Doctor of nursing practice (DNP) education is heavily focused on innovative and evidence-based practices (EBPs) that reflect the ability to translate research findings to practice settings. Unlike the PhD-prepared nurse who generates external evidence through rigorous research, the DNP-prepared nurse generates internal evidence through quality improvement, outcomes management, and EBP change projects. The practice-focused programs generally require the student to carry out a capstone project as the terminal work of the DNP. The capstone exemplar describes how a DNP student was guided to design and implement an EBP capstone project from beginning clinical inquiry to dissemination of the results of the completed project. This DNP capstone project used the seven steps of EBP and selected Essentials to implement an EBP change, resulting in improved outcomes for depressed teens treated at a rural community-based mental health clinic.

The research design is the foundation or backbone of a study. It is the overall plan for answering the study question(s) or testing the hypotheses, which includes: the strategies that will be used to control for confounding variables; the exact times that the intervention(s) will be implemented; and the number of times that data will be collected. Experimental designs are used to test the effects of an intervention or treatment on an outcome. They are the designs that need to be used when an investigator is interested in generating evidence to support causality. The gold standard for experimental studies is the randomized controlled trial (RCT) or a true experiment because it is the strongest design for testing cause and effect relationships. When designing an intervention study, it is best to choose valid and reliable measures that have been used with similar study populations.

The world of grant writing is highly competitive. Therefore, it is extremely important that every time one submits a grant application, it is near perfection. Many funding agencies list areas of priority for grant applications. It is often helpful to obtain presubmission consultation from the funding agency. If one does request a consultation from the funding agency, it is best to prepare an abstract of the study or project that one would like to propose, which outlines its background/significance, innovation, sample, methods, and analysis with implications for clinical practice and/or future research. Before submitting the application, it is helpful for a mock review of one's application to be conducted. This chapter describes the specific steps in writing a grant proposal. It presents criteria used in reviewing grants with common feedback from reviewers and provides strategies for resubmitting nonfunded grants.

One of the fundamental building blocks that lays the foundation for intervention work and evidence-based quality improvement (EBQI) is the "so what" factor. The "so what" factor is a term we are using to describe the development and conduct of research and EBQIs with high impact potential to improve important outcomes. We must focus more on the "so what" factors as investigators and clinicians craft new studies and build programs of research and EBQI initiatives focusing on problems that are amenable to change. Planting the "so what" seeds is the first step in designing a successful intervention study or EBQI project. Without this approach, we risk continuing to generate a large number of research findings that are disseminated through publications and presentations but, to a large extent, do not make it into the real world to positively impact outcomes.

Mental health/behavioral disorders have been increasing over recent decades and now affect approximately one out of five children and adolescents, creating a major public health epidemic. The three most common mental health problems in children and adolescents are anxiety disorders, depressive disorders, and attention-deficit/hyperactivity disorder with depression being the most costly primary mental health diagnosis. Early detection of and evidence-based intervention for mental health/behavioral problems is critical in order to prevent serious ongoing adverse outcomes. This chapter provides questionnaires that can be used for the purpose of collecting information on potential mental health/psychosocial problems from families in primary care or other types of pediatric and adolescent clinical settings. These questionnaires explore issues that parents and teens may be thinking about or reveal areas of concern. The chapter also presents screening tools that can be provided to children and adolescents.

Depressive disorders include major depressive disorder, persistent depressive disorder (dysthymia), disruptive mood dysregulation disorder, premenstrual dysphoric disorder, substance/medication-induced depressive disorder, and depressive disorder due to another medical condition. The common feature of depressive disorders is the presence of sad, empty, or irritable mood, which is associated with somatic and cognitive changes that interfere with functioning at home, in school and/or with peers. The risk in children/teens is increased if one or more parents are depressed. Depression is a risk factor for other high-risk behaviors and often precedes substance abuse by about four years. Depression is often misdiagnosed as ADHD in young children as they may present with inattention, impulsivity, and hyperactivity. This chapter provides a brief overview of depression and discusses the assessment and evidence-based management of depressive disorders in children and teens.

It is common for U.S. children to experience divorce of their parent, affecting more than 1 million every year. Several decades of research indicate that the outcomes for children and adolescents following divorce are determined by numerous factors that can increase risk or foster resilience. The risk of emotional, behavioral, social, and academic problems for children of divorced parents (25%) is more than double than that of children whose parents are continuously married (10%). Externalizing problems (e.g., acting out behaviors, impulsivity) have been consistently identified as the most common problems identified in children after divorce. Interparental hostility and lack of cooperation between parents following divorce is the most consistent predictor of poor outcomes among children. The child’s age at the time of divorce affects outcomes related to the developmental tasks associated with that age. This chapter describes the impact of marital separation and divorce on children and parents.