D396 Evidence-Based Practice for Health and Human Services
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Free D396 Evidence-Based Practice for Health and Human Services Questions
When a Health and Human Services team uses the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to guide statewide adoption of a new youth suicide prevention curriculum, which phase specifically involves selecting two pilot counties, hiring regional trainers, and establishing data-sharing agreements with schools before any classroom delivery begins?
- Exploration
- Preparation
- Implementation
- Sustainment
Explanation
The Preparation phase in EPIS focuses on building readiness through leadership buy-in, resource allocation, staff selection, and infrastructure development. Choosing pilot counties with strong principals, securing trainer salaries through federal grants, and creating MOUs for sharing anonymous screening data ensure the curriculum launches smoothly rather than failing due to last-minute logistical gaps.
Correct Answer
Preparation
When using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to report outcomes of a school-based anxiety prevention program, which dimension specifically calculates the percentage of eligible fourth-graders who received all eight sessions out of the 1,200 students across 15 elementary schools?
- Reach
- Effectiveness
- Implementation
- Maintenance
Explanation
Implementation measures fidelity and completeness of delivery. Calculating that 82% of enrolled students completed all eight sessions (accounting for absences via makeup materials) distinguishes full-dose effects from partial exposure, showing the program's core components were delivered as designed in diverse school settings.
Correct Answer
Implementation
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
A refugee health coordinator is using the Adapted GRADE approach for humanitarian settings to rate evidence on cash-transfer programs; which factor would cause upgrading of moderate-quality observational evidence by one level if the program showed a massive 78% reduction in severe acute malnutrition across multiple crisis contexts?
- Large effect size
- Dose-response gradient
- All plausible confounding would decrease the effect
- Opposing residual confounding
Explanation
GRADE allows upgrading observational evidence when the effect is very large (RR <0.2 or >5) and consistent. A 78% reduction in severe malnutrition with cash transfers in Yemen, Syria, and Somalia meets the “large effect” criterion, increasing certainty that the intervention truly works even without RCTs in emergency settings.
Correct Answer
Large effect size
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 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
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
A refugee resettlement agency wants to implement an evidence-based mental-health intervention; using the HEXACO evidence grading system adapted for humanitarian settings, which letter grade would be assigned to a single high-quality RCT conducted in a similar refugee camp showing large reductions in PTSD symptoms sustained at 12-month follow-up?
- A
- B
- C
- D
Explanation
HEXACO grades A evidence requires at least one high-quality RCT in a comparable humanitarian context with consistent, precise results and long-term follow-up. This single rigorous trial in Syrian refugees in Jordan showing 68% remission with TF-CBT earns the highest grade, justifying immediate scale-up across East African camps.
Correct Answer
A
When applying the Template for Intervention Description and Replication (TIDieR) checklist to document a youth mentorship program for court-involved teens, which item requires specifying exactly how mentors were matched to mentees using a 12-factor compatibility algorithm based on shared interests, trauma history, and neighborhood proximity?
- How
- What (materials)
- Tailoring
- Who provided
Explanation
TIDieR item 11 “Tailoring” describes rules or decision processes for individualization. Detailing the algorithm that weighted trauma similarity at 35%, shared hobbies at 25%, and living within 3 miles at 20% explains why matched pairs met weekly for 14 months versus 3 months in random matching, achieving 82% graduation rates.
Correct Answer
Tailoring
When applying the Quality Improvement Minimum Quality Criteria Set (QI-MQCS) to appraise a published quality-improvement project on reducing wait times for disability-benefits appeals, which domain specifically evaluates whether the team used statistical process control charts to distinguish common-cause variation from special-cause improvements after implementing online submission forms?
- Organizational motivation
- Intervention rationale
- Statistical process control
- Team composition
Explanation
The QI-MQCS domain “Statistical process control” requires appropriate run charts or control charts to prove that observed 42-day reduction in processing time represented true system improvement rather than random fluctuation. Correctly identifying special-cause signals after the online-portal launch validates that the digital intervention caused the sustained change.
Correct Answer
Statistical process control
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