Digital Commons Network^™

Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …

Addressing Adolescent Sexual Health Through An Educational Toolkit For Providers In Rural Alaska, Anna M. Martin, Tracy L. Brewer, Hannah E. Warren

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Introduction. Adequately addressing an adolescent’s sexual health is essential during the child’s development yet, 33% of adolescents have health visits with no mention of sexual health. On average, primary care providers spend approximately thirty-six seconds discussing sexual health topics with adolescents despite recommendations for comprehensive education. Alaska Native youth face significant disparities regarding sexual and reproductive health care. Implementation and evaluation of a comprehensive educational toolkit regarding various sexual health topics for rural healthcare providers in Alaska revealed positive outcomes in discussing sexual health with an adolescent.

Methods. Larrabee's Model for Evidence-based Practice Change guided the development, implementation, and …

Creating A Culturally Adaptable Comprehensive Sexuality Education Teacher's Manual, Stephanie Carteciano

Student Works

Purpose: The purpose of this project was to create a culturally adaptable comprehensive sexual education teacher’s manual by (a) standardizing content using The United Nations Educational, Scientific and Cultural Organization’s (UNESCO) 2018 International Technical Guidance on Sexuality Education (CSE), (b) providing evidence-based CSE pedagogy in the form of classroom activities, and (c) including adaptable teaching methods to fit diverse cultural contexts.

Development: The manual lessons were derived from UNESCO’s 2018 International Technical Guidance on Sexuality Education, and the pedagogy followed Anderson and Krathwohl’s revision of Bloom’s Taxonomy. Health information was obtained from various medical and university resources. We surveyed eight …

The Vaping Epidemic Among The Adolescent Population, Miranda O'Dell

Graduate Research Projects

No abstract provided.

Hidden And Unacknowledged: The Mental Health And Psychosocial Interventions Delivered By School Nurses In Western Australia, Anita Moyes, Shirley Mcgough, Dianne Wynaden

Research outputs 2022 to 2026

Schools are an important setting for the early identification, assessment and intervention of mental health problems in children and young people. Internationally, many nurses work in schools, but the role of this group with young people experiencing mental health problems has had only limited investigation. This study explored the activities school nurses undertook with young people experiencing mental health problems in Australia. Reporting was guided by the COREQ checklist. Thirty-one nurses participated in a semi-structured interview. Data were analysed using the constant comparative method of analysis as developed by Glaser and Strauss (1967). The findings identified that nurses working in …

Improving Human Papillomavirus Vaccination Rates In Adolescents: A Quality Improvement Project, Keylea Marenda Harrison, Allyson Neal, Katie Ingram-Willard

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Objective: The purpose of this quality improvement (QI) project was to implement an evidence-based intervention to improve the HPV vaccine series completion rates in the pediatric primary care setting. The goal of the project was to increase HPV series completion rates in adolescents aged 11 to 12 by 10% within 3 months of implementation of the intervention.

Methods: A multicomponent intervention was implemented at a pediatric primary care office that included a chart review of 11- and 12-year-old adolescents who had received their first and second dose of the HPV vaccine from June 2019 to June 2020 and patients …

Adolescents With Depression Capstone Benchmark Project, Myeshia Salter

MSN Capstone Projects

This change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents' desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression.

Postural Orthostatic Tachycardia Syndrome (Pots): A Frequently Missed Diagnosis, Aubrey R. George, Blaine A. Winters

Student Works

Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating chronic illness that involves a sustained tachycardia upon standing and affects millions of patients in the United States alone. POTS is most commonly seen in adolescent females and substantially reduces overall quality of life. In 2019, less than a third of all providers had heard of POTS and patients may wait over a decade for a proper diagnosis and treatment. With the intermittent and variable nature of symptoms, 83% of patients reported being misdiagnosed with a psychological condition before receiving a diagnosis of POTS. Understanding the relationship between autonomic compensation and hemodynamic …

Beliefs About Safe Traffic Behaviors Among Male High School Students In Hamadan, Iran: A Qualitative Study Based On The Theory Of Planned Behavior, Vahid Ranaei, Alireza Sahab Jahanlu, Laleh Hassani, Ghodratollah Roshanaei, Kristin Haglund, Jagnoor Jagnoor, Forouzan Rezapur Shahkolaei

College of Nursing Faculty Research and Publications

Road traffic injuries are public health challenges with heavy economic and social burdens. Road traffic injuries are common in developing countries and occur disproportionately with adolescents. This study aimed to elicit beliefs about traffic behaviors based on the theory of planned behavior among male high school students in Hamadan, Iran. We used a constructivist-interpretive qualitative design with directional content analysis. Interviews were conducted with 19 adolescent males in Hamadan, Iran. Analysis revealed that theory of planned behavior fit well to explain how perceptions, attitudes, and beliefs influenced traffic behaviors. Perceived subjective norms in the forms of parental encouragement, traffic rules …

Pediatric And Child Health Nursing: A Three-Phase Research Priority Setting Study In Western Australia, Evalotte Mörelius, Ailsa Munns, Stephanie Smith, Helen J. Nelson, Anne Mckenzie, Jade Ferullo, Fenella J. Gill

Research outputs 2022 to 2026

Purpose:

Priority settings are important to plan and direct future research. The aim of this study was to identify the top ten pediatric and child health nursing research priorities from the perspectives of consumers, community, and healthcare professionals in Western Australia.

Design and methods:

This study used an adapted James Lind Alliance Priority Setting Partnership design with three phases. 1) A planning workshop to inform a survey. 2) A survey using five open-ended-questions distributed between October 2020 and January 2021 through social media and healthcare professionals' emails. Responders' statements were analyzed with content analysis. 3) A consensus workshop to finalize …

Transition Readiness Tools To Improve Health Care Transitions Among Adolescents With Inflammatory Bowel Disease, Meagan Moffett

Doctor of Nursing Practice (DNP) Projects

Inflammatory bowel disease is associated with severe disease in pediatric patients often requires treatment through adulthood. Collaborative efforts of patients, families, and health providers are needed to foster a smooth transition of care from pediatric to adult health care.

The purpose of this quality improvement project was to establish a baseline understanding of transition readiness among adolescents at one gastroenterology clinic to improve transition to adult care. A cross-sectional design was used to assess adolescents’ readiness for transition of care over a three-month period. Transitioning Readiness Assessment Questionnaire (TRAQ) was administered followed by individualized education on topics covered in the …

Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi

School of Nursing & Midwifery

Background: The vast majority (90%) of the world's adolescents aged 10-19 live in low- and middle-income countries (LMICs); and in those resource-limited settings, girls face distinct challenges across multiple health, social, and economic domains. Gender equality and girls' empowerment are key goals in their own right and are central to all other development goals. Digital literacy is a great enabler for the empowerment of young girls. This systematic review aims to assess the range and nature of digital literacy interventions implemented to empower adolescent girls in LMICs and identify evidence about adolescent girls' access and use of digital technologies in …

Nurses' Pandemic Lives: A Mixed-Methods Study Of Experiences During Covid-19., Kathleen Gray, Paulette Dorney, Lori Hoffman, Albert Crawford

College of Nursing Faculty Papers & Presentations

BACKGROUND: The US healthcare settings and staff have been stretched to capacity by the COVID-19 pandemic. While COVID-19 continues to threaten global healthcare delivery systems and populations, its impact on nursing has been profound.

OBJECTIVES: This study aimed to document nurses' immediate reactions, major stressors, effective measures to reduce stress, coping strategies, and motivators as they provided care during COVID-19.

DESIGN: Mixed-methods, cross sectional design. Participants responded to objective and open-ended questions on the COVID-19 Nurses' Survey.

PARTICIPANTS: The survey, was sent to nurses employed in health care settings during the pandemic; 110 nurses participated.

RESULTS: Immediate reactions of respondents …

Adolescent E-Cigarette Use, Carley Lueken

The Eleanor Mann School of Nursing Student Works

Adolescent e-cigarette use in the United States (U.S.) is trending upward at a concerning rate. Many of the short-term and long-term effects of e-cigarette use are unknown. However, scientists do know that e-cigarettes can have harmful effects on the respiratory system playing a role in E-cigarette or Vaping Use-Associated Lung Injury (EVALI) and Coronavirus Disease 2019 (COVID-19). Additionally, some e-cigarettes contain nicotine, which is widely known to have negative effects on the developing adolescent brain. Previously, there is only one e-cigarette prevention program that has been developed, implemented, and evaluated in the U.S. Thus, showing the need for further research …

The Effectiveness Of Nurse-Led Interventions To Prevent Childhood And Adolescent Overweight And Obesity: A Systematic Review Of Randomised Trials, Lisa Whitehead, Istvan (Ishti) Kabdebo, Melissa Dunham, Robyn Quinn, Jennifer Hummelshoj, Cobie George, Elizabeth Denney-Wilson

Research outputs 2014 to 2021

Background:

Obesity among children and adolescents continues to rise worldwide. Despite the efforts of the healthcare workforce, limited high-quality evidence has been put forward demonstrating effective childhood obesity interventions. The role of nurses as primary actors in childhood obesity prevention has also been underresearched given the size of the workforce and their growing involvement in chronic disease prevention.

Aim:

To examine the effectiveness of nurse-led interventions to prevent childhood and adolescent overweight and obesity.

Design:

A systematic review of randomised trials.

Data sources:

Medline, CINAHL, EMBASE, Cochrane (CENTRAL), ProQuest Central and SCOPUS were searched from inception to March 2020.

Review …

A School-Based Cognitive Behavioral Progrm To Improve Adolescent Mental Health, Amanda Harper

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Problem. While anxiety and depression are prevalent in the adolescent population and can have significant long-term consequences, treatment rates remain low. The gold standard for treatment is cognitive behavioral therapy (CBT), but this is often unavailable.

Methods. This project aimed to increase access to CBT through a school-based program. Students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE). Measures of anxiety and depressive symptoms were collected at baseline, after the program, and one month after the program. A Friedman test was used to evaluate medians’ differences on the screening tools at all three time …

Association Of Patient-Centered Medical Home Designation And Quality Indicators Within Hrsa-Funded Community Health Center Delivery Sites, Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lòpez-De Fede

Faculty Publications

BACKGROUND: Patient-Centered Medical Home (PCMH) adoption is an important strategy to help improve primary care quality within Health Resources and Service Administration (HRSA) community health centers (CHC), but evidence of its effect thus far remains mixed. A limitation of previous evaluations has been the inability to account for the proportion of CHC delivery sites that are designated medical homes.

METHODS: Retrospective cross-sectional study using HRSA Uniform Data System (UDS) and certification files from the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC). Datasets were linked through geocoding and an approximate string-matching algorithm. Predicted probability scores were …

An Evidence-Based Approach To Understanding And Treating Electronic Cigarette Use In The Adolescent Population, Adelaide Amini

Student Works

ABSTRACT

An Evidence-Based Approach to Understanding and Treating Electronic Cigarette Use in the Adolescent Population

Adelaide Laurel Amini College of Nursing, BYU Master of Science

Electronic cigarette (e-cigarette) use is popular among adolescents and leads to high levels of nicotine exposure in this population. E-cigarette use by teenagers can lead to development of nicotine addiction, chronic lung disorders, and lifelong incidence of depression, anxiety, and attention-deficit disorder. Thus, it is vital that nurse practitioners understand electronic cigarette devices and their effects on adolescent health, as well as treatment guidelines regarding nicotine dependence specific to e-cigarettes. An educational module detailing the …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

What Predicts Regression From Pre-Diabetes To Normal Glucose Regulation Following A Primary Care Nurse-Delivered Dietary Intervention? A Study Protocol For A Prospective Cohort Study, Kirsten Coppell, Trish Freer, Sally Abel, Lisa Whitehead, David Tipene-Leach, Andrew R. Gray, Tony Merriman, Trudy Sullivan, Jeremy Krebs, Leigh Perreault

Research outputs 2014 to 2021

Introduction Pre-diabetes is a high-risk state for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Regression to normoglycaemia, even if transient, significantly reduces the risk of developing T2DM. The primary aim of this mixed-methods study is to determine if there are clinically relevant differences among those with pre-diabetes and excess weight who regress to normoglycaemia, those who have persistent pre-diabetes and those who progress to T2DM following participation in a 6-month primary care nurse-delivered pre-diabetes dietary intervention. Incidence of T2DM at 2 years will be examined.

Methods and analysis Four hundred participants with pre-diabetes (New Zealand definition …

Uniting Action Research And Citizen Science: Examining The Opportunities For Mutual Benefit Between Two Movements Through A Woodsmoke Photovoice Study, Robin A. Evans-Agnew, Chris Eberhardt

Nursing & Healthcare Leadership Publications

As an emerging movement in participatory inquiry, citizen science presents an opportunity for advancing the disciplinary reach and usefulness of action research. In this article, we explore this opportunity by considering a case study involving youth-driven air sampling, photovoice, and environmental justice in the Pacific Northwest. When combined with photovoice as an action research method, citizen scientists can be empowered through collective learning to transform themselves from data collectors into builders of community knowledge and generators of policy change.

Concept Analysis Of Impressionability Among Adolescents And Young Adults, Seok Hyun Gwon

Nursing Faculty Articles

Aim: To report a concept analysis of impressionability among adolescents and young adults.

Background: Adolescence and young adulthood are critical periods to establish health behaviour. Environmental determinants are associated with youth health risk behaviours. These populations are impressionable to a range of social and physical environmental factors.

Design: Concept analysis.

Methods: We selected 17 studies to review from Psych INFO, ERIC, MEDLINE, and Google Scholar as well as the University of Virginia library. We did not apply date limits. We included search terms: “adolescent”; “youth”; “young adult”; “impressionability”; and “impressionable.”

Results: The defining attributes of impressionability …

Sexual Risk Behaviors Of African American Adolescent Females: The Role Of Cognitive And Religious Factors, Safiya George Dalmida, Natasha Aduloju-Ajijola, Dora L. Clayton-Jones, Tami Thomas, Ricardo J. Erazo Toscano, Rashunda Lewis, Terri Fleming, Shirley Taylor, Macie Lunyong

College of Nursing Faculty Research and Publications

Introduction: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls’ risky sexual behaviors. Method: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. Results: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of …

Advertising Exposure And Use Of E-Cigarettes Among Female Current And Former Tobacco Users Of Childbearing Age, Kristin Ashford, Emily Rayens, Amanda T. Wiggins, Mary Kay Rayens, Amanda Fallin-Bennett, Molly Malany Sayre

Nursing Faculty Publications

Objective: The study examined the relationship between exposure to e‐cigarette advertising and e‐cigarette use by pregnancy status, including use of flavored e‐cigarette products, among women of childbearing age.

Design: A cross‐sectional, correlational design was used.

Subjects: Female current or former tobacco users in Central and Eastern Kentucky, 18–45 years old (N = 194, 52% pregnant).

Measures: Demographics, pregnancy status, cigarette and e‐cigarette use, and exposure to e‐cigarette advertising.

Results: Younger age, white non‐Hispanic race, and greater exposure to e‐cigarette advertising were associated with a higher likelihood of ever using e‐cigarettes (p < .05 for each variable). Pregnancy was not associated with ever use (p = .11). Younger age was associated …

Mindfulness Interventions For Preventing And Treating Eating Disorders In Adolescent And Young Adult Females, Amanda P. Graves, Jane Lassetter

Student Works

Purpose: The portrayal of women in the mass media is increasingly sexualized. An accumulation of negative media exposure can cause adolescent girls to fall prey to self-objectification. Repeated experiences of self-objectification can result in body shame, which consequently may lead to dietary restraint and binge eating to achieve the idealized thin body. The goals of a mindfulness intervention are to change how one feels in response to external cues and to develop healthier coping skills. The purpose of this literature review is to compare and contrast recent studies on mindfulness measures aimed at preventing or treating disordered eating behaviors in …

Spirituality And Religiosity In Adolescents Living With Sickle Cell Disease, Dora L. Clayton-Jones, Kristin Haglund, Ruth Belknap, Jame Schaefer, Alexis A. Thompson

College of Nursing Faculty Research and Publications

This study purports to address paucity in the literature regarding how adolescents with sickle cell disease (SCD) describe and experience spirituality and religiosity (S/R). This was a qualitative descriptive study. Two semi-structured interviews were conducted with nine adolescents (M_age = 16.2 years). Data were analyzed using a template analysis style and a concurrent analysis process of data reduction. Three major themes encompassed the participants’ descriptions of the relationships between S/R, health and illness in their lives including S/R as sources for coping, influence of S/R beliefs on health and illness, and sharing S/R with Health Care Providers (HCPs). …

Feasibility Of Hair Collection For Cortisol Measurement In Population Research On Adolescent Health, Jodi L. Ford, Samantha J. Boch, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Background: Black–White disparities in adolescent health are widespread and thought to be explained, in part, by exposure to chronic stress. Cortisol assayed from hair is increasingly recognized as a valid and reliable measure for chronic physiological stress, but the feasibility of collecting hair among large probability samples of diverse adolescents is unknown.

Purpose: The aim of the study was to investigate participation in hair collection for cortisol analyses in a probability sample of racially and socioeconomically diverse adolescents, including the extent to which sociodemographic factors and adverse exposures were associated with participation.

Methods: The study included a probability sample of …

Assent Described: Exploring Perspectives From The Inside, Rebecca D. Poston

Nursing Faculty Publications

Purpose- The purpose of this study was to describe the informed consent and assent experience for oncology research from the perspective of the participants: adolescents, their parents, and their physician providers.

Design & Methods- This descriptive mixed-methods study included the pilot use of the Quality of Informed Consent Questionnaire (QuIC) with an adolescent population and semi-structured interviews with adolescents, their parents, and their physician providers within 48-72 hours of the informed consent and assent discussion for a pediatric oncology clinical trial and again 6-9 weeks later. Results: Adolescents and their parents scored considerably lower on part A of the QuIC …

Age-Appropriate Post-Reduction Care Of Anterior Shoulder Dislocation, Hans B. Ayres, Blaine Winters, Craig Nuttall

Student Works

Background and Purpose: The shoulder is the most commonly dislocated joint in the body. This paper provides age-appropriate recommendations for post-reduction management of anterior shoulder dislocations. Methods: Literature was reviewed, limited to English language in the last five years. Appropriate articles were rated using the Levels of Evidence tool found in the Journal of Orthopaedic Trauma. Conclusion: We recommend aggressive treatment in younger patients, and increased screening for concomitant injuries in older patients. Implications for Practice: Age should be an important consideration when formulating a plan of care for the patient with shoulder dislocation.

Discovering Self: Childbearing Adolescents' Maternal Identity, Janelle L. B. Macintosh, Lynn Clark Callister

Faculty Publications

Purpose: Adolescent pregnancy and motherhood have long been a topic of interest for many healthcare professionals. However, there are limited data on how childbearing adolescents incorporate motherhood identity into their sense of self. The purpose of this study was to explore how childbearing adolescents perceive motherhood as becoming part of their personal identity.

Study Design: This qualitative study using ethnographic data collection involved 7 months of observation, interaction, and interviews.

Methods: Data were collected from nine expectant adolescents during in-depth interviews. All participants were patients at a teen mother and child clinic staffed by certified nurse midwives and a pediatrician. …