Data Collection and Analysis

Dear writer, please write the paper addressing following questions. I have made a manuscript and wanted to add answers for these questions to it. It’s a continuation of the project. I will give you my project outlines, so you can add it with Some explanation. Please make a rough budget, I will add the additions to it.

Data Collection and Analysis Plan, Barriers, Facilitators, Ethical Considerations, Resources, and Budget

Purpose- The purpose of this assignment is to continue the DNP Project Manuscript that you started in NR702. This assignment will allow you to present the data collection and analysis plan, barriers and facilitators, ethical considerations, project resources, and budget. These sections will further define the project design and plan and permit you to compose a meaningful DNP Project Manuscript.
Instruction
Take the information from prescreening documents and expand upon the content to provide an organized and well-written plan.
Follow the instructions on the template for the following sections that need to be completed as a part of this assignment. Contact your course faculty if you have questions.

1. Barriers, Facilitators, and Ethical Considerations: Describe the impact these items will have on your project implementation. Important elements for this section include the following:
   a. Assess barriers and state your plan to overcome these obstacles.
   b. Assess the facilitators and ways to leverage support.
   c. Evaluate changes with leadership that might impact the project.
   d. Analyze ethical considerations and your plan to protect private health information and/or data collected.
   e. State the IRB requirements from the university and practicum site.
   f. Explain if there is a need for informed consent or assent.
2. Data Collection and Analysis Plan: Describe your plan. Important elements for this section include the following:
   a. Create your detailed data collection plan with a description of how you plan to collect data and when.
   b. If a retrospective chart audit will be used, explain how you will collect pre- and post-intervention data.
   c. If a data collection instrument or tool is being used, describe the instrument or tool and provide validity and reliability for this tool with a citation and matching reference.
   d. Is permission to use the instrument or tool required? If so, state that you have permission and include the permission in the Appendix. permission? If the instrument or tool is in the public domain, provide this information.
   e. Explain the planned statistical analysis of the data collected.
   f. Summarize how the comparison of the pre-intervention and post-intervention data will determine the practice change project outcome and answer the practice question.
3. Resources and Proposed Budget: Describe the resources needed to implement your project. Include these resources for the project in your budget table in the appendix. Your completed budget table should be balanced so that every expense has an associated revenue entry.
4. References
   a. Each completed section of the template must be substantiated by citations from current peer-reviewed journals (within the last 5 years), government websites, such as the Centers for Disease Control and Prevention and the World Health Organization, and credible national and global organizations related to the problem.
   b. For the statistical data about incidence, prevalence, and mortality, students may use research and non-research such as peer-reviewed articles, government, and national registries on websites such as the CDC,AHRQ, World Health Organization, Kaiser Family Foundation, and Robert Wood Johnson
   c. Reference publication dates must be within the last 5 years.
   d. References must be from peer-reviewed journals, government websites, and credible national and global organizations related to the problem.
   e. In-text citations should align with the reference page.
   f. References must be in the current APA format.

Project outlines
Evidence based intervention- According to the Centers for Disease Control and Prevention (n.d), depression is a leading cause of mental health disability in the United States, often poses a significant health burden, and is a common cause of psychiatric outpatient visits. Recommended treatment for depression includes psychotherapy and pharmacotherapy (Haller et al., 2021). The identified practice gap is that mindfulness-based interventions (MBI), such as mindfulness-based stress reduction (MBSR), are not routinely recommended as a first-line or adjunct treatment at my clinical site. At my practicum site, depressive patients tend to stop increased doses of pharmacotherapy due to the side effects and are not able to access standard psychotherapy, such as Cognitive Behavioral Therapy (CBT) due to the financial burden that tends to keep them in the continuous depressive stage. The proposed DNP project intervention aims to decrease depression symptoms in mild to moderate depressive patients in an outpatient mental health setting by implementing an eight-week mindfulness-based stress reduction intervention administered through weekly lessons and self-directed daily sessions (Hoge et al., 2023). Mindfulness-Based Stress Reduction is a feasible and emerging non-pharmacologic treatment for depression, anxiety, and stress mitigation (Chi et al., 2018; Hoge et al., 2022). The intervention helps patients cultivate self-awareness, openness, and acceptance and assists individuals in making better decisions and enhancing their capacity for coping (Chi et al., 2018). The Mindfulness-Based Stress Reduction program helps individuals reduce their stress, distress, and somatic complaints of depression and anxiety and improve psychological well-being (Norouzi et al., 2020). With the explosion of self-help applications and telehealth interventions, Mindfulness Based Stress Reduction is available as self-administered or guided meditation and reflection exercises, providing a flexible and accessible treatment method (Chi et al., 2018; Hoge et al., 2022).
PICOT- In adult patients with mild to moderate depression at an outpatient mental health clinic, does implementing Mindfulness Based Stress Reduction (MBSR) compared to current practice improve depression symptoms in 8-10 weeks?

Population, inclusion and exclusion criteria- The patients will be included in the DNP project based on age and diagnosis. The project focuses on adults 18-65 years old experiencing mild to moderate depression. A Patient Health Questionnaire (PHQ-9) score of 5-14 is the threshold for inclusion. A consent form showing the project details will be offered, including how it will benefit them and any risks involved. Those meeting the inclusion criteria must give informed consent to the project and its requirements. Those with severe depression will be excluded from the study since they likely undergo more rigorous treatment methods. Exclusion criteria for the proposed project include patients’ population with chronic depression (>2 years), mania, psychosis, and participants with physical, cognitive, and intellectual disabilities. It is expected that the project will have about 20-25 participants.

Intervention- I will, along with trained mindfulness instructors, will implement the Mindfulness Based Stress Reduction intervention to participating 18-65-year-old patients with mild to moderate depression. Sessions will occur twice weekly, with 45-minute sessions and one 8-hour weekend class on the 6th week of the implementation period. The lessons on mindfulness meditation and Mindfulness Based Stress Reduction activities will be conducted through in-person and through Zoom sessions. The recommended daily self-directed activities can be completed by participants at their own homes or other location of choice.
Week 1: Recruitment and staff training begins. I will begin reaching out to potential participants to explain the Mindfulness Based Stress Reduction program, its benefits, and the structure of the program, explain the time commitment, and obtain informed consent. Appointments will be scheduled for the in-person and virtual sessions. Staff training will occur which will include details of the project, timeline, and outline of training sessions.
Weeks 2-9: Intervention begins. I will introduce the instructors, provide program materials, and demonstrate how to download the free My Possible Self app to participants. A baseline assessment will be conducted using participant completed PHQ-9 surveys to assess pre- intervention data, the initial depression screening score. I and a Psychiatric Mental Health Nurse Practitioner will be available to work with participants for 45 minute sessions twice weekly. These sessions on mindfulness principles and practices will be conducted through in-person or Zoom meetings. Participants will be instructed on using the My Possible Self app for guiding daily 45-minute self-directed Mindfulness Based Stress Reduction activities and logging their daily activities. During this intervention period, formative evaluations will take place. I will solicit and provide feedback through discussions with stakeholders in weekly leadership meetings, biweekly huddles, and 1:1 weekly meeting with participants to discuss challenges, and experiences and get guidance.
Week 6: Participants will attend a virtual mindfulness workshop conducted by a me and the Psychiatric Mental Health Nurse Practitioner. Topics will include yoga, mindful walking, and meditation to enhance their practice.
Week 10: Conclusion. I will wrap up the project, administer post-intervention PHQ-9 screenings, and thank participants for being part of my DNP practice change project. One-on-one discussions with participants to assess their experience and challenges will be completed, during which time we will discuss post-intervention recourses for maintenance of mindfulness, and celebrate achievements. I plan to utilize this time to thank every participant for being part of the practice change project and for their support.
Week 11: Analysis of data will begin. Project results will be disseminated.

Data collection plan- Pre and post-test depression assessment will be done using Patient Health Questionnaire-9, a validated tool with high sensitivity, specificity, and reliability. Levis et al. (2019) found the tool has a sensitivity of 0.88 (95% CI 0.83-0.92) and a specificity of 0.85 (95% CI 0.82-0.88) in a meta-analysis of 29 studies with 6725 participants. As the project manager, I will utilize the My Possible Self (MPS) app and data collection tools for week-to-week assessments. My Possible Self is a well-established, validated app with a track record of showing significant improvements in depression, anxiety, and stress in users over a short period (De Kock et al., 2022). Besides the My Possible Self app, I will rely on weekly logs, PHQ-9 scores, and Zoom meeting observations for data collection. I will conduct the assessment process during the second phase through three steps, including data collection, data analysis, and improvement, from weeks two to nine. I will rely on weekly check-ins, attendance records in Zoom meetings and mindfulness sessions, and track their daily activities on meditation, mindfulness, and other self-care activities on the My Possible Self app and monitor for data collection during the implementation periods. Participants will log their daily Mindfulness-Based Stress Reduction activities on an online My Possible Self app. Compliance with Mindfulness-Based Stress Reduction activities will be measured on an ordinal scale with three levels: low, moderate, and high based on the average number of minutes spent in the scheduled activities.
Data Analysis- The outcome identified in the PICOT question is depression symptoms assessed through patient-reported signs and symptoms and scored using the PHQ-9. Descriptive statistics: median and range for baseline and post-test PHQ-9 scores will be calculated. Compliance with Mindfulness-Based Stress Reduction activities will be reported in the form of frequencies for the three levels. The chi-square test will be used for baseline and post-test comparisons.
Data collection process- Participant pre and post-implementation PHQ-9 scores obtained through completed survey