Medicine and Health Sciences Commons^™

Addressing Barriers To Colorectal Cancer Screening In A Federally Qualified Health Center: A Quality Improvement Project, Tania Centra

DNP Scholarly Projects

Abstract

Background: Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of several high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (non-insured), younger age, racial or ethnic minority, recent immigration to the U.S. (non-English speaking), fear or distrust of the healthcare system and rural residence. Addressing health equity within underserved populations requires improved access to CRC screenings per evidence-based guidelines.

Local Problem: The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Christians’ Cut: Popular Religion And The Global Health Campaign For Medical Male Circumcision In Swaziland, Casey Golomski, Sonene Nyawo

Anthropology

Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom’s three ecumenical organisations, showing how a diverse group people singly glossed as ‘Christian’ in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision’s promotion and …

Comparison Of Environmental Supports To A Healthy Lifestyle On The Unh Campus With Student Behaviors, Mary Hammar

Honors Theses and Capstones

Background: Environmental factors play a large role in shaping diet and lifestyle behaviors. Creating a college campus environment conducive to healthy dietary choices and physical activity may promote student health.

Objective: The objective of this study was to explore and describe the availability of environmental supports for a healthy lifestyle on the UNH campus and student behaviors.

Design: The Healthy Campus Environmental Audit (HCEA), a comprehensive tool developed by a USDA multi-state research team led by Syracuse University, was implemented to measure the availability of healthy options in dining establishments (n=12) and the adequacy of recreation facilities (n=3) and walking/biking …

Dementia And Primary-Care Health Measures:Hearing, Gait, And Markers Of Inflammation, Elsa Lindgren

Honors Theses and Capstones

Dementia is a syndrome associated with declining cognitive function that has a variety of types and causes, and is encountered frequently in general medical practice. Researchers are actively exploring possible risk factors for dementia. The St. Louis University Mental Status (SLUMS) exam is a dementia-screening exam used in primary care visits to detect cognitive impairment that may be a sign of dementia. This study compared scores on the SLUMS exam to other measures recorded in a typical primary care visit in 86 patients of age 65 and older to look for correlations between indicators of health, such as physical examination …

Generational Inversions: 'Working' For Social Reproduction Amid Hiv In Swaziland, Casey Golomski

Anthropology

How do people envision social reproduction when regular modes of generational succession and continuity are disrupted in the context of HIV/AIDS? How and where can scholars identify local ideas for restoring intergenerational practices of obligation and dependency that produce mutuality rather than conflict across age groups? Expanding from studies of HIV/AIDS and religion in Africa, this article pushes for an analytic engagement with ritual as a space and mode of action to both situate local concerns about and practices for restoring dynamics of social reproduction. It describes how the enduring HIV/AIDS epidemic in Swaziland contoured age patterns of mortality where …

A Descriptive Study Of Undergraduate Contraceptive Attitudes Among Students At The University Of New Hampshire, Katrina Heisler, Danielle M. Van Eron

Honors Theses and Capstones

PURPOSE: The purpose of this study was to examine and to understand undergraduate students’ contraceptive attitudes and its effects on contraceptive use to further enhance the education regarding unwanted pregnancies and sexually transmitted diseases (STDs). DESIGN AND METHODS: A descriptive study to understand contraceptive attitudes while exploring demographics and sexual behaviors as well as the incorporation of the Contraceptive Attitude Scale (CAS). The researchers utilized an online survey system to distribute surveys electronically. RESULTS: Most students had a positive attitude regarding contraception. IMPLICATIONS: Nurses at college health facilities can focus on educating the college population since their age group is …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Urban Containment Policies And Physical Activity A Time–Series Analysis Of Metropolitan Areas, 1990–2002, Semra Aytur, Daniel A. Rodriguez, Kelly R. Evenson, Diane J. Catellier

Health Management & Policy

Background: Urban containment policies attempt to manage the location, character, and timing of growth to support a variety of goals such as compact development, preservation of greenspace, and efficient use of infrastructure. Despite prior research evaluating the effects of urban containment policies on land use, housing, and transportation outcomes, the public health implications of these policies remain unexplored. This ecologic study examines relationships among urban containment policies, state adoption of growthmanagement legislation, and population levels of leisure and transportation-related physical activity in 63 large metropolitan statistical areas from 1990 to 2002. Methods: Multiple data sources were combined, including surveys of …

Effects Of A Tailored Follow-Up Intervention On Health Behaviors, Beliefs, And Attitudes, Alissa D. Jacobs, Alice S. Ammerman, Susan T. Ennett, Marci K. Campbell, Katherine W. Tawney, Semra Aytur, Stephen W. Marshall, Julie C. Will, Wayne D. Rosamond

Health Management & Policy

Background: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers.

Methods: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled …

Vaccine Risk Communication: Lessons From Risk Perception, Decision Making And Environmental Risk Communication Research, Ann Bostrom

RISK: Health, Safety & Environment (1990-2002)

Dr. Bostrom reviews the rich variety of empirical findings available to guide risk communication and demonstrates how it can contribute to vaccine risk and safety communication.

Review Of: Bonnie L. Walker, Injury Prevention For The Elderly- A Research Guide (Greenwood Press 1995), David E. Belfort

RISK: Health, Safety & Environment (1990-2002)

Review of: Bonnie L. Walker, Injury Prevention for the Elderly- A Research Guide (Greenwood Press 1995). Acknowledgments, appendices, author index, bibliographical references, foreword, preface, subject index. LC 95-32989; ISSN 0743-7560 [328 pp. Cloth $75.00. 88 Post Road West, Westport, CT 06881.]