Critical Appraisal Of Research Discussion

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

Review the Resources and consider the importance of critically appraising research evidence.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

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Evaluation Table

Full *citation* of selected article	Article #1	Article #2	Article #3	Article #4
	Mckelvey, L. M., Edge, N. A., Fitzgerald, S., Kraleti, S., & Whiteside-Mansell, L. (2017). Adverse childhood experiences: Screening and health in children from birth to age 5. Families, Systems, & Health, 35(4), 420-429. doi:10.1037/fsh0000301	Melville, A. (2017). Adverse Childhood Experiences from Ages 0–2 and Young Adult Health: Implications for Preventive Screening and Early Intervention. Journal of Child & Adolescent Trauma, 10(3), 207-215. doi:10.1007/s40653-017-0161-0	Schofield, T. J., Donnellan, M. B., Merrick, M. T., Ports, K. A., Klevens, J., & Leeb, R. (2018). Intergenerational Continuity in Adverse Childhood Experiences and Rural Community Environments. American Journal of Public Health, 108(9), 1148-1152. doi:10.2105/ajph.2018.304598	Zare, M., Narayan, M., Lasway, A., Kitsantas, P., Wojtusiak, J., & Oetjen, C.A. (2018). Influence of adverse childhood experiences on anxiety and depression in children aged 6 to 11 years. Pediatric Nursing, 44(6), 267-274, 287.
*Conceptual Framework* Describe the theoretical basis for the study	Childhood toxic stress, precipitated by ACEs, is associated with biological changes in the developing brain and body that affect concurrent and long-term health and behavior.	Exposure to adversity, such as trauma, neglect, and abuse, in childhood has been identified as a major global public health issue. I chose this article because it focused on the assessment of ACEs that occurred in the early development of children. It explored the short and long-term impacts of childhood adversity during specific developmental periods, such as infancy and toddlerhood.	ACEs show intergenerational continuity and their impact on health and well-being can be repeated across generations. I chose this research article because it focused on reducing or preventing ACEs and its potential to produce long-lasting beneﬁts in both the physical/mental health and quality of life across generations. How effective is breaking the chain in a long history of trauma and other childhood adversities?	I chose this last research article because it examined the association of adverse childhood experiences with depression and anxiety in children aged 6 to 11 years old. The article explains that when children experience prolonged stressors such as ACEs, both a chemical and physical change can occur which can alter the neural pathways and the metabolic processes. This can lead to lifelong issues both with mental health and chronic illnesses.
*Design/Method* Describe the design and how the study was carried out	The survey asked all respondents the same questions in the same order to allow for statistical analysis. The survey gathered a narrow amount of information, 10 yes or no questions, from a large number of respondents. All of the questions were closed questions for quantification in order to be coded and processed quickly. This study used data collected for the evaluation of voluntary home visiting services funded through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program in the state of Arkansas. This study examined whether there is evidence to support a screening approach that assesses children’s current exposures to risks that act as precursors for ACEs, measured in a way that falls below a threshold of explicit abuse, neglect, or illegal behavior.	Mixed-methods research- The study examined the relationship between ACEs measured from age 0–2 and adult health outcomes using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) dataset which pull data from five national data collection sites. The data included past ACE scores as well as CPS reports and self-proclaimed adverse childhood experiences. Critical Appraisal Of Research Discussion	Quantitative research – During each assessment period, professional interviewers made home visits to each family for approximately 2 hours on 2 occasions. At each visit, father, mother, and adolescent independently completed a set of questionnaires in separate rooms covering an array of topics related to work, ﬁnances, school, family life, mental and physical health status, and social relationships.	Quantitative research – This article used data already collected by the National Survey of Children’s Health (NSCH). The NSCH collected interviews randomly all over the US of 95,677 children. This article took those surveys that applied to children aged 6-7 which included 31,060 children. The article focused further on only depression and anxiety relevant answers. Coding the answer as no or yes. Then that data was correlated with ACEs scores received from the same survey.
*Sample/Setting* The number and characteristics of patients, attrition rate, etc.	2,004 participants Families were eligible for services if they reported at least one of the following risks: low income (250% of federal poverty), homelessness, single and/or teen (aged 19 or younger) parent(s), parent mental illness, substance abuse, incarceration, military deployment, disability, suspected child maltreatment (based on referrals from child-protective services), child developmental delay, preterm/low-birth weight, or chronic illness.	139 participants Child Maltreatment Physical Abuse 17.4% (24), Emotional Abuse 8% (11), Physical Neglect 8.7% (12), Household Dysfunction Caregiver mental illness 35.5% (49), Substance use 34.8% (48), Caregiver treated violently 40.3% (60), Criminal household member 3.6% (5), Caregiver separation/divorce 11.6% (16).	451 two-parent families via telephone through the cohort of all seventh-grade students (aged 12–13 years) in 8 counties in north central Iowa who were enrolled in public or private schools during winter and spring of 1989. An additional criterion for inclusion in the study was the presence of a sibling within 4 years of age of the focal seventh grader. Seventy-seven percent of the eligible families agreed to participate in the study. We ﬁrst conducted interviews in 1989 with adolescents (G2) and their parents (G1) when they were in seventh grade.	The NSCH was conducted using telephone numbers that were dialed at random to identify households with children under 18 years old. In total, interviewers contacted 847,881 households, of which 87,422 households had age-eligible children, and interviews were completed on 95,677 children. The sample for the analysis included only children between the ages of 6 and 11 years. This subsample included 31,060 children.
*Major Variables Studied* List and define dependent and independent variables	Demographic controls and family resources scale scores. Below poverty line. Primary caregivers were 28 years of age (range = 13–74), White (60%), and had a high school education or less (61%). Children were 32 months of age (range = 13–76 months) and approximately half (51%) were male.	ACEs Measured early childhood ACE categories of child maltreatment were physical abuse, emotional abuse, and physical neglect. Household dysfunction was measured by caregiver mental illness, caregiver treated violently, incarceration, substance abuse, and parental separation or divorce. Traditional ACE categories of sexual abuse and emotional neglect were not measured due to limited variance of available data	ACEs items included indicators of abuse (physical, sexual, emotional), emotional neglect, and other household challenges (parent treated violently by spouse, household substance abuse, household mental illness, and parental separation or divorce). Community characteristics (block group level) Low socioeconomic status 6.42 (3.07), Population density (people per mi2) 227.93 (493.49), Perceived lack of community services (scale 1–4) 3.09 (0.29), Perceived community social cohesion (scale 1–4) 3.00 (0.27), Alcohol vendor density (vendors per km2) 4.13 (7.76)	outcome variable, namely depression and/or anxiety. Sociodemographic variables included race/ethnicity (Hispanic, White non-Hispanic, Black non-Hispanic, and Other; “Other” includes Asian, Ameri can Indian, Native Alaskan, Native Hawaiian, Other Pacific Islander and multi-racial children), family structure (two biological parents, parent and step-parent, single mother-no father, other family type), sex (male, female), and poverty level (0% to 99% Federal Poverty Level (FPL), 100% to 199% FPL, 200% to 399% FPL, 400% FPL or greater). The variable poverty level was constructed based on household income reported in the NSCH.
*Measurement* Identify primary statistics used to answer clinical questions	Using logistic regressions to examine the association between FMI-ACE groups (i.e., children in families with scores of 0, 1, 2, 3, and 4 or more FMI-ACEs) and health outcomes. Odds ratios reported in previous ACE work were used to inform power estimates for logistic regression.	Logistic regression was used to explore whether overall ACE score at age two as well as individual ACE categories predicted health worry and overall health. Both models utilized control variables of child race/ethnicity, gender, and income. Almost half of the sample in this study experienced two or more ACEs between the ages of 0 and 2. The central finding of this study was that early childhood ACEs, experienced from age 0–2, predicted health worries in adulthood.Critical Appraisal Of Research Discussion	During each assessment period, professional interviewers made home visits to each family for approximately 2 hours on 2 occasions. At each visit, father, mother, and adolescent independently completed a set of questionnaires in separate rooms covering an array of topics related to work, ﬁnances, school, family life, mental and physical health status, and social relationships. Assessments occurred when the adolescent was in 7th, 8th, 9th, 10th, and 12th grade, as well as a year later, when the adolescents averaged 18 years of age.	The nine adverse childhood experiences included: •How often has it been hard to get by on your family’s income, such as having enough money for basics like food or housing? •Did [child’s name] ever live with a parent or guardian who got divorced or separated after [he/she] was born? •Did [child’s name] ever live with a parent or guardian who died? •Did [child’s name] ever live with a parent or guardian who served time in jail or prison after [child’s name] was born? •Did [child’s name] ever see or hear any parents, guardians, or any other adults in [his/her] home slap, hit, kick, punch, or beat each other up? •Was [child’s name] ever the victim of violence or witnessed any violence in [his/her] neighborhood? •Did [child’s name] ever live with anyone who was mentally ill or suicidal, or severely depressed for more than a couple of weeks? •Did [child’s name] ever live with anyone who had a problem with alcohol or drugs? •Was [child’s name] ever treated or judged unfairly because of [his/her] race or ethnic group?