This article discusses the study design, statistical power, sample selection, and outcomes of the 'Power to Quit' Program, a smoking cessation program for homeless individuals. The article also references relevant research on randomized controlled trials and statistical power.
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Running head: HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE Name of the Student: Name of the University: Author note:
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1HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE Response to Question 1 The study design used in the ‘Power to Quit’ Program, conducted by authors Goldadeet al.(2011), was a two-group, randomized clinical trial. As researched by Deaton and Cartwright (2018), randomized controlled trials have been implicated as an accurate study design for obtaining a comparative analysis between a novel clinical treatment, as against a standardized procedure.Theobjectivesofthegivenresearchaimedtoevaluatetheeffectivenessof motivational interviewing on cessation of smoking in comparison to standard procedures. Hence, considering the primary research objectives of treatment efficacy comparison, a randomized controlling trial is a good research design. Further, as examined by Thall, Fox and Wathen (2015), randomized controlled trial necessitate participant selection through randomization, a process known to reduce biasand inconclusivenessof research results. Hence, opting a randomized controlled trial is appropriate research design for the given study, since it will aid in the avoidance of research bias during subject selection. Response to Question 2 The authors of the given research, based its evaluation of statistical power on the primary outcomes of cotinine levels in participant’s saliva, which was measure at the 26thweek. According to Akobeng (2016), the statistical power of any research is aimed at reducing the probability of occurrence of a null hypothesis which would be false. Hence, consideration of cotininelevelstoassesstheefficacyofmotivationalinterventionalasagainststandard procedures of enhancing adherence to nicotine replacement therapy is appropriate, considering the release of cotinine - the substance produced in response to nicotine exposure, which remains
2HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE in the system for a prolonged period in comparison to rapid metabolism and disappearance of nicotine. The secondary outcome of statistically powering the research is based upon checking of used patches, evaluating the number of patches left and administration of self-reported Morisky scale,whichisappropriate,consideringthenecessaryusageofnicotinepatchesinthe conductance of nicotine replacement therapy among participants. Response to Question 3 Thestudyarmconsistingof216homelessparticipantsreceivingmotivational interviewing along with nicotine replacement therapy was the intervention arm of this study, whereas the remaining 214 homeless individuals receiving standard smoking cessation was the control arm of this study. According to Cor (2016), for ensuring validity and conclusiveness in research findings, the sample selection must be in associated with the primary objectives of the study. The authors of the chosen study, aimed to design a smoking cessation program with the primaryobjectiveofevaluatingtheeffectivenessofmotivationalinterviewingasagainst standard procedures of smoking cessation upon nicotine patch adherence. Hence, in order to associate the primary objectives of the study the research design, the authors opted the above sample grouping procedure. Response to Question 4 Thepoint-prevalenceofcotininewastheprimaryoutcomeofthestudy.Direct observation of used nicotine patches and patch counts were the secondary outcomesof the study. The authors considered prevalence of substance abuse disorders and co-morbid psychiatric disordersasmoderatingormediatingfactors.Theobjectivemeasuresoftheoutlining
3HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE quantifiable results included patch checks, patch counts, scores of the Morisky Scale and results fromthePatientHealthQuestionnaire,MINIGeneralizedAnxietyDisorderAssessment, Smoking Self-Efficacy Questionnaire, Perceived Stress Scale, Rost-Burnham Screening for Depression and the Questionnaire of Smoking Urges. Subjective measures outlining qualitative results included participant answers in response to authors’ questions concerning participants’ history of alcohol and drug dependence and drug treatments undertaken.
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4HEALTHCARE RESEARCH ASSESSMENT: SUBSTANCE ABUSE Reference Akobeng, A.K., 2016. Understanding type I and type II errors, statistical power and sample size.Acta Paediatrica,105(6), pp.605-609. Cor,M.K.,2016.Trustme,itisvalid:Researchvalidityinpharmacyeducation research.Currents in Pharmacy Teaching and Learning,8(3), pp.391-400. Deaton,A.andCartwright,N.,2018.Understandingandmisunderstandingrandomized controlled trials.Social Science & Medicine,210, pp.2-21. Goldade, K., Whembolua, G.L., Thomas, J., Eischen, S., Guo, H., Connett, J., Des Jarlais, D., Resnicow, K., Gelberg, L., Owen, G. and Grant, J., 2011. Designing a smoking cessation intervention for the unique needs of homeless persons: a community-based randomized clinical trial.Clinical Trials,8(6), pp.744-754. Thall, P., Fox, P. and Wathen, J., 2015. Statistical controversies in clinical research: scientific and ethical problems with adaptive randomization in comparative clinical trials.Annals of Oncology,26(8), pp.1621-1628.