Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Meet Me In The Middle: A Scoping Review On Understanding Adolescent Needs In Climate Communication, Gwendolyn Monica Hoff Anderson

Master's Projects and Capstones

The greatest effects of climate change are likely to be felt by youth. Young people are disproportionately affected by climate change due to their critical developmental stage and lack of power, and they experience both higher severity and prevalence of mental health issues related to climate change. Strong emotions have long been recognized as potential catalysts for action, or they may lead to paralyzing feelings of being overwhelmed. Climate communication is a critical tool to spark climate concern and encourage action. Activism, in turn, may help youth manage their anxiety about climate change. This scoping review examines emerging evidence on …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

Therapeutic Gardening For Addiction Recovery, Hugo A. Rivera Lopez

Master's Projects and Capstones

Problem: The use of evidence-based alternative forms of therapy like horticulture therapy and therapeutic gardening is underutilized in substance use recovery programs in the United States. As the country continues to struggle with addiction, it is important that recovery programs look to and incorporate these alternative therapies into official curricula. Currently, 46.3 million individuals living in the United States are living with a substance use disorder (U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, 2022).

Context: The intervention was implemented at an all-male substance use treatment facility in San Jose, CA that houses up …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Surviving The Stigma: Incorporating Mental Health Literacy To Increase Help-Seeking In California First Responders, Yvonne C. Newson

Master's Projects and Capstones

First responders are at risk of developing mental health problems due to repeated exposure to traumatic incidents, increasing their chance of developing Post Traumatic Stress Disorder, substance abuse, suicidal ideation, and suicide. Unfortunately, first responders do not recognize that they may have a mental illness and are reluctant to seek help. This paper will discuss the prevalence of mental health problems among first responders and the barriers to their help-seeking. These barriers include the stigma around mental illness within the culture, the assessability of professional help, and the lack of mental health literacy regarding their well-being. Further discussion will focus …

Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Illegal Homeless Encampments In California: Using The Com-B Framework To Transform A Public Health Nuisance Into A New Housing Development Model, Desiree E. Orozco

Master's Projects and Capstones

California has the highest homeless population, with over 161,000 people experiencing homelessness. Despite approving a billion dollars in grants for the 2018-2019 budget, The 2021 Annual Homeless Assessment Report (AHAR) to Congress revealed California had an increase of over 3,500 individuals staying in shelters between 2020-2021. The multi-faceted and multi-dimensional issues of homelessness and policies make it difficult to prevent individuals experiencing homelessness from living in illegal encampments. Therefore, the author proposes a multi-prong approach to homelessness in California grounded in theories of the Socio-Ecological Model (SEM) and COM-B model and informed by housing first and permanent supportive housing practices. …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz

Master's Projects and Capstones

Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Reiki For Recovery: Incorporating Japanese Health Practices To Increase Contemporary Resiliency In American Health, Leif Peterson

Master's Projects and Capstones

The Japanese health practice of Reiki attempts to maximize the latent ability of the human system to heal itself. The Reiki system, established over a century ago, combines multiple Asian health traditions, experimenting with practices that maximize the natural processes of the body to perform its own repairs. Reiki encourages healthy behaviors that balance the mind and body, return the human system to a lowered stress level, and allow for an optimal recovery state for the patient. This paper illustrates how this Japanese health-affirming method can be integrated and utilized within existing health and medical practices. An area that is …

The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez

Master's Projects and Capstones

In efforts to challenge the Western medicine’s determination of nutrition as a holistic approach, this paper represents the intent for mental health facilities in California to improve or implement nutrition education curriculum by enhancing interprofessional teams with dietitians as an important component of recovery for severe mental illness patients. There is concrete evidence proving that individuals who are in facilities recovering from mental illnesses have benefited from optimal nutrition consumption. Nutrition education has become a component among the toolbox of recovery options, but unfortunately it is not encouraged enough. Pharmaceutical companies advertise drug therapy as the most effective way to …

Three Good Things To Extinguish Caregiver Burnout, Justin Haley

Master's Projects and Capstones

Caregiver burnout is a widespread issue in healthcare and institutions should be increasingly concerned about burnout because of the significant impact on quality of patient care, employee health, and financial stability. Many interventions and studies regarding burnout are focused on improving systems issues or removing negative stressors on caregivers. Although such interventions may be necessary to attempt, comprehensive systems-wide changes can be cumbersome and expensive, while removing negative stressors may be an unrealistic goal in a fast-paced, demanding healthcare environment. The Three Good Things method is an evidence-based, effective, simple, low-cost intervention to improve feelings of caregiver burnout in which …

Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams

Master's Projects and Capstones

Introduction

Perinatal substance use continues to be a major public health issue in women’s health. The purpose of this study was to determine the frequency of substance use screenings in care and assess how well the existing services in Marin County are serving the needs of pregnant and parenting women and identifying the gaps and/or weaknesses in current practice.

Methods

Data for this study was collected via semi-structured interviews with five professionals that worked at the local community clinic, hospital and a non-profit agency. Some questions were slightly modified to be configured toward the participant’s specific profession.

Results

Results from …

Understanding The Significance Of Virtual Support During Global Pandemic In Young Adults Diagnosed With Hepatitis C, Veronika Arkhipova

Master's Projects and Capstones

Hepatitis C is a viral infection that attacks the liver and leads to inflammation. In recent years, the prevalence of hepatitis C infections among 20 and 30 years of age has increased by 300 percent, and between 30 and 39 years by 400 percent. Due to the global coronavirus pandemic, people diagnosed with Hepatitis C have lost access to mental health services and resources, including in-person meetings with support groups. Since most states enforced stay-at-home order, many community centers, non-profit organizations that work with Hepatitis C patients and the affected population provide limited to no access to support group meetings …

Program Evaluation: Bring Change To Mind High School Club, Rachel Goldberg

Master's Projects and Capstones

Introduction. Mental illness (MI) stigma is common and causes adverse consequences such as reduced self-esteem and discrimination in housing and employment. Bring Change to Mind (BC2M), a national non-profit organization, strives to reduce this stigma through their high school club program. The evaluation goals were to assess the program’s operations and measure club members’ and advisors’ attitudes and perceptions around mental health (MH) and MI.

Methods. Qualtrics surveys were used to gather information from general club members (GCMs) (N=645), club advisors (N=97), and graduating seniors (N=57). BC2M staff held 52 small group discussions with club leaders. Data analysis was conducted …

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Changing Minds: Measuring The Impact Of A Student-Led Club To Reduce Mental Health Stigma Among Teenagers, Jennifer Anolin

Master's Projects and Capstones

Introduction: Stigma is a major barrier for teenagers to access mental health services. Additional barriers include low health literacy, and demographic factors, such as gender, socioeconomic status, and race/ethnicity. Studies show that successful solutions to decreasing stigma involve interventions inside of schools. The purpose of this project was to measure impact of the Bring Change 2 Mind (BC2M) program and recommend program improvement needs.

Methods: Four survey instruments were used to evaluate BC2M’s student-led club program and to determine the club’s impact on reducing stigma at each participating high school. Each survey consisted of both qualitative and quantitative questions fielded …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

In Home Support For All: A Community Outreach Project, Lily Moll

Master's Projects and Capstones

Abstract

In Home Supportive Services Public Authority (IHSSPA) is a Medi-Cal funded organization that helps the elderly and disabled living in San Francisco find care and support at home. The Public Authority component of IHSS specializes in providing support to their clients or “consumers” when attempting to hire home care workers or “providers.” However, IHSSPA services remain relatively unknown throughout many communities in San Francisco county and there is a need for increased community outreach. To address this problem, communities that are currently underserved by IHSSPA were defined by their zip code. These communities were compared with data indicating which …

Grounding Frequent Flyers: Understanding High Er Utilization And Developing Primary Care Solutions, Jillian Millares

Master's Projects and Capstones

Background: Regular access to primary care can positively impact long-term, chronic conditions. However, medically underserved individuals, particularly individuals with Severe Mental Illnesses(SMI), typically underutilize primary care. Root causes include client level factors such as socioeconomic barriers, provider level issues such as lack of training or general knowledge of SMI issues, and system level factors such as a lack of coordinated services. Methods: The present study conducted a needs assessment to identify the most influential of these factors on clients at an Acute Residential Treatment Center in San Francisco, California. The needs assessment consisted of semi-structured client and staff interviews. Results: …

Mindful Classroom: Developing And Testing Strategies For Resilience Among Urban 7th Grade Students, Alyssa Santos

Master's Projects and Capstones

Introduction: A growing body of research suggests mindfulness-based classroom interventions are an effective, low cost approach to reducing the effects of toxic stress among youth. The purpose of this project was to identify key sources of stress among urban 7th grade students at De Marillac Academy and develop and test mindfulness techniques to actively engage and potentially improve stress management skills among students.

Methods: Five focus groups with students were conducted to assess the most prominent sources of stress inside and outside of school as well as current self-management strategies. Additionally, anonymous online surveys were distributed to 7th grade parents, …

Child Abuse Prevention Training: Introducing A Train-The-Teacher Manual For Child Safety Awareness, Kimmera Wilson

Master's Projects and Capstones

Introduction. In order for the San Francisco Child Abuse Prevention Center community education department to extend the outreach of the Child Safety Awareness (CSA) curriculum, a training manual was created for San Francisco Unified School District (SFUSD) K- 5th grade teachers. This paper evaluates the effectiveness of a train the teacher manual for the child safety lessons.

Methods. A five question tool was developed to survey Kindergarten through 5th grade teachers working at elementary schools in the San Francisco Unified School District. The questions were designed to better understand the needs of the population before creating a resource for them …

On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis

Master's Projects and Capstones

Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.

Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.

Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …

“Do You Think I Should Be Worried?” Building A Call Structure For Hiv(-) Callers To The Nightline, Ivy Epstein

Master's Projects and Capstones

Abstract

San Francisco Suicide Prevention’s HIV Nightline provides emotional support to those living with human immunodeficiency virus (HIV) as well as support and basic medical information around relative risk and testing for who may have been exposed to HIV. Nightline counselors use a harm-reduction model, active listening, reflection of emotions, and encouragement to promote health maintenance and mental health self-care behaviors. Until now, there has been no process to assess whether callers had disproportionate anxiety about HIV given their actual risk level. Consequently, HIV(-) anxious callers could receive inconsistent information. The goal of this improvement study was to develop a …

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …

Tuning "The System": An Evaluation Or Restorative Practices In San Lorenzo School District, Amber White

Master's Projects and Capstones

In 2013, The Director of Student Support Services for the San Lorenzo Unified School District (SLZUSD) implemented a Restorative Practices program in an effort to improve relationships on campus and decrease suspension and expulsion rates in SLZUSD. The Directors push for RP was fueled by the passing of Assembly Bill 1729 (AB-1729), when the California Education Code changed to allow for alternative disciplinary actions. States nationwide have passed bills similar to AB-1729 and allowed schools to use alternative punitive practices. Despite good natured intentions there were many faculty members who did not respond with enthusiasm and there has since been …

Symptoms, Contributing Factors, And Screening For Perinatal Mood And Anxiety Disorders In U.S. Latinas: A Literature Review, Jennifer N. S. Massie

Master's Projects and Capstones

This literature review was conducted to gather the published information on the topic of perinatal mood and anxiety disorders in the Latina population in the United States. Academic databases were searched for articles published between 2005 and 2016. 60 articles were considered, and a final sample of 36 articles and websites was included in this review.

Evidence suggests that Latina women in the perinatal period (pregnant and up to one year postpartum) in the United States of America tend to have a higher risk and incidence of perinatal mood and anxiety disorders than White women, and a higher risk and …