D396 Evidence-Based Practice for Health and Human Services
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Free D396 Evidence-Based Practice for Health and Human Services Questions
A county human-services agency is using the RE-AIM framework to evaluate their new telehealth mental-health program for rural families; which RE-AIM dimension specifically measures the proportion of eligible families who actually enrolled and completed at least one session?
- Reach
- Effectiveness
- Adoption
- Implementation
Explanation
Reach quantifies the percentage of the target population that participates in the intervention. For rural telehealth, tracking how many eligible families with children on Medicaid actually signed up and attended reveals access barriers such as broadband availability or stigma, guiding future outreach efforts.
Correct Answer
Reach
In the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Plus Equity extension used for public-health programs, which additional equity-focused dimension specifically tracks whether the vaccination outreach program achieved equal uptake among Spanish-speaking families compared to English-speaking families in the same zip codes?
- Equity in reach
- Disparities in effectiveness
- Representativeness
- Equity in maintenance
Explanation
Equity in reach examines differential participation by marginalized groups. Finding that only 12% of delivered vaccine doses went to Spanish-speaking residents despite them comprising 38% of the population reveals language-access gaps, prompting same-day interpreter hiring and Spanish text campaigns.
Correct Answer
Equity in reach
When using the iCAHE Critical Appraisal Tool to evaluate a cohort study on long-term employment outcomes for youth aging out of foster care, which domain awards the highest points when follow-up exceeds 36 months with less than 10% attrition and active tracking of hard-to-reach participants through multiple contact methods?
- Study design
- Participant recruitment
- Data collection
- Follow-up
Explanation
The Follow-up domain in iCAHE recognizes that longitudinal child-welfare research faces massive dropout risks; studies achieving >90% retention at 36+ months through phone, social media, and collateral contacts provide the most reliable evidence on whether independent-living programs truly improve employment trajectories into adulthood.
Correct Answer
Follow-up
A mental health clinic is applying the Society for Implementation Research Collaboration (SIRC) Instrument Review Project criteria to select a fidelity measure for dialectical behavior therapy; which criterion requires the tool to have at least three published studies showing inter-rater reliability above 0.80 using independent coders on real therapy sessions?
- Pragmatic
- Psychometric
- Training requirements
- Adherence vs competence
Explanation
SIRC psychometric criterion demands strong evidence of reliability and validity across multiple sites. The DBT Adherence Coding Scale meets this threshold with ICC = 0.87 across 2,400 sessions coded by raters blind to outcomes, ensuring consistent measurement of whether therapists actually delivered skills training versus generic support.
Correct Answer
Psychometric
When using the Behaviour Change Techniques Taxonomy (BCTTv1) to code components of a successful text-message intervention that increased attendance at parenting classes for court-ordered fathers, which specific technique involves sending messages that highlight how other similar dads successfully completed the program and improved relationships with their children?
- Instruction on how to perform the behavior
- Social comparison
- Credible source
- Goal setting
Explanation
BCTTv1 technique 6.1 “Social comparison” uses observational learning by showing that peers with similar backgrounds have succeeded. Messages like “Last month, 47 other dads in your county finished all 12 classes and now have unsupervised visits—join them!” leverage normative influence to boost motivation and attendance.
Correct Answer
Social comparison
When a Health and Human Services researcher uses the Template for Intervention Description and Replication (TIDieR) checklist to fully document a home-visiting program for first-time mothers on Medicaid, which specific item requires describing any unplanned changes such as switching from in-person to virtual visits during a COVID surge while maintaining the same curriculum content?
- Tailoring
- Modifications
- Fidelity
- Planned intervention
Explanation
TIDieR item 12 “Modifications” mandates reporting any changes made during the study period. Documenting that visits 6–12 shifted to HIPAA-compliant Zoom with mailed activity kits while keeping core parenting modules unchanged allows accurate replication and explains why retention remained 87% despite pandemic restrictions.
Correct Answer
Modifications
When a Health and Human Services quality-improvement team applies the Johns Hopkins Nursing Evidence-Based Practice Model to integrate teletherapy for rural dementia caregivers, which specific level in their evidence-rating scale would a Level I systematic review of multiple RCTs receive as the highest designation for strength and quality?
- Level II
- Level III
- Level I
- Level IV
Explanation
Johns Hopkins rates evidence on an A–E quality scale within Levels I–V, with Level I (experimental studies or systematic reviews of RCTs) receiving the highest designation due to rigorous design minimizing bias. This positions teletherapy reviews as gold-standard for caregiver-support protocols, justifying agency-wide adoption.
Correct Answer
Level I
A child-protective services supervisor is searching Cochrane Library for evidence on family preservation programs; which specific Cochrane resource contains plain-language summaries written for consumers and frontline workers rather than researchers?
- Cochrane Database of Systematic Reviews
- Cochrane Central Register of Controlled Trials
- Cochrane Clinical Answers
- Cochrane Consumer Network summaries
Explanation
Cochrane Clinical Answers and consumer summaries translate complex review findings into short, actionable statements with color-coded certainty ratings (green = high confidence). For family preservation, a supervisor can quickly learn that “intensive 6-month programs probably reduce out-of-home placements by 25%” without deciphering statistical forest plots.
Correct Answer
Cochrane Clinical Answers
In the Joanna Briggs Institute framework commonly used in Health and Human Services for appraising evidence from cross-sectional surveys about community needs, which specific domain directly evaluates whether the researchers used valid and reliable statistical methods to identify and control for potential confounding variables in their analysis?
- Criteria for inclusion clearly defined
- Statistical analysis appropriate
- Confounding factors identified and strategies to deal with them described
- Response rate reported and managed
Explanation
The Joanna Briggs Institute checklist for analytical cross-sectional studies includes the explicit domain “Confounding factors identified and strategies to deal with them described” because community surveys in Health and Human Services often face multiple variables (age, income, education) that can distort true relationships. Proper multivariable regression, stratification, or propensity-score matching ensures that observed associations—such as between food insecurity and child welfare involvement—reflect genuine causal pathways rather than hidden confounders.
Correct Answer
Confounding factors identified and strategies to deal with them described
In the Ottawa Charter framework frequently applied in Health and Human Services for community-based interventions, which action area specifically calls for creating supportive environments by modifying physical spaces, policies, and social norms to make healthy choices the default for vulnerable populations?
- Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
Explanation
Create supportive environments is one of the five Ottawa Charter strategies that emphasizes redesigning settings—housing complexes, food pantries, transportation systems—so that healthier behaviors become easier than unhealthy ones. For example, placing fresh-produce refrigerators in emergency shelters or installing walking paths in public-housing courtyards directly supports nutrition and physical activity without requiring extra motivation from low-income residents.
Correct Answer
Create supportive environments
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