Digital Commons Network^™

Implementation Of Sleep Problem Screening In A Pediatric Primary Care Office, Jennifer Erin O'Donnell

Dissertations

Sleep problems, a major problem for children and their parents, are the most common complaint brought to pediatric clinicians (advanced practice nurses and other healthcare providers) attention but are often ignored and underdiagnosed in the pediatric population (Faruqui, Khubchandani, Price, Bolyard, & Reddy, 2011). “Sufficient amounts of good quality sleep are necessary for healthy development in childhood” (Bordeleau, Bernier, & Carrier, 2012, p. 254). Inadequate sleep in children has been linked to numerous adverse outcomes psychologically as well as physically (Owens, Jones, & Nash, 2011). The American Academy of Pediatrics (AAP), issued recommendations in 2002 stating screening for snoring, one …

The Impact Of Financial Incentives For Cervical Cancer Screening In Ontario's Primary Care Delivery Models, Ciara Pendrith

Electronic Thesis and Dissertation Repository

Physicians practicing in capitation-based Family Health Organizations and fee-for-service-based Family Health Groups receive bonuses for delivering preventive care, including cervical cancer screening, while those practicing in the traditional fee-for-service model do not. Financial incentives were introduced to increase Ontario’s cervical screening rate to 85%. To date, the impact of incentives for cervical screening on screening rate and cost-effectiveness have not been assessed. Patient-level data obtained from the Institute for Clinical Evaluative Sciences were used to estimate primary care model screening rates and cancer treatment costs. A microsimulation model was developed from published cervical cancer natural history models and parameterized using …

Primary Care Assessment And Interventions To Improve Physical Activity Among Insufficiently Active Adults Ages 18 Through 64 Years Old, Thomas A. Sanchez

Doctoral Dissertations

A number of chronic and debilitating conditions such as cardiovascular disease, stroke, hypertension, anxiety, depression, pain, osteoporosis, and falls are known to be delayed, improved, or prevented by increasing physical activity (PA) levels. The numbers of those affected form a substantial portion of the US population. As of 2011, for example, 26 million adults in the U.S. were diagnosed with diabetes mellitus (DM) alone. Another 79 million people had elevated blood glucose measurements putting them at risk for DM. Despite knowledge of the connection with chronic disease, PA levels are not consistently and quantitatively assessed during primary care office visits. …

Investigation Of Physician Assistants' Choice Of Rural Or Underserved Practice And Framing Methods Of Recruitment And Retention, Jennifer A. Snyder

Health Sciences Program Student Theses, Dissertations and Capstones

Objective: This dissertation analyzed one state's physician assistant (PA) workforce focusing on recruitment and retention. The goal was to identify factors associated with Indiana PAs working in medically underserved, rural, and primary-care medicine. The study evaluated characteristics of PAs who chose initially to work in rural versus urban areas and who have continued to do so. From the literature and as a result of study outcomes, a framework was developed, upon which recommendations were made for effective methods of increasing and retaining the number of PAs in primary care within rural areas. Subjects: Data were obtained from applications for PA …

Follow-Up Evaluation Of Treatment For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Renée M. Grinnell

Theses and Dissertations

Although integrated primary care psychology services are becoming increasingly common, the literature lacks adequate research support for the longitudinal durability of treatment effects following the conclusion of brief primary care interventions. This study served as a follow-up program evaluation of psychological services for depression and anxiety provided at the Medical College of Virginia’s Ambulatory Care Center in Richmond, Virginia. Data were collected on 47 adult primary care patients who received treatment for depression and/or anxiety between six and 18 months prior to the follow-up telephone call. Data were collected on the trajectory of depression scores throughout and following treatment, treatment …

Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani

DNP Projects

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and …

Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman

DNP Projects

This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …

Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser

DNP Projects

CAPSTONE INTRODUCTION

Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.

Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …