A Significant Role in the Adult's Health - Research Paper Example

Critiques on Long term retention of older adults in the Cardiovascular Health Study The research problem of the study is stated in paragraphs one, two and three. The statement of purpose in the study is indicated as in the objective that is "to describe retention by age and visit type (clinic, home, and phone) and to determine characteristics associated with visit types for a longitudinal epidemiologic study in older adults". The study has specified the research question which is to find out whether retention at repeated in person visits plays a significant role in the adults health. The research question in this study is not well stated since it does not bring out a clearer instant understanding of what the research was intended for. The study reports a hypothesis that the visits that are undertaken for the older age in the cardiovascular study is related to main demographic, lifestyle, health and function participant traits and that the oldest age would have the poorest retention for in-person visits, particularly clinic visits. The hypothesis of the study is directional as it has taken a stand on the subject matter which is yet to be determined. However, it is a complex one since the measurement methods would not be easy in terms of tool applications. It also requires the application of more than one tool for its determination. It was tested using the face to face interviews, phone interviews, as well as personal visits. This was also done through sampling from Medicare eligibility lists, non-institutionalized, ambulatory men and women aged 65 and above. During the study, men and women of age 65 and older got enrolled including the 5201 at 4 US field centers. These formed a mean enrollment age of 73 years with a range of 65-100 forming 58%, 16 % being black. The first phase took place in 1989 to 1990 with the addition of 687 African-American participants in the year 1992 to 93. The participants were taken through an extensive baseline evaluation. This included the laboratory assessments, physical and cognitive functioning and medical history. All these components were repeated at the annual clinic visits through 1998 to 1999. The total population of the study of surviving participants throughout the time was, N=43,772. By the year 2005-06, the entire population was re-recruited in order to reevaluate physical and cognitive functioning and reassess functional status. In this case, the median age was 85 while the range was 77-102 of which 67% were women, and 17% were black (Strotmeyer, et al., 2010). The study in this case was quasi-experimental since it involved the determination of the already assumed case. The research design here is appropriate since it will offer a comparative analysis and conclusions of the results established over a wide range of time covering a wider population over time. It will give an accurate finding due to the spread of the samples over a wide area and race. Other designs such as a longitudinal survey are equally appropriate for such studies and can as well offer valid conclusions when properly employed to accurately gather data over a wide area. In this study, power analysis was not employed in the determination of the sample size. As such the likelihood of committing a Type II error in the study was eminent. The implication of the presence of power analysis is that that when used a positive effect size is obtained in conditions where the postulated parameter value postulated is greater than the value of the parameter in the null hypothesis. It investigates the optimal allocation of study resources increasing the probability of the successfulness of the study. The degree of inference justification by the research methods is enhanced by the use of power size analysis that enabled the achievement of the target parameter in the study from a population sample. It also enables the avoidance of the Type II errors due to the power determination of a given sample size, effect size and other study parameters. The sampling procedure will determine the characteristics of the population through the use of the Pearsons correlation that ensures the degree of association between and among the variables in the study. The population of the study all went through the examination on psychological, medical factors, blood pressure among others that ensures the consistency in the correlation among the variable. The sampling criteria on the basis of age group provides an almost a constant finding about the directional hypothesis under the consideration. The interventions as provided in this study do not provide control measures for the situation. However, it emphasizes the importance of such visits in order that one will be able to have a proper preventive measures when under the visitation than those who are not. It encourages the checking of the rates of health, depreciation, medication and hospitalization when necessary thereby offers a better option for the aged. The research method shows a wider variation in a kind of population used, the fact that registers the inference to be true for broader groups. Another reason in the research design is the fact that the sample population was taken from various US field centers where different conditions prevail, hence show that inference must be of a broader perspective. Another important reason is that, the research method covered several years that have different variations in various aspects. Therefore, the research inference must be true for various groups as thousands of sample populations were involved within a wide period. Another point could be because non-institutionalized, ambulatory and African-American men and women were all involved in the exam. The sampling criteria specifying the characteristics a population does have or does not have, have not been well identified. The population is only quoted to be from certain groups in the society, such as, the African-American men and women, the non-institutionalized and ambulatory persons. This does give very general characteristics that are not specified. It is, therefore, not easy to say whether it is appropriate since the characteristics are general. The study does not disclose, in any way, of what the intervention and control treatment conditions are. It, therefore does not also include the administration method of any kind of treatment and control to be applied. The statistical tests that were utilized in the study included the use of analysis of variance (ANOVA) and Chi-square test. These were relevant and required in analyzing the characteristics of the participants in 1998-09 and comparing them across the visits in 2005-06. Multinomial regression was also carried out for the visits in 2005-06 to compare the characteristics in 1998-09. These tests were appropriate because, as we the study wanted to carry out comparisons; it is very easy to do so using analysis of variance method. Multinomial regression also comes in handy when one wants to carry out analysis with several variables. This study had various variables that included the many participant characteristics, hence; this regression analysis was very appropriate for the study. If these tests were not carried out, similarly statistical analysis using strata and regression analysis could be done to regress the model with various variables. Out of the total population samples subjected for the study, only 2,238 participants were recorded as refusals during analysis. This shows that the true population value of the study were not met. However, the remaining population was well spread and was very significant that could well be used to represent the true population value. The inferences made in the study are believed to be accurate and well founded due to the statistical analysis that were done. The results use figures and tables to display the results and make it easy for one to follow. The result discussed the various variables in details and uses the foundation of the statistical analysis to prove the validity of the study. The study shows that there was a dramatic difference in retention by age. There was a healthy participant bias during the beginning of the study. Therefore, the study found out that there is a difficulty in obtaining clinical visits in the olden days which is contributed to by impairment and disability, apart from poor health. This study is, therefore, significant to clinical practice in general and can be used to improve the clinical practice by improving accessibility of clinical visits to the old people. Conclusion In a nutshell, this study could be implemented in the clinic by ensuring that old people are provided with the clinical visits. To achieve this, the clinical services should be brought close to the old people around where they stay. It would be possible if they were provided a home for, and clinical practices and visits are institutionalized within the home. Reference Ensrud, K., Fullman, R., & Barett-Connor, E. (2005). Voluntary weight reduction in older menincreases hip bone loss: The Osteoporotic Fractures in Men Study. J Clin Endocrinal Metab, 1998-2004. Griffith, K., Sherrill, D., & EM., S. (2001). Predictors of loss of lung function in the elderly: The Cardiovascular Health Study. Am J Respir Crit Care Med, 61-68. Strotmeyer, E., Arnold, A., Boudreau, R., Ives, D., Cushman, M., Robbins, J., . . . Newman, A. (2010). Long-term Retention of Older Adults in the Cardiovascular Health Study (CHS): Implications for Studies of the Oldest Old. J Am Geriatr, 696-701. doi: 10.1111/j.1532-5415.2010.02770.x Read More