7/17/19, 11'24 PMEvidence–Based Health Evaluation and Application Transcript Page 1 of 3http://media.capella.edu/CourseMedia/MSN6011/evidenceBasedHealthEvaluation/transcript.html Evidence–Based Health Evaluation and Application Introduction Public health improvement initiatives (PHII) provide invaluable data for patient–centered care, but their research is often conducted in a context different from the needs of any individual patient. Providers must make a conscious effort to apply their findings to specific patients' care. In this activity, you will learn about a PHII, and explore its application to a particular patient's care plan. Overview You continue in your role as a nurse at the Uptown Wellness Clinic. You receive an email from the charge nurse, Janie Poole. Click the button to read it. Good morning! At last week's conference I spoke with Alicia Balewa, Director of Safe Headspace. They're a relatively new nonprofit working on improving outcomes for TBI patients, and I immediately thought of Mr. Nowak. At his last biannual cholesterol screening he mentioned having trouble with his balance. This may be related to his hypertension, but he believes it's related to the time he was hospitalized many years ago after falling out of a tree, and expressed distress that this might be the beginning of a rapid decline. Ms. Balewa will be on premises next week, and I'd like to set aside some time for you to talk. — Janie Alicia Balewa Director of Safe Headspace Overview Interview Alicia Balewa to find out more about a public health improvement initiative that might apply to Mr. Nowak's care. Interview: I have a patient who might benefit from some of the interventions for TBI and PTSD you recently studied. What populations did your public health improvement initiative study? 7/17/19, 11'24 PMEvidence–Based Health Evaluation and Application Transcript Page 2 of 3http://media.capella.edu/CourseMedia/MSN6011/evidenceBasedHealthEvaluation/transcript.html My father came home from Vietnam with a kaleidoscope of mental health problems. That was the 1970s, when treatment options for things like PTSD, TBI, and even depression were very different. Since then there has been a lot of investment in treatment and recovery for combat veterans. That's excellent news for veterans in treatment now, but they're not looking at my dad, and how his TBI and PTSD have affected him through mid–life and now as a senior. That's why I started Safe Headspace: to focus on older patients who are years or decades past their trauma, and find ways to help them. Which treatments showed the strongest improvement? Exercise. We were able to persuade about half of our participants — that's around 400 people, mostly men ages 45–80 — to follow the CDC's recommendations for moderate aerobic exercise. Almost everyone showed improvement in mood, memory, and muscle control after four weeks. After that a lot of participants dropped out, which is disappointing. But of t ...

1. 7/17/19, 11'24 PMEvidence–Based Health Evaluation and
Application Transcript
Page 1 of
3http://media.capella.edu/CourseMedia/MSN6011/evidenceBase
dHealthEvaluation/transcript.html
Evidence–Based Health Evaluation and Application
Introduction
Public health improvement initiatives (PHII) provide invaluable
data for patient–centered care, but their research is often
conducted in a context
different from the needs of any individual patient. Providers
must make a conscious effort to apply their findings to specific
patients' care.
In this activity, you will learn about a PHII, and explore its
application to a particular patient's care plan.
Overview
You continue in your role as a nurse at the Uptown Wellness
Clinic. You receive an email from the charge nurse, Janie Poole.
Click the button to read
it.
Good morning!
At last week's conference I spoke with Alicia Balewa, Director
of Safe Headspace. They're a relatively new nonprofit working

2. on improving outcomes
for TBI patients, and I immediately thought of Mr. Nowak. At
his last biannual cholesterol screening he mentioned having
trouble with his balance. This
may be related to his hypertension, but he believes it's related to
the time he was hospitalized many years ago after falling out of
a tree, and
expressed distress that this might be the beginning of a rapid
decline.
Ms. Balewa will be on premises next week, and I'd like to set
aside some time for you to talk.
— Janie
Alicia Balewa
Director of Safe Headspace
Overview
Interview Alicia Balewa to find out more about a public health
improvement initiative that might apply to Mr. Nowak's care.
Interview:
I have a patient who might benefit from some of the
interventions for TBI and PTSD
you recently studied. What populations did your public health
improvement initiative
study?

3. 7/17/19, 11'24 PMEvidence–Based Health Evaluation and
Application Transcript
Page 2 of
3http://media.capella.edu/CourseMedia/MSN6011/evidenceBase
dHealthEvaluation/transcript.html
My father came home from Vietnam with a kaleidoscope of
mental health problems. That was the 1970s, when treatment
options for things like PTSD,
TBI, and even depression were very different. Since then there
has been a lot of investment in treatment and recovery for
combat veterans. That's
excellent news for veterans in treatment now, but they're not
looking at my dad, and how his TBI and PTSD have affected
him through mid–life and
now as a senior. That's why I started Safe Headspace: to focus
on older patients who are years or decades past their trauma,
and find ways to help
them.
Which treatments showed the strongest improvement?
Exercise. We were able to persuade about half of our
participants — that's around 400 people, mostly men ages 45–80
— to follow the CDC's
recommendations for moderate aerobic exercise. Almost
everyone showed improvement in mood, memory, and muscle
control after four weeks. After
that a lot of participants dropped out, which is disappointing.
But of the 75 who stuck with it for another three months,
muscle control improved 15%,
mood improved 22%, and short–to–medium term memory
improved 61%. We didn't specify what kind of exercise, but we
did ask them to record
what they did every week, so that data is available.

4. Second was medication and therapy. Most of our participants
didn't receive any kind of psychotherapy in the years
immediately following their
trauma, so we had everyone assessed by a team of
psychotherapists. As a result of those assessments, 40% of
participants started on anti–
depressant medication and 9% started taking anti–psychotics.
Those who started taking medications now have regular contact
with a therapist to
manage that care. With some help at home to stick to the
regimen, all but a few have successfully followed their
treatment plans. They've reported a
26% improvement in mood over six months, and a 6%
improvement in memory.
The third treatment I want to mention is meditation. We only
had a small group interested in trying it, but the results were
dramatic. We prescribed
daily meditation at home, just 10 to 15 minutes, with a weekly
hour–long guided group meditation for all 23 participants. After
three weeks we lost two
to disinterest, but the other 21 showed improvements of over
70% in mood and memory, and 32% in muscle control.
Have you tried anything that hasn't worked?
Sure. There are memory exercises for patients in elderly care,
and things like Sudoku and crossword puzzles. We didn't see
any gains with those.
Some of our participants preferred strength training to aerobic
exercise, and the only improvement we saw in that group was in
muscle control, but
only 4%, which is significantly less than the aerobic group.
I should also say that we were working with a willing group of

5. participants. They knew they needed help, and were motivated
to get it. One of the
hurdles we see with veterans, especially in older generations, is
an unwillingness to acknowledge that they have a problem. We
haven't had to wrestle
with that because everyone who volunteers to participate wants
to be there.
Your organization is intervening with people who have TBI and
PTSD simultaneously.
We have a patient with moderate TBI suffered almost 40 years
ago, but no history of
PTSD. Have you separated your population and studied each
separately?
We haven't, no. In some cases we could, for those who come in
with previous diagnoses and medical records. But we have
participants who either
weren't diagnosed, were under–diagnosed at the time, or don't
have records to show us.
Conclusion
As you've seen, a PHII can apply to a patient under your care.
But it's not always a perfect fit, and it's
important to think carefully about how your patient's condition,
symptoms, background, and experience
compare to that of participants in a PHII.
You may find it helpful to download the responses you made in
this activity.
Credits

6. 7/17/19, 11'24 PMEvidence–Based Health Evaluation and
Application Transcript
Page 3 of
3http://media.capella.edu/CourseMedia/MSN6011/evidenceBase
dHealthEvaluation/transcript.html
Subject Matter Expert:
Bressie, Marylee
Interactive Design:
Olson, Lori
Media Instructional Designer:
Dolezalek, Holly
Instructional Designer:
Hagen, Brian
Project Manager:
Hall, Nakeela
Licensed under a Creative Commons Attribution 3.0 License
(http://creativecommons.org/licenses/by-nc-nd/3.0/)
http://creativecommons.org/licenses/by-nc-nd/3.0/
Overview
Write a report on the application of population health
improvement initiative outcomes to patient-centered care, based
on information presented in an interactive multimedia scenario.
In this assessment, you have an opportunity to apply the tenets
of evidence-based practice in both patient-centered care and

7. population health improvement contexts. You will be challenged
to think critically, evaluate what the evidence suggests is an
appropriate approach to personalizing patient care, and
determine what aspects of the approach could be applied to
similar situations and patients.
By successfully completing this assessment, you will
demonstrate your proficiency in the following course
competencies and assessment criteria:
· Competency 1: Apply evidence-based practice to plan patient-
centered care.
. Evaluate the outcomes of a population health improvement
initiative.
. Develop an approach to personalizing patient care that
incorporates lessons learned from a population health
improvement initiative.
· Competency 2: Apply evidence-based practice to design
interventions to improve population health.
. Propose a strategy for improving the outcomes of a population
health improvement initiative, or for ensuring that all outcomes
are being addressed, based on the best available evidence.
· Competency 3: Evaluate outcomes of evidence-based
interventions.
. Propose a framework for evaluating the outcomes of an
approach to personalizing patient care and determining what
aspects of the approach could be applied to similar situations
and patients.
· Competency 4: Evaluate the value and relative weight of
available evidence upon which to make a clinical decision.
. Justify the value and relevance of evidence used to support an
approach to personalizing patient care.
· Competency 5: Synthesize evidence-based practice and
academic research to communicate effective solutions.
. Write clearly and logically, with correct grammar and
mechanics.
. Integrate relevant and credible sources of evidence to support

8. assertions, correctly formatting citations and references using
APA style.
Required Resources
The following resources are required to complete the
assessment.
Evidence-Based Practice
· Evidence-Based Health Evaluation and Application(See
attachment).
Assessment Instructions
Preparation
In this assessment, you will base your Patient-Centered Care
Report on the scenario presented in the Evidence-Based Health
Evaluation and Application media piece. Some of the writing
you completed and exported from the media piece should serve
as pre-writing for this assessment and inform the final draft of
your report. Even though the media piece presented only one
type of care setting, you can extrapolate individualized care
decisions, based on population health improvement initiative
outcomes, to other settings.
Requirements
Note: The requirements outlined below correspond to the
grading criteria in the scoring guide, so be sure to address each
point. In addition, you may want to review the performance
level descriptions for each criterion to see how your work will
be assessed.
Writing, Supporting Evidence, and APA Style
· Write clearly and logically, using correct grammar and
mechanics.
· Integrate relevant evidence from 3–5 current scholarly or
professional sources to support your evaluation,
recommendations, and plans.
. Apply correct APA formatting to all in-text citations and

9. references.
. Attach a reference list to your report.
Report Content
Address the following points in a 4 page report:
· Evaluate the expected outcomes of the population health
improvement initiative that were, and were not, achieved.
. Describe the outcomes that were achieved, their positive
effects on the community's health, and any variance across
demographic groups.
. Describe the outcomes that were not achieved, the extent to
which they fell short of expectations, and any variance across
demographic groups.
. Identify the factors (for example: institutional, community,
environmental, resources, communication) that may have
contributed to any achievement shortfalls.
· Propose a strategy for improving the outcomes of the
population health improvement initiative, or ensuring that all
outcomes are being addressed, based on the best available
evidence.
. Describe the corrective measures you would take to address
the factors that may have contributed to achievement shortfalls.
. Cite the evidence (from similar projects, research, or
professional organization resources) that supports the corrective
measures you are proposing.
. Explain how the evidence illustrates the likelihood of
improved outcomes if your proposed strategy is enacted
· Develop an approach to personalizing patient care that
incorporates lessons learned from the population health
improvement initiative outcomes.
. Explain how the outcomes and lessons learned informed the
decisions you made in your approach for personalizing care for
the patient with a health condition related to the population
health concern addressed in the improvement initiative.
. Ensure that your approach to personalizing care for the
individual patient addresses the patient's:
. Individual health needs.

10. . Economic and environmental realities.
. Culture and family.
· Incorporate the best available evidence (from both the
population health improvement initiative and other relevant
sources) to inform your approach and actions you intend to take.
· Justify the value and relevance of evidence you used to
support your approach to personalizing care for your patient.
· Explain why your evidence is valuable and relevant to your
patient's case.
· Explain why each piece of evidence is appropriate for both the
health issue you are trying to correct and for the unique
situation of your patient and their family.
· Propose a framework for evaluating the outcomes of your
approach to personalizing patient care.
· Ensure that your framework includes measurable criteria that
are relevant to your desired outcomes.
· Explain why the criteria are appropriate and useful measures
of success.
· Identify the specific aspects of your approach that are most
likely to be transferable to other individual cases.