PUBH 8410 Week 6 Intervention Design Example

Course	PUBH 8410 Fundamentals of Leadership, System Evaluation, and Interventions in Public Health
Week	Week 6
Paper type	Intervention design paper
Length	About 1,090 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	PhD in Public Health
Updated	October 2026

Free sample paper for PUBH 8410 Week 6

Every Link an Assumption, Every Assumption a Measure: An Intervention Design for a Same-Day Treatment Pathway for Opioid Use Disorder in Pregnancy at Two Emergency Departments, a Jail and a Navigator Desk in a Composite County

Student Name

Walden University

PUBH 8410: Fundamentals of Leadership, System Evaluation, and Interventions in Public Health

Instructor Name

Month Day, Year

What this page is doingThe title states the design rule the paper follows: each step in the pathway is treated as a claim that could fail and is paired with an indicator.

Part One: The Intervention

Purpose

Ridgeline County, a composite county, will test the Bridge pathway for one year. No real hospital or jail is described; the settings combine common arrangements. The pathway responds to a finding from the county's root cause analysis: the doors where pregnant residents with opioid use disorder are recognized, two emergency departments, the jail's booking desk and the laboratory, have no one charged with starting or continuing treatment. Medication for opioid use disorder is the recommended treatment in pregnancy (American College of Obstetricians and Gynecologists [ACOG], 2017).

What this page is doingLinking the design to the earlier analysis shows the pathway answers a located cause rather than a general concern.

Who Is Eligible

Any patient who is pregnant, meets diagnostic criteria for opioid use disorder and is not currently receiving medication treatment is eligible at the emergency departments. At the jail, eligibility also includes anyone pregnant who reports or can be verified as taking buprenorphine or methadone at booking.

What Happens at Each Door

At Ridgeline General and St. Brendan's emergency departments, a standing order allows the treating clinician to give a first dose of buprenorphine once withdrawal is present, prescribe enough to last until a clinic visit, and send an electronic referral to the perinatal navigator before discharge. This mirrors the approach that kept most adults in treatment at 30 days in a randomized trial, compared with just over a third of those given only a referral (D'Onofrio et al., 2015).

At jail intake, the contractor verifies current medication with the prescriber or state prescription monitoring database and continues it within 24 hours. Pregnant people in withdrawal at booking are offered buprenorphine. Before release, the contractor books a clinic appointment and notifies the navigator. Forced withdrawal of pregnant people in custody is widespread and is contrary to clinical guidance (Ahlbach et al., 2020).

The county laboratory flags every positive opioid result from a prenatal panel to the navigator within one business day. The navigator contacts the patient, offers an appointment at Hollis Street Community Health Center within seven days, and keeps a list of every pregnant resident referred by any route.

What the Pathway Is Not

The pathway does not add toxicology testing, and its referrals do not go to child welfare. Infants born to people in treatment may still need monitoring for withdrawal, so the pathway's aim is treated pregnancy and milder, shorter nursery stays rather than the disappearance of withdrawal itself. Buprenorphine exposure in the MOTHER trial was associated with less morphine and shorter hospital stays for infants than methadone, though withdrawal still occurred (Jones et al., 2010).

Part Two: The Theory of Change

Weiss (1995) argued that programs rest on assumptions about how change will happen, and that evaluation should test those assumptions link by link rather than waiting for a final outcome. Laying the chain out exposes its weakest links before launch.

The chain shows why counting infants alone would mislead. Infant outcomes appear only at the seventh link, months after a pathway change, and a year's numbers in a single county are small.

Two links deserve particular attention. The third link, stock on hand, sounds trivial but determines whether a willing clinician can act at two in the morning; the readiness assessment found one department did not keep buprenorphine at all. The fourth link depends on one navigator serving the whole county. If either fails, every later link fails with it, however well the clinicians perform, so these two links receive monthly review from the first month. The second link carries a different kind of risk. Acceptance depends on trust, and trust depends on what patients have heard about reporting. That link cannot be fixed by supply or staffing, so its indicator is paired with the reasons patients give for declining, recorded in the pathway log without names.

Table 1

Theory of change for the Bridge pathway

Link	Assumption	Why it could fail \|
1	Eligible patients are identified at each door	Clinicians may not ask about pregnancy or opioid use \|
2	Patients accept a first dose or continuation	Fear that disclosure leads to a child welfare report \|
3	Buprenorphine is on hand when needed	Department or jail pharmacy does not stock it \|
4	The navigator reaches the patient within three days	Phone numbers change; one navigator for the whole county \|
5	The patient attends a first clinic visit within seven days	Transport, housing and work conflicts \|
6	The patient remains in treatment at 30 days and at delivery	Rearrest, lost coverage, side effects \|
7	Treated pregnancies lead to milder and shorter nursery stays	Other exposures or nursery practice changes dominate \|

Links 3 and 4 are judged weakest at launch, based on the readiness assessment.

Part Three: Measurement

Each link has its own indicator, so a failure can be located at a specific step.

Table 2

Indicators matched to each link

Link	Indicator	Data source	Baseline method	Target at one year	Review \|
1	Pregnant patients with opioid use disorder documented per month at each door	Department and jail records	Six months of chart review before launch	Rise above baseline	Monthly \|
2	Share of eligible patients given a first dose or continuation	Pathway log	Not available; set at first review	60%	Monthly \|
3	Days with buprenorphine out of stock	Pharmacy records	Prior six months	Zero	Monthly \|
4	Share of referrals contacted within three days	Navigator list	None before launch	75%	Monthly \|
5	Share attending a clinic visit within seven days	Clinic scheduling	Prior six months of referral slips	50%	Quarterly \|
6	Share in treatment at 30 days and at delivery	Clinic and hospital records	Prior year's case reviews	Rise above baseline	Quarterly \|
7	Infants needing medication for withdrawal; median nursery stay	Hospital records	Prior two years	Fall from baseline	Annually \|

Targets are illustrative design choices, not values derived from data.

Balancing Measures

A pathway can cause harm while meeting its targets. Three balancing measures will be tracked: emergency department length of stay for pathway patients, so the order does not crowd waiting rooms; reports to child welfare from pathway sites, so the pathway does not become a reporting route; and jail medical staff overtime, so continuation does not crowd out other care.

Fixing the Indicators in Advance

These indicators, sources and targets were fixed on a recorded date before any patient was enrolled, and they will be judged as written. Changing them later would require a dated amendment explaining why.

References

Ahlbach, C., Sufrin, C., & Shlafer, R. (2020). Care for incarcerated pregnant people with opioid use disorder: Equity and justice implications. Obstetrics & Gynecology, 136(3), 576-581. https://doi.org/10.1097/AOG.0000000000004002

American College of Obstetricians and Gynecologists. (2017). Committee opinion no. 711: Opioid use and opioid use disorder in pregnancy. Obstetrics & Gynecology, 130(2), e81-e94. https://doi.org/10.1097/AOG.0000000000002235

D'Onofrio, G., O'Connor, P. G., Pantalon, M. V., Chawarski, M. C., Busch, S. H., Owens, P. H., Bernstein, S. L., & Fiellin, D. A. (2015). Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: A randomized clinical trial. JAMA, 313(16), 1636-1644. https://doi.org/10.1001/jama.2015.3474

Jones, H. E., Kaltenbach, K., Heil, S. H., Stine, S. M., Coyle, M. G., Arria, A. M., O'Grady, K. E., Selby, P., Martin, P. R., & Fischer, G. (2010). Neonatal abstinence syndrome after methadone or buprenorphine exposure. New England Journal of Medicine, 363(24), 2320-2331. https://doi.org/10.1056/NEJMoa1005359

Weiss, C. H. (1995). Nothing as practical as good theory: Exploring theory-based evaluation for comprehensive community initiatives for children and families. In J. P. Connell, A. C. Kubisch, L. B. Schorr, & C. H. Weiss (Eds.), New approaches to evaluating community initiatives: Concepts, methods, and contexts (pp. 65-92). Aspen Institute.

Reading the PUBH 8410 Week 6 instructions

Intervention design assignments ask students to specify a program in enough detail that it could be implemented and evaluated. Prompts commonly require a description of the population, setting and activities, a logic model or theory of change, and a measurement plan with indicators and data sources. Some instructors also ask for balancing measures that would detect unintended harm. Students are expected to link the design to the problem analysis completed earlier in the course. Designs described in general terms, such as improving access or increasing awareness, are difficult to measure and tend to be marked down, since the purpose of the week is to show how each part of a program would be judged.

Inside the PUBH 8410 Week 6 example

Part one ties the pathway to the earlier root cause finding, defines who is eligible and describes what happens at each emergency department, at jail intake and at the laboratory and navigator desk. A short section states what the pathway is not, including that infants of treated mothers may still be monitored for withdrawal. Part two lays out a seven-link theory of change in a table and names the two weakest links. Part three gives a measurement table that mirrors the chain link for link. Balancing measures for emergency stays, child welfare reports and jail overtime follow, and a final paragraph records the date the indicators were fixed.

Reading the PUBH 8410 Week 6 rubric

Graders generally evaluate specificity of the design, coherence of the theory of change, quality of the measurement plan and attention to unintended effects. A design earns credit when a reader could tell exactly who receives what, where and when. The theory of change should state assumptions that could fail, not just list activities and outcomes. Measurement tables that match each link with an indicator, source, baseline and target show rigor. Recognizing that long-term outcomes are slow and small in number, and relying on earlier links for early judgment, demonstrates evaluation sense. Fixing indicators before launch and naming balancing measures both signal readiness for the evaluation work later in the course.

PUBH 8410 Week 6 help from the desk

Write the design as a sequence of things that happen to one patient, from the first door to the last appointment, and check that each step names a person and a time. Turn each step into an assumption by asking what must hold for that step to succeed. Then give every assumption an indicator you could actually collect. Decide which outcomes are too slow or rare to judge early, and say so. Add at least one measure of possible harm. Record the date you fix your targets. If you have a program idea but cannot turn it into a measurable chain, we can prepare a sample design worked through on your intervention.

Get a PUBH 8410 Week 6 example written to your instructions

Say what the intervention must change and where it would run, and include the Week 6 prompt and rubric; a design with its theory of change and a linked measurement table arrives in 24 to 48 hours, the first one free. A logic model template your section uses replaces the chain format if required.

More PUBH 8410 papers and PhD in Public Health samples

PUBH 8410 Week 6 questions, answered

Where can I find a free PUBH 8410 Week 6 sample paper?

The full Week 6 intervention design paper is above, specifying a same-day treatment pathway for opioid use disorder in pregnancy.

Who is eligible for the pathway?

Pregnant patients with opioid use disorder not on medication at the emergency departments, plus anyone pregnant already on treatment at jail booking.

Which links are judged weakest at launch?

Having buprenorphine in stock and one navigator reaching every referral within three days.

Why are infant outcomes treated as lagging?

They appear months after a change, are few in one county and can still include withdrawal among infants of treated mothers.

What balancing measures does the design track?

Emergency department stays for pathway patients, child welfare reports from pathway sites and jail staff overtime.