The following is our PICO question. The literature review needs to be based on a randomized control study I have attached below
It is well understood that birthing plans should address the significant changes a woman undergoes both physically and mentally during pregnancy. Traditional postpartum treatment may consist of follow-up visits with health care providers and mental health professionals as well as participation in support groups (Lowdermilk et al., 2020). We’ve also learned in our nursing Mental Health course that regular mindfulness and meditation practices can help reduce and manage stress, anxiety, and depression (Halter & Fratena, 2023). The question remains, however, about the effects of mindfulness during the perinatal period of pregnant women – specifically the long-term effects postpartum. To investigate this, we have developed the following PICO(t) question:
Does mindfulness training during pregnancy contribute to a reduction in long-term maternal mental health problems compared to traditional postpartum mental health care?
P: postpartum women
I: mindfulness training during pregnancy
C: traditional postpartum mental health care
O: reduction in mental health problems
T: long-term
Example of what I am needing:
Analysis of Strengths and Weaknesses
Introduction
This analysis of strengths and weaknesses relates to the article by Tingey et al. (2021). The intention of
this randomized clinical trial (RCT) was to determine if the Respecting the Circle of Life program (RCL)
implemented to Native American youths, ages 11 to 19, residing in a rural reservation community in the
southwestern United States, was effective in prevention of unwanted pregnancy and sexually transmitted
diseases (Tingey et al., 2021).
Overall Strengths and Weaknesses
The RCL program showed evidence of significant improvements in the prevention of pregnancy and
sexually transmitted diseases in Native American youth (Tingey et al., 2021). This RCT utilized
participants from a single reservation so it is not representative of all Native American youths. Response
bias is another weakness as responses were self-reported by the participants.
Reliability and Validity
This study analyzed its data using the proven methods of logistic regression for binary variables or
outcomes and linear regression for continuous variables. The probability of a statistically significant
difference between groups or variables was assigned to be p< 0.05. Bias was minimized by controlling all
analyses for both age and gender. While missing data can be another source of bias, the researchers in this
study mitigated that possibility by populating missing data through logical imputation. Additionally,
outcome measures comparing groups were generated with 95% confidence intervals to show that
differences were unlikely to have arisen by chance (p<0.05). Their use of proven methods for analysis and
non-overlapping confidence intervals in study outcomes establishes reasonable reliability, but authors
describe limited generalizability to similar Native American populations elsewhere in the US as a
limitation. Test-retest reliability in their sample was not determined.
Two possible concerns affecting the study’s validity were loss to followup and lack of details on
randomization. Study authors state that randomization was performed by “individual randomization”
following which youth self-sorted into peer groups, but did not provide details on how this was done
(Tingey et al., 2021). Randomization, when done appropriately, serves to eliminate selection bias which is
a threat to internal validity (LoBiondo-Wood & Haber, 2022). The lack of information provided by the
authors thus served to threaten the study’s validity. Additionally, a loss to follow-up of 16.5% by 12
months decreased the study’s power.
Ethics
This study was approved by the institutional review board of the Johns Hopkins University School of
Public Health. This study has been approved by the participating tribal community’s Health Advisory
Board and Tribal Council. All participants provided informed consent (Tingey et al., 2021). Topic,
Summary
This topic evaluated the efficacy of the Respecting The Circle of Life program (RCL) among Native
American youths in a rural reservation community. The RCL program showed evidence of improving
numerous domains for prevention of pregnancy and STIS among Native youths (Tingey et al., 2021).
Intervention participants had significantly better condom use self-efficacy, higher intentions to use
condoms and obstain from sex. The RCL program made an important contribution to the field of
adolescent pregnancy prevention