Evaluation of Population Health Improvement Initiative (PHII) Outcomes

Traumatic Brain Injury Report
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Evaluation of Population Health Improvement Initiative (PHII) Outcomes
Safe Headspace was established to enhance the lives of people, especially the older population, who have posttraumatic stress disorder (PTSD) after suffering from a traumatic brain injury (TBI) a long time, or probably decades after the initial insult. The Safe Headspace also established the PHII outcomes for both TBI and PTSD, which were inspired by the poor treatment of mental health issues among the combat veterans of Vietnam during the war in the 1970s. During the said period, there was insufficient information on mental health problems and their impact on the overall welfare of the individual, resulting in lifelong damage, even up to the time that the combatants were already senior citizens. Thus, the plan aimed to alleviate the overall sense of well-being of the patients with mental health issues. It also consisted of several interventions, but among these, the project focused on exercise, medications, and meditation (Capella University, n.d.).
The Interventions
The Safe Headspace Director mentioned that the assigned participants under the exercise group demonstrated the most significant improvement. The participants consisted of mostly men between 45 to 80 years old. The exercise regimen followed the recommendations of the Centers for Disease Control and Prevention (CDC) of undergoing moderate aerobic exercise for four weeks, but the specific exercises and duration were not mentioned. The results revealed a significant enhancement in the participants' memory, mood, and muscle control. The attrition rate was high, but approximately 75% of all the participants continued the exercise regimen for the next three months, resulting in an overall improvement of 15% for the muscle control, 22% for the mood, and 61% for the short- to medium-term memory (Capella University, n.d.).
Second, some of the participants, who did not receive initial medical therapy, were enrolled under the medication therapy where they were initially assessed by a psychotherapist and were prescribed by either an anti-depressant or anti-psychotic, comprising 40% and 9% of all the participants, respectively, for six months. Re-evaluation revealed that 6% and 26% improved muscle control and memory, respectively (Capella University, n.d.).
The last intervention that showed significant improvement was a 10- to 15-minute home meditation. Only 23 individuals participated for three weeks, resulting in 32% and 70% improvement in muscle control and mood, respectively (Capella University, n.d.).
Issues
Many issues have been identified in the plan of the Safe Headspace. This includes the number and distribution of the participants, the design of the treatment, and the analysis of the results. These are important to ensure that the data about the treatment regimens that showed significant improvement in mood, memory, and muscle control are reliable.
First, there was no mention of the diagnosis of the participants. It is unknown whether they were diagnosed with TBI or PTSD, or both, and the criteria for the diagnosis were not discussed. There was also an unequal distribution of the participants and a lack of randomization for each treatment regimen. The assignment of the participants was based solely on their interests, which may result in a placebo effect. According to Howick & Hoffmann (2018), this makes the intervention "inactive" since it does not have the active component, eradicating the intervention's baseline measurement, resulting in the lack of comparison for the effectiveness of one intervention against the other. Additionally, all the interested participants were welcomed without considering inclusion and exclusion criteria to generate a high-quality protocol for such patients in the future (Patino & Ferreira, 2018).
Second, the design of the treatment was not adequately explained. The exercise regimen was based on the recommendations of the CDC, which state that the older adult population needs moderate-intensity aerobic exercise for at least 150 minutes a week (Centers for Disease Control and Prevention, 2021). Safe Headspace allowed any exercise, and the duration was not specified. Thus, the results were unreliable since one form or the length may be effective for one participant but not the other.
Third, the analysis of results only utilized descriptive statistics, without inferential statistics and statistical tests. The percentage was used, which is a form of descriptive statistics, and this only aims to describe the basics of data.
Strategies for Improving PHII Outcomes
To improve the PHII outcomes, it is critical to address the three identified issues. The project should be converted to a clinical trial to prevent wasting the efforts in data gathering and ensure that the interventions are valid, applicable, and reliable to patients with PTSD who suffer from TBI. The following are the strategies to improve the PHII outcomes:
First, the number of participants should be representative of the whole population. The potential participants should be evaluated based on the inclusion and exclusion criteria formulated by the researchers. Problems with participant information should also be resolved to ensure the normality of data (Chaudhari et al., 2020).
Second, the interventions should be guided by a specific, measurable, achievable, relevant, and time-bound (SMART) objective to ensure the success of a working plan while systematically assessing the progress of each participant (Minnesota Department of Health, n.d.). Furthermore, the interventions should be evidence-based (Oliver & Pearce, 2017).
Third, descriptive and inferential statistics should describe and interpret the data gathered. This is to ensure that the project's goals were met and that the results about the effectiveness of the treatment regimen are valid, applicable, and reliable. Descriptive statistics describe the data, while inferential statistics he...