A nurse and a community team are using the nominal group planning method to analyze community-level data. Which of the following is true about nominal group planning?

Choice A Reason:
Increased exposure increases the risk of developing the disease. This statement describes a dose-response relationship, which is another important criterion for establishing causation. It indicates that as the level of exposure to a potential cause increases, the risk of developing the disease also increases. However, this does not specifically address the temporal sequence required to establish causation.

Choice B Reason:
The exposure must come before the disease develops. This is the correct definition of a temporal relationship in epidemiological studies. For causation to be established, it is essential that the exposure to the potential cause occurs before the onset of the disease. This temporal sequence is crucial because it helps to rule out reverse causation, where the disease might influence the exposure rather than the other way around.

Choice C Reason:
When the exposure is decreased or eliminated, the risk of disease declines or is eliminated. This statement describes the concept of reversibility, which is another criterion for causation. It suggests that reducing or removing the exposure should lead to a decrease in the incidence of the disease. While important, it does not specifically define the temporal relationship.

Choice D Reason:
A relationship is biologically plausible, and it makes sense. This statement refers to biological plausibility, which means that the observed association between exposure and disease is consistent with existing biological or medical knowledge. While biological plausibility supports causation, it does not define the temporal sequence necessary to establish a causal relationship.

Choice A: "I Think That I Missed Two Math Tutoring Classes Last Week, But I Can Still Catch Up."
This statement indicates that the client is aware of their academic responsibilities and is optimistic about catching up. Missing a couple of classes is not uncommon, and the client's positive attitude towards catching up is a good sign. This statement does not indicate an immediate need for intervention regarding their mental health.

Choice B: "I Have Not Used Drugs in 6 Weeks."
This statement is positive and indicates progress in the client's efforts to stay away from substance use. It shows that the client is making strides towards healthier behaviors, which is a crucial aspect of their overall well-being. This statement does not require immediate intervention but should be acknowledged and supported.

Choice C: "I Don't Have Anyone I Can Talk to About My Problems."
This statement is concerning and indicates a lack of social support, which is critical for someone with a history of depression and suicidal ideation. Feeling isolated and having no one to talk to can exacerbate feelings of depression and increase the risk of suicidal thoughts. This statement requires immediate intervention to ensure the client receives the necessary support and resources to address their feelings of isolation.

Choice D: "I Have Been Participating in My Local YMCA After-School Dance Program Again."
This statement is positive and indicates that the client is engaging in social and physical activities, which can be beneficial for their mental health. Participation in such programs can provide a sense of community, improve mood, and reduce feelings of isolation. This statement does not require immediate intervention but should be encouraged and supported.