| Course | NURS 700 Advanced Nursing Research (NURS700) |
|---|---|
| Module/Week | 8 |
| Assignment | Summary and Synthesis Assignment |
| Paper type | Evidence synthesis table with narrative analysis |
| Length | about 811 words, 3 double-spaced pages plus title page and references. Course guide: a table addressing the studies retrieved for the annotated bibliography, analyzing each in depth for quality and application to practice, supported by a written synthesis |
| Format | APA 7 student paper |
| Points | 150 |
| School | Liberty University Online |
| Program | DNP |
| Where it sits | Module/Week 8 in Liberty's published NURS 700 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for NURS 700 Week 8
Summary and Synthesis of Twelve Studies on Lung Cancer Screening Uptake: Quality, Agreement and What the Evidence Supports for Rural Primary Care
[Student Name]
School of Nursing, Liberty University
NURS 700: Advanced Nursing Research
Summary and Synthesis Assignment
[Instructor Name]
[Date]
The practice setting is a composite carried through the course; the twelve studies are real.
Summary and Synthesis of Twelve Studies on Lung Cancer Screening Uptake: Quality, Agreement and What the Evidence Supports for Rural Primary Care
Question and Rating Approach
The question followed through this course asks whether outreach by clinic nurses, built around decision counseling and staged reminders, compared with usual care, increases completion of lung cancer screening among eligible adults in rural primary care. Each of the twelve studies is rated on two scales. Level of evidence runs from I, a systematic review, through II for randomized trials, III for quasi-experimental and pilot designs, IV for nonexperimental surveys and V to VI for case, qualitative and descriptive studies. Each study also receives one of three quality grades, high, moderate or low, judged on sample size, risk of bias, measurement and reporting, and the main reason is given. Application describes how directly the findings transfer to four rural clinics where registered nurses would deliver outreach.
Evidence Table
| Study | Design and level | Sample and setting | Key result | Quality | Application to rural primary care |
|---|---|---|---|---|---|
| Arana-Chicas et al. (2026) | Qualitative, VI | 19 Hispanic adults, focus groups | Low awareness, fear and fatalism | Moderate: small, purposive | Moderate: shapes message tone |
| Carroll et al. (2026) | Pragmatic RCT, II | 894 never-screened patients, Colorado | Pre-visit letter did not raise orders | High: registered, adequate size | High: warns against passive prompts |
| Cho et al. (2026) | Ecological, IV | State-level survey and registry data | No link between facilities and uptake | Moderate: aggregate data | Moderate: capacity is not the barrier |
| DiCarlo et al. (2026) | RCT, II | 2,572 primary care patients | Outreach and counseling raised referrals | Moderate: eligibility data unreliable | High: nurse counseling transferable |
| Jia et al. (2026) | National survey, IV | 5,987 adults, weighted to 37.5 million | Past-year uptake 17.8% among eligible | High: national, weighted | Moderate: frames scale of gap |
| Katcher et al. (2026) | Pilot RCT, III | 36 Chinese and Korean Americans | Faster, higher completion with navigation | Low: very small sample | Moderate: navigation helped lower-income patients |
| Landsteiner et al. (2026) | Systematic review, I | 31 US studies | Decision support may raise participation | High method, low certainty of evidence | High: supports counseling by coordinators |
| Reid et al. (2026) | Qualitative, VI | 18 clinicians, navigators, staff | Data, priority and patient barriers | Moderate: framework-guided | High: barriers match the network |
| Samami et al. (2026) | Online survey, IV | 521 never-screened eligible adults | Most unaware but willing if recommended | Moderate: panel sample | High: supports direct recommendation |
| Sharifian et al. (2026) | Single-arm mixed methods, III | 70 patients, 5 physicians | Components rated helpful; stigma, scheduling barriers | Low: no comparison group | Moderate: bundle design ideas |
| Walsh et al. (2026) | Case study, V | Three community programs | Care pathways varied widely | Moderate: rich, not generalizable | High: map workflow before launch |
| Wernli et al. (2026) | Factorial RCT, II | 1,837 patients, integrated system | Stepped reminders raised annual adherence 27.7 points | High: large, objective outcome | Moderate to high: needs a coordinator role |
Synthesis of Findings
Active Outreach Increases Screening
The strongest finding across the table is that a person or system actively reaching out raises screening. Two randomized trials agree: telephone outreach with decision counseling increased referrals and orders in primary care (DiCarlo et al., 2026), and coordinator-led stepped reminders substantially increased annual adherence (Wernli et al., 2026). The one systematic review in the set leans the same way, though its authors grade their confidence as low (Landsteiner et al., 2026), and a small pilot suggests that tailored navigation shortened the time to screening (Katcher et al., 2026). The studies differ in outcome, first-time referral in one and annual adherence in the other, but they point the same way.
Passive Messages Do Not
The table also shows a consistent negative finding. A pre-visit letter did not increase orders (Carroll et al., 2026), and print and video communication did not improve adherence in the factorial trial (Wernli et al., 2026). Read together, the positive and negative trials suggest that what changes behavior is not information but someone taking responsibility for the next step.
Barriers Are Practical and Informational
The surveys and qualitative studies explain why passive approaches fail. Most eligible adults have never heard of screening, yet many would agree if a clinician recommended it (Samami et al., 2026). Clinicians, navigators and staff describe missing pack-year data, competing priorities, transportation and time off work as obstacles (Reid et al., 2026), and patients in a multilevel pilot added scheduling, insurance delays and stigma (Sharifian et al., 2026). Fear and fatalism appear among Hispanic adults as well (Arana-Chicas et al., 2026). Facility supply does not explain state differences in uptake (Cho et al., 2026), reinforcing that the gap lies between patients and existing services.
Adherence Is a Separate Target
Only one trial measured annual adherence, and it found the largest effect of any intervention in the set. Because the national survey shows that even first-time uptake is low (Jia et al., 2026), a program must address both getting patients to a first scan and keeping them on schedule.
Where the Studies Disagree
The studies are not entirely consistent. The outreach trial found a clear effect on referrals and orders but only a borderline effect on completed scans (DiCarlo et al., 2026), while the factorial trial found a large effect on completed annual scans. One explanation is that the second trial's coordinator handled scheduling as well as reminders, closing the gap between an order and a scan. Another is that the populations differed, since one trial studied first-time screening and the other repeat screening among patients who had already engaged once. The disagreement matters for the network: outreach that stops at an order may leave many patients unscreened, so the nurses' role should extend to scheduling and transport.
Strength of the Body of Evidence
Overall, the evidence for active outreach is moderate to strong: two randomized trials, one of them large and high quality, agree in direction and are supported by a systematic review and several descriptive studies. The evidence against passive messaging is also moderate, resting on two randomized comparisons. The weakest part of the body of evidence is applicability to rural primary care. Most trials took place in integrated urban or suburban systems with electronic infrastructure and coordinators, and none tested delivery by clinic nurses in rural Appalachia. The care pathway study (Walsh et al., 2026) shows that local workflows vary, which makes local adaptation essential.
Recommendation for Practice
The evidence supports implementing nurse-led outreach with decision counseling, pended orders and annual stepped reminders in the Blue Ridge network, with three adaptations: verifying pack-year histories before outreach, offering transportation and scheduling help, and mapping each clinic's pathway from registry to results before launch. The network should not invest in printed or video materials alone. Because rural applicability is uncertain, the program should be evaluated as planned in this course, with an interrupted time series and attention to reach among patients farthest from the scanner.
Remaining Gaps
Future work should test nurse-delivered outreach in rural settings with a comparison group, report results by distance and insurance, and follow patients beyond one annual cycle. Studies of patient-reported outcomes, such as decisional quality and anxiety after positive findings, are also scarce, and none of the twelve measured what screening outreach costs a small practice per additional patient screened.
References
Arana-Chicas, E., Reyes, A. V., Chavez-Iniguez, A., Macenat, M., Ferrante, J., Capurro, C., & Kinney, A. Y. (2026). Informing the cultural adaptation of a lung cancer screening shared decision-making and navigation intervention for Hispanic adults: A qualitative study. Cancer Causes & Control, 37(10). https://doi.org/10.1007/s10552-026-02257-7
Carroll, N. M., Maclennan, A. J., Wain, K. F., Hixon, B., Steiner, J., & Ritzwoller, D. P. (2026). Increasing uptake of lung cancer screening through a patient "nudge": A randomized pragmatic trial. American Journal of Preventive Medicine. Advance online publication. https://doi.org/10.1016/j.amepre.2026.108552
Cho, B., Stallings-Smith, S., & Kim, H. (2026). State disparities in lung cancer screening uptake despite facility availability in the United States, 2024-2025: A cross-sectional ecological study. Cancer Control, 33. https://doi.org/10.1177/10732748261494041
DiCarlo, M., Shimada, A., Sifri, R., Johnson, M., Keith, S. W., Zhan, T., Jackson, H., Indictor, A., Burgess, N., Mahon, I., Pisano, E., & Myers, R. E. (2026). Increasing lung cancer screening referral/order and completion rates in primary care through patient outreach and shared decision making. Journal of Medical Screening. Advance online publication. https://doi.org/10.1177/09691413261479224
Jia, Y., Zhao, J., & Rivera, M. P. (2026). Lung cancer screening uptake among adults newly eligible under the 2023 American Cancer Society guideline compared with USPSTF-eligible adults: A nationwide cross-sectional study. Chest. Advance online publication. https://doi.org/10.1016/j.chest.2026.09.005
Katcher, J. G., Wen, K. Y., Shusted, C. S., Liang, J., Koh, K., Juon, H. S., & Barta, J. A. (2026). Health beliefs and lung cancer screening uptake among eligible Asian Americans in Philadelphia, Pennsylvania, United States. Preventive Medicine Reports, 67, Article 103521. https://doi.org/10.1016/j.pmedr.2026.103521
Landsteiner, A., Zerzan, N., Ullman, K. E., Anthony, M., Claussen, A. M., Bayer, R., Do, T., Gustavson, A. M., Melzer, A. C., & Wilt, T. J. (2026). Shared decision-making for lung cancer screening: A systematic review. CHEST Pulmonary, 4(1), Article 100222. https://doi.org/10.1016/j.chpulm.2025.100222
Reid, M. J., LeLaurin, J. H., Ali, S., Sorial, C., Bylund, C. L., Woodard, J. N., Wollney, E. N., Goede, D. L., Lee, J. H., Nelson, D. S., Carter-Bawa, L., & Salloum, R. G. (2026). Identifying barriers and strategies to support a community navigator-driven approach for lung cancer screening. Current Oncology, 33(9), Article 499. https://doi.org/10.3390/curroncol33090499
Samami, E., Sarkar, S., Zaidi, M., & Poghosyan, H. (2026). Determinants of lung cancer screening intention among eligible individuals. Lung Cancer, 220, Article 109540. https://doi.org/10.1016/j.lungcan.2026.109540
Sharifian, M., Hoyt, M. A., Madan, A., Lee, S., Nguyen, T. Q., & Sadigh, G. (2026). Patients' and providers' perspective of a multi-level approach to improve participation in low-dose CT for lung cancer screening (Empower LCS): A mixed-methods analysis. Academic Radiology, 33(6), 2352-2360. https://doi.org/10.1016/j.acra.2026.03.014
Walsh, C., Palazzo, L., Hansell, L., Louie, T., Long, S., Brown, M., Hippe, D. S., Coronado, G. D., Decell, K., Leone, R. J., Lodhi, S., Wysham, N., Wernli, K. J., & Triplette, M. (2026). Lung cancer screening care pathways in community settings: An examination of 3 healthcare systems. Annals of the American Thoracic Society, 23(6), 908-917. https://doi.org/10.1093/annalsats/aaoag029
Wernli, K. J., Anderson, M. L., Palazzo, L., Luce, C., Bezman, N., Rogers, K., Chin, M., Gao, H., Ralston, J., Su, Y. R., Carter-Bawa, L., Triplette, M., Tuzzio, L., Vasavada, A., & Green, B. B. (2026). Health communication and stepped reminders interventions for lung cancer screening: A randomized clinical trial. JAMA Internal Medicine. Advance online publication. https://doi.org/10.1001/jamainternmed.2026.3666
What the NURS 700 Week 8 instructions ask
The final NURS 700 assignment asks the student to complete a table addressing the studies retrieved for the annotated bibliography, judging every study closely for its quality and for how it could be used in practice. The table is the core of the assignment, but a table alone cannot show the reasoning that connects individual studies to a practice recommendation, so the strongest submissions add a written synthesis. The Week 8 reading takes a closer look at evaluating research, which supports rating each study's level of evidence and quality with a consistent approach. Because this is the course's largest grade, it is where the topic followed across all eight weeks should arrive at a defensible recommendation for practice.
How this NURS 700 Week 8 example is built
The assignment opens with the clinical question and the rating approach, levels from I for systematic reviews to VI for qualitative and descriptive studies and a simple high, moderate or low quality rating with the main reason. The table follows, one row per study, with columns for design and level, sample and setting, key result, quality and application to rural primary care. Below it, the synthesis groups the evidence into four findings, each supported by several studies: active outreach works, passive messaging does not, practical and knowledge barriers dominate, and adherence is a distinct target. A short section rates the body of evidence as a whole, and the recommendation and remaining gaps close the paper.
NURS 700 Week 8 grading rubric: where the points go
This assignment is typically graded on the completeness and accuracy of the table, the depth of the quality analysis for each study, the soundness of judgments about application to practice, the quality of the synthesis across studies, and APA, including the formatting of the table. Graders look for consistent criteria applied to every study rather than ratings that seem arbitrary. A synthesis that identifies agreement and disagreement among studies and weighs evidence by level and quality, rather than counting studies for and against, shows doctoral-level reasoning. The paper should end where the evidence allows it to end, with a recommendation no bolder than the studies can bear.
NURS 700 Week 8 help: mistakes that cost points
The most common shortcomings are a table that copies the annotated bibliography into cells without rating quality or applicability, ratings with no stated basis, and no written synthesis, which leaves the reader to draw conclusions the student should have drawn. Some students count how many studies favor an intervention without considering that one large trial may outweigh several small surveys. Define your rating criteria first, apply them identically to each study, keep table cells short and specific, then write a synthesis organized by findings rather than by study and end with a recommendation that matches the strength of the evidence.
Related NURS 700 sample papers
Other NURS 700 weeks
- NURS 700 Week 2: Locating the Evidence Paper
- NURS 700 Week 3: Research Article Critique
- NURS 700 Week 4: Program Evaluation Paper
- NURS 700 Week 5: Discussion Board Two: EBP and QI
- NURS 700 Week 6: Statistical Analysis Paper
- NURS 700 Week 7: Annotated Bibliography
NURS 700 Week 8 questions, answered
What is the NURS 700 Summary and Synthesis Assignment?
The closing 150-point assignment in Module/Week 8, in which the studies from the annotated bibliography are placed in a table and judged for quality and for how they could change practice.
Where can I find a free NURS 700 Week 8 sample paper?
The full NURS 700 Week 8 summary and synthesis of twelve lung cancer screening studies, with the evidence table and written synthesis, is free here.
What columns should an evidence synthesis table include?
Usually the citation, design and level of evidence, sample and setting, key findings, a quality rating with its reason, and applicability to the student's practice setting.
How do you rate the level of evidence?
A common hierarchy places systematic reviews of trials at level I, randomized trials at level II, quasi-experimental studies at level III, nonexperimental studies at level IV and qualitative or descriptive studies at level VI.
What does the lung cancer screening evidence support?
It supports active outreach with decision counseling and coordinated reminders over passive letters or information alone, with less certainty about rural settings.
Use it as a model, or ask for your own
This paper is an original model written by our desk for study. It is not a submitted student paper and not an official Liberty University document. Read it for structure and reasoning, then write your own to the instructions in your Canvas course. If you want a version built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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