| Course | NR 539 Population Health II: Planning, Implementation, and Evaluation |
|---|---|
| Week | 3 |
| Paper type | Intervention selection memo |
| Length | About 940 words, 2 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Population Health |
| Updated | September 2026 |
Free sample paper for NR 539 Week 3
Memorandum
To: County Health Director; Up and Steady steering group
From: Student Name, RN, Public Health Nurse and Program Lead
Date: Month Day, Year
Re: Choice of core intervention for Up and Steady: home visits by the community paramedic rather than call alarms and volunteer calls
Decision Requested
The steering group has two sound options for the core of Up and Steady, and the grant cannot pay for both at full scale. I recommend Option A, a visit at home from the ambulance service's community paramedic in the week after any older resident's lift-assist call, who screens for fall risk, looks for hazards around the house and makes referrals. I recommend against Option B, free personal call alarms for the same residents, with weekly check-in calls by trained volunteers. Both options address the need the assessment identified. This memo explains why A is preferred and, as fairly as I can, why B was not chosen, so that the group can judge the decision rather than accept it.
What Each Option Would Do
Option A. About 280 visits a year by a community paramedic, costing about $38,000 a year in staff time and mileage, plus about $9,000 a year for minor home modifications through the aging agency's handyman program. Each visit screens for fall risk using a federal fall prevention resource, checks the home for hazards, sends a medication list to the person's primary care provider and refers to strength and balance classes. Repeat callers are reviewed monthly.
Option B. Call alarms, worn as a pendant or wristband, for about 200 residents at a monthly service cost of about $30 each, or $72,000 a year, plus a volunteer coordinator at $12,000 a year. Volunteers would call each person weekly. The alarm would summon help after a fall, and the calls would reduce isolation.
The Case for Option B
Option B deserves a serious hearing. It addresses the fear older adults described most vividly in the listening session: lying on the floor, unable to get up, for hours. Long lies are dangerous. Following people aged over 90 for a year, Fleming and Brayne (2008) found that four in five of those who fell could not get up at least once, that most falls happened with no one else present, and that the people left on the floor longest were the ones who went on to serious injury, admission and residential care. An alarm could shorten those lies. Weekly calls would also address isolation, which ranked third in the assessment and was the concern participants raised most strongly.
The Case Against Option B
Option B has three weaknesses that decide the choice.
Alarms are often not used. The same cohort study found that call alarms were widely available but were not used in most falls that led to a long lie, for reasons including a sense that the alarm was irrelevant, concern about independence and practical difficulties (Fleming & Brayne, 2008). If our residents behave similarly, a large share of the alarm budget would buy devices that stay in drawers or on bedside tables.
Alarms do not prevent falls. An alarm can shorten the time on the floor after a fall, but it does nothing to reduce the next fall. The assessment's priority was follow-up that changes what happens next, and among our repeat callers, falls followed patterns, such as night-time trips to the bathroom, that a home visit can address and an alarm cannot.
Most people in the target group already get help. Everyone in the target group has, by definition, already called the ambulance and been helped up. Their problem is not reaching help once; it is falling again. Option B spends most of its budget on a problem this group has shown it can solve.
The Case for Option A
Option A acts on the causes of the next fall. A Cochrane review found that exercise reduced the rate of falls in older people living in the community (Sherrington et al., 2019), and home visits are the route by which our target group would be referred to classes. A cluster randomized trial found that a community paramedic health promotion program in social housing buildings for older adults reduced ambulance calls compared with control buildings (Agarwal et al., 2018). The setting differed from ours, but the mechanism, a paramedic who knows the person and addresses risks at home, is the same. Option A also uses existing assets: the community paramedic, the ambulance data agreement and the handyman program.
Option A is cheaper. At about $47,000 a year, it leaves room in the $74,000 annual grant budget for the classes and evaluation. Option B would consume nearly all of it.
What Option A Borrows From Option B
Rejecting Option B does not mean ignoring what it was right about. The home visit will include a conversation about what the person would do if they fell and could not get up, and practice getting up from the floor where it is safe. People who live alone and want an alarm will be referred to the aging agency's existing subsidized alarm program, so that those who will use one can have one. And the monthly review will flag anyone the paramedic judges to be isolated for referral to the aging agency's friendly-caller volunteers. These additions cost little and keep the strongest parts of Option B.
Recommendation
I recommend that the steering group approve Option A as the core intervention, with the three borrowed elements above. If the evaluation after the first year shows that many repeat callers experienced long lies despite visits, the group should revisit alarms for that subgroup, using the remaining grant funds.
References
Agarwal, G., Angeles, R., Pirrie, M., McLeod, B., Marzanek, F., Parascandalo, J., & Thabane, L. (2018). Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: A cluster randomized trial. Canadian Medical Association Journal, 190(21), E638-E647. https://doi.org/10.1503/cmaj.170740
Fleming, J., & Brayne, C. (2008). Inability to get up after falling, subsequent time on floor, and summoning help: Prospective cohort study in people over 90. BMJ, 337, Article a2227. https://doi.org/10.1136/bmj.a2227
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019(1), Article CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
NR 539 Week 3 instructions, in plain terms
Choosing an intervention is the focus of Week 3. Prompts generally ask you to compare possible interventions for your priority need, using evidence, feasibility, cost and fit with the population, and to recommend one. Pick two options that are genuinely sound, since comparing a good option with a weak one proves little. Describe each with its costs and activities. Then argue the rejected option's case as strongly as you can before answering it with evidence. Explain why the chosen option fits better. Consider borrowing the rejected option's best features. State what evidence would make you revisit the choice. Use memo format with a clear request, and cite intervention evidence in APA 7.
Inside the NR 539 Week 3 example
The memo opens with the decision requested and a promise to argue against the rejected option fairly. Both options are described with annual costs. A section makes the case for call alarms, citing a cohort of people over 90 in which most who fell could not get up and long lies predicted serious harm. A section then answers it with three weaknesses: alarms often unused in that same study, no effect on the next fall and a target group that already reached help. The case for visits draws on exercise and community paramedicine trials and on cost. A section borrows three elements from the alarm option, and the memo closes with a condition for revisiting the choice.
Reading the NR 539 Week 3 grading rubric
Intervention selection rubrics typically reward comparison of evidence-based options, clear criteria, consideration of cost and feasibility, fit with the population and a justified recommendation. Graders favor memos that treat the rejected option fairly and answer its strongest points, since that shows judgment rather than advocacy. Using the same evidence to show both an option's appeal and its limits demonstrates careful reading. Cost figures tied to the program budget show practical grounding. Borrowing the rejected option's strengths reflects flexibility. A stated condition for revisiting the choice shows openness to evidence. Memo format and correct citations support the communication criterion. A clear request at the top, stated as a decision, helps a steering group act on the memo.
NR 539 Week 3 help from the desk
A frequent weakness is a comparison in which the rejected option is described in a sentence and dismissed. Make its case properly. Another is choosing on evidence alone without cost or feasibility, which leads to plans that cannot be funded. Include both. Students also cite evidence for the chosen option but none against the rejected one. Balance it. Avoid options that do not address the same need, since they cannot be compared. Do not ignore what participants said they wanted; explain how the choice responds. Keep the memo short enough for a steering group. Finally, name what would change your recommendation, since a choice with no conditions reads as preference.
Get a NR 539 Week 3 example written to your instructions
Send the memo instructions, the rubric and the population your section assigned, and a custom NR 539 example is written to them and returned inside 24 to 48 hours, the first one free. Say which candidate interventions you are weighing if you already have them; if not, the example proposes three and defends one.
More NR 539 papers and MSN samples
- NR 539 Week 1: Discussion on Program Commitments
- NR 539 Week 2: Logic Model Draft
- NR 539 Week 4: Implementation Timeline
- NR 539 Week 5: Stakeholder Engagement Plan
- NR 539 Week 6: Process Evaluation Write-up
- NR 539 Week 7: Outcome Evaluation Plan
- NR 539 Week 8: Program Report
- NR 538 Week 3: Indicator Selection Memo
- NR 530 Week 3: Social Determinants Map
NR 539 Week 3 questions, answered
How many options should the memo compare?
Three is the usual number in the examples that mark well, and rubrics rarely reward more. Two can look like a formality and five spreads the analysis so thin that no option gets a real paragraph. The count matters less than whether each option could realistically have been funded by the same body.
Does the memo need a formal criteria table?
Not always, but a table makes the reasoning inspectable and takes little space, so most finished examples include one. The important discipline is stating the criteria and their weights before applying them. A reader who sees the weights only in the discussion has no way of telling whether they were chosen to produce the answer already reached.
Can an intervention be adapted rather than adopted whole?
Yes, and saying which parts you would keep and which you would change is stronger than either copying or inventing. The useful move is to separate the elements the evidence rests on from the packaging around them, then adapt only the packaging. Memos that adapt silently lose marks because the reader cannot tell what is still evidence based.
Where can I find a free NR 539 Week 3 sample paper?
The visits-versus-alarms selection memo above is the complete NR 539 Week 3 sample, readable in full here. If you are choosing between other interventions, describe both options to us and a memo that argues each fairly can be written.
Should the NR 539 memo argue for the rejected option?
Yes, as strongly as it deserves before answering it. The sample makes the case for call alarms using evidence on long lies after falls, then shows why the same evidence and the target group favor home visits.