Community Guide

Community Guide

Guidelines for the Seminar Project

The final assignment for the seminar is the completion of a substantive written project, due no later than Day 1 of Week 12.The project involves the development of a research protocol for assessing the evidence base for a given program/policy. The choice of program is up to the student; however, it must be approved by the instructor.

The format for the project will be determined by the program/policy chosen as well as the goals and objectives of the student. The key is to use the methodology chosen to assess and present evidence for policy formulation.There are two options for structuring the project, the Cochrane methodology or the USDHHSGuide to Community Preventive Services, either of which allows for two types of evaluation: an effectiveness evaluation or an economic evaluation. Students are also urged to consult the appendices in the Muir Gray (2001) text for further guidance.

The seminar activities are designed to give students the opportunity to practice skills used when conducting policy research, that is, the identification of data, assessment of data quality, data synthesis, and the drafting of evidence-based recommendations, and to commence work on the project early in the term. Please review the Weekly Course Schedule, as assignments for Weeks 3, 4, 9, and 10 are related to the project.

While the length of an evidence-based research protocol can vary, for our purposes the paper should be about 10-12 double-spaced pages, using APA format. Note that the review you will find, for example the Cochrane Review example below, uses single spacing. However, per the guidelines of the University the final paper must conform to the format set forth in the Publication Manual of the American Psychological Association, also known as the APA manual. At a minimum the final paper must be double spaced, use Times Roman 12-point font, and a four level header. A title page, abstract, and a reference list are also required.

The seminar project is an ongoing project, which commences with the selection of your program and method for analysis (due Week 3) and culminates with the final project (due Week 12). Please review the following table for clarification. See the Weekly Course Schedule in the Syllabus for due dates and submission guidelines.

Seminar Project

Week 3 ? Program for analysis and method 2
Week 4 ? References, 8-10 peer-reviewed journal articles (2 pts) 2
Week 9 ? First draft for peer review (3 pts) 3
Week 10 ? Second draft for peer review and comment (3 pts) 3
Week 12 ? Seminar project due (20 pts) 20
Total Possible Points 30

Evaluative Criteria for Written Assignments Points
Evidence of the following demonstrated criteria in all written work: originality of ideas and research; depth of scholarship; use of the literature (course and peer reviewed); synthesis of key concepts and theories introduced throughout the course; consistency and logic in presentation; accurate syntax, grammar, and spelling; and APA format and organization.
20
Paper moderately deficient in one of the above criteria. 15
Paper moderately deficient in more than one of the above criteria.
10
Paper strongly deficient in more than one of the above criteria. 5
For the course project, if it is judged to be unacceptable in one of more of the above criteria or if no paper is submitted, then the grade of Incomplete will be assigned. An Incomplete, per University policy, defaults to the grade of F.
Incomplete

What is the Community Guide?

As noted above, the Community Guide offers two formats for evaluating and making recommendations on population-based and public health interventions: an effectiveness evaluation and an economic evaluation.

EffectivenessEvaluations

The Community guide reviews evidence on effectiveness, the applicability of effectiveness data, (i.e., the extent to which available effectiveness data is thought to apply to additional populations and settings), the intervention’s other effects (i.e., important side effects), economic impact, and barriers to implementation of interventions.

Economic Evaluations

Economic reviews are conducted for those interventions that are recommended or strongly recommended based on the evidence-based effectiveness reviews. This approach was chosen because effectiveness is a prerequisite for cost effectiveness; therefore, effectiveness should generally be shown before economic efficiency is assessed.

What is a Cochrane Review?
NOTE: The following material is excerpted from the Cochrane website at http://www.cochrane.org/reviews/revstruc.htm
Cochrane Reviews investigate the effects of interventions for prevention, treatment and rehabilitation in a healthcare setting. They are designed to facilitate the choices that doctors, patients, policy makers, and others face in health care. Most Cochrane reviews are based on randomized controlled trials, but other types of evidence may also be taken into account, if appropriate. Cochrane Reviews have the following general features:

• A structured format helps the reader to find his/her way around the review easily.
• A detailed methods section allows the reader to assess whether the review was done in such a way as to justify its conclusions.
• The quality of clinical studies to be incorporated into a review is carefully considered, using predefined criteria.
• A thorough and systematic search strategy, which includes searches for unpublished and non-English records, aims to provide as complete a picture as possible to try to answer the question considered.
• If the data collected in a review are of sufficient quality and similar enough, they are summarized statistically in a meta-analysis, which generally provides a better overall estimate of a clinical effect than the results from individual studies. A meta-analysis also allows the reviewer to explore the effect of specific characteristics of given studies (for example, study quality) on the reported results (for example, does exclusion of non-randomized studies change the overall result?). It also allows an exploration of the effects of an intervention on sub-groups of patients (for example, does the treatment have a different effect on smokers compared with non-smokers?).
• Reviews aim to be relatively easy to understand for non-experts (although a certain amount of technical detail is always necessary). To achieve this, Review Groups like to work with “consumers”, for example patients, who also contribute by pointing out issues that are important for people receiving certain interventions. Additionally, the Cochrane Library contains glossaries to explain technical terms.
• Multinational editorial teams try to ensure that a review is applicable in different parts of the world.
• Reviews are updateable. Results from newly completed or identified clinical trials can be incorporated into the review after publication. Additionally, readers can send in comments and criticisms to any review, and reviews may be changed accordingly to improve their quality.
Structure of a Cochrane Review
This is the general layout of a Cochrane Review:
1. Synopsis – a short summary of the review, specifically aimed at lay people
2. Structured Abstract – a structured summary of the review, subdivided into similar sections as the main review. This may be published independently from the review and appears on the medical bibliographic database MEDLINE.
3. Background – this gives an introduction to the question considered, including, for example, details on causes and incidence of a given problem, the possible mechanism of action of a proposed treatment, uncertainties about management options etc.
4. Objectives – short statement of the aim of the review.
5. Selection criteria – brief description of the main elements of the question under consideration. This is subdivided into:
• Types of studies – for example, randomized controlled trials.
• Types of participants – the population of interest. This section may include details of diagnostic criteria, if desired or appropriate.
• Types of interventions – the main intervention under consideration and any comparison treatments.
• Types of outcome measures – any outcome measures/endpoints (for example, reduction in symptoms) that are considered important by the reviewer, defined in advance; not only outcome measures actually used in trials.
6. Search strategy for identification of studies – details of how an exhaustive identification of relevant information was attempted, including details of searches of electronic databases, searches for unpublished information, handsearching of journals or conference proceedings, searching of reference lists of relevant articles, etc.
7. Methods of the review – description of how studies eligible for inclusion in the review were selected, how their quality was assessed, how data were extracted from the studies, how data were analyzed, whether any subgroups were studied or whether any sensitivity analyses were carried out, etc.
8. Description of studies – how many studies were found, what were their inclusion criteria, how big were they, etc.?
9. Methodological quality of included studies – were there any reasons to doubt the conclusions of any studies because of concerns about the study quality?
10. Results – what do the data show? The results section may be accompanied by a graph to show a meta-analysis, if this was carried out.
11. Discussion – interpretation and assessment of results.
12. Reviewers’ conclusions – subdivided into Implications for practice and Implications for research.
A Multi-stage Process
Preparing and maintaining a Cochrane Review is a process with many stages. In contrast to the practices of most print journals, reviewers do in general not approach the Cochrane Editorial Base with their finished review, but the Editorial Base provides an input to the review process from the very beginning. Suggested review titles are thoroughly discussed with the Editorial Team, reviewers are then encouraged to attend a protocol workshop, which leads to the preparation and subsequent publication of a protocol, i.e. a plan of how the review will be carried out. This is followed by work on the main review, with help available for problems with statistical or methodological issues and with trials searching. The Editorial Team will also try to help with any other issues. Finally, the reviewers, with the help of the Editorial Team, are responsible for updating their review regularly (usually about once a year). At all stages of the process, the work is carefully checked by members of the Editorial Team and by external referees to ensure its quality.

 
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