Final Assignment

This is my final paper.  This assignment is a combination of all my assignments for this semester.  Below are my assignments that you will have to reference. I also attached my grades.  This assignment is worth 200 points. Please read the feed back in the yellow from the professor. All citations have to be within 5 years.  My current grade is a 78% 

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Research Question; 65/100 = D

Review Matrix;  137/150 = A

Ethics; 92/100 = A

Collection = 88/150 = F

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Analysis = 87/100 = B 

NURS 500

Research Proposal: Final Assignment Instructions

Overview

The purpose of this assignment is to provide a full overview of the research process. When this assignment is completed a full research proposal will have been developed. The only new element is the narrative literature review. All other information is from previous assignments with an emphasis of improvement based on feedback on those assignments. This assignment will include all the elements of the research proposal you have completed up to this date. You will combine them into one continuous proposal (paper) following the steps of the research process. Use heading according to APA format to give the paper organization. This assignment is worth significant points therefore it should be done with an attention to detail.

All feedback from the previous graded assignments should be addressed in this final paper. This is an important feature of the final paper. By putting all the information for the proposal in one paper, the totality of the research process is addressed. The ability to accept feedback and make corrections is an essential feature of the research process. Full information from each section should be included in the final paper to receive full credit in each section on this assignment. Review the grading rubric for this assignment to ensure you know the required elements of the assignment.

Instructions

1.

This paper includes:

a. The research question and design.

b. The Literature Review.

You will need to take the information from the literature review matrix and convert it to a narrative format. This should be a cohesive and organized flow of information. Your references must be integrated throughout the body of your review, not listed independently like an annotated bibliography. Instead, they must flow in a way that supports your research question by providing the research findings of other scientists and building your case for the study you are proposing. There must be very few instances of copying and pasting large quotes from your sources. Instead, you must articulate the findings accurately using your own words. Make sure you cite your sources appropriately. The literature review section needs to end with a summary paragraph that leads into your proposed research question or hypothesis. For example, “In light of the studies reviewed, there is a need to conduct further studies that…” would serve as a good start to a summary paragraph.

c. The ethics assignment information.

d. Research Proposal: Data Collection Methodology and Research Proposal: Data Analysis Methodology.

e. Do not include possible outcomes for this paper. It is not appropriate in this context.

2. A full proposal should be at minimum 12 – 15 pages excluding the title and reference pages, though good quality papers will be longer than this minimum.

3. Current APA format.

4. Include all references from the previous assignments. If you have used the same reference for more than one section or assignment, it should only be cited once. There should be a minimum of 15 references for the full proposal. (excluding the textbook and Bible).

Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.

Page 2 of 2

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 1

Mammography Detection and Prevention of Breast Cancer

Nikita Chapman

Liberty University

Author Note

Nikita Chapman

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to

Nikita Chapman. Email: nmchapman@liberty.edu

mailto:nmchapman@liberty.edu

Donna Washburn (Donna)
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You did a nice job with APA format with only one minor problem. You are allowing extra spaces between paragraphs. This is a setting in the paragraph settings in your Word program. See comment below in references as well. Otherwise you did a very nice job with APA format.

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 2

Mammography Detection and Prevention of Breast Cancer

Several recommendations have been proposed for breast cancer screening and

intervention, including breast awareness, self-breast examination, clinical breast examinations,

and mammography, to mention a few. These techniques are meant to offer early detection of

breast cancer, especially in its early forms in women before cancer spreads (Black et al., 2019).

Early detection of breast cancer has been praised for reducing breast cancer mortalities in

women. According to experts, mammography remains the most effective screening tool for

breast cancer in women.

Mammography has led to a reduction of breast cancer mortalities by approximately

40%. However, 30% of women are still considered to fail in undertaking recommendations for

timely mammography screening (Alizada et al., 2021). Mammography screening has increased

from approximately 29% to 70% among women, which is remarkable. However, the rate has

remained unchanged for several years due to challenges, such as barriers and disparities in

mammogram adherence.

Mammography as a screening too; for breast cancer among women is complex and

multifactorial. Several factors are associated with mammography screening adherence among

women, including socioeconomic disparities such as income level, education, insurance,

geographical settings and location, health beliefs in communities, and health literacy (Black et

al., 2019). Women with higher levels of education are associated with higher incomes and better

insurance plans. They are also linked with increased health literacy and thus are likely to have

better adherence to mammography breast cancer screening; this leads to subsequent early

detection and less likelihood of breast cancer mortalities. High-income levels and insurance have

Donna Washburn (Donna)
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eliminate the extra spaces

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 3

been attached to improved adherence in mammography screening among white women, but

these factors are not positively reflected in black women’s adherence to mammography breast

screening (Alizada et al., 2021). However, several other factors, such as perceived discrimination

and distrust in the health sectors, are associated with the negative adherence patterns in black

women.

Purpose of the Study and Research Question

Adherence to mammography breast screening among women has indicated fluctuations.

Mammography has remained at the same rate for several decades; it is alarming. More breast

awareness programs are conducted to educate women on the importance of screening and early

detection of breast cancer. The study will identify women among the communities who are not

receiving timely mammography breast screening. It will explore past and current efforts to

improve breast screening among women. Its results will be used in developing a better plan to

improve adherence to mammography breast screening among women; it is an essential and

crucial health measure. Therefore, the research question for this study is;

Q1. Do counseling and addressing personal barriers improve mammography adherence among

women above 40 years?

The critical variables in the research question and population are;

1. Counseling and addressing personal barriers is the independent variable.

2. Mammography adherence is the dependent variable.

3. The population of interest in the study is women above 40 years

Donna Washburn (Donna)
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You will need to be more specific here . Especially with your population. What is the location? I noticed you had articles from research done all over the world. This is fine but you need to pinpoint a population. If this is a population in the US for example, then you’ll need to be more specific about location, race, or some other distinguishing factor that your background search has revealed is especially vulnerable.

Donna Washburn (Donna)
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This throws a net that is too wide to be helpful. Target a specific population supported by your background search. You’ll need to prove that there is a gap that is being addressed by your proposal.

Donna Washburn (Donna)
143770000000926309
Choose one intervention. This is two but still leaves a lot of room for interpretation. Does “counseling” need to be in the question or can it be part of a program to address a specific personal barrier?

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 4

Significance and Contribution to Nursing Research

Most estimates reveal that breast cancer treatment is reducing among women globally,

with averages indicating approximately 72.8% globally. Most regions in the United States have

recorded rates below the global goal of approximately 81.1% (Jiwa et al., 2021). The stats place

most of the regions in the United States in a higher need for initiatives to improve early detection

and prevention methods. Therefore, this research is significant for nursing research because it

will provide insights and understanding for better methods in improving adherence levels in

mammography in breast cancer screening, which will provide a benchmark in healthcare for

improving high-quality care.

Research Methodology and Design

The study shall utilize a qualitative non-experimental methodology and incorporate

several research designs, such as quality improvement, healthcare delivery innovations, and

policy evaluations. The qualitative methodology will effectively describe and answer a broad

range of questions illustrated in this research proposal, and it is also considered adequate for

studies involving several concepts and frameworks (Kang, 2018, p. 661). This study will be

focused on improving adherence to mammography breast screening for women in the United

States. Outcome measurement is an essential aspect of the quality improvement process. For this

project, the outcome measurement shall include determining the number of women undertaking

non-adherence who are scheduled for a mammogram after counseling and addressing personal

barriers. Specific data shall be collected regarding the quality of elements responsible for driving

improvements, especially with selected primary healthcare sites (Klarenbach et al., 2018). An

analysis shall be conducted for post and pre-intervention mammography rates to indicate the

Donna Washburn (Donna)
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The statements above don’t support this statement. Please provide supporting evidence from literature that this is an adherence issue and not a treatment or early detection or prevention issue.

Donna Washburn (Donna)
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Please focus on one research design and give justification for that design alone.

Donna Washburn (Donna)
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expound on this to show how it relates to your statements above.

Donna Washburn (Donna)
143770000000926309
You are now describing a quantitative study whereas above you said you would do a qualitative study.

Donna Washburn (Donna)
143770000000926309
re-word for clarity

Donna Washburn (Donna)
143770000000926309
outcome measurement is not qualitative. Quality improvement is not research. Be sure to familiarize yourself with research terms.

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 5

effectiveness of interventions, such as counseling and addressing personal barriers, in the

changes for improved adherence in mammography breast cancer screening.

Conceptual Framework; Model for Improvement

A conceptual framework is essential in plotting a map connecting all the essential

aspects of the study. The conceptual framework shall use the model for improvement because it

is the most appropriate for quality improvement, especially in the healthcare realm (O’Donovan

et al., 2020). This improvement model shall be based on three essential questions for healthcare

organizations because it will help the organizations set aims, establish measures, and select

appropriate changes. Once the changes are approved, the following step shall involve testing,

following the PDSA criteria. This illustrates planning for the changes, doing what is represented

by the implementing plan, studying and evaluating the represented results, and acting upon the

results.

The cyclical nature of the PSDA is essential for the development of the model of

improvement, and this is because the repeated cycles will be refined for optimum results. The

process can be initiated on a small scale and implemented on a large scale after realizing

effective results (O’Donovan et al., 2020). The model will be effective in answering three

questions for the study.

1. What shall the study accomplish? This question shall effectively answer the purpose and

aim of the study, which involves improving mammography adherence among women

with non-adherence practices in communities.

Donna Washburn (Donna)
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Please choose one design and rewrite the above section to correctly describe how you will conduct your study.

Donna Washburn (Donna)
143770000000926309
Your proposal should focus on what you plan to do, why, and how. Please generally avoid tutorials or definitions.

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 6

2. How will the improvements be measured? It will effectively refer to outcome

measurements; this shall be guided by the model for improvement that illustrates that all

improvements require changes.

3. What changes shall be made for improvement? This question shall be essential in

focusing on changes that will be effective for improvements. It explains the changes that

will lead to improved adherence to mammography breast screening among women.

Conclusion

Several recommendations have been proposed for breast cancer screening and

intervention, including breast awareness, self-breast examination, clinical breast examinations,
and mammography, to mention a few. These techniques are meant to offer early detection of

breast cancer, especially in its early forms in women before cancer spreads. The study will

identify women among the communities who are not receiving timely mammography breast

screening. It will explore past and current efforts to improve breast screening among women. Its

results will be used in developing a better plan to improve adherence to mammography breast

screening among women. The study shall utilize a qualitative non-experimental methodology

and incorporate several research designs, such as quality improvement, healthcare delivery

innovations, and policy evaluations. The qualitative methodology will effectively describe and

answer a broad range of questions illustrated in this research proposal.

Donna Washburn (Donna)
143770000000926309
Perhaps re-reading the instructions will help? You will need to identify and describe a gap in the literature that is available on your topic. After you identify the gap, you need to describe this in your background information and then write a research question that addresses the gap. Following that you must choose a single design that will best answer your question, and describe that here.

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 7

References

Alizada, F., Lachyan, A. S., & Simon, N. H. (2021). A literature review assessing knowledge,

attitude, and preventive practices towards breast cancer among Indian women.

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

Black, E., & Richmond, R. (2019). Improving early detection of breast cancer in sub-Saharan

Africa: why mammography may not be the way forward. Globalization and Health,

15(1), 3-3. https://doi.org/10.1186/s12992-018-0446-6

Jiwa, N., Takats, Z., Leff, D. R., & Sutton, C. (2021). Breast health screening: a UK-wide

questionnaire. BMJ Nutrition, Prevention & Health, bmjnph-2021.

https://doi.org/10.1136/bmjnph-2021-000266

Kang. (2018). Use of Breast Cancer Screening and Its Association with Later Use of Preventive

Services among Medicare Beneficiaries. Radiology., 288(3), 660–668.

https://doi.org/10.1148/radiol.2018172326

Klarenbach, S., Sims-Jones, N., Lewin, G., Singh, H., Thériault, G., Tonelli, M., Doull, M.,

Courage, S., Garcia, A. J., Thombs, B. D., & Canadian Task Force on Preventive Health

Care (2018). Recommendations on screening for breast cancer in women aged 40-74

years who are not at increased risk for breast cancer. CMAJ : Canadian Medical

Association journal = journal de l’Association medicale canadienne, 190(49), E1441–

E1451. https://doi.org/10.1503/cmaj.180463

O’Donovan, J., Newcomb, A., MacRae, M. C., Vieira, D., Onyilofor, C., & Ginsburg, O. (2020).

Community health workers and early detection of breast cancer in low-income and

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

https://doi.org/10.1186/s12992-018-0446-6

http://dx.doi.org/10.1136/bmjnph-2021-000266

https://doi.org/10.1148/radiol.2018172326

https://doi.org/10.1503/cmaj.180463

Donna Washburn (Donna)
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Be sure to eliminate the extra spaces between lines. This is easily accomplished by “unchecking” the box next to “extra space after paragraph” in the paragraph design options in Microsoft Word.

MAMMOGRAPHY DETECTION AND PREVENTION OF BREAST CANCER 8

middle-income countries: a systematic scoping review of the literature. BMJ global

health, 5(5), e002466.

LITERATURE REVIEW MATRIX NURS500

Name: Nikita Chapman Date: 23 Jan 22 Course: NURS500

Complete
Citation in
APA
format

Level of
Evidence

Theoretical/
Conceptual
Framework if
present

Research
Question(s)/
Hypotheses

Research
Design
Methodology

Statistical Analysis &
Results

Conclusions Implications for
Future research
and Practice

Alizada, F.,
Lachyan, A.
S., &
Simon, N.
H. (2021). A
literature
review
assessing
knowledge,
attitude, and
preventive
practices
towards
breast
cancer
among
Indian
women.
http://dx.doi
.org/10.2432
7/ijrsr.2021.
1204.5901

Peer-
reviewed
journal

Assessing the
attitude and
knowledge on
preventive
practices
towards breast
cancer.

Do women
know about
breast cancer
and breast self-
examination?
What is the
attitude of
women towards
breast cancer?

The study used a
review
approach. The
articles reviewed
were identified
and analyzed
through an
electronic data
search through
inclusion criteria
of 2010 and
afterward
Malaysia
(Alizada et.
2021).

The study utilized 12
articles, 7 of them
conducted in India, and
the rest from other parts
of the world, including
Pakistan, Nigeria,
Bangladesh, Iran, and
Malaysia (Alizada et.
2021). 16% of the women
revealed knowledge of
breast cancer in India,
50% in Pakistan, and a
2% self-examination
practice among Indian
women.
The study illustrated poor
knowledge of breast
cancer and the self-
examination among
women. Most women
were unaware of the
mammogram or other
screening methods.

Women with little
knowledge of
breast cancer and
self-examination
cause an increased
incidence rate
because they
inhibit the early
detection of breast
cancer. Awareness
and education are
necessary to
mitigate the
challenges of
inadequate
knowledge about
breast cancer and
self-examination.

The study provides
information
illustrating gaps in
breast cancer
detection and
prevention. More
research is required
to provide
substantive
information about
the importance of
early detection and
prevention of breast
cancer. The use of
mammograms in
screening and
detecting breast
cancer should also
be emphasized.

Black, E., &
Richmond,
R. (2019).
Improving
early
detection of

Peer-
reviewed
journal

Early
detection
practices and
the
effectiveness
of

Mammography
and other
screening
methods may
not be the most

The study
reviewed breast
cancer literature,
screening
methods, and
their

Results illustrate that
women with breast cancer
in SSA are younger than
in high-income nations.
Treatment options are
limited, leading to poor

According to the
study, early
detection of breast
cancer should be
context-specific in
SSA. Early

Further research is
required in
evaluating the
feasibility and
acceptability of
clinical downstaging

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

http://dx.doi.org/10.24327/ijrsr.2021.1204.5901

Donna Washburn (Donna)
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It is important to identify the Design used – what type of quantitative or qualitative method was used?

Donna Washburn (Donna)
143770000000926309
What level? See information regarding “Levels of Evidence” including the handy chart on inside back cover of your text.

Donna Washburn (Donna)
143770000000926309
Be sure to add your evidence level (I, II, III, IV, etc)

LITERATURE REVIEW MATRIX NURS500
breast
cancer in
sub-Saharan
Africa: why
mammograp
hy may not
be the way
forward. Gl
obalization
and
Health, 15(1
), 3-
3. https://doi
.org/10.1186
/s12992-
018-0446-6

mammograph
y in breast
cancer
detection and
prevention in
SSA.

effective in
SSA.

effectiveness in
SSA.

prognoses. Engagement
with early detection and
screening practices, such
as the mammogram, is
low, contributing to late-
stage diagnosis.

detection
strategies, such as
mammography,
need
complementary
methods to reduce
mortalities from
breast cancer in
low-income
nations, such as
SSA (Black &
Richmond, 2019).

as a tool for
controlling breast
cancer in SSA.

Jiwa, N.,
Takats, Z.,
Leff, D. R.,
& Sutton, C.
(2021).
Breast
health
screening: a
UK-wide
questionnair
e. BMJ
Nutrition,
Prevention
& Health,
bmjnph-
2021.
https://doi.or
g/10.1136/b
mjnph-
2021-
000266

Peer-
reviewed
journal

The study
emphasized on
the concept of
self-testing
based on the
nipple fluid.

NAF is an
acceptable tool
in screening
breast cancer.

The study was
conducted
through an
online survey.
The survey
consisted of four
parts, including
an overview of
breast health,
essential
demographic
data, questions
on the
acceptability of
NAF as a
screening tool,
and opinions
regarding NAF
collection for
cancer screening

A total of 3178
respondents completed
questionnaires, all having
consent to participate in
the study. This gave a
74.0% response rate out
of the 4305 respondents
who interacted with the
questionnaires (Jiwa et
al., 2021). The larger
population of women
(89.8%) were keen to
understand the risks
involved with breast
cancer, 8.5% were not
decided, and 1.6% did not
want to know the risk
involved with breast
cancer. 29.2% of women
needed to know the risk
of breast cancer due to

The study
illustrated that the
concept of NAF
as a screening tool
was highly
acceptable. The
study also
illustrated that
public awareness
of breast cancer
screening
protocols and
mammograms
needed
improvements.

Evaluating
improvements
needed on
mammograms as a
tool for breast
cancer screening.
Increased public
awareness is
required to enhance
the knowledge of
breast cancer to
more women.

https://doi.org/10.1186/s12992-018-0446-6

https://doi.org/10.1186/s12992-018-0446-6

https://doi.org/10.1186/s12992-018-0446-6

https://doi.org/10.1186/s12992-018-0446-6

http://dx.doi.org/10.1136/bmjnph-2021-000266

http://dx.doi.org/10.1136/bmjnph-2021-000266

http://dx.doi.org/10.1136/bmjnph-2021-000266

http://dx.doi.org/10.1136/bmjnph-2021-000266

LITERATURE REVIEW MATRIX NURS500
(Jiwa et al.,
2021).

family history and 11.5%
due to personal history.
83.4% of respondents
were unaware of NAF,
with 92.0% indicating
acceptability for home
screening.

Kang.
(2018). Use
of Breast
Cancer
Screening
and Its
Association
with Later
Use of
Preventive
Services
among
Medicare
Beneficiarie
s. Radiology
., 288(3),
660–668.
https://doi.or
g/10.1148/ra
diol.201817
2326

Peer-
reviewed
journal

Retrospective
assessing the
association
between
mammograph
y screening
with
preventive
services for
women
enrolled in
Medicare.

There is an
association
between
screening
mammography
and the use of a
variety of
preventive
services in
women who
are enrolled in
Medicare.

The study
collected data
for the research
through
retrospective
Medicare claims
from 2010 to
2014 identifiable
research files
(Kang, 2018, p.
666).
Qualitative
analysis was
conducted by
applying a
multivariate
logistic
regression
model.

The study recorded
555705 patients as
cohorts. 185625 of them
underwent
mammography, reflecting
33.4% of the total cohorts
(Kang, 2018, p. 667). The
results did not indicate
significant differences in
screened and unscreened
women in preventive
services.

The use of
mammography for
screening breast
cancer was
associated with
increased
adherence to other
preventive
methods.

The association
between
mammography and
cervical cancer
screening should be
emphasized through
further research.

Klarenbach,
S., Sims-
Jones, N.,
Lewin, G.,
Singh, H.,
Thériault,
G., Tonelli,
M., Doull,
M.,

Peer-
reviewed
journal

Screening
through
mammographs
may identify
breast cancer
earlier,
leading to
more effective
and less

Recommendati
ons for
screening
women for
breast cancer
should remain
similar to those
of the previous
task force.

The study relied
on two evidence
reviews. Review
protocols for the
study were
entered in
PROSPERO.
The Grading of
Recommendatio

Mammography screening
for breast cancer causes
modestly reduced breast
cancer mortalities for
women between 40 and
70 years. Mammography
was recommended for
such women, with more
specific descriptions

From the study,
mammography is
considered more
effective for
screening breast
cancer in women
between 40 and
70 years.

Further research is
required to evaluate
the effectiveness of
mammography in
other age brackets
and the effectiveness
of combining
mammography with

https://doi.org/10.1148/radiol.2018172326

https://doi.org/10.1148/radiol.2018172326

https://doi.org/10.1148/radiol.2018172326

https://doi.org/10.1148/radiol.2018172326

LITERATURE REVIEW MATRIX NURS500
Courage, S.,
Garcia, A.
J., Thombs,
B. D., &
Canadian
Task Force
on
Preventive
Health Care
(2018).
Recommend
ations on
screening
for breast
cancer in
women aged
40-74 years
who are not
at increased
risk for
breast
cancer. CM
AJ :
Canadian
Medical
Association
journal =
journal de
l’Associatio
n medicale
canadienne,
190(49),
E1441–
E1451.
https://doi.or
g/10.1503/c
maj.180463

invasive
cancer
treatment.

ns, Assessment,
Development
and Evaluation
(GRADE)
approach was
utilized in
determining the
quality of
evidence
provided and the
strength of the
recommendation
(Klarenbach et
al., 2018).

recommended for other
screening methods.

other screening
methods.

https://doi.org/10.1503/cmaj.180463

https://doi.org/10.1503/cmaj.180463

https://doi.org/10.1503/cmaj.180463

LITERATURE REVIEW MATRIX NURS500
O’Donovan,
J.,
Newcomb,
A., MacRae,
M. C.,
Vieira, D.,
Onyilofor,
C., &
Ginsburg,
O. (2020).
Community
health
workers and
early
detection of
breast
cancer in
low-income
and middle-
income
countries: a
systematic
scoping
review of
the
literature. B
MJ global
health, 5(5),
e002466.

Peer-
reviewed
journal

The study
examined the
role of
community
health workers
in the early
detection and
prevention of
breast cancer.

The research
questions
included;
Where and how
community
health workers
are deployed in
the role of
detection and
prevention of
breast cancer.
How the
community
health workers
are trained on
breast cancer
detection.
The cost
associated with
the deployment
of community
health workers
in breast cancer
detection
programs.

The study was
conducted
through a review
approach. The
review process
effectively
followed the
preferred
reporting items
for systematic
reviews and
meta-analyses.
Eight databases
were utilized to
identify peer-
reviewed
publications
from 1998 to
2019
(O’Donovan et
al., 2020). Data
were
systematically
extracted from
the resources
into data
charting forms a
shared
spreadsheet in
Microsoft Excel.

The initial search
provided 2938. A total of
2574 studies were
provided after
deduplicating the initial
resources. A screening of
the 2574 studies yielded
47 studies subjected to
full-text review
(O’Donovan et al., 2020).
Following the exclusion
and inclusion criteria, 31
more studies were
excluded, and only 16
were left. The roles of
community health
workers were identified,
including awareness and
community education,
performing community-
based breast screening,
and making referrals for
further examination or
critical considerations.

Community health
workers can play
a vital role in the
early detection

and prevention of
breast cancer.

Therefore, they
need to be
supported in a
wider health
system.

Early detection is
essential in the
prevention of breast
cancer. A study can
examine how
community health
workers can
promote detection
and prevention of
breast cancer and the
connection they may
have in
mammogram
utilization
(O’Donovan et al.,
2020).

Pashayan,
Antoniou,
A., Ivanuš,
U., &
Esserman,
L. (2020).
Publisher

Peer-
reviewed
journal

Risk-stratified
prevention and
early detection
strategies for
breast cancer.

Not Applicable A descriptive
qualitative
approach is used
in the study.

The study illustrates risk
assessment for breast
cancer, risk-stratified
prevention, risk-stratified
detection, and the
implementation of these
strategies.

The study shows
substantial
progress in
estimating risks of
developing breast
cancer, applying
risk stratification,

Further research is
required to evaluate
the acceptability and
the feasibility of
implementing risk-
stratified detection

LITERATURE REVIEW MATRIX NURS500
Correction:
Personalized
early
detection
and
prevention
of breast
cancer:
ENVISION
consensus
statement
(Nature
Reviews
Clinical
Oncology,
(2020),
10.1038/s41
571-020-
0388-
9). Nature
Reviews.

and modeling the
benefit-harm
balance in early
detection and
prevention of
breast cancer.

and prevention of
breast cancer.

White, M.
C.,
Kavanaugh-
Lynch, M.,
Davis-
Patterson,
S., &
Buermeyer,
N. (2020).
An
Expanded
Agenda for
the Primary
Prevention
of Breast
Cancer:
Charting a
Course for

Peer-
reviewed
journal

A structured,
innovative
approach to
integrating
scientific
evidence with
community
perspectives in
developing a
plan to reduce
breast cancer
incidences
(White et al.,
2020, p. 714).

Not Applicable The study used a
descriptive
approach to
reduce breast
cancer
incidences.

The results indicate that
the new approaches by
BCPP embrace expansive
mind frames, which are
essential in mapping
prevention measures for
the future. (White et al.,
2020, p. 714).

The prevention
methods identified
in the primary
prevention plan
can reduce breast
cancer incidences.

Extending research
to ascertain the
effectiveness of
implementing
dialogues and
awareness to
advocate reduced
breast cancer
incidences is an
opportunity
provided by the gaps
in this study (White
et al., 2020, p. 714).

LITERATURE REVIEW MATRIX NURS500
the
Future. Inter
national
journal of
environment
al research
and public
health, 17(3
), 714.
https://doi.or
g/10.3390/ij
erph170307
14

https://doi.org/10.3390/ijerph17030714

https://doi.org/10.3390/ijerph17030714

https://doi.org/10.3390/ijerph17030714

https://doi.org/10.3390/ijerph17030714

ETHICAL PRINCIPLES 1

Ethical Principles

Nikita Chapman

Liberty University

Author Note

Nikita Chapman

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to

Nikita Chapman. Email: nmchapman@liberty.edu

mailto:nmchapman@liberty.edu

Donna Washburn (Donna)
143770000000926309
Please see the APA 7 graduate student template/example. There should be an extra space between the title and your name. Otherwise you did well on the title page.

ETHICAL PRINCIPLES 2

Ethical Principles

Organization worldwide has made rapid progress in the field of research to

determine and evaluate different studies for future evaluations, standard formations, protecting

the individual’s health and activities such as clinical surveillance, disease prevention, or control.

However, due to scientific invention, the primary research portion of maintaining the record is on

electronic gadgets, which have created the considerable threat of disclosure, misuse, and leakage

of research information about an individual (Tsan, 2019, p. 188) In medicine, various researches

have been carried out based on qualitative and quantitative methods to fulfill diagnostic and

clinical information. Countries have organized data of individuals through public health

information systems.

One of the basic principles in medical research is protecting information and

research work as a private matter. Hence, the world’s health sectors have designed certain ethical

principles, rules, and regulations to meet the requirement of research records privacy. The need

of the principles is to protect medical records communicate the responsibility to the

researcher/investigator to maintain confidentiality. Ethical principles strengthen patients’ health

records, ensure security, and limit the use or disclosure of health information dignified,

respectable way. These ethical principles, carrying out research, enable the organization, health

sector services, and critical public authorities to understand the consequences, responsibilities,

and obligations during performing duties. Ethical principles provide a mechanism, directions,

and systematic guidance for research and investigations and enable entities for sustainable health

information protection.

Informed Consent

Donna Washburn (Donna)
143770000000926309
You have covered elements of consent, but how will you specifically consent your subjects? Who will consent the subjects, etc.

Donna Washburn (Donna)
143770000000926309
Be sure your indents are only half an inch – these indents are much to wide.

ETHICAL PRINCIPLES 3

Informed consent is one of the essential parts of any research work. Informed consent

will be helpful for the participant to understand well what the basics of research being done are

and what would be the possible outcomes. Through the consent form, every detail regarding the

research will be provided to the participant, and he will be allowed to take his time and

understand it well. The process and privacy of the research will be explained to the participant,

and it will be ensured that this research will remain highly confidential with his information and

no information regarding the research and participants will be leaked.

The consent form will be written in easy language so that it would be easy for the

participant to understand, and he will be allowed freely to ask if there are any queries regarding

the research. This informed consent will let the participant decide voluntarily whether either he

would like to become a part of it or not. The participant needs to think about the research and

understand its aim and purpose for the conduction (Tsan, 2019, p. 188). They will also be able to

understand their role in the research study. It will also help the participant understand their

medical condition, rates of success, and the information about treatment he would like to get to

cure himself. Time is given to the participant to consider, and then the consent is taken.

Protection of Privacy

Protection of the privacy of the data is very crucial for the study. The participant tries

to give the best possible honest response (Xiang & Cai, 2021). They tend to volunteer in a study

so that they will not be explicitly exposed for any reason and will not become a test subject for

other scientific studies. Privacy protects the participants from various sources of potential harm.

Furthermore, it also protects them from distress and social embracement of any kind. I will

protect the privacy of my study by collecting the data and analyzing it on my own. No one will

be part of it, and it will not be handed over to anyone for analysis.

Donna Washburn (Donna)
143770000000926309
This is good

ETHICAL PRINCIPLES 4

Furthermore, only two copies of the research data will be created that will remain

between the researcher and the supervisor only. The data used for the process could be saved in

specific coding languages that would only be understandable to the researcher. Another major

step that can be taken to protect the privacy of the participant’s data is that the whole collected

data will be destroyed after the six months of publishing the article and completion of the

research. All the confidential files will be maintained and saved so that participants can go

through research in a relaxing manner.

IRB Review:

IRB consists of a group of specialists who go through the research, and they are

formally designated to observe each part of the research. This specialist asks about each subject

whenever biomedical research is conducted (Tsan, 2019, p. 187). Once they approve the

research, it can move in a further direction. IRB is allowed to make changes in research or even

cancel it if it is not worthy of being conducted or contains any part that can be harmful to people.

They review the research project thoroughly and then allow it to be carried on. For my research

proposal, the IRB analyst will undoubtedly allow it as my research will be confidential and will

not be harmful to humanity in any possible way. As IRB has the authority to approve, a research

proposal with properly informed consent, confidential data, and harmless for humanity will be

accepted.

Risk-Benefit Ratio

A risk-benefit ratio for my study, based on human psychology, will be favorable. This ratio

defines the ratio of risk occurrence or potential of gaining a benefit from a research study. If the

number of risks is less than the benefits obtained from the study, then the study is likely to be

Donna Washburn (Donna)
143770000000926309
This is okay but an improvement would be to specifically address the process that you will take – for example, you need to assure the IRB that no research will be conducted until you have their approval.

Donna Washburn (Donna)
143770000000926309
Even though there are benefits, you will need to address the risks (such as potential data leak) and explain how you will present this possibility to your subjects in the consent, and how you will mitigate for the risks.

ETHICAL PRINCIPLES 5

successful. My study participants will observe more benefits and understand their medical

conditions at the end, and they will fully understand their profits at the end of the study.

References

Tsan, M.-F. (2019). Measuring the Quality and Performance of Institutional Review

Boards. Journal of Empirical Research on Human Research Ethics, 14(3), 187–189.

https://doi.org/10.1177/1556264618804686

Xiang, D., & Cai, W. (2021). Privacy Protection and Secondary Use of Health Data: Strategies

and Methods. BioMed Research International,

2021 http://dx.doi.org/10.1155/2021/6967166

https://doi-org.ezproxy.liberty.edu/10.1177/1556264618804686

Donna Washburn (Donna)
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Should start at the top of a new page and use bold font.

DATA COLLECTION: TELEHEALTH 1

Data Collection: Telehealth

Nikita Chapman

Liberty University

Author Note

Nikita Chapman

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to

Nikita Chapman. Email: nmchapman@liberty.edu

mailto:nmchapman@liberty.edu

Donna Washburn (Donna)
143770000000926309
Remember to use bold font

DATA COLLECTION: TELEHEALTH 2

Data Collection: Telehealth

Every day people need to travel to access health care. With the help of telehealth, instead of

accessing health care, health care can access them in their homes. Telehealth is the delivery of a

health service across a distance. An example of telehealth maybe if a patient has a video

conference appointment from their home or a regional hospital directly to a specialist at the main

city hospital. Telehealth can also be delivered using the simple telephone by sharing information.

An example of this can be sending a digital image by email or through cellphones is an

excellent example of telehealth. It is a method of supporting people in remote rural, or remote

areas that cannot have access to specialists or experienced doctors for complex or higher degree

diseases (Jennett & Andruchuk, 2001). Telehealth can be beneficial for a range of appointments,

such as follow-up appointments.

Many of these conventional hurdles to telemedicine adoption have been broken down by the

quick popularity of telehealth in reaction to the severe social distancing regulations related to

COVID-19 (Hirko, 2020, p. 1817). For many health care organizations or clinics, a quick change

to this alternative is seen as the only way to earn revenue and provide assistance to patients. For

several healthcare organizations or clinics, a quick change to this alternative is seen as the only

way to earn revenue and provide assistance to patients (Hakim et al., 2020, p. 48). While many

of these organizations took a cautious and deliberate response, others have not.

Many have adapted to this strategy without considering its impact and whether this approach

is capable in the long run and is productive for both parties (Hilty, 2018, p. 819). It is undeniable

that doctors’ and patients’ direct experiences with telehealth will change their minds, either

constructively or destructively, regarding this model of care provision. In order to check the

effectiveness of the approach, a study needs to be conducted, and a methodology needs to be

DATA COLLECTION: TELEHEALTH 3

outlined. This methodology importantly includes the main three steps that are: study setting,

sampling process, and the procedure, and finally, the data collection.

Research Design

A research design needs to be outlined and constructed to determine the possible impact and

implications of the approach. The need for this approach is already identified because the rise

and new pandemic waves of Covid-19 variants highlight the importance (Hirko, 2020, p. 1818).

Due to lockdowns and social distancing restrictions, it is hard for people to attend medical

appointments or consultations and difficult for doctors to manage the patients for face-to-face

consultations or appointments. Therefore, present-day it is the need of time. The competency of

this approach needs to be evaluated, for which further study needs to be conducted.

Study Setting

The study needs to be conducted essentially at hospitals. For using this strategy, clinical

variables may need to be considered. These characteristics are to be taken into account on a

service-by-service basis, with clear documentation to assist physicians in selecting people who

could benefit from a telehealth session.

Patient information: The variable that should be considered are age, any comorbidities,

communication barriers, the urgency to provide medical care because of the disease, possible

sensory impairment, and whether they are qualified for the

use of telehealth.

Accessing type of delivery: It can be provided in a “hybrid” approach, with some

consultations taking place in person and others taking place over the phone. Patients with

complex or advanced-stage diseases will need in-person consultations or appointments to access

their condition by the doctors, and then their subsequent consultations or follow-up appointments

can be conducted with the help of telehealth service.

Donna Washburn (Donna)
143770000000926309
where? Describe your study population

Donna Washburn (Donna)
143770000000926309
This is where you paper appears to begin??? – the previous information was not required for this assignment.

Donna Washburn (Donna)
143770000000926309
Please re-word for clarity – its not clear what part of data collection methodology you are describing here.

Donna Washburn (Donna)
143770000000926309
See instructions and rubric for information required including inclusion exclusion criteria

DATA COLLECTION: TELEHEALTH 4

All these points need to be consulted with the doctors first, and it is vital to take their point of

view. Similarly, patients and people also need to be consulted to take their point of view

regarding this approach. Furthermore, the patients who have already used this approach can

provide more insight into the effectiveness as this approach is more importantly about patients. It

is essential to understand the effectiveness of this approach and whether it aided in tackling the

problems patients were facing.

Sampling Processes and Procedure

Many people belonging to a different line of fields, for example, a specialist in bioinformatics,

medical health assistance, policymaking, and public policy, need to be interviewed to understand

this approach and tackle it effectively from every aspect. The representatives or experts are

brought in to contribute information and comments but are not considered the study’s writers,

neither are responsible for its accuracy, and the study may not necessarily represent their

perspectives. Representatives are given chances to respond to the preliminary study “as part of

the peer-review process,” in addition to the previous discussion. Conducting interviews and

discussion with them is to understand any loophole or the issues with the policies based on the

use of telehealth.

The representatives will highlight the scope of this approach and provide their view on

tackling the issues with the stakeholders. They will also be given a questionnaire covering

questions regarding communication, doctors’ consultation, and disease management on their

behalf. Moreover, whether they would be more comfortable directly using a telephone as a

means of communication or software that would help them connect with their choice of expert or

specialist to help them with their medical conditions. Accessing their answers will help identify

the mode of delivery people will be more comfortable using the approach.

Donna Washburn (Donna)
143770000000926309
It is unclear how this relates to your research proposal?

DATA COLLECTION: TELEHEALTH 5

People who have used this strategy during or before the pandemic will be provided with

different questionnaires; they will cover their experience and effectiveness. The changes they

would want to see in the strategy and the problems they came across.

Data Collection

The survey of people and patients and the interviews of representatives will be collected and

analyzed. The questionnaires will be evaluated, and their contents will be analyzed. The results’

significance can be calculated using various software, and this software will aid in representing a

small set of possibilities and estimations that are not very accurate. Similarly, the interviews of

representatives will also be evaluated, and combining the suggestions and requirements or

problems that patients faced will be put together to make telehealth effective, efficient, and cost-

effective. Lastly, chi-square will be performed to look for links between systematic review

findings and possible outcomes, whether the reviews utilized statistical analysis, and if the

reviews included quality of data evaluation in their results (Totten et al., 1995).

Combining these steps and following this research model will aid significantly in

understanding the scope and effectiveness of telehealth for the patients and the doctors. The

ethical consideration should also be evaluated. Patient consent is vital because their information

will be taken for this approach, and there is a difference between in-person and Telehealth

appointments or consultations. Furthermore, during a telemedicine consultation, the same level

of privacy and confidentiality must be maintained during an in-person session (Cottrell &

Russell, 2020).

This approach can be helpful not only in a pandemic but also in accessing medical care for the

people living in the country or remote areas. As a result, it should not be taken as a temporary

Band-Aid but a long-term solution for people to securely receive health services.

Donna Washburn (Donna)
143770000000926309

Donna Washburn (Donna)
143770000000926309
I do not see a description of variables and how each will be measured. More importantly, how will you collect the data? What instruments will be used? Much info missing here.

Donna Washburn (Donna)
143770000000926309
Outdated reference

Donna Washburn (Donna)
143770000000926309
You must be specific with your methodology, including naming the specific software that you plan to use.

DATA COLLECTION: TELEHEALTH 6

References

Cottrell, M. A., & Russell, T. G. (2020). Telehealth for musculoskeletal

physiotherapy. Musculoskeletal Science and Practice, 48, 102193. https://doi-

org.ezproxy.liberty.edu/10.1016/j.msksp.2020.102193

Hakim, A. A., Kellish, A. S., Atabek, U., Spitz, F. R., & Hong, Y. K. (2020). Implications for the

use of telehealth in surgical patients during the COVID-19 pandemic. The American

Journal of Surgery, 220(1), 48-49. https://doi.org/10.1016/j.amjsurg.2020.04.026

Hilty. (2018). The Need to Implement and Evaluate Telehealth Competency Frameworks to

Ensure Quality Care across Behavioral Health Professions. Academic Psychiatry Official

Journal of the American Association of Directors of Psychiatric Residency Training and

the Association for Academic Psychiatry., 42(6), 818–824.

https://doi.org/10.1007/s40596-018-0992-5

Hirko. (2020). Telehealth in response to the COVID-19 pandemic: Implications for rural health

disparities. Journal of the American Medical Informatics Association : JAMIA., 27(11),

1816–1818. https://doi.org/10.1093/jamia/ocaa156

Jennett PA, Andruchuk K. Telehealth: ‘real life’ implementation issues. Comput Methods

Programs Biomed. 2001 Mar;64(3):169-74. doi: 10.1016/s0169-2607(00)00136-x.

PMID: 11226614

Totten, P. L., King, B. J., & Chatterji, J. (1995). U.S. Patent No. 5,458,195. Washington, DC:

U.S. Patent and Trademark Office. https://doi.org/10.1016/1352-0237(94)00035-N

https://doi-org.ezproxy.liberty.edu/10.1016/j.msksp.2020.102193

https://doi-org.ezproxy.liberty.edu/10.1016/j.msksp.2020.102193

https://doi-org.ezproxy.liberty.edu/10.1016/j.amjsurg.2020.04.026

https://doi.org/10.1007/s40596-018-0992-5

https://doi.org/10.1093/jamia/ocaa156

https://doi-org.ezproxy.liberty.edu/10.1016/1352-0237(94)00035-N

Donna Washburn (Donna)
143770000000926309
Same here – too outdated.

Donna Washburn (Donna)
143770000000926309
Need resources that are less than 5 years old

RESEARCH PROPOSAL: TELEHEALTH 1

Research Proposal: Telehealth

Nikita Chapman

Liberty University

Author Note

Nikita Chapman

I have no known conflict of interest to disclose.

Correspondence concerning this article should be addressed to

Nikita Chapman. Email: nmchapman@liberty.edu

mailto:nmchapman@liberty.edu

Donna Washburn (Donna)
143770000000926309
Excellent work on APA format – see note on reference page.

RESEARCH PROPOSAL: TELEHEALTH 2

Data Analysis

The data collection will be based on the survey involving patients who will be interviewed.

The questions related to the interview and the questionnaire will be developed to understand the

comfort and satisfaction level of the patients who are using the telehealth system to seek help

from their physicians. With the interviewer, the questionnaire will distribute relevant information

and data regarding the benefits of the telehealth system. Considering the conditions due to the

pandemic, these tools will be facilitated by video calls and emails to avoid physical contact.

After collecting the data in the form of an interview and questionnaire, the synthesized

data will then be subjected to SPSS, which is a statistical tool to analyze the collected data and

its significance (Gamble, 2017, p. 2338). For this purpose, a quantitative approach will be

utilized to involve the patients’ responses regarding their experience with the telehealth system

(Gamble, 2017, p. 2339). These responses need to be statistically explained to better understand

the success rate of telehealth systems in familiar people, especially in remote areas.

The questionnaire and interviews will also involve the demographic information of the

patients and their background to understand better the facilitation of the telehealth system in

different areas and people. The demographic information will include age, gender, ethnicity, and

race to determine which group benefited the most from the telehealth system. For this purpose,

the descriptive analysis will also be done, which will represent the background of the participants

in the form of percentages and frequencies (Hancock et al., 2019, p. 114).

An inferential statistical test will analyze the determination of other factors included in the

questionnaire and interview questions. Inferential statistical tests allowed the researchers to

explain the possible findings from which a conclusion can be drawn representing that particular

population. For this purpose, a Chi-square test will be performed to determine significant

Donna Washburn (Donna)
143770000000926309
Be sure to use correct grammar and use language describing your quantitative research. Again here you are speaking as if you are doing a qualitative study (evaluating a patient’s “experience”)

Donna Washburn (Donna)
143770000000926309
Nikita you had a good start with headings but missing some subheadings here. Please reformat to include (a) preparation of the data for analysis, (b) description of the sample, (c) testing the reliability of the measurement (d) level of significance.

Donna Washburn (Donna)
143770000000926309
on what variable – why chi-square? Is your data nominal? How many groups? what is the comparison? what is your research design element and the recommended statistic for this data?

Donna Washburn (Donna)
143770000000926309
Have you switched to a qualitative study? You used the word “understand” comfort and satisfaction level. Be sure to clearly state your objectives for your study – what is the outcome you want to measure from your research question? Otherwise you confuse your readers. In quantitative studies we use terms like “measure” and “compare”.

RESEARCH PROPOSAL: TELEHEALTH 3

findings that can help explain the proposed telehealth system, i.e., whether it fulfilled its purpose

and facilitated people of remote areas.

Rationale

The use of quantitative analysis helps provide synthesized data that explains the figures, which

can help us determine the benefits of the telehealth (tele-wound) system for the people of distant

and remote areas.

Level of Significance

The significant value in this test will be p < 0.05. The p-value, p=0.01, is considered

highly significant (Gamble, 2017).

Anticipated Results

It is estimated that the proposed telehealth system will be beneficial for remote areas as it is

based on the provision of medical help to inaccessible areas. Sometimes the people of remote

areas have to cover long distances to reach the hospitals; however, with the help of telehealth

systems, they can access their physicians without the physical journey. Regular checkups can be

efficiently conducted through this system to avoid long distances and receive medical help

without waiting for their turn.

Mataxen & Webb (2019), explained that implementing a telehealth system to provide tele-

wound facilities to remote areas has proved to be beneficial in wound care of the patients.

According to this study, the individuals who were treated with the help of telehealth systems are

considered to have improved patient outcomes, which also resulted in cost savings leading to

speedy healing. Mataxen & Webb (2019), also suggested that the implementation of telehealth

systems is directly related to the improvement of the patients as it benefits the patient’s clinical

Donna Washburn (Donna)
143770000000926309
You are talking about explaining it, but not explaining it. I’m not sure how else to put this?

Donna Washburn (Donna)
143770000000926309
Are you using .05 or .01?

RESEARCH PROPOSAL: TELEHEALTH 4

signs and healthcare systems in general. However, more research is still required to make the

systems more efficient in different locations where the patients can be treated.

In another study conducted by Hancock et al. (2019), the efficiency of the telehealth system

was assessed, which resulted in positive outcomes in the clinical trials. In this, the patients in the

remote areas were included and assessed by implementing the telehealth strategies. Clinical trials

detect the results brought a positive response from the patient, and this system was efficient in

providing clinical wound care treatment leading to cost-efficiency. From the findings of these

studies, it can be estimated that the current proposal will bring positive outcomes in terms of

increased patient satisfaction and improved healthcare leading to cost-efficiency.

Strengths and Weaknesses of Proposed Study

The telephone system utilizes modern means of communication while taking the patients to

avoid the rush in the hospitals or healthcare facilities. This system is targeted at the people of

remote areas where it is difficult for the patients to find different ways to cover these distances to

reach their nearest healthcare center. The proposed study will help them save their effort of

coming to the nearest healthcare facility for regular checkups. It is even more beneficial for older

people because of their health status. The tele-wound system under the category of telehealth

system will also provide the patients with necessary checkups without coming to the healthcare

facility (Hancock et al., 2019, p. 114)

However, it will be difficult for the elderly population to understand and utilize this system

because of technical knowledge. They may find it challenging to operate a digital system even

though it is easier to understand, but it may become more challenging for older adults. There is

also a chance of network unavailability, which can be due to natural disasters.

Donna Washburn (Donna)
143770000000926309
Be careful not to write a tutorial or get caught up in your study rationale here. Remember that this is the data analysis section of your paper and should be very data oriented. What is your null hypothesis and do you anticipate rejecting the null hypothesis? why? What will that measurement be? Do you anticipate having any other findings?

Donna Washburn (Donna)
143770000000926309
reword for clarity

Donna Washburn (Donna)
143770000000926309
This sounds like a different system? How does it apply here?

Donna Washburn (Donna)
143770000000926309
These are all good points but you will need to be more specific with your data analysis to provide better information here.

Donna Washburn (Donna)
143770000000926309
reword for clarity

RESEARCH PROPOSAL: TELEHEALTH 5

The involvement of both interviews and questionnaires will help cover more patients who

have been using the telehealth system. The questionnaires may be complicated for some

participants to fulfill due to a deficiency of technical knowledge. Therefore, the conduction of

interviews will suffice and allow the continuation of the data collection. The use of

telecommunication systems, including video calls and emails, will help avoid physical contact.

The implementation of statistical analysis will increase the validation of the research as it can

provide the statistically analyzed data representing whether the implementation of telehealth

systems will be beneficial for remote areas.

Suggestions for Future Research

Currently, the studies are restricted to limited remote areas with a small population based on

the older people, especially when it comes to the tale wound healthcare system. Therefore, there

is a need to expand the area of research, which can include people from different areas and acne

cities with an increased variety (Rutledge et al., 2021). It is necessary to understand how people

from different ethnicities consider implementing telehealth systems and what benefits will be

provided to the patients regarding the improvement in the provision of quality healthcare.

This study is limited to a smaller area. However, it can be expanded to larger areas. The study

can be expanded nationwide to understand the benefits of the telehealth system in different areas.

However, it can also be expanded to intercontinental interaction and implementation of

telehealth systems so that people from different countries can interact with physicians (Rutledge

et al., 2021). Moreover, there is also a necessity to make the general public aware of telehealth

systems through their mobile phone applications, which can bring various benefits, including

cost-efficiency of both the patients and the organizations. The adoption of telehealth systems and

the provision of digital care solutions is beneficial and, therefore, should be researched at a larger

Donna Washburn (Donna)
143770000000926309
This is a great idea for future research

Donna Washburn (Donna)
143770000000926309
This is good.

Donna Washburn (Donna)
143770000000926309
clarify

Donna Washburn (Donna)
143770000000926309
grammar

RESEARCH PROPOSAL: TELEHEALTH 6

scale to identify limiting factors and possible solutions for the continuation of telehealth systems

(Gamble, 2017, p. 2340).

RESEARCH PROPOSAL: TELEHEALTH 7

References

Gamble. (2017). Guidelines for the Content of Statistical Analysis Plans in Clinical

Trials. JAMA : the Journal of the American Medical Association. 318(23), 2337–2343.

https://doi.org/10.1001/jama.2017.18556

Hancock, S., Preston, N., Jones, H., & Gadoud, A. (2019). Telehealth in palliative care is being

described but not evaluated: A systematic review. BMC Palliative Care, 18(1), 114-

114. https://doi.org/10.1186/s12904-019-0495-5

Mataxen, P. A., & Webb, L. D. (2019). Telehealth nursing: More than just a phone call. Nursing

(Jenkintown, Pa.), 49(4), 11-

13. https://doi.org/10.1097/01.NURSE.0000553272.16933.4b

Rutledge, C. M., O’Rourke, J., Mason, A. M., Chike-Harris, K., Behnke, L., Melhado, L.,

Downes, L., & Gustin, T. (2021). Telehealth competencies for nursing education and

practice: The four P’s of telehealth. Nurse Educator, 46(5), 300-

305. https://doi.org/10.1097/NNE.0000000000000988

https://doi.org/10.1001/jama.2017.18556

https://doi.org/10.1186/s12904-019-0495-5

https://doi.org/10.1097/01.NURSE.0000553272.16933.4b

https://doi.org/10.1097/NNE.0000000000000988

Donna Washburn (Donna)
143770000000926309
watch these spaces – it might help to ensure there is a space between the period and the doi link. You have this problem in the last three references. Otherwise your format looks great.

Donna Washburn (Donna)
143770000000926309
Good – just need to resolve the issue with the hyphens – see comment below.

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