(HLN710) Epidemiology principles assignment investigating organization strategy

Question

Task: how to undertake anepidemiology principles assignment to assess organization strategy effectiveness?

Answer

Introduction
The epidemiology principles assignment study focuses on the effectiveness of organizational strategies in the context of office workers' sitting time. The study though has clearly mentioned all important or associated factors to formulate the PICO format still it fails to mention it directly. From this particular perspective thereby it can be said that the study design though effective in the context of the PICO format; still it cannot be stated as the appropriate example of a study that adopts the PICO format. The factors of PICO - population, intervention, comparison, and outcome all are mentioned. The study design however is much more effective to offer clear information regarding the research area. It has successfully justified clusterrandomized parallel-group trials by dividing the entire population into two groups with the tracker and without a tracker. Henceforth, the epidemiology principles assignmentdesign can be confirmed as effective to use a randomized trial through a cluster randomized parallel-group trial. The two groups are trackers provided real-time feedback for positions, sitting, and activity monitoring to have the primary outcome. The study design has even confirmed its effectiveness by mentioning of the timeframe of 12 months for each group.

Risk of bias in selection and recruitment of the participants
The risk of bias is concerned with the likelihood of features in epidemiology principles assignmentstudy design that can lead to improper results or information. It can occur for several reasons specifically due to partiality in some contexts while doing the research or including the population. For the concerned paper, the researcher has identified the population from a particular organization which eventually confirm the risk of bias as workers of one organization can fail to address all relevant issues of different organization considering their workload,schedule, behavioral attributes, etc. Henceforth, it is very clear that individuals who participate in the study cannot represent the target population of office workers' sitting time.

Regarding the active participation of the participants, the study has not disclosed any clear information.Thereby, it can even show the chances of risk of bias as it is not clear whether active participation was there in the process or not.

As a whole, the risk of bias from selecting participants can be evaluated as moderate level as both the concerns of representing the target population and acceptance of the participants are not sure to offer positive or negative outcomes directly. The entireepidemiology principles assignment analysis depends on assumption; however, as the chances are there, thereby the risk of bias is there in the study at a moderate level.

Risks of bias arising from the randomization and allocation processes
For cluster randomized trials, randomization is an important process in which participants of trials get assigned to separate groups and are given different treatments to get the outcome properly. The paper has incorporated a cluster randomized trial where the allocation was random. The team leaders and the managers were given the responsibility of dividing the team. Finally, the randomization is accomplished into groups 'group org' and 'group org+tracker' through the randomization website. Some participants were excluded from the randomization procedure and afterward randomization schedule is even applied to the list of teams. The epidemiology principles assignment researchhas clearly mentioned that it has applied a randomization schedule which confirms that the sequence allocation was pre-scheduled which justifies assigning subjects randomly for trial.

Allocation sequence concealment is the procedure where the implementation of a random allocation sequence does not get acknowledged by any of the participants. It is a type of technique where every participant remains unaware or unacknowledged about their treatment procedure throughout. Such type of technique often raises the question of ethics for the entire research as acknowledgment is the basic right of every participant during a trial. However, the concerned study has perfectly addressed the ethics in the research as the allocation sequence was not concealed to the participants during the intervention as the epidemiology principles assignmentresearch has confirmed that neither the participants nor the research team was unaware of the randomization status of the participants. Henceforth, it can be confirmed that the ethical part is properly addressed by the research.

In order to avoid the risk of bias of associated factors, confounders play a significant role in the final outcome. Taking enough care towards the fact and understanding the concern that evaluation of workers needs to be gender-free, the research has accommodated sex in this particular research. Theepidemiology principles assignment research has significantly mentioned about women during the intervention and confirmed similar addressing to both men and women as per their ascribed group during the trial. Apart from gender, another confounder is even associated with the research. The nordic muscular skeletal questionnaire is even considered as a potential confounder in the research. The presence of confounders is quite strong in the study; however, the study has not mentioned any difference between the groups in the context of confounders. The name of the confounders is mentioned in the study clearly though, for specific groups, it does not share any connection as per the information of the research. It would be a better approach if the groups would be properly aligned with the confounders to understand the differences in outcome.

The risk of bias in the randomization and allocation process is very low and the epidemiology principles assignmentresearch becomes strong to confirm its information as authentic and reliable. For most of the sections, the risk of bias in the randomization process is not been seen clearly. The allocation was done randomly and it even does not accommodate allocation sequence concealment to abide by the ethical considerations and confounders are even mentioned properly and clearly. The only gap the research has shared for the risk of bias in randomization is no connection between the confounder and the groups before or after an intervention. It cannot direct the research as the force cannot be that strong.

Risk of bias from the integrity of the intervention, including adhering to theintervention
The epidemiology principles assignmentresearch design has confirmed its effectiveness by offering impartial, bias-free, or equal focus to all the participants during the intervention. The research has confirmed that after having an initial discussion and getting the confirmation of senior management and executive information, the booklet was emailed in the first week to all participating staff. The booklet carries all background information regarding the program, health implications, and sitting recommendation. It was given to the participant as an introductory email to convey an initial summary of the average activity for the participants. Henceforth, the research design confirms that all participants have received allocated intervention or exposure of interest successfully. The research has given maintained consistency in its intervention for the research. The intervention has perfectly maintained the follow-up throughout the period as senior executives have taken part in the baseline assessment. They have even confirmed effective communication with the participants. The participants even offered with workplace well-being in role with informal discussion with managers to confirm consistency during the intervention measured. The decided design has profoundly secured the fact that it has minimized the risk of bias as much as possible so the intervention by including all participants and maintaining consistency.

Transparency or clarity is maintained in the research throughout as no sudden situation comes during the intervention to be followed by an intended intervention. The design of the epidemiology principles assignmentresearch is articulated so clearly and with efficiency and mastery that it has planned all the phases with much detail do not to have any unintended intervention during the process to influence the outcome. However, it needs to be mentioned that no clear information regarding the same is there in the paper;though analysis of the entire paper confirms that the research has not spared any gap for unintended intervention to influence the result.

As a whole, the risk of bias in the intervention of the research is even low to make the paper strong enough in its finding. The intervention was successfully designed and equally distributed among all the participants. It has even confirmed throughout consistency during the intervention to not to have any issues from any of the groups. As per the analysis, unintended intervention even cannot be seen during the intervention to influence the result though clear confirmation is not there in the paper which confirms the low risk of bias for this particular section.

Risk of bias due to missing outcome data (attrition)
The epidemiology principles assignmentresearch however has some risk of bias due to missing outcome data. The research has reported that there are some adverse events of withdrawal or dropouts during the intervention. For both intervention groups, some withdrawals are associated where some participants are reported to not to use LUMOback and eventually after 3 months decline to offer re-consent for 12th-month questionnaires. Some dropouts or withdrawals are even there due to some unavoidable circumstances which make the participants unable to take a part in the assessment. Henceforth, it is quite clear that the risk of bias is associated with missing outcome data. As per the information of the paper, most of the participants have completed the study with all associated factors like the type of intervention and strategies which significantly have taken as per their group. Clear information regarding the percentage of participants who have completed the study is not being provided through the analysis. However, a thorough reading of the entire research confirms that 60 to 79% of participants have completed the study whereas the rest werecompelled to leave the study in between due to some considerations in both personal and professional contests.

The result of the epidemiology principles assignmentcan be different if the whole participation would be there. Henceforth, this particular concern can be stated as influential enough to direct the result toward positive or negative motion. There are some withdrawals where except for situational crises or unavoidable circumstances, behavioral characteristics even get highlighted. It further confirms that the research has some issues in its design of intervention as it fails to return the attention of the participants throughout. It eventually gets followed by medium participation for the assessment which spares a gap to include the whole target population. Thereby, the particular section can be confirmed as having a moderate risk of bias as it carries some concerns in its structuring.

Risk of bias in the measurement of the outcome (measurement bias)
The measurement of the outcome is not done effectively by the research to allow the gap for measurement bias. The epidemiology principles assignmentresearch has not confirmed anything about outcome assessors' awareness regarding exposure or intervention, the status of participation, etc. The research even fails to confirm who is the outcome assessor significantly to evaluate it with enough acknowledgment of the entire process. Apart from the assessors, it even has not mentioned anything about participants' awareness regarding study allocation or question allocation. The research has conveyed that the participants were well aware of their group still allocation of the research question is not mentioned anywhere to confirm if the entire assessment was done in cooperation with the workers or if they were only aware of the groups they are being divided with for the sake of the assessment. As the participants were not aware of the research question,henceforth, it cannot confirm whether it can affect the measurement of the outcome.

The data collection tool of the assessment was valid and reliable as it portrays proper information to confirm effective outcomes for the entire intervention. Most importantly, different tools are used for a different group to make the data more relevant and authentic in the context of each group
The measurement of the outcome can be confirmed as carrying high risk as most of the important information which can influence the result of the entire assessment is not conveyed clearly. In this particular section thereby the measurement bias makes the research weak.

Risk of bias in the analysis and reporting of the result
The analysis or reporting of the epidemiology principles assignmentresearch however is recommendable as it does not spare any gap for analysis bias. It has indicated all important variables for each group to confirm the final claim by the assessment. It has justified how the group with tracker has confirmed better results compared to the organization group. The analysis was done by the actual intervention received which further makes the study more strong and effective to justify its claim as that shows the main result and removes the chances of risk of bias. Finally, the analysis has directly and successfully justified the research question by confirming the effectiveness of organization strategies with or without activity trackers in the context of lowering office workers' sitting time.

The epidemiology principles assignmentanalysis section can be stated as low risk of bias as the section is strong enough to make the research reliable from every perspective.

Reference
Brakenridge, C. L., Fjeldsoe, B. S., Young, D. C., Winkler, E. A. H., Dunstan, D. W., Straker, L. M., & Healy, G. N. (2016). Evaluating the effectiveness of organisational-level strategies with or without an activity tracker to reduce office workers’ sitting time: a cluster-randomised trial. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 1-15. https://ijbnpa.biomedcentral.com/counter/pdf/10.1186/s12966-016-0441-3.pdfepidemiology principles assignment