Introduction
The article that was chosen for the critique is “Preterm Birth among Pregnant Women Living in Areas with High Social Vulnerability” by Givens et al. (2021). The title provides all the necessary information to understand the study’s key research questions: it outlines the studied population, what variables are important, and what specific issue is investigated. It is succinct, informative, and short while conveying everything the reader needs to know.
The abstract is divided into five separate parts: background, objective, study design, results, and conclusion, each of which contains the main relevant points. The Background part of the abstract is slightly uninformative as it provides general information on how vulnerable communities are identified, and the actual topic is only mentioned in the last sentence. It lacks information about the connection between preterm birth and women who belong to highly vulnerable social groups. However, the following Objective segment is concise and provides clear insight into the purpose of the study, and the Study Design part explains in detail how the data was collected and assessed. The Results section is also rather informative, with study findings presented in an understandable and comprehensive manner. Finally, the Conclusion part summarizes briefly the main implications of the study and is short and concise.
Main body
The introduction presents the problem very well, identifying the problem clearly and unambiguously, as well as providing strong argumentation as to why it should be researched. The issue of preterm birth is rather significant for nursing, and the fact that the authors studied it in the context of vulnerable populations solidifies its relevance to practice. Seeing as the authors incorporate an integrated database tool – Social Vulnerability Index – into their study, and connect it with assessing populations at risk, the quantitative approach is fully appropriate.
There are no explicitly stated research hypotheses, which is justified as the authors seek to investigate the connection between preterm birth and social vulnerability. However, there is an identified objective to the research, and the authors provide a clear explanation and description of it, outlining the studied variables and populations well. The authors do not provide a separate section for literature review – rather, it is incorporated into the introduction as supporting evidence and to signify its relevance to the research. Each outside source is appropriate for the study, although the number of references is slightly smaller than what could be expected of such research. Still, all evidences offer strong support for the study and are synthesized well into a cohesive narrative. Key concepts are also defined in the introduction, and together they are used to build the research basis and develop argumentation for its relevance to modern healthcare. Rationales for the study are provided in a separate table alongside the introduction, outlining the main challenges and findings associated with the issue which is appropriate for the study.
Method
The authors took effective measures to protect patients’ identities by geocoding their addresses and concealing any personal information from third parties. However, there is no information if the study was reviewed by a certain ethics commission. Moreover, as the research was designed to investigate a correlation between social vulnerability and preterm birth, it does not provide any direct benefit to the participants. The study used a well-thought-out research design for its purpose as it employed a specific tool to evaluate the vulnerability of women in multiple categories. The Social Vulnerability Index provides a strong and reliable framework for comparing different populations, thus making the results more interpretable. The authors also collected data on patients’ medical history and previous pregnancy and birth outcomes and complications, which expanded the data pool significantly, providing enough information points for appropriate interpretation. However, one cannot say that the biases and validity threats were minimized fully, as authors verified patient records manually, and only partially checked additional cases. Moreover, the patients were not chosen and evaluated blindly.
The population sample, its characteristics, and relevant features are well-described: the authors provide a full explanation of the criteria they used for choosing participants. It can be said that the sampling design the authors employed suits the study methods the best, as it provided the most information about the population and ensured the best representativeness. The sampling biases were minimized as the authors used clear criteria to select participants. Moreover, the sample pool consisted of 685 main patient cases and 156 additional cases, which makes it fully adequate for the study. There is no information on whether the power analysis was used to determine the sample size.
The operational and conceptual definitions are congruent: the authors provide a clear explanation of how the data was incorporated into the analysis, what criteria were relevant, and how they were measured. The key variables were operationalized through investigation of patients’ medical history during a specific time period with regards to their sociodemographic characteristics which is an adequately appropriate method for the study. Each data point was fully justified and bore relevance to the study objectives. The Social Vulnerability Index was used as an additional tool to evaluate each participant’s social situation, which was rather useful for determining the population’s vulnerability. Its implementation was described in great detail, providing strong justification and context for its use.
The authors provide supporting links to federal healthcare authorities in regard to the reliability of the data obtained via the Social Vulnerability Index; the patient cases were provided by the University of North Carolina Hospital. The study did not implement any interventions; it was observational research. There is no information on the staff’s training in data collection. However, it can be said that, while it was not bias-proof, the data collection process was evidence-based and adequately analytical.
Results
The authors analyzed each research question and determined the correlation between preterm birth and social vulnerability. They utilized a variety of statistical tests, including several regression models, to ensure the validity and reliability of analysis given the number of variables, comparisons, and relevant criteria. The use of regression models can definitely be considered the most powerful analysis method for this study. It allowed the authors to minimize biases and evaluate several factors in relation to preterm birth as an outcome. There are no null hypotheses, thus, Type I and Type II errors were avoided. The authors acknowledge that there are missing values, however, as there was already an ample pool of analysis criteria, they were not addressed.
The information about statistical significance is presented and briefly explained, with effect size and precision estimates. The authors provide a clear and concise summary of their findings, illustrated by five tables and one figure, each discussing specific aspects of the results. There is not enough information for meta-analysis, however, the study could be combined with other research in this area of interest. It could also serve as supporting research for the development of an evidence-based practice aimed at pregnant women from socially vulnerable populations.
Discussion
The authors discuss their findings in various aspects, interpreting them in the context of overall results, of what is known about the issue up to this day, and as clinical implications. They explain causal inferences between social vulnerability and the risk of preterm birth, relating it to specific factors such as psychosocial stress, exposure to pollution, and lack of safety in the neighborhood. Seeing as the authors recognize the study’s limitations and discuss them in detail, it can be said that the implications of the study are justified and tailored to them. It is also specifically mentioned that the data was generalized to a certain extent and that additional, more detailed research would be needed in that regard.
The authors provide a brief explanation of the clinical implications of the study, making several suggestions about how to incorporate the Social Vulnerability Index into clinicians’ work with pregnant women. Due to the fact that the study has a more observational character, it does not provide any specific recommendations but encourages to research the issue further. The authors make reasonable claims and offer a complete discussion of the issue in the clinical context.
Global Issues
The article is written in a clear, concise manner, without including irrelevant information or making unreasonable claims. It utilizes a strictly academic voice and is well-organized, separated into sections, and provides sufficient details for assessment and subsequent analysis. The study can be accessed and interpreted well by practicing nurses, as it discusses the predispositions of the research, its findings, and implications in an understandable manner, without overly complicated terminology and with sufficient references. All authors have academic degrees and exhibit knowledgeability in the clinical issue they research, as well as comprehensive skills in statistical analysis which facilitates confidence in their study results and conclusions.
Conclusion
The findings appear to be valid as the authors acknowledge all possible limits of their research and discuss the nature of the correlation between preterm birth and social vulnerability in depth. The article provides valuable implications for nursing practice as it explores the risk factors associated with premature childbirth and how social conditions influence them.
Reference
Givens, M., Teal, E. N., Patel, V., & Manuck, T. A. (2021). Preterm birth among pregnant women living in areas with high social vulnerability. American Journal of Obstetrics & Gynecology MFM, 3(5), 100414. Web.