D396 Evidence-Based Practice for Health and Human Services
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Free D396 Evidence-Based Practice for Health and Human Services Questions
In the Theoretical Domains Framework (TDF) used to diagnose barriers to implementing motivational interviewing in substance-use treatment programs, which domain would be targeted if caseworkers report “I know MI works, but I’m afraid I’ll sound fake using the scripted reflections with clients who’ve known me for years”?
- Knowledge
- Skills
- Social/professional role and identity
- Beliefs about capabilities
Explanation
Social/professional role and identity captures conflicts between perceived professional identity (“I’m a tough-love counselor”) and new practices (MI’s non-confrontational style). Training that includes role-play with actual long-term clients and supervisor modeling helps workers integrate MI into their authentic counseling persona.
Correct Answer
Social/professional role and identity
In the Critical Appraisal Skills Programme (CASP) randomized controlled trial checklist used to evaluate a study on family therapy for adolescent substance use, which specific question assesses whether the researchers blinded both therapists and families to group assignment and used independent outcome assessors to minimize detection bias in self-reported sobriety rates?
- Was the assignment of patients to treatments randomized?
- Were the groups similar at the start of the trial?
- Were the patients, health workers, and study personnel kept "blind" to treatment?
- Besides the experimental intervention, were the groups treated equally?
Explanation
CASP question 4 "Were the patients, health workers, and study personnel kept 'blind' to treatment?" directly evaluates blinding to prevent performance and detection bias. Double-blinding therapists (to prevent technique drift) and families (to avoid expectation effects) plus blinded urine-test analysts ensures reported 6-month abstinence rates of 72% in family therapy versus 38% in individual counseling reflect true efficacy.
Correct Answer
Were the patients, health workers, and study personnel kept "blind" to treatment?
When a Health and Human Services team conducts a rapid evidence review on peer-run respite centers as alternatives to psychiatric hospitalization, which pre-appraised evidence source maintained by the Agency for Healthcare Research and Quality provides critically appraised topics with strength-of-evidence grades ready for immediate policy use?
- UpToDate
- DynaMed
- AHRQ Evidence-based Practice Center reports
- Natural Medicines Comprehensive Database
Explanation
The AHRQ Evidence-based Practice Center program produces systematic reviews and technical briefs specifically for decision-makers, complete with GRADE ratings and summary guides. Their report on peer-respite services includes tables showing moderate evidence of reduced hospitalization rates, allowing state mental-health directors to justify funding without conducting their own full review.
Correct Answer
AHRQ Evidence-based Practice Center reports
In the Critical Appraisal Skills Programme (CASP) economic evaluation checklist used to assess a cost-effectiveness study of intensive case management versus standard care for chronically homeless adults, which question specifically checks whether the researchers used quality-adjusted life years (QALYs) gained as the primary outcome and applied appropriate discounting for future costs?
- Are the results of the study valid?
- What are the results?
- Will the results help locally?
- Was the economic evaluation appropriate?
Explanation
The CASP economic question focuses on methodological rigor: correct perspective (societal), valid outcome (QALYs or DALYs), proper discounting (3–5% annually), and sensitivity analysis. A study showing intensive case management costs $18,000 per QALY gained with robust one-way and probabilistic sensitivity analysis meets gold-standard economic criteria for homelessness interventions.
Correct Answer
Was the economic evaluation appropriate?
A mental-health agency is using the Program Sustainability Assessment Tool (PSAT) to evaluate their peer-support specialist program six years post-implementation; which of the eight domains specifically measures whether community partners like NAMI chapters and crisis centers continue to refer clients and co-host monthly support groups?
- Funding stability
- Partnerships
- Organizational capacity
- Strategic planning
Explanation
The Partnerships domain assesses the strength and number of ongoing external relationships. Scoring 6.8/7 here means NAMI provides free meeting space, the local hospital refers 40 clients monthly, and three peer specialists now sit on community coalitions—evidence that the program has become embedded in the local service ecosystem.
Correct Answer
Partnerships
When applying the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to a study on lived experiences of kinship caregivers raising grandchildren with fetal alcohol spectrum disorders, which domain requires the research team to disclose their own backgrounds as former foster parents or child-welfare workers that might influence interview questions?
- Research team and reflexivity
- Data collection
- Data analysis
Explanation
COREQ Domain 1 “Research team and reflexivity” mandates explicit statements about researchers’ credentials, occupation, gender, experience, and relationship with participants. A social worker-turned-researcher acknowledging 15 years in child welfare explains why certain follow-up probes focused on navigating school IEPs rather than medical appointments.
Correct Answer
Research team and reflexivity
When applying the Practical, Robust Implementation and Sustainability Model (PRISM) to sustain a domestic-violence shelter’s legal advocacy program, which contextual factor specifically addresses whether local judges consistently grant emergency protective orders when advocates submit the new standardized petition packet?
- External environment
- Organizational characteristics
- Patient characteristics
- Implementation infrastructure
Explanation
External environment in PRISM includes policies, regulations, and community partners. Tracking that protective-order approval rose from 64% to 93% after standardized packets aligns with judges’ preferences, showing the advocacy program successfully influenced the broader justice system context.
Correct Answer
External environment
In the PARiHS framework frequently used in Health and Human Services to implement evidence-based practices, which core element specifically examines whether the new domestic-violence risk-assessment tool has strong research backing, clinical consensus, and matches survivor preferences gathered through focus groups?
- Evidence
- Context
- Facilitation
- Innovation
Explanation
The Evidence element in PARiHS triangulates three sources: research (RCTs, systematic reviews), clinical experience (expert consensus), and patient experience (survivor input). A tool scoring high across all three is far more likely to be adopted than one relying solely on academic studies without practitioner or survivor buy-in.
Correct Answer
Evidence
A mental-health coordinator is formulating a foreground question for an evidence search on reducing seclusion use in adolescent residential treatment; using the SPIDER tool designed for qualitative and mixed-methods research, which component replaces the traditional PICO “Intervention” category to better capture lived-experience studies?
- Sample
- Phenomenon of Interest
- Design
- Evaluation
- Research type
Explanation
SPIDER replaces Intervention with “Phenomenon of Interest” to accommodate qualitative inquiries. Here, the phenomenon is “experiences of seclusion and restraint among adolescents in residential care,” allowing inclusion of powerful phenomenological studies that reveal how youth perceive locked-door timeouts versus purely quantitative restraint-rate trials.
Correct Answer
Phenomenon of Interest
A foster-care agency is applying the California Evidence-Based Clearinghouse (CEBC) rating system to select a parenting program; which scientific rating indicates that at least two rigorous randomized trials by independent investigators showed significant positive effects sustained at 12-month follow-up?
- 1 - Well-supported by research evidence
- 2 - Supported by research evidence
- 3 - Promising research evidence
- NR - Not able to be rated
Explanation
CEBC rating 1 requires multiple high-quality RCTs by different research teams with sustained effects. Programs like Parent-Child Interaction Therapy (PCIT) earn this top rating for reducing child maltreatment recidivism by 40–50% at one year, giving agencies confidence to replace untested curricula.
Correct Answer
1 - Well-supported by research evidence
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