiveness of an intervention? 1. **Internal Validity**: Is the intervention the most plausible cause of the observed outcome? 2. **Measurement Validity and Bias**: Was the outcome measured in a valid and unbiased manner? 3. **Statistical Conclusion Validity**: What is the likelihood that the results were influenced by chance? 4. **External Validity**: Are the study\'s participants and procedures applicable to your practice context? **2. Internal Validity** - **Definition**: Internal validity refers to the extent to which a study can establish a cause-and-effect relationship between the intervention and the outcome. - **Causal Inference Criteria**: - **Time Order**: The intervention must occur before the outcome change. - **Correlation**: Changes in the outcome should correlate with changes in the intervention. - **Rule Out Alternatives**: Other plausible explanations for the observed correlation should be accounted for. **2.1 Threats to Internal Validity** - **Common Threats**: - **History**: Other events coinciding with the intervention may affect outcomes. - **Maturation**: Changes in participants over time could be the reason for outcome changes. - **Statistical Regression to the Mean**: Extreme scores may appear to normalize without any intervention. - **Selectivity Bias**: Non-random assignment might lead to comparing groups that are inherently different. **2.2 Random Assignment** - **Importance**: Using random assignment helps mitigate selectivity bias, ensuring that groups are comparable. - **Process**: Participants have an equal chance of being assigned to each treatment condition, which can be facilitated via random number tables or coin tosses. **3. Measurement Issues** - **Validity of Measurement**: Studies must employ reliable and valid measurement tools to ensure credible results. - **Measurement Bias**: Bias in data collection can significantly distort results. - **Examples of Measurement Flaws**: Misunderstandings of scale instructions, biased prompting by researchers, or poorly translated instruments. **4. Statistical Chance** - **Understanding Statistical Significance**: Differences are often deemed statistically significant when the probability of them occurring by chance is less than 0.05. - **Interpretation**: A finding may be statistically significant but not practically meaningful, especially when based on small samples. - **Sample Size Influence**: A small sample size increases the probability that a result is due to chance. **5. External Validity** - **Definition**: This aspect evaluates whether study findings can be generalized to other settings and populations. - **Factors Affecting External Validity**: - Characteristics of participants and how they relate to the broader population. - Differences in settings used in the research versus typical practice environments. **7. Key Concepts Recap** - Internal validity relates to whether an intervention can be conclusively linked to observed outcomes. - Random assignment is a crucial method for eliminating biases. - Reliable and valid measurements are necessary for credible conclusions. - Statistical outcomes must be cautiously interpreted with consideration for context and sample size. - External validity determines the generalizability of findings to specific practice contexts. V. **Chapter 5 : Additional Design Flaws to Consider** - **Compensatory Equalization**: Control group practitioners may enhance their treatment to match experimental conditions, skewing results. - **Resentful Demoralization**: Control group clients may feel less motivated, impacting their outcomes negatively. - **Treatment Fidelity**: Monitoring if the intervention is implemented as intended to ensure valid conclusions. - **Differential Attrition**: The impact of different dropout rates between groups can compromise results. - **Synopses of Research Studies Study 1 Synopsis** - **Design**: Posttest-only control group with pretest measurements not conducted due to client circumstances. - **Findings**: The experimental group showed positive outcomes but was not statistically significant, leading to the conclusion that the intervention should not be continued without further investigation. - **Study 2 Synopsis** - **Design**: Used random assignment with a dual treatment approach in separate agencies. - **Findings**: Both interventions showed significant improvement, but without a control group, causality could not be confirmed. - **Critical Appraisals of Research Synopses Critical Appraisal of Study 1** - **Strengths**: - Random assignment helps mitigate bias. - Use of unobtrusive measures like agency records increases reliability. - **Limitations**: - Small sample size raises questions about equivalence and validity of results. - Treatment fidelity not assessed, potentially skewing outcome interpretations. - **Critical Appraisal of Study 2** - **Strengths**: - The study employed randomized designs and multiple unobtrusive measures. - Low attrition rates and high equivalence in practitioner backgrounds enhance reliability. - **Limitations**: - The absence of a control group undermines the conclusion that interventions were equally effective; alternative explanations (e.g., maturation effects) cannot be ruled out. - **Key Chapter Concepts** - Understanding underlying concepts in experimental design is crucial for appraising research quality. - Recognition of common flaws and their implications for study validity allows for better evaluation of intervention effectiveness. VI. **Chapter 7 : Overview of Quasi-Experimental Designs** - Quasi-experimental designs can be classified into two major forms: time-series designs and single-case designs. - This chapter focuses on time-series designs, which involve collecting multiple data points both before and after an intervention, program, or policy change. - **Key Benefits**: - Offers reasonably strong internal validity without needing a control group. - Useful when it\'s impractical to obtain a comparison group. - **Time-Series Designs** - **Simple Time-Series Designs** - Consist of multiple data points collected over time to analyze changes pre-and post-intervention. - **Data Collection**: - May use existing records or observations. - Example: Tracking traffic fatalities before and after a speed limit change. - **Notation**: - O1 O2 O3 O4 O5 X O6 O7 O8 O9 O10 - **O** represents an observation, while **X** signifies the introduction of the intervention. - **Strengths**: - Control for maturation (normal development over time). - Control for regression to the mean (fluctuations due to statistical averages). - Reduce plausibility of historical events impacting results. - **Multiple Time-Series Designs** - Similar to simple time-series but includes both experimental and comparison groups. - **Notation**: - Experimental Group: O1 O2 O3 O4 O5 X O6 O7 O8 O9 O10 - Comparison Group: O1 O2 O3 O4 O5 O6 O7 O8 O9 O10 - **Advantages**: - Allows for better control of external variables (history). - Can rule out alternative explanations when trends differ significantly between groups. - **Single-Case Designs** - Focuses on the application of time-series logic to single subjects, such as individuals or small groups. **Types of Single-Case Designs** 1. **AB Designs**: - A: Baseline phase. - B: Intervention phase. - Changes in data patterns indicate effectiveness of the intervention. 2. **ABAB Designs**: - Introduces withdrawal of the intervention to assess its impact more robustly. - Visual significance if improved patterns replicate with the introduction of B phases. 3. **Multiple Baseline Designs**: - Introduces the intervention at staggered points to multiple cases or targets. - Clear evidence of improvement supports the effectiveness of the intervention. 4. **Multiple Component Designs**: - Evaluates different components of an intervention to determine which are effective. - Helps in further breaking down intervention strategies to identify essential elements. - **Challenges with Single-Case Designs** - **External Validity**: - Limited ability to generalize findings to broader populations. - Findings from a single case may not accurately reflect outcomes in different contexts or larger groups. - **Measurement Concerns**: - Potential biases in data collection. - Need for unobtrusive and consistent measurement practices to maintain - **Key Chapter Concepts** - Multiple data points enhance the robustness of evidence in time-series designs. - The integration of comparison groups boosts internal validity and control for external influences. - Understanding various single-case designs helps assess and apply effective intervention strategies in practice. **CLASS SLIDES** - **CLASS 1** - **Evidence-Based Practice (EBP) Definitions** - **Definition 1:** *(Gibbs, 2003, p.6)* - Evidence-based practitioners prioritize client benefits through lifelong learning, question formation, evidence search, and actionable findings. - **Definition 2:** *(Rubin & Bellamy, 2012, p.7)* - EBP integrates the best research evidence with practitioners\' expertise and client characteristics, values, preferences, and circumstances. - **Importance of Evidence-Based Practice** **Ethical Considerations** - **Do No Harm:** - Research-driven decision-making minimizes risk and promotes ethical standards such as informed consent. **Critique: The \"Scared Straight\" Intervention** - **Research Findings:** - Evidence indicates that the \"Scared Straight\" intervention is more harmful than beneficial, potentially increasing delinquency among participants. *(Hale, 2010)* - **The Evidence-Based Practice Model** **Components of EBP:** - **Clinical State and Circumstances** - **Client Preferences and Actions** - **Current Best Evidence** - **Clinical Expertise** **The Cycle of Evidence-Based Practice** - Continuous cycle involving: - Assessing clinical situations. - Gathering client input. - Consulting current research. - Drawing on clinical expertise. **Steps in Evidence-Based Practice *(Gibbs, 2003)*** 1. Convert a clinical query into a PICO question (Population, Intervention, Comparison, Outcome). 2. Locate the best available evidence. 3. Critically assess the obtained evidence. 4. Fuse the critical appraisal with professional experience and client context. 5. Evaluate overall effectiveness and seek improvements. 6. Educate others on the EBP process. **EBP Policy Process *(Gray, 2001)*** - Core activities include: - Finding and appraising relevant evidence. - Building capacity among practitioners. - Transforming evidence into actionable practice. **EBP in Macro Social Work Practice** - Recognition that EBP is not limited to clinical practice, but applicable in: - Community settings. - Organizational frameworks. - Administrative policies. - Overall social work practice decisions. **Benefits of Evidence-Based Practice in Social Work** - Enhances overall quality of services. - Empowers both clients and practitioners. - Develops thoughtful and skilled social work professionals. - Contributes to scientific literature on social work. - Fosters collaboration across various professional domains. - Upholds ethical standards and professional integrity. **Concerns About EBP in Social Work / Social Policy** - Potential for EBP to oversimplify complex cases (termed as \"cookbook\" approaches). - Criticisms that EBP could undermine traditional practice methods. - Concerns about reductionism and the risk of ignoring unique client needs. - Misuse of EBP as a pretext for rationing services disguised as scientific evidence. **Developing an Inclusive Model of Evidence-Based Practice** - **Knowledge Gathering:** - Collect evidence across multiple sources: scholarly literature, professional experiences, and insights from clients. - **Knowledge Transformation:** - Implement evidence thoughtfully, considering the unique context of each situation to allow for meaningful transformation. **Understanding Contextual Influences on EBP** - Factors including: - Organizational mandate. - Community resources. - Training and supervision support. - Political, socio-historical, economic, and professional contexts. - Client preferences and circumstances. **Closing Thoughts** - Acknowledgment that knowledge management needs advancement for better integration. - Emphasis on enhancing the relationship between research, policy, and practice to promote effective social work intervention. - **CLASS 2: Understanding Evidence-Based Practice (EBP)** - **Organizational Mandates and Context** - **Organizational Factors:** - **Resources/Constraints:** Identify limitations like funding, staff limitations, or time constraints that impact service delivery. - **Community Context:** Understand the community dynamics and needs that influence social work practice. - **Training / Supervision:** Importance of ongoing professional development to ensure best practices. - **Political Context:** Recognition of policies and legislation that shape service provision. - **Socio/Historical Context:** Understanding historical factors that affect clients and services. - **Economic Context:** Analyzing how socio-economic conditions impact client needs and agency resources. - **Professional Context:** The role of social work ethics and professionalism in guiding practice. - **Client Preferences and Actions:** Emphasizing the necessity to incorporate clients' voices and choices into decision-making. - **Framework for Evidence-Based Practice** 1. **Knowledge Gathering:** - Comprehensive data collection from diverse sources such as: - **Research Literature:** Academic studies and findings. - **Professional Wisdom:** Insights from experienced practitioners. - **Client Wisdom:** Understanding clients\' unique experiences and preferences. 2. **Knowledge Transformation:** - Adapting evidence in relation to the specific context and individual circumstances to achieve meaningful practice outcomes. - **Steps in Evidence-Based Practice** 1. **Convert Information Need into an Answerable Question (PICO):** - Identifying specific queries regarding prevention, assessment, treatment, or risk. 2. **Tracking Current Best Evidence:** - Conducting a systematic search for the latest findings relevant to the posed question. 3. **Critically Appraising the Evidence:** - Evaluating the quality and applicability of the identified research. 4. **Integrating Appraisal with Experience:** - Merging findings from the evidence with the practitioner's experience and the client\'s preferences and values. 5. **Evaluating Effectiveness:** - Assessing the success of steps 1-4 in practical application and identifying improvement opportunities. 6. **Teaching Others:** - Sharing knowledge and techniques acquired through the EBP process to enhance collective practice. - **Interpretation of Evidence Activity** - Engage in reflective practice by listing pressing questions regarding clinical or social programs. Consider: - **Examples:** - Effectiveness of safe drug consumption sites on overall drug usage. - Impact of parenting interventions on child anxiety and stress levels. - Efficacy of ombudsperson programs in enhancing living conditions in nursing homes. - Role of food stamps in reducing food insecurity among low-income families. - **PICO and PICo Research Questions** - **PICO Framework:** - **P:** Population - Who is the target group? - **I:** Intervention - What treatment or approach is being investigated? - **C:** Comparison - What alternative intervention or absence of intervention is used for comparison? - **O:** Outcome - What is the expected effect or result? - **PICo Framework:** - **P:** Population - Target group or demographic. - **I:** Interest - Focus on a specific phenomenon or concept. - **Co:** Context - The setting or environment surrounding the inquiry - **Characteristics of Effective PICO/PICo Questions** - **Client-Oriented:** Questions should arise from issues pertinent to clients or community welfare. - **Practical Importance:** Questions must have direct relevance to the social work practice and services provided by agencies. - **Guidance for Evidence Search:** Questions should be framed clearly to facilitate searches in professional literature. - **Types of PICO/PICo Questions** - **PICO for Quantitative Research:** - **Effectiveness questions:** Assess program efficacy using randomized control trials. - **Prevention questions:** Investigate the preventive capacity of certain interventions. - **PICo for Qualitative Research:** - **Description questions:** Explore client experiences and perceptions through surveys or interviews. - **Features of Effective PICO Questions** - Key attributes must include a clear population definition, intervention details, comparison analysis, and anticipated outcomes. - **Examples of PICO Questions** **Effectiveness Examples:** 1. For high school students with low GPAs, does motivational interviewing improve their academic performance? 2. For clients experiencing depression, how does cognitive behavioral therapy compare to no intervention in reducing symptoms? **Prevention Examples:** 1. For low-income families, do asset-building interventions increase future college attendance among their children? 2. For middle-aged adults with hearing loss, how do hearing aids affect the likelihood of cognitive decline? - **Formulating Descriptive PICo Questions** **Descriptive Examples:** 1. How do caregivers describe their experience caring for elderly relatives? 2. What are the experiences of abused women within the US legal system? **CLASS 4: Library. Comprehensive Study Guide for SWK4510: Finding Evidence** **Course Overview** - This course focuses on how to locate the best, most current evidence in relation to community health and social work practices. - Students will learn to evaluate the quality of research studies and integrate findings into social work practice. - **Scenario Exploration** **Research Question Example:** - **Question:** For the surrounding community, does having a supervised consumption site result in negative outcomes? **Evaluating Evidence:** - To determine the relevance and quality of evidence, studies such as the following should be referenced: - **Reference:** Government of Alberta. (2020). *Impact: A socio-economic review of supervised consumption sites in Alberta.* - [[Link to Study]](https://www.alberta.ca/supervised-consumption-services-review.aspx) **Key Findings from the Alberta Study:** - **Crime Increase:** Generally, police calls for service increased in areas with supervised consumption sites (SCS), except in Edmonton. - **Needle Debris Concern:** The rise in needle debris on public and private property created community perceptions of decreased safety and increased crime. - **Assignment Overview:** 1. **Select a Study:** - Choose a qualitative or quantitative article/study that answers your developed PICo/PICO question. - Exclude systematic reviews or meta-analyses. - Use University of Toronto Library research databases for your literature search. 2. **Search Documentation:** - Provide screenshots of your electronic database search strategy in an appendix. - Demonstrate your exact search terms used in at least three different electronic databases. - **Learning Outcomes:** - **Database Selection:** Choose relevant databases for your research topic. - **Keyword Identification:** Extract keywords from your research question to create a keyword search strategy. - **Study Discovery:** Find qualitative and quantitative studies relevant to course assignments. - **Troubleshooting:** Learn to resolve common research search challenges. - **Post-Graduation Access:** Identify how to access open research after leaving the University. - **Effective Searching Strategy** **Where to Search:** - **Search Engines:** - **Examples:** Google Scholar provides an easy-to-use interface. - **Library Catalogue:** - **Resource:** LibrarySearch at UofT allows you to discover both print and electronic collections with filters. - **Journal Databases:** - **Targeted Resources:** PsycINFO and Social Services Abstracts specialize in specific disciplines, offering advanced search features. - **Considerations for Searching:** - Identify the **discipline** or **subject** relevant to your topic. - Determine the **type of literature** needed (journal articles, dissertations, news articles, etc.). - Assess the **features** available in databases (filters, search fields, controlled vocabulary). - **Keyword Selection and Framework** **Example Topic:** - **Research Question:** Among pregnant women, does having a birthing doula associate with fewer c-sections? **Research Keywords:** - **Population:** - Keywords: Pregnant women - **Intervention:** - Keywords: Birthing doula - **Outcome:** - Keywords: Fewer c-sections **PICO/PICo Framework:** - **PICO Elements:** - **Population:** Pregnant women - **Intervention:** Birthing doula - **Comparison:** None in this question - **Outcome:** The rate of c-sections **Practice Example for Music Therapy:** - **Question:** If people living with dementia receive music therapy vs no music therapy, are they likely to have a better quality of life? - **Keyword Breakdown:** - Population: People living with dementia - Intervention: Music therapy - Comparison: No music therapy - Outcome: Better quality of life **Search Implementation Tips** - Use **advanced search options** and **structured search strings** for comprehensive results. **Example Structured Search String:** - **(dementia OR \"dementia patients\")** - **AND (music therapy OR \"music-based interventions\")** - **AND (\"quality of life\")** **Troubleshooting Search Results** **Encountering Few Results:** - Remove a concept (e.g., only search for Population and Intervention). - Broaden keywords or use alternative phrases. **Too Many Irrelevant Results:** - Add more specific concepts to narrow down the focus. **Citation Searching** - Use citations to explore related articles. Databases such as Web of Science or Google Scholar offer features to track references and citations. **Additional Search Strategies:** - Use the **NOT** operator to exclude certain keywords or terms effectively. **Conclusion: Recap Key Points** 1. Utilize the Subject A-Z Database List to choose science-focused databases. 2. Identify PICO/PICo concepts and brainstorm keywords. 3. Use quotations and truncation for precise searching. 4. Apply methodology filters for empirical studies. 5. Adjust search strategies based on results obtained. **Class 5: Experimental and Quasi-Experimental Research Designs - Expanded Study Material** **Key Concepts: Laying the Foundation** **Intervention** - **Definition**: An intervention is a set of organized activities aimed at inducing change in an individual, group, or community. - **Purpose**: Designed to influence outcomes, known as dependent variables. - **Role**: The intervention represents the independent variable in research, manipulated by the researcher to assess effects on outcomes. **Causality** - **Concept**: Refers to the relationship between a cause (an independent variable) and its effect (a dependent variable). - **Criteria for Establishing Causality**: - **1) Association/Correlation**: There must be a measurable relationship between the independent and dependent variables. - **2) Time Ordering/Temporal Relationship**: The cause must precede the effect in time. - **3) Absence of Confounder**: The relationship cannot be confounded by a third variable that also influences the outcome. **Internal Validity** - **Definition**: The extent to which an intervention can be confirmed as the cause of an observed effect. - Questioning whether other explanations for the results exist is crucial. - Importance: Strong internal validity implies that outcomes can confidently be attributed to interventions rather than outside factors. **Confounding Variable** - **Definition**: An external variable that can influence both the independent and dependent variables, leading to spurious associations. - **Impact**: If a confounder is present, it complicates the interpretation of causality as it may be the true source of the observed effect. **Importance of Understanding Causality and Interventions** - Informs effective, evidence-based practices within social work. - Ensures ethical standards in client care, minimizing potential harm. - Optimizes resource allocation for interventions, enhancing value for clients and communities. **Threats to Internal Validity** - **1) History**: External events linked to the intervention that may skew results. - *Example*: External funding for youth violence intervention unrelated to the intervention conducted. - **2) Maturation**: Natural development over time affecting outcomes. - *Example*: Older middle school students becoming less involved in bullying, not due to intervention but due to growing maturity. - **3) Testing Effects**: The act of measuring influences behavior change rather than the intervention. - *Example*: Participants tailoring responses to survey questions to meet perceived expectations. - **4) Changes in Measurement/Instrumentation**: Variations in the tools or methods used for assessment during the study. - *Example*: Switching indicators mid-study, leading to misleadingly positive results. - **5) Statistical Regression to the Mean**: Extreme cases trending toward average with time, potentially misleading results. - *Example*: Temporary spikes in school fights normalizing over time without intervention effect. - **6) Selection Bias**: Systematic differences between treatment and control groups that may influence outcomes. - *Example*: Higher parental involvement among intervention group influencing reported efficacy. - **7) Attrition**: Loss of participants during a study affecting results. - *Example*: Dropouts from the intervention without follow-up can lead to inconclusive findings about effectiveness. - **8) Causal Ambiguity**: Uncertainty in the direction of cause and effect. - *Example*: Anxiety reduction impacting loneliness or vice versa. - **9) Control Group Contamination**: Untargeted exposure of control groups to experimental conditions. - *Example*: Non-treatment students adopting intervention practices through mingling. **Randomization** - **Definition**: A methodological approach involving random assignment of participants to treatment or control groups to eliminate biases. - **Importance**: Essential for establishing comparability between groups and ensuring that outcomes can be attributed to the intervention rather than pre-existing differences. **External Validity** - **Definition**: Refers to the extent to which findings from a study can be generalized to settings beyond the experimental conditions. - **Alternate Term**: Generalizability. **Types of Research Designs** - **Pre-Experimental Designs**: Simple designs lacking rigorous control, including: - One Shot Case Study Design. - One Group Pretest Post-test Design. - **Experimental Designs**: More robust, providing strong causal inference through: - Pretest-post-test control group design. - Solomon four group design. - Post-test only control group design. - **Quasi-Experimental Designs**: Used where randomization is impractical; offers a less stringent but still informative approach. **Symbols in Experimental Research Designs** - **X**: Intervention - **Cn**: Control Group (Treatment as Usual or No Intervention) - **O**: Observation - **R**: Random Assignment/Randomization - **T**: Time **Types of Experimental Research Designs** **Pretest-Post-test Control Group Design** - Involves two groups where subjects are randomly assigned to either receive the intervention or not. - Allows comparison of pre and post-intervention measures but may suffer from testing effects. **Post-test Only Control Group Design** - Focuses on comparing outcomes after the intervention with no pretest needed, useful when pretests cannot be conducted. **Solomon Four Group Design** - Combines elements of previous designs to evaluate the impact of pretesting on participants while still measuring outcome differences. **Quasi-Experimental Research Designs** 1. **Non-Equivalent Control Group Design**: Involves comparing a treatment group to a similar but non-randomized control group, allowing some assessment of internal validity. 2. **Time-Series Design**: Observes the same group over time before and after intervention without a control group. 3. **Multiple Time-Series Design**: Similar to time-series but includes a comparison group for better relative assessment. **Advantages and Disadvantages** - **Advantages**: Higher practicality in real-world settings. - **Disadvantages**: Increased susceptibility to bias due to lack of randomization. **Intervention Fidelity** - **Definition**: The degree to which an intervention is implemented as intended, crucial for validating effectiveness. - **Terms Used**: Treatment adherence, program integrity, or program fidelity. **Assessing Intervention Fidelity** - Conduct training to adhere to intervention protocols. - Use videotaped sessions to evaluate delivery fidelity through expert assessment. **Class Summary** - Key concepts are integral to understanding causal relationships within social work research. - Identifying threats to internal and external validity aids in refining research methodologies. - Differentiating between experimental and quasi-experimental designs ensures proper application based on contextual constraints.